Browse Health
Internist, Radiologist, Pediatric Specialist
14 years of experience
Accepting new patients

Education ?

Medical School
King George Medical University (1996)
Foreign school

Awards & Distinctions ?

Appointments
Massachusetts General Hospital
Associations
American Board of Internal Medicine
American Board of Radiology

Affiliations ?

Dr. Sagar is affiliated with 3 hospitals.

Hospital Affilations

Score

Rankings

  • Massachusetts General Hospital
    55 Fruit St, Boston, MA 02114
    • Currently 4 of 4 crosses
    Top 25%
  • Waltham: Mass General West
  • Boston: Massachusetts General Hospital
  • Publications & Research

    Dr. Sagar has contributed to 79 publications.
    Title An Assessment of Bacterial Dysbiosis in Pouchitis Using Terminal Restriction Fragment Length Polymorphisms of 16s Ribosomal Dna from Pouch Effluent Microbiota.
    Date August 2009
    Journal Diseases of the Colon and Rectum
    Excerpt

    Previous studies on dysbiosis and pouchitis using conventional culture techniques have been disappointing because of inherent limitations associated with the technique. This study was designed to use terminal restriction fragment length polymorphism to evaluate patients with and without pouchitis.

    Title Pre-operative Mr Assessment of Recurrent Rectal Cancer.
    Date October 2008
    Journal The British Journal of Radiology
    Excerpt

    The potential for curative resection of recurrent rectal cancer and the recognized benefits of palliative resection have led to increased numbers of patients being referred for MRI assessment. This study assesses the use of MRI to provide a roadmap of tumour recurrence to allow for appropriate surgical planning. Differentiation of recurrent rectal cancer from post-surgical and post-radiotherapy changes on MR proved particularly problematic when assessing the pelvic sidewalls. Areas of uncertainty on imaging, therefore, need to be discussed on a case by case basis regarding the decision to proceed to curative or explorative surgery.

    Title Case Records of the Massachusetts General Hospital. Case 29-2008. A 19-year-old Man with Weight Loss and Abdominal Pain.
    Date September 2008
    Journal The New England Journal of Medicine
    Title Case Records of the Massachusetts General Hospital. Case 12-2008. A Newborn Infant with Intermittent Apnea and Seizures.
    Date April 2008
    Journal The New England Journal of Medicine
    Title The Assessment of a Rapid Noninvasive Immunochromatographic Assay Test for Fecal Lactoferrin in Patients with Suspected Inflammation of the Ileal Pouch.
    Date April 2008
    Journal Diseases of the Colon and Rectum
    Excerpt

    PURPOSE: Pouchitis is a common complication after ileal pouch-anal anastomosis. Diagnosis is based on the Pouch Disease Activity Index, which comprises clinical symptoms, endoscopic appearance, and histologic confirmation. A Pouch Disease Activity Index > or = 7 confirms pouchitis. Fecal lactoferrin is a marker of intestinal inflammation, which can aid in the diagnosis of pouchitis. The IBD EZ VUE test is a simple, rapid, noninvasive test for fecal lactoferrin. Our goal was to study the sensitivity and specificity of this test in the diagnosis of pouchitis. METHODS: Consecutive patients with pouch dysfunction were recruited from October 2005 to July 2006. A fecal sample was collected before calculation of the Pouch Disease Activity Index. An IBD EZ VUE test was performed on each fecal sample and the results correlated with the diagnosis of pouchitis to calculate sensitivity and specificity of the IBD EZ VUE test. RESULTS: There were 32 patients (21 healthy and 11 inflamed pouches). The IBD EZ VUE test was positive in 14 patients. It had a sensitivity of 100 percent and a specificity of 86 percent in diagnosing pouchitis. The positive predictive value was 76 percent. There were three false-positive results. CONCLUSIONS: The IBD EZ VUE test is a sensitive method that may remove the need for invasive pouch investigations and lead to greater confidence when antibiotic therapy is commenced. Further investigations may be reserved for those patients who have a positive lactoferrin test and fail to respond to antibiotic treatment.

    Title The Impact of Preoperative Immunomodulation on Pouch-related Septic Complications After Ileal Pouch-anal Anastomosis.
    Date July 2007
    Journal Diseases of the Colon and Rectum
    Excerpt

    PURPOSE: We studied preoperative and perioperative factors with particular attention to the role of immunomodulatory medication, which may impact the incidence of pouch-related septic complications. METHODS: A retrospective review of data from patients who underwent ileal pouch surgery during a 20-year period from 1985 to 2005 was performed. Preoperative use of immunomodulatory medication along with perioperative clinical, surgical, and disease variables were recorded. Patients were monitored for pouch-related sepsis in the early (within 30 days of surgery) and late (after 30 days of surgery) postoperative periods. Univariate and multivariate logistic regression analysis was performed. RESULTS: There were 445 patients (206 females; 46.4 percent). Median age was 36 (interquartile range, 27-46) years. Median follow-up period was 52 (interquartile range, 26-86) months. Complete data were available for 335 patients. Early sepsis was seen in 58 patients (17.3 percent). Another 22 patients (6.5 percent) developed late sepsis. On multivariate analysis, only steroid use remained predictive of higher rates of early sepsis (odds ratio, 1.81; 95 percent confidence interval, 1.02-3.45; P=0.002). Likewise on multivariate analysis, both male gender (odds ratio, 0.24; 95 percent confidence interval, 0.09-0.71; P=0.007) and 5-aminosalicylic-acid use (odds ratio, 0.22; 95 percent confidence interval, 0.08-0.76; P=0.023) remained predictive of lower rates of sepsis. CONCLUSIONS: Preoperative steroid use is associated with higher rates of early but not late pouch-related septic complications. We recommend that patients be weaned of steroids before ileal pouch surgery or be warned of the higher risk of postoperative sepsis.

    Title The Effect of Faecal Diversion on Human Ileum.
    Date June 2007
    Journal Gut
    Excerpt

    BACKGROUND: The use of a loop ileostomy is an effective method in protecting pelvic anastomoses. Its use has increased recently, although there is some debate as to the routine use of a stoma. Reversal of the ileostomy is associated with a significant morbidity, which may be related to impaired function of the bypassed distal limb of the ileum. AIM: To investigate the changes that might occur in the distal limb after an interval of faecal diversion. METHODS: Full-thickness intestinal circular muscle (CM) strips were prepared from excised loop ileostomies taken at the time of closure. The study sample was from the distal limb and the control from the proximal limb. Contractile activity was measured using an organ bath set up to record isometric contraction after stimulation by acetylcholine (ACh). Histological sections were assessed for an index of villous atrophy, smooth muscle area, and nerve and vessel density. Analysis was with the Wilcoxon signed ranks test for paired data and the Mann-Whitney U test for unpaired data. RESULTS: Samples were acquired prospectively from 35 consecutive patients. The median time between formation and closure of ileostomy was 34 weeks. Significant reduction was observed in the strength of CM contraction, smooth muscle area and median villous index of the distal limb compared with the proximal limb. CONCLUSION: Impaired intestinal function has been proposed as a contributory factor in the morbidity that may follow closure of loop ileostomy. Significant loss of contractility and smooth muscle strength and villous atrophy occur in the distal ileal limb after faecal diversion. Methods of preventing these changes should be considered.

