Search PubMed⌕ Search

Biomedical subjects

M Shah

Publications and source records attributed to M Shah.

At least 163 records · Page 9Linked to original sources

Use of gadolinium-enhanced MR imaging for differentiating mucoceles from neoplasms in the paranasal sinuses.

The purpose of this study was to determine whether additional clinically useful information could be obtained from gadolinium-enhanced magnetic resonance (MR) imaging compared with the information obtained from nonenhanced MR imaging and computed tomography (CT). Therefore, the authors selected 41 patients, whose results at CT examinations demonstrated a variety of pathologic conditions of the paranasal sinuses, to undergo MR imaging both with and without the use of gadopentetate dimeglumine for contrast enhancement. In 22 of 35 cases of neoplasms and mucoceles occurring separately, the lesions were correctly differentiated by established MR signal criteria alone. However, 32 of these 35 cases were accurately differentiated when gadolinium-enhanced MR images were obtained. Six cases demonstrated co-existing neoplasm and mucocele: Gadolinium-enhanced MR enabled correct differentiation of five of these lesions, while unenhanced MR enabled correct differentiation of three. On the basis of these results, the authors conclude that the use of gadopentetate dimeglumine for contrast enhancement at MR imaging is useful for differentiating mucoceles from neoplasms in the sinonasal tract.

Contrast Media↗

Secular trend in body mass index in the adult population of three communities from the upper mid-western part of the USA: the Minnesota Heart Health Program.

Secular trend in body mass index (BMI) over 7 years (1980-1987) was examined in the upper mid-western part of the USA using annual cross-sectional data collected by the Minnesota Heart Health Program. Significant secular increase in BMI adjusted for age and education was found in both men (0.08 kg/m2/year, P less than 0.02) and women (0.19 kg/m2/year, P less than 0.0001). In women, the secular increase occurred throughout the distribution of body weights but the change in the upper end was two to three times greater than that in the other parts of the distribution. In men, most of the increase in BMI occurred in the upper end of the distribution. Prevalence of obesity (defined as BMI greater than or equal to 85th percentile at year 1: men, 30.16 kg/m2; women, 29.94 kg/m2) increased by 0.6 percent/year (P = 0.1) in men and by 1.0 percent/year (P = 0.002) in women. The results indicate that body weight is increasing in upper mid-western adults, probably largely as a result of already overweight individuals becoming more obese. The secular increase in BMI was not accompanied by systemic change in reported food intake and exercise, and could not be explained by decreased prevalence of smoking. Large increases in body weight, especially among those who are already overweight, may have a significant public health impact.

Adult↗

Expression and secretion of rice alpha-amylase by Saccharomyces cerevisiae.

We report the high level expression and secretion of rice alpha-amylase isozyme by Saccharomyces cerevisiae. Transcription of this gene was under control of the yeast enolase promoter. The synthesized protein had an approximate molecular size of 45 kDa and a pI of approx 4.7 to 5.0. The rice alpha-amylase signal peptide was recognized and efficiently processed by yeast and the active, glycosylated enzyme was secreted into the culture media. This enzyme was purified to homogeneity by affinity chromatography and its enzymatic properties were characterized. The Km and Vmax were found to be similar to those of alpha-amylases from other organisms. The high level of secretion observed in these studies may be due to the unique features of the rice signal peptide and/or to the glycosylation of the recombinant enzyme.

Amino Acid Sequence↗

Immediate exposed skin grafting in children's burns.

The technique of immediate exposed skin grafting following early tangential excision of burns in children overcomes the difficulties of applying dressings with the attendant risk of graft loss from shearing forces. We report on 36 patients treated by this method. Wound healing was achieved in all patients without the need for further surgery.

Burns↗

Chronic postoperative endophthalmitis from Staphylococcus aureus.

We recently treated a patient with chronic postoperative endophthalmitis caused by Staphylococcus aureus, which usually presents with a fulminant clinical course. Because of the chronic course, the initial treatment was high dose steroids followed by lensectomy and vitrectomy. However, this was not effective, and intravitreal antibiotics and steroids were ultimately required. We now recommend that in patients with chronic postoperative inflammation unresponsive to high dose steroids, intraocular cultures followed by injection of intraocular antibiotics be considered.

Aqueous Humor↗

Biodistribution, tissue reaction, and lung retention of pentamidine aerosolized as three different salts.

