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Biomedical subjects

R Kumar

Publications and source records attributed to R Kumar.

At least 865 records · Page 48Linked to original sources

Long-term oral anticoagulant therapy: update on indications, therapeutic ranges, and monitoring.

Oral anticoagulant therapy is used extensively in the treatment of deep venous thrombosis-pulmonary embolism and prevention of systemic thromboembolism. Adoption of the International Normalized Ratio system for the laboratory monitoring of therapy has solved the problems encountered with the variable sensitivities of the available thromboplastins in North America. Although in recent years the recommended intensity of treatment has been reduced for many indications, bleeding remains the most common side effect of long-term oral anticoagulation therapy. Several drugs interact with warfarin sodium, the most commonly used oral anticoagulant drug, and potentiate its effect, thereby increasing the risk of bleeding. However, awareness of potential drug interactions and careful monitoring to maintain patients within the recommended therapeutic ranges can minimize the risk of bleeding and lead to its safe use in most patients.

Administration, Oral↗

High prevalence of rotavirus infection among neonates born at hospitals in Delhi, India: predisposition of newborns for infection with unusual rotavirus.

Although rotavirus is the most common cause of diarrhea in children older than 3 months of age, neonatal infections, which are asymptomatic, have rarely been surveyed and have been identified in only a few discrete nosocomial outbreaks. After such a nosocomial outbreak of rotavirus infection among newborns at a hospital in Delhi, we screened infants born at five other nurseries in the immediate area to assess the prevalence of neonatal infections and to determine whether the unique neonatal rotavirus strain, 116E, previously identified in Delhi, was present in other settings. Infection was documented in 43 to 78% of hospitalized infants between 4 and 6 days of life born at five of the six hospitals. Infection with strains related to 116E were the most common, but other unusual strains and no strains common in the community were detected. In addition a shift in genotype was observed among specimens collected from two of these hospitals during a 2-year period. Our observation that neonatal rotavirus infections are more common than recognized previously would encourage the administration of rotavirus vaccines during the newborn period and suggests that the low efficacy of vaccines observed during trials in developing countries may be caused by early natural exposure of infants before immunization. The extraordinary predisposition of neonates for unusual rotavirus strains not commonly found in the community should encourage others to screen neonates for this infection, characterize the strains more fully and attempt to understand at a molecular level the unique relationship between the infecting strain type and the age of the host.

Feces↗

Endothelin-stimulated monocyte supernatants enhance neutrophil superoxide production.

Endothelin-1 (ET-1) is a vasoconstrictive peptide released by ischemic/injured endothelium which increases intracellular ionized calcium [Ca2+]i in vascular smooth muscle. Previous work from this lab has shown that ET-1 also increases human peripheral blood monocyte [Ca2+]i, and that 24 h incubation of monocytes with 10(-9) M ET-1 causes production of prostaglandin E2 and interleukin-6. In these studies, ET-1-stimulated monocyte supernatants were evaluated for their effect on neutrophil superoxide production. While ET-1 alone had no direct effect, incubation of neutrophils for 20 min in ET-1-stimulated monocyte supernatants resulted in a 10-fold increase in superoxide production over basal levels, 44% as much superoxide production as induced by peptide N-formyl-methionyl-leucyl-phenylalanine (N = 6, p < .001). Monocyte supernatants were analyzed for interleukin-8 (IL-8 or neutrophil activation protein) content by radioimmunoassay. ET-1-stimulation resulted in production of 54% as much IL-8 as lipopolysaccharide controls (N = 6, p < .001). While a number of monokines can activate neutrophils, IL-8 has been shown to be a potent neutrophil activator as well as a superoxide primer. Therefore, ET-1-treated monocytes probably upregulate neutrophil superoxide production via a mechanism which includes IL-8.

Cytochrome c Group↗

Vitamin D and renal calcium transport.

