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Biomedical subjects

S Kumar

Publications and source records attributed to S Kumar.

At least 829 records · Page 46Linked to original sources
PubMed1999

Hyaluronan stimulates tumor cell migration by modulating the fibrin fiber architecture.

The glycosaminoglycan hyaluronan, which supports tumor cell migration and metastasis, interferes with fibrin polymerization and leads to increased fiber size and porosity of fibrin clots. Here we have studied the proportionate effect of fibrin polymerization on hyaluronan-mediated migration of glioblastoma cells. The structural and physical properties of hyaluronan-containing fibrin gels were analyzed by turbidity measurement, laser scanning microscopy, compaction assay, and calculation of pore size by liquid permeation. When fibrin polymerized in the presence of hyaluronan or dextran, the resulting gels strongly stimulated cell migration, and migration significantly correlated with fiber mass-to-length ratios and pore diameters. In contrast, cell migration was not induced by addition of hyaluronan to supernatants of already polymerized gels. Hyaluronan-mediated migration was inhibited in fibrin gels by antibodies to alphav- and beta1integrins and the disintegrin echistatin, but not by antibodies to the hyaluronan receptor CD44 (up to 50 microg/ml). As a control, we show that anti-CD44 (10 microg/ml) inhibited cell migration on a pure hyaluronan matrix using a two-dimensional Boyden chamber system. In contrast to three-dimensional migration, the migration of cells on the surfaces of variably structured fibrin gels was not significantly different, indicating that increased gel permeability (porosity) may account for hyaluronan-mediated migration. We conclude that, in complex three-dimensional substrates, the predominant effect of hyaluronan on cell migration might be indirect and requires modulation of fibrin polymerization.

Animals↗
PubMed1999

ERK pathway mediates the activation of Cdk2 in IGF-1-induced proliferation of human osteosarcoma MG-63 cells.

Insulin-like growth factor-1 (IGF-1) is a potent mitogen for osteoblasts. The primary signaling mechanism involved in mediating this proliferative effect of IGF-1 is not well defined. The roles of extracellular signal-regulated kinase 1 (ERK1) and cyclin-dependent kinase 2 (Cdk2) kinases in the IGF-1-induced proliferative signaling pathway of human osteosarcoma MG63 cells were investigated using a selective inhibitor of MEK, PD98059, and a Cdk inhibitor, olomoucine. Treatment of MG63 cells with PD98059 and olomoucine inhibited IGF-1-stimulated proliferation of these cells and induced cell cycle arrest at G0/G1. PD98059 significantly abolished IGF-1-stimulated kinase activity of ERK1 in a dose-dependent manner. PD98059 also inhibited the kinase activity of Cdk2 in IGF-1 stimulated cells, although the inhibition by olomoucine was much greater. The extent of inhibition of Cdk2 activity by PD98059 and olomoucine was consistent with their effects on cell proliferation and cell cycle. Cyclin A was complexed with Cdk2 in unstimulated MG63 cells, but Cdk2 kinase activity in the complex was up-regulated only in IGF-1-treated cells. This was consistent with an observed IGF-1-stimulated hyperphosphorylation of retinoblastoma protein (pRb) with the possibility that the activated Cdk2 kinase is involved in phosphorylation of pRb in IGF-1-induced cell proliferation. Taken together, these results suggest that the MEK/ERK pathway act in a positive regulatory fashion to activate Cdk2 in IGF-1-induced mitogenesis in osteoblasts.

CDC2-CDC28 Kinases↗
PubMed1999

Latex allergy.

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Child↗
PubMed1999

Responses of low-IQ students on the learning awareness questionnaire compared to students matched on mental and chronological age.

Learning awareness, including semantic content, response strategy, processing strategy, summarization, and memory in the classroom, were examined in students with mental retardation. From urban schools in Japan special high school students with average IQ of 60 (n = 40) and students with normal intellectual capacity matched on mental (n = 40) and chronological age (n = 40) were administered a 16-item Learning Awareness Questionnaire. Students of low IQ on the Tanaka-Binet test obtained lower scores on semantic content and memory strategies than chronological or mental age-matched controls, but not on response and processing. Scores indicated that students of low IQ may be equally aware of learning processes related to response and processing strategies.