Aerosolized pentamidine isoethionate is retained in the lung and appears to prevent Pneumocystis carinii pneumonia (PCP) in many AIDS patients. We evaluated alternative formulations of pentamidine that might reduce the airway irritation associated with aerosolized pentamidine isoethionate. Specifically, we assessed the biodistribution, histologic response, and lung retention of the isoethionate, gluconate, and lactate salts of pentamidine after aerosol administration to mice. For each of the three aerosolized salts tested, greater than 50% of the pentamidine initially recovered from the lungs after one dose was still retained there 14 days later. Thus, significant levels of pentamidine, aerosolized as three different salts, are retained in the lung for at least 2 wk after a single dose. The three salts of pentamidine each produced high lung to extrapulmonary drug ratios, the converse of that produced by intravenous injection of pentamidine isoethionate. At very high aerosol doses, the ability of the lung to retain pentamidine appeared saturable. Even aerosolized daily for 2 wk at very high doses, none of the three pentamidine salts produced histologic evidence of organ toxicity. A Phase 1 trial of aerosolized pentamidine gluconate in AIDS-PCP patients is now in progress to determine if this approach can reduce airway irritation.

Aerosols↗

The effect of pre-anaesthetic fasting on blood glucose level in children undergoing surgery.

Blood glucose concentrations were measured in 104 children aged 6 months- 10 years (mean 3.1 years) undergoing inpatient anaesthesia. The mean fasting period was 10.87 +/- 2.68 hours. Mean preanaesthetic and 1/2 hour post-anaesthetic blood glucose levels were 4.8 +/- 0.8 and 6.1 +/- 1.9 mmoles/L respectively. Pre- anaesthetic low blood glucose level (2.7-3.3 mmoles/L) could only be detected in 3.8% cases. Post-anaesthetic increase in blood glucose level was the same as reported in adults.

Blood Glucose↗

Hypertension Prevention Trial (HPT): food pattern changes resulting from intervention on sodium, potassium, and energy intake. Hypertension Prevention Trial Research Group.

The Hypertension Prevention Trial (HPT) was a multicenter randomized trial designed to assess the effects of long-term dietary changes on blood pressure in a normotensive population (diastolic blood pressure greater than or equal to 78 but less than 90 mm Hg) for a period of 3 years. The dietary treatments were reduction of sodium intake, increase of potassium intake, and decrease of energy intake. Estimates of changes in food intake were made by comparing 24-hour food records of the treatment and control participants. The participants in the treatment groups reported sodium intakes that were 30% to 40% lower than those of the controls. The restriction was achieved mainly by reducing intake of salt, meats, and grain products. Meats and grain products were still a major source of total sodium intake after treatment (41% to 47%), perhaps because of continued use of processed foods. Potassium intake was reported to be 16% to 25% higher in the treatment groups than in the controls, the increase achieved largely through increased consumption of fruits, with a lesser contribution from vegetables. Participants with higher initial body weights reported smaller increases in fruit and vegetable consumption than participants of normal weight, perhaps because of concerns about weight gain. Energy intake in the weight loss groups was 8% to 11% less than that of the controls. Men reported success in restricting calories from meats, dairy products, fats, beverages, and sugars. Women were less successful in restricting calories from most food groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Pressure↗

Acute inflammatory demyelinating polyradiculoneuropathy presenting as complete heart block and Stoke-Adams attacks.

A patient with acute inflammatory demyelinating polyradiculoneuropathy (AIDP, Guillain-Barré syndrome) whose presenting complaints were related to autonomic dysfunction in the form of parasympathetic and sympathetic overactivity is reported. Parasympathetic overactivity was severe enough to cause complete atrioventricular block (atropine-responsive) and Stoke-Adams attacks, for which a demand pacemaker was required. Limb weakness was apparent 48 hours later. To our knowledge no such presentation of AIDP has been previously recorded.

Acute Disease↗

Relationship between socio-demographic and behaviour variables, and body mass index in a population with high-normal blood pressure: Hypertension Prevention Trial.

The relationship between socio-demographic and behaviour variables and body mass index (BMI: weight/height2) adjusted for age were studied in a population with high-normal blood pressure who participated in the Hypertension Prevention Trial. The BMI of the participants ranged from 19.1 to 35.1 kg/m2 in men and from 16.0 to 35.1 kg/m2 in women. The prevalence of obesity (BMI greater than or equal to 25.0 kg/m2) was 77 per cent in men and 61 per cent in women, with prevalence of severe obesity (BMI greater than or equal to 30.0 kg/m2) being 23 per cent and 19 per cent respectively. Stepwise regression was carried out to identify the most important correlates of BMI. In men, they were family income (+), occupation (-), leisure time exercise frequency (-), number of meals eaten out (-), alcohol intake (-), smoking (-), caffeinated drink intake (+), and meal planner. Men who planned meals with their partners had a higher BMI than men who planned their own meals or had someone else plan their meals. Correlates of little importance were marital status, race, education, number of members in household, energy intake, percentage of total calories from fat, occupation activity level, and vitamin/mineral supplement intake. In women the most important correlates of BMI were alcohol intake (-), caffeinated drink intake (+), and race. Black women had a higher mean BMI than white women. The important socio-demographic and behaviour variables in both men and women accounted for about 20 per cent of the variance in BMI which leaves about 80 per cent of the variation unexplained. This indicates the presence of other factor(s) which may be determining body weight.

