Coronary artery bypass grafting without cardiopulmonary bypass in pheochromocytoma.
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Aged↗
Biomedical subjects
A Roy
Publications and source records attributed to A Roy.
Sacral and skull base chordoma: metastases or second primary?
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Chordoma↗
Malnutrition and hypernatraemia in breastfed babies.
Despite the well-known advantages of breast-feeding to both mother and infant, malnutrition of breastfed infants does occur. We report two term neonates who presented in the 3rd week of life with severe wasting, hypernatraemic dehydration and pre-renal failure while being exclusively breastfed. Breast-milk sodium levels were markedly elevated on admission. Both infants recovered following adequate hydration and showed excellent catch-up growth during follow-up while exclusive breast-feeding was maintained. The critical malnutrition in both cases was detected by the family physician during routine postnatal visits. Both mothers were well motivated toward breast-feeding and were unaware of the severity of the baby's illness.
Breast Feeding↗
Efficient sensitivity/uncertainty analysis using the combined stochastic response surface method and automated differentiation: application to environmental and biological systems.
Estimation of uncertainties associated with model predictions is an important component of the application of environmental and biological models. "Traditional" methods for propagating uncertainty, such as standard Monte Carlo and Latin Hypercube Sampling, however, often require performing a prohibitive number of model simulations, especially for complex, computationally intensive models. Here, a computationally efficient method for uncertainty propagation, the Stochastic Response Surface Method (SRSM) is coupled with another method, the Automatic Differentiation of FORTRAN (ADIFOR). The SRSM is based on series expansions of model inputs and outputs in terms of a set of "well-behaved" standard random variables. The ADIFOR method is used to transform the model code into one that calculates the derivatives of the model outputs with respect to inputs or transformed inputs. The calculated model outputs and the derivatives at a set of sample points are used to approximate the unknown coefficients in the series expansions of outputs. A framework for the coupling of the SRSM and ADIFOR is developed and presented here. Two case studies are presented, involving (1) a physiologically based pharmacokinetic model for perchloroethylene for humans, and (2) an atmospheric photochemical model, the Reactive Plume Model. The results obtained agree closely with those of traditional Monte Carlo and Latin hypercube sampling methods, while reducing the required number of model simulations by about two orders of magnitude.
Animals↗
Standards for the management of cervical and vulval carcinoma.
OBJECTIVE: To examine the feasibility of achieving designated target standards for the management of women with cervical and vulval cancer. DESIGN: Retrospective casenote review. SETTING: The Gynaecological Oncology Centre at Hammersmith Hospital, London. POPULATION: Sixty-one women with cervical and vulval cancer presenting to the gynaecological oncology clinic at the Hammersmith Hospital during 1996 and 1997. Various aspects of the management of those women were compared with standards suggested by a multidisciplinary panel of local experts. Targets included the referral and treatment process, the accuracy of staging, and measures of surgical performance. RESULT: The target interval of seven days between receipt of the referral and the first visit at the cancer centre was achieved in 93% of women. Surgical treatment was administered to 92% of the women within the target of 20 working days from the first clinic appointment. Tumour close to or involving the margins of the specimen was noted in 13% of cervical and 9% of vulval cancers. The node count fell below the target standards in 13% of pelvic and 10% of groin dissections. Appropriate imaging investigations for staging were not undertaken in 15 of 39 cases (38%) of cervical cancer and in 5 out of 22 (23%) of vulval cancers. CONCLUSION: The suggested targets of process and surgical performance are reasonable and achievable. These standards would be appropriate for national use. The area most clearly identified where these targets were not achieved was the requesting of complementary staging investigations. This could be addressed by the use of a simple investigation protocol to be included in each patient's notes and available at specialist clinics and gynaecology wards.
Benchmarking↗
Motilin receptors in the human antrum.
Motilin is an intestinal peptide that stimulates contraction of gut smooth muscle. The motilin receptor has not been cloned yet, but motilin-receptor agonists appear to be potent prokinetic agents for the treatment of dysmotility disorders. The aim of this study was to determine neural or muscular localization of motilin receptors in human upper gastrointestinal tract and to investigate their pharmacological characteristics. The binding of (125)I-labeled motilin to tissue membranes prepared from human stomach and duodenum was studied; rabbit tissues were used for comparison. Solutions enriched in neural synaptosomes or in smooth muscle plasma membranes were obtained. Various motilin analogs were used to displace the motilin radioligand from the various tissue membranes. The highest concentration of human motilin receptors was found in the antrum, predominantly in the neural preparation. Human motilin receptors were sensitive to the NH(2)-terminal portion of the motilin molecule, but comparison with rabbit showed that both species had specific affinities for various motilin analogs [i.e., Mot-(1-9), Mot-(1-12), Mot-(1-12) (CH(2)NH)(10-11), and erythromycin]. Motilin receptors obtained from synaptosomes or muscular plasma membranes of human antrum expressed different affinity for two motilin-receptor agonists, Mot-(1-12) and Mot-(1-12) (CH(2)NH)(10-11), suggesting that they correspond to specific receptor subtypes. We conclude that human motilin receptors are located predominantly in nerves of the antral wall, are functionally (and probably structurally) different from those found in other species such as the rabbit, and express specific functional (and probably structural) characteristics dependent on their localization on antral nerves or muscles, suggesting the existence of specific receptor subtypes, potentially of significant physiological or pharmacological relevance.
