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Biomedical subjects

A Jain

Publications and source records attributed to A Jain.

At least 199 records · Page 11Linked to original sources
PubMed1997

Gastrointestinal bleeding after liver transplantation.

To investigate the causes of gastrointestinal bleeding (GIB) and its impact on patient and graft survival after orthotopic liver transplantation (OLTx), the first 1000 consecutive OLTx using tacrolimus were studied. Our patient population consisted of 834 adults. The bleeding episodes of patients with GIB (n=74) were analyzed, and patients without GIB (n=760) were used as controls. The mean age, gender, and United Network for Organ Sharing status were similar in both groups. Endoscopy was done in 73 patients with GIB and yielded a diagnosis in 60 patients (82.2%): 39 with a single, and 21 with multiple GIB episodes. In the remaining 13 patients (17.8%), the bleeding source was not identified. Of 92 GIB episodes with endoscopic diagnoses, ulcers (n=25) were the most common cause of bleeding, followed by enteritis (n=24), portal hypertensive lesions (n=15), Roux-en-Y bleeds, and other miscellaneous events (n=28). The majority (73%) of the GIB episodes occurred during the first postoperative trimester. The patient and graft survival rates were statistically lower in the GIB group compared with the control group. The adjusted relative risk of mortality and graft failure was increased by bleeding. In summary, the cumulative incidence of GIB was 8.9%. Endoscopy identified the source of GIB in most cases. Ulcers were the most common cause of GIB after OLTx. The onset of GIB after OLTx was an indicator of decreased patient and graft survival.

Adolescent↗
PubMed1997

Effectiveness of the 585nm flashlamp-pulsed tunable dye laser (PTDL) for treatment of plantar verrucae.

BACKGROUND AND OBJECTIVE: The objective of this study was to establish the 585 nm flashlamp-pulsed tunable dye laser (PTDL) as a potentially effective modality in the treatment of plantar verrucae. Furthermore, this study attempted to identify if certain regions of the plantar surface yielded a different clearance rate in comparison to others. STUDY DESIGN/MATERIALS AND METHODS: Thirty-three patients were recruited for this case series study, representing a total of 97 plantar warts. Patients were treated using the flashlamp-PTDL with a pulse duration of 450 microseconds, a spot diameter of 5.0 mm, and energy fluences ranging between 8.1 and 8.4 J/cm2. Patients were followed-up an average of 2-24 weeks assessing for recurrence of verrucae. RESULTS: Each patient exhibited one to eight plantar lesions. Of the 97 verrucae treated by the flashlamp-PTDL, 68 (70.1%) resolved with 100% clearance of the lesion. The overall mean clearance of the 97 lesions was 95.1 +/- 16.5%. Of the 97 lesions treated to maximal clearance, 14 lesions recurred after a mean follow-up period of 9.0 weeks. CONCLUSION: Results of this study have established the 585 nm flashlamp-pulsed tunable dye laser as a potentially effective modality treatment of plantar warts. Furthermore, it was determined that there was no significant difference in the clearance rate of warts located at a given plantar site when compared to the clearance rates of the other plantar sites (F3/44 = 0.58, P = 0.634).

Adolescent↗
PubMed1997

"Tombstone" anterior ST-segment elevations secondary to acute pericarditis: the role of two-dimensional echocardiogram.

Prompt and appropriate administration of thrombolytic therapy is important for patients with acute myocardial infarction. However, in addition to contraindications, alternative causes of ST-segment elevation should be considered before thrombolytic therapy is instituted. A patient with marked ST-segment elevation in the anterior leads suggestive of acute ischemia is presented. Because of lack of ischemic symptoms, an echocardiogram was performed. This showed mild generalized hypokinesis, and thrombolytic therapy was not administered. Subsequent ECGs demonstrated evolutionary findings consistent with pericarditis. In selected patients a two-dimensional echocardiogram, which can be easily performed at patient bedside, will help in appropriate patient management.

Aged↗
PubMed1997

Antihypertensive effects of mibefradil: a double-blind comparison with diltiazem CD.