Adolescent↗
PubMed1999

Open reduction of late unreduced traumatic posterior hip dislocation in 12 children.

We present 12 children with late unreduced traumatic posterior dislocation of the hip. All had posterior dislocation and no associated fracture. The dislocation had remained unreduced for a mean period of 20 (6-52) weeks. Open reduction was done in all cases, since none of the hips could be reduced with upper tibial skeletal traction in abduction. All the hips showed varying degrees of avascular necrosis, with preservation of joint space on roentgenograms. 11 children had an excellent outcome, according to the criteria of Garrett et al. (1979), after a follow-up of mean 26 (24-36) months. We suggest that open reduction is a satisfactory treatment for hip dislocation of any duration in children.

Child↗
PubMed1999

Hypercalcemia complicating leukemic transformation of agnogenic myeloid metaplasia-myelofibrosis.

Hypercalcemia is a common and potentially life-threatening metabolic derangement associated with many malignancies, especially solid tumors and multiple myeloma. Hypercalcemia has been reported only rarely with acute myelogenous leukemia. We describe a patient who developed hypercalcemia in association with transformation of agnogenic myeloid metaplasia into M7 acute myelogenous leukemia. Laboratory investigation revealed low levels of serum parathyroid hormone, undetectable levels of parathyroid hormone-related peptide, and normal levels of 25-hydroxyvitamin D. These observations suggest that another mediator was responsible for hypercalcemia in this patient. Awareness of this rare complication of acute myelogenous leukemia is essential for prompt diagnosis and management.

Cell Transformation, Neoplastic↗
PubMed1999

Genetic determinants of diabetic nephropathy.

Diabetic nephropathy is the most serious complication of diabetes mellitus. Progression of the condition leads to end-stage renal failure, and other complications of diabetes are also common in this group of patients. The onset of overt albuminuria in a patient with diabetes heralds an increased risk of death, particularly from cardiovascular disease. There is considerable evidence to show that nephropathy is influenced by genetic factors. Epidemiological studies show that only a minority of patients with diabetes develop nephropathy irrespective of glycaemic control, suggesting that a subgroup of patients are at higher risk of nephropathy. Marked ethnic variation is observed, with nephropathy being more common in certain ethnic groups. Familial clustering of nephropathy is also observed. Parental history of hypertension, diabetes or cardiovascular disease appears to predispose to nephropathy in patients with diabetes. A number of methods are available to dissect polygenic disease: animal models, genetic association studies (case-control studies), affected sib-pair studies, discordant sib-pair studies and transmission distortion analysis. Most published work has been based on association studies. Association studies have shown conflicting results often due to small numbers of cases and controls, and poor phenotypic characterization. The angiotensin-converting enzyme gene insertion (I)/deletion (D) polymorphism has been studied in detail, but does not appear to be a strong risk marker for nephropathy. It does, however, appear to have a role in response to angiotensin-converting enzyme inhibition, with II homozygotes being the most responsive and DD homozygotes the least. A number of other genetic loci have also shown positive associations with nephropathy, including apolipoprotein E, heparan sulphate and aldose reductase. More recently, affected sib-pair analysis and discordant sib-pair analysis have suggested possible genetic loci on chromosomes 3, 7, 9, 12 and 20. These have yet to be reproduced in larger numbers of families, and the specific gene regions on these chromosomes remain elusive. The evidence presented in this review strongly supports the role of genetic factors in nephropathy. Detection of strong genetic risk markers for nephropathy will allow further insights into the pathogenesis of nephropathy, and possibly the development of novel therapeutic agents for its treatment. It will also allow preventive therapy to be directed at those patients with the greatest risk for development of diabetic nephropathy.

Animals↗
PubMed1999

Comparative formation, distribution, and elimination kinetics of diphenylmethoxyacetic acid (a diphenhydramine metabolite) in maternal and fetal sheep.

