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Biomedical subjects

R George

Publications and source records attributed to R George.

At least 109 records · Page 6Linked to original sources
PubMed1993

Intrafamilial transmission of leprosy in Vellore Town, India.

A hospital-based study was done from 1968 to 1991 to determine the risk and extent of intrafamilial transmission of leprosy in relation to the characteristics of the index cases and contacts in urban areas in India. Families were examined by doctors annually. Skin smears were done for contacts of multibacillary (MB) leprosy patients. Person years of follow up were computed for each contact and used as the denominator for computation of incidence rates. Specific rates were computed by age, sex, type of leprosy, smear in index cases, age at registration, and sex of contacts. Of the 120 index cases (81 males, 39 females) 44% were MB; 410 contacts (186 males, 224 females) and 14 co-prevalent cases were registered. The cumulative years of follow up was 2725 years. Fourteen contacts developed the disease (9 TT, 3 indeterminate, and 2 BT); 85.7% were in the 0-14 age group; 12 of 14 patients were detected to have leprosy during the first 5 years. The incidence rate (IR) was 5.1/1000 (males 5.15, females 5.12). The IR was 7.3/1000 and 2.3/1000 among contacts of MB and paucibacillary leprosy patients (p < 0.05). The IR in multiple-case families was 1.8. The importance of active surveillance by a hospital-based survey is emphasized. It should be designed to focus on children younger than 15 years and should be limited to 5 years of follow up.

Adolescent↗
PubMed1993

Fulminant hepatitis in dengue infection.

Eight cases of liver failure and encephalopathy were observed among twenty cases of grade 3 and grade 4 dengue hemorrhagic fever/dengue shock syndrome admitted to the Department of Pediatrics, University Hospital, Kuala Lumpur from January 1990 to December 1991. All patients with deterioriation in mental status showed a marked increase in liver enzymes (aspartate and alanine aminotransaminases) and severe coagulopathy. Six patients needed cerebral protection, including ventilation, intravenous sedation and muscle relaxants. There was one death during the period of study and one case of residual hemiparesis in a boy who had, in addition, intracerebral hemorrhage. All other survivors had complete recovery of liver and neurological function.

Alanine Transaminase↗
PubMed1993

Spectrum of beta-thalassaemia mutations in transfusion dependent thalassaemia patients: practical implications in prenatal diagnosis.

The study concerned the identification of the beta-thalassaemia mutations that were present in 24 patients with beta-thalassaemia major who were transfusion dependent. The application of a modified polymerase chain reaction, the amplification refractory system (ARMS) was found to be an effective and rapid method for the identification of the beta-thalassaemia mutations. Six different mutations were detected. Seventy five percent of the patients were Chinese-Malaysians and showed the commonly occurring anomalies: 1. frameshift codon 41 and 42 (-TCTT); 2. the C to T substitution at position 654 of intron 2 (IVS-2); 3. the mutation at position -28(A to G); and the nonsense mutation A to T at codon 17. In the Malays, the common mutations seen were: 1. the G to C mutation at position 5 of IVS-1; 2. the G to T mutation at position 1 of intron 1 (IVS-1); and the A to T at codon 17. The delineation of the specific mutations present will enable effective prenatal diagnosis for beta-thalassaemia to be instituted.

Base Sequence↗
PubMed1993

Comparison of quantitative methodologies to define chronic pressure ulcer measurements.

The objective of this study was to evaluate and compare various methodologies of measuring the characteristics of pressure ulcers. This prospective, four-week, follow-up study consisted of 20 patients, of whom 17 completed the study. Each patient had at least one full-thickness pressure ulcer (surface area between 1.2 and 61.6 cm2) that had been present for at least four weeks. The ulcers were assessed weekly for four weeks using the following techniques: direct measurement (length, width, and depth), tracing of the ulcer outline onto transparent material, standard photography, and volume measurement. Computer-assisted planimetry from the tracings and photographs, and calculations from the direct measurements determined ulcer areas. Each technique estimating ulcer area gave similar results; however, the areas obtained from the direct measurements slightly over-estimated the areas when compared with the areas obtained by computer-assisted planimetry (mean difference of about 1.5 cm2). Areas obtained from the photographs were more variable than the other measurement techniques. Volumes calculated from bedside measurements were consistently larger than those calculated by jeltrate impression (mean difference of 4.0 cm3). While all the measurement methodologies gave similar and reproducible results, the areas obtained from the photographs were more variable than the areas obtained from the other measurement techniques. The photographic measurements could be improved either by tracing the ulcer outline at the bedside onto the photograph shortly after being taken, or by drawing an outline of the ulcer margin directly on the patient's skin just before taking the photograph.

