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Biomedical subjects

S K Gupta

Publications and source records attributed to S K Gupta.

At least 685 records · Page 38Linked to original sources
PubMed1987

Reoperation for polytetrafluoroethylene bypass failure: the importance of distal outflow site and operative technique in determining outcome.

Of 724 bypasses with polytetrafluoroethylene grafts performed for critical ischemia during a 6-year period, 165 (23%) failed and necessitated reoperation for continued limb salvage. Forty-three failures occurred in 199 femoral-above-knee-popliteal bypasses (F-AKP), 33 failures in 177 femoral-below-knee-popliteal bypasses (F-BKP), 52 failures in 182 femorodistal bypasses (F-D), 28 failures in 85 axillofemoral bypasses (Ax-F), and nine failures in 81 femorofemoral bypasses (F-F). Our reoperative approach consisted of dissection of the distal anastomosis, longitudinal incision in the hood of the graft directly over the anastomosis, and proximal graft thrombectomy. Intimal hyperplasia was treated by patch angioplasty, proximal or distal progression of atherosclerosis was treated by a graft extension, and thrombectomy alone was performed when no cause of graft failure was identified. More recently, a totally new bypass was constructed in 27 cases of F-BKP or F-D failures. Reoperations featuring graft salvage for failed extra-anatomic and F-AKP bypasses yielded 3-year patency rates from the time of first reoperation of 71% and 52%, respectively, whereas for F-BKP and F-D reoperations, 3-year patency rates were 13% and 15%, respectively, at 3 years. However, totally new grafts to a different outflow artery in these settings had 3-year patency rates of 48% and 39%. These data support the aggressive use of reoperation with graft salvage when F-AKP or extra-anatomic graft failure reproduces critical ischemia. Conversely, a new bypass to a virginal outflow site, preferably with autologous vein, should be performed when a polytetrafluoroethylene F-BKP or F-D bypass fails.

Adult↗
PubMed1986

Extramedullary plasma cell tumors: diagnosis by fine-needle aspiration cytology.

Nine cases of plasma cell tumors were diagnosed by fine-needle aspiration cytology, the sites of aspiration being soft-tissue swellings in five cases, lymph nodes in three cases, and both soft-tissue swelling and lymph node in one case. The age of the patients ranged from 33 to 74 yrs, with a median of 52 yrs. Only three of these nine cases were clinically diagnosed as multiple myeloma. Unequivocal demonstration of myeloma cells was possible in eight cases. The smear in ninth case showed mostly undifferentiated blast cells with a few cells showing plasmacytoid differentiation. Giant myeloma cells with monstrous segmented nuclei were encountered in two cases. M-component could be demonstrated in serum and/or urine samples in all seven cases in which it was sought.

Adult↗
PubMed1986

Cytology of hepatocellular carcinoma.

Twenty-five cases of cytologically and histologically confirmed hepatocellular carcinoma (HCC) were cytomorphologically analyzed using May-Grünwald-Giemsa (MGG)-stained aspiration smears and supplemented with special stains. The cell types were categorized as well differentiated (18 cases), vacuolated (four cases), giant cell (one case), and poorly differentiated (two cases). Glycogen staining was positive in 80% of the cases and hence served as a reliable parameter of diagnostic importance in HCC. Cytoplasmic hyaline bodies (14.6%) and bile pigment (17%), when present, were other important features supporting the diagnosis of HCC. Vacuolation of the cell cytoplasm (80%) was possibly related to glycogen accumulation. The cause of nuclear vacuolation (60%) and the significance of nuclear argyrophilia as markers of abnormal cell growth remain to be studied.

Adolescent↗
PubMed1986

Malignant lymphoma of convoluted lymphocytes: diagnosis by fine-needle aspiration cytology and cytochemistry.

The technique of fine-needle aspiration cytology (FNAC) was utilized in the diagnosis of 31 cases of malignant lymphoma of convoluted lymphocytes. The age of the patients ranged from 5 to 70 yr (median, 24 yr). Clinical history was available in 29 cases. All patients had peripheral lymphadenopathy. There was radiological evidence of mediastinal adenopathy in 62% of the cases, and 41% had pleural effusion; 52% of the patients presented with mediastinal compression syndrome. The diagnostically crucial convoluted cells comprised 47.3 +/- 23.73% of all lymphoid cells. Nuclear convolutions were appreciated in a significant number of cells in paraffin sections of 17 of 21 cases (85.7%) having subsequent histopathology. Cytochemical and E-rosette tests performed in 17 cases confirmed the T cell nature of the neoplasms. On an average, 72.3% of cells showed focal positive reaction for acid phosphatase, and 73.8% of cells formed E-rosettes.

