1
|
Patel PJ, Shah JS. Metformin pretreatment potentiates the antiproliferative action of doxorubicin against breast cancer. Ann Pharm Fr 2023:S0003-4509(23)00023-8. [PMID: 36907329 DOI: 10.1016/j.pharma.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 01/17/2023] [Accepted: 03/07/2023] [Indexed: 03/13/2023]
Abstract
OBJECTIVES The present study aimed to evaluate the effect of metformin pretreatment on the potentiation of antiproliferative action of doxorubicin against breast cancer. MATERIAL AND METHODS Female Wistar rats were administered with 7,12-Dimethylbenz(a)anthracene (DMBA) (35mg) in 1mL olive oil subcutaneously beneath the mammary gland. Animals were pretreated with metformin (Met) 200mg/kg two weeks before DMBA administration. DMBA control groups received doxorubicin (Dox) (4mg/kg and 2mg/kg), Met (200mg/kg) alone and in combination with Dox (4mg/kg). Met pre-treated DMBA control groups received Dox 4mg/kg and 2mg/kg. RESULTS Met pre-treated groups treated with Dox exhibited a decrease in tumor incidence, tumor volume and increased survival rate than the DMBA group. Organ-to-body weight ratios and histopathology of heart, liver and lungs of Met pre-treated groups treated with Dox showed lesser toxicity than Dox treated DMBA control groups. There was a noteworthy decrease in malondialdehyde levels and a substantial increase in the levels of reduced glutathione together with a significant decrease in the levels of inflammatory markers like IL-6, IL-1β and NF-κB in Met pre-treated groups treated with Dox. Histopathology of breast tumors revealed better control of tumors in Met pre-treated groups treated with Dox than DMBA control group. Immunohistochemistry and real-time PCR data revealed a significant reduction in Ki67 expression in Met pre-treated groups treated with Dox as compared to the DMBA control group. CONCLUSION The present study suggests that metformin pretreatment potentiates the antiproliferative action of doxorubicin against breast cancer.
Collapse
Affiliation(s)
- P J Patel
- Department of Pharmacology, Institute of Pharmacy, Nirma University, Ahmedabad, Gujarat, 382481, India.
| | - J S Shah
- Department of Pharmacology, Institute of Pharmacy, Nirma University, Ahmedabad, Gujarat, 382481, India.
| |
Collapse
|
2
|
Balaskas K, Glinton S, Keenan TDL, Faes L, Liefers B, Zhang G, Pontikos N, Struyven R, Wagner SK, McKeown A, Patel PJ, Keane PA, Fu DJ. Prediction of visual function from automatically quantified optical coherence tomography biomarkers in patients with geographic atrophy using machine learning. Sci Rep 2022; 12:15565. [PMID: 36114218 PMCID: PMC9481631 DOI: 10.1038/s41598-022-19413-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 08/29/2022] [Indexed: 11/18/2022] Open
Abstract
Geographic atrophy (GA) is a vision-threatening manifestation of age-related macular degeneration (AMD), one of the leading causes of blindness globally. Objective, rapid, reliable, and scalable quantification of GA from optical coherence tomography (OCT) retinal scans is necessary for disease monitoring, prognostic research, and clinical endpoints for therapy development. Such automatically quantified biomarkers on OCT are likely to further elucidate structure-function correlation in GA and thus the pathophysiological mechanisms of disease development and progression. In this work, we aimed to predict visual function with machine-learning applied to automatically acquired quantitative imaging biomarkers in GA. A post-hoc analysis of data from a clinical trial and routine clinical care was conducted. A deep-learning automated segmentation model was applied on OCT scans from 476 eyes (325 patients) with GA. A separate machine learning prediction model (Random Forest) used the resultant quantitative OCT (qOCT) biomarkers to predict cross-sectional visual acuity under standard (VA) and low luminance (LLVA). The primary outcome was regression coefficient (r2) and mean absolute error (MAE) for cross-sectional VA and LLVA in Early Treatment Diabetic Retinopathy Study (ETDRS) letters. OCT parameters were predictive of VA (r2 0.40 MAE 11.7 ETDRS letters) and LLVA (r2 0.25 MAE 12.1). Normalised random forest feature importance, as a measure of the predictive value of the three constituent features of GA; retinal pigment epithelium (RPE)-loss, photoreceptor degeneration (PDR), hypertransmission and their locations, was reported both on voxel-level heatmaps and ETDRS-grid subfields. The foveal region (46.5%) and RPE-loss (31.1%) had greatest predictive importance for VA. For LLVA, however, non-foveal regions (74.5%) and PDR (38.9%) were most important. In conclusion, automated qOCT biomarkers demonstrate predictive significance for VA and LLVA in GA. LLVA is itself predictive of GA progression, implying that the predictive qOCT biomarkers provided by our model are also prognostic.
Collapse
Affiliation(s)
- Konstantinos Balaskas
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust, UCL Institute of Ophthalmology, Moorfields Reading Centre and Clinical AI Hub, 162 City Rd, London, EC1V 2PD, UK.
| | - S Glinton
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust, UCL Institute of Ophthalmology, Moorfields Reading Centre and Clinical AI Hub, 162 City Rd, London, EC1V 2PD, UK
| | - T D L Keenan
- Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, MD, USA
| | - L Faes
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust, UCL Institute of Ophthalmology, Moorfields Reading Centre and Clinical AI Hub, 162 City Rd, London, EC1V 2PD, UK
| | - B Liefers
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust, UCL Institute of Ophthalmology, Moorfields Reading Centre and Clinical AI Hub, 162 City Rd, London, EC1V 2PD, UK
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - G Zhang
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust, UCL Institute of Ophthalmology, Moorfields Reading Centre and Clinical AI Hub, 162 City Rd, London, EC1V 2PD, UK
| | - N Pontikos
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust, UCL Institute of Ophthalmology, Moorfields Reading Centre and Clinical AI Hub, 162 City Rd, London, EC1V 2PD, UK
| | - R Struyven
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust, UCL Institute of Ophthalmology, Moorfields Reading Centre and Clinical AI Hub, 162 City Rd, London, EC1V 2PD, UK
| | - S K Wagner
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust, UCL Institute of Ophthalmology, Moorfields Reading Centre and Clinical AI Hub, 162 City Rd, London, EC1V 2PD, UK
| | - A McKeown
- Apellis Pharmaceuticals, Inc, Waltham, MA, USA
| | - P J Patel
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust, UCL Institute of Ophthalmology, Moorfields Reading Centre and Clinical AI Hub, 162 City Rd, London, EC1V 2PD, UK
| | - P A Keane
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust, UCL Institute of Ophthalmology, Moorfields Reading Centre and Clinical AI Hub, 162 City Rd, London, EC1V 2PD, UK
| | - D J Fu
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust, UCL Institute of Ophthalmology, Moorfields Reading Centre and Clinical AI Hub, 162 City Rd, London, EC1V 2PD, UK
| |
Collapse
|
3
|
Gemenetzi M, Lotery AJ, Patel PJ. Risk of geographic atrophy in age-related macular degeneration patients treated with intravitreal anti-VEGF agents. Eye (Lond) 2016; 31:1-9. [PMID: 27716750 DOI: 10.1038/eye.2016.208] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 08/20/2015] [Indexed: 02/07/2023] Open
Abstract
Anti-vascular endothelial growth factor (VEGF) intravitreal agents are the only successful treatment for wet age-related macular degeneration (AMD). However, there are emerging signals that anti-VEGF treatment can potentially increase development of geographic atrophy (GA). Histopathologic, animal, and clinical studies support this hypothesis although direct proof of a relationship between GA and use of anti-VEGF agents in neovascular AMD is not yet established. This review presents current evidence supporting an association between anti-VEGF therapy and progression of geographic atrophy. The need of exploring alternative methods of treating AMD is indirectly but clearly emphasized.
