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Biomedical subjects

R Pai

Publications and source records attributed to R Pai.

67 records · Page 4Linked to original sources
PubMed1994

Uremic serum subfraction inhibits apolipoprotein A-I production by a human hepatoma cell line.

Abnormalities in lipoprotein metabolism are common in uremic patients and may represent an additional risk factor for the development of atherosclerosis. Despite the frequent occurrence of lipoprotein abnormalities, the role of various serum toxins and subfractions that accumulate in uremic patients on lipoprotein metabolism is not clearly understood. This study addressed the role of uremic toxins on lipoprotein metabolism by examining the effect of a 500 to 2,000-d subfraction obtained from the serum of uremic and control subjects on the synthesis of apolipoprotein (apo) A-I in a human hepatoma cell line (Hep-G2). Serum subfractions obtained from uremic patients inhibited apo A-I synthesis and secretion by Hep-G2 cells in a dose-dependent manner as measured by (3H)leucine incorporation into apo A-I, immunoprecipitation, and ELISA. The uremic serum subfraction decreased the mRNA expression for apo A-I in Hep-G2 cells when compared with controls. These observations suggest that a component of uremic serum can have the potential to inhibit hepatic apo A-I synthesis and may adversely influence high-density lipoprotein metabolism, thus increasing the risk for the development of atherosclerotic vascular complications in uremic patients.

Apolipoprotein A-I↗
PubMed1992

Comparison of intrinsic versus paced ventricular function.

UNLABELLED: There is increasing evidence supporting the benefits of providing optimum AV delay in cardiac pacing, though controversy exists regarding its value and the benefits of intrinsic versus paced ventricular activation. This study compared various AV delays at rest in patients whose native AV delays were > or = 200 msec. Only patients with DDD pacemakers who had intact AV conduction and normal ventricular activation were included in the study. Nine patients were studied. METHODS: Ten studies were performed. Evaluation was done in AAI and DDD modes at paced heart rates of 60/min or as close as possible to the intrinsic heart rate if this was > 60/min. Stroke volume (SV) and cardiac output (CO) were measured. RESULTS: When AV sequential pacing in the DDD mode with an optimum AV delay was compared to AAI pacing with a prolonged AV interval, the average optimum AV delay in the DDD mode was 157 msec and ranged from 125 to 175 msec. The average AV interval in the AAI mode was 245 msec and ranged from 212 to 300 msec. In the DDD mode, there was an overall significant improvement in CO of 11% and SV of 9%. Patients with intrinsic AV conduction times of > 220 msec showed an overall significant improvement in CO of 13% and SV of 11%. In patients with intrinsic AV conduction times of < 220 msec, an improvement in CO of 6% and SV of 4% was seen. CONCLUSIONS: (1) An optimum AV delay is an important component of hemodynamic performance; and (2) AV sequential pacing at rest with an optimum AV delay may provide better hemodynamic performance than atrial pacing with intrinsic ventricular conduction when native AV conduction is prolonged > 220 msec.

Aged↗
PubMed1989

Leprosy survey in industries in Bombay.

Population surveys for leprosy in industrial cities like Bombay revealed that about 60% of adult subjects especially males could be examined. The fact that the prevalence rate of leprosy particularly multibacillary type is much higher in this segment of population as compared to other groups indicates the importance of examining this population at their workspot like industries. 22287 industrial workers were examined for leprosy by paramedical auxiliaries in their establishments and 270 leprosy cases were detected (P.R. 12/1000). However, only 13 multibacillary cases (P.R. 0.5/1000) could be unearthed. 12 patients were with grade II and above. 184 (83%) were untreated. 161 (60%) patients reported for treatment. With available resources, case holding of patients who are not within the control area of the project becomes a challenging job for paramedical workers though large number of leprosy cases are detected amongst industrial workers. If industrial management arranges treatment for leprosy patients without dislocating them from their service, the pool of infection in the urban community will be reduced and can contribute tremendously towards urban leprosy control programme.

Humans↗
PubMed1986

Aggressive angiomyxoma of the vulva.

An unusual myxoid and vascular appearing neoplasm of the vulva, termed an aggressive angiomyxoma, is described in a 36-year-old Hispanic woman. The clinical presentation and recurrence pattern were typical for previously described neoplasms of the same cellular pattern. The histopathology, difficulties in determining the surgical margins, and the treatment of this tumor are discussed.

Adult↗
PubMedDate not supplied

NSAIDs inhibit the activation of egr-1 gene in microvascular endothelial cells. A key to inhibition of angiogenesis?

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, indomethacin (IND), ibuprofen and newer cyclooxygenase-2 selective NSAIDs (e.g. celecoxib) delay gastric ulcer healing partly through the inhibition of angiogenesis, but the molecular mechanisms involved are not fully elucidated. Effective angiogenesis is required for ulcer healing to supply oxygen and nutrients to the healing site. The early growth response factor (Egr-1) is a transcription factor, which is rapidly activated by a variety of extracellular signals or tissue injury and is important for angiogenesis to occur. This study aimed to determine whether indomethacin (IND) and/or the selective COX-2 inhibitor, NS-398, interfere with egr-1 gene expression in human microvascular endothelial cells (HMVEC) in response to vascular endothelial growth factor (VEGF) stimulation. HMVEC were treated with 0.5 mM IND or 100 microM NS-398 for 16 h, and then VEGF (10 ng/ml) or vehicle was added. Egr-1 mRNA and protein expression levels were determined by RT-PCR and Western-blotting, respectively. VEGF treatment caused a significant elevation of Egr-1 mRNA (261+/-21%, P<0.001) and protein expression (174+/-15%, P<0.01) vs. vehicle. IND pre-treatment significantly inhibited VEGF-induced Egr-1 mRNA expression by 29+/-4% (P<0.01) and protein expression by 41+/-8% (P<0.05). NS-398 inhibited VEGF-induced Egr-1 mRNA and protein expression by 23+/-3% and 35+/-4%, respectively (both P<0.01). Since transcriptional activation of egr-1 is responsible for expression of proteins involved in proliferation of endothelial cells essential for angiogenesis, these results provide a new mechanism for NSAIDs' interference with angiogenesis.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMedDate not supplied

