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Biomedical subjects

N Rao

Publications and source records attributed to N Rao.

At least 55 records · Page 3Linked to original sources

The Cbl protooncogene product: from an enigmatic oncogene to center stage of signal transduction.

The c-cbl protooncogene was first identified as the cellular homologue of a viral oncogene v-cbl that induces pre-B lymphomas and myeloid leukemias in mice. Until recently, the biochemical basis for Cbl's transforming potential and its physiological role remained unclear. However, a convergence of biochemical studies in mammalian cells and genetic studies in C. elegans and Drosophila has now identified Cbl as a negative regulator of tyrosine kinase signaling. The N-terminal transforming region of Cbl (Cbl-N) and an adjacent RING finger domain are the elements most conserved during evolution. The Cbl-N region has now been shown to contain a novel phosphotyrosine-binding (PTB) domain that directly interacts with autophosphorylated tyrosine kinases via a D(N/D)XpY motif. A critical role of the PTB domain in Cbl function is demonstrated by the localization of a loss-of-function mutation in C. elegans Cbl homologue SLI-1 within this region. The corresponding mutation in human Cbl inactivates the PTB domain function and abrogates Cbl-mediated regulation of tyrosine kinase function. Recent studies have also identified a novel signaling pathway initiated by the interaction of mammalian Cbl proteins with the SH2 domains of Crk adaptor molecules, which results in Cbl's linkage with C3G, a guanine nucleotide exchange protein for Rap1 family of small G-proteins. Presently, Rap1 is thought to antagonize Ras function, although Rap1-specific targets have emerged recently. Thus, recent advances have firmly placed the little known protooncoprotein Cbl on the center stage of tyrosine kinase-mediated signal transduction.

Amino Acid Sequence↗

Increase of manganese superoxide dismutase, but not of Cu/Zn-SOD, in experimental optic neuritis.

PURPOSE: To evaluate the role of manganese superoxide dismutase (Mn-SOD) and copper/zinc superoxide dismutase (Cu/Zn-SOD) in cellular protection of the optic nerve against the oxidative injury that contributes to demyelination in experimental allergic encephalomyelitis (EAE). METHODS: Immunocytochemistry for Mn-SOD and Cu/Zn-SOD and ultracytochemical localization of hydrogen peroxide (H2O2) were performed on the optic nerves of guinea pigs with EAE and normal guinea pigs. Cell-specific enzyme expression of SOD was quantitated by computerized morphometric analysis. RESULTS: Light microscopy showed a perivascular distribution of Mn-SOD-positive cells in the optic nerves of animals with EAE. Electron microscopy showed that the Mn-SOD immunogold was confined exclusively to mitochondria, whereas Cu/Zn-SOD immunogold was found in the cytoplasmic matrix and nucleus of cells of the optic nerve in both animals with EAE and normal animals. Results of quantitative analysis of the optic nerves of animals with EAE showed an 8-fold increase in Mn-SOD immunogold in astroglial cells and a 13-fold increase in microglial/phagocytic cells in comparison with that of normal animals. Increases in Mn-SOD immunogold were contiguous to H2O2-derived reaction product. No increases in Cu/Zn-SOD immunogold were detected in EAE. CONCLUSIONS: Increases in Mn-SOD activity in astroglial cells and microglial/phagocytic cells may contribute to the relative sparing of these cells from injury in EAE, whereas the low level of Mn-SOD in oligodendroglial cells and axons may increase their vulnerability to the effects of superoxide-induced oxidative injury that results in demyelination.

Animals↗

Cuspal fracture resistance and microleakage of glass ionomer cements in primary molars.

The purpose of this study was to comparatively evaluate the fracture strength and microleakage among two new glass ionomer cements. One hundred and ten primary first and second molars were divided into two main groups, one group comprising of fifty teeth for microleakage evaluation and second group of sixty for fracture strength. Both the groups were subdivided equally into four based on the materials used, consisting of the same number of teeth respectively, in each. Two controls were used for cuspal fracture strength and an additional trial group was added for microleakage evaluation. Ideal, non retentive class II were prepared and restored with amalgam, Fuji IX, Fuji II LC and Vitremer. The statistical analysis revealed highly significant differences among all the subgroups except between subgroup 3 vs. 4 and 1 for cuspal fracture strength. Similarly microleakage values were significantly different statistically among sub groups 4 and 5 vs 1 and 2. The present study revealed that Fuji IX was the best in terms of cuspal fracture strength and Fuji IX with an additional application of light cure resin sealant gave the lowest degree of microleakage.

