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Biomedical subjects

R Srinivasan

Publications and source records attributed to R Srinivasan.

At least 55 records · Page 3Linked to original sources
PubMed2001

Simultaneous intraesophageal impedance and pH measurement of acid and nonacid gastroesophageal reflux: effect of omeprazole.

BACKGROUND & AIMS: Nonacid reflux may explain symptoms in acid-suppressed patients. Simultaneous intraesophageal impedance and pH measurement was used to evaluate the frequencies of postprandial acid and nonacid reflux before and after omeprazole administration. METHODS: Twelve heartburn patients underwent two 2-hour studies of intraesophageal impedance and pH in the right lateral decubitus position after a refluxogenic meal; session 1 without medication, session 2 after 7 days of omeprazole twice daily. Acid and nonacid reflux were quantified. RESULTS: Two hundred seventeen reflux episodes were detected before and 261 after omeprazole treatment (P > 0.05). Percentage of acid reflux decreased (from 45% to 3%, P = 0.02) and nonacid reflux increased (from 55% to 97%, P = 0.03) after omeprazole. Heartburn and acid taste were more commonly linked to acid reflux but were also produced by nonacid reflux. Regurgitation was reported equally in acid and nonacid reflux. Delta(pH) > 1 did not help predict the presence of symptoms during nonacid reflux. CONCLUSIONS: During treatment with omeprazole, postprandial reflux becomes predominantly nonacid. Symptoms are more common with acid reflux but are also produced by nonacid reflux. Simultaneous intraesophageal impedance and pH may be useful in evaluating the role of nonacid reflux in symptoms that persist despite adequate acid suppression.

Adult↗
PubMed2001

Autoimmune hemolytic anemia in treatment-naïve chronic hepatitis C infection.

Extrahepatic immunologic abnormalities have been shown to occur in patients with chronic hepatitis C virus (HCV) infection. Induction of autoimmune hemolytic anemia has been reported, either during or after interferon treatment of HCV infection. I report a 48-year-old patient with HCV infection who developed Coombs-positive autoimmune hemolytic anemia in the absence of treatment with interferon, with a review of the available literature. Other potential etiologies of autoimmune hemolytic anemia were ruled out. Prednisone therapy was instituted because of the severity of the fall in the hemoglobin. There was resolution of the hemolytic anemia and the prednisone was tapered gradually. No deterioration of the underlying HCV liver disease was evident even though an increase in HCV viremia was noted. Coombs-positive autoimmune hemolytic anemia can occur as an extrahepatic immunologic abnormality in treatment-naïve patients with chronic HCV infection.

Anemia, Hemolytic, Autoimmune↗
PubMed2001

Simultaneous occurrence of inflammatory bowel disease and thyroid disease.

We report a case of simultaneous occurrence of inflammatory bowel disease (IBD) and Graves' disease. A review of reported cases of simultaneous onset of ulcerative colitis (UC) and autoimmune hyperthyroidism is presented. A discussion of the prevalence of thyroid disease in patients with UC and possible common autoimmune etiology is entertained. The concurrent presentation has implications for the diagnosis and treatment of both diseases. At the time of suspected initial presentation or exacerbation or preexisting IBD, we emphasize the need to consider both IBD and thyroid disease in the differential diagnosis for optimal patient management.

Adult↗
PubMed2001

Esophageal function testing using multichannel intraluminal impedance.

