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Biomedical subjects

N Rao

Publications and source records attributed to N Rao.

At least 91 records · Page 5Linked to original sources
PubMed1992

Predicting return to work in traumatic brain injury using assessment scales.

This study compared two frequently used brain injury assessment scales with a comprehensive functional scale in their capability to predict return to work in a traumatic brain injured population. Fifty-seven consecutive admissions to an inpatient brain injury program were rated at admission and discharge using the following scales: Patient Evaluation and Conference System (PECS), Disability Rating Scale, and Levels of Cognitive Functioning Scale. Their relative accuracy in predicting return to work or school up to 26 months after the injury was assessed using hierarchical logistic regression analysis. In each analysis, return to work/school was the dependent variable. The independent variables were initial status and discharge status on each rating scale. Overall these scales predicted return to work with 73.5% to 84.4% accuracy. Total PECS and PECS Cognition scores were the most accurate predictors. Analysis of incorrect predictions revealed the importance of additionally tracking the social factors of substance abuse, family/community support and financial need to return to work.

Activities of Daily Living↗
PubMed1992

Propionibacterium acnes-enhanced lens-induced granulomatous uveitis in the rat.

Propionibacterium acnes (Corynebacterium parvum) is being implicated more frequently as a cause of intraocular inflammation following cataract surgery. In addition to its role as an infectious agent, P. acnes also may possess adjuvant-like or adjuvant-enhancing properties. The presence of this organism in an eye with residual lens material after extracapsular cataract surgery could augment inflammation resulting from a phacoantigenic (phacoanaphylactic) response. We have modified an established rat model of lens-induced granulomatous uveitis (LIGU) to examine the adjuvant properties of P. acnes. Our results suggest that P. acnes effectively potentiates LIGU.

Adjuvants, Immunologic↗
PubMed1991

Structural requirements for the carbohydrate ligand of E-selectin.

The acute inflammatory response requires that circulating leukocytes adhere to, and then migrate through, the vascular wall at the site of injury or infection. Several receptors have been implicated in this adhesion and migration process, including the selectins, a family of carbohydrate-binding proteins. The ligand for one of these proteins, E-selectin (LECAM-2, ELAM-1) has been described by several groups to contain a polylactosamine structure bearing a terminal sialic acid residue and at least one fucose residue. We report here a more detailed investigation into the minimum structural requirements for carbohydrate recognition by E-selectin. Using both direct binding and inhibition studies we demonstrate that the sialyl Lewisx tetrasaccharides Sia(alpha 2-3)Gal(beta 1-4)[Fuc(alpha 1-3)]GlcNAc, and Sia(alpha 2-3)Gal(beta 1-4)[Fuc(alpha 1-3)]Glc are the smallest oligosaccharides recognized by the lectin. In addition, an oligosaccharide containing the sialyl Lewisa epitope is also recognized, but less avidly. We propose a structural model of functional groups necessary for recognition by E-selectin, based on these data and additional experiments on modifications of sialic acid and the reducing terminal saccharide.

Animals↗
PubMed1991

Identification of human erythrocyte blood group antigens on the C3b/C4b receptor.

The Knops/McCoy (Kn/McC) human erythrocyte blood group system belongs to the category of blood group Ag that generate so-called "high titer low avidity" antibodies in immunized transfusion recipients. Screening of red cells lacking certain high titer low avidity Ag demonstrated markedly diminished CR1 expression on McC(d-) and Kn/McC "null" (Kn(a-)McC(a-b-c-d-e-f-] erythrocytes. Additional testing by other methods confirmed these data, and biochemical assays demonstrated no detectable immunoreactive CR1 protein in membranes from Kn/McC null red cells. Human antisera to various Kn/McC Ag were then used to demonstrate that many of these antisera could be used to isolate a protein of identical m.w. to that isolated from the same cells using murine mAb CR1 antisera. Finally, protein isolated by using murine mAb anti-CR1 reacted specifically with anti-Kn/McC antibodies, demonstrating the identity of the Kn/McC and CR1 proteins. Thus, CR1 protein bears the human erythrocyte Kn/McC blood group Ag.

Antibodies, Monoclonal↗
PubMed1991

45,X/47,XYY mosaicism: clinical discrepancy between prenatally and postnatally diagnosed cases.

45,X/47,XYY mosaicism is a rare chromosomal disorder with clinical information limited to 11 postnatal cases in the literature and with uncertainty regarding prenatal prediction of phenotype and prognosis. We report on 7 new cases of 45,X/47,XYY mosaicism, three detected prenatally and 4 diagnosed postnatally. A clinical comparison of the cases of 45,X/47,XYY mosaicism is presented together with a literature review.

Amniocentesis↗
PubMed1991

Triple trisomy in a 17-week-old fetus.

Autosomal trisomies account for the majority of chromosome abnormalities associated with spontaneous miscarriages. Occasionally, double autosomal trisomies are found to be present in abortuses. This report describes the second occurrence of triple trisomy associated with fetal demise.

