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Biomedical subjects

V Reddy

Publications and source records attributed to V Reddy.

At least 91 records · Page 5Linked to original sources
PubMed1996

Cutaneous and subcutaneous masses of the chest wall: a fine-needle aspiration study.

Primary cutaneous and subcutaneous neoplasms of the chest wall are uncommon. However, metastatic tumors involving this region may be seen in local recurrence, widespread metastases, or as the first manifestation of an occult malignant neoplasm. We report a series of 81 fine-needle aspirations (FNA) of cutaneous and subcutaneous masses involving the chest wall of 45 males and 36 females (age range 32-89 yr, mean 63 yr). Sixty-nine patients (85%) have a previous history of malignancy. The most common sites of the primary malignancy are breast (n = 32, 46%), lung (n = 19, 26%), head and neck (n = 6, 9%). Of these 69 aspirates, 65 (94%) are malignant and consistent with patients' primaries; two (3%) are benign aspirates, and two (3%) are unsatisfactory for cytologic evaluation. The remaining 12 (15%) aspirates from patients with no previous history of malignancy reveal 10 (84%) occult malignancies, and two (16%) benign entities. The malignant cases consist of nine (90%) metastatic epithelial neoplasms of unknown primary origin, and one (10%) primary soft-tissue sarcoma. In summary, this study demonstrates that the majority of cutaneous and subcutaneous masses of the chest wall subjected to FNA are neoplastic. FNA is an effective technique for primary assessment of these lesions.

Adult↗
PubMed1996

Gastrointestinal complications after orthotopic cardiac transplantation.

OBJECTIVE AND METHODS: A retrospective chart review was performed on all patients undergoing orthotopic cardiac allograft transplant at Oregon Health Sciences University. Our purpose was to evaluate the incidence of gastrointestinal complications in these patients, and to assess the effect of immunosuppression. RESULTS: From December, 1985, to June, 1994, 240 recipients underwent 250 orthotopic cardiac allograft transplants at Oregon Health Sciences University with a 30 day mortality of 15 patients (6.3 +/- 3.0%). Of the 225 operative survivors, the follow-up ranges from 1.0 month to 8.8 years with a mean of 39.9 +/- 1.9 months. In our population of late survivors, 21 recipients (9.3%) have had gastrointestinal complications (GIC). Hepatobiliary (29%), peptic ulcer (14%), and pancreatic (14%) complications were the most prevalent. Surgical intervention was required in 19 patients (90%). Twelve procedures (63%) were either emergently or urgently performed, and seven procedures (37%) carried out electively. Operative mortality was 33% in those patients with an emergent or urgent intervention. There was no operative mortality among those who had an elective procedure. CONCLUSION: Maintenance prednisone dose was higher in patients with GIC than in those patients without GIC, 16.1 +/- 2.5 mg versus 7.3 +/- 0.2 mg (P = 0.001), respectively. However, immunosuppression therapy for rejection episodes (i.e., Solumedrol megapulse or OKT3 therapy) was not related to an increased incidence of GIC. We present a review of our 21 cardiac transplant recipients to emphasize the potential for severe GIC and their corresponding perioperative morbidity and mortality.

Adolescent↗
PubMed1996

Atrial switch (Senning procedure) in the era of the arterial switch operation: current indications and results.