    Title Clinical and Subclinical Leaks After Low Colorectal Anastomosis: a Clinical and Radiologic Study.
    Date December 2006
    Journal Diseases of the Colon and Rectum
    Excerpt

    PURPOSE: This study was designed to examine the natural history of subclinical leaks and their effect on bowel function and quality of life and to evaluate water-soluble contrast enema features that predict anastomotic healing after leaks. METHODS: Consecutive patients who underwent low rectal anastomosis were followed up postoperatively for leaks. All leaks were confirmed radiologically with CT scanning and water-soluble contrast enema imaging. Water-soluble contrast enemas were serially repeated to identify healing. Characteristics on initial water-soluble contrast enema were correlated with observed healing. Postoperatively, patients were required to fill in a quality of life and a bowel function questionnaire. RESULTS: A total of 138 patients underwent low rectal anastomosis procedures with a median follow-up period of 26 (interquartile range, 19-37) months. There were 23 documented leaks of which 13 (9 percent) presented clinically and 10 (8 percent) presented subclinically. Ileostomy closure was possible in 4 of 13 (30 percent) patients with a clinical leak and all 10 (100 percent) patients with a subclinical leak. Median quality of life scores were lower for patients with clinical leaks and no ileostomy closure (P = 0.03). Bowel function for subclinical leak patients and clinical leak patients with ileostomy closure were similarly impaired. The presence of a cavity (P = 0.01) and a stricture (P = 0.01) at the anastomotic site were unfavorable radiologic features associated with nonhealing. CONCLUSIONS: Subclinical leaks are more benign in their natural history compared with clinical leaks. Quality of life and bowel function is no better in patients with a subclinical leak compared with patients with a clinical leak who have ileostomy closure. Anastomotic leaks may resolve if favorable radiologic features are present.

    Title Case Records of the Massachusetts General Hospital. Case 38-2006. A 5-year-old Boy with Headache and Abdominal Pain.
    Date December 2006
    Journal The New England Journal of Medicine
    Title Dysbiosis and Pouchitis.
    Date December 2006
    Journal The British Journal of Surgery
    Excerpt

    BACKGROUND AND METHODS: The exact aetiology of pouchitis is unknown, but an association with dysbiosis has been suggested. This is a retrospective review of 17 studies published between 1985 and 2005, identified by a search of the Medline, Pubmed and Embase databases. RESULTS: The methodology of the studies varied widely. Many were performed at a time when the distinction between a healthy and an inflamed pouch was vague; misclassification of patients makes the analysis of data difficult and conclusions uncertain. CONCLUSION: The evidence that dysbiosis is a cause of pouchitis is poor. Nevertheless, available data allow the construction of an algorithm to aid management and suggest a structured approach for future research.

    Title Adenocarcinoma in a Pouch Without a Preceeding History of Dysplasia.
    Date November 2006
    Journal Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
    Title Letter 1: Randomized Clinical Trial of Bowel Preparation with a Single Phosphate Enema or Polyethylene Glycol Before Elective Colorectal Surgery (br J Surg 2006; 93: 427-433).
    Date September 2006
    Journal The British Journal of Surgery
    Title Use of a Large Bore Syringe Creates Significantly Fewer High Intensity Transient Signals (hits) into a Cardiopulmonary Bypass System Than a Small Bore Syringe.
    Date May 2006
    Journal Perfusion
    Excerpt

    INTRODUCTION: High intensity transient signals (HITS) have been reported to occur following perfusionist intervention during cardiac surgery. This study investigates the relationship of the syringe bore, injection rate, and HITS created. METHODS: Syringes (10 mL) with a male luer-lock connection (Large Bore) and Abboject 'jet syringes' with a 20 GA needle and male luer-lock connector (Small Bore) were filled with 10 mL of 0.9 N saline. A perfusionist was randomly assigned a set of four similar syringes followed by the other syringe bore. Each of the four syringes was injected into an in vitro saline-primed cardiopulmonary bypass (CPB) system over 5, 10, 15, or 20 sec. Sixteen randomizations of small and large bore syringes were completed at the four injection times (128 injections). HITS in the CPB arterial line were detected with transcranial Doppler (TCD) probes, were recorded for the 2 min following the injection, and were counted independently off-line by two reviewers. RESULTS: The use of a large bore syringe compared to a small bore syringe created significantly fewer HITS (29 +/- 6 versus 145 +/- 17 [mean +/- SEM], p<0.001) introduced into the CPB arterial line. Injection over a longer time produced significantly fewer HITS than shorter injection times (p<0.001). CONCLUSION: Significantly fewer HITS are introduced into the CPB system by using standard syringes and slower injection time.

    Title Diffusion-weighted Mr Imaging: Pediatric Clinical Applications.
    Date May 2006
    Journal Neuroimaging Clinics of North America
    Excerpt

    We have summarized the diffusion-weighed imaging (DWI) findings in a number of different cerebral disorders. In many cases, DWI with the accompanying apparent diffusion coefficient (ADC) map provides additional useful information to the standard imaging sequences. Pathophysiologic mechanisms resulting in baseline normal ADC values and changes with disease processes are not well understood; therefore, caution should be used when prognosticating the outcome of regions with abnormal ADCs. DWI should be used as an adjunct to routine imaging and interpreted in the context of the routine imaging findings and clinical scenario. As our understanding of ADC mechanisms increases and we begin to incorporate information about tissue organization from diffusion tensor imaging or diffusion spectrum imaging, the role of these methods in clinical diagnosis should continue to increase.

    Title Surgery for Recurrent Rectal Carcinoma: The Role of Preoperative Magnetic Resonance Imaging.
    Date May 2006
    Journal Clinical Radiology
    Excerpt

    Despite apparent curative resection of rectal carcinoma, local recurrence rates of between 3 and 32% have been reported. For those patients, radical surgical resection offers the only hope of cure. We present a review of the magnetic resonance imaging (MRI) findings and contraindications to curative surgery demonstrated using imaging.

    Title Acute Epiploic Appendagitis and Its Mimics.
    Date March 2006
    Journal Radiographics : a Review Publication of the Radiological Society of North America, Inc
    Excerpt

    Acute epiploic appendagitis most commonly manifests with acute lower quadrant pain. Its clinical features are similar to those of acute diverticulitis or, less commonly, acute appendicitis. The conditions that may mimic acute epiploic appendagitis at computed tomography (CT) include acute omental infarction, mesenteric panniculitis, fat-containing tumor, and primary and secondary acute inflammatory processes in the large bowel (eg, diverticulitis and appendicitis). Whereas the location of acute epiploic appendagitis is most commonly adjacent to the sigmoid colon, acute omental infarction is typically located in the right lower quadrant and often is mistaken for acute appendicitis. It is important to correctly diagnose acute epiploic appendagitis and acute omental infarction on CT images because these conditions may be mistaken for acute abdomen, and the mistake may lead to unnecessary surgery. The CT features of acute epiploic appendagitis include an oval lesion 1.5-3.5 cm in diameter, with attenuation similar to that of fat and with surrounding inflammatory changes, that abuts the anterior sigmoid colon wall. The CT features of acute omental infarction include a well-circumscribed triangular or oval heterogeneous fatty mass with a whorled pattern of concentric linear fat stranding between the anterior abdominal wall and the transverse or ascending colon. As CT increasingly is used for the evaluation of acute abdomen, radiologists are likely to see acute epiploic appendagitis and its mimics more often. Recognition of these conditions on CT images will allow appropriate management of acute abdominal pain and may help to prevent unnecessary surgery.

