Bladder diverticulum causing acute urinary retention.
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Diverticulum↗
Biomedical subjects
K Singh
Publications and source records attributed to K Singh.
Auditory profile in children recovering from bacterial meningitis.
In the present study BERA profile of 30 post-meningitic children was compared with 15 normal children of the same age and it was observed that 36.6% children in the age range of 6 months to 36 months were found to have varying degree of sensorineural deafness. Severe bilateral sensorineural hearing loss (> 80 dB) was observed in 6.6% children and moderate (40-80 dB) hearing loss in 30% of children. Abnormalities were bilateral in both the samples of children with severe hearing loss (> 80 dB) whereas among 9 children who had moderate hearing loss abnormalities were bilateral in one patient and unilateral in the remaining 8 children. A relationship between higher incidence of sensorineural deafness and younger age of children, and occurrence of seizures during meningitis were noted. But no relationship was observed with either sex, hydrocephalus, subdural effusion or with low CSF sugar and high CSF proteins.
Age Distribution↗
Endoscopic retrograde cholangiopancreatography in the evaluation of anomalous junction of the pancreaticobiliary duct and related disorders.
BACKGROUND: Anomalous junction of the pancreaticobiliary duct (AJPB) is a rare finding in endoscopic retrograde cholangiopancreatography (ERCP). We present our data on the incidence of AJPB and associated diseases. METHODS: A retrospective analysis of 2885 ERCPs performed over 15 years was done to study the incidence of AJPB and the diseases associated with this anomaly. RESULTS: Of the 2885 patients who underwent ERCP, AJPB was seen in 46 (1.6%). AJPB was taken as a common channel exceeding 15 mm in length with or without dilatation of the common channel. Anomalous junction was of type I in 50%, type II in 39.1%, and type III in 2.2% cases. Y-type anomalous junction was seen in 8.7% of cases. Choledochal cyst was found in 87% of patients. Other disorders associated with AJPB were gallstones, gallbladder polyps, gallbladder carcinoma, protein plugs. and pancreatic ductal calculi. Four patients with AJPB did not show any associated abnormality. CONCLUSION: AJPB is a rare finding, and the diagnosis is based on a common channel longer than 15 mm on ERCP. Choledochal cyst is the most common association with AJPB. We believe that the clinical spectrum of AJPB may unfold further with the widespread use of cholangiographic techniques.
Adolescent↗
Small bowel tuberculosis: enteroclysis findings.
We describe the radiologic appearances of small bowel tuberculosis as shown by enteroclysis. A total of 265 patients with proven small bowel tuberculosis seen over a period of more than one decade was evaluated. All patients had positive radiologic findings as shown on enteroclysis examination. Of the 265 patients with small bowel tuberculosis, 174 had isolated small bowel involvement with a normal ileocecal region, whereas 91 had associated noncontiguous involvement of the ileocecal region. The most common radiologic finding was the presence of strictures, noted in 62.7% of cases. Most strictures were short, concentric, and smooth in outline. These strictures were solitary or multiple and located mainly in the jejunum. Other radiologic findings were adhesions (21.8%), ulcerations (9.1%), and diffuse thickening of folds (6.4%). Complications noted were in the form of enteroliths, perforations, and fistulae. The radiographic findings of small bowel tuberculosis, although non-specific, may indicate tuberculosis in a high-risk population.
Adolescent↗
Primary small bowel tumors: a radiologic-pathologic correlation.
BACKGROUND: Primary small bowel tumors are rare and their preoperative diagnosis is unsatisfactory. The cornerstone of diagnosis remains contrast radiography. The present study was done to evaluate the radiologic findings of primary small bowel tumors as shown on enteroclysis and to correlate these observations with surgical and histopathologic findings. METHODS: Seventy two patients with primary small bowel tumors identified by enteroclysis were evaluated. All the patients were subjected to jejunal biopsy or surgery. The diagnosis was established by histopathologic examination in all cases. RESULTS: Radiologic findings were suggestive of benign tumors in 19 patients and malignant tumors in 31 patients. Nonspecific findings in the form of diffuse involvement of the small bowel were noted in 22 patients. There was 100% radiologic-surgical correlation. Leiomyomas and lymphomas were the most common benign and malignant tumors, respectively. Tumor specificities were 89.5% for benign tumors and 41.5% for malignant tumors. CONCLUSION: Distinctive morphologic patterns as shown on enteroclysis are highly suggestive of specific tumor types in the majority of cases.
