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Biomedical subjects

S Suri

Publications and source records attributed to S Suri.

At least 73 records · Page 4Linked to original sources
PubMed1998

Regain of fertility and normality of progeny born during below protective threshold antibody titers in women immunized with the HSD-hCG vaccine.

PROBLEM: Phase II clinical trials with the heterospecies dimer of beta hCG and alpha-subunit of ovine luteinizing hormone (HSD)-human chorionic gonadotrophin (hCG) vaccine showed that pregnancy was prevented at and above 50 ng/ml titers, whereas conceptions occurred below 35 ng/ml of hCG bioneutralization capacity. The effect of below-protective threshold anti-hCG antibodies on the progression of pregnancy and the normality of progeny was studied. METHOD OF STUDY: Four women enrolled by informed consent in the Phase II trials. The women studied were immunized with the HCG vaccine and did not receive booster injections in consideration of their desire to have another child. They were examined clinically at least once every month until delivery. The babies were followed up from 2 to 3.5 years, and their anthropometric indices were compared with elder siblings. RESULTS: The pregnancies progressed to 35 to 38 weeks with the usual obstetric problems, and the children developed normally. CONCLUSIONS: The anti-fertility effect of the HSD-hCG vaccine is reversible and low titers of antibodies below the protective threshold have no apparent side effects on the progression of pregnancy and on the early development of the progeny.

Adult↗
PubMed1998

Ultrasound guided fine needle aspiration cytology in abdominal tuberculosis.

Although barium studies and CT are useful in assessing abdominal pathology in tuberculosis, imaging findings are not always specific and a histopathological or bacteriological confirmation is often required. The aim of the present study was to evaluate the role of ultrasound (US) guided fine needle aspiration cytology (FNAC) in the diagnosis of abdominal tuberculosis in patients with non-palpable lesions detected on US/CT. FNAC was performed on 31 sites in 30 patients. The sites included enlarged lymph nodes (n = 14), focal lesions in liver (n = 2) and spleen (n = 8), and thickened bowel in the ileocaecal region (n = 7). The results were classified cytomorphologically into four groups: (1) definite evidence of tuberculosis; (2) presumptive evidence of tuberculosis; (3) suggestive of tuberculosis; and (4) negative for tuberculosis. 18 of the 31 FNACs (58%) revealed a positive diagnosis of tuberculosis (definite evidence in nine patients and presumptive evidence in nine patients). 13 of the 31 FNACs (42%) showed either necrosis alone (n = 4) or negative results (n = 9). Zeihl-Neelson staining for acid-fast bacilli on direct smear was positive in only nine patients (29%). Splenic and lymph nodal FNAC had a high sensitivity (87.5% and 78.6%, respectively) in the diagnosis of tuberculosis. None of the bowel and liver FNACs was diagnostic. No complications were encountered. US guided FNAC offers a safe and accurate method of achieving a diagnosis in patients with suspected abdominal tuberculosis who present with radiologically demonstrable but non-palpable lesions, especially those involving lymph nodes and spleen.

Abdomen↗
PubMed1998

Percutaneous treatment of liver abscesses: needle aspiration versus catheter drainage.

OBJECTIVE: This study was designed to determine and compare the efficacy of sonographically guided percutaneous needle aspiration and percutaneous catheter drainage in the treatment of liver abscesses. SUBJECTS AND METHODS: In a randomized study, 50 patients (38 males and 12 females; age range, 2-72 years; average age, 35 years) with liver abscesses (amebic, 20; pyogenic, 11; indeterminate, 19) underwent either percutaneous needle aspiration (n = 25) or catheter drainage (n = 25) along with appropriate antimicrobial therapy. In patients assigned to the needle aspiration group, an 18-gauge needle was used to aspirate the abscess cavity. Repeated aspiration was attempted only once in each patient not responding to the first aspiration; nonresponse to the second aspiration was considered failure of treatment, and these patients were given catheter drainage (however, these patients were not included in the catheter drainage group). For catheter drainage, 8- to 12-French catheters were introduced into the abscess cavity using the Seldinger technique. In patients with multiple abscesses (seven in aspiration group and five in catheter group), all the abscesses except those smaller than 3 cm were subjected to percutaneous treatment. Patients were followed up to assess the outcome of the percutaneous treatment, length of hospital stay, and development of any complications. Sonography was performed every third day during hospitalization. After discharge of the patient, periodic clinical and sonographic examinations were done until total resolution of abscesses was achieved. RESULTS: Although percutaneous needle aspiration was successful in only 15 (60%) of the 25 patients after one (n = 11) or two (n = 4) aspirations, catheter drainage was curative in all 25 patients (100%) (p < .05). Among the successfully treated patients, the average time for clinical improvement and the mean hospital stay were similar in the two treatment groups. Although the average time needed for a 50% reduction in the size of the abscess cavity was significantly (p < .05) greater in the aspiration group than in the catheter group (11 days versus 5 days), the average time taken for total resolution of abscess was the same (15 weeks) in both groups. No major complications were encountered. No relapse was documented on clinical and sonographic examination during follow-up, which ranged from 8 to 37 weeks. CONCLUSION: Our results show that percutaneous catheter drainage is more effective than needle aspiration in the treatment of liver abscesses. Needle aspiration, if limited to two attempts, has a high failure rate.

