Primary actinomycotic lung abscess.
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Actinomycosis↗
Biomedical subjects
R Sharma
Publications and source records attributed to R Sharma.
Plasma cell balanitis: clinical and histopathological features--response to circumcision.
OBJECTIVE: To evaluate the clinicopathological features and response to circumcision in patients with plasma cell balanitis. SUBJECTS AND METHOD: 32 uncircumcised men with penile lesions typical of plasma cell balanitis. Twenty specimens were available for histopathology. RESULTS: Lesions involved prepuce and glans in 17, prepuce only in 10 and in 5 were localised to glans alone or extended to coronal sulcus. Histopathology showed variable features but were consistent with the diagnosis of plasma cell balanitis. Haemosiderin pigment could be detected in only three specimens of patients with shorter duration of the disease. Twenty seven patients were treated with circumcision and no recurrence was noticed in 3 years of follow up. CONCLUSION: Circumcision is an effective treatment modality in plasma cell balanitis. Absence of haemosiderin pigment in majority of tissue sections is difficult to explain but may be related to longer duration of the disease.
Adult↗
Congenital midline nasofrontal mass. Two case reports with a clinical review.
Because of aberrant embryologic development, encephalocele, nasal dermoid, and glioma may present as a nasofrontal midline mass in a newborn infant. Though uncommon, vascular malformation or hemangioma in the nasofrontal region may present similarly. The correct diagnosis and early management of a nasofrontal mass is imperative because complications such as brain herniation, hypertelorism, or cerebrospinal fluid rhinorrhea may ensue, resulting in poor facial or visual development, recurrent meningitis, and brain abscess. Nasofrontal encephalocele and midline frontal vascular malformation are rare congenital abnormalities presenting as a midline nasofrontal mass. We report two neonatal cases, one a frontoethmoidal encephalocele and another, a frontal vascular malformation. Both had uncomplicated surgical interventions. The physical findings and clinical review are presented. The diagnostic approach toward midline nasofrontal mass is discussed.
Cerebellum↗
Systemic-to-pulmonary artery collateral vessels and surgical shunts in patients with cyanotic congenital heart disease: perioperative treatment by transcatheter embolization.
OBJECTIVE: Systemic-to-pulmonary collateral vessels can develop in patients with obstruction of the right ventricular outflow tract or the pulmonary artery. Occlusion of these vessels is necessary before surgical correction of the primary disease. We report the results of transcatheter coil embolization in the treatment of 56 patients. MATERIALS AND METHODS: Seventy-four procedures were done in the perioperative period for treatment of 67 aortopulmonary collateral arteries, five modified Blalock-Taussig shunts, and two enlarged veins. RESULTS: In the "aortopulmonary collateral" group, occlusion was complete in 51 patients (76%), subtotal in seven (10%), partial in four (6%), and failed in five (8%). Inadvertent embolization to the aorta occurred in two procedures, but both coils were retrieved nonsurgically. During follow-up of 1-12 months (n = 32; mean, 6.3 months), the coils remained in position, without any migration. Follow-up angiograms in 14 embolized vessels showed no recanalization (mean, 5.3 months; range, 2-12 months). In the "shunt" group, occlusion was complete in four patients and failed in one. Distal embolization to the pulmonary artery occurred in one patient. This coil was retrieved during surgery. During follow-up of 3-6 months, coils remained in position in all patients. In one patient, a follow-up angiogram at 3 months showed no recanalization. In the "venous embolization" group, occlusion was complete in one patient. The coils were in position 5 months later. The procedure was unsuccessful in the other patient. CONCLUSION: We conclude that transcatheter coil embolization is useful in the treatment of abnormal systemic-to-pulmonary vessels and shunts in patients with obstruction of the right ventricular outflow tract or the pulmonary artery. Homemade coils are safe and effective in obliterating antegrade flow.
Adolescent↗
Efficacy of standard ten millicurie dose of radio-iodine in management of autonomously functioning toxic thyroid nodules.
