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Biomedical subjects

V P Kumar

Publications and source records attributed to V P Kumar.

At least 73 records · Page 4Linked to original sources
PubMed1992

Soft tissue "rheumatism" in sports.

Pain and stiffness of the injured region after prolonged periods of inactivity is commonly encountered following soft tissue injuries in sports. The injury in most of these instances is due to stress failure although occasionally an acute injury with a protracted course in recovery may develop similar symptoms. The most common of these condition are the enthesopathies, that include tendonitis and fasciitis, sprains and strains, bursitis, tenovaginitis and the fibrositis syndrome.

Athletic Injuries↗
PubMed1992

The Hitchcock procedure. A cause for failure: a case report.

A 40-year-old man with a tenodesis of the long head of the biceps brachii in the bicipital groove (Hitchcock's operation) for bicipital tendinitis had recurrence of pain seven months after the operation. Roentgenograms of the acromiohumeral interval, taken when the patient tensed the biceps brachii, showed significant upward migration of the humeral head with a decrease in the acromio-humeral interval on the operated side. The authors postulate that resection of the stabilizing, intraarticular segment of the long head of the biceps in the Hitchcock's procedure allowed the short head to draw the humeral head proximally, resulting in a decrease in the acromiohumeral interval and recurrence of impingement. This is one possible explanation for the poor long-term results of the Hitchcock procedure.

Adult↗
PubMed1991

Surgical management of non-union of neglected fractures of the patella.

Three cases of non-union of the patella with large gaps between the fragments are presented. The patients' ability to cope with the problem was not entirely satisfactory. Surgical management by mobilization of the patellar fragments and fixation using the tension band principle achieved union of the fracture in all three cases. The patients also recovered an excellent, pain-free range of movement and strength in the affected knees.

Adult↗
PubMed1991

Pregnanes that bind to the digitalis receptor: synthesis of 14-hydroxy-5 beta,14 beta-pregnane glycosides from digitoxin and digitoxigenin.

The preparation of the mono-, bis-, and trisdigitoxosides of 14-hydroxy-5 beta,14 beta-pregnan-20-one and 14,20 beta-dihydroxy-5 beta,14 beta-pregnane by two routes, based on the conversion of the alpha,beta-unsaturated gamma-lactone in digitoxin to the 20-ketone and 20 beta-alcohol by ozonolysis and zinc-acetic acid treatment followed by lithium tri-tert-butoxyaluminum hydride reduction, are described. Synthesis of the alpha-L-rhamnoside derivatives is described also. Structures were confirmed by 1H and 13C NMR spectra. These derivatives show strong interaction with the cardiac glycoside receptor of heart muscle in an [3H]ouabain radioligand binding assay. Structure-activity relationships which are reported for glycosides and genins show that the alpha-L-rhamnoside derivatives are more potent than the beta-D-digitoxoside or the beta-D-glucoside and that the beta-D-glucosides are more potent than the mono-, bis-, and trisdigitoxosides. Potency is not increased by the addition of the second and third digitoxose units.

Digitalis↗
PubMed1991

Surgical management of arthritis.

The progression and manifestations of arthritis can to a large extent be controlled by medical measures. In the instance of inflammatory arthritis surgical synovectomy may have to be undertaken to control the disease. Once the arthritis has resulted in significant damage to the joints surgical intervention may be the only means of providing relief of pain and restoring function to the affected limb. Arthroplasty, arthrodesis, debridement and osteotomy remain the most used surgical procedures to achieve this.

Arthritis↗
PubMed1990

Stress fractures around the knee in elderly patients. A cause of acute pain in the knee.

A review of the cases of sixteen elderly patients who had eighteen stress fractures around the knee revealed that thirteen fractures had been misdiagnosed, which led to inappropriate management of six. The most frequent factor contributing to misdiagnosis was the presence of other abnormalities of the knee for which the patient had previously consulted the physician. Conservative treatment with rest, walking aids, and, for some patients, splinting of the extremity resulted in relief of pain and healing of the fracture. A careful clinical assessment that includes new radiographs and, if necessary, bone scans is essential for early diagnosis in patients who have acute, incapacitating pain in the knee.

Aged↗
PubMed1989

Cardiac glycoside-like structure and function of 5 beta,14 beta-pregnanes.

5 beta-Reduction and 14 beta-substitution convert the planar progesterone molecule to the cardiac glycoside configuration--A and D rings of the steroid moiety are bent toward the alpha-face relative to the B and C rings. Potency of the 5 beta,14 beta-derivative in a [3H]ouabain binding assay or its ability to inhibit the sodium pump in red blood cells is enhanced by 3 beta-hydroxylation, 20 beta-hydroxylation, and 3 beta-glycosidation. Synthesis of 14,20 beta-dihydroxy-3 beta-(beta-D-glucopyranosyloxy)- 5 beta,14 beta-pregnane from digitoxin is described. The glucoside is 1/20 as potent as ouabain and elicits prominent, sustained, positive inotropy in isolated cardiac muscle.