Multichannel intraluminal impedance (MII) is a new technique for evaluation of bolus transport. We evaluated esophageal function using bolus transport time (BTT) and contraction wave velocity (CWV) of liquid, semisolid, and solid boluses. Ten healthy subjects underwent MII swallow evaluation with various boluses of sterile water (pH 5), applesauce, three different sized marshmallows, and iced and 130 degrees F water. The effect of bethanechol was also studied. There was no difference in BTT or CWV for all water volumes from 1 to 20 ml. There was significant linear increase of BTT with progressively larger volumes of applesauce, and BTT of applesauce was longer than for water. BTT was significantly longer with large marshmallows vs. small and medium and was longer than for water. BTT for iced water was similar to 130 degrees F water. Applesauce showed a significant linear decrease of CWV with progressively larger volumes and was slower than water. Marshmallow showed significantly slower CWV with the large vs. small, and CWV for ice water was significantly slower than 130 degrees F water. Therefore, BTT of liquid is constant, whereas BTT of semisolid and solid are volume dependent and longer than liquids. CWV of semisolids and solids are slower than liquids. CWV of cold liquids is slower than warm liquids. MII can be used as a discriminating test of esophageal function.

Adult↗
PubMed2001

Colorectal cancer in women: an equal opportunity disease.

Colorectal cancer is the second leading cause of cancer-related deaths in developed countries. For women, it is the third leading cause of cancer-related deaths behind lung and breast cancers. Women have the same risk as men, and the lifetime risk of the development of colorectal cancer is 6%. One in 17 woman will have colorectal cancer diagnosed. There are risk factors unique to women, including gynecologic cancers, and treatment of gynecologic cancers, as well as delayed diagnosis in pregnancy. Fortunately, colorectal cancer is a preventable disease, as almost all colorectal cancers arise from premalignant polyps. Colorectal cancer screening is recommended in asymptomatic women aged 50 years and older who are at average risk. Screening and surveillance for colorectal cancer in women are important to improve the morbidity and mortality rates of this preventable disease.

Adult↗
PubMed2001

Relative efficacy of DEPA and neem oil for repellent activity against Phlebotomus papatasi, the vector of leishmaniasis.

The insect repellent N, N-diethylphenyl acetamide (DEPA) was compared with neem oil, a commercial preparation, for protection against 3 day old un-fed female of the sandfly, Phlebotomus papatasi, (Diptera: Psychodidae) under laboratory conditions on mouse. The percentage protection against sandfly bite provided by neem oil was significantly higher than DEPA when applied at 1% and 2% concentrations (p = 0.000, t = 21.474; df = 6 and p = 0.001, t = 5.960; df = 6 respectively). However, neem oil did not show any significant difference with DEPA at 5% (p = 0.1682, t = 0.15667; df = 6). This clearly indicates that at higher concentration (5%) both neem oil and DEPA exhibited similar repellent action against P. papatasi.

Acetamides↗
PubMed2000

The Flory isolated-pair hypothesis is not valid for polypeptide chains: implications for protein folding.

Using an all-atom representation, we exhaustively enumerate all sterically allowed conformations for short polyalanyl chains. Only intrachain interactions are considered, including one adjustable parameter, a favorable backbone energy (e.g., a peptide hydrogen bond). The counting is used to reevaluate Flory's isolated-pair hypothesis, the simplifying assumption that each phi,psi pair is sterically independent. This hypothesis is a conceptual linchpin in helix-coil theories and protein folding. Contrary to the hypothesis, we find that systematic local steric effects can extend beyond nearest-chain neighbors and can restrict the size of accessible conformational space significantly. As a result, the entropy price that must be paid to adopt any specific conformation is far less than previously thought.

Models, Molecular↗
PubMed2000

Nuclear expression of the c-erbB-4/HER-4 growth factor receptor in invasive breast cancers.

The prevalence and sites of expression of the c-erbB-4 receptor have been determined by immunocytochemical staining in a series of 178 human breast cancers. Most tumors displayed cytoplasmic staining of variable intensity. When compared with adjacent normal tissue, 32 cases (18%) showed lower than normal expression, and 13 (7%) showed greater than normal expression. Nuclear immunoreactivity, confirmed by two different antibodies, was present in 87 cancers (49%) but was found in normal adjacent breast epithelial cells in <5% of cases. There were no significant associations with cytoplasmic or membrane immunoreactivity, but cases showing nuclear expression in >25% of cells were associated with good histological grade, epidermal growth factor receptor expression, c-erbB-3 positivity, cripto, amphiregulin, and transforming growth factor-alpha overexpression.

