Is risk of neuroleptic malignant syndrome increased in the postpartum period?
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Adult↗
Biomedical subjects
A Das
Publications and source records attributed to A Das.
Visual outcome and ocular survival in patients with retinal detachments secondary to open- or closed-globe injuries.
BACKGROUND AND OBJECTIVE: A retrospective study was undertaken to establish predictive clinical features for final visual outcome and ocular survival for patients who have sustained traumatic retinal detachments (RDs). PATIENTS AND METHODS: The authors reviewed 191 cases of RD following open- or closed-globe trauma. The clinical features that were analyzed included the initial visual acuity, the location of the wound, the mechanism of injury (blunt, sharp, or projectile), and the number of quadrants of RD. RESULTS: The significant predictive factors for good visual outcome (1/200 or better) included an initial visual acuity of hand motions or better, wounds located anterior to the equator, closed-globe injuries, sharp injury in open globes, and three or fewer quadrants of RD. The factors that predicted enucleation included an initial visual acuity of light perception or no light perception, wounds located posterior to the equator, and four quadrants of RD. CONCLUSION: The significant predictive factors for final visual outcome in patients with traumatic RD were the initial visual acuity, the location of the wound, the mechanism of injury, and the number of quadrants of RD.
Adolescent↗
Holmium laser resection of bladder tumors (HoLRBT).
We investigated the safety, technique, and effectiveness of holmium laser resection of bladder tumors (HoLRBT). Data are presented on 23 patients who were treated with the HoLRBT technique. Holmium:YAG laser has a wavelength of 2,140 nm, which is delivered in a pulsed fashion via an end-firing quartz fiber placed through a modified resectoscope. Twenty-three patients with newly diagnosed transitional cell carcinoma underwent HoLRBT. Cold cup biopsies of the bladder tumor base were taken and compared to the HoLRBT specimens. Twenty-two of 23 patients were discharged catheter-free within 24 hours. One patient required a catheter for 3 days. The mean total energy used was 13.14 kJ with a maximum of 34.31 kJ. Mean resection time was 18.6 minutes. Cold cup biopsy of the tumor base did not alter the stage of the bladder tumor. The HoLRBT technique can be used to safely and effectively treat bladder tumors. This laser technique did not alter the stage or the diagnosis of bladder tumors. Holmium resection of bladder tumors usually can be performed as an outpatient catheter-free procedure and is a viable alternative to the standard electrocautery transurethral resection of bladder tumors.
Aged↗
A retrospective review of patients with clinically definite multiple sclerosis.
Multiple sclerosis (MS) is an uncommon disease in Singapore. We retrospectively reviewed our experience from a large single medical institution to identify prominent clinical features and forms of this disease. Of the 21 patients entered into the study, 10 patients developed optic-spinal symptoms over the course of their illness. None of these patients with optic-spinal symptoms had Devic's disease. Unusual clinical manifestations included paroxysmal symptoms either at presentation or during the course of their illness in 3 patients. While cerebrospinal fluid oligoclonal bands were present in only 4 patients, the majority of patients had abnormal neurophysiology and neuroimaging studies. Due to the presence of autoimmune markers in a significant number of cases, we recommend that as part of the initial evaluation for MS, an underlying collagen vascular disorder should be excluded.
Adolescent↗
Tardive dyskinesia: dental prosthetic therapy.
The object of this study was to demonstrate that the dental prosthetic therapy that has long been shown to be effective in the treatment of idiopathic ov Spontaneous Orofacial Dyskinesia (SOFD) was also effective in the treatment of the orofacial manifestations of Tardive Dyskinesia (TD). This preliminary work consisted of evaluation of the results of dental prosthetic treatment provided to TD patients at the University of Illinois, College of Dentistry at Chicago. All patients who presented demonstrating orofacial manifestations of TD were accepted for treatment. No standard dental appliance exists to treat either SOFD or TD. Each case requires an individualized approach. Natural teeth should be maintained because the more natural teeth present, the easier it is to fabricate a stable and effective prosthesis, and TD occurs with greater frequency and severity in edentulous than in dentulous patients. Effective treatment of such patients requires the dentist to be flexible and tailor his therapy to idiosyncrasies of each case, rather than being wedded to rigid theories of what is supposed to be appropriate treatment and appliance design. Two representative cases of treatment of TD with dental prostheses are presented. Prosthetic dental therapy should be considered in the management of the orofacial manifestations of Tardive Dyskinesia because it often is effective and has no known side effects. Since the treatment described here is prosthetic, any team approach to the treatment of TD should include an interested general dentist or prosthodonist.
