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Biomedical subjects

R Sharma

Publications and source records attributed to R Sharma.

At least 181 records · Page 10Linked to original sources

Delayed Tc-99m citrate scintigraphy in the evaluation of palpable breast masses.

The aim of this study was to evaluate the potential of Tc-99m citrate as a new tumor-localizing agent in palpable breast masses. Scintimammography was performed in 43 female patients. Of these, 10 women (group A) were considered to be healthy with no palpable breast masses, and the remaining 33 patients (group B) had palpable breast masses. All patients with palpable breast masses underwent fine-needle aspiration cytology and subsequent biopsy within 2 weeks of the study. Nine patients had a primary malignant lesion of the breast, whereas 24 patients had benign disease. The patients with breast cancer underwent surgery, and subsequently a histopathologic diagnosis was made. Sensitivity, specificity, and accuracy values obtained in our study were 87%, 100%, and 90%, respectively. Scintimammograms were performed in these patients up to 24 hours. Initial uptake at 1 and 3 hours was noted in all the breast masses. However, benign masses did not show persistence of tracer uptake at 24 hours, whereas those that were malignant continued to show persistent radionuclide concentration. Thus, the uptake and outflow pattern seemed to differentiate benign breast disease from breast cancer. The study shows the potential of Tc-99m citrate for imaging and evaluating breast masses.

Adolescent↗

Cyanoacrylate tissue adhesive augmented tenoplasty: a new surgical procedure for bilateral severe chemical eye burns.

PURPOSE: To report on cyanoacrylate tissue adhesive augmented tenoplasty, a new surgical procedure for bilateral severe chemical eye injuries. METHODS: A 26-year-old man presented with bilateral severe (grade IV) chemical burns involving the eye, periorbital tissues, face, and neck. Despite adequate medical therapy, corneal, limbal, and scleral ulceration progressed in both eyes. Secondary Pseudomonas keratitis necessitated therapeutic penetrating keratoplasty in the right eye. Tenoplasty and glued-on rigid gas permeable contact lens were unsuccessful to arrest progression of corneolimboscleral ulceration in the left eye. We applied n-butyl cyanoacrylate tissue adhesive directly on the ulcerating corneal, limbal, and scleral surface to augment tenoplasty. RESULTS: The left ocular surface healed with resultant massive fibrous tissue proliferation and symblepharon on the nasal side. Ocular surface rehabilitation resulted in a vascularized leukomatous corneal opacity with upper temporal clear cornea. The patient achieved visual acuity of 6/36 in the left eye. CONCLUSION: We suggest that cyanoacrylate tissue adhesive-augmented tenoplasty can be undertaken to preserve ocular integrity and retain visual potential in a severe chemical eye injury.

Adult↗

Role and limitations of magnetic resonance imaging in the diagnostic work-up of patients with liver cancer.

The main objectives of liver imaging are detection and characterization of focal liver lesions. There is a wide range of imaging modalities available for the work-up of patients with liver cancer. In the current environment of cost containment, the most appropriate modality should be chosen to answer the clinical question. Contrast-enhanced computed tomography is currently the modality of choice for liver imaging for routine applications. Until recently magnetic resonance imaging was used only as a problem solving technique for lesions that were equivocal after contrast-enhanced computed tomography. However magnetic resonance with the use of tissue specific contrast agents, has already challenged the role of computed tomography portography in preoperative staging of liver cancer, and may soon completely replace this technique. It is also the primary modality for screening patients with cirrhosis for hepatocellular carcinoma. This review describes the role of magnetic resonance imaging, in the evaluation of patients with liver cancer, and outlines a rational approach for the diagnostic work-up of these patients.

Contrast Media↗

Confirmation of two magnetoencephalographic epileptic foci by invasive monitoring from subdural electrodes in an adolescent with right frontocentral epilepsy.

