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Biomedical subjects

R Ramachandran

Publications and source records attributed to R Ramachandran.

At least 37 records · Page 2Linked to original sources
PubMed2000

Risk of development of tuberculosis in HIV-infected patients.

OBJECTIVE: To estimate the rate of development of active tuberculosis (TB) in a cohort of human immunodeficiency virus (HIV) positive patients, and to identify the characteristics of these patients. DESIGN: A total of 175 HIV-positive individuals were recruited from clinics for sexually transmitted diseases and followed up for 31 +/- 6.8 months. Clinical examination, chest X-ray, sputum smear for acid-fast bacilli and culture for mycobacteria and HIV serology were performed at the time of registration and repeated periodically. RESULTS: Seventeen patients had TB at intake and another 24 developed TB during follow-up, giving a breakdown rate of 6.9/100 person-years (p-y) (95% confidence interval [CI] 4.1-9.6). The attack rates were similar in tuberculin positive (7.1/100 p-y, 95%CI 3.4-10.8) and negative (6.7/100 p-y, 95%CI 2.6-10.8) patients. There was a trend towards higher mortality in patients who developed TB (10.5/100 p-y, 95%CI 4.8-15.2) compared to those who did not (6.1/100 p-y, 95%CI 3.2-8.8). CONCLUSIONS: The results of this study provide information regarding the high risk of development of active tuberculosis and its associated mortality in HIV-infected persons. The risk of developing TB appears to be equally high in tuberculin positive and negative individuals, suggesting that new infections could play a major role in this susceptible population.

AIDS-Related Opportunistic Infections↗
PubMed2000

Management of non-pulmonary forms of tuberculosis: review of TRC studies over two decades.

Tuberculosis Research Centre, Chennai has been conducting randomized controlled clinical trials in both adults and children (n = 1015) in various non-pulmonary forms of tuberculosis, for the last two decades. This communication discusses the salient findings of these studies. The important finding is that short course chemotherapeutic regimens have been proven to be highly effective in tuberculosis of spine, superficial tuberculous lymphadenitis, abdominal tuberculosis, brain tuberculoma and Pott's paraplegia. However, in tuberculous meningitis, the outcome appears to be directly related to the stage of the disease on admission. The intermittent regimens have been found to be as effective as daily regimens. The other important aspects highlighted are the need to obtain bacteriological/histo-pathological confirmation by resorting to relevant diagnostic procedures, value of Mantoux as a diagnostic tool and role of surgery.

Adult↗
PubMed1999

Magic angle spinning NMR spectroscopy with composite RF pulses.

Using numerical optimization procedures it is shown that it is possible to design composite 180 degrees RF pulses for MAS NMR spectroscopy by explicitly taking into account the variation of the resonance offset of each crystallite during the application of the RF pulses. When using composite RF pulses in experiments such as TOSS, where the delays between the RF pulses have to be critically adjusted, an optimization of these delays can lead to the desired performance characteristics.

Magnetic Resonance Spectroscopy↗
PubMed1999

Triple-resonance experiments for correlation of H5 and exchangeable pyrimidine base hydrogens in (13)C,(15)N-labeled RNA.

Triple-resonance two-dimensional H5(C5C4N)H experiments are described that provide through-bond H5 to imino/amino connectivities in uridines and cytidines in (13)C, (15)N-labeled RNAs. The experiments employ selective INEPT steps for transferring magnetization from the H5 hydrogens through the intervening C5, C4, and N3/N4 nuclei to the imino/amino hydrogens. The improved sensitivity of these experiments for assignments in a large 43-nucleotide RNA is demonstrated.

Carbon Isotopes↗
PubMed1999

Single-unit responses in the inferior colliculus of decerebrate cats. I. Classification based on frequency response maps.

This study proposes a classification system for neurons in the central nucleus of the inferior colliculus (ICC) that is based on excitation and inhibition patterns of single-unit responses in decerebrate cats. The decerebrate preparation allowed extensive characterization of physiological response types without the confounding effects of anesthesia. The tone-driven discharge rates of individual units were measured across a range of frequencies and levels to map excitatory and inhibitory response areas for contralateral monaural stimulation. The resulting frequency response maps can be grouped into the following three populations: type V maps exhibit a wide V-shaped excitatory area and no inhibition; type I maps show a more restricted I-shaped region of excitation that is flanked by inhibition at lower and higher frequencies; and type O maps display an O-shaped island of excitation at low stimulus levels that is bounded by inhibition at higher levels. Units that produce a type V map typically have a low best frequency (BF: the most sensitive frequency), a low rate of spontaneous activity, and monotonic rate-level functions for both BF tones and broadband noise. Type I and type O units have BFs that span the cat's range of audible frequencies and high rates of spontaneous activity. Like type V units, type I units are excited by BF tones and noise at all levels, but their rate-level functions may become nonmonotonic at high levels. Type O units are inhibited by BF tones and noise at high levels. The existence of distinct response types is consistent with a conceptual model in which the unit types receive dominant inputs from different sources and shows that these functionally segregated pathways are specialized to play complementary roles in the processing of auditory information.