Aged↗
Utilization of autologous blood donation during radical retropubic prostatectomy.
We investigated the utilization patterns of autologous blood donation for radical retropubic prostatectomy (RRP) during a 6-year period. A total of 225 patients electing RRP with blood donation were identified for analysis. Group 1 consisted of 113 men who had an RRP from 1990 to 1993. Group 2 consisted of 112 men who had an RRP from 1993 to 1995. Charts were reviewed for the number of units transfused, number of autologous units donated, and operative blood loss. More patients autodonated blood in the later group (84% vs. 75%). Technical improvements and experience have significantly decreased blood loss and the need for transfusions (69% vs. 96% in the early group). In the more current series, only 14% of patients who autodonated blood required homologous transfusion vs. 42% in the earlier group. An increase in the amount of wasted blood (42% vs. 16% in the early group) also was noted. The 4-unit donors had the lowest homologous transfusion rate in both series (group 1 = 21%, group 2 = 5%); the 2-unit donors had the lowest units wasted per person (0.74). In addition, the 2-unit donors maintained a low homologous transfusion rate of 16%. These data suggest that 2 units of autologous blood donation has a reduced risk of homologous blood transfusion while the amount of autologous blood wasted is minimized.
Blood Loss, Surgical↗
External clues to inner malformations.
A malformation is a morphological defect of an organ, or a larger region of the body resulting from an intrinsically abnormal developmental process. In this analysis of 1421 neonatal autopsies performed between 1984 and 1993, 243 (17.1%) cases showed malformations. The data was analysed to find external cues to internal malformations. Twenty three (85%) of the 27 neonates with various facial abnormalities had associated internal malformations in the form of cardiac (n = 11; 40%), renal (n = 7; 25%), or gastrointestinal (n = 3; 11%) abnormalities and diaphragmatic hernia (n = 2). Sixty seven neonates had neural abnormalities. These were associated with cardiac (n = 7; 10%), renal (n = 12; 18%) or gastrointestinal (n = 7; 10%) abnormalities; 43 cases, however, did not have any associated malformations. Renal malformations (n = 66) had highest association with skeletal abnormalities (n = 9; 22%). As many as 45(76%) of the 59 cases with cardiac abnormalities had no external anomalies. Five cases of hypoplastic lungs were seen, all associated with external malformations.
Abnormalities, Multiple↗
The effects of ArginMax, a natural dietary supplement for enhancement of male sexual function.
This study examines the role of ArginMax, a natural daily dietary supplement, on male sexual function. 25 subjects diagnosed with mild to moderate erectile dysfunction were evaluated over a 4-week period while on ArginMax. Of the 21 subjects that completed the study, 88.9% improved in ability to maintain erection during sexual intercourse and 75.0% improved in satisfaction with their overall sex life. No significant side effects were noted.
Adult↗
Regulation of the elongation-termination decision at intrinsic terminators by antitermination protein N of phage lambda.
