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Biomedical subjects

S Sharma

Publications and source records attributed to S Sharma.

At least 1,477 records · Page 82Linked to original sources
PubMedDate not supplied

Influence of angiographic morphology on the acute and longer-term outcome of percutaneous transluminal angioplasty in patients with aortic stenosis due to nonspecific aortitis.

PURPOSE: We studied the relationship of initial angiographic morphology in patients with aortic stenosis due to nonspecific aortitis and its relationship to immediate and later outcome following percutaneous transluminal angioplasty (PTA). METHODS: Correlation was performed in 10 successive patients by retrospective analysis. All had clinically inactive nonspecific aortitis and hemodynamically significant aortic stenosis resulting in hypertension or lower limb claudication. Five patients had discrete concentric stenosis; the other five had eccentric stenosis with diseased aortic segments adjacent to the stenosis. RESULTS: The five patients with concentric stenosis (Group I) had primarily successful and uncomplicated PTA with sustained improvement. The five patients (Group II) with eccentric stenosis had initial success in three patients and two initial treatment failures with one patient showing late improvement. Four of these patients developed large intimal flaps. One of these had an aneurysm during follow-up. Follow-up angiograms in five patients showed remodelling with further angiographic and clinical improvement. CONCLUSION: Eccentricity of the stenosis and diffuse aortic disease correlate unfavorably with immediate outcome of PTA but late improvement may still be seen.

Adolescent↗
PubMedDate not supplied

Comparison of computed tomography and cineangiography in the demonstration of central pulmonary arteries in cyanotic congenital heart disease.

PURPOSE: To assess the diagnostic accuracy of contrast-enhanced computed tomography (CT) for central pulmonary artery pathology in patients with cyanotic congenital heart disease (CCHD) and right ventricular outflow obstruction. METHODS: We compared contrast-enhanced CT and cine pulmonary arteriography in 24 patients including hte confluence. Both investigations were interpreted by a cardiac radiologist in a double-blinded manner at an interval of 3 weeks. Angiography was used as the gold standard for comparison. RESULTS: The sensitivity for visualization of main pulmonary artery (MPA), right pulmonary artery (RPA), left pulmonary artery (LPA), and confluence on CT was 94%, 100%, 92.8%, and 92.8%, respectively. Diagnostic specificity for the same entities was 28.5%, 100%, 80% and 50%, respectively. The positive predictive value for each was 76.2%, 100%, 94.1%, and 72.2%, respectively. The low specificity of CT in the evaluation of the MPA and the confluence is perhaps due to distorted right ventricular outflow anatomy in CCHD. Large aortopulmonary collaterals in this region were mistaken for the MPA in some patients with pulmonary atresia. CONCLUSION: CT is a useful, relatively noninvasive, imaging technique for the central pulmonary arteries in selected patients. It can supplement diagnostic information from angiography but cannot replace it. LPA demonstration on axial images alone is inadequate.

Adolescent↗
PubMedDate not supplied

Coronary artery to pulmonary artery collaterals in nonspecific aortoarteritis involving the pulmonary arteries.

We report a patient with nonspecific aortoarteritis (Takayasu's disease) in whom occlusion of the right upper lobe pulmonary artery was associated with collateral flow from the left circumflex coronary artery. Coronary to pulmonary artery collaterals are rare in this disease but have important clinical implication because of their ability to produce coronary steal and myocardial ischemia. Awareness of these pathways is essential for their detection in patients with angina-like symptoms and for differentiation of myocardial ischemia due to direct coronary artery involvement by this disease.

Adult↗
PubMedDate not supplied

Renal vein injury during percutaneous transluminal renal angioplasty in nonspecific aortoarteritis.

Percutaneous transluminal renal angioplasty of a right renal artery stenosis in a patient with nonspecific arteritis (Takayasu's arteritis) was performed for the treatment of renovascular hypertension and led to ipsilateral renal vein perforation and massive retroperitoneal bleeding. The mechanism of injury and its relationship to nonspecific arteritis remains obscure. Awareness of this potentially lethal complication is essential because early diagnosis is mandatory for definitive management.

Adolescent↗
PubMedDate not supplied

Congenital spinal lipomas--tumor versus hamartoma.

Congenital spinal lipomas as a form of dysraphism are frequently reported in literature. A few studies have highlighted their histologic features and found them different from lipomas in other parts of the body. In a review of eight cases of spinal lipomas, we found heterotopic tissue in seven. Neural tissue, muscle, bone and cartilage were frequently encountered. The presence of meningothelial cells in one case was an unusual finding. These findings support the concept of their hamartomatous origin. Malignancy, occurring later in life in one of the heterotopic elements is known, though uncommon, and is one of the reasons, besides neurologic deficit, for long term follow-up.

Child, Preschool↗
PubMedDate not supplied

Intrapelvic obturator neurectomy in cerebral palsy.

Results of 202 obturator neurectomies including 190 intrapelvic and 8 extrapelvic obturator neurectomies in 100 patients were evaluated. Obturator neurectomy, intrapelvic in particular, yielded gratifying results in properly selected patients. It controlled adductor spasticity, scissoring, improved perineal care and helped the patients in sitting and early ambulation. Pre- and post-operative intensive physiotherapy was necessary to get maximum benefit of the surgery. Poor motor status, low IQ, athetosis and inadequate post-operative care had adverse effect on final outcome.