Deamination to diphenylmethoxyacetic acid (DPMA) is the major route of diphenhydramine (DPHM) clearance in many species. In this study, we assessed the contribution of this pathway to nonplacental DPHM elimination and disposition of DPMA in maternal and fetal sheep. Paired maternal-fetal experiments were conducted in five chronically catheterized pregnant sheep (124-140 days gestation) with an appropriate washout period in between. Both maternal and fetal dosing experiments involved administration of an i.v bolus of deuterium-labeled DPMA ([2H10]-DPMA) combined with a 6-h infusion of DPHM (or a bolus of unlabeled DPMA with an infusion of deuterium-labeled DPHM). Maternal and fetal arterial plasma and urine samples were collected and analyzed for DPMA, [2H10]-DPMA, DPHM, and deuterium-labeled DPHM concentrations using gas chromatography-mass spectrometry. The preformed DPMA (or [2H10]-DPMA) had a substantially lower clearance (maternal: 0.55 +/- 0.18 versus 40.9 +/- 14.0 ml/min/kg; fetal: 0.37 +/- 0.11 versus 285. 6 +/- 122.2 ml/min/kg) and steady-state volume of distribution (Vdss, maternal: 0.10 +/- 0.02 versus 2.1 +/- 1.1 l/kg; fetal: 0.40 +/- 0. 06 versus 13.1 +/- 3.1 l/kg) as compared with the parent drug. The contribution of DPMA formation to maternal and fetal DPHM nonplacental clearance in vivo was 1.78 +/- 2.12% and 0.87 +/- 0.56%, respectively, indicating that DPMA formation is not a major route of DPHM clearance in fetal or maternal sheep. The recoveries of DPMA (or [2H10]-DPMA) in maternal urine were 88.0 +/- 6.5 and 92.1 +/- 7. 4% of the administered dose during maternal and fetal dosing experiments, respectively. Thus, this metabolite does not appear to be secondarily metabolized in fetal or maternal sheep. These findings are in contrast to other species (dog, rhesus monkey, human) where DPMA and its conjugates constitute approximately 40 to 60% of the total DPHM metabolites.

Acetates↗
PubMed1999

Vascular endothelial growth factor and its receptor, KDR, in human brain tissue after ischemic stroke.

Ischemic stroke results from a reduction in cerebral blood flow to a focal region of the brain after the occlusion of an artery, causing damage to nervous tissue. There is a region of cerebral ischemic tissue (penumbra) surrounding an acute cerebral infarct that is dysfunctional but potentially viable. Restoration of perfusion in the penumbra may ameliorate the tissue damage. The identity and the role of growth factors that control the extent of tissue damage and its repair are poorly understood. Angiogenesis has been demonstrated to occur in brain tissues of patients surviving an acute ischemic stroke. In this paper we have investigated the status of a potent angiogenesis factor, vascular endothelial growth factor (VEGF), in patients after acute ischemic brain stroke. Western blotting and immunohistochemistry were used to determine protein expression, and in situ hybridization was used to quantify and localize mRNA synthesis. The expression of VEGF protein was increased in the penumbra compared with infarcted brain and contralateral hemisphere. Neurones, endothelial cells, and astrocytes in the penumbra in all patients studied had significant up-regulation of both VEGF165 and VEGF189 mRNA (p < 0.01, Wilcoxon Matched-Pairs Signed-Ranks Test) compared with infarcted tissue and the normal looking contralateral hemisphere that was used as a control. Immunohistochemistry demonstrated that kinase insert domain receptor was present in blood vessels within the infarct/penumbra and absent from the normal contralateral hemisphere. VEGF, which is important in angiogenesis, may also influence long term neuronal survival, and possibly its modulation may prove to be of therapeutic value for patients with ischemic stroke.

Aged↗
PubMed1999

Mice lacking NT-3, and its receptor TrkC, exhibit profound deficiencies in CNS glial cells.

Neurotrophin-3 (NT-3) and its receptor TrkC are known to be important for neuronal survival. More recently, NT-3 has been implicated as playing a role in oligodendrocyte (OL) proliferation and survival in vitro. Examination of NT-3 and TrkC knockout mice revealed a reduction in NT-3-dependent neurons. To date, no study has examined alterations in glial cell populations in these knockout mice. In this report, we demonstrate a decline in OL progenitor cell numbers within the CNS of NT-3 and TrkC knockout mice. We also observed that immature and mature OL-specific markers were attenuated in the NT-3 and TrkC knockout animals. Deficiencies in other CNS glial cells, including astrocytes and ameboid microglia, were also observed. The subventricular zone (SVZ), a highly proliferative region for progenitor glial cells, was reduced in size. Furthermore, a nuclear-specific stain revealed a decline in the numbers of pyknotic nuclei in and around the SVZ of the knockout mice. These data will support an in vivo NT-3-dependent mechanism for the normal development of CNS glial cells.