Therapeutic effect of radio-iodine treatment on thyroid patients with autonomously functioning toxic thyroid nodule was evaluated. Fifty one patients were given a standard dose of 10 mci of radioiodine (I-131) and were followed up for 2-3 years. The failure rate (relapse after 10 mci of radioiodine) of this regime was 10%. It was found that the nodules less than or equal to 3 cms. in size were completely cured after a dose of 10 mic. of radio-iodine therapy, over a follow up period of next 6 months. Patients having nodules larger than 3 cms. relapsed after first dose of 10 mci of radio-iodine, but were cured completely after the second dose of 10 mci of radio-iodine therapy. Tri-iodothyronine (T3) and thyroxine (T4) values were both found to be high before giving treatment in all the cases. Only one case developed hypothyroidism after radioiodine therapy.
Female↗
The influence of diets and gut microflora on lectin binding patterns of intestinal mucins in rats.
BACKGROUND: The mechanisms responsible for the biosynthesis, storage, secretion, or degradation of intestinal mucins are still unclear. Little is known about the carbohydrate composition of mucins in response to changes in the intestinal lumen, so lectin histochemical techniques were used to study the alterations in glycoconjugate synthesis of mucins in rats under different diets and microfloras. EXPERIMENTAL DESIGN: Nine-week-old germ-free and conventional rats were given either a purified diet of finely powdered ingredients, including cellulose as a source of fiber, or a more coarsely ground commercial diet of natural ingredients containing crude fiber of cereal origin. To mimic the human situation more closely, a group of rats born germ-free, inoculated with a suspension of human feces, and fed a purified diet were used as an experimental model. RESULTS: In rats fed a commercial diet, the surface goblet cells in the small intestine were more intensely labeled with N-acetyl-glucosamine and sialic acid-linked D-galactose-specific lectins than in rats fed the purified diet. A similar increased staining with a N-acetylgalactosamine-specific lectin was observed in the large intestine of rats fed a commercial diet. The microbial flora modified the crypt-surface glycosylation of fucosyl and sialic acid residues in the large intestine. The human flora specifically altered the goblet cell glycoconjugates in the surface epithelium. CONCLUSIONS: The significant changes in goblet cell glycoconjugates reflect the adaptation of the intestinal mucosa to different diets and microbial populations. An overall reduction in sialic acid-linked D-galactose residues in conventional rats and a loss of crypt-to-surface gradient of fucosyl expression in the large intestine of human flora rats are likely to be due to differing strains of glycosidases in the two microflora.
Acetylglucosamine↗
The right ventricle to pulmonary artery connection: when homografts are not always available.
Aortic or pulmonary homografts are currently the most popular conduits for correction of right ventricle to pulmonary artery (RV-PA) discontinuity. Problems of nonavailability or limited supply in developing countries, however, necessitate recourse to other forms of repair. Forty-nine patients of 72 with RV-PA discontinuity underwent repair without use of a homograft at our institution over a 5-year period. Handmade pericardial valved conduits (n = 18), nonvalved tubes (n = 13), and nonconduit procedures like the REV operation (n = 11) and extended pericardial gusset (n = 5) were mainly used. The choice of procedure was governed by various factors including type of cardiac defect, pulmonary artery pressure and morphology, previous operation, and socioeconomic constraints. Extracardiac conduits do not provide a permanent solution to the problem of RV-PA discontinuity, and efforts to innovate and refine nonconduit procedures must continue.
Anastomosis, Surgical↗
Postnatal changes in kidney glucocorticoid receptor of mice.
The specific binding of [3H]dexamethasone to its receptor and the activation of the hormone-receptor complexes from the kidney of mice at various postnatal ages were investigated. The results indicated that the level (fmol/mg protein) of glucocorticoid receptors remained unaltered at 10-, 15- and 30-day, increased significantly at 45-day and thereafter declined to its earlier level in 60-day old mice. Scatchard analysis of binding data confirmed the increased level of receptors at 45-day compared to day 15, without any change in the hormone affinity to its receptor at these two ages. The extent of temperature- and salt-dependent activation of the receptor showed no marked differences in 10- and 60-day old mice, as determined by DNA-cellulose binding assays. However, the nuclear binding of temperature- and salt-activated glucocorticoid-receptor complexes was significantly higher in 10-day old mice. Cross-mixing experiments showed nuclear specificity in higher binding of thermally activated receptor at day 10 of postnatal age. Molybdate, tungstate and N-ethylmaleimide inhibited the temperature- and salt-dependent activation of glucocorticoid-receptor complexes similarly at both the ages studied. DNase I extraction of bound hormone-receptor complexes from nuclei showed higher extractability at day 10 (63%) compared to day 60 (43%). These findings indicated changes in glucocorticoid receptor concentration together with chromatin organization that might play an important role in glucocorticoid-mediated responses during postnatal development of mice.