BACKGROUND AND HYPOTHESIS: Mibefradil is the first compound of a new class of calcium antagonists with a unique chemical structure and mechanism of action. This trial compared mibefradil with diltiazem CD, a widely prescribed calcium antagonist for the treatment of hypertension. METHODS: In all, 201 patients with uncomplicated, mild-to-moderate essential hypertension with a baseline sitting diastolic blood pressure (SDBP) of > or = 95 and < or = 114 mmHg were evenly randomized to receive either mibefradil (100 mg) or diltiazem CD (360 mg) daily for 12 weeks. To determine whether antihypertensive effects persisted after 12 weeks, patients then entered a 4-week withdrawal period during which they remained on active treatment or were switched to placebo. RESULTS: Efficacy variables were the changes from baseline in SDBP to the end of the treatment period (Week 12) and during the randomized withdrawal period (Week 16). At Week 12, the reduction from baseline in SDBP at trough was significantly greater (p < 0.001) in the mibefradil group (-14.0 +/- 7.8 mmHg) than in the diltiazem CD group (-9.5 +/- 7.5 mmHg). Significantly more patients (72%) on mibefradil achieved SDBP normalization by Week 12 than did patients on diltiazem (51%) (p < 0.01). Patients maintained on mibefradil or diltiazem CD during the withdrawal period had a significantly larger reduction in trough SDBP at Week 16 than those switched to placebo. The incidence of side effects was similar in both treatment groups. CONCLUSIONS: Once-daily mibefradil was equally well tolerated as diltiazem CD, but was more effective in lowering blood pressure at the doses studied than the extended-release formulation of diltiazem.

Adult↗
PubMed1996

Oxygen is not required for degradation of DNA by glutathione and Cu(II).

Previous studies by others have shown that thiols, such as glutathione, cause cleavage of DNA in the presence of Cu(II) ions and that the hydroxyl radical derived from molecular oxygen is the major cleaving species. In this paper, we present several lines of evidence that strongly suggest that molecular oxygen is not essential for DNA cleavage and that thiyl radicals may also be involved. Indirect evidence is presented to indicate that glutathione may substitute oxygen as an electron acceptor. In addition, DNA degradation occurs to a significant extent under anaerobic conditions and no inhibition of single-strand cleavage of supercoiled plasmid DNA is seen in the presence of superoxide dismutase and catalase. In view of the ubiquitous presence of glutathione, these results could be of interest under certain diseased conditions where copper concentrations are elevated.

Animals↗
PubMed1996

A 30-kDa host protein binds to two very-late baculovirus promoters.

A 30-kDa host factor (polyhedrin-promoter-binding protein; PPBP) specifically binds to sequences critical for transcription from the baculovirus polyhedrin (p29) gene initiator promoter [Burma, S., Mukherjee, B., Jain, A., Habib, S. & Hasnain, S. E. (1994) J. Biol. Chem. 269, 2750-2757; Mukherjee, B., Burma, S. & Hasnain, S. E. (1995) J. Biol. Chem. 270, 4405-4411]. A host factor also binds, in gel shift assays, to the very-late p10 gene promoter through DNA sequence motifs similar to the PPBP.p29 interaction. The p10 host factor complex was specifically competed out with oligonucleotides containing p29 cognate sequence motifs AATAAA and TAAGTATT, but this did not occur when these motifs were replaced with random sequences. From ultraviolet cross-linking analysis, the molecular mass of this host factor was estimated to be approximately 30 kDa. Experiments were performed to investigate if this host factor displayed any differences in affinity and turnover with respect to the p29 and p10 untranslated leader sequences known to be important for temporal fine tuning and the late burst of transcription. Half-life determination of the p10-binding protein revealed similar binding affinities for the initiator elements of both the promoters, but higher affinity for the p10 5'-untranslated region (approximately 30 min versus approximately 10 min). The involvement of a similar host factor binding to both the p10 and p29 promoters indicates the possibility of a similar mode of transcription initiation from these two very-late promoters.

Animals↗
PubMed1996

BCL-6 expression during B-cell activation.