Collapse
Affiliation(s)
- M Gemenetzi
- NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - A J Lotery
- Division of Neurosciences, Faculty of Medicine, University of Southampton, Southampton, UK.,Eye Unit, Southampton University Hospital NHS Foundation Trust, Southampton, UK
| | - P J Patel
- NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| |
Collapse
|
4
|
McKibbin M, Devonport H, Gale R, Gavin M, Lotery A, Mahmood S, Patel PJ, Ross A, Sivaprasad S, Talks J, Walters G. Aflibercept in wet AMD beyond the first year of treatment: recommendations by an expert roundtable panel. Eye (Lond) 2016; 29 Suppl 1:S1-S11. [PMID: 26156564 PMCID: PMC4506328 DOI: 10.1038/eye.2015.77] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
This paper provides expert recommendations on administration of aflibercept in wet age-related macular degeneration (AMD) after Year 1 (Y1), based on a roundtable discussion held in London, UK in November 2014. The goals of treatment after Y1 are to maintain visual and anatomical gains whilst minimising treatment burden and using resources effectively. The treatment decision should be made at the seventh injection visit (assuming the label has been followed) in Y1, and three approaches are proposed: (a) eyes with active disease on imaging/examination but with stable visual acuity (VA) at the end of Y1 should continue with fixed 8-weekly dosing; (b) eyes with inactive disease on imaging/examination and stable VA should be managed using a 'treat and extend' (T&E) regimen. T&E involves treating and then extending the interval until the next treatment, by 2-week intervals, to a maximum of 12 weeks, provided the disease remains inactive. If there is new evidence of disease activity, treatment is administered and the interval to the next treatment shortened; and (c) if there has been no disease activity for ≥3 consecutive visits, a trial of monitoring without treatment may be appropriate, initiated at the end of Y1 or at any time during Y2. Where possible, VA testing, OCT imaging and injection should be performed at the same visit. The second eye should be monitored to detect fellow eye involvement. In bilateral disease, the re-treatment interval should be driven by the better-seeing eye or, if the VA is similar, the eye with the more active disease.
Collapse
Affiliation(s)
- M McKibbin
- Ophthalmology Department, St James's University Hospital, Leeds, UK
| | - H Devonport
- Ophthalmology Department, Bradford Royal Infirmary, Bradford, UK
| | - R Gale
- Ophthalmology Department, The York Hospital, York, UK
| | - M Gavin
- Ophthalmology Department, NHS Greater Glasgow and Clyde, UK
| | - A Lotery
- Southampton General Hospital, Southampton, UK
| | - S Mahmood
- 1] Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK [2] Centre for Ophthalmology & Vision Sciences, Institute of Human Development, University of Manchester, Manchester, UK
| | - P J Patel
- NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
| | - A Ross
- Bristol Eye Hospital, Bristol, UK
| | - S Sivaprasad
- NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
| | - J Talks
- Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - G Walters
- Department of Ophthalmology, Harrogate District Hospital, Harrogate, UK
| |
Collapse
|
5
|
Patel PJ, Bakker-Dyos J, McMenamin D. Winter Deployment 14 and 15: an audit of injury and illness rates in an Arctic environment. J R Nav Med Serv 2016; 102:85-87. [PMID: 29894132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Arduous military training in a cold weather environment is likely to lead to a variety of injuries to the population at risk (PAR). This paper examines injury rates and medical presentations over the two years of Winter Deployments in 2014 and 2015 (WD14 and WD15) and proposes recommendations for future WDs. METHODS Data on injury rates, number of aeromedical evacuations, and number of days of restricted duties allocated were collected prospectively for all patients presenting to Asegarden Medical Centre, Norway, during WD14 and WD15. The data were calculated as a percentage of the total PAR on each deployment to allow meaningful comparison. RESULTS During WD14, 22.8% of the PAR presented to the Medical Centre compared to 26.9% during WD15. WD15 saw a reduction in the presentation of musculoskeletal (MSK) injuries, cold weather (CW) injuries and burns. Skin problems and diarrhoea and vomiting (D&V) remained similar in both years. An increase in dental and other presentations was seen in WD15. A reduction in the overall aeromedical evacuations and number of patients requiring a light duties (LD) chit was seen during WD15. CONCLUSION WD15 has seen a decrease in injury rates, the number of aeromedical evacuations and LD chits issued. It is difficult to know whether these changes are a result of improved medical support, training or equipment. The liaison between the command, medical and training elements has led to improvements and should now concentrate on ways to further reduce injury rates whilst maximising arduous training benefits in an Arctic environment.
Collapse
|
6
|
Shweikh Y, Ko F, Chan MPY, Patel PJ, Muthy Z, Khaw PT, Yip J, Strouthidis N, Foster PJ. Measures of socioeconomic status and self-reported glaucoma in the U.K. Biobank cohort. Eye (Lond) 2015; 29:1360-7. [PMID: 26315700 PMCID: PMC4815692 DOI: 10.1038/eye.2015.157] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 07/20/2015] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To determine ocular, demographic, and socioeconomic associations with self-reported glaucoma in the U.K. Biobank. METHODS Biobank is a study of U.K. residents aged 40-69 years registered with the National Health Service. Data were collected on visual acuity, intraocular pressure (IOP), corneal biomechanics, and questionnaire from 112,690 participants. Relationships between ocular, demographic, and socioeconomic variables with reported diagnosis of glaucoma were examined. RESULTS In all, 1916 (1.7%) people in U.K. Biobank reported glaucoma diagnosis. Participants reporting glaucoma were more likely to be older (mean 61.4 vs. 56.7 years, P<0.001) and male (2.1% vs. 1.4%, P=0.001). The rate of reported glaucoma was significantly higher in Black (3.28%, P<0.001) and Asian (2.14%, P=0.009) participants compared with White participants (1.62%, reference). Cases of reported glaucoma had a higher mean IOP (18 mm Hg both eyes, P<0.001), lower corneal hysteresis (9.96 right eye, 9.89 left eye, P<0.001), and lower visual acuity (0.09 logMAR right eye, 0.08 logMAR left eye, P<0.001) compared with those without (16 mm Hg both eyes, hysteresis 10.67 right eye, 10.63 left eye, 0.03 logMAR right eye, 0.02 logMAR left eye). The mean Townsend deprivation index was -0.72 for those reporting glaucoma and -0.95 for those without (P<0.001), indicating greater relative deprivation in those reporting glaucoma. Multivariable logistic regression showed that people in the lowest income group (<£18,000/year) were significantly more likely to report a diagnosis of glaucoma compared with any other income level (P<0.01). We observed increasing glaucoma risk across the full range of income categories, with highest risk among those of lowest income, and no evidence of a threshold effect. CONCLUSIONS In a large U.K. cohort, individuals reporting glaucoma had more adverse socioeconomic characteristics. Study of the mechanisms explaining these effects may aid our understanding of health inequality and will help inform public health interventions.
