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Biomedical subjects

S Raju

Publications and source records attributed to S Raju.

At least 109 records · Page 6Linked to original sources
PubMed1984

Serial monitoring of T-cell subset ratios with monoclonal antibodies in steroid- and antithymocyte globulin-treated patients with renal allotransplants.

Sequential changes in T-cell subsets or their ratios were employed to predict severity of rejection crises and to identify those patients who might require future antirejection therapy. Forty-two percent of the transplant recipients had a pretransplant OKT4:8 ratio in the range of 1.3 +/- 0.5. By contrast, only 11% had a OKT4:8 ratio of 2.9 or greater. Examination of the entire study group demonstrated that the mean OKT4:8 ratios fell (P less than 0.01) in the first week following the transplant procedure. All patients had at least one episode of acute rejection. There was a marked increase (P less than 0.05) in the OKT4:8 ratio between the first week value and the value immediately preceding (within 3 days) the start of the rejection episode which was 2.64 +/- 0.27. The mean OKT4:8 ratio in the 15 patients leaving the hospital with a functioning transplant was 1.18 +/- 0.35. Three months post-transplant, the OKT4:8 ratio was 1.98 +/- 0.39 in the 12 patients with functioning allografts. This value was not different from those patients' initial pretransplant values. Clinically, the rejection episodes could be divided into two groups based on their response to intravenous methylprednisolone therapy. The first group (n = 9) had milder rejection crises which responded rapidly to administration of one course of methylprednisolone. The second group of patients (n = 9) were also treated initially with methylprednisolone, to which they did not respond, and subsequently received antithymocyte globulin in an attempt to control their ongoing rejection crises. Following the transplant procedure, the OKT4:8 ratio decreased in patients who were destined to have steroid-responsive rejection episodes (P less than 0.01). The OKT4:8 ratio however, failed to fall in those who required ATG for control of their transplant rejection episodes. The onset of rejection episodes was associated with an increase in OKT4:8 ratio in both groups. Following steroid administration, two patterns of OKT4:8 cell responses were observed. Those in whom renal function improved demonstrated a decline in OKT4:8 ratio from 2.4 +/- 0.4 to 1.4 +/- 0.4 (P less than 0.05). However, no change occurred in the OKT4:8 ratios with steroid therapy (2.6 to 2.4 +/- 0.33, P greater than 0.05) in individuals in whom the serum creatinine concentration failed to decline. The patients who failed to respond to steroid therapy were treated with antithymocyte globulin (ATG).(ABSTRACT TRUNCATED AT 400 WORDS)

Acute Disease↗
PubMed1984

Experimental small bowel transplantation utilizing cyclosporine.

Cyclosporine prolonged the survival of ectopic small bowel allografts in a canine model. A 9-fold increase in mean survival as compared with controls was obtained. Addition of prednisone to cyclosporine did not result in further graft prolongation, but improved the gross and histological appearance of the allograft. Monitoring the motility and histology of the allograft appears to be useful in predicting approaching rejection. Xylose absorption was not helpful in this regard. A new technique for measuring fat absorption in the transplant is described. Following allografting, fat absorption is resumed by 14 days posttransplantation.

Animals↗
PubMed1983

Venous insufficiency of the lower limb and stasis ulceration. Changing concepts and management.

In a group of patients studied for venous insufficiency, the incidence of deep venous insufficiency was much higher than previously suspected. Insufficiency of the superficial system, when present, was associated invariably with deep venous insufficiency, suggesting a leading role for the latter condition. Evidence is presented to show that in many instances, such reflux is probably non-thrombotic. The results of various types of direct venous valve surgery in a group of patients are presented.

Axillary Vein↗
PubMed1983

Chronic granulocytic leukemia after renal transplantation.

Chronic granulocytic leukemia (CGL) developed in a 31-year-old man after he underwent a third renal transplant. The leukemia was initially controlled with azathioprine sodium and prednisone therapy, but eventually it entered blast cell crisis. This was controlled with an adult acute lymphocytic leukemia protocol with an excellent response. Despite discontinuing treatment with azathioprine and with the use of busulfan to control the peripheral WBC count, the patient maintained stable renal function for one year following treatment of the blast cell crisis and subsequently died of sepsis. We suggest that CGL after renal transplantation is similar to that observed in the general population and can be treated with the usual chemotherapeutic agents for the disorder without sacrificing renal function.

Adult↗
PubMed1983

The response of venous valvular endothelium to autotransplantation and in vitro preservation.

Intraoperative preservation techniques in popular use produced endothelial damage in venous valves of dogs. This damage was evident with only 20 minutes of preservation. Severe endothelial damage was also evident after surgical autologous transfer of valve-bearing vein segments. The damage evolved over a period of days. At 28 days there was essentially complete desquamation of the valve apparatus with exposure of the collagen fibrils to the bloodstream. Complete reendothelialization had occurred by 4 months. The clinical implications of these findings are discussed.