Aged↗
PubMed1992

The effect of cholesterol and epicholesterol on the activity and temperature dependence of the purified, phospholipid-reconstituted (Na+ + Mg2+)-ATPase from Acholeplasma laidlawii B membranes.

The (Na+ + Mg2+)-ATPase purified from Acholeplasma laidlawii B membranes was reconstituted into large, unilamellar vesicles formed from dimyristoylphosphatidylcholine (DMPC) and varying amounts of cholesterol or epicholesterol. The ATP hydrolytic activity of the reconstituted enzyme was then determined over a range of temperatures and the phase state of the DMPC in the ATPase-containing vesicles was characterized by high-sensitivity differential scanning calorimetry. In the vesicles containing only DMPC, the ATPase activity is higher in association with lipids in the liquid-crystalline state than with gel-state phospholipids, resulting in a curvilinear, biphasic Arrhenius plot with a pronounced change in slope at the elevated gel to liquid-crystalline phase transition temperature of the DMPC. The incorporation of increasing amounts of cholesterol into the DMPC vesicles results in a progressively greater degree of inhibition of ATPase activity at higher temperatures but a stimulation of activity at lower temperatures, thus producing Arrhenius plots with progressively less curvature and without an abrupt change in slope at physiological temperatures. As cholesterol concentration in the ATPase-DMPC vesicles increases, the calorimetric phase transition of the phospholipid is further broadened and eventually abolished. The incorporation of epicholesterol into the DMPC proteoliposomes results in similar but less pronounced effects on ATPase activity, and its effect on the phase behavior of the DMPC-ATPase vesicles is also similarly attenuated in comparison with cholesterol. Moreover, cholesterol added to the purified enzyme in the absence of phospholipid does not show any significant effect on either the activity or the temperature dependence of the detergent-solubilized ATPase. These findings are consistent with the suggestion that cholesterol exerts its effect on the ATPase activity by altering the physical state of the phospholipid, since the ordering effect of cholesterol (or epicholesterol) on liquid-crystalline lipid results in a reduction of ATPase activity while the disordering of gel-state lipid results in an increase in activity.

Acholeplasma laidlawii↗
PubMed1992

Assessing the symptoms, anxiety and practical needs of HIV/AIDS patients receiving palliative care.

We report the work of two community teams who care for people with AIDS/HIV related illness, the characteristics of patients referred, and the impact of the teams on four aspects of quality of life. Data was collected on 140 patients (85 St. Mary's Home Support Team, 55 Bloomsbury Community Care Team) who were referred to and remained in the care of these teams until death. All patients were male, mean age 37.9 years, 116 were homosexual. Most referrals were from genito-urinary medicine clinics (48%) or AIDS wards (41%). There was a wide range of reasons for referral. At referral 62% were in hospital and 35% at home. Mean time in care was 31 weeks 5 days. Fifty-seven per cent died in hospital, 22% at home and 21% in a hospice. The Support Team Assessment Schedule (STAS), consisting of 17 items of care, was used by the teams to measure aspects of quality of life. Throughout care until death four STAS items: pain control, symptom control, patient anxiety and practical aid are reported in detail. Symptom control was a commonly severe problem at referral and although the teams had some success in improving this item it remained a serious problem throughout care. Patient anxiety, also a commonly severe problem at referral, improved significantly throughout care. Pain control was less commonly severe at referral and improved significantly throughout care. Practical aid, in contrast, was rarely a severe problem at any stage of care.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Macrophage responses and myelin clearance during Wallerian degeneration: relevance to immune-mediated demyelination.

Macrophages are important effector cells in immune-mediated demyelination. Current concepts regarding their entry and activation focus on the effects of T-cell-derived cytokines. This presentation describes the responses of macrophages and microglia to a non-inflammatory, non-immune injury, Wallerian degeneration. During Wallerian degeneration in the peripheral nervous system (PNS), macrophages are promptly and abundantly recruited from the circulation, and myelin clearance is prompt. In the central nervous system (CNS), the appearance of macrophages is markedly slower, and entry from the circulation is modest or absent. Myelin clearance is similarly delayed. The nature of the factors promoting macrophage entry and activation in Wallerian degeneration, and the bases for the differences between PNS and CNS, are relevant to current issues in immune-mediated demyelination.