Acoustic Stimulation↗
PubMed1999

Single-unit responses in the inferior colliculus of decerebrate cats. II. Sensitivity to interaural level differences.

Single units in the central nucleus of the inferior colliculus (ICC) of unanesthetized decerebrate cats can be grouped into three distinct types (V, I, and O) according to the patterns of excitation and inhibition revealed in contralateral frequency response maps. This study extends the description of these response types by assessing their ipsilateral and binaural response map properties. Here the nature of ipsilateral inputs is evaluated directly using frequency response maps and compared with results obtained from methods that rely on sensitivity to interaural level differences (ILDs). In general, there is a one-to-one correspondence between observed ipsilateral input characteristics and those inferred from ILD manipulations. Type V units receive ipsilateral excitation and show binaural facilitation (EE properties); type I and type O units receive ipsilateral inhibition and show binaural excitatory/inhibitory (EI) interactions. Analyses of binaural frequency response maps show that these ILD effects extend over the entire receptive field of ICC units. Thus the range of frequencies that elicits excitation from type V units is expanded with increasing levels of ipsilateral stimulation, whereas the excitatory bandwidth of type I and O units decreases under the same binaural conditions. For the majority of ICC units, application of bicuculline, an antagonist for GABAA-mediated inhibition, does not alter the basic effects of binaural stimulation; rather, it primarily increases spontaneous and maximum discharge rates. These results support our previous interpretations of the putative dominant inputs to ICC response types and have important implications for midbrain processing of competing free-field sounds that reach the listener with different directional signatures.

Acoustic Stimulation↗
PubMed1998

Nuclear magnetic resonance solution structure of the plasminogen-activator protein staphylokinase.

Staphylokinase, a 15.5 kDa protein from Staphylococcus aureus, is a plasminogen activator which is currently undergoing clinical trials for the therapy of myocardial infarction and peripheral thrombosis. The three-dimensional (3D) NMR solution structure has been determined by multidimensional heteronuclear NMR spectroscopy on uniformly 15N- and 15N,13C-labeled samples of staphylokinase. Structural constraints were obtained from 82 3JHNH alpha as well as 22 3JNH beta scalar coupling constants and 2345 NOE cross-peaks, derived from 15N-edited and 13C-edited 3D NOE spectra. NOE cross-peak assignments were confirmed by analysis of ¿15N,13C¿-edited and ¿13C,13C¿-edited 4D NOE spectra. The structure is presented as a family of 20 conformers which show an average rmsd of 1.02 +/- 0.15 A from the mean structure for the backbone atoms. The tertiary structure of staphylokinase shows a well-defined global structure consisting of a central 13-residue alpha-helix flanked by a two-stranded beta-sheet, both of which are located above a five-stranded beta-sheet. Two of the connecting loops exhibit a higher conformational heterogeneity. Overall, staphylokinase shows a strong asymmetry of hydrophilic and hydrophobic surfaces. The N-terminal sequence, including Lys10 which is the site of the initial proteolytic cleavage during activation of plasminogen, folds back onto the protein core, thereby shielding amino acids with functional importance in the plasminogen activation process. From a comparison of the structure with mutational studies, a binding region for plasminogen is proposed.

Crystallography, X-Ray↗
PubMed1997

Structure of an RNA hairpin loop with a 5'-CGUUUCG-3' loop motif by heteronuclear NMR spectroscopy and distance geometry.

Structural features of a 19-nucleotide RNA hairpin loop (5'-GGCGUACGUUUCGUACGCC-3'), a loop motif which occurs in eukaryotic 18S rRNA, have been derived using multidimensional heteronuclear NMR spectroscopy in combination with local conformational analysis and torsion angle distance geometry followed by restrained energy minimization. A method to obtain both the 3JC4'P3' and 3JC4'P5' coupling constants from a set of spin-echo difference constant time HSQC spectra is introduced, and it is shown how these couplings can be assigned to the backbone angles beta and epsilon. A total of 280 distance constraints as well as 132 homo- and heteronuclear three-bond scalar coupling constants were derived from the NMR data. The structure which has been determined is a pentaloop rather than a triloop with no base pairing between G8 and C12. G8 is pointed to the minor groove where it forms a base triplet with C7-G13 that is further stabilized by hydrogen bonding to the 2'-hydroxyl group of C7. C12 is directed to the major groove where its conformation is stabilized by hydrogen bonding between O2 and HO2'. The NMR data suggest two possible, interconverting conformations with stacking of bases U10-G8 or U11-C7. Overall, the loop provides a variety of interaction sites for RNA or protein interactions.