Adult↗

Mucin histochemistry of the upper gastrointestinal tract.

Histochemically differentiated mucins have been studied in the mucosal lining of the esophagus and the stomach. Acid mucin was differentiated from neutral mucin by the alcian blue/PAS technique and sulphomucin by the high iron diamine/alcian blue technique. Neutral mucin secreted normally by the stomach mucosa was replaced by acid mucin in 17 of the 19 mucin secreting adenocarcinomas involving the lower third of the esophagus, and in 24 of the 28 mucin secreting gastric adenocarcinomas studied. The intestinal metaplasia (IM) seen in the gastric mucosa associated with adenocarcinoma, chronic gastric ulcer and chronic gastritis was classified according to the type of mucin secreted by the goblet cells. IM secreting sulphomucins was seen to be associated with gastric adenocarcinoma.

Adenocarcinoma↗

Mucin histochemistry of the lower gastrointestinal tract.

Variations in the mucin secretion pattern in the mucosal lining of the colon and rectum have been studied. Mucins have been differentiated histochemically as neutral mucins, sialomucins and sulphomucins, using alcian blue/PAS and HID/alcian blue techniques. In the normal colonic mucosa, the goblet cells secrete predominantly sulphomucins with small amounts of sialomucins. Twenty one cases with benign lesions showed varying patterns of mucin secretion. In the 35 cases with adenocarcinoma studied, the transitional mucosa adjacent to the lesion showed a reversal of mucin secretion pattern, with an increase in sialomucins and a marked decrease in sulphomucins, suggesting a reaction to neoplasia.

Adenocarcinoma↗

Lectin binding in colorectal mucosa.

Lectin binding of goblet cell mucin in human colonic mucosa was studied in patients with irritable bowel syndrome, colorectal malignancy and ulcerative colitis using plant lectins, Dolichos biflorus agglutinin (DBA) and peanut agglutinin (PNA). Normal colonic mucosa demonstrated a strong binding with DBA (100%) but did not bind to PNA at all. Colonic carcinomas showed strong PNA binding (7 of 15 biopsies) while DBA binding was absent in 14 of 15 biopsies. The transitional mucosa showed reduced or absent DBA binding in 6 and positive PNA binding in 2 of 15 biopsies. During the active phase of ulcerative colitis, there was a loss of DBA binding in 10 of 15 biopsies, which was restored during remission in all. One biopsy with severe dysplasia showed PNA binding. It is concluded that normal colorectal mucosa binds DBA strongly but not PNA. Malignant tissue and transitional mucosa reveal PNA binding often, with decreased DBA binding. In ulcerative colitis DBA binding decreases during phases of activity.

Arachis↗

Development of human palmar and digital flexion creases.

To determine the timing of the development of the various palmar and digital creases, we examined the hands of 100 human fetuses obtained after therapeutic abortion. The fetuses ranged in age from 7 to 19 fetal weeks, with age being established by menstrual period dates and ultrasound examination before termination. Our observations show that palmar and digital creases develop between 8 and 13 fetal weeks. Digital creases are well defined by 10 weeks; palmar creases are consistently seen by 13 weeks of gestation. The volar pads are present from 8 to 14 fetal weeks. A hand malformation or specific insult that occurs before the time of crease development and that alters the form or function of the fetal hand can cause secondary alterations increase patterns of the hand.

Dermatoglyphics↗

Lower metabolic rates of post-obese versus lean women: thermogenesis, basal metabolic rate and genetics.

Components of daily metabolic rate (thermogenesis, BMR and net exercise) were compared between 16 women predisposed to obesity (post-obese) and 16 naturally lean controls of matching age, weight and height, at three levels of activity, in a whole-body respirometer. At all levels of activity, the mean metabolic rate of the post-obese was 15 per cent lower than that of the lean controls. Expenditure on net exercise showed the same relationship, but BMR was only 10 per cent lower, while thermogenesis was 50 per cent lower. The latter was partly due to the smaller food intake of the post-obese and also to a lower thermogenic response. In absolute terms BMR accounted for less than half of the difference in total energy expenditure between the post-obese and the lean (45 per cent). Thermogenesis accounted for approximately 40 per cent of the difference, and 15 per cent after adjusting for the different energy intakes. Significantly more post-obese subjects had a family history of obesity (88 per cent) than lean subjects (38 per cent). Within the post-obese and lean groups there was a consistent trend at each level of activity for those with a family history to have lower metabolic rates, indicating that family history of obesity has an influence on energy expenditure over and above personal history of obesity.

Adult↗