Animals↗
A case of giant cell hepatitis recurring after liver transplantation and treated with ribavirin.
A patient who underwent orthotopic liver transplantation for giant cell hepatitis with cirrhosis and in whom giant cell hepatitis recurred twice after orthotopic liver transplantation is reported. He was treated with ribavirin with an excellent result. The literature on this subject is reviewed. This observation clearly confirms the efficacy of ribavirin for the treatment of giant cell hepatitis, thus providing evidence for its viral origin.
Adult↗
Rate limitations of unitary event analysis.
Unitary event analysis is a new method for detecting episodes of synchronized neural activity (Riehle, Grün, Diesmann, & Aertsen, 1997). It detects time intervals that contain coincident firing at higher rates than would be expected if the neurons fired as independent inhomogeneous Poisson processes; all coincidences in such intervals are called unitary events (UEs). Changes in the frequency of UEs that are correlated with behavioral states may indicate synchronization of neural firing that mediates or represents the behavioral state. We show that UE analysis is subject to severe limitations due to the underlying discrete statistics of the number of coincident events. These limitations are particularly stringent for low (0-10 spikes/s) firing rates. Under these conditions, the frequency of UEs is a random variable with a large variation relative to its mean. The relative variation decreases with increasing firing rate, and we compute the lowest firing rate, at which the 95% confidence interval around the mean frequency of UEs excludes zero. This random variation in UE frequency makes interpretation of changes in UEs problematic for neurons with low firing rates. As a typical example, when analyzing 150 trials of an experiment using an averaging window 100 ms wide and a 5 ms coincidence window, firing rates should be greater than 7 spikes per second.
Animals↗
Relation of family history of suicide to suicide attempts in alcoholics.
OBJECTIVE: This study was an examination of whether a family history of suicide is associated with attempts at suicide among alcoholics. METHOD: A consecutive series of 333 alcoholics were interviewed about whether or not they had ever attempted suicide and about their family history of suicide. RESULTS: Compared with alcoholics who had never attempted suicide, significantly more of the alcoholics who had attempted suicide reported that a first- or second-degree relative had committed suicide. CONCLUSIONS: A family history of suicide may indicate that an alcoholic has a higher risk of attempting suicide.
Alcoholism↗
Expression of 5-hydroxytryptamine receptor subtype messenger RNA in interstitial cells from human heart valves.
BACKGROUND AND AIM OF THE STUDY: Severe heart valve disorder has been reported in patients receiving a combination of the anorectic drugs fenfluramine and phentermine. The exact molecular mechanisms involved remain unknown. Fenfluramine alters the serotonin level in the brain, while phentermine interferes with the pulmonary clearance of serotonin; these data suggest that serotonin levels affect regulation of valve function. The aim of the present study was to characterize the serotonin receptor (5-hydroxytryptamine) subtypes expressed in the interstitial cells of human heart valves. METHODS: Interstitial cells were isolated and cultured from the aortic, pulmonary, mitral and tricuspid valves of recipient hearts obtained during transplantation. Total RNA was extracted from cultured cells in order to determine gene expression by reverse transcription-polymerase chain reaction (RT-PCR) using 5-hydroxytryptamine (5-HT) subtype-specific primer pairs. RESULTS: The results show that: (i) 5-HT 1B and 1D receptor subtypes are expressed in all four heart valves. This is significant as the 1B and 1D receptor subfamilies are the target of the anti-migraine drug sumatriptan, and these receptors regulate cardiac function and movement; (ii) 5-HT 1A, 5-HT 1E and 5-HT 1F are not expressed in interstitial cells isolated from the valves. CONCLUSION: We conclude that preliminary evidence exists for the presence of distinct subsets of 5-HT receptors in human heart valves, indicating that interstitial cells of the valves potentially respond to serotonin levels.
Appetite Depressants↗
Morning glory disk anomaly, choroidal coloboma, and congenital constrictive malformations of the internal carotid arteries (moyamoya disease).