Collapse
Affiliation(s)
- Y Shweikh
- Division of Genetics and Epidemiology, NIHR Biomedical Research Centre, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
| | - F Ko
- Division of Genetics and Epidemiology, NIHR Biomedical Research Centre, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
| | - M P Y Chan
- Division of Genetics and Epidemiology, NIHR Biomedical Research Centre, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
| | - P J Patel
- Division of Genetics and Epidemiology, NIHR Biomedical Research Centre, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
| | - Z Muthy
- Division of Genetics and Epidemiology, NIHR Biomedical Research Centre, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
| | - P T Khaw
- Division of Genetics and Epidemiology, NIHR Biomedical Research Centre, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
| | - J Yip
- Division of Genetics and Epidemiology, NIHR Biomedical Research Centre, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK.,Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - N Strouthidis
- Division of Genetics and Epidemiology, NIHR Biomedical Research Centre, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK.,Singapore Eye Research Institute, Singapore, Singapore.,Discipline of Clinical Ophthalmology and Eye Health, University of Sydney, Sydney, NSW, Australia
| | - P J Foster
- Division of Genetics and Epidemiology, NIHR Biomedical Research Centre, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
| | | |
Collapse
|
7
|
Sharma SK, Bharathi P, Prahlad V, Patel PJ, Choksi B, Jana MR, Bansal LK, Qureshi K, Sumod CB, Vadher V, Thakkar D, Gupta LN, Rambabu S, Parmar S, Contractor N, Sahu AK, Pandya B, Sridhar B, Pandya S, Baruah UK. Characteristics of the positive ion source at reduced gas feed. Rev Sci Instrum 2014; 85:113504. [PMID: 25430113 DOI: 10.1063/1.4901596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The neutral beam injector of steady state superconducting tokamak (SST1-NBI) at IPR is designed for injecting upto 1.7 MW of neutral beam (Hº, 30-55 keV) power to the tokamak plasma for heating and current drive. Operations of the positive ion source (PINI or Plug-In-Neutral-Injector) of SST1-NBI were carried out on the NBI test stand. The PINI was operated at reduced gas feed rate of 2-3 Torr l/s, without using the high speed cryo pumps. Experiments were conducted to achieve a stable beam extraction by optimizing operational parameters namely, the arc current (120-300 A), acceleration voltage (16-40 kV), and a suitable control sequence. The beam divergence, power density profiles, and species fractions (H(+):H2(+):H3(+)) were measured by using the diagnostics such as thermal calorimetry, infrared thermography, and Doppler shift spectroscopy. The maximum extracted beam current was about 18 A. A further increase of beam current was found to be limited by the amount of gas feed rate to the ion source.
Collapse
Affiliation(s)
- S K Sharma
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - P Bharathi
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - V Prahlad
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - P J Patel
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - B Choksi
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - M R Jana
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - L K Bansal
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - K Qureshi
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - C B Sumod
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - V Vadher
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - D Thakkar
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - L N Gupta
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - S Rambabu
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - S Parmar
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - N Contractor
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - A K Sahu
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - B Pandya
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - B Sridhar
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - S Pandya
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - U K Baruah
- Institute for Plasma Research, Bhat, Gandhinagar, India
| |
Collapse
|
8
|
Wilson JM, Groeschl R, George B, Turaga KK, Patel PJ, Saeian K, Gamblin TC. Ciliated hepatic cyst leading to squamous cell carcinoma of the liver - A case report and review of the literature. Int J Surg Case Rep 2013; 4:972-5. [PMID: 24055921 PMCID: PMC3825928 DOI: 10.1016/j.ijscr.2013.07.030] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 07/10/2013] [Accepted: 07/12/2013] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION Ciliated hepatic foregut cysts (CHFC) are rare, typically benign liver lesions. Primary squamous cell carcinoma (SCC) of the liver is also a rare entity with only approximately 25 reported cases in the literature. Recently, there have been four reports of malignant transformation of CHFC into primary squamous cell carcinoma of the liver. Here we report a fifth with unique presentation and review the literature. PRESENTATION OF CASE A 34 year-old man, with a history of ulcerative colitis, was incidentally found to have a 10 cm lesion in the right anterior sector plus left medial section of the liver on computerized tomography (CT) scan. The patient was asymptomatic at presentation and neoplastic markers were not elevated. Sequential transarterial chemoembolization (TACE) and portal vein embolization (PVE) allowed for left lateral section plus segment 1 hypertrophy and subsequent resection. Histology later revealed the cyst to be a CHFC and showed its malignant transformation. At 6 month follow-up, the patient has lung and abdominal recurrence. DISCUSSION With now the fifth case of malignant transformation of CHFC being reported, approximately 5% of all reported CHFC have undergone malignant transformation. This frequency, taken together with the aggressive disease course and poor prognosis, suggests that CHFC must not be presumed benign and should be regarded with clinical suspicion. CONCLUSION Accurate diagnosis of CHFC is mandatory given its potential malignant transformation. Even in asymptomatic CHFC, surgical excision is recommended. In addition, in cases of otherwise unresectable lesions, sequential TACE and PVE may provide optimal hypertrophy of future liver remnant.
Collapse
Affiliation(s)
- J M Wilson
- Medical College of Wisconsin, Department of Surgery, Division of Surgical Oncology, Milwaukee, WI 53226, United States
| | | | | | | | | | | | | |
Collapse
|
9
|
Tufail A, Patel PJ, Sivaprasad S, Amoaku W, Browning AC, Cole M, Gale R, George S, Lotery AJ, Majid M, McKibbin M, Menon G, Yang Y, Andrews C, Brittain C, Osborne A. Erratum: Ranibizumab for the treatment of choroidal neovascularisation secondary to pathological myopia: interim analysis of the REPAIR study. Eye (Lond) 2013. [DOI: 10.1038/eye.2013.84] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
|
10
|
Tufail A, Patel PJ, Sivaprasad S, Amoaku W, Browning AC, Cole M, Gale R, George S, Lotery AJ, Majid M, McKibbin M, Menon G, Yang Y, Andrews C, Brittain C, Osborne A. Ranibizumab for the treatment of choroidal neovascularisation secondary to pathological myopia: interim analysis of the REPAIR study. Eye (Lond) 2013. [PMID: 23449508 DOI: 10.1038/eye.2014.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
AIMS To evaluate the efficacy and safety of intravitreal ranibizumab in patients with choroidal neovascularisation secondary to pathological myopia (myopic CNV). Data are from a pre-planned, 6-month interim analysis. METHODS Phase II, open-label, single arm, multicentre, 12-month study, recruiting patients (aged ≥18 years) with active primary or recurrent subfoveal or juxtafoveal myopic CNV, with a best-corrected visual acuity (BCVA) score of 24-78 Early Treatment Diabetic Retinopathy Study (ETDRS) letters in the study eye and a diagnosis of high myopia of at least -6 dioptres. Patients received 0.5 mg ranibizumab administered intravitreally to the study eye, followed by monthly injections given as needed (based on a predefined algorithm) for up to 11 months. RESULTS At 6 months, mean BCVA improved from baseline by 12.2 letters, as did central macular thickness (in this interim analysis defined as a measure of either central subfield macular thickness or centre point macular thickness) from baseline by 108 μm in the 48 study eyes of 48 patients. Fewer patients had centre-involving intraretinal oedema (13.0% vs 91.5%), intraretinal cysts (10.9% vs 57.4%), or subretinal fluid (13.0% vs 66.0%) at 6 months than at baseline. Patients received a mean of 1.9 retreatments, were satisfied with ranibizumab treatment, and well being was maintained. No new safety signals were identified. CONCLUSIONS Results from the planned interim analysis support the role of ranibizumab in the treatment of myopic CNV, with excellent efficacy achieved with a low number of injections and few serious adverse events.
Collapse
Affiliation(s)
- A Tufail
- Moorfields Eye Hospital, London, UK.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Tufail A, Patel PJ, Sivaprasad S, Amoaku W, Browning AC, Cole M, Gale R, George S, Lotery AJ, Majid M, McKibbin M, Menon G, Yang Y, Andrews C, Brittain C, Osborne A. Ranibizumab for the treatment of choroidal neovascularisation secondary to pathological myopia: interim analysis of the REPAIR study. Eye (Lond) 2013; 27:709-15. [PMID: 23449508 DOI: 10.1038/eye.2013.8] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
AIMS To evaluate the efficacy and safety of intravitreal ranibizumab in patients with choroidal neovascularisation secondary to pathological myopia (myopic CNV). Data are from a pre-planned, 6-month interim analysis. METHODS Phase II, open-label, single arm, multicentre, 12-month study, recruiting patients (aged ≥18 years) with active primary or recurrent subfoveal or juxtafoveal myopic CNV, with a best-corrected visual acuity (BCVA) score of 24-78 Early Treatment Diabetic Retinopathy Study (ETDRS) letters in the study eye and a diagnosis of high myopia of at least -6 dioptres. Patients received 0.5 mg ranibizumab administered intravitreally to the study eye, followed by monthly injections given as needed (based on a predefined algorithm) for up to 11 months. RESULTS At 6 months, mean BCVA improved from baseline by 12.2 letters, as did central macular thickness (in this interim analysis defined as a measure of either central subfield macular thickness or centre point macular thickness) from baseline by 108 μm in the 48 study eyes of 48 patients. Fewer patients had centre-involving intraretinal oedema (13.0% vs 91.5%), intraretinal cysts (10.9% vs 57.4%), or subretinal fluid (13.0% vs 66.0%) at 6 months than at baseline. Patients received a mean of 1.9 retreatments, were satisfied with ranibizumab treatment, and well being was maintained. No new safety signals were identified. CONCLUSIONS Results from the planned interim analysis support the role of ranibizumab in the treatment of myopic CNV, with excellent efficacy achieved with a low number of injections and few serious adverse events.
