Browsing by Author "SANDHYAMANI, S"
Now showing 1 - 8 of 8
Results Per Page
Sort Options
Item A MONKEY MODEL FOR MUCOID VASCULOPATHY(INTERNATIONAL ANGIOLOGY, 1992)Mucoid vasculopathy is a new vascular entity observed by the Author in autopsy material in Kerala, a southwest coastal state of tropical India. This non-atherosclerotic, non-inflammatory connective tissue disorder affects mainly arteries, veins, vasa-nervosum and fascial tissues. Characteristically, there are large deposits of acid mucopolysaccharide (glycosaminoglycan) material in the intima and media of arteries, accompanied by hyperplastic changes in cellular elements of the vessel wall and dystrophic changes in internal elastic laminae. There is secondary mineralization of elastic laminae and of medial mucoid material in some cases. To ascertain the role of diet in the aetiology of mucoid vasculopathy, groups of bonnet monkeys were fed protein-deficient normal carbohydrate, or protein-deficient high-carbohydrate tapioca (cassava) starch based diets or control diets of normal protein and carbohydrate for 3 or 5 months periods. The diet of the poorer sections in Kerala is deficient in protein and tapioca is the main source of carbohydrate. A generalised mucopolysaccharidosis and vasculopathy similar to the human condition and associated with some cardiomyopathic changes could be induced in the monkeys by protein deficient diets. These were enhanced both by ingestion of a high carbohydrate and by a longer experimental period. In order to exclude the effect of toxic factors which might be present in tapioca starch, experiments were repeated with corn starch as the carbohydrate: identical cardiovascular lesions were induced. The animal experiments established pivotal role for protein-deficiency in inducing mucoid vasculopathy with enhancement of degenerative cardiovascular lesions by ingestion of higher levels of carbohydrate in a protein-deficient state. This experimental study establishes a good animal model for mucoid vasculopathy.Item ATRIAL SEPTAL-DEFECT IN A BONNET MACAQUE (MACACA-RADIATA)(JOURNAL OF MEDICAL PRIMATOLOGY, 1990)Atrial Septal Defect was detected at autopsy in a subadult bonnet macaque (Macaca radiata). Case history and autopsy findings were described.Item CARDIOVASCULAR EFFECTS IN BONNET MONKEYS (MACACA-RADIATA) OF A CASSAVA-BASED PROTEIN-DEFICIENT DIET(VETERINARY AND HUMAN TOXICOLOGY, 1991)Bonnet Monkeys (Macaca radiata) were maintained for up to 5 mo on protein-deficient diets that contained tapioca starch (cassava starch) as the source of carbohydrate. The animals developed mucopolysaccharidosis of blood vessels and cardiomyopathic changes in the heart. These changes were similar to the mucoid vasculopathy and cardiomyopathy seen in Kerala where tapioca is consumed as a staple diet by a large proportion of the people. The lesions were enhanced by longer duration of feeling the diet and in protein-deficient animals given additional amounts of tapioca starch. This indicates that protein-carbohydrate malnutrition does play a role in the induction of such cardiovascular disorders.Item MUCOID VASCULOPATHY - VASCULAR-LESIONS IN AN AUTOPSY STUDY(MODERN PATHOLOGY, 1993)Mucoid vasculopathy is a unique, idiopathic, vascular entity observed in autopsy material at the Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India. The vascular lesions are the most prominent manifestation of a pathologic condition characterized by a generalized mucopolysaccharidosis of connective tissues found, for example, within nerve bundles in the adventitia of blood vessels and in the interstitium of such organs as the heart, lung, and kidney. Tissue deposits are accompanied by a mastocytosis.The pathology of vascular lesions observed in 44% of 131 autopsies is described. In this group, mucoid vasculopathy occurred more commonly in young males of lower socioeconomic status. Both arteries and veins are affected, particularly muscular arteries. They present a uniform concentric thickening of the intima and media, causing an apparent reduction in luminal diameter. Significant histological features include (a) large quantities of glycosaminoglycans accompanied by smooth muscle hyperplasia in the intima and media and (b) degenerative changes with mineralization