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Biomedical subjects

S C Reddy

Publications and source records attributed to S C Reddy.

At least 37 records · Page 2Linked to original sources

Comparison of echocardiographic acoustic quantification system and radionuclide ventriculography for estimating left ventricular ejection fraction: validation in patients without regional wall motion abnormalities.

Echocardiographic automated border detection of blood-endocardium interface is made on the basis of the principle of acoustic quantification. The automated border system is capable of providing on-line left ventricular (LV) cavity area and function. Recently, ABD algorithms have been devised to estimate LV volume on line from a long-axis image, calculated by established area-length method or Simpson's formula. To test the clinical validity of this newly developed echocardiographic method, LV volumes and ejection fraction measured by real-time acoustic quantification were compared with radionuclide ejection fraction in 24 subjects on the same day. Patients were included in the study if > or = 75% of their endocardium was visualized with conventional two-dimensional echocardiography. Sixteen (66%) of 24 patients had a technically adequate conventional echocardiogram with a broad range of ventricular dimensions and systolic function. None of the study patients had regional wall motion abnormalities. Echocardiographic measurements were obtained from the LV apical four-chamber, long-axis view. Ejection fraction, determined by the acoustic quantification and by radionuclide ventriculography, showed a strong linear relation (r = 0.92, standard error of the estimate = 4.4, p < 0.05). However, acoustic quantification overestimated the radionuclide ejection fraction with rather wide limits of agreement (3.8% +/- 16.4%; bias +/- 2 SD). Thus echocardiographic automated border detection technique is a reasonably accurate method for on-line assessment of LV function.

Adult↗

Aneurysm of the membranous ventricular septum resulting in pulmonary outflow tract obstruction in congenitally corrected transposition of the great arteries.

Aneurysm of the membranous ventricular septum causing subpulmonic obstruction in patients with corrected transposition is rare but well documented. Higher left-sided (morphologic right) ventricular pressure causes protrusion of the aneurysm into the pulmonary outflow tract of the right-sided morphologic left ventricle, causing obstruction related to lack of conus and proximity of the aneurysm to subpulmonary region. Echo Doppler studies and angiography are useful in making a correct diagnosis. Surgical resection of the aneurysm along with closure of the ventricular septal defect is the treatment of choice. The prognosis is likely to be excellent.

Angiocardiography↗

Macular haemorrhage in adult acute leukaemia patients at presentation and the risk of subsequent intracranial haemorrhage.

Retinal changes are common in adult acute leukaemia patients at presentation, but whether they correlate with the risk of subsequent intracranial haemorrhage is unknown. A 4-year study has been carried out in 82 newly-diagnosed acute leukaemia patients, aged 12-77 years, who were studied prospectively for the presence of intra-retinal haemorrhages (IRH), white-centred haemorrhages (WCH), cotton-wool spots (CWS) and macular haemorrhages (MH). Groups with and without these features were compared for their risk of intra-cranial haemorrhage (ICH) within the first 30 d following diagnosis. There was no association between the incidence of ICH and the presence of IRH, WCH or CWS. However, 6/13 of those with MH developed ICH, compared to 6/69 of those without MH (relative risk 5.0, CI 95% [2.03-12.33], P=0.003). The only other identifiable risk factor for ICH was the M3 subtype of AML, but if the four cases of M3-AML were discounted from analysis, MH remained a highly significant risk factor for ICH. Patients with MH should be monitored intensively for the development of ICH, and receive priority in the allocation of platelets where these are in short supply.

Adolescent↗

Ocular complications of adult rheumatoid arthritis.

In a prospective study of 325 patients with adult rheumatoid arthritis, ocular complications were seen in 73 patients (22.4%). Keratoconjunctivitis sicca was the most common ocular lesion. Other lesions were episcleritis, scleritis, marginal thinning of the cornea with keratolysis, stromal corneal opacities with peripheral vascularisation, and iridocyclitis. The mean duration of the arthritis and the mean duration of seropositivity were found to be significantly higher in patients with ocular complications. Physicians should include ophthalmic examination as a routine in their protocol for patients with rheumatoid arthritis to facilitate early diagnosis and treatment of ocular complications.