Collapse
Affiliation(s)
- A Tufail
- Moorfields Eye Hospital, London, UK.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Ranganathan N, Patel PJ, Pasha Y. Seizures and chest x-rays: can you Pott the diagnosis? Case Reports 2012; 2012:bcr-2012-006666. [DOI: 10.1136/bcr-2012-006666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
|
13
|
Chen FK, Patel PJ, Uppal GS, Tufail A, Coffey PJ, Da Cruz L. Long-term outcomes following full macular translocation surgery in neovascular age-related macular degeneration. Br J Ophthalmol 2010; 94:1337-43. [DOI: 10.1136/bjo.2009.172593] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
14
|
Abstract
BACKGROUND Age-related macular degeneration (AMD) is a leading cause of blind registration in Western Europe and the third leading cause of blindness worldwide. METHODS The management of AMD is discussed with a review of current and new treatments. RESULTS Although there is no treatment for advanced dry AMD (geographic atrophy), there have been considerable advances in the management of neovascular AMD (nAMD). Established therapies for nAMD include laser photocoagulation and photodynamic therapy (PDT), but these have largely been superseded by agents which block the action of vascular endothelial growth factor (anti-VEGF agents). Current preventative strategies involve cessation of smoking and use of specific nutritional supplements to reduce the risk of developing nAMD. CONCLUSIONS There have been exciting advances in the treatment of nAMD and increased understanding of the genetics and pathogenic mechanisms involved will hopefully lead to the development of new therapies in the future.
Collapse
Affiliation(s)
- H L Cook
- Moorfields Eye Hospital, City Road, London EC1V 2PD, UK.
| | | | | |
Collapse
|
15
|
Abstract
PURPOSE To assess the long-term safety and efficacy of intravitreal triamcinolone acetonide injection in the management of macular oedema caused by central, hemi-, and branch retinal vein occlusion (CRVO, HRVO, or BRVO). METHODS This prospective, interventional case series included 13 patients (13 eyes) with retinal vein occlusion and macular oedema. They received an intravitreal injection of 4 mg triamcinolone acetonide. Follow-up was for 1 year with repeat injections where appropriate. Outcome measures were visual acuity and macular thickness measured using ocular coherence tomography (OCT). RESULTS There were four patients with CRVO, one with HRVO, and eight with BRVO (13 eyes). Mean duration of symptoms before intravitreal triamcinolone acetonide injection was 6.8 months (SD 4.5 months). Eight eyes (62%) responded well with improved visual acuity and macular thickness 1-3 months postinjection. All eight eyes developed recurrent macular oedema and five received repeat injections. Three patients declined a second injection. No improvement in visual acuity or OCT macular thickness was seen after the second injection with visual acuity returning to baseline levels at 1-year follow-up. Three eyes (23%) showed no response to the initial injection (no improvement in macular thickness or visual acuity). Seven patients (54%) had a rise in intraocular pressure with six (46%) requiring treatment. CONCLUSIONS Intravitreal injection of triamcinolone acetonide is effective as a short-term treatment of macular oedema owing to retinal vein occlusion, improving both visual acuity and macular thickness. However, this effectiveness is not maintained after 1 year despite repeat injections.
Collapse
Affiliation(s)
- P J Patel
- Department of Ophthalmology, Southend Hospital NHS Trust, Prittlewell Chase, Westcliff-On-Sea, Southend, Essex, UK
| | | | | |
Collapse
|
16
|
Gonzales JA, Tawansy K, Hayden A, Patel PJ, Chung M, Evans M. 50 PERIPHERAL RETINAL NON-PERFUSION IN THE SHAKEN BABY SYNDROME. J Investig Med 2005. [DOI: 10.2310/6650.2005.00005.49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
17
|
Abstract
Spontaneous and asymptomatic supraclavicular thoracic duct cysts (lymphoceles ) are rare. Only five cases have been reported so far. They are more common after surgery or trauma and have been reported in the abdomen, mediastinum, pelvis and neck. They must be differentiated from other neck cysts as failure to recognise their attachment may result in the disastrous consequence of chylothorax. A high index of suspicion is necessary, and diagnosis usually can be established by fine-needle aspiration and suitable imaging. This case is reported along with a review of the literature and management options, including that of inadvertent damage to the thoracic duct.
Collapse
Affiliation(s)
- J Ray
- Department of Otolaryngology, University Hospital of Birmingham, UK.
| | | | | |
Collapse
|
18
|
Abstract
UNLABELLED Sarcoidosis is a systemic noncaseating granulomatous disorder of unknown origin. The cutaneous manifestations of sarcoidosis often enable the dermatologist to be the first physician to make the diagnosis. This article reviews essential sarcoidosis pathophysiology, clinical polymorphisms, systemic evaluation, and treatment modalities for cutaneous sarcoidosis to further enhance the dermatologist's understanding of this disease entity. LEARNING OBJECTIVE At the conclusion of this learning activity, participants should be familiar with the theories of the pathogenesis of sarcoidosis, its cutaneous manifestations, its various syndromes and associations, and its presentation in children. Participants should also be more knowledgeable about diagnostic evaluation, measurement of disease progression, treatment modalities, and the prognosis and mortality data of sarcoidosis.
Collapse
Affiliation(s)
- J C English
- Department of Dermatology, University of Virginia, Charlottesville, USA
| | | | | |
Collapse
|
19
|
Ozcan C, Jahangir A, Friedman PA, Patel PJ, Munger TM, Rea RF, Lloyd MA, Packer DL, Hodge DO, Gersh BJ, Hammill SC, Shen WK. Long-term survival after ablation of the atrioventricular node and implantation of a permanent pacemaker in patients with atrial fibrillation. N Engl J Med 2001; 344:1043-51. [PMID: 11287974 DOI: 10.1056/nejm200104053441403] [Citation(s) in RCA: 223] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND In patients with atrial fibrillation that is refractory to drug therapy, radio-frequency ablation of the atrioventricular node and implantation of a permanent pacemaker are an alternative therapeutic approach. The effect of this procedure on long-term survival is unknown. METHOD We studied all patients who underwent ablation of the atrioventricular node and implantation of a permanent pacemaker at the Mayo Clinic between 1990 and 1998. Observed survival was compared with the survival rates in two control populations: age- and sex-matched members of the Minnesota population between 1970 and 1990 and consecutive patients with atrial fibrillation who received drug therapy in 1993. RESULTS A total of 350 patients (mean [+/-SD] age, 68+/-11 years) were studied. During a mean of 36+/-26 months of follow-up, 78 patients died. The observed survival rate was significantly lower than the expected survival rate based on the general Minnesota population (P<0.001). Previous myocardial infarction (P<0.001), a history of congestive heart failure (P=0.02), and treatment with cardiac drugs after ablation (P=0.03) were independent predictors of death. Observed survival among patients without these three risk factors was similar to expected survival (P=0.43). None of the 26 patients with lone atrial fibrillation died during follow-up (37+/-27 months). The observed survival rate among patients who underwent ablation was similar to that among 229 controls with atrial fibrillation (mean age, 67+/-12 years) who received drug therapy (P=0.44). CONCLUSIONS In the absence of underlying heart disease, survival among patients with atrial fibrillation after ablation of the atrioventricular node is similar to expected survival in the general population. Long-term survival is similar for patients with atrial fibrillation, whether they receive ablation or drug therapy. Control of the ventricular rate by ablation of the atrioventricular node and permanent pacing does not adversely affect long-term survival.