Adolescent↗
PubMed1998

Sonographically guided fine-needle aspiration biopsy of superior mediastinal lesions by the suprasternal route.

OBJECTIVE: Our objective was to assess the technical feasibility, safety, and accuracy of sonographically guided fine-needle aspiration biopsy of superior mediastinal masses by the suprasternal route. CONCLUSION: Sonographically guided biopsy through the suprasternal route is safe and effective for lesions in the pretracheal, right paratracheal, and prevascular compartments of the superior mediastinum. This procedure is especially useful for lesions with an acoustic window too small for parasternal biopsy under sonographic guidance.

Adolescent↗
PubMed1997

Ilio-psoas abscesses: percutaneous drainage under image guidance.

Over a 5-year period, 56 psoas abscesses occurring in 51 patients were managed by image-guided percutaneous drainage, either by needle aspiration (n = 10) or by catheter drainage (n = 46) in conjunction with medical therapy. Twenty-seven patients had tuberculous abscesses (bilateral in five) while 24 patients had pyogenic abscesses. Percutaneous treatment was successful in 16 of the 24 patients (66.7%) with pyogenic abscesses. The reasons for failure were co-existent bowel lesions, phlegmonous involvement of muscle without liquefaction, multiloculated abscess cavity and thick tenacious pus not amenable to percutaneous drainage. Surgery was required in seven patients, either for failed percutaneous drainage or for the management of co-existent disease. Percutaneous drainage was initially successful in all 27 patients of tuberculous psoas abscesses. However, eight patients presented with recurrence requiring repeat intervention. The average duration of catheter drainage was longer in patients with tuberculous abscess (11 days) than in patients with pyogenic abscess (6 days). Percutaneous drainage under image guidance provides an effective and safe alternative to more invasive surgical drainage in most patients with psoas abscesses.

Adolescent↗
PubMed1997

Percutaneous nephrostomy with real-time sonographic guidance.

PURPOSE: Percutaneous nephrostomy (PCN) is an effective method for achieving temporary drainage of the obstructed urinary system and is usually performed under fluoroscopic guidance alone or more commonly under combined sonographic and fluoroscopic guidance. We undertook a retrospective analysis of 273 PCNs performed solely under ultrasound (US) guidance with the aim of evaluating the technique and the safety and efficacy of the procedure. MATERIAL AND METHODS: A total of 273 PCN procedures in 267 patients were performed under real-time US guidance using the Seldinger technique. The indications for PCNs comprised benign (n = 215) and malignant (n = 46) urinary obstruction, and urinary fistulae (n = 6). RESULTS: PCN was successful in 269 of the 273 attempts (98.5%). Satisfactory catheter placement was achieved in 245 of the 269 procedures (91.1%) under US guidance. Fluoroscopic assistance for catheter repositioning was required in 24 PCNs owing to the unsatisfactory position of the catheter tip. Major complications occurred in 15 patients (5.6%). Catheter dislodgement and catheter blockage was seen in respectively 12.6% and 3.3% of procedures. CONCLUSION: In most patients, PCN can be performed safely using real-time sonographic guidance.

Adolescent↗
PubMed1997

Computed tomography features of lung parenchymal changes in pulmonary tuberculosis.

Twenty-five patients with active pulmonary tuberculosis were prospectively studied with CT. Three major parenchymal patterns were noted. The nodular opacities pattern was seen in all cases. Confluent consolidation was seen in 37% of patients and consolidation with associated loss of volume (CWALV) was seen in 69% of patients. High-resolution CT (HRCT) features of bronchogenic spread included (i) a centrilobular nodule or a branching linear structure (92.3%); (ii) bronchial wall thickening (61.5%); (iii) a 'tree in bud' appearance (92.3%); and (iv) poorly marginated 5-8 mm nodules (61.5%). Most of the patterns showed satellite lesions in the form of small nodules or peripheral areas of increased attenuation. Cavitation was most common in CWALV lesions. Bronchiectasis was a common accompaniment (81.3%), and its occurrence paralleled the distribution of parenchymal lesions. Associated pleural thickening was noted in half the cases. To conclude, distinctive parenchymal changes were noted with CT in cases of pulmonary tuberculosis, which may suggest the diagnosis in the appropriate clinical setting.

Adult↗
PubMed1997

Wegener's presenting as submandibular swelling.

We describe a patient in whom bilateral swelling of submandibular glands was the initial manifestation of limited Wegener's disease. The diagnosis was based on positive anti-neutrophil cytoplasmic antibody [C-ANCA], dense inflammatory infiltrate predominantly of lymphocytes in submandibular glands, presence of non-caseating ill-formed granulomas in transbronchial biopsy and resolution of symptoms following immuno-suppressive treatment.