PURPOSE: To report our evaluation of interictal two epileptic spike fields on magnetoencephalography (MEG) by using invasive intracranial monitoring in a patient without lesion on magnetic resonance imaging (MRI). METHODS: A 15-year-old left-handed boy with a 9-year history of refractory simple partial seizures, secondarily generalized, and a normal MRI, was studied with MEG to define magnetic spike sources, followed by invasive intracranial monitoring with subdural electrodes to delineate the epileptogenic zone and eloquent function pursuant to focal cortical excision. RESULTS: MEG demonstrated two spike foci on the right middle frontal and inferior rolandic areas adjacent to the sensory area. Ictal recordings during prolonged invasive monitoring from subdural electrodes revealed two epileptogenic zones in the same locations as those defined by MEG. Focal cortical excision was performed of each epileptogenic zone. The patient has been seizure free for 24 months without neurologic deficit. CONCLUSIONS: Magnetic source imaging is a valuable adjunct in the planning of subdural grid placement in epilepsy surgery, particularly in patients in whom conventional imaging fails to reveal a lesion.

Adolescent↗

Intrapericardial streptokinase in purulent pericarditis.

Six consecutive children with proven purulent pericarditis were treated with pericardial irrigation with streptokinase. Mean (SD) 861 (678) ml (range 240-2000) of thick purulent fluid was drained, and five children had complete clearance of the pus within 3-8 days. One child developed intrapericardial haemorrhage with a submitral pseudoaneurysm and underwent patch closure of the neck of the aneurysm as well as anterior pericardiectomy. Follow up of 13 to 30 months revealed no pericardial constriction.

Child↗

Na(+)-K(+)-ATPase gene regulation by glucocorticoids in a fetal lung epithelial cell line.

The Na(+) pump, Na(+)-K(+)-ATPase, along with the Na(+) channel is essential for the removal of alveolar solute and fluid perinatally. Because Na(+)-pump mRNA and activity increase before birth and maternal glucocorticoids (GCs) influence Na(+)-K(+)-ATPase mRNA expression in fetal rat lung, we hypothesized that GCs increased Na(+)-K(+)-ATPase gene expression in a fetal lung epithelial cell line. After 24 h of exposure, dexamethasone increased the steady-state levels of Na(+)-K(+)-ATPase alpha(1) and beta(1) mRNA in a fetal rat lung epithelial cell line in a dose-dependent fashion (10(-7) to 10(-5) M). The maximal increase in mRNA levels was 3. 8-fold for alpha(1) and 2.8-fold for beta(1). The increase in mRNA was detected as early as 6 h for the beta(1)-subunit and 18 h for the alpha(1)-subunit, and both peaked at 24 h. This gene upregulation was not due to increased mRNA stability based on mRNA half-life determination after actinomycin D inhibition. Transfection experiments with alpha(1) and beta(1) promoter-reporter constructs demonstrated 3.2 +/- 0.5- and 2.6 +/- 0.4-fold increases, respectively, in promoter activity, consistent with transcriptional activation of the promoter-reporter construct. These findings, increased promoter activity with no change in stability, indicate that GCs increased Na(+)-K(+)-ATPase transcription in a fetal lung epithelial cell line.

Animals↗

"The FSGS factor:" enrichment and in vivo effect of activity from focal segmental glomerulosclerosis plasma.

A circulating causative factor has been postulated in focal segmental glomerulosclerosis (FSGS). It has been shown that serum or plasma from some FSGS increases glomerular albumin permeability (Palb) in vitro. Palb greater than 0.5 (i.e., FS activity) is associated with recurrence after transplantation. Specimens from 15 FSGS patients were studied to document the presence of a permeability factor, to isolate this factor, to characterize its biochemical properties, and to show its effect in vivo. Total lipids were extracted by chloroform/methanol (2: 1); FS activity was absent from total lipid extract. Chylomicrons and lipoproteins were removed from the plasma with dextran sulfate, followed by sequential precipitation of proteins at 50 and 70% ammonium sulfate saturation. FS activity was retained in the 70% ammonium sulfate supernatant and exhibited a 100-fold purification. FS activity was lost after heating at 100 degrees C for 10 min or after protease digestion. Under nondenaturing conditions, electrophoresis of the FSGS 70% supernatant showed a prominent low molecular weight band that was not evident in the 70% supernatant from normal plasma. Dialysis and centrifugation-based membrane ultrafiltration of the FSGS factor indicated a molecular size between 30 and 50 kD. Injection of the 70% FSGS supernatant into rats caused a threefold increase in urine protein in collections from 6 to 24 h after injection. No increase in proteinuria occurred in rats injected with 70% supernatant from normal individuals. It is concluded that the FSGS factor is a low molecular weight protein with the potential to increase Palb in vitro and to cause proteinuria in vivo.