Collapse
Affiliation(s)
- C Ozcan
- Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minn 55905, USA
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Siddiq MA, Patel PJ. Pharyngeal pouch surgery: a five year review. Rev Laryngol Otol Rhinol (Bord) 2000; 121:37-40. [PMID: 10865482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
The treatment of pharyngeal pouch varies widely. Our aim was to establish current and recent practice in pharyngeal pouch surgery in our department and set guidelines for future management. A retrospective audit over a 5-year period was performed with all data derived from patient notes. 28 procedures were performed on 24 patients with a mean age of 72 years. Over two thirds of these patients (68%) underwent an endoscopic procedure (stapling or diathermy) and the remainder underwent excision (14%), inversion (10%), cricopharyngeal myotomy (4%) or dilatation (4%). The primary diagnostic investigation performed was a barium swallow in 17 cases, but in 7 cases, referred by gastroenterologists, an oesophagogastroscopy was performed despite characteristic presenting features in all cases. The average inpatient stay was similar for endoscopic and excision procedures (5.5 and 5 days respectively), but longer for inversion procedures (9 days). This was influenced mainly by operative complications. 2 endoscopic stapling procedures were complicated by perforations and 1 patient developed hoarseness after an inversion procedure. The mean follow up time was one month at which stage all asymptomatic patients were discharged. 2 patients treated by endoscopic stapling and 1 patient treated by inversion complained of persistent symptoms and required further surgery. We conclude that endoscopic stapling was the commonest procedure used. Concerning future management, the use of nasogastric tubes after uncomplicated stapling procedures was abandoned. Also it was felt that large pouches should be treated by excision, small pouches by cricopharyngeal myotomy and the remainder by endoscopic stapling. The long-term evaluation of results was also deemed necessary.
Collapse
Affiliation(s)
- M A Siddiq
- Walsgrave Hospital NHS Trust, ENT Department, England
| | | |
Collapse
|
21
|
Abstract
Aeromonas Hydrophila is a gram-negative bacillus commonly found in soil, sewage, and fresh or brackish water in many parts of the United States. In healthy people, the most common clinical manifestations attributed to Aeromonas are diarrhea and soft tissue infections. In people with suppressed immune systems or liver disease, A hydrophila can cause meningitis, endocarditis, peritonitis, hemolytic-uremic syndrome, or septicemia. We present the first known case of fulminant necrotizing fasciitis from A hydrophila that is not associated with trauma, liver disease, or immunosuppression.
Collapse
Affiliation(s)
- V R Minnaganti
- Infectious Disease Division and the Department of Pathology, Winthrop-University Hospital, Mineola, NY 11501, USA
| | | | | | | | | |
Collapse
|
22
|
Abstract
We report a case of metastatic endometrial carcinoma of the neck. A patient with a past medical history of squamous cell carcinoma of the larynx, breast carcinoma and endometrial carcinoma presented with a neck mass. Fine needle aspiration cytology (FNAC) showed this to be a poorly differentiated carcinoma with squamoid features and thus a potentially curative neck dissection was performed. Histology of the mass showed a clear cell endometrial carcinoma. Metastatic gynacecological malignancies to the head and neck are rare and this is the first reported case of metastatic endometrial carcinoma in the neck.
Collapse
Affiliation(s)
- M A Siddiq
- Department of Otolaryngology, Walsgrave Hospital, Coventry, UK
| | | | | | | |
Collapse
|
23
|
Abstract
The present study was conducted to determine whether local production of neutrophil chemoattractant cytokines preceded the influx of neutrophils following dermal scald injury. To accomplish this, dermal tissue was examined for inflammatory infiltrate and the level of KC, a murine homolog of human interleukin-8, at various time points after scald injury. The studies reveal that there was a largely neutrophilic infiltrate at 1 day post-injury which persisted for 4 days. Dermal KC levels increased significantly at 4 h, returned to baseline at 8 h and were elevated again from 1 to 3 days post-burn (P < 0.01). At 3 days post-burn, KC was elevated 15-fold above the level in sham treated mice (P < 0.01). These observations demonstrate that the influx of neutrophils into the skin follows the expression of KC in the skin. This suggests that it should be possible to alter neutrophil accumulation at the wound site by manipulating the local chemokine signal.
Collapse
Affiliation(s)
- D E Faunce
- Department of Cell Biology, Neurobiology, and Anatomy, Loyola University of Chicago, Maywood, IL 60153, USA
| | | | | | | | | | | |
Collapse
|
24
|
Patel PJ, Faunce DE, Gregory MS, Duffner LA, Kovacs EJ. Elevation in pulmonary neutrophils and prolonged production of pulmonary macrophage inflammatory protein-2 after burn injury with prior alcohol exposure. Am J Respir Cell Mol Biol 1999; 20:1229-37. [PMID: 10340942 DOI: 10.1165/ajrcmb.20.6.3491] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Various studies have shown that alcohol exposure before thermal injury leads to increased morbidity and mortality. Pulmonary failure is a major complication seen in these patients. This study examines the effects of prior alcohol exposure on lung pathology after burn injury. There is a marked increase in neutrophil recruitment in the lung after thermal injury, and herein we show that this appears to be significantly elevated in animals given alcohol before burn injury. Consequently, we chose to determine whether there is a difference in pulmonary production of macrophage inflammatory protein (MIP)-2, a potent neutrophil chemoattractant, in mice subjected to a 15% total body surface area scald (or sham) injury with or without prior ethanol treatment. Lung tissue was obtained at various time points after injury and homogenates were assayed for MIP-2 by enzyme-linked immunosorbent assay. At 2 h after injury, peak levels of the chemokine were produced in both burn and burn + alcohol-treated mice. This represents a 7-fold increase above baseline. In mice exposed to burn injury alone, the level of MIP-2 returned to baseline within 8 h. In contrast, mice given alcohol before burn injury continued to show elevated levels of the chemokine at 8 h, after which MIP-2 decreased. This study may provide a basis for understanding the mechanism responsible for the increased neutrophil presence in the lung after thermal injury in individuals who have consumed alcohol. Subsequently, this may lead to the enhanced neutrophil-mediated pulmonary damage observed in these patients.
Collapse
Affiliation(s)
- P J Patel
- Department of Cell Biology, Neurobiology, and Anatomy, Burn and Shock Trauma Institute, Loyola University Medical Center, Maywood, Illinois 60153, USA
| | | | | | | | | |
Collapse
|
25
|
Alagiakrishnan K, Patel PJ. Left-sided hepatic hydrothorax with ascites. Int J Clin Pract 1999; 53:225-6. [PMID: 10665138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
Abstract
Hydrothorax has long been recognised as a complication of cirrhosis, but it is seen in only a few patients, mostly on the right side. We report an unusual case of massive left-sided hydrothorax complicating cirrhosis with ascites, where pleuro-peritoneal communication was demonstrated on the left side by radionuclide scanning.
Collapse
Affiliation(s)
- K Alagiakrishnan
- Department of Medicine, Saint Barnabas Medical Center, Livingston, New Jersey, USA
| | | |
Collapse
|
26
|
Blatt JM, Allen MP, Baddam S, Chase CL, Dasu BN, Dickens DM, Hardt SJ, Hebert RT, Hsu YC, Kitazawa CT, Li SF, Mangan WM, Patel PJ, Pfeiffer JW, Quiwa NB, Scratch MA, Widunas JT. A miniaturized, self-contained, single-use, disposable assay device for the quantitative determination of the bone resorption marker, NTx, in urine. Clin Chem 1998; 44:2051-2. [PMID: 9733007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- J M Blatt
- Metrika, Inc., Sunnyvale, CA 94086, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Abstract
A retrospective review of the 17 cases of acromegaly, recorded in the hospital and with available CT scans was undertaken in order to determine the presence and of cutis verticis gyrata (CVG) frequency, and the spectrum of other associated radiographic appearances of CVG. The hormone levels were analysed, and the histopathology of the surgical specimens reviewed. Five cases were uncovered. In these, the scalp in CVG was markedly thickened with convoluted, gyriform or cog-wheel appearances. There was no correlation in the age, sex, duration of symptoms or the hormone levels in these two groups of acromegalics: with or without CVG. All cases were histologically pituitary adenoma. It is concluded that CVG is not uncommon in acromegaly. Its presence on a CT scan should caution the radiologist to the presence of pituitary adenoma or any of the other neurological causes of CVG.