Analysis of Variance↗

A blood group-related polymorphism of CD44 abolishes a hyaluronan-binding consensus sequence without preventing hyaluronan binding.

CD44 is a widely expressed integral membrane protein that acts as a receptor for hyaluronan (HA) and is proposed to be important to cell-extracellular matrix interaction. The Indian (In) blood group antigens reside on CD44, and most individuals express the Inb antigen. Homozygosity for the Ina allele occurs as a rare event and is associated with production of alloantibody to the common Inb antigen after transfusion or pregnancy. The present study demonstrates that a single point mutation (G252 --> C) causes an Arg46 --> Pro substitution, which is responsible for the Inb/Ina polymorphism. Additional mutations were found in In(a+b-) cDNA but were not necessary to the antigenic phenotype as determined in site-directed mutagenesis studies. In studies using CD44 chimeric constructs, Arg46 has previously been shown to be crucial for maintenance of HA-binding ability to a CD44 peptide. However, the present study demonstrates that the Arg46 --> Pro substitution does not reduce HA binding to the intact CD44 protein, which contains two proposed extracellular HA-binding motifs. Down-regulation of HA binding to In(a+b-) CD44 by anti-CD44 monoclonal antibody (mAb) ligands, however, was weakened, although all mAbs tested bound In(a+b-) and In(a-b+) CD44 equally well. Competitive inhibition studies using human anti-Inb also showed that some mAbs that inhibit HA binding to CD44 may do so by interacting with a domain separate from, but affecting the structure of, the Inb epitope.

Amino Acid Sequence↗

An investigation of the dose proportionality of deflazacort pharmacokinetics.

The dose proportionality of deflazacort was assessed following single-dose oral administration at doses of 3, 6, and 36 mg to 24 healthy young adult volunteers. The active metabolite of deflazacort (21-desacetyl deflazacort) was monitored in plasma using a sensitive, semi-microbore liquid chromatographic method. Cmax averaged 10.4 +/- 5.0, 19.8 +/- 7.5, and 132.6 +/- 52.5 ng mL-1 for the 3, 6, and 36 mg doses, respectively. AUC(0-infinity) averaged 38.5 +/- 37.1, 64.9 +/- 20.8, and 411.7 +/- 148.5 ng h mL-1 for the same three doses, respectively. Elimination half-life ranged from 1.9 +/- 0.5 h at the 6 mg dose to 2.4 +/- 1.5 h at the 36 mg dose. Regression analyses of dose versus Cmax and AUC(0-infinity) yielded intercepts which were not significantly different from zero (p > 0.05) and slopes which were significant (p < 0.05). Regression analysis of dose versus apparent oral clearance yielded a slope which was not significantly different from zero (p > 0.05). These data indicate that deflazacort exhibits dose-proportional pharmacokinetics.

Administration, Oral↗

Squamous cell carcinoma of the conjunctiva in a patient with the acquired immunodeficiency syndrome.

PURPOSE: To alert ophthalmologists to the possibility of human immunodeficiency virus (HIV) infection in individuals with conjunctival squamous cell carcinoma. METHODS: We treated a 24-year-old patient with the acquired immunodeficiency syndrome who developed a limbal mass. The mass was excised and examined by routine histologic and immunohistochemical methods. RESULTS: The histopathologic examination disclosed infiltrating squamous cell carcinoma with features of spindle cell carcinoma. Frequent abnormal mitotic figures were present in this neoplasia. CONCLUSIONS: Squamous cell carcinoma with histologic features of aggressive behavior in a young individual should alert physicians to the possibility of HIV infection. Such patients may require frequent follow-up examination, even after complete excision of the tumor.

Acquired Immunodeficiency Syndrome↗

Risk factors for death and emergency transfer in acute and subacute inpatient rehabilitation.