Adolescent↗
Effect of hyperthermia on blood composition in Bos indicus and their crosses with Bos taurus breeds.
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Animals↗
Sporotrichosis in Himachal Pradesh (north India).
Sporotrichosis is being increasingly reported from a particular area of Himachal Pradesh, a state in north-west India. A skin-test survey was conducted using sporotrichin and peptido-rhamnomannan antigen among the population in the villages where 2 or more cases of sporotrichosis had been reported and results were compared with those for villages of the same where no case of sporotrichosis had been reported. The study was helped by local doctors, leaders and patients who were cured of sporotrichosis. The delayed-hypersensitivity positivity rates were significantly higher in case villages (range 22.9-40.0%) compared to control area (range 6.5-7.6%). Analysis by age showed that positivity rate increased with increase in age for both sexes. Analysis by occupation showed higher skin-test positivity in populations engaged in horticulture, nursery work, gardening, woodwork (43.2%) and farming (33.9%). The case villages have lower temperature and higher rainfall than the control villages. During the 1-year study period (1996-97), 25 cases of sporotrichosis were diagnosed: 16 cases were referred by doctors from the local area and 9 were from cases suspected during the skin-test survey. This study identifies Kangra district and adjoining areas in Himachal Pradesh as an endemic region for sporotrichosis and highlights the need for evaluation of geo-climatically similar areas.
Adult↗
Refinement of 3D structure of bovine lens alpha A-crystallin.
In absence of 3D structures for alpha-crystallin subunits, alpha A and alpha B, we utilized a number of experimental and molecular modeling techniques to generate working 3D models of these polypeptides (Farnsworth et al., 1994. In Molecular Modeling: From Virtual Tools to Real Problems (Eds. Kumosinski, T.F. and Liebman, M.N.) ACS Symposium Series 576, Ch. 9:123-134, 1994, ACS Books, Washington DC). The refinement of the initial bovine alpha A model was achieved using a more accurate estimation of secondary structure by new/updated methods for analyzing the far UV-CD spectra and by neural network secondary structure predictions in combination with database searches. The spectroscopic study reveals that alpha-crystallin is not an all beta-sheet protein but contains approximately 17% alpha-helices, approximately 33% beta-structures and approximately 50% turns and coils. The refinement of the alpha A structure results in an elongate, asymmetric amphipathic molecule. The hydrophobic N-terminal domain imparts the driving force for subunit aggregation while the more flexible, polar C-terminal domain imparts aggregate solubility. In our quaternary structure of the aggregate, the monomer is the minimal cooperative subunit. In bovine alpha A, the highly negatively charged C-terminal domain has three small positive areas which may participate in dimer or tetramer formation of independently expressed C-terminal domains. The electrostatic potential of positive areas is modulated and become more negative with phosphorylation and ATP binding. The refined bovine alpha A model was used to construct alpha A models for the human, chick and dogfish shark. A high degree of conservation of the three dimensional structure and the electrostatic potential was observed. Our proposed open micellar quaternary structure correlates well with experimental data accumulated over the past several decades. The structure is also predictive of the more recent data.
Amino Acid Sequence↗
Interaction of DNA with bovine lens alpha-crystallin: its functional implications.
Under normal conditions, lens aggregates of alpha-crystallin subunits, alpha A and alpha B, are found in the cytoplasm. However, during stress in nonlenticular tissues, alpha B translocates to the nucleus. A sequence study revealed that both subunits share a consensus sequence with other DNA binding proteins. These observations prompted us to investigate DNA binding with alpha-crystallin by UV-mediated photo-crosslinking. The data show that both single and double stranded DNA crosslink mainly with tetramers of alpha-crystallin subunits. The formation of tetramers appears to modify alpha-crystallin interactive properties and, therefore, its induction may have functional significance. These observations suggest that alpha-crystallin may have a nuclear function which includes DNA binding.