OBJECTIVE: Since 1990, the policy at Oregon Health Sciences University is to perform an arterial switch for all patients with transposition of the great arteries. In the last four years we have performed the Senning operation in two patients. Our impression is that the long-term results with Senning procedure at our center are quite good. This prompted a review of our experience with this procedure. METHODS: A retrospective review of all patients' charts was undertaken to document preoperative and operative clinical variables. During follow-up, emphasis was placed on reviewing all cardiology clinic charts, transthoracic echocardiograms and ambulatory holter monitor logs. Transthoracic echocardiograms and 24 hour Holter monitoring were performed yearly on all patients during follow-up. RESULTS: Since September, 1982, 54 patients underwent the Senning operation for transposition of the great arteries. All patients were palliated at birth with the Rashkind atrial septostomy. The interatrial septum was reconstructed with a dacron patch, and the systemic and pulmonary venous baffles were constructed with autogenous atrial tissue. All but 2 patients underwent profound hypothermia and total circulatory arrest during their operative repair. Of 54 patients, early mortality occurred in 5 patients (9%). Follow-up is complete for the 49 operative survivors. The length of follow-up ranges from 6.0 months to 12.1 years (mean 6.4 +/- 0.5 years). There are no late deaths. Forty-five patients (94%) are in NYHA Class I. All late survivors are in sinus rhythm with brief episodes of junctional rhythm (32 patients). CONCLUSIONS: Our series demonstrates that the Senning operation can be safely performed in early infancy. Further, it provides excellent symptomatic and clinical outcomes during late follow-up. Thus, in the era of the arterial switch procedure, close and complete late follow-up results with the Senning procedure, as in this series, should be considered the benchmark in the continued evaluation of the arterial switch operation.

Arteries↗
PubMed1996

Specificity C and e: tests using Rh variant cells.

Monoclonal antibodies, specificity C, e, and Rh subgroup? ein the Section 1-Rh were tested with selected blood samples of various Rh variant types in KwaZulu-Natal, South Africa. The standard red cell serological techniques supplied were used.

Antibodies, Monoclonal↗
PubMed1996

Tuberculosis outbreak in a Texas prison, 1994.

In 1994 a Texas prison containing a population of mentally retarded inmates experienced a large tuberculosis outbreak. Fifteen cases of tuberculosis were identified (8 confirmed by positive cultures for Mycobacterium tuberculosis) and more than 100 inmates became infected. The culture-confirmed patients were infected with an identical strain of tuberculosis as demonstrated by polymerase chain reaction (PCR) based DNA fingerprinting technique. The prison followed standard tuberculosis infection control policies, but these controls were inadequate to prevent tuberculosis transmission in this special population. Two hundred and thirty inmates (119 inmates showing evidence of new tuberculosis infection or active disease and 111 healthy controls) were enrolled in the investigation. Inmate cell assignments, job duties, and educational classes were identified and medical chart reviews were conducted on all inmates. Tuberculosis transmission was associated with residing on the D Wing of the prison (OR = 25.84, P < 0.01), attending school in Classroom A (OR = 8.34, P = 0.01) and working on the prison utility work crew (OR = 2.52, P < 0.01). The index case in the outbreak had been prescribed 6 months of isoniazid (INH) chemoprophylaxis in 1988.

Case-Control Studies↗
PubMed1996

DNA fingerprinting by infrequent-restriction-site amplification.

Identification of bacterial strains by DNA fingerprinting facilitates epidemiologic studies and improves disease control. For some species of organisms, no typing method is available; for others, typing methods are tedious. We developed a method of amplifying DNA sequences flanking infrequent restriction sites by PCR and used the method to produce strain-specific electrophoretic patterns from crude bacterial lysates. This method of fingerprinting is rapid, sensitive, and widely applicable. Identical enzymes, adaptors, primers, and PCR conditions were used to characterize 32 Mycobacterium avium-M. intracellulare isolates, 4 Pseudomonas aeruginosa isolates, and 4 Staphylococcus aureus isolates.

DNA Fingerprinting↗
PubMed1996

Detection of Mycobacterium tuberculosis in cerebrospinal fluid following immunomagnetic enrichment.

The detection of Mycobacterium tuberculosis by culture of cerebrospinal fluid (CSF) is unacceptably slow. Low numbers of organisms and the presence of reaction inhibitors may prevent detection of M. tuberculosis by PCR. We used immunomagnetic enrichment to accelerate and enhance the detection of mycobacteria in CSF after demonstrating the utility of the method with pure suspensions. Growth was detected earlier in Bactec cultures of magnetically recovered mycobacteria than in untreated CSF (7 versus 15 days). We detected M. tuberculosis DNA by PCR in the immunomagnetically enriched sample but not in untreated CSF. PCR fingerprintings of the immunomagnetically recovered M. tuberculosis and of the isolate subsequently recovered by culture were identical.