    Title A Versatile Aminobenzannulation Method Based on the Deprotonation of 2-(1-alkynyl)benzaldimines and Similar 2-aza-2,4-heptadienyl-6-ynes: a Multistep Rearrangement Cascade.
    Date October 2005
    Journal Angewandte Chemie (international Ed. in English)
    Title Gangrenous Cholecystitis: Prediction with Ct Imaging.
    Date August 2005
    Journal Abdominal Imaging
    Excerpt

    The aim of this study is to determine the usefulness of different patterns of gallbladder mucosal enhancement on contrast-enhanced computed tomography (CT) for differentiating between gangrenous and uncomplicated acute cholecystitis. This retrospective evaluation involved 56 patients with histopathologically proved acute cholecystitis (32 with gangrenous and 24 with uncomplicated acute cholecystitis) who had preoperative contrast-enhanced CT imaging. CT in 38 patients showed a gallbladder mucosal enhancement pattern that could be categorized into continuous, discontinuous, and/or irregular categories. In the other 18 patients, the mucosal enhancement pattern could not be classified due to lack of mucosal enhancement or inadequate mucosal enhancement. On contrast-enhanced CT evaluation, continuous and discontinuous and/or irregular mucosal enhancement patterns were seen in 20 and 18 patients, respectively. Among the 20 patients with continuous mucosal enhancement, 17 had uncomplicated acute cholecystitis. Seventeen of the 18 patients with discontinuous and/or irregular mucosal enhancement had gangrenous cholecystitis. The sensitivity and positive predictive value (PPV) of discontinuous and/or irregular mucosal enhancement in the diagnosis of gangrenous cholecystitis were 30.3% and 94.4% (17 of 18), respectively. The sensitivity and PPV of continuous mucosal enhancement in the diagnosis of uncomplicated acute cholecystitis were 30.3% and 85.5% (17 of 20), respectively. There was a statistically significant difference (p=0.0005) between the PPV of discontinuous and/or irregular (94.4%) and that of continuous (15%) mucosal enhancement for predicting gangrenous cholecystitis. The pattern of gallbladder mucosal enhancement on CT can be used as a reliable criterion for distinguishing acute, uncomplicated cholecystitis from gangrenous cholecystitis.

    Title The Modern Abdominoperineal Excision: the Next Challenge After Total Mesorectal Excision.
    Date August 2005
    Journal Annals of Surgery
    Excerpt

    OBJECTIVES: Examine the cause of local recurrence (LR) and patient survival (S) following abdominoperineal resection (APR) and anterior resection (AR) for rectal carcinoma and the effect of introduction of total mesorectal excision (TME) on APR. METHODS: A total of 608 patients underwent surgery for rectal cancer in Leeds from 1986 to 1997. CRM status and follow-up data of local recurrence and patient survival were available for 561 patients, of whom 190 underwent APR (32.4%) and 371 AR (63.3%). Also, a retrospective study of pathologic images of 93 specimens of rectal carcinoma. RESULTS: Patients undergoing APR had a higher LR and lower survival (LR, 22.3% versus 13.5%, P = 0.002; S, 52.3% versus 65.8%, P = 0.003) than AR. LR free rates were lower in the APR group and cancer specific survival was lowered (LR, 66% versus 77%, log rank P = 0.03; S, 48% versus 59%, log rank P = 0.02). Morphometry: total area of surgically removed tissue outside the muscularis propria was smaller in APR specimens (n = 27) than AR specimens (n = 66) (P < 0.0001). Linear dimensions of transverse slices of tissue containing tumor, median posterior, and lateral measurements were smaller (P < 0.05) in the APR than the AR group. APR specimens with histologically positive CRM (n = 11) had a smaller area of tissue outside the muscularis propria (P = 0.04) compared with the CRM-negative APR specimens (n = 16). Incidence of CRM involvement in the APR group (41%) was higher than in the AR group (12%) (P = 0.006) in the 1997 to 2000 cohort. Similar results (36% and 22%) were found in the 1986 to 1997 cohort (P = 0.002). CONCLUSIONS: Patients treated by APR have a higher rate of CRM involvement, a higher LR, and poorer prognosis than AR. The frequency of CRM involvement for APR has not diminished with TME. CRM involvement in the APR specimens is related to the removal of less tissue at the level of the tumor in an APR. Where possible, a more radical operation should be considered for all low rectal cancer tumors.

    Title Cardiac Arrest: Abdominal Ct Imaging Features.
    Date September 2004
    Journal Abdominal Imaging
    Excerpt

    We report computed tomographic findings of two unusual cases of sudden cardiac arrest. The imaging features documented include reflux of contrast into the abdomen as indicated by opacification of renal veins, hepatic veins, inferior vena cava, and hepatic and renal parenchyma. The reflux of contrast into the portal vein in one patient has not been described in the literature. The thoracic findings were reflux of contrast into the coronary sinus, nonopacificaton of the left ventricle with intravenous contrast, and lack of cardiac motion artifact.

    Title Bouveret's Syndrome: Appearance on Ct and Upper Gastrointestinal Radiography Before and After Stone Obturation.
    Date September 2003
    Journal Ajr. American Journal of Roentgenology
    Title Sarcoidosis with Musculocutaneous Involvement.
    Date January 2002
    Journal Clinical Nuclear Medicine
    Title Mccune-albright Syndrome with Thyrotoxicosis.
    Date December 2001
    Journal Clinical Nuclear Medicine
    Title Adductor Insertion Avulsion Syndrome.
    Date October 2001
    Journal Clinical Nuclear Medicine
    Title Ultrasound-guided Transthoracic Co-axial Biopsy of Thoracic Mass Lesions.
    Date December 2000
    Journal Acta Radiologica (stockholm, Sweden : 1987)
    Excerpt

    PURPOSE: To compare the diagnostic yield of fine-needle aspiration biopsy (FNAB) and cutting needle biopsy in thoracic lesions. MATERIAL AND METHODs: Thirty patients with thoracic mass lesions were subjected to ultrasound-guided co-axial FNAB and cutting needle biopsy using 0.7 mm aspirating and 1.0-mm cutting needles, respectively. The diagnostic yield of the individual modalities was compared with the combined yield. RESULTS: A conclusive diagnosis was obtained in 76.6% (n=23) of patients by FNAB and in 66.6% (n=20) by cutting needle biopsy. The combined diagnostic yield of FNAB and cutting needle biopsy was 93.3% (n=28) with a significant statistical difference (p<0.03) as compared to cutting biopsy alone. Of the patients, 23.2% (n=7) had benign and 76.6% (n=23) malignant aetiologies. The diagnostic yield of FNAB versus cutting needle biopsy in benign lesions was 57.1% (n=4) and 100% (n=7), respectively. The diagnostic yield of FNAB versus cutting needle biopsy in malignant lesions was 82.6% (n=19) and 56.5%, (n=13). Two patients remained undiagnosed by either modality. There were no complications. CONCLUSION: FNAB and cutting needle biopsy are complementary to each other and attempts should be made to obtain small tissue cores in addition to routine cytologic specimens in diagnosing thoracic lesions, especially in benign pathologies. US provides a safe guidance modality for lesions abutting the chest wall.