Antibodies, Antineutrophil Cytoplasmic↗
PubMed1997

Combined percutaneous-endoscopic approach for biliary endoprosthesis placement.

A nonoperative method of palliation was used in four patients with malignant obstructive jaundice in whom biliary endoprosthesis could not be placed endoscopically. A guide wire was manipulated through the lesion by a percutaneous transhepatic route and retrieved from the duodenum through an endoscope. A 10 Fr stent was then passed through the endoscope over the guide wire across the stricture. The procedure was successful in all four patients, with no complication.

Aged↗
PubMed1996

Bisphosphonates induce apoptosis in mouse macrophage-like cells in vitro by a nitric oxide-independent mechanism.

Bisphosphonates (BPs) are an important class of antiresorptive drugs used in the treatment of bone diseases, including osteoporosis. Although their mechanism of action has not been identified at the molecular level, there is substantial evidence that BPs can have a direct effect on osteoclasts by mechanisms that may lead to osteoclast cell death by apoptosis. BPs can also inhibit proliferation and cause cell death in macrophages in vitro. We have now shown that the toxic effect of BPs on macrophages is also due to the induction of apoptotic, rather than necrotic, cell death. Morphological and biochemical features that are definitive of apoptosis (chromatin condensation, nuclear fragmentation, and endonuclease-mediated internucleosomal cleavage of DNA) could be identified in mouse macrophage-like J774 and RAW264 cells, following treatment with 100 microM pamidronate, alendronate, and ibandronate for 24 h or more. Clodronate was much less potent, even at 2000 microM, while 2000 microM etidronate did not cause apoptosis. Apoptosis was not due to increased synthesis of nitric oxide and could not be prevented by inhibitors of nitric oxide synthases. Since macrophages, like osteoclasts, are particularly susceptible to BPs, these observations support the recent suggestion that the mechanism by which BPs inhibit bone resorption may involve osteoclast apoptosis. Furthermore, the macrophage-like cell lines used in this study may be a convenient model with which to identify the molecular mechanisms by which BPs promote apoptosis in osteoclasts. Induction of macrophage apoptosis by BPs in vivo may also account, at least in part, for the anti-inflammatory properties of BPs as well as the ability of BPs to cause an acute phase response.

Alendronate↗
PubMed1996

Diagnostic criteria for Takayasu arteritis.

Diagnosis of Takayasu arteritis (TA) is often delayed because of a non-specific clinical presentation. Ishikawa's criteria (1988) has been widely used for the diagnosis of this disease. Few modifications have been proposed in Ishikawa's criteria for the diagnosis of TA. The proposed modifications include: (a) removal of the obligatory criteria of age less than 40 years; (b) inclusion of characteristic signs and symptoms as a major criteria; (c) removal of age in defining hypertension; (d) deletion of the absence of aorto-iliac lesion, in defining abdominal aortic lesion; and (e) an addition of coronary artery lesion in absence of risk factors. The criteria proposed consists of three major criteria including left and right mid subclavian artery lesions and characteristic signs and symptoms of at least one month duration and ten minor criteria-a high erythrocyte sedimentation rate, carotid artery tenderness, hypertension, aortic regurgitation or annuloaortic ectasia, pulmonary artery lesion, left mid common carotid lesion, distal brachiocephalic trunk lesion, descending thoracic aorta lesion, abdominal aorta lesion and coronary artery lesion. Presence of two major or one major and two minor criteria or four minor criteria suggests a high probability of TA. When applied to 106 Indian patients of angiographically proven TA and 20 control subjects, it had a sensitivity of 92.5% and specificity of 95% that was higher than that of Ishikawa's criteria (sensitivity 60.4%, specificity 95%) and American college of Rheumatology criteria (sensitivity 77.4%, specificity 95%). Similarly, this criteria had a 96% sensitivity and 96% specificity in 79 Japanese patients of TA and 79 control subjects. Adoption of these criteria is expected to prevent the possibility of an under diagnosis of TA.

Adult↗
PubMed1996

Radiology of pancreatic tuberculosis: a report of three cases.

We report three cases of biopsy proven pancreatic tuberculosis. The patients presented with abdominal pain and intermittent fever. Ultrasound and computed tomography revealed a diffusely enlarged pancreas with focal hypoechoic/hypodense lesions in all three patients. In addition, one patient had a large pancreatic cyst with internal echoes. Associated findings included peripancreatic and mesenteric lymph nodes, bowel wall thickening of ileocecal junction, focal hepatic or splenic lesions, splenic vein thrombosis, and ascites. Pancreatic tuberculosis should be considered in the differential diagnosis of focal pancreatic lesions, especially if associated with ancillary findings such as enlarged hypodense nodes in the peripancreatic region or in the mesentery in patients presenting with longstanding fever and abdominal pain.

Adult↗