The mechanisms that control N-protein-dependent antitermination in the phage lambda life cycle have counterparts in the regulatory systems of other organisms. Here we examine N-dependent antitermination at the intrinsic tR' terminator of lambda to elucidate the regulatory principles involved. The tR' terminator consists of a sequence of six base-pairs along the template at which the transcription complex is sufficiently destabilized to make RNA release possible. Within this "zone of opportunity" for termination the termination efficiency (TE) at each template position is determined by a kinetic competition between alternative reaction pathways that lead either to elongation or to termination. TE values at each position within tR' have been mapped as a function of NTP concentration, and it is shown that N protein (in the presence of NusA and a nut site; the minimal system for N-dependent antitermination) can offset increases in TE that are induced by limiting the concentrations of each of the next required NTPs. By limiting NTP concentrations or working at low temperature we show that a significant effect of N within the minimal system is to increase the rate of transcript elongation three- to fivefold at most positions along the template. Assuming that a comparable increase in elongation rate applies at template positions within the terminator, we show that an increase of this magnitude is not sufficient to account for the antitermination efficiency observed and that an approximately 100-fold stabilization of the transcription complex at intrinsic termination sites as a consequence of binding the N-containing antitermination sub-assembly must be invoked as well. A general method for partitioning TE effects in antitermination between changes in elongation rate and termination complex stability is demonstrated, based on competing free energy of activation barriers for the elongation and termination reactions. The analysis and utility of such mixed modes of transcriptional regulation are considered in general terms.
Bacterial Proteins↗
Role of an RNA-binding protein in import of tRNA into Leishmania mitochondria.
Nuclear-encoded cytoplasmic tRNAs are imported into the mitochondria of kinetoplastid protozoa by an unknown mechanism. In a Leishmania in organello system, ATP-dependent import of a cloned, unspliced tRNATyr(GUA) transcript was demonstrated by protection from ribonuclease, whereas import of a tRNAGln(CUG) transcript was much less efficient. Specific binding of tRNATyr to two mitochondrial surface proteins of 15 and 22 kilodaltons was observed. Tubulin antisense-binding protein (TAB), the 15-kilodaton species, was purified to apparent homogeneity by RNA affinity chromatography. TAB forms stable complexes with the D stem-loop region of tRNATyr. Immunocytochemical and cell fractionation experiments, combined with limited proteolysis, suggested the association of TAB with the outer mitochondrial membrane. Importantly, anti-TAB antibody specifically inhibited binding as well as import of tRNATyr and of a synthetic structural homolog. These results support the role of TAB as a membrane-bound receptor or carrier for RNA import into Leishmania mitochondria.
Animals↗
Distortions of visuotopic map match orientation singularities in primary visual cortex.
The map of orientation columns in primary visual cortex (V1) is known to show strong local distortions, with a generally smooth progression of orientation preference across extended regions of cortex, interrupted by sharp jumps (fractures) and point singularities. The map of visual space on V1, in contrast, has been assumed to be locally smooth and isotropic. We find, on the contrary, that the map of visual space on cat V1 shows strong and systematic local distortions in register with inhomogeneities in the orientation map, with the rate of receptive field movement across cortex being largely proportional to the local rate of change of orientation. This suggests possible systematic local variations in the functional connectivity of short-range lateral connections that underlie local cortical processing.
Animals↗
Complexes of N antitermination protein of phage lambda with specific and nonspecific RNA target sites on the nascent transcript.
The mechanisms that control N protein dependent antitermination in phage lambda have counterparts in many eukaryotic systems, including specific regulatory interactions of the antitermination protein with the nascent RNA transcript. Here we describe the specific and nonspecific RNA binding modes of antitermination protein N. These modes differ markedly in RNA binding affinity and in structure. N protein, either free in solution or as a complex with nonspecific RNA, lacks observable secondary and tertiary structure and binds RNA sequences indiscriminately with a dissociation constant (Kd) of approximately 10(-6) M. In contrast N becomes partially folded with at least 16-18 amino acids of ordered alpha-helical structure and binds much more tightly (Kd approximately 10(-9) M) on forming a highly specific 1:1 complex with its cognate boxB RNA hairpin. These observations and others are used to help define a bipartite model of N-dependent antitermination in which these specific and nonspecific interactions control the binding of N to the nascent transcript. Finally the role of RNA looping in delivering the bound N to the transcription complex and determining the stability (and thus the terminator specificity) of the resulting antitermination interaction of N with the RNA polymerase is considered in quantitative terms.
