Use of Dacron velour in choledochoplasty. An experimental study.

Patch choledochoplasty for experimentally produced defect and annular stricture and replacement choledochoplasty with Dacron velour was carried out in 20 healthy mongrel dogs with a maximum follow-up of 485 days. There was no derangement of liver functions after patch choledochoplasty for defect and replacement choledochoplasty. Elevated levels of serum bilirubin and alkaline phosphatase observed after stricture production returned toward normal following choledochoplasty. Flat diameter of the common bile duct could be increased significantly after patch choledochoplasty for defect and annular stricture. There was no change in the flat diameter of the common bile duct at the anastomotic sites after replacement choledochoplasty. The graft became completely incorporated in the common bile duct. Neobiliary and glandular regeneration occurred over the graft, which persisted without shrinkage or fibrosis.

Autoantibodies in thromboangiitis obliterans (Buerger's disease).

Autoantibodies, organ and non-organ specific, were studied in 10 patients of thromboangiitis obliterans by immunofluorescence technique and compared with age matched controls without peripheral vascular disease and patients of other peripheral vascular diseases. Organ specific autoantibodies (various classes of immunoglobulins IgM, IgG, IgA) and C3 component were observed in the diseased vessels of thromboangiitis obliterans. Antibodies, antiarterial, were present in the sera of these patients. Among the non-organ specific antibodies (ANA and AMA), only ANA were found in the sera of patients. Presence of autoantibodies in patients of thromboangiitis obliterans strongly point out of that probably this disease entity is an autoimmune disorder.

Significance of circulatory immune complexes in thromboangiitis obliterans (Buerger's disease).

Circulatory immune complexes were estimated in the sera of 25 patients and 20 age and sex matched controls by precipitation with 8% polyethylene glycol (PEG). Characterization of the immune complexes, thus obtained, was performed by the double immuno-diffusion method. The mean protein content of the PEG precipitates was significantly higher in the patients of thromboangiitis obliterans than in the controls. The immunoglobulins in the immune complexes were predominantly of mixed type in contrast to mainly single class immunoglobulins in the controls. C3 complement distribution in immune complexes of patients and control sera was 64% and 45% respectively. The immune complexes in patients were found to be biologically active. The mechanism of formation of circulatory immune complexes and their role in the pathogenesis of arteritis in relation to smoking of tobacco has been postulated.

Solitary nodular goiter. Review of cytomorphologic features in 441 cases.

OBJECTIVE: To study the cytomorphologic features of solitary nodular goiters (SNG). STUDY DESIGN: May-Grünwald-Giemsa-stained smears in 441 SNG diagnosed by ultrasonography and fine needle aspiration (FNA) and found to have optimum cellular material at review were subjected to detailed cytologic assessment. The age of the patients ranged from 11 to 75 years, with a median of 35. Male: female ratio was 69:372. The parameters for cytologic assessment included cellularity, colloid content, acinar formation, papillary formation, intranuclear cytoplasmic inclusions, nuclear grooves, marginal vacuoles, Hürthle cells and various inflammatory cells. Histopathology reports on thyroidectomy specimens were available in 27 cases from two Delhi hospitals. RESULTS: Hyperplastic nodules (68 cases) differed significantly from colloid goiters (269 cases) by having more cases with excessive cellularity, acinar formation and marginal vacuoles (P < .001). There was also a significant difference with respect to papillary formation and moderate-to-excessive colloid content (P < .001). As compared to hyperplastic nodules, neoplasms (60 cases) had a significantly higher number of cases with papillary formation, intranuclear inclusions and nuclear grooves but lower number of cases with marginal vacuoles (P < .01-.001). Among neoplasms, usual papillary carcinoma (19 cases) differed from follicular neoplasms (20 cases) with respect to acinar formation, papillary formation and nuclear grooves (P < .001). A significant difference was also observed with respect to colloid content and nuclear inclusions. Follicular variant of papillary carcinomas (FVPC) (10 cases) emerged as a distinct cytologic entity following review and differed from usual papillary carcinomas in having a higher number of cases with acinar formation, tubular formation and marginal vacuoles (P < .01-.001) and lower number of cases with nuclear grooves (P = .05). FVPC also differed from follicular neoplasms with respect to papillary formation, tubular formation, intranuclear inclusions and nuclear grooves (P < .01-.001). Overall cytohistologic agreement was achieved in 24 of 27 (88.9%) cases. CONCLUSION: Detailed cytologic assessment of FNA smears-in SNG was helpful in highlighting parameters that differentiate between various types of goiters.

A study of immune profile in human hydatid diseases.