Collapse
Affiliation(s)
- T M Kolawole
- Radiology Department No. 40, King Khalid University Hospital, Riyadh, Saudi Arabia
| | | | | | | |
Collapse
|
28
|
Patel PJ, Ghanem AH, Higuchi WI, Srinivasan V, Kern ER. Correlation of in vivo topical efficacies with in vitro predictions using acyclovir formulations in the treatment of cutaneous HSV-1 infections in hairless mice: an evaluation of the predictive value of the C* concept. Antiviral Res 1996; 29:279-86. [PMID: 8739606 DOI: 10.1016/0166-3542(96)80225-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The purpose of this study was to carry out an extensive examination of the C* concept for prediction of the topical antiviral efficacies of acyclovir (ACV) formulations in a hairless mouse model for the treatment of cutaneous herpes simplex virus type-1 (HSV-1) infections. This method is based on estimation of the free drug concentration at the target site (C*), which is presumed to be the basal cell layer of the epidermis. Five different formulations (containing 5% ACV) were examined in a finite dose multiple dosing regimen (twice a day application) to simulate the clinical situation. For determination of C*, in vitro ACV fluxes across the hairless mouse skin were measured in an in vivo-in vitro experimental design that approximated the in vivo antiviral treatment protocol. Then, the in vivo antiviral efficacies were measured using a 1-day delayed (after HSV-1 virus inoculation) 4-day treatment protocol. 10 microL/cm2 dose of ACV formulation was applied every 12 h for 4 days after which the lesions were scored and efficacies were calculated. Our results indicate that, over a wide range of efficacies, the predictions based on C* (estimated from the experimental fluxes) are in good agreement with the in vivo antiviral efficacies. These studies, therefore, support the validity of the C* concept for various ACV formulations and suggest that the C* approach has potential for future practical situations.
Collapse
Affiliation(s)
- P J Patel
- Department of Pharmaceutics and Pharmaceutical Chemistry, College of Pharmacy, University of Utah, Salt Lake City 84112, USA
| | | | | | | | | |
Collapse
|
29
|
Al Herbish AS, Al Jurayyan NA, Abo Bakr AM, Abdullah MA, Al Husain M, Al Rabeah AA, Patel PJ, Jawad A, Al Samarrai AI. Sex reassignment: A challenging problem - current medical and islamic guidelines. Ann Saudi Med 1996; 16:12-5. [PMID: 17372394 DOI: 10.5144/0256-4947.1996.12] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Sexual ambiguity is a complex and often confusing medical problem. In addition to the life-threatening adrenal crises which may accompany some forms, ambiguity of the genitalia may lead to incorrect sex assignment by parents and/or health personnel. Children who present to medical attention beyond the neonatal period constitute a challenging problem due to the grave consequences of this condition. Thirty cases in whom sex reassignment was indicated were seen at King Khalid University Hospital, Riyadh, over a 10-year period. Of these, 27 (90%) were genetic females (20 were 21- and seven were 11-hydroxylase deficient) and three (10%) were genetic males (two partial androgen insensitive and one 5alpha-reductase deficient). All genetic males who were incorrectly assigned as females accepted reassignment. But 9 out of 27 (33%) of the genetic females who were incorrectly assigned as males refused reassignment. Preference for male sex assignment, delayed diagnosis and sociocultural circumstances seem to be the contributing factors for refusal. A national consensus about this important issue strengthened by the existing religious recommendations in demanded.
Collapse
Affiliation(s)
- A S Al Herbish
- Departments of Pediatrics, Surgery, and Radiology, King Khalid University Hospital, Department of Pediatrics, Security Forces Hospital, and Pediatric Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Al-Rasheed SA, Patel PJ, Kolawole TM, Al-Mugeiren M, Malabarey T, Al Salloum A, Al-Herbish AS, Al-Jurayyan NA. Renal sonographic patterns in Bartter's syndrome. Pediatr Radiol 1996; 26:116-9. [PMID: 8587809 DOI: 10.1007/bf01372088] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The renal sonographic findings in ten cases of Bartter s syndrome investigated at the King Khalid University Hospital, Riyadh, Saudi Arabia are described. There were various sonographic abnormalities other than those of hyperechoic pyramids as previously described. These were diffuse increased renal echogenicity and hyperechoic echogenicity in the kidneys with the exception of the pyramids. This condition can be suspected early if nephrocalcinosis is present in a child with a history of polyhydramnios and premature delivery.
Collapse
Affiliation(s)
- S A Al-Rasheed
- Pediatric Department (39) and Department of Radiology, King Khalid University Hospital, P. O. Box 2925, Riyadh 11461, Saudi Arabia
| | | | | | | | | | | | | | | |
Collapse
|
31
|
Al-Jurayyan NA, Al-Herbish AS, Abo Bakr AM, Al-Rabeeah AA, Al-Samarrai AI, Jawad AJ, Patel PJ, Abdullah MA. Congenital adrenal hyperplasia in a referral hospital in Saudi Arabia: Epidemiology, pattern and clinical presentation. Ann Saudi Med 1995; 15:447-50. [PMID: 17590636 DOI: 10.5144/0256-4947.1995.447] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Eighty-two children (30 males and 52 females) with congenital adrenal hyperplasia (CAH) were seen at King Khalid University Hospital (KKUH) over a 10-year period. Of these, 74 (90.2%) were Saudis and eight (9.8%) non-Saudis. Fifty-nine (72%) patients were 21-hydroxylase deficient. Of these, 56 (95%) had variable degrees of salt depletion. Nineteen (23.2%) patients had a deficiency of 11-ss-hydroxylase enzyme and four (4.8%) showed deficiency of 3-ss-hydroxysteroid dehydrogenase. The consanguinity rate was high (71.2%) and positive family history was documented in 45.8%. Thirty-nine infants deaths occurred within 25 families. The diagnosis was often delayed. Of the 52 females, 27 (52%) were initially assigned male sex. These results indicate the importance of physicians' awareness and the need for a neonatal screening program for early detection and appropriate management.
Collapse
Affiliation(s)
- N A Al-Jurayyan
- Division of Pediatric Endocrinology, Division of Pediatric Surgery, Department of Radiology, College of Medicine, King Saud University, Riyadh, and Department of Pediatrics, Security Forces Hospital, Riyadh, Saudi Arabia
| | | | | | | | | | | | | | | |
Collapse
|
32
|
al Jurayyan NA, Patel PJ, al Herbish AS, Abdullah MA, Abo-Bakr AM, al Rabeeah AA, Jawad AJ, al Sammarai AI. Ambiguous genitalia: comparative role of pelvic ultrasonography and genitography. Ann Trop Paediatr 1995; 15:203-7. [PMID: 8534038 DOI: 10.1080/02724936.1995.11747773] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Ambiguous genitalia represents a true medical and social emergency which needs a multi-disciplinary team approach for elucidation. The paediatric radiologist plays an important role in defining the genital anatomy which remains one of the most important factors in sex determination. Aiming to compare the predictive value of pelvic ultrasonography and genitography in sex determination in patients with ambiguous genitalia, we retrospectively reviewed the medical records of 69 patients, 53 females and 16 males, where both procedures were employed. In female pseudohermaphroditism, the presence of a uterus with or without vagina was predicted in 46 (86.8%) patients by ultrasound compared with 44 (83%) patients in whom a genitogram revealed a vagina +/- uterus. In six (11.3%) patients, a genitogram revealed a male-type urethra. The combination of ultrasound and genitogram, however, was more sensitive and predicted the presence of a uterus with or without vagina in 52 (98.1%) patients. In male pseudo-hermaphroditism, there was no false positive by ultrasound, and a genitogram revealed a male-type urethra in 12 (75%) patients. In conclusion, although real time pelvic ultrasonography is less invasive than genitography, its yield in elucidating genital anatomy is comparable. The combination of both procedures is more informative and has a better yield.