PURPOSE: To report a patient with congenital constrictive malformations of the internal carotid arteries and a morning glory disc anomaly (MGDA). METHODS: Descriptive case report. RESULTS: A 14-year-old girl underwent serial ophthalmologic examinations since the age of seven years because of blurred vision and floaters. A right optic disk anomaly was present that was most compatible with an MGDA accompanied by an inferior choroidal coloboma. Because of the association of such disc malformations with moyamoya disease, the patient underwent cerebral MRI and MRA that showed narrowing of both internal carotid arteries, a finding consistent with early-stage moyamoya disease. CONCLUSION: This case illustrates the importance of recognizing the association of MGDA with moyamoya disease, a treatable condition that may have devastating neurological consequences.
Adolescent↗
Molecular characterization of interstitial cells isolated from human heart valves.
BACKGROUND AND AIM OF THE STUDY: Myofibroblasts have been described as possessing certain characteristics of both fibroblasts and skeletal myocytes. These cells are of mesenchymal origin, were first described in wound healing, and have been found in many tissues. Myofibroblasts from other tissues have been shown to contract and to express sarcomeric (muscle) genes. In addition, these cells express certain regulatory (transcription factor) genes. The specific alignment of the cells may, at least in part, be governed by tissue polarity signals transmitted by members of the frizzled family of vertebrate tissue polarity genes. The aim of the present study was to characterize interstitial cells, with regard to the expression of myofibroblasts markers, isolated from the human heart valves. The expression of muscle structural, regulatory and tissue polarity genes has been undertaken with a view to understanding the development and contribution of interstitial cells to valve function and structure. METHODS: Interstitial cells were isolated and cultured from aortic, pulmonary, tricuspid and mitral valves of recipient hearts obtained during transplantation. Specific oligonucleotide primer pairs suitable for polymerase chain reaction (PCR) were designed for the genes of interest. Total RNA was extracted from the cultured cells and reverse transcriptase-PCR was used to determine gene expression. RESULTS: Cells from the four valve types were found to express various muscle structural genes. These include the thin filament sarcomeric genes for the cardiac isoforms of troponin T, I and C. Evidence was also found for expression of beta-myosin heavy chain (beta-MHC), alpha-MHC and cardiac myosin light chain 2 (MLC2) in these cells. The tissue polarity genes frizzled 2 (fz2) were expressed in all four valve types analyzed. CONCLUSION: Interstitial cells express a number of genes whose products may have functional significance for heart valves. These include members of the contractile apparatus such as MHC and troponins. The presence of members of the frizzled family, which specify the orientation of cell polarization, in these cells could indicate that interstitial cells are not randomly arranged in the valve tissue. Therefore, interstitial cells isolated from the human heart valves express a number of functionally important genes, suggesting a role in their specialized function.
Contractile Proteins↗
[Autoimmune hepatitis in children. Initial presentation as fulminant hepatic failure].
UNLABELLED: There are few cases reported of autoimmune hepatitis (AIH) type 2 presenting as fulminant hepatic failure (FHF) in children. The purpose of this study was to report three girls with AIH type 2 that presented as FHF. METHODS: Over a period of 12 years, 123 patients with AIH diagnosed based on international criteria, 9 (7%) were type 2.3 of them presented as FHF. Other etiologies (viral, metabolic and toxic) were ruled out. The treatment was started with prednisone (2 mg-kg-day) and azathioprine (2 mg-kg-day). EVOLUTION: Patients 1 and 3 died while waiting for liver transplant (LT) at 72 and 48 hours after initiating medical treatment. Patient 2 underwent LT3 days after starting treatment, with excellent evolution at 3 years and 7 months of follow up. CONCLUSIONS: 1--AIH type 2 was very infrequent in our group. 2--33% of cases had initial presentation as FHF. 3--The course of the disease was aggressive, not responding to immunosuppressive therapy. The evolution was unfavorable in all patients. 4--LT is an alternative treatment for this severe disease.
Adolescent↗
Effect of serum dilution in diagnosis of malaria in community.
Recently, it has been shown that immunological methods can be used for the diagnosis of malaria other than sero-epidemiology. A study has been done to investigate optimum binding capacity of antigen-antibody (Ag-Ab) at different serum dilutions. For validating antigen-antibody (Ag-Ab) reaction at 1:100, 1:1000 and 1:1000 serum dilutions, have been tested in two different laboratories to establish validation of the ELISA method. Inter laboratory test on synthetic peptide (RI) ELISA was found comparable and meaningful for assessing malaria transmission in defined locality at 1:100 dilution. Results also showed that 1:1000 serum dilution can be useful for diagnostic purpose.
Binding Sites, Antibody↗
A study of myasthenia gravis in patients with and without thymoma.