The kidney plays an important role in maintaining calcium balance in plasma and extracellular fluid. 1,25 Dihydroxyvitamin D3, which regulates intestinal calcium absorption, bone calcium resorption, and renal calcium reabsorption, is synthesized in the renal proximal tubules. Vitamin D-dependent calcium reabsorption from urine occurs in renal distal tubules. New information, obtained from both intestinal and kidney cells, enables us to propose a model of the mechanism of vitamin D-dependent calcium transport in renal distal tubule cells. This model involves several vitamin D-regulated processes and proteins. Briefly, 1,25 dihydroxyvitamin D3 stimulates calcium uptake at the distal tubule luminal membrane. A cytosolic vitamin D-dependent calcium binding protein (calbindin-D) sequesters calcium, which allows more calcium to enter the cell and more efficient diffusion of calcium across the cell. The ATP-dependent plasma membrane Ca2+ pump in the basolateral membrane pumps calcium out of the distal tubule cells into plasma.

Animals↗

Plasmid-coded DNA fragment developed as a specific gene probe for the identification of enteroaggregative Escherichia coli.

Enteroaggregative Escherichia coli (EAggEC) is a recently discovered diarrhoeal pathogen implicated as a cause of persistent diarrhoea in children. EAggEC strains exhibit a characteristic pattern of adherence when incubated with HEp-2 cells. Because of the difficulty in identifying this group of bacteria, the epidemiological significance of this pathogen as a diarrhoeal agent has not been fully realised. A gene probe was developed from the 60-MDa plasmid associated with EAggEC strains that encodes the genes for adherence and fimbriae. The sensitivity of the gene probe was 93% and the specificity 98% for detecting EAggEC isolates and is potentially useful for diagnostic and epidemiological studies.

Bacterial Adhesion↗

Evidence for the presence of plasmids in four therapeutically important strains of Lactobacillus acidophilus.

Four therapeutically important strains of Lactobacillus acidophilus designated as R, 301, 1899 and NCFM were screened for the presence of plasmids. Two lysis methods were used for the isolation of plasmid DNA: an alkaline method and a more gentle technique. It was found that the gentle lysis method yielded better plasmid DNA both quantitatively and qualitatively. All four strains studied apparently possess plasmids. The strains 301 and NCFM possessed one plasmid each, with a size of 4.2 kb, whereas R possessed three plasmids (3.5, 2.4 and 2.1 kb) and 1899 possessed two plasmids (4.1 and 4.2 kb). Restriction analysis revealed that the plasmid DNA from strain R was cleaved by Bam HI but not by Hind III and Eco RI. The plasmid DNA from the remaining three strains was cleaved by all three restriction enzymes used.

DNA, Bacterial↗

Characterization of rotavirus strains from newborns in New Delhi, India.

Between 1986 and 1993, 72% of rotavirus strains isolated from newborns at five hospitals in New Delhi, India, had long electropherotypes, subgroup II VP6 antigens, and G and P genotypes (G9P11) identical to those of prototype strain 116E. A novel strain with a G9P6 genotype, representing 13% of the isolates, was identified. These results demonstrate that G9P11 and G9P6 rotavirus strains are common in nurseries in New Delhi.

Base Sequence↗

Evaluation of a safe sputum processing method for detecting tuberculosis.

AIMS: To evaluate a safe sputum processing method for detection of tuberculosis in developing countries. METHODS: A sample processing method was developed in which acid fast bacilli were killed with 1% sodium hypochlorite and concentrated by flotation on a layer of xylene before staining by the Ziehl Neelsen or auramine O methods. RESULTS: Best results were obtained by auramine O staining after flotation. Staining by the Ziehl Neelsen method after flotation gave better results than direct Ziehl Neelsen staining without flotation. CONCLUSIONS: The flotation method with Ziehl Neelsen staining offers advantages for smear preparation in the tuberculosis control programmes of developing countries.

Bacteriological Techniques↗

Immunohistochemical localization of the 1,25(OH)2D3 receptor and calbindin D28k in human and rat pancreas.