Collapse
Affiliation(s)
- N A al Jurayyan
- Division of Paediatric Endocrinology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | | | | | | | | | | | | |
Collapse
|
33
|
Dincsoy MY, Salih MA, al-Jurayyan N, al Saadi M, Patel PJ. Multiple congenital malformations in two sibs reminiscent of hydrolethalus and pseudotrisomy 13 syndromes. Am J Med Genet 1995; 56:317-21. [PMID: 7778599 DOI: 10.1002/ajmg.1320560321] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
We report on two sibs, born to consanguineous parents, with defects of the midline including cleft lip and palate, flat nose, hypotelorism, and dysgenesis of corpus callosum, in addition to short limbs, radiolucent tibial notch, digital anomalies, ambiguous genitalia, and hypopituitarism. In spite of the similarities between this condition and the hydrolethalus and pseudotrisomy 13 syndromes, our patients had neither preaxial nor postaxial polydactyly, but had previously undescribed bilateral radiolucent tibial notch, which is not known to be part of those two syndromes. The cases presented here may very well represent a new autosomal recessive syndrome.
Collapse
Affiliation(s)
- M Y Dincsoy
- Department of Pediatrics, King Khalid University Hospital, Riyadh, Saudi Arabia
| | | | | | | | | |
Collapse
|
34
|
Abstract
A case of adrenoleukodystrophy (ALD) with CT and MRI findings is described. The CT scan showed low densities in the white matter of the parietal and occipital lobes. No calcifications were seen. Post-contrast CT showed an abnormal enhancement within the involved white matter. MRI showed changes of demyelination around the atria of the lateral ventricles bilaterally involving the posterior aspect of the cerebrum symmetrically. The posterior part of the posterior corpus callosum, splenium and pyramidal tracts also showed increased signal intensity. From a review of the literature, these findings are typical of the radiological changes seen in ALD. ALD can be diagnosed from typical history and biochemical changes as well as from CT and MRI findings.
Collapse
Affiliation(s)
- P J Patel
- Department of Radiology, King Saud University, King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia
| | | | | | | | | | | |
Collapse
|
35
|
Affiliation(s)
- P S Sahni
- Division of Radiology, Sulaimania Children's Hospital, Riyadh, Saudi Arabia
| | | | | | | | | | | |
Collapse
|
36
|
Kolawole TM, Patel PJ, Malabarey T, Hulailah A, Hawass ND. Symmetrical lesions in the basal ganglia. Afr J Med Med Sci 1994; 23:67-74. [PMID: 7839949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Bilateral and symmetrical non-space occupying lesions in the basal ganglia of 27 cases were studied. Nine cases had low attenuation lesions while the remaining 18 had high attenuation lesions due to bleeding or calcifications. The clinical presentations and final diagnosis were collated and related to these changes. In the low-attentuation cases, definite hypoxic-ischaemic insults were the aetiological basis for low attenuation lesions in 3 cases; and hypothesised to be the basis in the remaining six. Amongst the high attenuation group, bleeding was noted in 4 cases with trauma or cardiac arrest. The remainder had calcifications. It is suggested that a hypoxic-ischaemic pathophysiological phenomenon might have also accounted for some of these calcifications. The co-existence of both low and high attenuation lesions in the same patients in some of our cases tends to lend credence to this hypothesis.
Collapse
Affiliation(s)
- T M Kolawole
- Department of Radiology, King Khalid University Hospital Riyadh, Saudi Arabia
| | | | | | | | | |
Collapse
|
37
|
Abstract
Inhibition and inactivation of two presynaptic cholinergic "markers", choline acetyltransferase and high affinity choline transporter, has been investigated using inhibitors designed with a redox-reactive catechol tethered to a quaternary ammonium group. Two quaternary ammonium alkyl-substituted catechols, 3[(trimethylammonio)methyl]catechol (TMC, 1) and N,N-dimethylepinephrine (catecholine, 2) were shown to bind weakly and noncompetitively to bovine choline acetyltransferase yet inactivated the enzyme in a time course consistent with the involvement of early intermediates in the spontaneous oxidation of these catechols. Both agents also inhibited high-affinity choline uptake. The time course of TMC and catecholine spontaneous oxidation-dependent inactivation of high affinity choline uptake sites was slower than, if it occurred at all, the spontaneous degradation of measurable choline transport in synaptosomes. When compared with inhibition of uptake of other neurotransmitters, it was shown that catecholine demonstrated more selectivity than TMC toward inhibition of choline transport. Km (microM) and Vmax (pmol/min per mg of protein) were measured for high affinity transport of choline, dopamine, and serotonin and were observed to be Km = 2.04 +/- 0.31, Vmax = 22 +/- 1; Km = 1.4, Vmax = 53; and Km = 0.15, Vmax = 23, respectively, in good agreement with published literature values. Ki's (mM) for catecholine and TMC, calculated from experimentally determined IC50's, were for catecholine 0.13 +/- 0.06, 0.53 +/- 0.09, and 0.39 +/- 0.10, and for TMC 0.06 +/- 0.03, 0.09 +/- 0.03, and 0.09 +/- 0.08, for choline, dopamine, and serotonin transport, respectively. In vivo studies using catecholine suggest that this compound impairs learning ability associated with long-term memory. Thus, catecholine represents a lead compound in a potential series of redox-reactive choline analogs, which may become useful irreversible antagonists of the critical cholinergic macromolecular targets underlying cholinergic hypofunction in disorders such as Alzheimer's disease.
Collapse
Affiliation(s)
- P J Patel
- Department of Medicinal and Biological Chemistry, College of Pharmacy, University of Toledo, Ohio 43606
| | | | | |
Collapse
|
38
|
Affiliation(s)
- M L Hart
- Department of Laboratory, Animal Medicine and Pathology, University of Rochester, NY
| | | | | | | | | |
Collapse
|
39
|
Abstract
Adolescent idiopathic scoliosis is a common disorder of unknown etiology. The lack of symptoms delays its detection, sometimes beyond the remedial range. In this study, consent forms were distributed to elementary schoolgirls between 11-13 years, at random, in the city of Riyadh. Out of 1,147 girls screened, 40 girls were positive on screening. In the clinic, nine girls were found to have no scoliosis, one had old poliomyelitis and one had lumbar lipoma. The remaining 29 girls had idiopathic scoliosis, giving a prevalence of 2.5%. However, the Cobb's angle were more than five degrees in nine girls only, reducing the prevalence of significant curves to 0.78%. The study was acceptable to all parties involved. We feel studies that address the issues of female screeners, transportation problems, and cost-effectiveness are needed prior to embarking on larger scale programs.
Collapse
Affiliation(s)
- A Abo-Bakr
- Departments of Pediatrics, Orthopedics, and Radiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | | | | | | | | |
Collapse
|
40
|
Abstract
A case of osteopetrosis presenting with rare features of dysmorphism with proptosis due to hypoplasia of the orbits and the temporal bone is described. The case also had calcifications in the periventricular regions, the falx cerebri and the corpora colliculi. These features and sonographic findings of osteopetrosis have not been reported previously. The sensitivity and specificity of imaging modalities in the diagnosis of intracranial calcifications is discussed.
Collapse
Affiliation(s)
- P J Patel
- Radiology Division, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | | | | | | | | |
Collapse
|
41
|
Abstract
Computed tomographic (CT) scan of eight cases of paranasal sinus aspergillosis were reviewed. Different CT patterns were observed such as areas of high densities, linear interlacing network of high density, radiolucent thin rim periphery to the masses, calcification, expansion of involved sinuses and bone erosion. Two cases of invasive type showed extension beyond the sinuses into the orbit and intracranially simulating a malignant tumour. The findings are similar to those described by previous authors. The differential diagnosis is also discussed.
