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Biomedical subjects

K Sriram

Publications and source records attributed to K Sriram.

At least 37 records · Page 2Linked to original sources

Protection and potentiation of 1-methyl-4-phenylpyridinium-induced toxicity by cytochrome P450 inhibitors and inducer may be due to the altered uptake of the toxin.

Earlier studies from our laboratory have demonstrated that 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) toxicity could be modulated by inhibitors and inducer of cytochrome P450 (P450) in an in vitro model consisting of sagittal slices of mouse brain. To understand the molecular mechanisms underlying the role of P450 on MPTP toxicity, it was undertaken to study the effect of the modulators of P450 on the toxicity of the metabolite of MPTP, namely, 1-methyl-4-phenylpyridinium ion (MPP+). Incubation of mouse brain slices with various concentrations of MPP+ (1-100 microM) resulted in dose-dependent inhibition of mitochondrial enzyme NADH-dehydrogenase (NADH-DH) and leakage of the cytosolic enzyme lactate dehydrogenase from the slice into the medium. MPP(+)-induced toxicity was abolished by pretreatment of the slices with inhibitors of monoamine oxidase (MAO; pargyline and deprenyl) or inhibitors of P450 (piperonyl butoxide or SKF-525A) or dopamine uptake blocker (GBR-12909), as measured by the activity of NADH-DH in slices and leakage of lactate dehydrogenase from the slice into the medium. Slices prepared from mice pretreated with phenobarbital (an inducer of P450) potentiated the toxic effects of MPP+. Pretreatment of slices with MAO-inhibitor, P450 inhibitors, or dopamine uptake blocker attenuated the uptake of MPP+ into the slices. In contrast, MPP+ uptake was significantly increased in slices prepared from phenobarbital-pretreated mice. Thus, both MAO and P450 inhibitors abolish the toxicity of MPP+ in the sagittal slices of mouse brain by altering the uptake of the toxin into the slices.

1-Methyl-4-phenylpyridinium↗

Myocardial fibrosis: role of angiotensin II and aldosterone.

In this report we review the replacement (i.e., scarring) and reactive (i.e., perivascular and interstitial fibrosis) fibrous tissue responses found in the myocardium in response to effector hormones of the renin-angiotensin-aldosterone system. Experimental data are presented to indicate: a) endogenous or exogenous elevations in plasma angiotensin II are associated with acute cardiac myocyte necrosis and subsequent microscopic scarring; b) chronic elevations in plasma aldosterone (ALDO), relative to Na+ intake, are associated with a perivascular and interstitial fibrosis of the coronary and systemic circulations and are also seen in response to chronic administration of the mineralocorticoid hormone deoxycorticosterone (DOC); and c) chronic mineralocorticoid excess, due to ALDO or DOC, is associated with enhanced urinary K+ excretion, cardiac myocyte necrosis and scarring. Pharmacologic agents which interfere with these effector hormones (e.g., ACE inhibition and ALDO receptor antagonism) protect the myocardium against this pathologic structural remodeling created by the reactive and replacement (reparative) fibrosis. Evidence is also presented to indicate that chronic ACE inhibition is associated with a regression in reactive myocardial fibrosis. Based on these experimental findings we would suggest that clinical trials are indicated to address the prevention and regression of myocardial fibrosis--an important determinant of pathologic structural remodeling and abnormal myocardial stiffness.

Aldosterone↗

Vapour toxicity of aerosol formulation, allethrin on Culex quinquefasciatus (Diptera: Culicidae), Say & Musca domestica (Diptera: Muscidae) N.

Studies on the toxicity of aerosol vaporizer formulation, allethrin were carried out on both male and female species of C. quinquefasciatus and M. domestica at different times of exposure. ANOVA models revealed significant differences in the mean values of the percentage mortalities in relation to sex and time-of-exposure for both the species.

Aerosols↗

Absorption of cobalamin (vitamin B12) administered via jejunostomy.