Adult↗
PubMed1996

Culturally appropriate measures for monitoring child development at family and community level: a WHO collaborative study.

Culturally appropriate techniques for monitoring child psychosocial development were prepared and tested in China, India and Thailand on a total of 28,139 children. This is the largest study of its kind ever undertaken. Representative groups aged between birth and 6 years were examined and the results were used to produce national development standards-separately for rural and urban children in China and India, and for all children combined in Thailand-which are considered to be more satisfactory than foreign-based standards. In each country, between 13 and 19 key milestones of psychosocial development were selected for a simplified developmental screening operation and these have been incorporated on a home-based record of a child's growth and development. Between 35 and 67 tests have been devised in each country to test the children at first-referral level.

Child↗
PubMed1996

Incidence of post-transplant malignancy among 674 solid-organ-transplant recipients at a single center.

We evaluated the post-transplant course of the entire solid-organ-transplant population at our institution to determine the frequency, incidence and specific type of post-transplant malignancies which occurred at a single center. Of 674 solid-organ-transplant recipients (305 renal, 307 heart, 54 lung, 8 heart/lung), we detected 79 malignancies (48 heart, 28 renal, 2 lung, 1 heart/lung), representing an overall cancer frequency of 11.7%, 15.6% for heart and 9.2% for renal transplant recipients. The frequency in both transplant groups was higher than that reported previously in the multicenter data in the literature (about 6%); we also noted a shorter interval to malignancy (27 vs. 61 months). The most common malignancies overall were skin/lip carcinomas and post-transplant lymphoproliferative disorder (PTLD). The frequency of PTLD was higher in non-renal (6.5%) than renal (0.7%) transplant recipients and statistical analysis confirmed a significant higher incidence of all malignancies (p = 0.0032) and of PTLD (p = 0.0001) in heart and lung recipients as opposed to renal transplant recipients. The frequency of total skin/lip carcinomas was essentially equal in the heart and renal transplant groups (6%), and statistical analysis showed no significant difference in incidence of this general type of malignancy; however, there was a marked disparity in interval to squamous cell carcinoma (SCC) between renal and heart transplant recipients (27 versus 59 months). This was associated with an apparent increase in the rate of occurence of SCC after 60 months in heart transplant recipients, a finding not previously reported in the multicenter data in the literature. We did not demonstrate a significant effect of the withdrawal of prophylactic OKT3 from the immunosuppression regimen of heart transplant recipients on the incidence of all tumors, PTLD or skin/lip tumors.

Aged↗
PubMed1995

Three-dimensional quantitative structure-activity relationships of somatostatin analogues. 1. Comparative molecular field analysis of growth hormone release-inhibiting potencies.

Somatostatin is a hypothalamic hormone that inhibits the release of growth hormone (GH). It has also been shown to inhibit the release of a broad range of hormones including insulin, glucagon, and gastrin. Presently, five different receptor subtypes of somatostatin have been characterized and cloned. Our previous work on the structure-activity relationship of somatostatin and that of many others has generated a large database of analogues with different biological activities and receptor affinities. This present work is an investigation of the growth hormone release-inhibiting potencies of somatostatin analogues by the three-dimensional quantitative structure-activity paradigm, comparative molecular field analysis (CoMFA). A total of 64 analogues were modeled in SYBYL using structural information from two NMR studies. The molecules were aligned by a root-mean-square fit of atoms and field-fit of the steric and electrostatic molecular fields and the resulting databases analyzed by partial least squares analysis with cross-validation to extract the optimum number of components. The analysis was then repeated without cross-validation to give the final QSAR models. Preliminary investigations with the CoMFA models led to the synthesis of a new somatostatin analogue. This compound together with five other newly synthesized compounds not included in the original training sets were used to test the predictive ability of the CoMFA models. Two models with good predictive powers are presented.