    Title Pressure Modulates Monocyte Migration.
    Date January 1998
    Journal American Journal of Hypertension : Journal of the American Society of Hypertension
    Excerpt

    Migration of monocytes into the subendothelial space of the aorta has been considered to be an important event in the development of atherosclerosis. Because hypertension is commonly associated with atherosclerosis, we studied the effect of applied pressure on the migration of monocytes. Direct applied pressure increased the migration (P < .001) of monocytes across a filter when compared with normal atmospheric pressure. The migration of monocytes was found to be directly related to the amount of the applied pressure. Amlodipine, a calcium channel blocker, attenuated the migration of monocytes under normal as well as increased pressure conditions in a dose-dependent manner. These studies provide a basis to speculate on the role of direct pressure in the migration of monocytes into the subendothelial space and the possibility that vasoactive agents may modulate the migration of monocytes independent of their pressure-lowering effect.

    Title Anorectal Melanoma--an Incurable Disease?
    Date July 1997
    Journal Diseases of the Colon and Rectum
    Excerpt

    PURPOSE: This study was designed to describe recurrence and survival rates after operative treatment for anorectal melanoma and to identify predictive factors for recurrence. METHODS: Records of 50 patients with anorectal melanoma from 1939 to 1993 were reviewed. RESULTS: Overall five-year survival and disease-free survival were 22 and 16 percent, respectively. At the time of diagnosis, 26 percent of patients had metastatic disease, and all died within 12 (mean, 6.3) months. Five-year survival and recurrence rates were identical after either abdominoperineal resection (APR) or wide local excision, both with curative intent. Gender, size of tumor, presence of melanin, positive perirectal lymph nodes, or treatment were not predictive of recurrence. Anorectal melanoma was found incidentally after hemorrhoidectomy or polypectomy in five patients. Three other patients underwent an excisional biopsy of a lesion measuring less than 2 cm. Of these eight patients, five underwent APR and three underwent wide local excision with no microscopic residual tumor at pathology. All developed regional or systemic recurrence at a mean of 21 (range, 4-88) months, and all died of their disease at a mean of 29 (range, 5-98) months. CONCLUSION: Prognosis for anorectal melanoma is poor, irrespective of surgical treatment performed. No predictive factors for recurrence were identified in this series. Wide local excision with a negative margin of a least 1 cm is suggested as the treatment of choice. APR should be reserved for tumor not amenable to local excision or for palliative treatment of large obstructive lesion until effective adjuvant therapies are available.

    Title Whither Child Psychiatry?
    Date January 1997
    Journal The Australian and New Zealand Journal of Psychiatry
    Title Risk-adjusted Analysis of Surgeon Performance: a 1-year Study.
    Date July 1995
    Journal The British Journal of Surgery
    Excerpt

    A 1-year prospective analysis was undertaken of all non-day-case general surgery in a district general hospital. Using the Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) scoring system 3004 patients were assessed. From the predictions of mortality and morbidity so obtained, a quality measure, the ratio of observed to expected numbers of deaths and complications (O:E ratio) was determined for each surgeon, both overall and within specialty zones. The present study demonstrates the serious hazard in using 'raw' uncorrected mortality and morbidity statistics to compare surgeon performance. Mortality rates varied from 1.0 to 4.9 per cent whereas O:E ratios ranged from 0.83 to 1.06; morbidity rates varied from 5.3 to 12.6 per cent with O:E ratios 0.86-1.02. Great misunderstanding may result from the publication of surgeon or hospital 'league tables'. The present study demonstrates a technique that might allow surgeon performance to be monitored adequately and accurately.

    Title The Prevalence of Gut Translocation in Humans.
    Date September 1994
    Journal Gastroenterology
    Excerpt

    BACKGROUND/AIMS: Gut translocation of enteric organisms across the intact intestinal mucosa has been postulated as a potential source of sepsis in susceptible patients. However, little is known of its occurrence or significance in humans. The aim of this study was to determine the prevalence of gut translocation of bacteria in humans and attempt to identify any predisposing factors to its occurrence. METHODS: A consecutive series of 267 general surgical patients were examined for evidence of bacterial translocation by bacterial analysis of intestinal serosa and mesenteric lymph nodes taken at the time of surgery. RESULTS: Translocation occurred in 10.3% of patients overall. Both aerobic and anaerobic bacteria translocated. Excluding patients with distal intestinal obstruction and those with inflammatory bowel disease in whom translocation was more common, the prevalence was 5%. Neither jaundice, nutritional status, nor total parenteral nutrition predisposed to translocation. Similarly, mucosal atrophy did not predispose to this phenomenon. The development of postoperative septic complications was twice as common in patients with translocation as in those without, but mortality was unaffected. CONCLUSIONS: Translocation occurs as a spontaneous event in humans, but its clinical significance remains to be defined.

    Title Literacy Differentials in Tribal and Non-tribal Population of India, 1981.
    Date April 1994
    Journal Population Geography : a Journal of the Association of Population Geographers of India
    Excerpt

    The author investigates literacy differentials between tribal and non-tribal populations in India, using 1981 census data. "Spatially, the index is high in tradition gripped and economically backward areas of Western Rajasthan, of central highlands and of Western Arunachal Pradesh. It is low in [the] Christian tribal belt of [the] northeast; the early exposed areas of [the] southern peninsula, parts of Gujarat, Maharashtra and Karnataka, and numerically insignificant areas of northern Rajasthan and Western Himalayas."

    Title P53 Expression and K-ras Mutation in Colorectal Adenomas.
    Date July 1993
    Journal Gut
    Excerpt

    The frequency of p53 overexpression and K-ras codon 12 mutation was investigated in a series of colorectal adenomas. p53 was detected by immunohistochemistry in only 5% of tumours, whereas K-ras mutation was found in eight of 30 adenomas examined. In vitro, mutant p53 and ras genes cooperate to transform primary rat cells into a tumourigenic cell line. The presence of both p53 overexpression and K-ras mutation in a benign tubulovillous polyp in the present series suggests that in vivo this combination of events is insufficient to cause malignant transformation of a large bowel adenoma.

    Title Partial Purification of Acid Phosphomonoesterase in Axenically Grown Entamoeba Histolytica Nih-200.
    Date April 1993
    Journal The Journal of Communicable Diseases
    Excerpt

    Entamoeba histolytica possesses significant acid phosphatase activity as compared to alkaline phosphatase activity. The acid phosphatase activity in the amoebic cells eluted at higher saline concentration as three distinct peaks at 200, 300 and 400 mM sodium chloride.