Carbon Isotopes↗
PubMed1997

An NMR study of the interaction of 15N-labelled bradykinin with an antibody mimic of the bradykinin B2 receptor.

An isotope-edited NMR study of the peptide hormone bradykinin (RPPGFSPFR) bound to the Fab fragment of a monoclonal antibody against bradykinin (MBK3) is reported. MBK3 was previously shown to provide a binding site model of the B2 bradykinin receptor [Haasemann, M., Buschko, J., Faussner, A., Roscher, A. A., Hoebeke, J., Burch, R. M. & Muller-Esterl, W. (1991) Anti-idiotypic antibodies bearing the internal image of a bradykinin epitope, J. Immunol. 147, 3882-3892]. Bradykinin was obtained in a uniformly 15N-labelled form using recombinant expression of a fusion protein consisting of the glutathione-binding domain of glutathione S-transferase fused to residues 354-375 of the high-molecular-mass kininogen from which bradykinin was released by proteolytic digestion with its natural protease plasma kallikrein. Bradykinin forms a complex with the Fab fragment of MBK3 which exchanges slowly on the NMR time scale. The 15N and 1H resonances of the tightly bound residues of bradykinin show appreciable changes in chemical shift with respect to the free form, while the 15N and 1H linewidths indicate that the hydrodynamic behaviour of bound bradykinin is dominated by the high-molecular-mass Fab fragment. The NMR data indicate that essentially the entire nonapeptide is involved in binding. The kinetics of the ligand-exchange process, together with resonance assignments obtained via exchange spectroscopy. indicate that bradykinin binds to MBK3 only in the all-trans conformation at all three Xaa-Pro amide bonds. NH-NH NOE connectivities suggest that bradykinin is bound in an extended conformation. The spectroscopic data obtained from this study are compared to recently proposed computational models of the conformation of bradykinin bound to the B2 receptor.

Amino Acid Sequence↗
PubMed1997

NMR secondary structure of the plasminogen activator protein staphylokinase.

Staphylokinase (Sak) is a 15.5 kDa protein secreted by several strains of Staphylococcus aureus. Due to its ability to convert plasminogen, the inactive proenzyme of the fibrinolytic system, into plasmin, Sak is presently undergoing clinical trials for blood clot lysis in the treatment of thrombovascular disorders. With a view to developing a better understanding of the mode of action of Sak, we have initiated a structural investigation of Sak via multidimensional heteronuclear NMR spectroscopy employing uniformly 15N- and 15N, 13C-labelled Sak. Sequence-specific resonance assignments have been made employing 15N-edited TOCSY and NOE experiments and from HNCACB, CBCA(CO)NH, HBHA-(CBCACO) NH and CC(CO)NH sets of experiments. From an analysis of the chemical shifts, 3JHNH alpha scalar coupling constants, NOEs and HN exchange data, the secondary structural elements of Sak have been characterized.

Amino Acid Sequence↗
PubMed1997

Release of the thrombin receptor (PAR-1) N-terminus from the surface of human platelets activated by thrombin.

Platelet activation by thrombin is at least partially mediated by a G-protein-coupled receptor whose extended N-terminus is cleaved by thrombin. Theoretically, this should release a small fragment containing the original receptor N-terminus. However, the fate of this fragment is unknown, as is its biological role, if any. To begin to examine these issues, we have prepared monoclonal anti-receptor antibodies whose epitopes lie entirely N-terminal to the thrombin cleavage site. By flow cytometry and fluorescence microscopy of human platelets and megakaryoblastic CHRF-288 cells, these antibodies were found to recognize intact receptors and receptors activated by the agonist peptide, SFLLRN, but not receptors whose N-terminus had been cleaved by thrombin or cathepsin G. Incubating CHRF-288 cells with thrombin released pre-bound antibody from the cell surface. An assay based upon the antibodies was able to detect a fragment containing the original receptor N-terminus in the supernate of thrombin-treated human platelets. The concentration of the fragment obtained with platelets from 15 normal donors was 4.8 +/- 0.9 pmol per 10(9) platelets (mean +/- sem), which is similar to the value expected if all of the thrombin receptors present on human platelets have been cleaved. Taken together, these results demonstrate that 1) following receptor cleavage a fragment containing the original N-terminus of the receptor is released from the platelet surface, 2) based upon epitope mapping, this fragment is at least 15-20 residues long, 3) it is possible to quantitate the receptor fragment in the supernates of cells exposed to thrombin, and 4) the results of the quantitation suggest that on platelets all of the receptors have been cleaved and 100% of the fragment is present in the cell supernate. Depending on it survival time, measurements of the receptor fragment in blood or urine samples may eventually prove to be a useful marker for thrombin receptor activation in vivo.