Collapse
Affiliation(s)
- P J Patel
- Radiology Department, King Khalid University Hospital, Riyadh, Saudi Arabia
| | | | | | | | | | | |
Collapse
|
42
|
Abstract
Seventeen patients, age 1 day to 6 years with infantile polycystic kidney disease were evaluated with ultrasound and other imaging techniques. Most patients showed bilaterally enlarged kidneys with hyperechoic renal parenchyma, which had poor differentiation in outlines as well as between renal sinus, cortex and medulla. Cysts of various sizes were also identified in the kidneys. However, a third of these cases showed well-defined renal outlines, normal echogenic cortical rim, whilst dilated renal collecting systems were seen in another third of the cases. Twelve cases showed hepatomegaly. Few rare findings such as liver cysts, associated Meckel syndrome, renal stone, bilateral vesicoureteric reflux and renal calcification were also noted. This study confirms the diagnostic value of sonography and intravenous pyelography examination. However, the noninvasiveness and the opportunity for repeat examination in antenatal and postnatal life makes sonography the ideal investigative modality.
Collapse
Affiliation(s)
- P J Patel
- Radiology Division, King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
43
|
Abstract
We studied the pattern and outcome of strokes in 200 Saudi patients. Cerebral infarction constituted 87% of strokes, subarachnoid hemorrhage 4.5%, cerebral hemorrhage 6.5%, and venous infarction 2%. The vessel most commonly involved was part or all of the middle cerebral artery, constituting 52% (90) of the 174 arterial infarcts. Lacunar infarcts were seen in 21% (37) of the patients with arterial infarcts. Among all 200 patients, 8% died and 8% had secondary generalized seizures. Hypertension occurred in 41% of the 174 patients with arterial infarcts and 62% of the 13 with cerebral hemorrhages. The highest incidence of hypertension as a risk factor was among those with lacunar infarcts (81%), ganglionic cerebral hemorrhages (80%), and infarcts of deep branches of the middle cerebral artery (57%). Embolic infarcts due to rheumatic heart disease constituted 11% of all arterial infarcts. We conclude that our pattern of strokes is similar to that of the west rather than that of the Japanese, but with less frequent arteriovenous malformations and aneurysms.
Collapse
Affiliation(s)
- B A Yaqub
- Department of Neurology, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | | | | | | |
Collapse
|
44
|
Karrar Z, Patel PJ, Abdurrahman MB. Hydrops of the gall bladder in a child with Wilson's disease: a rare association. Indian Pediatr 1991; 28:791-4. [PMID: 1800355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Z Karrar
- Department of Pediatrics and Radiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | | |
Collapse
|
45
|
Abstract
3-Trimethylammoniomethyl catechol and N,N-dimethylepinephrine (catecholine) are redox reactive reagents which possess quaternary ammonium functional groups and the capacity to inhibit or inactivate choline binding macromolecules which mediate cholinergic neuronal function. Earlier studies reported the synthesis of 3-trimethylammoniomethyl catechol and demonstrated its redox-dependent covalent inactivation of the nicotinic acetylcholine receptor (Nickoloff et al., Biochemistry 24, 999-1007 (1985)]. Here we present the synthesis of catecholine and show that both 3-trimethylammoniomethyl catechol and catecholine are weak noncompetitive inhibitors (Ki = 15 +/- 6 and 25 +/- 4 mM, respectively) of choline acetyltransferase (EC 2.3.1.6). Both agents irreversibly inactivate the enzyme.
Collapse
Affiliation(s)
- P J Patel
- Department of Medicinal and Biological Chemistry, College of Pharmacy, University of Toledo, OH 43606
| | | | | | | | | |
Collapse
|
46
|
Amonoo-Kuofi HS, Patel PJ, Fatani JA. Sagittal diameters of the lumbar spinal canal in normal adult Saudis. Clin Anat 1991. [DOI: 10.1002/ca.980040304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
47
|
Abdullah MA, Katugampola M, al-Habib S, al-Jurayyan N, al-Samarrai A, Al-Nuaim A, Patel PJ, Niazi M. Ambiguous genitalia: medical, socio-cultural and religious factors affecting management in Saudi Arabia. Ann Trop Paediatr 1991; 11:343-8. [PMID: 1721791 DOI: 10.1080/02724936.1991.11747526] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Twenty-eight children with ambiguous genitalia were seen at King Khalid University Hospital over a 6-year period. The incidence of this disorder was 0.4/1000 live births. Of the total, 21 (75%) were Saudis and seven (25%) were non-Saudis. The consanguinity rate was 67.9%. Twenty-four (85.7%) were born in hospital and four (14.3%) at home. In only three (10.7%) was the news first broken to the parents by a senior doctor, in 13 (46.4%) by a junior doctor, and in 11 (39.3%) by a nurse. Ambiguous genitalia were observed in 22 (78.6%) at birth and in six (21.4%) were picked up later. Owing to a lack of immediate investigative facilities and for some socio-cultural reasons, 19 of the latter groups were assigned sex without prior investigations. There was an obvious preference to assign male sex. On investigation, 13 (46.4%) had XX chromosomes, 11 (39%) XY and one (3.6%) XO: in three (10.7%), chromosomal results were not available. There were 14 cases (50%) of congenital adrenal hyperplasia, two of 5-alpha reductase deficiency (7.1%), and five of testicular feminization syndrome (17.9%), in addition to others. After investigation, five (17.9%) of the children needed sex reassignment. This was accepted by two and rejected for socio-cultural reasons by three. The opinion of the religious leaders was obtained. Some recommendations on management of these cases are made, based on our local experience.
Collapse
Affiliation(s)
- M A Abdullah
- Department of Paediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | | | | | | | | | | | | |
Collapse
|
48
|
Kolawole TM, Suhaibani AS, Patel PJ, Malabarey T, Hulailah H. Gaseous distension of the gut during intravenous urography. Urol Int 1991; 46:35-8. [PMID: 2024368 DOI: 10.1159/000281770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
During intravenous urography, the changes in the gastrointestinal tract were assessed in a total of 101 patients within two subgroups: allergic and non-allergic, depending on the patient's reaction or non-reaction to the intravenously injected Conrary 420. The gastrointestinal changes were either nil (that is normal) or abnormal with definite increase in the total volume of gas in the abdomen. Increased gas was commoner (66%) among the non-allergic group as compared with 34% of the allergic group. The aetiological basis being postulated for this observation includes biochemical and chemical changes as well as allergic response within the gut.
Collapse
Affiliation(s)
- T M Kolawole
- Department of Radiology, King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia
| | | | | | | | | |
Collapse
|
49
|
Kolawole TM, Patel PJ, al-Muzrakchi AM, Malabarey T. Carotid angiography in a teaching hospital in Saudi Arabia. Afr J Med Med Sci 1990; 19:145-51. [PMID: 2120912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The carotid angiographic studies performed in a teaching hospital (King Khalid University Hospital, Riyadh) in Saudi Arabia were reviewed, and the incidence of lesions demonstrated was analysed. Intracranial tumours accounted for 50% of the lesions, with meningiomas being 40%, whilst arteriovenous malformations accounted for 5.9% of lesions. It was noted that the incidence of atherosclerosis and arteritis was low, and the examination was almost without complications. Some lesions supplied by vertebral arteries were missed. In view of this, vertebral angiography is advocated in those cases with suspected supratentorial tumour especially when the carotid angiograms are normal.
Collapse
Affiliation(s)
- T M Kolawole
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | | | | |
Collapse
|
50
|
Abstract
A neonate with multicentric hepatic haemangioendothelioma complicated by jaundice and microangiopathic haemolytic anaemia is presented. To our knowledge such a constellation has not been previously reported.
Collapse
Affiliation(s)
- M D Yohannan
- Department of Paediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | | |
Collapse
|