1,25-Dihydroxyvitamin D3 [1,25(OH)2D3] is required for normal glucose-stimulated insulin release from pancreatic beta-cells. Biochemical characterization techniques have demonstrated the presence of the 1,25(OH)2D3 receptor (VDR) in homogenates of whole pancreas. Autoradiographic studies using radiolabeled 1,25(OH)2D3 suggest that the VDR is localized to beta-cells but are inconclusive. We used immunohistochemical techniques to stain serial sections from both human and rat pancreas with polyclonal antibodies to human VDR, chick calbindin D28k, insulin, glucagon, and somatostatin. VDR was present in the islet cells and also at low levels in acinar cells of the human and rat pancreas. Calbindin D28k was distributed in a manner similar to the VDR in pancreatic islets but was not present in acini. These results show for the first time that VDR and calbindin D28k are present in human pancreatic tissue. VDR and calbindin D28k are focally distributed throughout pancreatic islet cell types in humans and rats; VDR is also present in the exocrine pancreas. These findings suggest that 1,25(OH)2D3 may influence both endocrine and exocrine pancreatic function.

Animals↗

Immunolocalization of calcitriol receptor, 24-hydroxylase cytochrome P-450, and calbindin D28k in human kidney.

The precise localization of the calcitriol (1 alpha,25-dihydroxyvitamin D3) receptor (VDR) and the 25-hydroxyvitamin D3 [25(OH)D3] 24-hydroxylase cytochrome P-450 in the human kidney is unknown. Using newly developed polyclonal antibodies against the human VDR, we demonstrate that the receptor is present in cells of the distal tubule, the collecting duct, the proximal tubule, and in the parietal epithelial cells of the glomerulus. In the distal tubule and collecting duct not all cells contain epitopes for the receptor. The protein is not detected in glomerular capillaries, in the glomerular mesangium, in the interstitium, or in blood vessels. Specific polyclonal antibodies directed against the 25(OH)D3 24-hydroxylase cytochrome P-450 demonstrate epitopes for the cytochrome in cells of the proximal tubule, the distal tubule, glomerular parietal epithelial cells, and mesangial cells. The protein is absent from interstitial cells. Calbindin D28k is present exclusively in principal cells of the distal tubule and collecting duct. In the human kidney, the VDR is present in cells where vitamin D-inducible proteins are found; conversely it is absent from cells where vitamin D-dependent proteins are not present.

Animals↗

Clinical predictors of Japanese encephalitis.

Over a 5-year period, virological investigations for Japanese encephalitis (JE) were conducted in children presenting with acute encephalopathic illness. Clinical features of JE-positive patients (n = 116) were compared with patients in whom the diagnosis could be excluded (n = 57). Multivariate analysis by logistic regression revealed that two clinical signs--central hyperpneic breathing pattern and extrapyramidal signs--were significant predictors of the diagnosis. Application of the model yielded a sensitivity of 41.3% and a specificity of 80.7% with positive and negative predictive values of 81.3 and 40.3%, respectively. This indicates that the model may be helpful in making the diagnosis but not in excluding it. The model should be further validated in different areas where the disease is prevalent.

Child↗

Developmental changes in modulation of calcium currents of rabbit ventricular cells by phosphodiesterase inhibitors.