Translocations involving the BCL-6 gene are common in the diffuse large cell subtype of non-Hodgkin's lymphoma. Invariably, the BCL-6 coding region is intact, but its 5' untranslated region is replaced with sequences from the translocation partner. The present study shows that BCL-6 expression is regulated in lymphocytes during mitogenic stimulation. Resting B and T lymphocytes contain high levels of BCL-6 mRNA. Stimulation of mouse B cells with anti-IgM or IgD antibodies, bacterial lipopolysaccharide, phorbol 12-myristate 13-acetate plus ionomycin, or CD40 ligand led to a five-fold to 35-fold decrease in BCL-6 mRNA levels. Similar downregulation of BCL-6 mRNA was seen in human B cells stimulated with Staphylococcus aureus plus interleukin-2 or anti-IgM antibodies and in human T lymphocytes stimulated with phytohemagglutinin. BCL-6 mRNA levels began to decrease 8 to 16 hours after stimulation, before cells entered S phase. Although polyclonal activation of B cells in vitro invariably decreased BCL-6 MRNA expression, activated B cells from human germinal centers expressed BCL-6 mRNA at levels comparable to the levels in resting B cells. Despite these similar mRNA levels, BCL-6 protein expression was threefold to 34-fold higher in germinal center B cells than in resting B cells, suggesting that BCL-6 protein levels are controlled by translational or posttranslational mechanisms. These observations suggest that the germinal center reaction provides unique activation signals to B cells that allow for continued, high-level BCL-6 expression.

Amino Acid Sequence↗
PubMed1996

Left ventricular diastolic function in hypertension and role of plasma glucose and insulin. Comparison with diabetic heart.

BACKGROUND: Experimental production of glucose intolerance has been associated with increased diastolic stiffness of the left ventricle, accompanied by interstitial fibrosis. Because carbohydrate metabolism is altered in hypertension, we undertook the present study to assess the relation of diastolic dysfunction in hypertension to plasma glucose and insulin concentrations. The latter are also affected by obesity. To facilitate this analysis, we studied moderately obese hypertensives. Elucidation of these relations was then sought in diabetic subjects. METHODS AND RESULTS: Subjects undergoing catheterization for chest pain were included in the study when significant coronary disease was not present. In groups 1 (lean), 2 (obese), 3 (lean hypertensive), and 4 (obese hypertensives), intraventricular pressures and volumes were determined. Fasting plasma glucose, insulin, hemoglobinAIC, and glucose tolerance were assessed. Basal ejection fraction and end-systolic wall stress were normal in the four groups. Chamber stiffness was significantly elevated in the hypertensives and was higher in group 4 than in group 3 (P < .05). Diastolic dysfunction was correlated with fasting blood glucose (r = .69, P < .006) but not with plasma insulin or left ventricular mass. Chamber stiffness was also increased in diabetics, with a larger effect in the obese. CONCLUSIONS: Hypertension is associated with increased diastolic stiffness of the left ventricle, which is enhanced by moderate obesity, and abnormal carbohydrate metabolism. Experimentally and in humans, hypertension is associated with interstitial fibrosis of mycardium, the presumed basis for the diastolic dysfunction. Chamber stiffness in group 4 hypertensives was similar to that in the lean diabetics but less than that in the obese diabetics. Although the latter exhibited a correlation with plasma hemoglobinAIC, the large rise in stiffness suggests a potential role for growth factors in further alteration of myocardial composition.

Blood Glucose↗
PubMed1996

Psychophysiological correlates of infant temperament: stability of behavior and autonomic patterning from 5 to 18 months.

The stability of infant temperament and autonomic patterning (heart period and cardiac vagal tone) was examined longitudinally when infants were 5, 10, and 18 months of age. Behavioral measures of reactivity and regulation to frustration tasks, and maternal perceptions of infant temperament were obtained at each age along with baseline measures of cardiac activity. No stability was found from 5 to 10 months while some stability of behavior and autonomic patterning was identified from 10 to 18 months, with the exception of negative reactivity. High levels of cardiac vagal tone (V) were associated with negative reactivity at 18 months. When examining groups based on degrees of reactivity and regulation, we found infants who responded negatively to frustration but who also displayed more regulatory behavior to have higher V.

Arousal↗
PubMed1996

Oral prednisolone supplement abolishes the acute adverse effects following initiation of depot bromocriptine therapy.