Adolescent↗

Circulating factor in patients with recurrent focal segmental glomerulosclerosis postrenal transplantation inhibits expression of inducible nitric oxide synthase and nitric oxide production by cultured rat mesangial cells.

BACKGROUND: Primary focal segmental glomerulosclerosis (FSGS) recurs in nearly 30% of patients who progress to end-stage renal disease and then receive a kidney transplant. A circulating plasma factor has been isolated from these patients that increases glomerular permeability to albumin in vitro. Because of the pivotal role of the mesangial cell in the accumulation of extracellular matrix (ECM) material within the glomerulus and the modulation of matrix protein synthesis by nitric oxide (NO), we examined the effect of the FSGS factor on inducible nitric oxide synthase (iNOS) expression and NO production by cultured rat mesangial cells (RMC). METHODS: RMC were incubated with the supernatant following 70% ammonium sulfate precipitation of serum from patients with recurrent FSGS. RESULTS: Addition of the FSGS factor to cultured RMC led to a significant inhibition of nitrite accumulation, an index of NO synthesis. There was a parallel decline in iNOS gene and protein expression. Sera obtained from control patients or those with minimal change nephrotic syndrome or diabetic nephropathy that was processed in the same manner as FSGS samples had no effect NO synthesis or iNOS activity. The inhibitory effect of the FSGS factor on NO production persisted despite addition of indomethacin (0.1-1 mumol/L) or cyclosporine (25 micrograms/mL) to test media. CONCLUSIONS: These data indicate that the FSGS factor independently alters two aspects of glomerular function--permselectivity and matrix protein synthesis--by distinct mechanisms. FSGS factor-induced disturbances in iNOS gene and protein expression and NO production by mesangial cells may antagonize the antifibrotic effect of NO within the mesangium and contribute to progressive glomerulosclerosis in patients with primary FSGS.

Animals↗

Secretory carcinoma of breast in an elderly female.

Secretory carcinoma is the currently preferred designation for a unique neoplasm earlier thought to be exclusive to the adolescent/pre-menarchal breast. The neoplasm has a predilection for juveniles and young adults (< 30 years of age), becoming progressively less common with advancing age. This report is of one such instance in a 52 year old female, a rare occurrence in the elderly (> 50 years of age), with only five earlier cases on record in the English literature.

Breast Neoplasms↗

99Tcm-citrate: a new bone imaging radiopharmaceutical.

