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Biomedical subjects

S K Sharma

Publications and source records attributed to S K Sharma.

At least 757 records · Page 42Linked to original sources
PubMedDate not supplied

Saphenous--peritoneal shunt in refractory ascites: a neglected technique.

Management of intractable ascites has always been a challenge. Peritoneovenous shunt (PVS) plays a major role in the surgery of intractable ascites in patients with liver cirrhosis. Positive pressure gradient between the ascitic fluid and venous pressure leading to one-way drainage of ascitic fluid into venous circulation is the mainstay. Over decades, various modifications of shunting technique have been done. Here we report our experience with this procedure which is safe, easy and effective. Here the long saphenous vein is used as a drainage system. One-way ascites flow is ensured by a natural valve in the saphenous orifice.

Ascites↗
PubMedDate not supplied

Fiberoptic bronchoscopy in patients with haemoptysis and normal chest roentgenograms.

Over the last 10 years, 53 patients with hemoptysis, but with a normal chest radiograph underwent diagnostic fiberoptic bronchoscopy. Forty-three patients did not show any abnormal findings, the site of bleeding could be localised in five and non-specific mucosal changes were seen in the remaining five patients. Thirty-two patients were followed up clinically for a 3-18 months period. One patient on follow-up developed tubercular pleural effusion. Bronchogenic carcinoma was not detected in any of these patients during the procedure or at follow up. A review of literature revealed a 3 per cent incidence of bronchogenic carcinoma and the risk factors associated with higher incidence were age above 40 years, cigarette smoking and a longer duration of hemoptysis. We conclude that fiberoptic bronchoscopy has little role in this relatively benign condition (hemoptysis) especially when the risk factors are absent.

Adult↗
PubMedDate not supplied

Antibody directed enzyme prodrug therapy (ADEPT): a three phase system.

Monoclonal anti-CEA antibody, A5B7, and its fragments conjugated to CPG2 localize to a peak concentration in the LS174T xenografts within 24 h after injection, but enzyme activity persists in plasma such that prodrug injection has to be delayed for 5-6 days in order to avoid toxicity. Injection of prodrug at this time did not result in growth delay of this tumour. A three-phase system has been developed in which residual plasma enzyme was inactivated and cleared by a galactosylated anti-CPG2 antibody, SB43gal, allowing prodrug administration within 24 h after the conjugate. Using this three-phase system, a marked growth delay of this tumour was achieved after a single course of treatment consisting of conjugate injection followed by SB43gal, 19 h later and three doses of the prodrug.

Animals↗
PubMedDate not supplied

Antibody directed enzyme prodrug therapy (ADEPT): clinical report.

Following an extensive series of studies in nude mice with human xenografts a pilot scale clinical trial of antibody directed enzyme prodrug therapy has been initiated. The principle is to activate a relatively inert prodrug to an active cytotoxin by a tumour located enzyme. In the first stage of the study a prodrug para-N-(mono-2-chloroethyl monomesyl)-aminobenzoyl glutamic acid was administered to six patients with advanced colorectal cancer in a dose escalating protocol. Nausea and vomiting occurred as the only discernible toxic effect at the higher dose levels. Three of these patients and two other patients with advanced disease have proceeded to the second stage of the study in which an antibody-enzyme conjugate was given IV, followed after 36-48 h by a galactosylated anti-enzyme antibody. When plasma enzyme levels had become undetectable the patients received multiple doses of the prodrug. At the lower doses toxicity was minimal as were clinical responses. Two patients received higher doses which resulted in myelosuppression and temporary regression of advanced disease. No complications resulted from administration of the antibody-enzyme complex or enzyme inactivating antibody. The myelosuppression is attributable to the relatively long half-life of the active drug formed from the prodrug used in the present study.

Antibodies, Monoclonal↗
PubMedDate not supplied

Pulmonary blastoma.

Pulmonary blastoma is a rare tumour of the lung. We report three cases of this tumour. In all three cases, a possibility of blastoma was considered on aspiration cytology of the tumours. The relevant literature including its pathogenesis is reviewed.

Adolescent↗
PubMedDate not supplied

Interrelationship between bronchoalveolar lavage cellular constituents and pulmonary functions in sarcoidosis.

