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Biomedical subjects

B Banerjee

Publications and source records attributed to B Banerjee.

At least 37 records · Page 2Linked to original sources

Molecular cloning and expression of a recombinant Aspergillus fumigatus protein Asp f II with significant immunoglobulin E reactivity in allergic bronchopulmonary aspergillosis.

The cDNA of Aspergillus fumigatus encoding an allergen was cloned and expressed in Escherichia coli. The 987 bp long cDNA clone expressed a recombinant protein Asp f II of 34 kd. This protein exhibited binding to immunoglobulin E (IgE) in the serum samples from patients with allergic bronchopulmonary aspergillosis (ABPA). The patients with ABPA and central bronchiectasis demonstrated high levels of serum IgE antibodies, whereas patients with ABPA without central bronchiectasis, patients with asthma and Aspergillus skin test reactivity but no evidence of ABPA, and patients with aspergilloma showed only low levels of IgE antibody to Asp f II. In two-dimensional electrophoresis, a native antigen electroeluted from an A. fumigatus culture filtrate antigen preparation showed an isoelectric point and molecular weight similar to that of Asp f II. In a competitive enzyme-linked immunosorbent assay (ELISA), the IgE antibody reactivity of Asp f II with patient serum samples could be significantly inhibited by culture filtrate antigens of A. fumigatus. These results indicate that Asp f II has immunologic reactivities comparable to those of native A. fumigatus antigens. The recombinant Asp f II can be expressed in E. coli in large quantities and should prove useful as a standardized allergen for sensitive and specific immunodiagnosis of ABPA, especially in patients with central bronchiectasis.

Animals

Thermodynamic studies with acetylthiocholine on nicotinic receptors of mammalian skeletal muscle in vitro.

The temperature dependency of binding of acetylthiocholine, a specific nicotinic agonist, to the nicotinic receptor of mammalian skeletal muscle was studied using isotonic contractions of the rat denervated diaphragm preparation in vitro. The dissociation constants at different temperatures (22-39 degrees) were determined by the Furchgott method using alpha-bungarotoxin as an irreversible antagonist. Both free energy of association (delta G zero = -22.93 kJ/mol at 37 degrees) and enthalpy of binding (delta H zero = -58.35 kJ/mol) calculated from Kd (dissociation constant) and slope of lnKd versus 1/T (van't Hoff plot) respectively were found to be negative. The negative entropy value (delta S zero = -0.113 kJ/mol/deg) obtained from the intercept of this van't Hoff plot differs from the large positive value obtained earlier employing radioligand binding studies of the nicotinic receptor of Electrophorus electricus.

Acetylthiocholine

Nonsurgical management of primary cholangiocarcinoma. Retrospective analysis of 40 cases.

Forty patients with cholangiocarcinoma (23 men, 17 women) underwent nonsurgical palliative biliary drainage over a period of 12 years. All were surgically unfit or had unresectable disease. All were jaundiced at presentation with a mean serum bilirubin of 11.5 +/- 1.9 mg/dl. Thirty patients (75%) had hilar obstruction. Twenty-eight were drained percutaneously, three endoscopically and nine by a combined endoscopic and percutaneous procedure. Technical success was 97.5%. Final mean bilirubin was 1.5 +/- 0.4 mg/dl. Minor complications occurred in 10 (25%) patients, and major complications in four (10%). Procedure-related mortality was 2.5% with a 30-day mortality of 7.5%. Mean survival was 8.2 +/- 0.5 months. Stent changes were required in eight patients. In patients with inoperable or unresectable cholangiocarcinoma, percutaneous or endoscopic biliary drainage offers effective palliation.

Aged

A crowded ureter.

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Foreign-Body Migration

The epidemiology of fractured femurs and the effect of these factors on outcome.

We have analysed 250 cases of fractured shaft of the femur with the objective of highlighting any preventative measures and anticipating morbidity associated with cause and type of injury. The younger patients typically injure themselves as pedestrians, motorcyclists and bicyclists in Summer. The older patients tend to have falls in late Summer and Winter. The outcome varies depending on the cause, type and age of the injured person. The greatest morbidity was found in high-velocity accidents involving motorcyclists, pedestrians and car accidents. Knee flexion is a particular problem with these injuries and we are currently using continuous passive motion in conjunction with a continuous opiate infusion where this is likely to be a problem. The results also suggest that the mechanism of injury and its possible prevention, particularly in motorcycle design, could be as important as the type of treatment. Elderly females following falls also form a distinct group, suggesting that osteoporosis is a major factor with the best outcome associated with treatment by internal fixation. We feel that age alone should not be a reason for exclusion from intramedullary fixation and this merits further study.

Accidental Falls

Injuries associated with a fractured shaft of the femur.