99Tcm-citrate has been shown to incorporate irreversibly in the skeleton with a biodistribution different to that on a conventional bone scan. The aims of this study were to confirm the bone-imaging properties of 99Tcm-citrate, to identify the variabilities influencing its skeletal uptake, to compare its uptake in bone with that of 99Tcm-MDP and to assess its possible role in bone scintigraphy. Appropriate animal and human studies (n = 45) were conducted. The 3 h lesion-to-bone ratio of 99Tcm-citrate was compared with that of 99Tcm-MDP in more than 150 lesions, including osteoblastic sites (Group A), lesions undergoing treatment or healing (Group B), and degenerative or old healed lesions (Group C). The uptake ratio was classified as concordant (< 20% variation), mildly discordant (20-50% variation) or significantly discordant (> 50% variation). Animal experiments showed most bone uptake of 99Tcm-citrate when prepared at a pH of 6.0-6.5. The two radiopharmaceuticals appeared to compete for bone uptake, suggesting related but different sites of bone accumulation. The 99Tcm-citrate/99Tcm-MDP uptake ratio in Group A was concordant (mean +/- S.D. = 0.92 +/- 0.15), while Group C lesions had a significantly lower 99Tcm-citrate/99Tcm-MDP uptake ratio (0.34 +/- 0.24, P < 0.01). A comparison of Group B lesions showed wide variation in intensity and area of involvement in many lesions (uptake ratio < 0.5 or > 1.5 in 13 of 30 sites). We conclude that 99Tcm-citrate has a different site of bone localization than phosphonates, possibly in the organic matrix. Although its skeletal uptake is lower than that of 99Tcm-MDP, it may have better specificity in differentiating osteoblastic from degenerated or healed bony lesions, and therefore be useful in predicting healing of bone secondaries, fractures or osteomyelitic lesions.

Adult↗

Physicochemical characterization of hepatic glucocorticoid receptors from pre- and post-weaned mice.

The physicochemical parameters viz., molecular weight, stokes radius and ionic state of hepatic glucocorticoid receptors from pre-(10-day) and post-(60-day) weaned mice were studied. Gel permeation studies of the crude receptors showed a molecular mass of approximately 290 kDa for the unactivated receptors from both the age groups while the thermally activated receptors showed a molecular mass of approximately 90 kDa. The stokes radii were approximately 5.8 and 3.6 for the unactivated and activated receptors, respectively from both the age groups studied. Elution of the bound glucocorticoid receptors from anion-exchanger did not reveal any charge difference in the two age groups; the unactivated receptors eluted at approximately 250 mM KCl whereas the activated receptors eluted at approximately 100 mM KCl. Salt extraction of thermally activated nuclear bound receptors and immunological studies on the unactivated receptors revealed no age-related variation in the two groups of mice. Our findings confirm that the physicochemical properties of hepatic glucocorticoid receptors remain unchanged at these developmental stages of mice.

Amino Acid Sequence↗

Neuronal responses of periaqueductal gray to peripheral noxious stimulation.

Central pathways transmit pain from peripheral regions to one of the most important area of the descending pain modulatory system, the Periaqueductal gray (PAG). Independent discoveries in the past suggest that the PAG contains afferent input, output neurons and intrinsic interneurons. An attempt was made in the present study to find out the effects of more than one kind of noxious stimulus on the PAG neuronal activity. Experiments were conducted in rhesus monkeys and the effects of noxious mechanical, thermal and tooth-pulp stimulation on the activity of 14 neurons were studied. The neurons responded to more than one kind of noxious stimuli by increasing or decreasing its firing rate. No limb specificity could be identified and homogeneous distribution of the excitatory and inhibitory neurons was found.

Animals↗

Hypothalamo-limbic involvement in modulation of tooth-pump stimulation evoked nociceptive response in rats.

The hypothalamo-limbic system has been implicated in recognizing the affective significance of pain and elicitation of related emotional responses. Several evidences from different studies support a role of these areas in endogenous analgesic mechanisms for pain modulation as elucidated by different pain tests in more than one animal model. In the above context, the aim of this study was to investigate the relative effectiveness of the pain modulatory action of hypothalamic and limbic structures in rat using similar stimulation parameters, and studying the effect on tooth pulp stimulation evoked jaw opening reflex (TP-JOR). To achieve the objective, unilateral stimulation of hypothalamic (lateral = LH; ventromedial = VMN; anterior = AH) and limbic areas (amygdala = AMYG; hippocampus = HIPP) was done on the TP-JOR test. A significant reduction in the amplitude of EMG recorded from the digastric muscle (dEMG) as a result of tooth-pulp stimulation was observed on stimulation of LH, VMN, AMYG and HIPP but not from AH. Also, the magnitude of this effect was almost similar from these areas. The results suggest that these areas (except AH) have an antinociceptive role in tooth-pulp stimulation evoked pain response.