Adolescent↗
PubMed1986

Absorption and disposition of aluminum in the rat.

The kinetics of aluminum were determined in the rat. Intravenous bolus and oral doses of 8.1-mg/kg of aluminum as the chloride salt were administered to six rats. Serial blood samples and total urine and feces were collected and assayed for aluminum by atomic absorption spectrophotometry. The fraction absorbed orally (mean +/- SEM) was 0.27 +/- 0.03; the half-life was 5.29 +/- 0.47 h; the steady-state volume of distribution was 38.4 +/- 6.4 mL/kg, and the clearance was 8.87 +/- 1.76 mL X h-1 X kg-1. It was found that aluminum did not significantly penetrate the cellular components of blood. Plasma protein binding was determined to be approximately 98%. Sixty percent of the intravenous dose was excreted in the urine and the remaining 40% was excreted in the feces.

Administration, Oral↗
PubMed1986

Six-year prospective multicenter randomized comparison of autologous saphenous vein and expanded polytetrafluoroethylene grafts in infrainguinal arterial reconstructions.

Autologous saphenous vein (ASV) and polytetrafluoroethylene (PTFE) grafts were compared in 845 infrainguinal bypass operations, 485 to the popliteal artery and 360 to infrapopliteal arteries. Life-table primary patency rates for randomized PTFE grafts to the popliteal artery paralleled those for randomized ASV grafts to the same level for 2 years and then became significantly different (4-year patency rate of 68% +/- 8% [SE] for ASV vs. 47% +/- 9% for PTFE, p less than 0.025). Four-year patency differences for randomized above-knee grafts were not statistically significant (61% +/- 12% for ASV vs. 38% +/- 13% for PTFE, p greater than 0.25) but were for randomized below-knee grafts (76% +/- 9% for ASV vs. 54% +/- 11% for PTFE, p less than 0.05). Four-year limb salvage rates after bypasses to the popliteal artery to control critical ischemia did not differ for the two types of randomized grafts (75% +/- 10% for ASV vs. 70% +/- 10% for PTFE, p greater than 0.25). Although primary patency rates for randomized and obligatory PTFE grafts to the popliteal artery were significantly different (p less than 0.025), 4-year limb salvage rates were not (70% +/- 10% vs. 68% +/- 20%, p greater than 0.25). Primary patency rates at 4 years for infrapopliteal bypasses with randomized ASV were significantly better than those with randomized PTFE (49% +/- 10% vs. 12% +/- 7%, p less than 0.001). Limb salvage rates at 3 1/2 years for infrapopliteal bypasses with both randomized grafts (57% +/- 10% for ASV and 61% +/- 10% for PTFE) were better than those for obligatory infrapopliteal PTFE grafts (38% +/- 11%, p less than 0.01). These results fail to support the routine preferential use of PTFE grafts for either femoropopliteal or more distal bypasses. However, this graft may be used preferentially in selected poor-risk patients for femoropopliteal bypasses, particularly those that do not cross the knee. Although every effort should be made to use ASV for infrapopliteal bypasses, a PTFE distal bypass is a better option than a primary major amputation.

Actuarial Analysis↗
PubMed1986

Evaluation of sodium cromoglycate and medrysone in the management of atopic keratoconjunctivitis: a double masked clinical study.

The efficacy of topical sodium cromoglycate and medrysone was evaluated in 38 patients suffering from atopic keratoconjunctivitis. It was found that medrysone (1%) significantly improved the symptoms of itching, watering, photophobia and hyperaemia, while sodium cromoglycate (2%) was found to be ineffective. Tear prostaglandin E2 and histamine levels did not decrease significantly after sodium cromoglycate therapy. The findings of the present study reveal that sodium cromoglycate has no significant role in the management of atopic keratoconjunctivitis.

Adolescent↗
PubMed1986

Efficacy of miconazole in experimental keratomycosis.