Absorption of cobalamin (Cbl) administered via feeding jejunostomy (J) was compared with that given by mouth (PO) to study the role of transgastric passage in its binding to gastric Intrinsic Factor and subsequent ileal absorption. Modified Schilling tests were performed on 10 patients, each patient serving as his own control. A labeled Cbl capsule was dissolved in 10 cc of water, 7 cc (containing approximately 0.4 microCi 57Co) measured in a syringe and administered PO or via J, followed by 30 cc of water. The remaining solution was used for counting. Starting 1 hour later, following 1 mg of IM cyano-Cbl USP to saturate body storage sites of Cbl, urine was accurately collected for 24 hours and a 4-ml aliquot analyzed for 57Co. Results are expressed as % of tracer excreted in the urine (normal: greater than 7%). The test was repeated in 1 week through the alternate route using the identical protocol. In the eight patients in whom results could be analyzed, absorption was 21.18 +/- 5.83% in J group (range: 5.8-51.9%) and 9.75 +/- 2.62% in PO group (range: 1.9-24.2%). This difference was highly significant p = 0.02) using the paired Student's t-test. Route of the first test (PO or J) made no difference. It is concluded that cobalamin (vitamin B12) administered via jejunostomy is absorbed to a degree significantly greater than that given by mouth.

Administration, Oral↗

Clinical zinc deficiency during adequate enteral nutrition.

Deficiency of zinc (Zn), resulting in characteristic skin changes resembling those seen in acrodermatitis enteropathica, has been reported in patients on total parenteral nutrition, but rarely in patients on long-term enteral feeding. Reported here is a patient who developed characteristic skin changes while he was receiving what was considered to be a balanced liquid enteral diet. The skin rash resolved with Zn supplementation.

Enteral Nutrition↗

The continent gastrostomy.

In an attempt to facilitate long-term care and patient acceptance of gastrostomy feeding, the technique of permanent Janeway gastrostomy was modified. Using an auto-stapling device, a full-thickness gastric tube (6 cm long and 1.5 cm in diameter at its base) is created from the anterior wall of the stomach, based on the greater curve, with special attention to its vasculature. The base is invaginated into the stomach wall to create a tight valve. After skin closure, the terminal 1 cm is excised and the mucosa is sutured flush with the skin. A #10 French tube is inserted and positioned perpendicularly. A gastrostomy thus created will allow intermittent cannulation without leakage of gastric contents. Results of this procedure in 26 patients show a postoperative wound infection incidence of 3.8 per cent. With a mean follow up of 257 days, the gastrostomy was continent in 87 per cent of patients.

Gastrostomy↗

Acute suppurative parotitis in a patient on total parenteral nutrition.

A report of a patient who developed acute suppurative parotitis while on total parenteral nutrition for small bowel fistula is presented. The importance of early detection of parotitis as a cause of fever is emphasized. Attention to oral hygiene and early resumption of oral intake, whenever possible, are to be encouraged.

Acute Disease↗

Efficacy of enteral diets in the prevention of stress-induced gastric erosions in rats.

This study compares the prophylactic effects of two different diets and routes of feeding on restraint stress-induced gastric erosions in the rat. Thirty male Sprague-Dawley rats were food-deprived and immobilized for 24 hours using a steel wire mesh. A small silicone tube was placed into either the proximal jejunum or the stomach via a laparotomy. There were three groups of ten rats (five jejunum-fed, five stomach-fed), receiving infusions (50 ml/24 h) of: (A) normal saline; (B) free amino acids (Vivonex HN, Norwich Eaton Pharmaceuticals) (60 cal and 0.318 G nitrogen); or (C) a peptide diet, with the nitrogen source as lactalbumin hydrolysate, otherwise identical to B. Gastric acidity was measured every 4 hours. At 24 hours, blood was collected and serum gastrin levels determined. The animals were then sacrificed and the stomachs examined. The results were analyzed using one-way analysis of variance. Fewer gastric erosions and lower serum gastrin levels and gastric acidity were found in animals fed diets B and C, versus animals fed normal saline (p less than 0.05). There was no difference between groups B and C. Our results also show that enteral diets using the jejunal route are better than those using the gastric route in reducing the incidence of stress-induced gastric erosions in rats.

Amino Acids↗

Induction of cytochrome P-450 and phosphatidylcholine synthesis by endosulfan in liver of rats: effect of quality of dietary proteins.

