Avulsion of the anterior papillary muscle of the mitral valve due to non-penetrating trauma to the chest.
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Adult↗
Biomedical subjects
R Pillai
Publications and source records attributed to R Pillai.
Arterial fistula between the left internal mammary artery and left pulmonary artery.
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Adult↗
A study on the prevalence of antibodies to Toxoplasma gondii in Singapore.
The indirect fluorescence antibody technique has been employed to study the prevalence of toxoplasma antibodies in Singapore. 42.5% of clinically suspected cases of toxoplasmosis showed antibody titres. Of these, 17.5% had titres greater than or equal to 1.64. Malays and Indians have higher positive rates compared to the main ethnic group, the Chinese. Antibody titres are found in both males and females and span through the various age groups. The possible mode of transmission is discussed and the importance of congenital toxoplasmosis is indicated.
Adolescent↗
Cocaine metabolite (benzoylecgonine) in hair and urine of drug users.
Two methods of drug detection, urinalysis and hair analysis, were compared with respect to the efficiency of identification of drug use in a population of men living on the Arizona-Mexico border. The standard curve of cannabinoids in urine was linear to 20 ng/mL. The GC/MS levels for all cannabinoids combined in urine were very similar to that obtained by radioimmunoassay (RIA), 91% concordance. Similar results were obtained from samples analyzed dually for the cocaine metabolite benzoylecgonine (BE) after spiking. As determined by RIA of urine, 74% of the subjects were positive for cannabinoids. The majority were in the range of 100-1000 ng/mg creatinine. The pattern of excretion of THC metabolites with respect to the verbally reported time of first use was fairly normal, with the peak rate of elimination 13-24 hours following the last reported use. Washed hair samples were extracted by overnight acid hydrolysis. Urine samples and neutralized hair extracts were analyzed for cocaine and BE by RIA. Of the hair samples, 55% contained cocaine/BE, as compared with only 4.3% of the urine samples. Most hair samples contained cocaine/BE in the range of 25-100 ng/sample (100 mg hair). All hair samples testing negative for cocaine/BE by RIA also tested negative by GC/MS, and four samples containing the highest amounts of cocaine and BE by RIA were similarly found to contain the highest amounts by GC/MS. Hair analysis, therefore, gives a wider window of detection of drug use than does urinalysis and shows merit in the confirmation of cocaine use in small clinical research studies.
Adolescent↗
Platelet responses to cardiopulmonary bypass. Assessment by a shear stress activation technique.
Platelet responses before and during cardiopulmonary bypass were studied using a shear stress activation technique. Whole blood was passed through a 10 microns micro-porous filter and the percentage of platelets retained was determined. Retention in control subjects (n = 20, age 62 +/- 11 years) was 65.2 +/- 15.1%. Patients with ischaemic heart disease (n = 20, age 61 +/- 9 years) had significantly higher retention at 82.6 +/- 13.2%, p less than 0.001. In valvular heart disease (n = 15, age 57 +/- 14 years) the retention rate was 43.5 +/- 15.4%, lower than both controls and ischaemic heart disease patients (p less than 0.001). In vitro haemodilution had no significant effect on platelet retention. High retention rates were maintained in patients undergoing coronary artery surgery. During valve surgery retention increased before aortic cross-clamp removal (83.5 +/- 13.4%) compared with baseline values (p less than 0.001) and remained high 24 hours postoperatively (79.6 +/- 9.4%). Platelet retention also increased within 20 minutes of thoracotomy without cardiopulmonary bypass (n = 10, age 57 +/- 8 years, 79.3 +/- 11.6% versus 61.6 +/- 10.9% baseline, p less than 0.01) and remained high 24 hours postoperatively. Significant differences in platelet responses, assessed by shear stress activation, were demonstrated between healthy controls and patients with ischaemic and valvular heart disease. Surgery, with or without extracorporeal circulation, caused a significant increase in platelet retention.