Amino Acid Sequence↗
Swan-Ganz catheter: misconceptions, pitfalls, and incomplete user knowledge--an identified trilogy in need of correction.
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Bias↗
Human serum albumin-benzo[a]pyrene anti-diol epoxide adduct structure elucidation by fluorescence line narrowing spectroscopy.
Cryogenic (4-10 K) laser-induced vibrationless ground state and vibronic excited state fluorescence emission spectra of the adducts resulting from reaction in vitro of human serum albumin and the carcinogen (+-)-r-7,t-8-dihydroxy-c-9,c-10-epoxy-7,8,9,10- tetrahydrobenzo[a]-pyrene were recorded in order to determine the structures formed. Comparison of these fluorescence line-narrowed (FLN) spectra to those obtained from BaP-7,8,9,10- tetrahydrotetrols, synthetic N-t-BOC-alaninate ester, and N tau- and N pi-histidine amine anti-BaPDE adducts revealed that a mixture of adduct types are formed with the protein. Extensive dialysis of the adducted protein simplified the FLN spectrum, causing it to become nearly identical to the FLN spectrum obtained from the stable peptide adduct. Comparison of the FLN spectra of the synthetic histidine adducts to those obtained from peptide adducts isolated from enzymic digestion of the adducted protein indicated that only one of the imidazole nitrogens is the nucleophile which forms a stable adduct with anti-BaPDE. The FLN studies confirm that N tau-histidine adducts are formed between human serum albumin and the C-10 position of anti-BaPDE.
7,8-Dihydro-7,8-dihydroxybenzo(a)pyrene 9,10-oxide↗
Characterization of benzo[a]pyrene anti-diol epoxide adducts to human histones.
Nuclei from human lymphoblast cells grown in culture were treated with [7-14C]-(+/-)-r-7,t-8-dihydroxy-t-9,t-10-epoxy-7,8,9,10- tetrahydrobenzo[a]pyrene (anti-BPDE), and the nucleosomal core histones were isolated for adduct studies by cryogenic fluorescence line narrowing spectroscopy. The four core histones H2A, H2B, H3, and H4 were separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, which yielded each histone free of contamination by the others. Further purification of histones H2A, H2B, and H4 by reversed-phase HPLC also yielded a tetrahydrotetrol of benzo[a]pyrene, indicating that these three histones had some labile adducts. No tetrol was observed upon purification of histone H3. Fluorescence emission spectra of the HPLC-purified histones recorded at 4K after vibronic excitation into the S1 state were generally similar. Fluorescence line-narrowed spectra of model compounds formed by reaction of anti-BPDE with acetic acid, ethylenediamine, cysteamine, and histidine were also recorded. Only the spectra of the ethylenediamine adduct model matched consistently, at different excitation wavelengths, the spectra of the adducted histones. From this it is concluded that the stable human histone adducts of anti-BPDE are formed by reaction with lysine residues and/or the amino groups of the N-termini.
7,8-Dihydro-7,8-dihydroxybenzo(a)pyrene 9,10-oxide↗
Enantiospecificity of covalent adduct formation by benzo[a]pyrene anti-diol epoxide with human serum albumin.
Human serum albumin was reacted with the (+)- and (-)-enantiomers of r-7,t-8-dihydroxy-t-9,t-10-epoxy-7,8,9,10-tetrahydrobenzo[a]pyrene to determine if the chiral nature of the protein influences adduct formation. The alkylated proteins were analyzed directly by fluorescence line narrowing spectroscopy, and their spectra were compared to those of the model synthetic adducts N tau-(7,8,9-trihydroxy-r-7,t-8,t-9,c-10-tetrahydrobenzo[a]pyren-10- yl)histidine and 7,8,9-trihydroxy-r-7,t-8,t-9,c-10-tetrahydrobenzo[a]pyren- 10-yl N-t-BOC-alaninate ester. The results from these analyses indicated that different adducts were formed by the enantiomers of the diol epoxide. The adducted proteins were also enzymatically digested, and the 8,9-cis-dihydroxy-7,8,9,10-tetrahydrobenzo[a]pyrene-containing adducts and hydrolysis products were isolated by boronate affinity chromatography. Diode array UV, fast atom bombardment, and on-line atmospheric pressure ionization-mass spectral analysis of the HPLC purified products indicated that the more mutagenic and tumorigenic (+)-enantiomer forms carboxylic ester adducts with the protein at either Asp(187) or Glu(188), while the (-)-enantiomer forms N tau-histidine adducts at His(146). This previously unrealized enantiospecificity of the reaction of benzo[a]pyrene anti-diol epoxide with human serum albumin has important consequences for the application of the adducts as biomarkers of internal exposure.