Amino Acid Sequence↗
PubMed1995

Usefulness of the American College of Rheumatology recommendations for liver biopsy in methotrexate-treated rheumatoid arthritis patients.

OBJECTIVE: To test the usefulness and cost savings resulting from application of the new American College of Rheumatology (ACR) guidelines for assessing the risk for the development of clinically significant liver disease in rheumatoid arthritis (RA) patients treated with methotrexate (MTX). METHODS: One-hundred twelve MTX-treated RA patients were prospectively followed up for MTX hepatotoxicity and underwent liver biopsies according to modified guidelines of the Psoriatic Task Force (PTF). All biopsies were graded according to the Roenigk classification. The new ACR recommendations were then retrospectively applied to test their usefulness and cost-effectiveness in this cohort. RESULTS: Based on the PTF guidelines, 66 patients underwent liver biopsies; a total of 110 liver biopsies were performed. Two patients had biopsy-related complications. Five patients were found to have Roenigk grade IIIB or IV histologic abnormalities. The total cost for this group was $111,380. Applying the new ACR criteria, only 15 patients would have undergone liver biopsies; there would have been a total of 18 biopsies, with no complications. Four of the 5 patients with Roenigk grade IIIB or IV liver abnormalities would have been identified. One patient with insulin-dependent diabetes mellitus (IDDM) who was found to have cirrhosis (Roenigk grade IV) on liver biopsy as a result of use of the PTF guidelines would have been missed with use of the ACR guidelines. The total cost for the group receiving biopsies based on the ACR guidelines would have been $16,956. Overall, the new ACR guidelines had 80% sensitivity and 82% specificity and resulted in a cost savings of $1,430 per patient. CONCLUSION: The new ACR guidelines on MTX monitoring and biopsy surveillance appear to be clinically useful and result in considerable cost savings. However, 1 IDDM patient with significant liver histologic abnormalities would have been missed. We suggest that IDDM be added to the ACR guidelines as a risk factor for MTX hepatotoxicity.

Adult↗
PubMed1995

Palmolein and groundnut oil have comparable effects on blood lipids and platelet aggregation in healthy Indian subjects.

Substitution of palmolein (POL) for groundnut oil (GNO) doubles saturated fatty acids and decreases by half the linoleic acid (18:2n-6) content of Indian diets. The effects of this substitution on selected parameters of cardiovascular risk and membrane functions were studied in middle-aged subjects. Both metabolic (short-term) and "in-home" (long-term) studies were conducted, and the subjects were crossed over from GNO to POL or vice versa. During both studies and in both sexes, blood pressure, plasma levels of total cholesterol and triglycerides and their distributions in various lipoprotein fractions were not altered. The lower 18:2n-6 and higher 16:0 intakes were reflected in fatty acid compositions of cholesteryl esters and triglycerides. However, the plasma and platelet phospholipid fatty acid patterns did not shift toward saturation. The observation that the levels of long-chain polyunsaturated fatty acids in phospholipids were similar at the end of GNO and POL regimens indicates that 18:2n-6 furnished during POL regimen may be sufficient to maintain the levels of arachidonic acid in cell membranes. Platelet aggregation, erythrocyte membrane fluidity, and activity of Na+, K+ ATPase, a membrane-bound enzyme, were essentially similar at the end of the two oil regimens. These results indicate that POL is comparable to GNO and may not induce hypercholesterolemia in Indian subjects consuming cereal-based diets containing 30% total fat calories and low cholesterol.

Adult↗
PubMed1995

Comparative results of transluminal extraction coronary atherectomy in saphenous vein graft lesions with and without thrombus.