Amphiregulin↗
PubMed2000

Early initiation of post-PEG feeding: do published recommendations affect clinical practice?

Since its introduction in 1980, percutaneous endoscopic gastrostomy (PEG) has become the procedure of choice for long-term enteral feeding in patients who are unable to take adequate oral nutrition. Traditionally, gastroenterologists have waited for 24 hr after PEG tube placement before initiating feedings. However, recently published data have described the safety and efficacy of initiating PEG tube feedings as early as 3 hr after PEG tube placement. The objectives of this study were to determine how many hours after PEG tube placement practicing gastroenterologists initiate feedings and to determine whether they were aware of the pertinent literature. A four-page questionnaire was mailed to 35 practicing gastroenterologists, and the data gathered were analyzed using the SAS statistical package. A majority (81.5%) were aware of articles published in the last six years regarding the safety and efficacy of early initiation of feeding after PEG; of interest, however, only 10.7% were initiating feedings less than 3 hr after PEG tube placement. In conclusion, there exists a discrepancy between published recommendations and clinical practice regarding early initiation of feedings after PEG tube placement in this group of gastroenterologists who were surveyed.

Adult↗
PubMed2000

c-erbB-4 protein expression in human breast cancer.

The Type 1 family of growth factor receptors includes epidermal growth factor receptor (EGFR), c-erbB-2, c-erbB-3 and c-erbB-4. Overexpression of the first two members is associated with poorer prognosis in patients with breast carcinoma. In this study we examined the expression of c-erbB-4 protein using the monoclonal antibody HFR-1. A total of 127 consecutive cases of primary operable invasive breast carcinoma presenting between 1975 and 1977 were studied. All patients were managed by simple mastectomy or conservation surgery with radiotherapy and no adjuvant therapy given. Long-term follow-up was maintained. Routine, formalin-fixed, paraffin-embedded tumour samples were used and sections were stained immunohistochemically using the Duet StreptABC method. Immunoreactivity was classified using a simple semi-quantitative scoring method. Protein expression was generally low but definite positive cytoplasmic, membranous and nuclear reactivity was identified in 58%, 41% and 25% of cases respectively. Expression at all three sites demonstrated significant inverse associations were histological grade. In addition, membrane accentuation correlated inversely with the Nottingham Prognostic Index (NPI), while cytoplasmic reactivity showed a positive association with c-erbB-3 expression. No significant associations were found with disease-free interval or survival. The results of this study demonstrate that higher levels of c-erbB-4 protein expression are associated with a more differentiated histological phenotype in contrast to the other members of the Type 1 family. Larger series with extended follow-up will be required to ascertain definitively the prognostic value of c-erbB-4 expression in breast carcinoma.

Adult↗
PubMed2000

Immunization with DNA coding for gp100 results in CD4 T-cell independent antitumor immunity.

BACKGROUND: Xenogeneic DNA immunization can exploit small differences in expressed protein sequence resulting in immune recognition of self-molecules. We hypothesized that immunizing mice with xenogeneic DNA coding for the human melanosomal membrane glycoprotein gp100 would overcome immune ignorance or tolerance and result in tumor immunity. We also investigated the immunologic mechanisms of the antitumor immunity. METHODS: C57BL/6 mice were immunized with DNA coding for human gp100, mouse gp100, or control vector by gene gun. After immunization, mice were challenged with a syngeneic melanoma expressing gp100, and tumor growth was analyzed. Mice deficient in major histocompatibility complex class I or class II molecules were similarly studied to assess the immunologic mechanism of the tumor protection. RESULTS: There was significant tumor protection after vaccination with xenogeneic human gp100 DNA. Class I, but not class II, major histocompatibility complex molecules were required for tumor immunity. In addition, mice immunized with human gp100 demonstrated autoimmunity manifested as coat color depigmentation. CONCLUSIONS: Immunization with xenogeneic DNA coding for the melanosomal glycoprotein gp100 results in tumor protection and autoimmune depigmentation. These results show that xenogeneic DNA vaccines can lead to cancer immunity without CD4(+) T-cell help with potential implications for rational vaccine design.