Animals↗
Congenital cytomegalovirus infection in Shimla Hills, Himachal Pradesh, India.
We came across some cases clinically suggestive of intrauterine infection which were confirmed to be congenital cytomegalovirus infection. A clinical profile of these patients is presented. Intracranial calcification was not seen in any of these patients. Mental retardation was profound in all the patients and all had hepatomegaly. Uncommon findings encountered included hydrocephalus, patent ductus arteriosus and corneal opacities. Other clinical findings and investigation are also discussed.
Altitude↗
Sodium nitroprusside increases glomerular capillary hydraulic conductivity in isolated rat glomeruli.
Sodium nitroprusside (SNP) causes renal vasodilation, increased renal blood flow, and increased renal sodium excretion. Systemic vascular effects of SNP are dependent on generation of nitric oxide and increase in smooth muscle intracellular cyclic guanosine monophosphate (cGMP). In the current studies isolated glomeruli were used to determine the effects of SNP on glomerular capillary hydraulic conductivity (Lp) and on mesangial tone. The direct effects of the cGMP analogue 8-bromo-cGMP on Lp were studied. Glomeruli were isolated from the superficial renal cortex of adult male Sprague-Dawley rats weighing 143 to 383 gm. Lp was calculated from videomicroscopic images of individual glomeruli during the initial 0.1 second of filtration induced by an albumin oncotic gradient. Incubation of glomeruli in 10(-3) mol/L SNP increased Lp from a control value of 1.38 +/- 0.08 microliter/min.mm Hg.cm2 to 1.91 +/- 0.13 microliter.min.mm Hg.cm2 (p < 0.01). Incubation of glomeruli in 10(-5) mol/L 8-bromo-cGMP increased Lp to a comparable degree from a control value of 2.00 +/- 0.58 microliter/.min.mm Hg.cm2 to 2.39 +/- 0.62 microliter/min.mm Hg.cm2 (p < 0.03). Increase in Lp was observed independent of any effects on systemic or renal circulations, neural effects, or humoral effects. Changes in mesangial tone were estimated from changes in glomerular volume during 15 minutes of incubation with SNP or control medium. Incubation of glomeruli in 10(-5) mol/L SNP increased glomerular volume 6%, a consequence of mesangial relaxation. Incubation of glomeruli in 10(-7) and 10(-3) mol/L SNP did not affect mesangial tone.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
Trilateral retinoblastoma: CT evaluation.
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Brain Neoplasms↗
Orthotopic pulmonary valve replacement with a homograft.
Eight pulmonary valve replacements (PVR) have been performed from January 1992 to October 1994. Three patients (mean age 7.7 years, range two to 16 years) had absent pulmonary valve with tetralogy of Fallot and underwent primary PVR at the time of surgical correction. Five other patients, who had correction of tetralogy of Fallot (four cases) and of double outlet right ventricle with ventricular septal defect and pulmonary stenosis (one case), were reoperated for pulmonary regurgitation with progressive right ventricular dysfunction. Mean age at the time of reoperation was 18 years (range seven to 34 years). There was no early death. Early postoperative recovery was satisfactory in all of them. The follow up ranges from six to 35 months (mean 19 months). Seven patients were in functional class I and one in functional class II when they were last evaluated in the out-patient department and five of them were off diuretics and vasodilator. In the presence of right ventricular dysfunction pulmonary regurgitation is poorly tolerated. A competent and non-obstructive pulmonary valve is often life saving in these critically ill patients.
Adolescent↗
Unusual radiological manifestations of Lemierre's syndrome: a case report.
Lemierre's syndrome is an uncommon clinical entity characterized by oropharyngeal infection followed by septic thrombophlebitis of the jugular vein with embolization to the lungs and other organs. The organism is a gram-negative anaerobic bacterium, Fusobacterium necrophorum. We report a case of Lemierre's syndrome in an 8-year-old child who presented with septic arthritis of the left hip joint. Roentgenograms and computed tomography demonstrated gas in the joint and adjacent soft tissues, along with a dislocated hip. Sonography of the neck coupled with the colour Doppler technique did not reveal any abnormality in the jugular veins. A blood culture grew Fusobacterium necrophorum, confirming the diagnosis of Lemierre's syndrome.