    Title Adjuvant Therapy and Quality of Life.
    Date March 1993
    Journal Lancet
    Title Prognostic Value of P53 Overexpression and C-ki-ras Gene Mutations in Colorectal Cancer.
    Date February 1993
    Journal Gastroenterology
    Excerpt

    BACKGROUND: Mutations in Ki-ras codon 12 and the p53 gene are common abnormalities in colorectal cancer. The occurrence of p53 overexpression and/or Ki-ras codon 12 mutations were analyzed in 100 colorectal adenomas to determine if they were related to patient survival. METHODS: p53 overexpression was identified by immunohistochemistry, and Ki-ras codon 12 mutations were detected using the polymerase chain reaction and a restriction enzyme digestion method. RESULTS: p53 overexpression was identified in 45% of tumors, with a higher frequency identified in DNA aneuploid and left-sided tumors than in DNA diploid and right-sided tumors. Mutations in Ki-ras codon 12 were identified in 24% of carcinomas. Individually, mutations in Ki-ras codon 12 or p53 overexpression were not prognostic indicators of survival. However, a statistically significant difference in survival was identified when these two oncogenic abnormalities were analyzed together. The median survival of patients whose tumors contained both oncogenic abnormalities was less than half of that of patients with either alteration alone or without either abnormality. CONCLUSIONS: Screening for multiple genetic abnormalities in colorectal cancers excised at surgery may prove to be a useful tool in determining prognosis.

    Title Cerebral Ammonia Levels and Enzyme Changes During Plasmodium Yoelii Infection in Mice.
    Date January 1993
    Journal The Journal of Tropical Medicine and Hygiene
    Excerpt

    Ammonia, lactate and glutamate levels and the activities of glutamine synthetase (GS), glutamate dehydrogenase (GDH), glutaminase (GLN), aspartate transaminase (AST), phosphofructokinase (PFK) and monoamine oxidase (MAO) were compared in the brain tissue of normal and P. yoelii infected mice. The brain lactate increased by 96% at peak parasitaemia. Cerebral ammonia also exhibited an increase in infected mice which was parasitaemia dependent, while glutamate remained almost unchanged. The brain glutamine synthetase registered an increase of 35% (P < 0.001) in post-mitochondrial fractions, this effect being perceptible even at low parasitaemia, but attained constancy at parasitaemia levels higher than 20%. The activity of monoamine oxidase and phosphofructokinase increased by 105% (P < 0.02) and 41% (P < 0.05) respectively while glutamate dehydrogenase decreased by 15% (P < 0.001). Glutaminase and aspartate transaminase were not significantly influenced by infection (tested only at high parasitaemia levels). It has been postulated that cerebral hypoxia and aberrations in ammonia metabolism may both contribute towards malaria induced cerebral complications.

    Title Oxido-reductive Functions of Entamoeba Histolytica in Relation to Virulence.
    Date December 1992
    Journal Annals of Tropical Medicine and Parasitology
    Excerpt

    Entamoeba histolytica can reduce nitro-blue tetrazolium (NBT) in Hank's balanced salt solution to almost the same extent as in Eagle's minimal medium. Further, this reduction was stimulated only to a minor degree by glucose, pyruvate and DL-serine, substrates known to support respiratory activity (O2 uptake) in E. histolytica. However, both NADH and NADPH increased NBT reduction several-fold, the effect being greater with NADPH. A sizeable proportion of this endogenous dye-reducing capability (in Hank's solution) was associated with low-speed sediments obtainable from amoebic homogenates, which also shared the bulk of 125I labelling (when the homogenates were prepared after surface labelling with Na 125I). Conversion of the dye to formazan was strongly inhibited by -SH blocking agents, but was not influenced by rotenone and antimycin A. The activity was also inhibited by H2O2, but stimulated by catalase. Superoxide dismutase only slightly curtailed NBT reduction in intact cells, but inhibited it in homogenates in a concentration-dependent manner to a maximal extent of 33%. Almost the same degree of curtailment of this activity was induced by anaerobic conditions. Both concanavalin A (Con A) and phorbol myristate acetate stimulated the activity in intact cells, though the effect of Con A was nullified by alpha-methyl mannoside. Both NBT-reducing capability and alcohol dehydrogenase activities were higher in the more virulent IP:106 strain, and they increased with time in cultures of NIH:200 in a cholesterol-enriched environment.

    Title Aberrations in Cerebral Vascular Functions Due to Plasmodium Yoelii Nigeriensis Infection in Mice.
    Date November 1992
    Journal Experimental and Molecular Pathology
    Excerpt

    Plasmodium yoelii nigeriensis infection in mice caused an increase in uptake of 125I-labeled bovine serum albumin, 51Cr-labeled erythrocytes and Evans blue dye from peripheral circulation into the brain. Isolated cerebral microvessels which were characterized in terms of their morphology under scanning electron microscope and enhancement of the specific activities of biochemical markers, viz. alkaline phosphatase, gamma-glutamyl transpeptidase, and monoamine oxidase, showed significant decrease in these activities due to P. yoelii nigeriensis infection. On the other hand, relatively minor (statistically insignificant) changes occurred in the first two enzyme specific activities in the cerebral cortex and monoamine oxidase registered an increase in this tissue due to infection. Histological examination of the cerebral tissue of infected animals by light and electron microscopy showed broken blood vessel walls and leakage of erythrocytes into extravascular space, some of which contained intraerythrocytic malarial parasite in a state of cell division.

    Title Male-female Literacy Differential in India--1981.
    Date March 1992
    Journal Population Geography : a Journal of the Association of Population Geographers of India
    Excerpt

    The author examines inequalities in the literacy rates between males and females in India. Regional variations in literacy are examined by district using maps. "The male-female literacy differential is low in coastal, peripheral and metropolitan areas and is high in inland and mountainous areas. These regional disparities are the product of differences in length of educational background, age at marriage, level of urbanisation, standard of living and proportion of socially conservative and backward sections of society....The study in spatial dimension provides a strong base for the removal of sex biased discrimination in society."

    Title Biochemical and Ultrastructural Studies Induced by Phanquone on Entamoeba Histolytica Nih-200.
    Date November 1991
    Journal The Journal of Communicable Diseases
    Excerpt

    The action of phanquone on the incorporation of (14C)1-DL-valine and (14C)-8-adenine in TCA insoluble fractions of Entamoeba histolytica was examined as indices of RNA and protein synthesis respectively. The former was found to show greater sensitivity to the drug in terms of the effect manifested in the dose response curves for these parameters. Electron microscopic investigations with increasing concentrations of the drug demonstrated progressive vacuolization with concomitant dissolution of ribosomal helices. The drug had no significant effect on nucleus and plasma membrane even at concentration as high as 200 micrograms/ml.

    Title P53 in Colorectal Cancer: Clinicopathological Correlation and Prognostic Significance.
    Date April 1991
    Journal British Journal of Cancer
    Excerpt

    p53 protein was detected by immunohistochemistry in 42% of 52 colorectal adenocarcinomas. Positive tumours were significantly more frequent in the distal colon, and demonstrated a higher rate of cell proliferation. No correlation was found with tumour grade, Dukes' stage, presence of DNA aneuploidy or patient survival. The role of p53 in colorectal carcinogenesis is discussed with particular reference to differences between proximal and distal large bowel cancers.