of the internal elastic lamina of arteries and of mucoid material in the media.Except for the mucoid arteriopathy described in popliteal vessels in cases of idiopathic peripheral gangrene from Central Africa, which mucoid vasculopathy resembles somewhat, the latter condition is not exactly comparable to any other known vascular or connective tissue disorder.Item MUCOID VASCULOPATHY OF UNKNOWN ETIOLOGY(ANGIOLOGY, 1991)A new vascular disorder with generalized deposition of abnormal amounts of acid mucopolysaccharide (AMPS) material in arteries, veins, and vasanervorum has been observed in a large number of autopsies at the author's institution. It is unlike any of the known vascular diseases and has emerged as a distinct disorder of vascular connective tissue. This has been named "mucoid vasculopathy of unknown etiology." This hitherto unreported entity is described here.Item MULTIPLE PULMONARY-ARTERY ANEURYSMS DUE TO MUCOID VASCULOPATHY - ANGIOGRAPHIC AND HISTOLOGICAL OBSERVATIONS(THORACIC AND CARDIOVASCULAR SURGEON, 1993)Multiple peripheral pulmonary artery aneurysms were diagnosed by Computed Tomography and confirmed angiographically in a 7-year-old boy. On histological examination unusual mucoid vasculopathic changes were noted in the pulmonary artery aneurysms and pulmonary vasculature as a part of systemic vascular involvement. This case demonstrates a new association between mucoid vasculopathic changes and pulmonary aneurysms. Mucoid vasculopathy could represent one more disorder having a causative role in the etiology of intrapulmonary arterial aneurysms.Item PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY OF THE SUBCLAVIAN ARTERY IN NONSPECIFIC AORTOARTERITIS - RESULTS OF LONG-TERM FOLLOW-UP(JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, 1994)PURPOSE: The results of percutaneous transluminal angioplasty (PTA) of the subclavian artery in nonspecific aortoarteritis (Takayasu disease) are analyzed.PATIENTS AND METHODS: Twenty-four patients (15 men, nine women; age range, 18-47 years; mean, 37.1 years) with occlusive disease in 26 subclavian arteries, had symptoms due to vertebrobasilar insufficiency, upper limb claudication, or both. Aortography revealed stenosis in 19 arteries and occlusion in seven. The lesions were focal in 14 arteries (< 3 cm) and extensive in 12. Associated lesions involved the brachiocephalic artery in three patients, carotid arteries in five patients, and renal arteries in five patients.RESULTS: Initial technical and clinical success was achieved in 21 of 26 arteries (81%, 17 of 19 stenoses and four of seven occlusions). The maximum follow-up was 82 months (mean, 26 months), during which time restenosis occurred in six arteries, all of which had extensive lesions. The cumulative primary, secondary, and overall patencies were 64%, 82%, and 65%, respectively, as analyzed by means of the life-table method. The cumulative patencies for short- and long-segment lesions were 100% and 50%, respectively (P = .0113). Minor complications were observed in four of 26 procedures (15%) and included vasospasm (three patients) and transient loss of consciousness (one patient). There were no major complications.CONCLUSIONS: PTA is useful for treatment of occlusive disease of the subclavian artery in nonspecific aortoarteritis. The procedure is simple and associated with minimal morbidity. Long-term results are excellent in focal lesions but are less durable in the presence of more extensive disease.Item PULMONARY WEDGE ASPIRATION CYTOLOGY IN THE DIAGNOSIS OF RECURRENT TUMOR EMBOLISM CAUSING PULMONARY ARTERIAL-HYPERTENSION(INTERNATIONAL JOURNAL OF CARDIOLOGY, 1993)Recurrent subacute pulmonary embolism leading to pulmonary arterial hypertension is an uncommon presentation of malignancy. We describe one such patient who presented to us with features of pre-capillary pulmonary arterial hypertension. A novel yet simple technique, involving pulmonary wedge aspiration cytology, provided the tissue diagnosis of trophoblastic malignancy, thus enabling prompt institution of chemotherapy and consequent impressive clinical improvement. This technique appears to be a hitherto unreported indication for intravascular catheterisation in the diagnostic work up of pulmonary arterial hypertension.