OBJECTIVE: Although an effective treatment for hyper-prolactinaemia, initiation of bromocriptine therapy may be associated with significant acute side-effects in some patients, particularly nausea, vomiting and postural hypotension. These may be minimized by initial treatment with i.m. depot bromocriptine (Parlodel-LAR, Sandoz, Basel, Switzerland), but adverse effects following the first injection may still be a significant problem. Following the observation that cortisol deficient patients were subject to an increased incidence of severe side-effects on initiation of bromocriptine therapy, we have evaluated whether concurrent administration of oral prednisolone to patients without cortisol deficiency might reduce adverse effects. DESIGN: Double-blind placebo-controlled trial with prednisolone (20 mg) prior to, and 16 hours after, depot injection of i.m. bromocriptine (50 or 100 mg). PATIENTS: Twenty-one consecutive patients with hyperprolactinaemia (serum prolactin > 1000 mU/l on 3 separate occasions) who were due to start depot bromocriptine and who had a normal cortisol response to insulin-induced hypoglycaemia. MEASUREMENTS: Symptoms at 0, 16 and 40 hours after injection were assessed using visual linear analogue scales and both inter and intra-group scores were compared by non-parametric tests. RESULTS: Depot bromocriptine was associated with the significant occurrence of light-headedness and lethargy in the placebo-administered group by 16 hours, and also with nausea and nasal congestion by 40 hours. These symptoms did not occur in the prednisolone-administered group. CONCLUSIONS: Concurrent oral administration of prednisolone significantly reduces the incidence of acute adverse effects following depot bromocriptine. Two 20 mg doses of prednisolone given at 12-hour intervals may be used to avoid dopamine-agonist-induced adverse effects at the initiation of treatment with depot bromocriptine, and may also be of value in the treatment of side-effects associated with other dopamine agonist drugs.

Administration, Oral↗
PubMed1996

Bifunctionality of the AcMNPV homologous region sequence (hr1): enhancer and ori functions have different sequence requirements.

The Autographa californica multinucleocapsid nuclear polyhedrosis virus (AcMNPV) homologous region sequence hr1 is a putative origin of replication (ori) sequence and can also function as a transcriptional enhancer for delayed-early genes. We demonstrate that this 750-bp sequence, carrying five 28-bp core palin-dromes, enhances expression from the very late polyhedrin promoter up to 11-fold in a classical enhancer fashion in transient expression assays. Enhancement is at the level of transcription, as evident from RNase protection assay analysis. It is mediated by an alpha-amanitin-insensitive RNA polymerase from the authentic polyhedrin promoter transcription start site and follows the temporal activation profile characteristic of the polyhedrin promoter. Three lines of evidence conclusively demonstrated that hr1 acts typically as an enhancer of polyhedrin gene transcription independent of its role as an ori: (i) linearized hr1-reporter plasmids, incapable of replicating in the host cell, could enhance transcription from the promoter; (ii) reporter plasmid copy number was not affected by the presence of aphidicolin during transfection; (iii) reporter plasmid DNA recovered from Sf9 cells was sensitive to Dpn I confirming its unreplicated state in the transfection regime followed by us. Molecular dissection of the hr1 sequence elements revealed that a core palindrome alone can function as an ori sequence whereas a palindrome along with flanking sequences is essential for the enhancer activity. Enhancement of luciferase expression from the polyhedrin promoter is a function of the number of core palindromes and flanking sequences. Our results demonstrate that hr1, which has several motifs for enhancer binding proteins and transcription factors, has a dual role associated with both DNA replication and transcriptional enhancement.

Animals↗
PubMed1996

Interaction of carbohydrate and fat fuels in human skeletal muscle: impact of obesity and NIDDM.

The current study was undertaken to examine the impact that obesity and non-insulin-dependent diabetes mellitus (NIDDM) have on the ability of glucose to stimulate its own uptake and oxidation in muscle. Euglycemic and hyperglycemic clamp experiments were performed with somatostatin infusions so that insulin could be replaced to basal levels or to physiological hyperinsulinemia. Arteriovenous leg balance methods were used to measure the pathways of leg muscle glucose uptake, oxidation, and storage. Percutaneous biopsies of the vastus lateralis muscle were taken to determine the pyruvate dehydrogenase complex or glycogen synthase activities. During basal insulin replacement, obese compared with lean nondiabetic subjects had higher values for glucose uptake, respiratory quotient, and glucose oxidation (all P<0.05) and a higher proportion of leg energy expenditure derived from glucose. Obese NIDD patients had a greater reliance on fat calories than lean diabetics during basal insulin replacement (P< 0.05). Hyperinsulinemia increased leg glucose metabolism (P<0.001) in all groups, but obese NIDD patients were significantly more insulin resistant. Hyperglycemia in NIDDM compensated for insulin resistance to the extent that rates of glucose metabolism were the same as those for nondiabetics studied at euglycemia. When nondiabetics were studied at hyperglycemia matched to the diabetics, the insulin resistance was still readily apparent.

Adult↗