Administration of endosulfan significantly increased microsomal protein, cytochrome P-450 content and the activity of aminopyrine N-demethylase. Effect of endosulfan and actinomycin D either alone or together on microsomal protein, cytochrome P-450, NADPH cytochrome c reductase, aniline hydroxylase, aminopyrine N-demethylase, phosphatidylcholine content, incorporation of 3H-choline and 14C-methionine were studied in rats given amino acid deficient and supplemented diets. Administration of endosulfan significantly increased the above parameters in both the dietary groups, whereas administration of actinomycin D did not have any effect in rats fed supplemented diets, however, significant decrease in the PC and the incorporation of choline and methionine into PC of rats fed deficient diet were observed. A positive correlation in the effect of endosulfan on hepatic mixed function oxidase activity and hepatic phosphatidylcholine is observed.

Animals↗

Suppression of appetite by parenteral nutrition in humans.

The effects of parenteral nutrition on appetite during and after therapy are unclear. Previous studies done in animals, as well as in humans, are inconclusive. The purpose of this study was to investigate the effects of parenteral nutrition on voluntary oral intake of food. The study was done on ten stable patients receiving parenteral nutrition for transient dysfunction of their gastrointestinal tract. For each patient, a calorie count of the ingested food was obtained for 3 consecutive days. Parenteral calories were then decreased without the patient's knowledge. A calorie count for 3 more days was obtained following the day of change. The mean daily oral intake was 823 kcal when the mean daily parenteral nutrition intake was 2,902, providing a total of 3,723 kcal. When parenteral nutrition calories were decreased to a mean of 1,550, the mean daily oral intake increased to 1,396. This difference in oral and parenteral calorie intake was statistically significant (P less than .001). It can be concluded from this data that parenteral nutrition decreases voluntary oral intake of food. It is therefore suggested that if the gastrointestinal tract is functionally satisfactory, parenteral nutrition can be rapidly weaned off, provided oral consumption is monitored to assure adequacy.

Adult↗

Interaction of endosulfan and dietary vitamin A on rat hepatic drug metabolising enzymes.

The effect of interaction of Endosulfan, a chlorinated insecticide of the cyclodiene group, with dietary vitamin A on the hepatic mixed function oxidase system in rats has been studied. Endosulfan administration (ten days) significantly increased microsomal protein content and cytochrome P-450 levels, NADPH cytochrome C-reductase aminopyrine N-demethylase and aniline hydroxylase activities, with respect to control rats. Administration of vitamin A (10,000 I.U./100 g body weight) daily for ten days reduced the activity of the above mentioned enzymes, when vitamin A and endosulfan were given together, vitamin A reduced the endosulfan induced increase of microsomal proteins and cytochrome P-450 levels, the activity of NADPH cytochrome C-reductase, aminopyrine N-demethylase and aniline-hydroxylase.

Aminopyrine N-Demethylase↗

The efficacy of nutritional support in the elderly.

One hundred two consecutively nutritionally supported patients were studied to determine the effect of age on the response to nutritional support and outcome of hospital stay. The patients were divided into two groups: group 1 (n = 37) consisted of all patients under 65 years of age, and group 2 (n = 65) consisted of patients 65 years of age and older. All patients underwent a complete nutritional assessment prior to the initiation of nutritional support and weekly thereafter. The patients' somatic compartments were assessed using weight, arm muscle circumference, creatinine height index, and triceps skinfold thickness. The visceral compartments were assessed using serum albumin level, transferrin total iron binding capacity (TIBC) level, and total lymphocyte count. Nitrogen balance was evaluated and cell-mediated immunity was determined using a standard battery of antigens. The patients' nutritional assessment parameters at the start of therapy were compared with those at discharge or death and correlated with outcome of hospital stay. The difference in crude mortality rates between the two groups was statistically significant; however, there was no significant difference between the type and degree of nutritional depletion and mean length of nutritional therapy between the two groups. There was also no significant difference between the degree of improvement or maintenance of somatic or visceral parameters, nitrogen balance, or cell-mediated immunity between the two groups. It is therefore concluded that age alone is not a deterrent to the use of aggressive nutritional support in the elderly.

Age Factors↗