This study was undertaken to compare the clinical, neurophysiological, radiological and prognostic features of myasthenia gravis with and without thymoma. 37 patients with myasthenia gravis (27 males, 10 females), with age range of 4.5 to 72 (mean 39) years, were managed at a tertiary care centre in India. Four patients were below 15 years of age and 6 above 55 years. Most of the patients were in stage II (34). There were 2 patients in stage III and 1 in stage I. 27 patients underwent thymectomy. Thymoma was detected in 10 cases. The decrement in patients with thymoma ranged between 11 and 62% (mean 27.9%) and nonthymoma group 10-75% (mean 28%). CT scan of thorax revealed mediastinal mass in 5 out of 10 cases of thymoma and 2 out of 27 patients without thymoma. Outcome of myasthenia gravis with thymoma was worse than without thymoma at 1 year followup. Severity of illness, extent of decrement, lack of facilitation, duration of illness and age of the patients were not related to the outcome. It is concluded the clinical and neurophysiological changes in myasthenia gravis with and without thymoma do not differ. However, patients with thymoma have a worse outcome.
Adult↗
Serological investigation of malaria outbreak in Thar desert of Rajasthan.
A serological investigation by a repeat cross-sectional survey was conducted in Thar desert (Rajasthan) during and after one year of malaria outbreak to determine malaria endemicity using ELISA as a tool. The assay was based on indirect ELISA to measure antibody levels against a nonapeptide R1 (EENVEHDA-cys) derived from Pf 155/Resa and Plasmodium falciparum crude antigen. Finger prick blood samples were collected from individuals belonging to all age groups. Sera were tested at already standardized optimum dilution to detect antigen specific immunoglobulin isotype. The mean ELISA O.D. values 0.153 for anti R1 peptide and 0.162 for anti Pf antigen reflected the seronegative profile, when the focal malaria outbreak occurred in 1994. A substantial increase in antibody levels was detected in individuals after one year showing mean ELISA values for anti-R1 and anti-Pf antigens as 0.52 and 0.58 and seropositivity as 75.2% and 52% respectively. Data obtained from the present study indicate that serological survey could be done to assess the situation in case of reappearing or disappearing status of malaria in a defined population.
Animals↗
Gall stones and carcinoma gall bladder.
One hundred and fifty surgically resected gall bladder specimens were included in the study to evaluate the relationship between the prevalence of gall stones and histochemical alteration in sequential changes of metaplasia, dysplasia and neoplasia in gall bladder epithelium. Multiple sections were processed and stained with haematoxylin and eosin, Periodic acid Schiff's stain, Alcian blue (pH 2.5)/Periodic acid, Orcein/Alcian blue (pH 2.5) and Alcian Blue/Periodic acid/Potassium borohydride saponifications stains. Details of gall stones present were also noted. Prevalence of gall stones in gall bladders with metaplastic, dysplastic and neoplastic mucosal changes was significantly higher (P < 0.001) than those gall bladders which had no epithelial changes. Increase in sialomucin with a corresponding decrease in sulphomucin was observed from metaplasia to malignancy. Neutral mucin increased in metaplastic cells but was significantly reduced in neoplastic cells. Loss of O-acylation in sialmucin was also present in neoplastic cells. The histochemical changes suggest that chronic injury due to cholelithiasis induces appearance of neutral mucin positive metaplastic cells, which may further dedifferentiate to sialomucin containing dysplastic or neoplastic cells if the stimulation persists.
Cholelithiasis↗
Validity of mechanism of gene transfer in the process called conjugation in bacteria.
We have attempted a new evaluation of the process of conjugation in bacteria, because of some basic dissimilarities observed between this and that of eukaryotes, or plants and animals. Reference donor and recipient strains, widely used to prove conjugation in bacteria, were chosen; addition of DNase during the conjugation process, led to an unexpected but highly reproducible increase in the transconjugant colony counts (TCC; ca. > or = 1 log), when compared with that of the controls without DNase. Transconjugants were also obtained when the same live donors were substituted with the UV-killed ones although the TCC was very low initially. Contrarily, donors treated with DNA-intercalating agents, e.g. acridine orange or ethidium bromide, resulted in a complete failure to produce transconjugants. There was a quantitative relationship between the DNase used on donors and levels of DNA sugars/nucleotides/DNA, which possibly resulted from interaction between the DNase and DNA being present/produced on the donor surface. This may be indicative of what may actually happen in the donor-recipient mixtures in the conjugation test proper, where the recipient DNase may activate a donor DNA production cycle. The evidences presented did not suggest that the donor DNA in the conjugation process is actually vestibuled through any intercellular conjugation passages, and is susceptible to the action of DNase or the intercalating dyes.
Animals↗