Animals↗
PubMed1992

Cutaneous lupus erythematosus in India: immunofluorescence profile.

The clinical profile and cutaneous lesions of 65 patients with lupus erythematosus (LE) are described. This included 28 discoid LE (13 disseminated, 15 localized), five subacute cutaneous LE, and 32 systemic LE. The need to recognize a pigmented macular form constituting 25% of discoid LE is emphasized. Increased incidence of involvement of the lower lip in discoid LE and pigmentation in systemic LE is noted. Lupus band test was found to be highly sensitive; it was positive for lesional skin of all untreated patients with subacute cutaneous LE and systemic LE, it was, however, not useful on nonlesional skin.

Adolescent↗
PubMed1992

Hypophosphatemia after major hepatic resection.

METHODS: We performed a retrospective study of 44 patients who underwent right or extended right hepatic lobectomy to determine the incidence and significance of hypophosphatemia after major hepatic resection. RESULTS: The postoperative serum phosphate level (measured as inorganic phosphorus) dropped in all 44 patients studied. Profound hypophosphatemia (less than 1.0 mg/dl) was significantly (p less than 0.001) associated with the frequent development of major postoperative complications (cardiorespiratory, five cases; infections, four cases; hemorrhage, one case; and liver failure, one case). Factors such as extent of liver resection, blood loss, blood or plasma transfusion, postoperative bilirubin level, and preexisting liver diseases showed no significant correlation with the nadir inorganic phosphorous level. Use of aluminum-containing antacids caused a further drop of the serum values (p less than 0.05). Early phosphorous replacement showed a significant protective effect (p less than 0.05), with higher serum levels and fewer major complications. CONCLUSIONS: These observations affirm the importance of frequent monitoring and replacement of phosphate after major hepatic resection.

Aluminum↗
PubMed1991

Effects of subcutaneous and intracerebroventricular administration of the sigma receptor ligand 1,3-Di-o-tolylguanidine on body temperature in the rat: interactions with BMY 14802 and rimcazole.

The current study investigated the effects of the acute s.c. and i.c.v. administration of 1,3-di-o-tolylguanidine (DTG) on body temperature in rats. The effects of putative sigma receptor antagonists BMY 14802 and rimcazole on DTG-induced changes in body temperature also were evaluated. The acute s.c. administration of DTG (10.0 and 20.0 mg/kg) produced hypothermia but no observable behavioral effects. Similarly, the acute i.c.v. administration of DTG (12.0-100.0 micrograms/rat) produced hypothermia, but ataxia occurred after this route of administration. The s.c. administration of BMY 14802 alone (25.0 mg/kg) decreased body temperature and enhanced the DTG-induced hypothermia, whereas the administration of rimcazole (25.0 mg/kg) neither altered body temperature nor affected the hypothermia produced by DTG. Neither BMY 14802 nor rimcazole produced any behavioral effects when administered alone. The inability of the putative sigma receptor antagonists BMY 14802 and rimcazole to antagonize DTG-induced hypothermia suggests that either these compounds at the dose used have little sigma receptor antagonist activity, or that the DTG-induced hypothermia is not due to specific interactions with sigma receptors.

Animals↗
PubMed1991

Cross-reactivity on western blots in HIV-1 and HIV-2 infections.

To examine cross-reactivity of antibodies to heterologous antigens, on HIV-1 and HIV-2 Western blots, we tested sera from 1362 consecutive tuberculosis (TB) patients and 2127 consecutive blood donors. Specimens positive on enzyme-linked immunosorbent assay (ELISA) for HIV-1 or HIV-2 were further characterized by synthetic peptide-based tests, and tested by HIV-1- and HIV-2-specific Western blots. Dual serologic reactivity on synthetic peptide tests was proportionately more frequent in HIV-positive TB patients than in blood donors, and HIV-2 reactivity less frequent. Positive HIV-1 Western blots were seen in 73-83% of specimens specifically characterized as positive for HIV-2 on synthetic peptide tests. Cross-reactivity to HIV-2 Western blots by HIV-1-positive specimens was significantly more frequent in TB patients (35%) than in asymptomatic donors (9%; P less than 0.001). Using recently recommended criteria for HIV-2 Western blot interpretation (presence of two env bands) reduced the overall proportion of HIV-1-positive specimens having a positive HIV-2 Western blot from 27.5 to 16.4%, with [corrected] minimal effect on sensitivity in the diagnosis of HIV-2 reactivity on specimens positive on synthetic peptide tests.

Blotting, Western↗