A knowledge of injury patterns, both from the mechanism of injury and from their associations, allows specific injuries to be suspected and actively excluded. We have reviewed fractures of the femoral shaft to highlight the patterns of their associated high morbidity and mortality. Our survey shows that accidents involving motorcyclists, pedestrians and motor cars have the highest incidence of associated injury. Common associations include chest, head, pelvis and ipsilateral leg injuries in pedestrians, and pelvic and ipsilateral leg injuries in motorcyclists. Rarer associations with femoral shaft fractures include ipsilateral tibia and talus/navicular fractures in motorcyclists, knee injuries and contralateral acetabular fractures in pedestrians and contralateral necks of femur in motor car passengers.

Accidental Falls

Serological findings in patients with allergic bronchopulmonary aspergillosis during remission.

The concentrations of total IgG, complement C3 and circulating immune complexes (CIC) were studied in 15 patients with allergic bronchopulmonary aspergillosis (ABPA) during remission and compared with those of 10 matched controls. The concentrations of complement and circulating immune complexes were similar to those of the controls but 33% of patients with ABPA in remission still had circulating immune complexes, mainly of IgG. Even so, the concentrations of IgG were significantly higher in patients during remission compared to controls but were lower than those observed during the acute stage of ABPA.

Acute Disease

Extrahepatic biliary tract obstruction. Modern methods of management.

Extrahepatic biliary tract obstruction can often be diagnosed by means of thorough history taking, physical examination, and basic laboratory data. The cause of obstruction can be best defined and is often best treated by biliary endoscopy and/or percutaneous radiologic techniques, which appear to be safer than surgical decompression.

Cholangiography

An unusual complication of paracentesis.

Paracentesis is an important and commonly performed procedure in patients with ascites. It is a safe procedure when carried out in the midline below the umbilicus, with a complication rate of less than 1%. We report an instance in which a large midline varix was entered during paracentesis. The utility of different imaging techniques in detecting such anomalies in the portal hypertensive patient with portal hypertension and ascites is discussed. The approach and management of this complication are outlined.

Abdominal Muscles

Sonographic detection of foreign bodies of the extremities.

A prospective study to assess the accuracy of ultrasound in the detection and localization of foreign bodies of the extremities was undertaken. Forty-five patients with clinical suspicion of foreign bodies were included in the study. Among 20 patients with radio-opaque foreign bodies, ultrasonic detection of foreign bodies was achieved in 19 patients. In 25 patients, with no radiographic evidence of foreign body, ultrasonic detection of foreign bodies was made in seven patients and among these foreign bodies were confirmed and removed at surgery in five patients. Accurate pre-operative ultrasonic localization of foreign bodies was carried out in three patients.

Evaluation Studies as Topic

Ultrasound diagnosis of horseshoe kidney.

Ultrasound diagnosis of horseshoe kidneys depends on the demonstration of an isthmus or band of renal tissue across the midline of abdomen connecting the lower poles of the kidneys. In a number of cases this band of renal tissue may evade ultrasonic detection. In a series of 11 patients with horseshoe kidneys, sonographic detection of renal isthmus was achieved in seven patients, but in all 11 cases there was demonstrable alteration of renal outlines. Instead of normal reniform shape, the kidneys appeared "inverted pyriform" or "inverted triangular". Detection of such an altered renal outline should raise suspicion of horseshoe kidney.

Child

Identification and partial characterization of diagnostically relevant antigens of Aspergillus fumigatus.

Metabolic antigens of Aspergillus fumigatus, soil strain 2605 and sputum isolate, were evaluated for their diagnostic applicability using hyperimmune sera and sera of adults and pediatric patients of allergic bronchopulmonary aspergillosis. An indirect ELISA was standardised by using 2-10 micrograms/ml of coating antigen for detection of specific IgG and IgE antibodies in the sera of patients. The ratios of absorbance for specific IgE and IgG antibodies by ELISA (normal to patients) were observed to be in the range of 1:2 to 1:3 to 1:8 respectively. These antigenic preparations were further analyzed to identify and characterize the individual components by immunoblotting. This analysis indicated the presence of allergenic and antigenic determinants in the antigens of molecular weights 70, 34, and 28 Kd. The utility of the antigens of soil strain for diagnostic purpose is suggested.

Adolescent

Effects of metoclopramide and ranitidine on gastric fluid volume and its acidity.

The effects of metoclopramide 10 mg and ranitidine 150 mg on gastric fluid volume and its pH are studied when given orally either alone or in combination, 3 hours before induction of anaesthesia in adult surgical patients. The study shows that metoclopramide causes reduction of gastric fluid volume but does not elevate its pH. Ranitidine elevates the pH of gastric fluid satisfactorily in all cases, but reduces the gastric volume below the critical level only in 50% cases. A combination of the said two drugs offered most satisfactory protection against acid aspiration syndrome almost in all cases. This regime seems to be superior to either ranitidine or metoclopramide alone in order to reduce the risk factors for aspiration of gastric contents.

Adult