Adolescent↗

Metastatic osteosarcoma of the ethmoid: an unusual cause of recurrent epistaxis and proptosis.

Osteosarcoma is the most common primary malignant tumour of bone and it usually metastasises to the lung. In the nasal cavity metastatic disease is extremely rare. We describe a case of osteosarcoma presenting with recurrent epistaxis, and proptosis due to secondaries in the nasal cavity. To our knowledge such a case has not been reported previously in the available English literature.

Adolescent↗

Retinal findings in adult leukaemia: correlation with leukocytosis.

The associations between retinal findings and haematological parameters in acute leukaemia are controversial. Sixty-three newly-diagnosed acute leukaemia patients, aged 12-77 years, were studied prospectively for the presence of intra-retinal haemorrhages (IRH), white-centred haemorrhages (WCH), cotton wool spots (CWS) and macular haemorrhages (MH), Thirty-three patients (52.4%) showed at least one retinal abnormality. The prevalence of individual findings was: IRH (30 cases), WCH (20 cases), CWS (5 cases), MH (11 cases). In contrast to previous studies, there was no association between any of these retinal findings and the haemoglobin level or the platelet count. There was a higher median WBC in patients with IRH (68 x 10(9)/l) than in those without IRH (15.4 x 10(9)/l), P = 0.037. When the acute myeloblastic leukaemia cases were considered separately, an association was also found between higher WBC and the presence of WCH and CWS. There was no association between retinal findings and FAB type in the AML cases. We conclude that a high WBC may be at least as important as anaemia and thrombocytopenia in the pathogenesis of the retinopathy of acute leukaemia.

Acute Disease↗

Developmental changes in neurotransmitter receptor binding in the human periaqueductal gray.

The periaqueductal gray (PAG) plays a central role in the integration of defense responses to threatening or stressful stimuli. Little is known about the neurochemical development of the human PAG around the time of birth, when the fetus makes the transition to extrauterine life and independent defense responses are needed. We analyzed receptor binding to selected neurotransmitters implicated in PAG function in 7 fetuses (19 to 26 gestational weeks), 9 infants (38 to 74 postconceptional weeks), 1 child (4 years), and 3 adults (20 to 68 years). Tissue autoradiography was used with radioligands for opioid, nicotinic, muscarinic, kainate, and serotoninergic receptors. By midgestation, binding to nicotinic, muscarinic, serotoninergic, opioid, and kainate receptors is already localized to the human PAG. The subsequent developmental profiles are unique for each radioligand. Binding to nicotinic and serotoninergic receptors decreases significantly from the fetal to mature periods, but at different tempos. In contrast, there is no significant change from midgestation to infancy for muscarinic, kainate, and opioid binding: between infancy and the mature period there is a downward trend in binding for muscarinic and kainate receptors and an upward trend for opioid receptors. This study provides baseline information about the neurochemical development of the human PAG in early life. This information is of value in considering the neurochemical substrate of the maturation of defense responses in human infancy, and in evaluating potential neurochemical disorders of the developing human PAG.

Age Factors↗

Tumours and tumour-like lesions of the eye: a clinicopathological study from Hospital University Sains Malaysia.

A total of 89 histopathologically proven ocular tumours and tumour-like lesions treated in Hospital University Sains Malaysia, Kubang Kerian, Kelantan over a period of nine years were reviewed for their age distribution, site of lesion and histological type. The tumours were observed in all age groups with a maximum prevalence in the first decade. Twenty lesions were malignant and 69 were benign. The eyelid was the most frequent location (51%), followed by the conjunctiva (32%). Retinoblastoma was the most common malignant tumour (10 cases) and dermoid cyst was the most common tumour-like lesion (16 cases).

Adolescent↗

Risk factors for retinopathy in diabetes mellitus in Kelantan, Malaysia.