The antacid Talcid adsorbs and neutralizes all proteins secreted by H. pylori including VacA cytotoxin: a new mechanism for its ulcer-healing action?

BACKGROUND AND AIM: Helicobacter pylori culture supernatant containing VacA cytotoxin significantly inhibits gastric cell proliferation and delays healing of experimental gastric ulcers. Since cell proliferation is crucial for ulcer healing, the removal of inhibitory effects of H. pylori secreted cytotoxin would have a beneficial effect on the healing process. In this study, we determined whether the antacid Talcid can adsorb, remove, or neutralize H. pylori derived VacA cytotoxin responsible for the above deleterious actions. METHODS: Supernatants of viable H. pylori isogenic strains producing VacA cytotoxin [VacA(+)] and with disrupted cytotoxin gene not producing cytotoxin [VacA(-)] were incubated with either placebo, Talcid 10 mg/ml, omeprazole 10 mg/ml (positive control) for 1-24 h. Treated supernatants were analyzed using sodium dodecyl sulfate-polyacrylamide gel electrophoresis to evaluate proteins. We also studied the effect of supernatants on epidermal growth factor stimulated Kato III cell proliferation using BrdU labeling. RESULTS: Talcid very effectively removed from the H. pylori culture supernatant the approximately 90 kD VacA(+) cytotoxin at 3 and 24 h (99.5% removal vs. placebo-treated control; p<0.001). It also removed all other proteins, including 66-kD urease and 58-kD heat shock protein, secreted by both VacA(+) and VacA(-) H. pylori strains. Omeprazole was completely ineffective in this regard. Preincubation with Talcid completely abolished the inhibitory effect of VacA(+) H. pylori culture supernatant on epidermal growth factor stimulated Kato III cell proliferation. CONCLUSION: Adsorption and neutralization by Talcid of all H. pylori secreted proteins may explain, at least in part, the ulcer-healing action of this drug.

Aluminum Hydroxide↗
PubMedDate not supplied

Mesothelial cyst at porta hepatis.

Mesothelial cysts are fluid-filled sacs lined by mesothelial cells. They are rare lesions that have been known to occur at various sites, but have not been reported at the porta hepatis. We report a 45-year-old woman with mesothelial cyst at the porta hepatis that was detected incidentally during open cholecystectomy.

Biopsy, Needle↗
PubMedDate not supplied

Insulinoma.

A case of insulinoma who had episoic bizarre behaviour is presented here. Pre-operative fasting and two hour post-prandial blood sugar values indicated hypoglycemia with inappropriately high insulin levels. USG and CT scan of the abdomen revealed a tumor of head of the pancreas. The tumour was enucleated surgically. Histopathological examination confirmed the origin as islet cells. The post-operative blood sugar and insulin levels were found to be in normal range. Since insulinoma is a rare pancreatic tumor, differential diagnoses along with a brief review of the literature is also presented.

Adult↗
PubMedDate not supplied

Our experience with epidural steroid injections in management of low backpain and sciatica.

BACKGROUND: Low back pain and sciatica is a common clinical condition. It is a most common orthopaedic complaint in the Kaski region of Nepal. The reason for its increased incidence may be hilly terrain, difficult working and living environment of the region. The initial treatment of Low back pain is conservative. Epidural steroid injection is being slowly established as are liable mode of conservative management in many orthopaedic centres of the world. This is a preliminary report of on-going study of the use of epidural steroid in the management of low back pain cases coming to the orthopaedic department of Manipal Teaching Hospital. METHODS: Prospective clinical trial was carried out on the patients reporting with low back pain and sciatica not responding to other modes of conservative treatment. Pre and post injection evaluation was done clinically. The level of pain, improvement in physical signs and ability to do activities of daily living were noted. RESULTS: Fifty two patients were observed for the average duration of 2.87 months. Average duration of symptoms was for 10 months. After first epidural steroid injection 83% of patients reported relief on day one. In some cases the onset of analgesia was delayed. Four patients reported no relief after first injection. Fifteen patients were given two injections and four received three injections. The average duration between two injections was three weeks. Average duration of pain relief was 20 days. At the end of 3 months, good results were seen in 39%, fair in 33% and bad results in 27%. Overall 59% of patients were able to do activities of daily living. Three patients (5.76%)required operation for disc prolapse. Postoperatively two patients reported back with back pain. Most common complaint of patients after injection was pain at the injection site. No major complications were encountered. CONCLUSION: Epidural Steroid Injection is a safe and effective mode of treatment of Low Back Pain. It provides painfree period to enable the patient for physiotherapy which helps in early recovery.

Adult↗