Amygdala↗

Role of radionuclide perfusion study in cold solitary thyroid nodule for diagnosis of malignancy: a complimentary diagnostic modality to fine needle aspiration cytology.

One hundred and forty eight subjects with euthyroid solitary thyroid nodules (STN) were taken up for radionuclide perfusion study. They were found to have a cold STN on 99mTc thyroid static scan. All had fine needle aspiration cytology (FNAC), and except for subjects with chronic lymphocytic thyroiditis, were subjected to surgery for tissue diagnosis by histopathology. The diagnostic findings in these patients of solitary thyroid nodules were correlated with the histopathology. Radionuclide perfusion study is considered useful to differentiate benign from malignant cold thyroid solitary nodules with high degree of sensitivity (95%) and specificity (87.9%).

Adolescent↗

Neural tissue transplant in the lateral hypothalamic lesioned rats: functional recovery pattern.

Transplantation has come of age as an important investigative tool for studying normal growth and development of the brain tissue. The present study reports the effect of lateral hypothalamic (LHA) lesion and foetal hypothalamic tissue transplantation on the feeding behaviour. In a group of rats, LHA was lesioned bilaterally by passing direct current. Subsequently, in a separate group of rats, foetal hypothalamic tissue was transplanted at the lesioned site. Following LHA lesion, all the rats died of aphagia and adipsia within 7 days, whereas, the rats in whom foetal hypothalamus was transplanted, started taking food and water in small quantities from the first day of transplantation itself. Later, they were able to attain their preoperative values. This recovery of the feeding behaviour following foetal tissue transplantation may be due to the formation of synaptic connections or due to the release of neurotrophic factors.

Animals↗

Synthesis of rotavirus-like particles in insect cells: comparative and quantitative analysis.

When the three major structural proteins, VP2, VP6, and VP7, of rotavirus are co-expressed in insect cells infected with recombinant baculoviruses, they self-assemble into triple-layered virus-like particles (VLPs) that are similar in morphology to native rotavirus. In order to establish the most favorable conditions for the synthesis of rotavirus VLPs, we have compared the kinetics of 2/6/7-VLP synthesis in two different insect cell lines: High Five cells propagated in Excell 405 medium and Spodoptera frugiperda 9 cells in Excell 400 medium. The majority of VLPs produced in both cell lines were released into the culture medium, and these released VLPs were predominantly triple-layered and were found to be stable for the period of six or seven days examined. The optimal synthesis of VLPs depended upon the cell line and the culture medium used as well as the time of harvesting infected cell cultures. The highest yield of VLPs was obtained from High Five cultures in the late phase of infection when the yield was at least 5-fold higher than that from S. frugiperda 9 cultures on a per cell basis. Our results demonstrate the usefulness of High Five cells for the production of VLPs as potential rotavirus subunit vaccines.

Animals↗

Structure and Extent of Adsorbed Gelatin on Acrylic Latex and Polystyrene Colloidal Particles.

The extent and structure of the adsorbed layer of gelatin onto colloidal particles is measured using dynamic light scattering, small-angle neutron scattering, and dilution viscometry. Adsorption isotherms are measured using solution depletion of fluorescein-5-isothiocyanate tagged gelatin. The results show that the adsorbed gelatin layer at saturation on acrylic-based latex (pH 6.5, 0.01 M sodium acetate) has approximately twice the average density of the free gelatin in solution, while for the adsorption onto polystyrene latex (pH 8.7, deionized water), it has nearly the same average density. The energetics of gelatin affinity is calculated from the temperature dependence of the adsorption equilibrium constant. It was found that the enthalpy of adsorption of a net negatively charged gelatin onto a negatively charged surface is favorable. An additional, favorable entropy of adsorption is measured for the polystyrene latex, for which hydrophobic interactions are important. Selective, competitive adsorption of nonionic and anionic surfactants confirms the specific source of the adsorption interactions. Copyright 1998 Academic Press.

Journal Article↗