BACKGROUND: We have previously shown major differences in beta-adrenergic and muscarinic modulation of L-type calcium currents (ICa) in newborn and adult rabbit heart. However, little is known about developmental changes in modulation of ICa by phosphodiesterases (PDEs), which also regulate intracellular cAMP concentration by its hydrolysis. METHODS AND RESULTS: Enzymatically isolated adult and newborn (1- to 3-day-old) rabbit ventricular myocytes were used to study the effects of PDE inhibitors on ICa measured by the whole-cell patch-clamp method. 3-Isobutyl-1-methyl-xanthine (IBMX), a nonselective PDE inhibitor, increased ICa in a dose-dependent manner for both groups. The maximal effect of IBMX, expressed as percentage increase in ICa over control levels, was greater for newborn myocytes than for adult myocytes, but the effects of IBMX applied alone were observed only at concentrations > 10 mumol/L. The concomitant use of 0.1 mumol/L isoproterenol produced a significant potentiation of the IBMX effect on ICa, with a significant additive effect of IBMX in newborn myocytes even at 0.05 mumol/L IBMX. The concomitant use of a subthreshold concentration of IBMX (0.1 mumol/L) did not potentiate the dose dependence of adult ICa on isoproterenol but did markedly potentiate the dose dependence of newborn ICa on isoproterenol. The Emax and EC50 of isoproterenol in the presence of 0.1 mumol/L IBMX on newborn ICa were 235% and 8 nmol/L, respectively, whereas the Emax and EC50 of isoproterenol in the absence of IBMX on newborn ICa were 111% and 81 nmol/L, respectively. The addition of 50 mumol/L IBMX to 10 mumol/L isoproterenol markedly increased the newborn ICa density up to a level equivalent to that reached with 200 mumol/L cAMP in the pipette (14.9 +/- 1.2 versus 13.4 +/- 0.7 pA/pF). Our data suggest that the inhibition constant (Ki) of IBMX for inhibiting PDEs that participate in the regulation of ICa is much lower in newborn than in adult myocytes. Milrinone 1 mumol/L, a selective PDE III inhibitor, increased the 0.1 mumol/L isoproterenol-stimulated ICa of adult myocytes but had no significant additive effect for the 0.1 mumol/L isoproterenol-stimulated ICa of newborn myocytes. Rolipram 1 mumol/L, a selective PDE IV inhibitor, increased the 0.1 mumol/L isoproterenol-stimulated ICa for newborn myocytes but had no significant additive effect for the 0.1 mumol/L isoproterenol-stimulated ICa for adult myocytes. CONCLUSIONS: These results suggest that the most important PDE isozyme for regulation of ICa of rabbit myocytes changes from PDE IV to PDE III during the postnatal period.

1-Methyl-3-isobutylxanthine↗

Effects of vitamin D metabolites on proliferation and differentiation of cultured human epidermal keratinocytes grown in serum-free or defined culture medium.

We examined the effects of 1,25-dihydroxyvitamin D3 [1,25(OH)2D3], 25-hydroxyvitamin D3 (25OHD3), and vitamin D3 on human keratinocyte proliferation and differentiation in a serum-free or defined culture system. Concentrations greater than 10(-8) M 1,25-(OH)2D3 or 10(-7) M 25(OH)2D3 caused marked inhibition of cell growth. Growth inhibition with high doses of 1,25-(OH)2D3 was not stringent, but was mainly exerted in the G1 phase of the cell cycle. Early release from the cell cycle block restored the proliferation of human keratinocytes. The calcium concentration in the medium had no significant effect on the antiproliferative action of 1,25-(OH)2D3, 25OHD3, and vitamin D3. We also show that human keratinocyte proliferation is enhanced at doses of 1,25-(OH)2D3 and 25OH2D3 of 10(-9) M or less. Enhanced proliferation of human keratinocytes with physiological concentrations of 1,25-(OH)2D3 could only be shown in fully defined medium that contained no vitamin D3, related sterols, or bovine pituitary extract. Human keratinocyte differentiation was enhanced with higher doses of 1,25-(OH)2D3 when cells were grown in the presence of high calcium concentrations. These studies demonstrate that the lower, physiological concentrations of vitamin D3 metabolites are capable of stimulating the proliferation of epidermal keratinocytes grown under selected conditions that eliminate confounding or unidentified medium culture factors. Vitamin D3 metabolites are shown to exert mitogenic trophic effects in cultured human epithelial cells similar to their established activities in vivo.

Calcifediol↗

Interactions at the alpha 1 beta 1 interface in hemoglobin: a single amino acid change affects dimer ratio in transgenic mice expressing human hemoglobin.