Abortion, Spontaneous↗
PubMed1991

Protecting travelers from typhoid fever.

Although the incidence of domestically acquired typhoid fever is declining, the proportion of cases resulting from foreign travel has continued to rise. The widely available heat-phenol-inactivated parenteral vaccine has an efficacy of 65% but evokes severe adverse reactions in approximately 25% of recipients. A major advance in the control of typhoid fever was the development of an oral live, attenuated vaccine. Three doses of Ty21a in an enteric coated formulation given over one week provides 69% efficacy for at least four years. A series of four doses confers maximum protection. Increasing the interval between doses does not improve protection. Vaccine should be refrigerated and is currently not recommended for pregnant women, children older than 6 years of age, or immunocompromised patients. With respect to vaccines that are not available in the United States, parenteral purified Vi polysaccharide is considered safe and provides 64% to 72% protection over 21 months. Lastly, the safety and immunogenicity of an auxotrophic (Aro-, Pur-) S typhi recently has been evaluated. Travelers to areas of high risk should be vaccinated but must be cautioned that vaccination is not a substitute for careful selection of food and water. Since typhoid vaccines are not 100% effective, the protection of the vaccine can be overcome by large inocula of S typhi. Physicians caring for world travelers must also keep in mind that other infections, such as plague, typhus, and arboviral fever, may mimic a typhoidal pattern.

Adolescent↗
PubMed1991

Rehabilitation of three patients after treatment for herpes encephalitis.

Patients with Herpes simplex encephalitis often are considered to be poor rehabilitation candidates because of their multiple deficits and grave prognosis. This report presents case reports on three patients with biopsy-proven Herpes simplex encephalitis, all of whom were treated with acyclovir in acute care and then admitted to an inpatient rehabilitation program. All had multiple brain lesions with minimal motor findings but cognitive and communication deficits. One patient, two weeks after admission, slipped into a coma and was transferred to an acute care hospital where he subsequently expired. The other two made useful functional gains and were discharged home in two weeks and 10 weeks, suggesting that a trial of rehabilitation may be warranted after Herpes simplex encephalitis.

Activities of Daily Living↗
PubMed1990

Disposition of bismuth in the rat. II. Pharmacokinetics and biliary excretion.

The pharmacokinetics and biliary excretion profile of intravenously administered bismuth ions were investigated in male Sprague Dawley rats. The data indicated that in the dose range studied, the percentage of dose excreted in urine ranged from 58 to 63%. The mean residence time for bismuth ions was 3.93, 4.07, and 5.45 hr for the 0.5, 0.75, and 1.0 mg/kg dose, respectively, while the volume of distribution at steady state was 0.75, 1.24, and 1.38 L/kg for the three doses. Blood clearance values ranged from 0.2 to 0.32 L/hr/kg. Blood bismuth ion concentrations toward the latter part of the sampling schedule indicated significant variability. The bile-to-blood concentration ratio of intravenously administered bismuth exceeded 1.0 for the three doses studied, suggesting that transport of bismuth from blood to bile may be carrier mediated.

Animals↗
PubMed1990

Disposition of bismuth in the rat. I. Red blood cell and plasma protein binding.

The plasma protein and red blood cell binding profile of bismuth was investigated as a function of bismuth concentration. The binding of bismuth to human serum albumin, bovine serum albumin, and human plasma was also evaluated by ultrafiltration and the data analyzed by nonlinear regression techniques. The binding of bismuth to plasma proteins was nonlinear and decreased as a function of incubation concentration and appeared to be limited by the number of ionized l-cysteine residues available for binding. In the concentration range studied, bismuth was associated primarily with the red blood cell fraction of whole blood obtained from male Sprague Dawley rats. The data indicated that binding to proteins was of moderate affinity, and in whole blood it was present primarily in the red blood cell compartment.

Animals↗
PubMed1990

Chemoprevention of 7,12-dimethylbenz[a]anthracene-induced mammary carcinogenesis in rat by the combined actions of selenium, magnesium, ascorbic acid and retinyl acetate.

The chemopreventive actions of sodium selenite (SS), magnesium chloride (MC), ascorbic acid (AA) and retinyl acetate (RA), given singly or in combinations, on mammary carcinogenesis induced by 30 mg of 7,12-dimethylbenz[a]anthracene (DMBA) in female adult rats were evaluated. Administration of modulators was carried out from the age of 40 +/- 3 days to 240 +/- 3 days. When DMBA alone was given 100% of the rats developed mammary tumors. When modulators were given singly the tumor incidences were reduced to 51.77% (SS), 46.4% (MC), 57.1% (AA) and 48.1% (RA). When the modulators were given in combination of twos, the tumor incidences were further reduced to 29.5% (SS + MC), 31% (SS + AA), 29.6% (SS + RA), 25.9% (MC + AA), 31.8% (MC + RA) and 34.6% (AA + RA). Administration of modulators in combinations of threes resulted in still further reduction of tumor incidences to 22.2% (SS + MC + AA), 19.2% (SS + MC + RA), 16% (MC + AA + RA) and 23.1% (AA + RA + SS). When all four modulators were given concurrently the tumor incidence was only 12%. Further, the number of tumors per tumor-bearing animal declined with the increase in the number of agents used in combination for modulation.