Few attempts have been made to determine the risk factors for diabetic retinopathy which is a major cause of visual impairment and blindness. One hundred and forty patients of diabetes mellitus were studied to determine the prevalence and types of retinopathy, and its relation to various risk factors. Nearly half (48.6%) of the patients suffered from retinopathy. The significant associated risk factors were long duration of diabetes, proteinuria and elevated serum creatinine level. However, there was no significant association between the prevalence of retinopathy and high levels of serum cholesterol, C-peptide levels, associated hypertension, and glycaemic control of diabetes mellitus. An effective screening programme for detection of retinopathy in the patients of diabetes as a regular practice is encouraged.

Adolescent↗

Echocardiographic predictors of success of catheter closure of atrial septal defect with the buttoned device.

Transcatheter occlusion of ostium secundum atrial septal defects (ASD) with the buttoned device has been shown to be feasible, effective, and safe. The final decision to implant the device is largely based on the balloon sizing of the ASD during cardiac catheterization. Only subjective criteria of ASD size and the septal rims on echocardiography have been used before catheterization, balloon sizing, and transcatheter occlusion. The purpose of this study was to determine whether objective echo criteria could be developed to predict successful occlusion of the ASD. During a 46-month period ending August 1992, 29 children with secundum ASD were evaluated for transcatheter occlusion. The device was successfully implanted in 15 (group A); in the remaining 14 children, this procedure could not be performed (group B). Preocclusion echos were analyzed by independent investigators who had no knowledge of outcome of the procedure. Echo parameters studied included size of ASD, length of atrial septum (LAS), and size of the superior and inferior rims in precordial and subcostal views and maximum jet width by color flow mapping. From these measurements several ratios were derived, and the data were compared. A smaller (p < 0.05) ASD was present in the group of patients with successful implantation of the device; LAS was similar (p > 0.1) in both groups. A lower (p < 0.05) ratio of ASD to LAS and a higher (p < 0.05) ratio of the superior and inferior septal rims to ASD were associated with the group of patients with successful implantation of the device.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Upper eyelid and eyebrow dimensions in Malays.

The upper eyelid crease height pretarsal skin and eyebrow height were studied in 305 Malay subjects (146 males and 159 females) varying in age from 2-80 years, who were randomly selected from the residents of Kota Bharu, Kelantan. In females, from the age of 11 years the mean pretarsal skin height increased progressively with age. In males, however, it decreased with age up to 60 years. In both sexes, subjects more than 60 years old showed highest values for pretarsal skin height. The mean eyelid crease height increased progressively with age from 11 years onwards in males but not in females. The mean eyebrow height increased with age in females but not in males. Eyebrow and eyelid measurements seem to show a definite racial variation. Besides establishing normal values for eyelid and eyebrow measurements in Malays, our findings indicate that age and sex should be taken into consideration to achieve satisfactory results in cosmetic eyelid surgery in Malays.

Adolescent↗

Utility and limitations of biplane transesophageal echocardiographic automated border detection for estimation of left ventricular stroke volume and cardiac output.

Recent echocardiographic ABD algorithms can estimate LV volume on-line from a single long-axis plane. The objective of this study was to assess the capability and limitations of transesophageal ABD to estimate stroke volume and cardiac output in patients before and after coronary artery bypass surgery by correlating these data with simultaneous thermodilution measurements. ABD data were acquired on-line from the transverse-plane four-chamber view and the longitudinal-plane two-chamber view and calculated by automated area-length and Simpson's rule formulas for volume. Thirty-three studies were attempted in 18 patients. Technically adequate ABD data were available in all patients from at least one view. Twenty-two (67%) of 33 studies from the four-chamber view and 27 (82%) of 33 studies from the two-chamber view were technically adequate. Cardiac output by all ABD methods was significantly correlated with thermodilution values (r range 0.72 to 0.89; SEE range 0.48 to 0.55 L/min). The two-chamber view underestimated cardiac output slightly, by an average of 0.4 L/min, whereas the four-chamber view consistently underestimated cardiac output by an average of 1.9 L/min. The area-length and Simpson's rule algorithms produced similar results. Biplane transesophageal ABD is an alternative method for estimating cardiac output; the two-chamber view in particular has potential for on-line volume determination.

Adult↗