OBJECTIVES: To compare the risk of death or emergency transfer (ET) to an acute care hospital for acute and subacute rehabilitation inpatients, to identify risk factors, and to determine whether the risk factors vary by level of care. DESIGN: Proportional hazards regression analysis of retrospective cohort data. Explanatory variables included level of care, age, sex, medical stability at admission, and diagnosis. SETTING: An acute inpatient rehabilitation hospital and a skilled nursing facility-based subacute rehabilitation program. PATIENTS: Patients were selected from a database of all acute and subacute inpatients discharged between January 1992 and August 1994 (N = 4,755). Readmissions and pediatric patients were excluded (n = 896). Patients who had complete data (n = 3,185) were included in the survival analysis; a separate univariable analysis was performed for patients who lacked complete data (n = 674). OUTCOME MEASURE: Rate of death or emergency transfer during rehabilitation. RESULTS: The overall risk was greater for subacute patients than for acute inpatients, 20.6% vs 11.6%, odds ratio = 2.0, CI = 1.6 to 2.5. The survival analysis indicated that age, level of care, sex, and stability were associated with the risk of death or emergency transfer (2.1 < or = zeta < or = 4.7; p < .05 for each). However, the difference in risk between subacute and acute care was greatest among younger patients. CONCLUSIONS: Careful consideration of risk factors is critical for proper assignment of patients to rehabilitation levels of care. However, research is needed to test these findings in other settings and to improve identification of high-risk patients.

Aged↗

Emergency department do-not-attempt-resuscitation orders: next-of-kin response to the emergency physician.

OBJECTIVE: To evaluate the response by families of incompetent, chronically debilitated, and/or terminally ill patients who were contacted for do-not-attempt-resuscitation (DNAR) status by an emergency physician (EP). METHODS: A prospective observational study was performed to assess next-of-kin willingness to support DNAR status for incompetent, chronically debilitated, and/or terminally ill patients. The families also were contacted by telephone follow-up 48-72 hours after the ED visit. Upon follow-up evaluation, the families were surveyed regarding prior DNAR instructions and their perceptions of the establishment of DNAR status in the ED. The study was conducted in an urban teaching hospital with an emergency medicine residency training program. RESULTS: Of the 71 patient families contacted, 60 (85%) of the patients had DNAR orders written in the ED. The families of these 60 patients had no negative response regarding contact by ED personnel. Of the 11 (15%) patients whose families wished no DNAR order, only two families had negative responses to being contacted by the EP. In both cases the families had previously given detailed instructions to the chronic care facility. CONCLUSION: The EP can play an important role in assisting the decision making process of families of incompetent, chronically debilitated, and/or terminally ill patients regarding institution of DNAR orders in the ED. Improved communication regarding existing DNAR orders with chronic care facilities might minimize the rare complaints received from families with preestablished DNAR orders.

Advance Care Planning↗

Physical and genetic mapping of the CMT4A locus and exclusion of PMP-2 as the defect in CMT4A.

We have previously localized one form of the autosomal recessive Charcot-Marie-Tooth disease type 4 (CMT4A) to a 5-cM region of chromosome 8q13-q21. We now report the formation of a 7-Mb YAC contig spanning the region. This contig was used to map nine additional microsatellites and six STSs to this region, and subsequent haplotype analysis has narrowed the CMT4A flanking interval to less than 1 cM. In addition, using SSCP and our physical map, we have demonstrated that the myelin protein PMP-2, mapped by FISH to this region, is not the defect in CMT4A.

Adaptor Proteins, Signal Transducing↗

Limbal and choroidal Cryptococcus infection in the acquired immunodeficiency syndrome.

PURPOSE: A 30-year-old patient with the acquired immunodeficiency syndrome (AIDS) had limbal nodules and multifocal choroidal lesions. METHODS: A biopsy of the limbal nodules was performed. RESULTS: The biopsy showed Cryptococcus neoformans surrounded by thick mucinous capsules without inflammatory cell infiltration. CONCLUSION: In the differential diagnosis of limbal mass in patients with AIDS, cryptococcal infection should be considered.

AIDS-Related Opportunistic Infections↗

Investigations using a novel monoclonal antibody to the glycosylphosphatidylinositol-anchored protein that carries Gregory, Holley, and Dombrock blood group antigens.

BACKGROUND: The high-frequency Hy and Gya antigens have been shown to reside on the same protein. Gy(a-) Hy-negative red cells are also Do(a-b-). A mouse monoclonal antibody, 5B10, was produced with specificity related to the human Gregory, Holley, and Dombrock blood group antigens. STUDY DESIGN AND METHODS: The antibody reacted in direct hemagglutination assays, and its specificity was investigated by radioimmunoassay, inhibition assay, and Western blotting. RESULTS: The 5B10 antibody failed to bind to abnormal paroxysmal nocturnal hemoglobinuria red cells and human erythroleukemia cell line K562, but it was weakly reactive with HEL cells. Red cells, but not other circulating hematopoietic cells, express the 5B10 antigen. The 5B10 antibody had a specificity similar but not identical to that of Gya. Gy(a-) Hy-negative red cells reacted extremely weakly with 5B10 antibody, but Gy(a-) Hy-negative red cells treated with a variety of proteases bound 5B10 antibody strongly. This suggests that these cells express a variant form of the protein recognized by 5B10. CONCLUSION: Identification of a monoclonal antibody to this glycosylphosphatidylinositol-linked protein opens a new avenue for investigation of the biochemistry, genetics, and function of the glycosylphosphatidylinositol-linked protein that bears the Gya, Hy, and Do antigens.