Amino Acid Sequence↗
Bilateral endophthalmitis as an initial presentation in meningococcal meningitis.
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Adolescent↗
Intrarenal use of the holmium laser.
BACKGROUND AND OBJECTIVE: We investigated the safety, effectiveness, and techniques of the holmium (Ho:YAG) laser intrarenally. Data are presented on 52 patients who were treated with the Ho:YAG laser intrarenally for urinary calculi or neoplasms. STUDY DESIGN/MATERIALS AND METHODS: The Ho:YAG laser has a wavelength of 2,100 nm, which is delivered in pulsed fashion via a small flexible quartz fiber (365 microns), which is placed through a working channel (> 2.2 Fr) of a small diameter endoscope. RESULTS: Sixty-three intrarenal procedures were performed with the Ho:YAG laser for calculi and neoplasms. Twenty-four procedures were performed for intrarenal neoplasms. Average total energy used in these patients was 2.61 kilojoules (kJ) with a maximum of 15.28 kJ. Thirty-nine procedures were performed for intrarenal calculi; 7/39 procedures were approached percutaneously. Average total energy in stone patients was 5.41 kJ with a maximum of 37.77 kJ. CONCLUSION: The Ho:YAG laser can be used safely and effectively to treat intrarenal calculi or neoplasms. All types of calculi were fragmented and all patients with intrarenal tumor were treated successfully. There were no vascular or renal injuries and there was no evidence of renal loss. No intrarenal strictures were seen on follow-up. The Ho:YAG laser energy can be delivered through a small flexible quartz fiber passed through a small diameter endoscope. The techniques and applications of the Ho:YAG laser make it well suited for urologic application.
Adult↗
Physicochemical basis of the universal genetic codes--quantitative analysis.
Quantitative mathematic models have been developed to correlate the fragment hydrophobicity contribution constants (faa) of 20 amino acids with the physicochemical properties (mu, Hb, and square root of MW) of the four bases (U, A, C, G) of the codons, or those of the anticodons. Using the general equation faa = a mu 1 + b mu 2 + c mu 3 + d square root of MW1 + e square root of MW2 + f square root of MW3 + g Hb1 + h Hb2 + i Hb3 + j, where 1, 2, 3 refer to the first, the second and the third base respectively, correlation coefficient of about 0.82 can be obtained for all 20 amino acids coded by 61 different triplet codes. These correlations are statistically highly significant, even though they do not take into account the involvement of various factors and peptidyl transferases. Furthermore, the reasons for the three stop codons are revealed. The graphic presentation of the codons and the amino acids coded separates the acidic and the basic, the aromatic and the heterocyclic amino acids into different quadrants of an octagon. This is in agreement with the ancient Chinese Ying-Yang theory embedded in the classical I-Ching.
Genetic Code↗
The Preterm Prediction Study: association of cesarean delivery with increases in maternal weight and body mass index.
OBJECTIVE: Our purpose was to evaluate whether maternal weight and body mass index measured either before or during pregnancy are associated with an increased risk of cesarean delivery. STUDY DESIGN: Maternal weight and height were prospectively collected on 2929 women in the National Institutes of Health Maternal-Fetal Medicine Units Network Preterm Prediction Study. Prepregnancy and 27- to 31-week maternal weight and height were used to calculate the body mass index, and its contribution to the risk of cesarean delivery was determined. Women with prenatally diagnosed congenital anomalies (n = 89) and pregestational diabetes (n = 31) were excluded from analysis. RESULTS: Univariate analysis of risk factors for cesarean delivery in the 2809 eligible women revealed a decreased risk of cesarean delivery with maternal age < 18 years and multiparity; increased risk of cesarean delivery was noted with maternal age > 35 years and a male fetus. Increases in either prepregnancy or 27- to 31-week maternal weight (5-pound units) or body mass index (1.0 kg/m2 units) were significantly associated with an increased odds of cesarean delivery (p = 0.0001). Each unit increase in prepregnancy or 27- to 31-week body mass index resulted in a parallel increase in the odds of cesarean delivery of 7.0% and 7.8%, respectively. Multivariable stepwise logistic regression analysis confirmed the association of male fetus, age, nulliparity, and body mass index as significant variables contributing to cesarean delivery risk. CONCLUSIONS: The risk of cesarean delivery is associated with incremental changes in maternal weight and body mass index before and during pregnancy after adjustment for potential confounding factors. Prepregnancy counseling about optimizing maternal weight and monitoring weight gain during pregnancy to decrease the risk of cesarean delivery are supported by this study.