Amino Acid Sequence↗
PubMed1997

NMR investigations of recombinant 15N/13C/2H-labeled bradykinin bound to a Fab mimic of the B2 receptor.

NMR spectroscopy has been used to obtain structural information on the bioactive conformation of the nonapeptide hormone bradykinin (Arg-Pro-Pro-Gly-Ser-Pro-Phe-Arg, BK) bound to the Fab-fragment of an antibody that mimics the hormone binding site of the natural bradykinin B2-receptor. Using 15N or 15N,13C, 60% 2H isotope labelled bradykinin, complete 1H, 13C and 15N assignments for bradykinin bound to the Fab-fragment have been obtained. Preliminary interpretation of 15N edited NOE spectra indicates that the conformation of bradykinin bound to the model receptor differs substantially from previous computer models of the bioactive conformation of bradykinin.

Bradykinin↗
PubMed1996

Sequential assignments in uniformly 13C- and 15N-labelled RNAs: the HC(N,P) and HC(N,P)-CCH-TOCSY experiments.

An approach for the simultaneous acquisition of HCN and HCP as well as HCN-CCH-TOCSY and HCP-CCH-TOCSY triple resonance data sets for 13C-/15N-labelled RNAs is presented. The new HCN-CCH-TOCSY scheme unambiguously links all sugar resonances to the base nitrogen. In addition, simultaneous acquisition of HCN-CCH-TOCSY and HCP-CCH-TOCSY data sets provides sequential and base-type information in a single experiment, thereby saving data acquisition time as well as providing complementary data sets that are useful in clarifying ambiguous assignments. Virtually complete sequence-specific phosphate-ribose 1H, 31P, and base 15N1,9, assignments as well as partial 13C assignments could be obtained in a single experiment for a 0.5-mM sample of a 19-mer ribonucleotide.

Base Sequence↗
PubMed1996

Polyethylene glycol-modified interleukin-2 and thymosin alpha 1 in human immunodeficiency virus type 1 infection.

The safety and antiviral effects of polyethylene glycolated interleukin-2 (PEG-IL-2) and thymosin alpha 1 in addition to zidovudine were studied in 12 human immunodeficiency virus (HIV)-infected subjects with 50-250 CD4 T cells/mm3. PEG-IL-2 was administered by intravenous infusions every 2 weeks at 10(6) IU/m2 for 20 weeks. Thymosin alpha 1 was administered subcutaneously at 400 microgram/m2 after four doses of PEG-IL-2, escalating to 1600 microgram/m2 weekly for an additional 2 months. Significant elevations of CD4 T cell numbers of 30%-40% were seen after PEG-IL-2 infusions, but no additional increase in CD4 cell count was observed with thymosin alpha 1. Virologic monitoring by polymerase chain reaction quantitation of proviral DNA and plasma RNA and p24 antigen assays showed no evidence of increased HIV activation during PEG-IL-2 or thymosin alpha 1 therapy. Patients tolerated both PEG-IL-2 and thymosin alpha 1 without significant toxicities.

Antiviral Agents↗
PubMed1994

Managing hypertension among veterans in an outpatient screening program.

This report describes the outcomes of a hypertension screening and management program in an outpatient clinic for veterans (pharmacologic/nonpharmacologic subjects, N = 207) located in the Southeastern United States using a retrospective descriptive research approach. Health care was provided in the clinic by nurse practitioners and physicians in conjunction with classes that emphasize lifestyle changes. Weight was a major risk factor on admission and at subsequent visits. Quetelet Index values indicated pharmacologic patients were significantly more overweight (> 30% over ideal weight) than nonpharmacologic patients (> 20% over ideal weight). Significant reductions in blood pressure were obtained for both groups between admission readings and readings taken at 12 and 24 months (p = .0001). No significant differences in blood pressure were noted between the nonpharmacologic and pharmacologic groups. Reported lifestyle behavior changes incorporating exercise from first to last visit were more significant for the nonpharmacologic group; however, this group also reported increased alcohol consumption during this time. The pharmacologic group reported overall beneficial improvement in both exercise and decreased use of alcohol. The nonpharmacologic group on average required fewer clinic visits. Interventions targeted toward lifestyle behaviors, a common element in the treatment plans for both groups, appear to have therapeutic benefit.

Adult↗