7,8-Dihydro-7,8-dihydroxybenzo(a)pyrene 9,10-oxide↗
Expression of enhanced levels of small RNA polymerase III transcripts encoded by the B2 repeats in simian virus 40-transformed mouse cells.
Although specific viral genes are known which are sufficient to transform certain types of cells, viral transformation has been shown to be accompanied by a change in the level of expression of cellular genes. Assuming that this latter class of genes is involved in some way in the establishment of the transformed state, we and others have sought to characterize them. To this end, we constructed a complementary DNA library from a simian virus 40 (SV40)-transformed mouse cell line and screened this library for induced genes. Here we focus on the characterization of a specific cDNA clone called 10 lambda 5. We show that the clone 10 lambda 5 contains a B2 repeat, and that the levels of the small heterogeneously sized B2 cytoplasmic RNAs homologous to 10 lambda 5 are enhanced in transformed cells. Our studies show that these RNAs are a specific class of polymerase III transcripts containing a highly conserved 5' end. SV40 transformation results, therefore, in the activation of specific polymerase III transcripts as well as specific polymerase II transcripts.
Animals↗
Preparation of the cervix for surgical termination of pregnancy in the first trimester.
Worldwide, surgical vacuum aspiration is the method of choice of terminating first trimester unwanted pregnancy. Cervical priming prior to surgical evacuation reduces the risks of cervical injury by making the cervix softer and easier to dilate. Over the years, a number of effective methods of cervical priming have became available: osmotic dilators; antiprogesterone and prostaglandins. Of these, prostaglandins remain the most widely used method of cervical preparation. However many of the natural and synthetic analogues of prostaglandins are either expensive or associated with troublesome side-effects. More recently, misoprostol, a synthetic 15-deoxy-16 hydroxy 16-methyl analogue of naturally occurring prostaglandin E, used in the management of peptic ulcers, has established a lead for cervical priming in terms of availability, ease of administration, cost and effectiveness. In fact it appears that both oral and vaginal misoprostol given at dosages of 400 microg are effective for cervical priming when administered 3 h prior to surgical vacuum aspiration. Now that the use of misoprostol for cervical priming has been validated, its widespread use in gynaecological practice is expected.
Abortifacient Agents, Nonsteroidal↗
Transient abnormality in carbohydrate metabolism during enterically transmitted non-A, non-B acute viral hepatitis.
Blood glucose, plasma insulin and free fatty acids (FFA) responses, during the 2 h oral glucose tolerance test (OGTT) with 75 g of dextrose, were measured in 30 consecutive patients with acute enterically transmitted non-A, non-B hepatitis. All of these parameters during the OGTT were compared with 10 age-, sex- and weight-matched healthy volunteers from the same community. The fasting blood sugar, insulin and FFA were not different from normal controls (P greater than 0.05). According to the WHO criteria, the blood glucose response during OGTT in these patients was normal in 23%, impaired in 33% and diabetic in 43%. There was significant hyperinsulinaemia (P less than 0.001) in patients with impaired and diabetic GGT and it persisted even at the end of 2 h. None of the abnormal liver function tests correlated with blood sugar, insulin and FFA response during the OGTT. All abnormal responses during the OGTT were, however, transient and returned to normal in all the patients after the recovery from acute hepatitis.