Aged↗
Early extubation after coronary artery bypass surgery: effects on oxygen flux and haemodynamic variables.
The effect of extubation within the first postoperative hour was evaluated in 13 patients (mean +/- SD age 59 +/- 6 years) undergoing elective coronary artery bypass surgery without active systemic hypothermia. The mean cardiopulmonary bypass time was 50 +/- 14 minutes. Postoperative improvements in cardiac index and oxygen uptake (from 2.0 +/- 0.4 l/min/m2 and 144 +/- 26 ml/min postinduction to 2.88 +/- 0.76 l/min/m2 and 229 +/- 104 ml/min, p less than 0.01) were maintained following extubation. Lower postoperative systemic and pulmonary vascular resistances (p less than 0.01) did not change to a significant extent following extubation. Despite a two-fold rise in the intrapulmonary shunt (Qs/Qt) following surgery (18.5 +/- 9.7% vs 9.6 +/- 3.2% before surgery) the immediate post-extubation value was similar (18.8 +/- 8.2%) and all patients were discharged from the cardiac recovery area within 16 hours without complication. Extubation within the first postoperative hour is a safe procedure following elective coronary artery surgery with short bypass times where sustained hypothermia less than 32 degrees C is avoided.
Aged↗
Coronary blood flow does not decrease during allograft rejection in heterotopic heart transplants.
To evaluate changes in coronary blood flow during allograft rejection, 16 beagles with cervical cardiac allografts from mongrel donors were immunosuppressed postoperatively for 7 days with cyclosporine (20 mg/kg orally) and prednisone (0.5 mg/kg orally). They were weaned from immunosuppression over 3 days and then treated with methylprednisolone (30 mg/kg/day IV), cyclosporine (20 mg/kg orally), and prednisone (0.5 mg/kg orally) for 4 days. Previous experiments with this model have suggested the utility of phosphorus 31 nuclear magnetic resonance spectroscopy (31P NMR) in the diagnosis of rejection. Therefore in 10 dogs (NMR group) bioenergetic changes during rejection were assessed using the 31P NMR index of the ratio of phosphocreatine to inorganic phosphate (PCr/Pi). To correlate coronary blood flow and graft ischemia with allograft rejection, six dogs (FLOW group) underwent placement of a magnetic flow probe on the left anterior descending coronary artery to determine mean and peak coronary flow. In both NMR and FLOW groups, grafts were evaluated by endomyocardial biopsy (grading 0 to 8 for increasing rejection), and measurement of lactate production and left ventricular end-diastolic pressure. During the initial 7 days of immunotherapy, cellular rejection was effectively suppressed, and the bioenergetic status of the grafts remained stable (day 7: PCr/Pi = 70% of baseline, biopsy score = 2.0). During weaning of immunotherapy, however, the metabolic profile of the grafts decayed (day 10: PCr/Pi = 45% of baseline, biopsy score = 5.8; p less than 0.05 vs day 0). After 4 days of augmented immunosuppression, PCr/Pi recovered to 83% of baseline; this metabolic recovery corresponded with an improvement in mean biopsy score to 3.2.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
The immunohistochemistry of solid tumours: potential problems for new laboratories.
Immunohistochemistry has become an important tool for tumour typing and has the potential to improve the histopathological diagnosis of neoplasms. However, the large number of publications on the different aspects of the technology are often contradictory. In many instances the immunochemical reactions may not be reproducible and can create problems in the diagnosis of certain tumours. The use of optimal materials and techniques enhance the sensitivity, specificity and reproducibility of these methods. In this article we discuss the common problems of tissue preparation, and antigenic variation, distribution and presentation. However, immunopathological diagnosis has to be accompanied by an in-depth and fundamental understanding of basic immunochemistry and diagnostic immunohistochemistry has to be interpreted in the context of a standard clinical and histopathological examination.
Antigenic Variation↗