    Title Action of Metronidazole on Entamoeba Histolytica: an Ultrastructural Study.
    Date December 1990
    Journal The Journal of Communicable Diseases
    Excerpt

    Metronidazole (19 micrograms/ml) caused progressive increase in vacuolization in Entamoeba histolytica cells with disintegration of its plasma membrane leading to almost complete disappearance of the latter within 3 hours. The drug also induced formation of helical ribosomal aggregates in the cytoplasm and disappearance of button like structures inside the nucleus.

    Title Avoiding Needle-stick Injury.
    Date November 1990
    Journal Anaesthesia and Intensive Care
    Title Specific Features of Phosphomonoesterase of Entamoeba Histolytica (nih-200).
    Date August 1990
    Journal Indian Journal of Experimental Biology
    Excerpt

    Axenically grown E. histolytica possess significant acid phosphatase activity. The Km of the enzyme was found to be 7.1 x 10(-3) and was maximally active at pH 4.5. Acid phosphatase activity was significantly inhibited by Cu2+, cysteine and was activated by tartrate and fluoride. It was found that E. histolytica acid phosphatase differs in some properties as compared to the enzyme reported from other sources.

    Title Effect of Plasmodium Yoelii Infection on Gaba Metabolism of Mouse Brain.
    Date June 1990
    Journal Experimental and Molecular Pathology
    Excerpt

    Plasmodium yoelii infection in albino mice decreased the activity of brain glutamic acid decarboxylase (GAD) by about 30 and 48% in crude homogenate and its synaptosomal fraction, respectively. The decrease was evident from 20% parasitemia and remained more or less constant up to 80% parasitemia. The Km values of GAD in normal and infected animals were 1.2 x 10(-2) and 3.3 x 10(-2) mM, respectively, indicating a decrease in enzyme substrate affinity due to infection. The lowered GAD activity rose to slightly above normal by treatment of infected animals with chloroquine. Decrease in GAD activity reflected lower gamma-aminobutyric acid (GABA) levels in the infected brain; however, GABA-transaminase activity was not significantly influenced by infection. It has been proposed that impaired GABA synthesis may be due to hypoxia induced by malarial infection.

    Title Evidence for Selection of Virulent Sub-populations of Entamoeba Histolytica by Cholesterol.
    Date January 1990
    Journal Annals of Tropical Medicine and Parasitology
    Excerpt

    Quantitatively much higher Concanavalin A (Con. A) agglutinability, haemolytic potency, and activities of acid hydrolases, namely phosphatase (EC 3.1.3.2), ribonuclease (EC 2.7.7.16), deoxyribonuclease (EC 3.1.4.5) and proteinase--were observed in a virulent strain of Entamoeba histolytica (IP-106), as compared to attenuated and avirulent strains (200-NIH) and DKB respectively. In addition, significant differences in these parameters were observed among clonal cultures derived from the latter two cultures by cultivation of single amoebic cells picked out by micromanipulation. Repeated sub-culturing of parent cultures of both these strains in cholesterol-enriched medium resulted in marked enhancement of all the above activities, but no such change occurred in the derived clonal cultures following similar cholesterol treatment. The implication of these findings in relation to enhancement of the virulence of E. histolytica by cholesterol is discussed.

    Title Sensitivity of Protein and Rna Synthesis to Antiamoebic Drugs in Axenic Entamoeba Histolytica (nih-200).
    Date October 1989
    Journal Zentralblatt Für Bakteriologie : International Journal of Medical Microbiology
    Excerpt

    The action of antiamoebic drugs on the incorporation of (14C) 1-DL-valine and (14C)-8 adenine in TCA insoluble fraction of axenic Entamoeba histolytica was investigated. Adenine showed greater sensitivity to all the drugs tested viz. camoquin, chloroquine, diodoquin, metronidazole, entobex and diloxanide furoate except enterovioform.

    Title Failure of Heimlich Manoeuvre.
    Date October 1989
    Journal Anaesthesia
    Title Action of Cholesterol on Virulence Related Biochemical Functions of Entamoeba Histolytica.
    Date June 1989
    Journal Indian Journal of Experimental Biology
    Title Secretion of Acid Phosphatase by Axenic Entamoeba Histolytica Nih-200 and Properties of the Extracellular Enzyme.
    Date June 1989
    Journal The Journal of Protozoology
    Excerpt

    Entamoeba histolytica (NIH-200) secreted large amounts of acid phosphatase in its external environment when grown axenically in modified TPS-II medium. Fractionation by DEAE-cellulose chromatography of the precipitate obtained from the cell-free medium at 60% ammonium sulfate saturation yielded 3 distinct peaks of enzyme activity. The enzyme in all the peaks showed resistance to tartrate but was inhibited by fluoride, cupric chloride, ethylene diamine-tetra acetic acid, ammonium molybdate and cysteine; however, enzyme associated with different peaks differed in its polyacrylamide gel electrophoretic profiles and behavior towards concanavalin A.

    Title Action of Praziquantel on Calcium Transport in Hymenolepis Diminuta.
    Date April 1989
    Journal Folia Parasitologica
    Excerpt

    Effect of praziquantel on inward and outward Ca++ fluxes was investigated in Hymenolepis diminuta in glucose supplemented balanced electrolyte solution and under conditions of glucose/Mg++ deficiency. The 45Ca++ uptake in freshly isolated worms presented, generally, a biphasic kinetics. This comprised of an initial fast uptake phase, followed by a continued slower influx. The initial fast kinetics showed insensitivity to or slight stimulation by praziquantel depending on its concentration, and such stimulatory action was particularly prominent under Mg++ deficient condition (P less than 0.01). The subsequent slower 45Ca++ uptake was, however, markedly inhibited by the drug under both these conditions (P less than 0.01). Glucose starvation of the worms resulted in abolition of the fast 45Ca++ influx phase and uniform inhibition by the praziquantel without any indication of initial stimulatory effect (P less than 0.01). The extrusion of 45Ca++ from the label preloaded worms was stimulated by praziquantel under all the conditions investigated (P less than 0.01).

    Title Acid Phosphomonoesterase Heterogeneity in Axenically Grown Entamoeba Histolytica.
    Date May 1988
    Journal Annals of Tropical Medicine and Parasitology
    Title In Vitro Insulin Action on Erythrocyte Glucose Metabolism in Normal and Diabetic Rats.
    Date May 1988
    Journal Diabetologia
    Excerpt

    Alloxan-induced diabetes in rats significantly impaired the capacity of the erythrocytes to metabolise glucose in vitro to either lactic acid or CO2. Both these metabolic activities were initially insensitive to insulin in normal as well as in diabetic animals; but became responsive when these cells were subjected to insulin and glucose 'starvation' for 1 h through incubation in their absence. This action of insulin in starved cells showed concentration dependence and required preincubation with the hormone prior to addition of glucose.