Bronchoalveolar lavage (BAL) using a fiberoptic bronchoscope was done in 36 patients with sarcoidosis on 45 occasions and in 19 control subjects over a period of seven years. Total cell, polymorphonuclear cell and eosinophil cell counts of bronchoalveolar lavage fluid (BALF) in patients with sarcoidosis were not significantly different from control subjects. However, lymphocyte count (% total cells) in BALF was significantly higher (P less than 0.001) in patients with sarcoidosis as compared to control subjects. Alveolar macrophage was the predominant cell type in BALF in control subjects. A significant positive correlation (r = 0.46; P less than 0.01) between vital capacity (VC) and pulmonary diffusing capacity (DLCO) and a negative correlation (r = -0.52; P less than 0.001) between BAL fluid lymphocytes (%) and DLCO (per cent predicted) was found in patients with sarcoidosis. An increase in lymphocytes in BALF is considered to be one of the parameters indicating activity of sarcoidosis. In view of the relationship between this parameter and the reduction in DLCO, the latter may also be an indicator of disease activity.

Adolescent↗
PubMedDate not supplied

Bronchoalveolar lavage fluid (BALF) analysis in interstitial lung diseases--a 7-year experience.

Bronchoalveolar lavage (BAL) was performed in 89 patients with diffuse interstitial lung disorders of varied aetiology and 19 normal control subjects over a period of 7 years. Alveolar macrophage was the predominant cell in BALF in normal control subjects. Increased neutrophils were found in BALF in patients with cryptogenic fibrosing alveolitis (CFA) and fibrosing alveolitis associated with collagen vascular diseases. BALF lymphocytosis was seen in patients with chronic hypersensitivity pneumonitis, sarcoidosis, miliary tuberculosis, silicosis and carcinomatosis. Diagnosis of alveolar microlithiasis was made in one patient with the help of BALF examination. One patient developed anaphylactic reaction to the topical xylocaine solution and there was no mortality with the procedure.

Adult↗
PubMedDate not supplied

Gold-induced hypersensitivity pneumonitis in a patient with rheumatoid arthritis.

A case of gold-induced hypersensitivity pneumonitis in a patient with rheumatoid arthritis is reported. Its differentiation from interstitial pulmonary fibrosis associated with rheumatoid arthritis is discussed and the low T4/T8 ratio in the bronchoalveolar lavage fluid of these patients is highlighted.

Alveolitis, Extrinsic Allergic↗
PubMedDate not supplied

Differential diagnosis of ascitic fluid: evaluation and comparison of various biochemical criteria with a special reference to serum ascites albumin concentration gradient and its relation to portal pressure.

Among various biochemical indices measured in 93 patients with ascites, ascitic LDH estimation was proved to be indiscreminatory, while ascites/serum LDH ratio has shown a diagnostic accuracy of 85 per cent. Ascitic total protein levels and ascites/serum total protein ratio (accuracy rates of 72 and 77% respectively) were limited, especially in differentiating the ascites due to heart failure. Serum ascites albumin gradient, showed a strong correlation to portal pressure (r, + 0.83 + 0.88), and was found to be the best diagnostic index (with an overall accuracy of 97 per cent) in distinguishing the 'transudative' from 'exudative' ascites. However, no index could discreminate the 'mixed' cases and provide the etiological diagnosis of the ascites.

Adult↗
PubMedDate not supplied

Cytomorphologic aspects of thyroiditis. A study of 51 cases with functional, immunologic and ultrasonographic data.

Fine needle aspiration provided material for detailed cytomorphologic study in 51 cases of thyroiditis, 40 of which were diagnosed as Hashimoto's (autoimmune) thyroiditis. Of these 40 cases, 22 were found to be euthyroid on clinical examination and radioimmunoassay (RIA), 10 were hyperthyroid and 8 were hypothyroid. Of the 11 cases of subacute thyroiditis, 4 were thyrotoxic and 7 were euthyroid. Radioactive iodine uptake (RAIU) showed decreased to negligible uptake in ten and normal uptake in one case of subacute thyroiditis, whereas all of the thyrotoxic cases of Hashimoto's thyroiditis showed markedly increased RAIU. Echography showed a hypoechoic or anechoic pattern in most of the cases. Antimicrosomal and/or antithyroglobulin antibodies were positive in 25 cases of Hashimoto's thyroiditis and in 1 case of subacute thyroiditis. The cytologic features that characterized subacute thyroiditis were the presence of multinucleated giant cells and a polymorphonuclear and lymphocytic population associated occasionally with epithelioid-cell granulomas. Hashimoto's thyroiditis was characterized by Hürthle-cell changes and a significant lymphoid population consisting of mature and transformed lymphocytes, often impinging on follicular cells. There was an overlap in the cytomorphologic features between some cases of Hashimoto's and subacute thyroiditis. In such cases, the final diagnosis was arrived at by an integrated approach incorporating all of the diagnostic parameters available.

Adult↗