Alleles↗

Evidence that CDw108 membrane protein bears the JMH blood group antigen.

BACKGROUND: CDw108 is a cluster-of-differentiation antigen that resides on a glycosylphosphatidylinositol (GPI)-linked protein; it has not previously been shown to be expressed on red cells. JMH is a high-frequency red cell blood group antigen that resides on a GPI-linked protein of molecular weight similar to that bearing CDw108. The purpose of this study was to investigate whether CDw108 is expressed on red cells and whether it resides on the same membrane protein as does JMH. STUDY DESIGN AND METHODS: Murine monoclonal antibodies to CDw108, MEM-121 and MEM-150, as well as a murine monoclonal antibody and human antibodies to JMH were used in radioimmunoassay, inhibition assay, Western blotting, and monoclonal antibody-specific immobilization of erythrocyte antigen assay. RESULTS: MEM-121 and MEM-150 were found to bind to red cells, and MEM-150 blocked binding of human anti-JMH to red cells. Anti-CDw108 and anti-JMH identified red cell membrane proteins that were of similar size and that were absent from JMH-negative red cells on Western blotting. MEM-150 and MEM-121 also immobilized the same protein that reacted with human anti-JMH. CONCLUSION: CDw108 is expressed on red cells and resides on the same GPI-linked membrane protein as does the JMH blood group antigen.

Antibodies, Monoclonal↗

Identification of the Tcb allele of the Cromer blood group gene by PCR and RFLP analysis.

The Cromer blood group antigens reside on the complement regulatory protein, decay-accelerating factor (DAF). The Cromer system comprises 10 antigens, 3 of which are of low incidence. When an individual is homozygous for the allele encoding one of these low-incidence antigens, they are liable to produce an antibody to the antithetical high-frequency antigen if challenged by pregnancy or transfusion. These antibodies are often difficult to identify, because of the lack of readily available antigen-negative cells and typing sera. In blacks, about 5 percent of individuals carry the rare Tcb Cromer allele. We have shown that the presence of the low-incidence Tcb allele can be detected by polymerase chain reaction (PCR) amplification of a fragment of the gene encoding DAF, followed by allele-specific restriction enzyme digestion.

Journal Article↗

Changing indications for penetrating keratoplasty, 1989-1993.

The purpose of this study was to identify new trends in the changing indications for penetrating keratoplasty. We retrospectively reviewed the clinical and pathologic diagnoses of 1,104 corneal buttons that had been submitted to the Estelle Doheny Eye Pathology Laboratory, Los Angeles, during the 5-year period 1989-1993. The leading indications, in order of decreasing frequency, were pseudophakic corneal edema (24.8%), regrafts (21.3%), scarring with or without chronic inflammation (11.1%), keratoconus (7.1%), aphakic corneal edema (6.4%), and ulcerative conditions (5.8%). The incidence of pseudophakic corneal edema remained stable over the study period and was actually surpassed by regraft in the last year of the study. Although pseudophakic corneal edema remains the predominant indication for penetrating keratoplasty, our findings suggest that its occurrence rate has begun to level off.

Adolescent↗

Identification of the urokinase receptor as an adhesion receptor for vitronectin.

Urokinase receptors, expressed on surfaces of many cell types, focus to the pericellular space plasminogen-dependent proteolysis important in matrix remodeling and cell movement. We now report that the urokinase receptor (uPAR) is also a high affinity (Kd < 30 nM) receptor for vitronectin. Recombinant uPAR binds vitronectin in the absence of urokinase, but vitronectin binding is promoted by concurrent receptor binding of either urokinase or fragments thereof containing its uPAR binding domain. Stable epithelial cell transfectants expressing membrane-anchored uPAR, but not cells expressing soluble uPAR, become strongly adhesive with altered morphology in the absence of urokinase. These observations identify a new class of vitronectin receptor and imply a duality in function for the receptor that intrinsically links matrix adhesion to regulation of protease activity. Increases in urokinase receptor expression known to be associated with cellular activation and malignant transformation could modulate cellular trafficking and function by promoting attachment to vitronectin.

Adsorption↗