A clinico haematological and immunological study was undertaken in 90 patients clinically suspected to be suffering from hydatid disease over a period of 1 year. The parameters studied included age of presentation, site of cyst localisation, haematological profile, total immunoglobins of different classes (IgG, IgM, IgA & IgE) and complement component C3, rosette forming lymphocytes, blast cell formation in response to phytohaemagglutinin (PHA-P) and concanavalin A (Con-A) and casoni test using standard methods. Twenty two out of 90 (22.44%) clinically suspected patients were surgically confirmed as hydatid disease cases. Hydatid disease occured in all age groups. Youngest case was 8 years and oldest 70 years. In 17/22 cases the cyst localised in the liver followed by lungs (3) neck (1) and kidney (1). Majority of patients (63.65%) belonged to blood group B. The mean total leucocyte and eosinophill counts were raised significantly (p < 0.001 and p < 0.05, respectively) in confirmed patients. The mean ESR value was raised in hydatid patients though, not significantly (P > 0.08). All the four classes of immunoglobulins viz. IgG, IgA, IgM, IgE and complement C3 were significantly raised in patients of hydatid disease compared to controls (P < 0.001, P < 0.002, p < 0.01 and p < 0.01, P < 0.02 respectively). The percentage of lymphocytes in peripheral blood in hydatid patients was reduced though, not significantly (P > 0.2). The absolute lymphocyte count was raised and mean percentage of T cells was reduced in patients with hydatid disease (P < 0.001 and P < 0.001, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Immunodiagnosis of human hydatid disease.

A study was undertaken to evaluate the efficacy of Enzyme Linked Immunosorbent Assay using locally prepared antigens for immunodiagnosis of human hydatid disease. A total of 90 cases clinically suspected to be suffering from hydatid disease and 100 controls matched for age and sex were included in the study. Two types of ELISA were performed on detected specific antihydatid antibodies belonging to IgG/IgM/IgA classes and other type detected IgE class of antibodies. Antigen prepared from the human hydatid fluid was found to be unsuitable for diagnosis as it contained host proteins i.e. IgG. Sheep hydatid fluid obtained from the fertile hydatid cyst was used to prepare and standardize the antigen. ELISA test to detect anti hydatid antibodies belonging to either IgG, IgM and or IgA was found to be highly specific (98 per cent) in surgically confirmed hydatid disease and was negative in all the controls. The results of the study indicate that ELISA along with casoni test may provide the best results in diagnosis of hydatid disease.

Carcinogenic effect of nicotine on normal mammary ductal epithelial cells and the protective role of beta-carotene.

A number of carcinogens like polycyclic hydrocarbons and aromatic amines have been incriminated to induce mammary carcinomas in vitro and in vivo. Studies have supported an inter-relationship between tobacco consumption and breast cancer. Because nicotine is the major alkaloid present in tobacco this study was conducted to find the direct in vitro effect of nicotine on normal mammary ductal epithelial cells. It was seen in the present work that nicotine causes a statistically significant increase in the proliferative rate and ER (estrogen receptor) expression as compared to the control group. This change was more pronounced with a lower concentration of nicotine (650 microg/ml). Colony efficiency also showed a similar trend. Beta carotene was added in the present work to study its anti oxidant effect on nicotine induced changes. Beta carotene significantly decreased the proliferation rate induced by 650 microg/ml nicotine. It also prevented the cytotoxic effect of higher dose of nicotine, however, it failed to alter significantly the ER expression induced by lower concentration of nicotine though it showed decreasing trend.

Comparative study of free omental, peritoneal, Dacron velour, and Marlex mesh reinforcement of large-bowel anastomosis: an experimental study.

The comparative role of free omental, peritoneal, Dacron velour, and Marlex mesh grafts in reinforcement of an extremely vulnerable experimental model of large-bowel anastomosis was studied in dogs. While both the omentum and peritoneum proved not to be effective in preventing anastomotic leakage, Dacron velour did considerably lower this incidence to within reasonable limits but led to formation of low-grade lymphoma at the reinforcement site in two animals. Only Marlex mesh was found to be highly effective in sealing the suture line, and it is anticipated that, with the usual technique of anastomosis, this sealing effect will be foolproof, thereby nullifying any risk of suture-line breakdown.

Upper airway obstruction in patients with goiter studies by flow volume loops and effect of thyroidectomy.

The patient with goiter and his or her physician frequently overlook symptoms of upper respiratory obstruction. Conventional radiology is the accepted method for detecting upper airway obstruction in these patients. Flow volume loops provide additional information on airflow dynamics. Twenty-five patients of goiter undergoing surgery were evaluated for upper airway obstruction by symptomatology, conventional radiology, and flow volume loops. Flow volume loops were repeated 1 month after surgery. Ten (40%) patients had mild symptoms on direct questioning. Tracheal deviation, compression, or both were noted in eight (32%) patients on radiology. Flow volume loops detected upper airway obstruction in 15 (60%) patients. Surgery resulted in normalization of all preoperative abnormal curves. The flow volume loop is a simple noninvasive method for detecting upper airway obstruction in patients with goiter. Abnormal upper airway dynamics are present in more patients with goiter than previously recognized, and relief of this obstruction should be an important aspect of thyroid surgery.