Adult↗
Accuracy of magnetic resonance imaging of inguinofemoral lymph nodes in vulval cancer.
Inguinofemoral lymphadenectomy contributes to the high morbidity related to surgical treatment of vulval cancer. The objective of this study was to assess the accuracy of magnetic resonance imaging (MRI) in predicting inguinofemoral lymph nodes metastasis in women with vulval cancer. We reviewed the clinical, MRI, surgical, and pathologic findings of 59 women with vulval cancer who were treated at our institution from January 2000 to June 2004. Histology was available for 39 women who had undergone inguinofemoral lymphadenectomy. Clinical and MRI findings were compared with histology result to assess test accuracy. MRI had a positive likelihood ratio (LR+) of 4.8 (95% confidence interval of 2.7-8.6) and negative likelihood ratio (LR-) of 0.17 (0.06-0.49). It had a sensitivity of 85.7% (63.7-97), specificity of 82.1% (69.6-91.1), positive predictive value (PPV) of 64.3% (44.1-81.4), and negative predictive value (NPV) of 93.9% (83.1-98.7). Clinical examination had an LR+ of 6.1 (1.8-21.6) and LR- of 0.69 (0.5-0.96). It had a sensitivity of 35% (15.3-59.4), specificity of 94.3% (84.3-98.8), PPV of 70% (34.7-93.3), and NPV of 79.4% (67.3-88.5). Kappa statistics for interobserver and intraobserver agreement were 0.9091 and 0.8475, respectively. MRI assessment was accurate in predicting negative nodal status that is clinically useful in identifying women who can be spared inguinofemoral lymphadenectomy. It is noninvasive and is superior to clinical assessment. In clinical practice, this should encourage toward nodal sparing surgery, thus lowering surgical-related patient morbidity.
Aged↗
Cisplatin nephrotoxicity in a patient with a single kidney.
OBJECTIVE: To describe a patient with a single kidney who experienced cisplatin-associated nephrotoxicity. CASE SUMMARY: A 78-year-old African-American woman with squamous cell carcinoma of the base of her tongue (T4N2M1) was admitted electively to our institution for the first cycle of chemotherapy. Her past medical history was significant for a left nephrectomy secondary to well-differentiated papillary transitional cell carcinoma of the left renal pelvis, hypothyroidism, asthma, and coronary artery disease. Her blood urea nitrogen (BUN) was 27 mg/dL of urea, and serum creatinine was 1.2 mg/dL. On admission she was hydrated adequately, and was treated with an evening dose of cisplatin 100 mg/m2 (180 mg) in 250 mL of NaCl 0.9% solution in a 3-hour infusion, and a 5-day course of fluorouracil 1000 mg/m2 (1800 mg) in a 24-hour infusion. Serum creatinine and BUN concentrations following cisplatin administration were 1.1 mg/dL and 8 mg/dL, respectively. Four days after cisplatin therapy, a decline in renal function was observed, with an increase in serum creatinine and BUN concentrations to 4.0 mg/dL and 31 mg/dL, respectively. These tests remained elevated throughout her hospitalization. With hemodialysis treatments a resolution in altered mental status was observed; however, her chronic renal failure persisted. She was subsequently discharged and followed in the outpatient renal, geriatric, and oncology clinics. DISCUSSION: Cisplatin is a principal chemotherapeutic agent used in the treatment of a variety of solid tumors. Nephrotoxicity is a major complication associated with this compound. Although many clinicians believe that cisplatin nephrotoxicity is unlikely to occur in patients with a single kidney, recent reports have suggested otherwise. The physiologic changes of the aging kidney are such that they should foster cisplatin clearance rather than expose the kidney to the drug's nephrotoxic potential. In addition, evening administration of cisplatin is thought to minimize nephrotoxicity. We describe a 78-year-old woman with a single kidney who developed nephrotoxicity following a single evening dose of cisplatin. Details of the patient's history and cisplatin-associated complication and therapy are discussed. CONCLUSIONS: Cisplatin circadian rhythmic pharmacotherapy to minimize cisplatin toxicity in patients with a single kidney appears to be controversial and needs further evaluation.
Aged↗