    Title Sensitivity of Protein and Rna Synthesis to Emetine in Axenic Entamoeba Histolytica.
    Date March 1988
    Journal Zentralblatt Für Bakteriologie, Mikrobiologie, Und Hygiene. Series A, Medical Microbiology, Infectious Diseases, Virology, Parasitology
    Excerpt

    The action of emetine on the incorporation of (14C)1-DL-valine and (14C)-8-adenine in TCA insoluble fraction of axenic Entamoeba histolytica was investigated. These compounds were almost exclusively incorporated in the 'protein' and 'RNA' fractions, respectively. Incorporation of the purine showed a significantly higher sensitivity to emetine. While the percentage inhibition of valine incorporation by emetine decreased with increasing pH, the susceptibility of adenine incorporation was greater in the alkaline range.

    Title Insulin Binding Parameters in Erythrocytes of Alloxan Induced Diabetic Rats.
    Date December 1987
    Journal Indian Journal of Experimental Biology
    Title Cholesterol Induced Changes in Glucose-6-phosphate Generating Enzymes, Concanavalin A Agglutinability and Haemolytic Activity of Axenic Entamoeba Histolytica.
    Date November 1987
    Journal Annals of Tropical Medicine and Parasitology
    Excerpt

    Repeated passage of the 200-NIH strain of Entamoeba histolytica through cholesterol-enriched axenic growth medium induced marked increases in cholesterol, phosphoglucomutase and hexokinase levels and a less prominent rise in the protein content of amoebic cells. There was also pronounced enhancement of haemolytic activity and Concanavalin A (Con A) agglutinability of the culture, but no significant change was observed in glucose phosphate isomerase. These cholesterol-induced effects persisted to a large extent when amoebae were subsequently repassaged through normal axenic medium lacking exogenous cholesterol, but changes in cellular cholesterol and protein levels did not persist. Qualitatively similar results were obtained whether the sterol was layered as a film on the glass walls of the culture tubes or supplied as sonicated micells, but the latter was in general more effective.

    Title Changes in Insulin Receptor Functions of the Erythrocyte by Treatment of Non-insulin-dependent Diabetes Mellitus (niddm) Patients with Glibenclamide and Diet Control.
    Date January 1987
    Journal Acta Diabetologica Latina
    Excerpt

    The insulin binding of erythrocytes from: (i) fifteen age-matched normal subjects, (ii) ten untreated NIDDM patients and (iii) fifteen treated (glibenclamide + hypocaloric diet) NIDDM patients (all males) has been studied. A significant decrease in specific insulin binding was observed in group (ii) which improved in cases controlled after treatment (group iii). Scatchard analysis of the results suggested that changes in insulin binding were due to alteration in the number of insulin receptors on erythrocytes. The number of insulin receptors/cell was 471 in normals, 160 in diabetics and 282 in treated diabetic subjects. No significant change in the binding affinity was observed in the three groups (1.0 X 10(8), 1.2 X 10(8) and 1.1 X 10(8) M-1 in normal subjects, untreated diabetics and treated diabetics, respectively).

    Title In Vitro Insulin Effect on Acetylcholine Esterase of Erythrocyte Membranes of Normal and Diabetic Rats.
    Date May 1986
    Journal Acta Diabetologica Latina
    Excerpt

    Alloxan induced diabetes in rats was associated with a significant reduction in the acetylcholine esterase activity of the erythrocyte membrane. Preincubation of these membranes with insulin caused a rapid but transient stimulation of this enzyme activity in both normal and diabetic rats, the effect being more marked in the latter group.

    Title In Vitro Insulin Action on Different Atpases of Erythrocyte Membranes in Normal and Diabetic Rats.
    Date January 1986
    Journal Acta Diabetologica Latina
    Excerpt

    The in vitro effect of porcine insulin on Na+ + K+, Ca2+- and Mg2+-ATPases of the rat erythrocyte membrane of normal and alloxan-induced diabetic rats was investigated. Na+ + K+- and Ca2+-stimulated enzyme activities were significantly decreased in diabetic rats in comparison to normal animals. The specific activities of both these ATPases in the latter group were markedly reduced on pre-incubating the ghosts with insulin. Similar treatment of the erythrocyte membranes of diabetic animals, however, resulted in a significant increase of these activities. These qualitatively different effects of the hormone in the two groups increased progressively with hormone concentration and duration of pre-incubation. Mg2+-stimulated ATPase activity was not significantly affected in diabetes or by insulin.

    Title Comparison of in Vitro Demyelination and Cytotoxicity of Humoral Factors in Multiple Sclerosis and Other Neurological Diseases.
    Date November 1985
    Journal Journal of the Neurological Sciences
    Excerpt

    The distribution and nature of serum factors causing in vitro demyelination and glial lysis were investigated in multiple sclerosis (MS), other neurological diseases (OND), ill control and control groups. MS sera were unique in affecting only CNS myelin and glia whereas stroke and Guillain-Barré syndrome (GBS) sera brought changes to both CNS and PNS tissue. Through both visual scoring of myelin damage and the quantitative measurement of radiolabel release from cerebellar cultures, it was evident that the MS and OND groups have similar myelino- and cytotoxic effects. This may reflect MS and OND sera sharing similar humoral factors. 74% MS, 68% OND and 22% of control scores were above a score threshold designed to exclude culture handling trauma effects. When classified by their current disease state MS patients with severe and mild disease yielded higher in vitro scores than did those with moderate disease who comprised an older age group. No other clinical features of MS patients gave any association with in vitro serum effects. The rare demonstration of bound Fab IgG in cultures after MS serum tests indicates that immune mechanisms are unlikely to make a large contribution to serum-induced demyelination and cellular change in vitro.

    Title Differential Lectin Agglutinability of Virulent and Avirulent Entamoeba Histolytica Strains.
    Date August 1985
    Journal Indian Journal of Experimental Biology
    Title In Vivo Distribution & Action of Emetine on Protein Synthesis in Hamster Tissues.
    Date April 1984
    Journal Indian Journal of Experimental Biology
    Title Haemolysis: an in Vitro Model to Investigate Tissue Necrotic Activity of Entamoeba Histolytica.
    Date April 1983
    Journal Indian Journal of Experimental Biology
    Title Cholesterol Induced Changes in Concanavalin A Agglutinability of Entamoeba Histolytica.
    Date May 1982
    Journal Indian Journal of Experimental Biology
    Title Action of Certain Anaesthetic Agents on Erythrocyte Calcium Permeability.
    Date December 1981
    Journal Indian Journal of Experimental Biology
    Title Correlation of Encystment and Division in Schizopyrenus Russelli.
    Date September 1977
    Journal The Journal of Protozoology
    Excerpt

    Schizopyrenus russelli, a free-living soil ameba, grows and encysts in the presence of bacteria. The encystment occurs with decline in the division rate. This is accompanied by incorporation of [U-14C] glucose into cyst cellulose. The degree of multiplication (but not of encystment) is a function of bacterial concentration. Berenil, a trypanocidal drug, while allowing excystment, completely inhibited multiplication of emerged amebae and their encystment. Addition of this drug after 24 hr, when amebae had gone into a phase of active division failed to check encystment, although it still inhibited further multiplication of the amebae. The findings suggest that a phase of cell division may be a prerequisite for encystment.