Adolescent↗
The preterm prediction study: patterns of cervicovaginal fetal fibronectin as predictors of spontaneous preterm delivery. National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network.
OBJECTIVE: Our purpose was to determine how various temporal patterns of fetal fibronectin positivity from 24 to 30 weeks predict subsequent fetal fibronectin test results and spontaneous preterm delivery. STUDY DESIGN: A total of 2929 women had vaginal and cervical fetal fibronectin tests obtained at least once at 24, 26, 28, or 30 weeks, and 1870 women had tests performed at all four gestational ages. Fetal fibronectin values > or = 50 ng/ml were considered positive. Various patterns of positive and negative tests were evaluated for prediction of (1) whether the next fetal fibronectin test would be positive or negative and (2) the percent of women with a spontaneous preterm delivery > or = 4 weeks after the last fetal fibronectin test at < 30, < 32, < 35, and < 37 weeks' gestational age. RESULTS: Women with previous negative test results had only a 3% chance of a subsequent positive test result; however, if the last test result was positive, 29% of the next tests were positive. Of the 1870 women with tests at 24, 26, 28, and 30 weeks, 89% had all negative results, 8.4% had one positive result, 1.8% had two positive results, and 0.8% had three or four positive results. The higher the percent of positive tests at 24 to 26 weeks, at 28 to 30 weeks, or at 24 to 30 weeks, the greater the risk of subsequent spontaneous preterm birth. As an example, the risk of spontaneous preterm birth at < 30 weeks for women with two negative fetal fibronectin test results at 24 and 26 weeks was 0.3% versus 16% for women with two positive results. CONCLUSION: The presence of a positive cervical or vaginal fetal fibronectin test result predicts subsequent positive fetal fibronectin positivity and subsequent spontaneous preterm birth. The greater the percent of positive results, the higher is the risk of spontaneous preterm birth. After a positive test result, two negative results are required before the risk of spontaneous preterm birth returns to baseline.
Cervix Uteri↗
Molecular characterization and ultrastructural localization of Plasmodium falciparum Hsp 60.
Heat shock proteins (Hsp) are a group of highly conserved proteins which are widely represented phylogenetically. Genes for members of the Hsp 70, 90 and 60 families have been cloned from the human malaria parasite Plasmodium falciparum. In this study, we have cloned and expressed the P. falciparum Hsp 60 (PfHsp60) in E. coli. The sequence analysis identified a previously unknown intron of 257 bp beginning after the nucleotide 142 in the coding sequence. Antisera raised against the recombinant PfHsp60 was employed in immunoprecipitation studies with biosynthetically labeled parasite extracts to investigate regulation of expression of PfHsp60 at various temperatures. In contrast to the three to four fold accumulation of PfHsp60 transcripts in heat shocked parasites (37-40 degrees C), the expression of PfHsp60 was not induced in the blood stages of P. falciparum. On the other hand, the effect of heat induction on PfHsp70 was seen both at the level of specific mRNA and protein. In these studies we also observed co-immunoprecipitation of a number of other cellular proteins suggesting possible interaction with PfHsp60. Immunofluorescence analysis indicated the presence of PfHsp60 in the cytoplasm of all the various stages of the parasite. In addition, immunoelectron microscopic analysis distinctly localized PfHsp60 in the mitochondrion of P. falciparum. This study suggests that different mechanisms are involved in the regulation of expression of various members of the heat shock proteins in the parasite.
Animals↗