Achilles Tendon↗
PubMedDate not supplied

Angiographic morphology in nonspecific aortoarteritis (Takayasu's arteritis): a study of 126 patients from north India.

We have studied the angiographic morphology of nonspecific aortoarteritis, or Takayasu's arteritis, in 126 patients who underwent total aortoarteriography by intravenous or intraarterial digital subtraction angiography (DSA). Steno-obstructive lesions were seen in 124 (98.4%) patients and commonly involved the abdominal aorta (76.1%), the renal (67.5%), and the subclavian (56.3%) arteries. They were usually symptomatic. Aneurysms were seen in 16 (12.7%) patients and predominantly involved the descending thoracic aorta (62.5%). They were clinically silent. Localized saccular aneurysms (75%) were more common than the fusiform variety. Asymptomatic pulmonary artery involvement was seen in 11 patients (n = 74; 14.9%). Right lung involvement (72.8%) was more common, usually as a stenosis or occlusion of a lobar branch in the upper zone. Intravenous DSA was usually adequate for establishing the diagnosis. In this population a distinct pattern of involvement and the young age at diagnosis were remarkable.

Adolescent↗
PubMedDate not supplied

Neonatal hypoglycemia following maternal glucose infusion prior to delivery.

Intravenous glucose therapy to mother prior to delivery significantly affects glucose and insulin homeostasis in fetus and newborn infants. Specifically, the infants show hyperglycemia, and hyperinsulinism at birth, and are predisposed to hypoglycemia in the first few hours of life. In this paper we have focussed attention on the clinical significance of these changes and suggest some remedial measures, in light of our own research.

Blood Glucose↗
PubMedDate not supplied

Congenital deficiency of factor VII.

A case of congenital factor VII deficiency in a five-year-old child is reported. The patient, born of a non-consanguineous marriage, presented with repeated bouts of epistaxis since childhood. The prothrombin time (PT) was markedly prolonged with a normal bleeding time (BT), partial thromboplastin time with Kaolin (PTTK) and platelet count. The patient has been on follow up for the last four years and is doing apparently well.

Blood Coagulation Tests↗
PubMedDate not supplied

In vitro colony formation from fetal liver cells and their infusions in patients of aplastic anaemia.

This study evaluated whether the number of granulocyte-macrophage colony forming units (CFU-GM) grown from fetal liver in agar in vitro, would affect the ability of fetal liver infusion (FLI) to achieve a favourable outcome in patients with severe aplastic anaemia. Nine fetal liver infusions from 12 to 24 week old abortuses were administered to six patients with severe aplastic anaemia. Three samples from each fetal liver were scored for cluster (3-50 cells) and colony (>50 cells) formation after 12-15 days of culture. The mean numbers of clusters observed were 165.4+/-51.5 and colonies were 41+/-15.3 per 8 x 10(5) cells plated. Two patients showed partial response to FLI therapy. However, no correlation between fetal liver CFU-GM counts and patient outcome after FLI (response and survival) was observed.

Adolescent↗
PubMedDate not supplied

Transcatheter arterial embolization in the management of hemobilia.

BACKGROUND: This retrospective analysis evaluated the clinical and radiologic results of transcatheter arterial embolization (TAE) in the treatment of significant hemobilia. The imaging findings, embolization technique, complications, and efficacy are described. METHODS: Thirty-two consecutive patients (21 male, 11 female, age range 8-61 years) who were referred to the radiology department for severe or recurrent hemobilia were treated by TAE. Causes of hemobilia were liver trauma (n = 19; iatrogenic in six and road traffic accident in 13), vasculitis (n = 6), vascular malformations (n = 2), and hepatobiliary tumors (n = 5). Iatrogenic liver trauma was secondary to cholecystectomy in those six patients. Four of five hepatobiliary tumors were inoperable malignant tumors and one was a giant cavernous hemangioma. Arterial embolization was done after placing appropriate catheters as close as possible to the bleeding site. Embolizing materials used were Gelfoam, polyvinyl alcohol particles or steel coils, alone or in combination. Postembolization angiography was performed in all cases to confirm adequacy of embolization. Follow-up color Doppler ultrasound and contrast-enhanced computed tomography was done in all patients. RESULTS: Ultrasonic, computed tomographic, and angiographic appearances of significant hemobilia were assessed. Angiogram showed the cause of bleeding in all cases. Three patients with liver trauma due to accidents required repeat embolization. Eight patients required surgery due to failed embolization (continuous or repeat bleeding in four patients, involvement of the large extrahepatic portion of hepatic artery in two, and coexisting solid organ injuries in two). Severity of hemobilia did not correlate with grade of liver injury. All 13 patients with blunt hepatic trauma showed the cause of hemobilia in the right lobe. No patient with traumatic hemobilia showed an identifiable cause in the left lobe. There were no clinically significant side effects or complications associated with TAE except one gallbladder infarction, which was noted at surgery, and cholecystectomy was performed with excision of the hepatic artery aneurysm. CONCLUSION: TAE is a safe and effective interventional radiologic procedure in the nonoperative management of patients who have significant hemobilia.

Adolescent↗