Animals↗
PubMed1989

The role of the long head of biceps brachii in the stabilization of the head of the humerus.

The role of the tendon of the long head of the biceps in the stabilization of the head of the humerus was studied in 15 freely hanging anatomic specimen shoulders. Upward migration of the humeral head was measured by noting any reduction in the acromiohumeral distance in roentgenograms of the shoulder. There was a statistically significant decrease in the acromiohumeral interval on tensing the short head of biceps, but there was no significant change in the interval on tensing either the long head or both heads of the biceps brachii. Severing the tendon of the long head while both the heads were tensed caused a significant upward migration of the head of the humerus. One of the important functions of the long head of the biceps is to stabilize the humeral head in the glenoid during powerful elbow flexion and forearm supination by the main muscle. Sacrifice of the intraarticular segment of this tendon in surgical procedures of the shoulder may produce instability and dysfunction.

Arm↗
PubMed1988

The arteriovenous pattern of the distal digital segment.

By injection of eosin dye with latex into 45 cadaveric fingers we were able to demonstrate: (1) a distinct digital pulp arch formed by the ulnar and radial digital arteries over the mid-point of the terminal phalanx in 93% of digits; (2) variations in size of the proper digital arteries to each digit; (3) numerous branches from the pulp arch to the tip of each digit and (4) a constant pattern of dorsal veins over the terminal segment in 89% of digits.

Aged↗
PubMed1988

Free vascularised epiphyseal transplantation in upper extremity reconstruction.

We describe preliminary observations on the use of free vascularised transfer of proximal fibular epiphysis in replacement of proximal humeral epiphysis or distal radial epiphysis in three patients. An analysis of the early results shows evidence of longitudinal growth, graft hypertrophy and epiphyseal adaptation in transplanted epiphysis. A review of the problems in this type of surgery is included.

Arm↗
PubMed1988

14 beta-Hydroxyprogesterone binds to the digitalis receptor, inhibits the sodium pump and enhances cardiac contractility.

1. Certain derivatives of progesterone are potent inhibitors of high affinity, specific binding of 3H-cardiac glycosides. The steroids interact at the cardiac glycoside site on Na,K-ATPase and inhibit the enzyme (the sodium pump) in cardiac and other tissues. However, the active congeners identified previously have been, unlike the cardiac glycosides, predominantly cardiodepressant. 2. Because a 14 beta-hydroxy substituent is an important determinant of activity of the cardiotonic cardiac glycosides, we synthesized 14 beta-hydroxyprogesterone. This derivative has about one-tenth the potency of the aglycone, ouabagenin, in a [3H]-ouabain binding assay. 3. Like ouabagenin, but in contrast to the cardiodepressant congeners of progesterone, 14 beta-hydroxyprogesterone consistently elicited positive inotropy in isolated cardiac muscle and enhanced both the magnitude and frequency of fluctuations in scattered light (an index of oscillatory intracellular release of calcium). 4. Thus, at least one hydroxylated derivative (and putative endogenous metabolite) of progesterone, mimics the cardiac effects of cardiac glycosides including enhanced contractility.

Adult↗
PubMed1988

Digitalis-like pregnanes. Cardiac and renal effects of a glycoside of 14 beta-hydroxyprogesterone.

The synthesis of the glucoside, 3 beta-[(beta-D-glucopyranosyl)oxy]-14-hydroxy-14 beta-pregn-4-en-20-one, a 14 beta-hydroxyprogesterone glucoside (14 beta-OHP-glu), is described. This compound has an IC50 of 1 microM in a [3H]ouabain binding assay, and is about 10 times more potent than the aglycone. Like 14 beta-hydroxyprogesterone, the glucoside enhances contractility of isolated cardiac muscle. 14 beta-OHP-glu or ouabain, when infused at comparable doses into the renal artery of the anesthetized rat, markedly increases urine volume. Whereas ouabain significantly enhances urinary potassium excretion with little or no effect on sodium excretion, 14 beta-OHP-glu promotes a marked natriuresis with no significant effect on potassium excretion.

Animals↗
PubMed1988

Surgical treatment of primary tumours of the innominate bone.

9 cases of primary malignant tumours of the pelvis were treated in our department from 1981 to 1987. There was three chondro-sarcomas, one giant cell tumour and five had soft tissue tumours. One has a classical hemipelvectomy while eight had limb preservation surgery performed. In this later group., three had type I (Enneking) resection, three combined type II/III and one a type III resection. Four patients have died since and three deaths were related to surgery and its complications. As to date, no local recurrences has occurred in those living (up to 7 years' follow up). We feel that local resection with limb preservation provides adequate local control of tumour. Various reconstructive procedures to cover skin defects, and reconstruct stability of the pelvis or create hip stability were also performed. Patients with no previous irradiation has less mobidity and tend to do well.

Adolescent↗