For the first time comparative efficacy of 1% miconazole in ointment base and drops has been evaluated against Candida, Aspergillus and Fusarium organisms in experimental keratomycosis. The findings of the present study reveal that miconazole in ointment drug delivery system has the advantage of being more effective in healing the fungal ulcers and associated lesions. It requires much less frequent application than drops, a parameter of great importance in improving patient compliance. Miconazole ointment was well tolerated by the rabbit eye and produced no ocular or systemic toxicity. The present study confirms that miconazole is a broad-spectrum antifungal agent and it could be a better alternative to presently available drugs to treat human keratomycosis.

Animals↗
PubMed1986

Prevention and management of ischemic complications of vein harvest incisions in cardiac surgery--case reports.

Leg wound complications following saphenous vein harvest for coronary revascularization are uncommon. We have encountered five patients in whom unrecognized arterial occlusive disease contributed to wound necrosis. All required vascular reconstruction in addition to local wound care to achieve healing. Careful preoperative attention to symptoms of arterial insufficiency is recommended and appropriate modification of lower extremity incisions may reduce the frequency of this complication. Prompt recognition and appropriate arterial revascularization should avoid prolonged morbidity if ischemic necrosis of leg wounds does occur. If arterial reconstruction is required, PTFE is an acceptable graft material if the remaining saphenous vein is inadequate for use.

Adult↗
PubMed1986

Monoclonal antibodies based sandwich erythro-immunoassay and 'dot' enzyme immunoassay for human chorionic gonadotropin in urine.

Two simple solid-phase sandwich immunoassays for human chorionic gonadotropin (hCG) employing monoclonal antibodies have been described. One is a sandwich erythro-immunoassay employing V-shaped well microtitration plates coated with monoclonal anti-beta-hCG antibody and monoclonal anti-alpha-hCG antibody labelled sheep erythrocytes. The second is a 'dot' enzyme immuno-assay employing dip-stick (plastic strips pasted with nitrocellulose pads) coated with monoclonal anti-beta-hCG antibody. Anti-alpha-hCG monoclonal-alkaline phosphatase conjugate was used to reveal hCG bound to solid surface. The assays can be performed by 'one-step' or 'two-step' procedures. Erythro-immunoassay as well as 'dot' enzyme immunoassay was able to detect in urine as low as 10 mIU hCG/ml. A good correlation was observed between the values obtained by these two methods as well as 'two-step' sandwich enzyme immunoassay on 47 urine samples.

Antibodies, Monoclonal↗
PubMed1986

Limb salvage in octogenarians and nonagenarians.

Although advanced age has often been a relative contraindication to attempts at limb salvage, we have not regarded it as an important deterrent to arterial reconstruction. Our 6-year experience with 168 consecutive patients over 80 years of age who underwent arterial reconstruction or percutaneous transluminal angioplasty represented 18% of all patients treated with limb-threatening ischemia during this period. The average age was 84 years, with 14 patients over 90 years of age. Sixty-eight patients were men (41%) and 100 were women (59%). Indications for treatment in 189 limbs were restricted to limb salvage. One hundred eighty-two operative procedures were performed consisting of 84 femoropopliteal, 72 femorotibial, 12 axillofemoral, 11 femorofemoral, two axillopopliteal and one iliofemoral bypass. Percutaneous transluminal angioplasty was performed in 12 iliac and 14 femoral or popliteal arteries as an alternative (seven) or adjunct (19) to vascular reconstruction. The 30-day procedural mortality rate was 6%. The cumulative life table survival rate of all patients who underwent an attempt at limb salvage was 78% at 1 year, 65% at 2 years, and 54% at 3 years. Cumulative life table limb salvage rates were 84% at 1 year, 74% at 2 years, and 71% at 3 years. Overall graft patency for 182 arterial reconstructive operations was 80% at 1 year and 62% at 3 years. Of patients in whom limb salvage was attempted, 65% lived more than 1 year and 51% more than 2 years with a functional limb. Of patients who died within 5 years of treatment, 76% did so with their previously threatened limb intact. These data support an aggressive approach to arterial reconstruction in elderly patients and indicate that advanced age alone should not be considered a contraindication to attempts at limb salvage.

Actuarial Analysis↗