The erythrocytes of transgenic mice expressing human hemoglobin contain mouse, human, and two hybrid hemoglobins. These hybrids include a predominant one, the human-alpha/mouse-beta and one found at lower levels, the human-beta/mouse-alpha. We used molecular modeling-aided hydropathic analysis of the globin alpha 1 beta 1 interface to identify a residue partly or wholly responsible for this distribution. Hemoglobin containing a single amino acid change [beta 112(G14)Cys-->Val] was expressed in transgenic mice. The hybrid ratio was reversed in transgenic mice expressing this mutated human hemoglobin as compared to the control transgenic mice expressing native human hemoglobin. These results demonstrate the importance of subunit assembly in the expression of hybrids in transgenic animals and may lead to successful design approaches for optimal expression of hemoglobin in larger animals such as the pig.

Amino Acid Sequence↗

Recombinant hemoglobin A produced in transgenic swine: structural equivalence with human hemoglobin A.

Recombinant human hemoglobin A produced by coexpressing human alpha and beta globin genes in swine, and purified from the lysate of transgenic swine has been subjected to detailed protein chemical analysis. These structural studies involving laser desorption mass spectrometry, separation of globin chains by RPHPLC, amino terminal sequence analysis of the isolated globin chains, the tryptic peptide mapping of the purified globin chains and the amino acid composition analysis of the purified tryptic peptides of globin chains have established the primary structural equivalence of the globin chains of the transgenic swine derived hemoglobin A with that of human hemoglobin A. These results demonstrate that the transgenic swine system correctly translates the human alpha and beta globin m-RNA; carries out the correct cotranslational processing of globin chains, and does not introduce any unwanted post translational modifications into the mature chains. Thus, the transgenic swine expression system is an excellent approach for the production of HbA for developing an effective hemoglobin based oxygen carrier.

Amino Acid Sequence↗

Synthesis and biodistribution of [4-14C]-5-bromo-6-methoxy-5,6-dihydro-prodrug derivatives of 5-ethyl-2'-deoxyuridine.

The radiochemical syntheses of the [4-14C]-(-)-trans-(5S,6S)-5-bromo-5- ethyl-6-methoxy-5,6-dihydro-2'-deoxyuridine [2,(5S,6S)-BMEDU] and (+)-trans-(5R,6R)-5-bromo-5-ethyl-6- methoxy-5,6-dihydro-2'-deoxyuridine [3,(5R,6R)-BMEDU] are reported. These BMEDU diastereomers were synthesized in 21 and 25% radiochemical yield, respectively, by direct addition of methyl hypobromite to the 5,6-olefinic bond of [4-14C]-5-ethyl-2'-deoxyuridine (EDU). The biodistributions of [4-14C]-labelled diastereomers of 2 and 3, and EDU were determined in male Balb-C mice. The uptake of radioactivity in brain after injection of [4-14C]-BMEDU diastereomers of 2 and 3 was not significantly different than that of [4-14C]-EDU (P > 0.05). However, clearance of radioactivity from blood was substantially faster after injection of [4-14C]-EDU relative to the [4-14C]-BMEDU diastereomers. Liver samples, obtained after injection of the [4-14C]-BMEDU diastereomers, showed a higher percentage uptake of the injected dose per gram of tissue relative to liver samples obtained after injection of [4-14C]-EDU.

Animals↗

In vivo effects of isatin on certain enzymes, lipids & serotonergic system of rat brain.

Isatin (10 microM) strongly inhibited the activity of rat brain monoamine oxidase-B (MAO-B) in vitro. At millimolar concentrations (1-10 mM) it inhibited brain acetylcholinesterase (AChE) and sodium, potassium-adenosine triphosphatase (Na+, K(+)-ATPase) activity also. However, isatin did not affect these enzymes after both acute and chronic treatments in vivo. Administration of isatin to rats at 300 mg/kg body weight for 2 and 6 h significantly raised brain serotonin levels. Chronic treatment for 20 days resulted in enhanced brain glycolipids and plasmalogen levels. There was no change in the levels of 5-hydroxy indole acetic acid (5 HIAA), phospholipids, cholesterol and gangliosides under these conditions.

Animals↗