Amino Acid Sequence↗
PubMed2000

Performance on the three-point Vernier alignment or acuity test as a function of age: measurement extended to ages 5 to 9 years.

The three-point Vernier alignment (or acuity) test was conducted on children from 5 to 9 years old. There is a significant difference between the 5-9 year old subjects and those in age groups 10 to 19 and 20 to 29 years in Vernier performance. These data were also compared with previously published data from older subjects (up to age 70). We conclude that Vernier function has not fully matured within the age range of 5 to 9 years; this finding is consistent with previous results reported in the literature.

Adolescent↗
PubMed2000

Role of flexible endoscopy in the evaluation of possible esophageal trauma after penetrating injuries.

OBJECTIVE: In urban medical centers, penetrating injuries of the chest, neck, and head are frequently encountered due to the use of firearms and sharp weapons. Successful management of esophageal injury requires a high index of suspicion and prompt diagnosis. The role of flexible endoscopy, a readily available modality, has not been studied extensively in the management of potential esophageal injuries due to trauma. METHODS: A retrospective chart review of 55 patients who underwent emergent flexible endoscopy for the evaluation of suspected penetrating esophageal injuries was performed to determine if endoscopy was safe and if it yielded information that altered patient management. RESULTS: Flexible endoscopy was performed safely in all patients. It yielded a sensitivity of 100%, specificity of 92.4%, a negative predictive value of 100%, and a positive predictive value of 33.3% for detecting an esophageal injury. Although positive findings (prevalence, 3.6%) are infrequent, no esophageal injuries were missed. Endoscopy altered patient management in 38 (69.1%) patients. CONCLUSIONS: Emergent flexible endoscopic examination of the esophagus is a safe and useful diagnostic tool in the early evaluation of penetrating injuries. Flexible endoscopy resulted in four negative surgical explorations, which was deemed acceptable by the Trauma Service, as the consequences of a missed esophageal injury is likely to be devastating.

Adolescent↗
PubMed2000

The non-collagenous dentin matrix proteins are involved in dentinogenesis imperfecta type II (DGI-II).

Dentinogenesis Imperfecta type II (DGI-II) is a localized form of mesodermal dysplasia of the dentin affecting both the primary and permanent dentitions. This is an autosomal-dominant disease in which there is a disorder in dentin mineralization. Several studies have localized DGI-II to human chromosome 4 in the region 4q 12-21. Many ECM genes-such as OPN, DMP1, DMP2, DMP3 (DSPP), and BSP-have been mapped to the same locus. Biochemical studies indicated that dentin phosphophoryn (DMP2) might be a candidate gene in DGI-II. In this study, we have used histological and RFLP analyses of tissues from a DGI-II-affected patient, as compared with two normal controls, to determine if DMP1, 2, or 3 was linked to DGI-II. The histology of the affected tooth was very different in the DGI-II patient as compared with the normals. In particular, the dentinal tubules in the DGI-II patient were very irregular, which could be the result of perturbations in the process of dentin formation. Patient and control DNA samples were digested with EcoRI or PstI and Southern-hybridized with the DMP1, DMP2, and DMP3 cDNAs. Few differences in the restriction pattern were observed between affected and normal samples for DMP1 and DMP3-3' region (phosphophoryn-like sequences) probes. On the other hand, DMP2 showed a dramatic shift in the restriction pattern in DGI-II. This study suggests that the different restriction enzyme digestion profiles of the DNA from the DGI-II patient, as probed by DMP2, might be related to the defective mineralization of dentin in DGI-II.

Chromosomes, Human, Pair 4↗