    Title Correlation of Encystment and Division in Schizopyrenus Russelli.
    Date September 1977
    Journal The Journal of Protozoology
    Excerpt

    Schizopyrenus russelli, a free-living soil ameba, grows and encysts in the presence of bacteria. The encystment occurs with decline in the division rate. This is accompanied by incorporation of [U-14C] glucose into cyst cellulose. The degree of multiplication (but not of encystment) is a function of bacterial concentration. Berenil, a trypanocidal drug, while allowing excystment, completely inhibited multiplication of emerged amebae and their encystment. Addition of this drug after 24 hr, when amebae had gone into a phase of active division failed to check encystment, although it still inhibited further multiplication of the amebae. The findings suggest that a phase of cell division may be a prerequisite for encystment.

    Title Effect of Certain Anabolic Inhibitors on Excystment & Related Utilization of Labelled Adenine in Schizopyrenus Russelli.
    Date June 1975
    Journal Indian Journal of Experimental Biology
    Title Ultrastructural Changes During Encystment of Schizopyrenus Russelli.
    Date January 1975
    Journal The Journal of Protozoology
    Title Role of Riboflavin and Certain Amino Acids in the Excystment of Schizopyrenus Russelli.
    Date November 1973
    Journal The Journal of Protozoology
    Title Changes in the Levels of Some Macromolecules and Certain Enzyme Activities in Excysting Schizopyrenus Russelli.
    Date March 1972
    Journal The Journal of Protozoology
    Title Production of Single-walled Cysts of Schizopyrenus Russelli by Sonication and Their Behaviour Towards Excystment-inducing and Excystment-blocking Agents.
    Date February 1971
    Journal Journal of General Microbiology
    Title Marked Delay in Excystment of Schizopyrenus Russelli Cysts by P-chloromercuric Benzoate and Its Reversal with Reduced Glutathione.
    Date August 1969
    Journal Journal of General Microbiology
    Title Activation of Deoxycytidylate Deaminase from Certain Embryonal and Tumour Tissues by 6-aza-2'-deoxycytidine-5'-monophosphate and 2'-deoxycytidine-5'-triphosphate.
    Date November 1966
    Journal Folia Biologica
    Title Effect of Cellular Disruption on Certain Metabolic Activities in Vibrio Cholerae.
    Date October 1966
    Journal Enzymologia
    Title Effect of Ultraviolet Radiation on the Oxidation of Certain Krebs Cycle Substrates in Vibrio Cholerae.
    Date June 1966
    Journal Indian Journal of Biochemistry
    Title The Effects of Major Abdominal Surgery, Enteral and Parenteral Nutrition on Pancreatic Function and Morphology.
    Date
    Journal Clinical Nutrition (edinburgh, Scotland)
    Excerpt

    The effects of major abdominal surgery and nutritional support upon pancreatic function and morphology were studied in similar groups of patients who underwent major abdominal surgery (n = 18), received parenteral nutritional support (n = 18) or received enteral nutritional support (n = 16). The exocrine function of the pancreas was measured by means of an oral pancreatic function test (using 1 g of N-benzoyl-L-tyrosyl para-aminobenzoic acid) with measurement of serum para-aminobenzoic acid at 3 h and the Pancreatic Excretion Index. Pancreatic morphology was assessed by real time ultrasound and a pancreatic size index was calculated (maximum diameter of head x body). Serial measurements of function and morphology were carried out in each patient at entry into the study and at 7 and 14 days after operation or start of nutritional support. Serum PABA levels were similar in the 3 groups at the start of the study. Although the levels remained unchanged in the enteral and parenteral groups, a significant and progressive decrease was observed in the surgical group (serum PABA = 27.5 nmol/l (24.0-30.6) before operation, 10.5 nmol/l (5.5-13.4) 14 days after operation, P < 0.01). No significant changes in pancreatic size were seen. Parenteral and enteral nutrition preserves pancreatic exocrine function. A dramatic reduction in pancreatic exocrine function is seen after major abdominal surgery.

    Title Laparoscopic Restorative Proctocolectomy with and Without Previous Subtotal Colectomy.
    Date
    Journal Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
    Excerpt

    Introduction: Laparoscopic techniques have been applied to the procedure of restorative proctocolectomy. The aim of this study was to compare the outcomes of patients after laparoscopic ileal pouch-anal anastomosis (IPAA) with (restorative proctocolectomy - RPC) and without previous colectomy (restorative proctectomy - RP) and to highlight some technical tips. Method: Data were collected prospectively from all patients who underwent laparoscopic restorative proctocolectomy with IPAA from July 2006 to December 2007. Results: Thirty-six patients underwent IPAA with total proctocolectomy (n=25) or after previous emergency colectomy (n=11). Postoperative morbidity occurred in 22% of patients. The overall median operative time were 210 (range 120-325) minutes; 240 (170-325) minutes and 180 (120-240) minutes for RPC and RP respectively (P<0.05). The median length of stay for all patients was 6 (3-26) days; 6 (4-26) days and 4 (3-13) days for RPC and RP respectively (P<0.05). There was no correlation between BMI, age, use of immunosuppressive agents and length of stay. The operative procedure was facilitated by use of specific devices at particular stages of the operation Conclusion: Laparoscopic IPAA is not only safe and feasible for the virgin abdomen but also for patients with a previous emergency colectomy through a midline laparotomy incision.

    Title Efficacy of the Anal Fistula Plug in Complex Anorectal Fistulae.
    Date
    Journal Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
    Excerpt

    Objective: The treatment of complex anorectal and rectovaginal fistulae remains a difficult problem. The options are fistulotomy, setons, fibrin glue, and a variety of flap procedures. Recently, there have been several reports of a new plug; the Surgisis((R)) AFPtrade mark plug. Reports from various centres do not give consistent results. The aim of this study was to assess the efficacy of the Surgisis((R)) AFPtrade mark fistula plug in a wide spectrum of patients with anorectal, rectovaginal and pouch vaginal fistulae. Patients and Methods: Between March 2006 and September 2007, patients with a variety of anal fistulae were selected for fistula plug insertion in the coloproctology units at Leeds, UK and Aarhus, Denmark. Demographic and fistulae details were obtained. Post operatively, all patients had a course of oral antibiotics. Results: Forty-three patients with a median age of 45 (range 18-65) years underwent a total of 45 procedures. Seventy-five per cent (n=32) had a fistula secondary to cryptoglandular abscess. Median follow up was 47 (range 12-77) weeks. The success rate for complete healing was 44%. Dislodgement caused failure on 10 (22%) occasions. Conclusion: Our study shows a moderate success rate for treatment with fistula plugs. The complex nature of the fistulae selected may be the reason for the low success rate.

    Similar doctors nearby

    Dr. Jules Dienstag

    Internal Medicine
    38 years experience
    Boston, MA

    Dr. Ryan Thompson

    Internal Medicine
    5 years experience
    Boston, MA

    Dr. Taha Gholipour

    Internal Medicine
    Boston, MA

    Dr. Isaac Ritter

    Internal Medicine
    Boston, MA

    Dr. Lorie Smith

    Internal Medicine
    5 years experience
    Boston, MA

    Dr. Michael Mannstadt

    Internal Medicine
    19 years experience
    Boston, MA
    Search All Similar Doctors