OBJECTIVES: The purpose of this retrospective study was to compare the results of transluminal extraction coronary atherectomy in saphenous vein graft lesions with and without angiographic thrombus. BACKGROUND: Percutaneous interventions in lesions with thrombus are associated with reduced procedural success and increased risk of complications. Use of the transluminal extraction catheter, which cuts and aspirates atheroma and thrombus, has been advocated as a potential revascularization strategy for lesions with thrombus. METHODS: Baseline patient characteristics, lesion morphology, immediate angiographic results, in-hospital complications and follow-up were prospectively entered into an interventional cardiology data base. The results of transluminal extraction coronary atherectomy in saphenous vein bypass grafts with angiographic thrombus were compared with results in similar grafts without angiographic thrombus. RESULTS: Transluminal extraction coronary atherectomy was performed in 175 patients with 183 vein graft lesions, including 59 lesions (32%) with thrombus (Group 1) and 124 (68%) without thrombus (Group 2). Compared with lesions in Group 2, lesions in Group 1 were associated with a higher incidence of baseline total occlusion, diffuse disease and abnormal Thrombolysis in Myocardial Infarction (TIMI) grade flow (p < 0.05); more severe diameter stenosis at baseline, after atherectomy and after final angiography (p < 0.05); a lower rate of clinical success (69% vs. 88%, p < 0.01); and more angiographic and clinical complications, including no reflow (p < 0.05), vascular repair (p < 0.05) and Q wave myocardial infarction (p = 0.09). CONCLUSIONS: In transluminal extraction coronary atherectomy of saphenous vein bypass grafts, the presence of thrombus is associated with more baseline lesion complexity, reduced clinical success and increased risk of no reflow, Q wave myocardial infarction and vascular repair.

Aged↗
PubMed1995

Mucinous carcinoma of the eyelid. An immunohistochemical study.

Mucinous carcinoma is a rare primary eyelid malignancy. It is, however, more common in other sites and may metastasize to the eye. Thus, it is important to consider a distant primary when diagnosing mucinous carcinoma of the eyelid. We studied various immunohistochemical markers that may be useful. Two cases of mucinous carcinoma from the eyelid were reacted with antibodies to cytokeratins (35-beta-H11), carcinoembryonic antigen, S-100 protein, gross cystic disease fluid protein-15, alpha-lactalbumin, estrogen receptor, and progesterone receptor. All antigens were positive in both cases. This study shows that immunohistochemistry may help exclude metastatic mucinous carcinoma to the eyelid from many sites, except the breast, which the eyelid primary closely resembles. Thus, a breast primary should be specifically sought and excluded clinically.

Adenocarcinoma, Mucinous↗
PubMed1995

Scalp lesions. A review of histopathologic and fine-needle aspiration biopsy findings.

We reviewed surgical and cytological scalp specimens at Loyola University Medical Center over an 8-year period. The incidence and types of pathologic entities that appeared in the scalp were tabulated, and the roles of surgery and fine-needle aspiration biopsy (FNAB) were investigated. There were 352 patients with scalp tissue biopsies. There were 41 primary malignancies, and 3 metastatic carcinomas. FNAB specimens were obtained from 36 other patients. Of these, 29 specimens showed malignant cytology. All of these patients had a previous diagnosis of malignancy. Scalp tissue biopsy specimens were far more likely to have a benign diagnosis than were FNAB specimens (P < 0.00001). This difference is probably due to the patients' histories and referring physicians. Healthy patients with a scalp lesion will generally present to a dermatologist, who will obtain a tissue specimen. In contrast, a patient with a history of malignancy with a scalp lesion will follow up with an oncologist, who may prefer FNAB to surgical procedures in order to diagnose such a lesion rapidly. The scalp is a common repository for metastatic tumors, most likely due to its rich vascularity. Awareness of this fact can be useful to dermatologists or oncologists in selecting the better diagnostic procedure for a patient.

Adolescent↗