Arthritis, Infectious↗
Regulation of hepatic glucocorticoid receptor during development of mice.
Specific binding of [3H]dexamethasone to its intracellular receptors and the subsequent activation of hormone-receptor complexes were studied in the liver of mice at various postnatal ages. The results indicate that the level (fmol/mg protein) of receptors is significantly higher in the liver of 30-day old mice as compared to other ages studied. Scatchard analysis of binding data exhibits no change in the affinity of hormone to receptor during development. The magnitude of both temperature- and salt-dependent activation of glucocorticoid receptor shows no change in 10- and 60-day old mice, as judged by DNA-cellulose binding. Whereas nuclear binding of temperature activated hormone-receptor complexes is more pronounced in 10-day old mice. Cross-mixing experiments indicate nuclear specificity. DNase I digestion studies showed higher extractability of bound [3H]dexamethasone-receptor complexes from nuclei of 10-day (70%) as compared to 60-day (46%) old mice. These findings indicate changes in the hepatic glucocorticoid receptor level and also in the nature of chromatin organization during development, which might play an important role in the glucocorticoid action mechanism in developing animals.
Animals↗
A genetically engineered fusion protein M4/TNF with increased bifunctional activity refolded in the presence of protein disulfide isomerase.
Recombinant DNA techniques were used to clone, to construct and to express a fusion protein M4/TNF in Escherichia coli. The fusion protein includes the chimeric F(ab')2 fragment (M4) recognizing the human tumor-associated TAG72 antigen and the tumor necrosis factor alpha (TNF) moiety. The M4/TNF purified from inclusion bodies of the bacteria homogenates was further solubilized in a denaturing buffer containing 6 mol l-1 guanidine and refolded in a refolding buffer. Our results showed that the M4/TNF refolded in a buffer containing 6 mmol l-1 oxidized glutathione (GSSG), 0.2 mmol l-1 dithioerythione (DTE) and 0.5 mumol l-1 protein disulfide isomerase (PDI) displayed a 4-fold higher anti-TAG72 immunoreactivity and a 5-fold higher TNF activity than that refolded in the same refolding buffer but without PDI. Our data thus indicates that the protein disulfide isomerase not only facilitates the correct formation of disulfide-bonds of the antibody molecule, but also the correct refolding of the TNF moiety in vitro.
Amino Acid Sequence↗
Microcolpohysteroscopy compared with colposcopy in evaluation of abnormal cervical cytology.
Microcolpohysteroscopy (MCH) permits in vivo visualisation of cervical epithelium and is a useful procedure in the diagnostic workup of a patients with abnormal pap smear. Our study compared standard colposcopy with MCH in 45 patients with dysplasia reported on cytology. On comparing with final histopathological diagnosis colposcopy had an accuracy of 95.6 percent in diagnosing cervical intraepithelial neoplasia (CIN) within one grade. MCH had a diagnostic accuracy of 84.4 percent in predicting CIN changes. Further MCH was able to evaluate the endocervical squamocolumner junction in all cases of unsatisfactory colposcopy. Microcolpohysteroscopy is a useful adjunct to colposcopy and is also of value in locating the epicenter of lesions and is diagnosing HPV infection. MCH prior to conisation is of value in tailoring the biopsy to fully include the CIN lesion.
Adult↗
Tissue magnesium content and histopathological changes in non-survivors of aluminium phosphide poisoning.
The study was conducted in 30 non-survivors of Aluminium Phosphide poisoning and similar number of age and sex matched controls (fatalities as a result of road side accidents, head injury, etc). Magnesium content was estimated in brain, heart, stomach, kidney, liver and lung using atomic absorption spectrophotometer. It was found that tissue magnesium levels were not significantly different (p = NS) when comparison was carried out between controls (Group II) and Patients who were not given magnesium as part of treatment (group IB). However magnesium levels in different organs of patients who received magnesium as part of treatment were found to be significantly higher (group IA)(P < 0.01) in comparison to controls as well as patient group not treated with magnesium sulphate. Significant histopathological changes were observed in almost all the organs. The changes seem to be the result of direct tissue damage by phosphine rather than shock and anoxia which occurred in all these cases.
Adolescent↗