9,10-Dimethyl-1,2-benzanthracene↗
PubMed1990

S100 immunophenotypes of uveal melanomas.

To determine whether ocular melanomas are immunophenotypically identical to cutaneous melanomas, 34 primary and metastatic choroidal melanomas representing all major histotypes defined by the Callender's classification, plus one melanoma of the iris and one conjunctival melanoma, were subjected to a panel of immunostains designed to distinguish anaplastic biopsies of cutaneous melanomas from carcinomas and lymphomas. All ocular melanomas were found to express the intermediate filament vimentin but not keratin, and all but 2 were melanotic by immunostaining. Thirty-three of 34 (97%) choroidal melanomas were strongly stained with a rabbit polyclonal antibody (P-S100) developed against the S100 protein family. In contrast, none of 14 spindle cell type primary lesions was stained with a monoclonal antibody (MAB-079) specific for both S100 alpha and S100 beta, the best-characterized S100 polypeptides. Furthermore, only 2 of 5 epithelioid and 3 of 10 mixed-cell-type melanomas were weakly reactive. Overall, 14.7% (5 of 29) were stained. In comparison, MAB079 stained 85% of all cutaneous melanomas. Five metastases of choroidal melanomas (spindle B, epithelioid, and mixed cell types) from different organ sites also were stained by P-S100 but not by MAB079. These findings were corroborated by immunostaining with another monoclonal antibody (MAB4D4) specific for S100 beta. Differential staining by the polyclonal but not the monoclonal antibodies suggests the possible presence of a variant S100 polypeptide(s) in choroidal melanomas. Since S100 alpha, S100 beta, and related proteins appear to be physiologically important, additional studies of these S100 proteins may shed light on the etiology or pathology of choroidal melanomas.

Antibodies, Monoclonal↗
PubMed1989

Wound sepsis following Ramstedt pyloromyotomy.

Wound sepsis is common following pyloromyotomy in children and in a retrospective study of 178 cases the incidence of wound infection was 21 (11.8 per cent). On preliminary analysis, three variables were associated with wound sepsis: age, duration of projectile vomiting and surgical technique. Only surgical technique was found to be statistically significant on sequential multivariate analysis. Mass closure with polydioxanone was associated with a 1 per cent (one of 70) wound sepsis rate. Wound sepsis after pyloromyotomy is dependent on technique, and mass closure with polydioxanone is recommended. The routine use of tension sutures should be abandoned.

Female↗
PubMed1989

Characterization of uveal melanoma cell lines that grow as xenografts in rabbit eyes.

Two cell lines, OCM-1 and OCM-2, were established from biopsied specimens of choroidal melanomas of spindle B and mixed cell type morphologies. Both cell lines were phenotypically malignant. Karyotypic analyses revealed human chromosomes with a modal number of 95 and 85, respectively. These cell lines have been passaged for over 2 years and are essentially immortal. The cells grew without contact inhibition as monolayers in liquid culture or as clones in soft agar. Electron microscopy revealed melanoma cells containing premelanosomes and cultures free from contamination by fibroblasts. To categorize the morphologies of these cultured cells better by the Callender classification, they were grown as xenografts in the anterior chambers of rabbits immunosuppressed with daily i.m. doses of Cyclosporin A (10 mg/kg). Tumor plaques were detected after 10 days. The eyes were enucleated and fixed in formalin and stained with hematoxylin and eosin for histopathological evaluation. The xenograft from OCM-1 was found to consist predominantly of spindle B-type melanoma cells. In contrast, the xenograft from OCM-2 contained epithelioid, spindle B and clear cell ("balloon") melanoma cells. The ability of these cell lines to grow as xenografts confirmed their neoplastic origin. In fact, the types of the uveal melanoma cells in the xenografts resembled those in the original biopsied tumors. This suggests that the morphology of human uveal melanoma cells is an inherited trait and may be genetically fairly stable.

Animals↗
PubMed1988

A simulation based decision support system for a health promotion center.

This study represents the financial and qualitative evaluation of a Health Promotion Center of a private hospital located in a medium-sized town located in a predominantly agricultural area. The major objective of this study was to evaluate the impact of various pricing, advertising, and service strategies on profitability. The result is a pricing strategy which allows the center to reach their financial goal of breaking even while maintaining their service policies. The hospital, which serves a community of 500,000 people, recently developed a new concept called a "Health Promotion Center" (HPC). The HPC provides services such as fitness programs, nutrition awareness, rehabilitation and therapy, and child and adult care. For this purpose, a new building was constructed and the center became operational in June 1983. A variety of management options available to the center are described with evaluations of their usefulness. Evaluation methods include scenarios, stochastic simulations, and analyses of how the decision makers use these methods. The inclusion of risk management, model flexibility, and user involvement are stressed throughout the paper and are critical in the decision process.

Child↗