Animals↗
PubMed1982

Early clinical studies with cis-diammine-1,1-cyclobutane dicarboxylate platinum II.

cis-Diammine-1,1-cyclobutane dicarboxylate platinum II (CBDCA, JM8), an analogue of cisplatin showing reduced toxicity in preclinical studies, was evaluated in 60 patients. Doses were given initially every 3 weeks and escalated from 20 to 520 mg/m2. Following this, doses were given every 4 weeks and escalated from 300 to 500 mg/m2. The dose-limiting toxicity, thrombocytopoenia, occurred in four-fifths of patients treated at 520 mg/m2, with the nadir occurring 3 weeks after treatment. Leucopoenia and anaemia also occurred but were less severe. Vomiting occurred in all patients receiving over 120 mg/m2 but seldom persisted beyond 24 h. Serial measurements of 51Cr-EDTA clearances, urinary N-acetylglucosaminidase, urinary leucine aminopeptidase, and beta 2-microglobulin did not reveal significant evidence of nephrotoxicity. Detriment to the audiogram has not been seen in the first 13 patients studied. Pharmacological studies showed that most of the dose of platinum was excreted in the urine, and that impairment of renal function may be associated with drug retention and an increased risk of myelosuppression. The previous therapy and age of the patient also affected the tolerance of the drug. Clinical responses were seen in patients with ovarian carcinoma receiving greater than 120 mg/m2. A further dose escalation was performed on a 4-week schedule in patients under 65 with good renal function. The maximum dose it was possible to administer repeatedly without incurring myelosuppression was in the range 400-500 mg/m2. JM8 is not significantly nephrotoxic and is less emetic than cisplatin. It has antitumour activity in man and deserves wider evaluation, along with the other analogues under study in various centres, as an alternative to cisplatin.

Adult↗
PubMed1982

The Tenckhoff catheter for peritoneal dialysis--an appraisal.

We prospectively evaluated early (within 40 days) catheter complications in all patients receiving a dialysis catheter between 1/8/80 and 1/8/81. 50% of patients achieved a functioning catheter at the first insertion and 24% required replacement of the catheter because of poor dialysate flow. Leaking from the catheter exit site occurred in 20%, infection at the exit site in 9% and peritonitis in 19% of patients. In patients who maintain a catheter over 40 days and undergo treatment by long-term peritoneal dialysis median catheter survival was 400 days with delayed cytheter failure primarily due to failure to resolve a clinical episode of peritonitis. Although the Tenckhoff catheter is readily inserted frequent complications occur.

Adolescent↗
PubMed1982

Chemotherapy of endodermal sinus tumour (yolk sac tumour) of the ovary: preliminary communication.

Eight patients presenting with endodermal sinus tumour of the ovary have been treated with combination chemotherapy using cisplatin, bleomycin and vinblastine (PVB). Complete remission occurred in 7 out of 8 cases, all of whom are alive and well 3 to 33 months later. These preliminary results are compared with our own past experience and recent reports in the literature. It is concluded that the PVB regimen is probably as effective in female germ cell tumours as it is in testicular teratoma.

Adolescent↗
PubMed1982

Abdominal hernia in patients undergoing continuous ambulatory peritoneal dialysis.

We found abdominal hernias in 12 of 51 patients trained for continuous ambulatory peritoneal dialysis. Five patients were noted to have abdominal hernias before the start of continuous ambulatory peritoneal dialysis, and the conditions of seven patients were diagnosed during routine clinic visits. Four patients had incarceration. We suggest that a careful search for the presence of a hernia be performed at the initial examination for peritoneal dialysis. Continued monitoring of the patient's condition for the development of a hernia is essential. If a hernia is found, elective repair should be performed.

Adolescent↗
PubMed1981

Brachial plexus compression: complication of delayed recognition of arterial injuries of the shoulder girdle.

In six cases of penetrating trauma to the subclavian or axillary arteries without primary coincident injury to the brachial plexus, the vascular injury was not initially recognized as there were no suggestive clinical signs. The first clinical sign of vascular injury in all cases was delayed onset of brachial plexus palsy due to compression by an expanding false aneurysm. Following vascular repair, neurological recovery occurred only in two of six cases. Since brachial plexus injuries are associated with a poor prognosis, and the functional impairment of the upper extremity is serious, an aggressive investigative approach to all penetrating shoulder girdle injuries is advocated. Arteriography should be considered, even when suggestive clinical signs of vascular injury are absent. Even relatively small false aneurysms should be repaired without delay before the onset of neurological symptoms.

Adolescent↗