Animals↗
PubMed1999

Diagnostic utility of ELISA test using antigen A60 in suspected cases of tuberculous meningitis in paediatric age group.

The aim of the study was evaluation of the utility of ELISA test using antigen A60 for rapid diagnosis of tuberculous menigitis (TBM) in paediatric age group. ELISA test based on mycrobacterial antigen A60 (Anda biological, France) was used to estimate specific IgM and IgG antibodies in the sera and CSF of 20 suspected cases of TBM which were selected on the basis of numerous parameters and were smear negative on concentrated smear of CSF. Sera of 20 Montoux negative healthy children was taken as control by detecting IgM and IgG antibodies to A60 antigen. Response to anti-tubercular treatment was observed in all the suspected cases of TBM. This study showed that specificity for diagnosis of TBM by detecting IgM and IgG antibodies in sera was 90% and 80% respectively. Sensitivity of the test by detecting IgM and IgG antibodies in sera was 85% and 80% respectively with positive predictive value of 89.47% for IgM antibody and 80% for IgG antibody. In CSF IgM and IgG antibodies were found in 75% and 60% cases respectively. Both were positive only in 60% of cases. It is concluded from this study that 80-85% cases of TBM in paediatric age group have eigher IgM or IgG antibodies in sera whereas 60-75% have antibodies in CSF.

Adolescent↗
PubMed1999

Hepato-toxic effect of diuron in albino rats.

Tumour initiating/promoting effect of diuron, a widely used substituted urea herbicide, was studied in rats using liver tumour model. Chronic exposure to diuron at a dose of 250 mg/kg body wt resulted in high mortality and weight loss in treated animals. The animals which received diuron + HCH treatment showed an increase in size and weight of liver as compared to controls. Liver tumours were not observed in any of the treated group whereas some significant histological changes were seen in diuron treated rat liver. Diuron thus has been found to be hepatotoxic albeit neither tumour initiating nor promoting in rat liver tumorigenesis assay system.

Animals↗
PubMed1999

The crowded ward.

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Aggression↗
PubMed1999

The Crowded Ward.

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Journal Article↗
PubMed1999

The Louisiana Medicare Electro-Convulsive Therapy Quality Improvement Project.

The first collaborative statewide psychiatric quality improvement project, initiated by Louisiana Health Care Review, Inc, focused on the practice of inpatient electro-convulsive therapy (ECT) among Medicare patients. Data from the project indicated that the majority of Medicare patients receiving ECT were white females living at home, in good physical health, in their seventies, and with a diagnosis of major depression or major depression with psychotic features. The quality indicators for the project included: (documentation of) monitoring of cognitive side effects, monitoring of depressive target symptoms, ECT appropriateness, electrode placement, anesthesia evaluation, and dental examination. An additional indicator (administration of possibly detrimental medication during ECT) was developed based on the recommendation by the study group. At project conclusion, significant improvement occurred in all project indicators. ECT as practiced in the participating hospitals was effective and appropriate. Appropriateness was determined as depression refractory to two medication trails or an emergency due to severe suicidal ideation or physical deterioration secondary to malnutrition. Transient hypertension (13%) and cardiac dysrhythmia (3.5%) which resolved in the recovery period were the most frequent complications.

Aged↗
PubMed1999

Laparoscopic or Lichtenstein repair for recurrent inguinal hernia: one unit's experience.

Surgical treatment of recurrent inguinal hernia is controversial. This is a prospective study of 50 patients who had laparoscopic total extraperitoneal repair (n = 25) or Lichtenstein repair (n = 25) for recurrent inguinal hernia. The two groups of patients were comparable in age, sex and type of hernia. Post-operatively, a seroma or a wound haematoma developed in 12 patients after Lichtenstein repair and in 4 patients after laparoscopic repair (p < 0.05). On average, analgesia was taken for 6.4 days after Lichtenstein repair compared with 3.4 days after laparoscopic repair (p < 0.05). In our unit, laparoscopic repair was associated with fewer complications and a significantly shorter duration of post-operative analgesia than Lichtenstein repair for recurrent inguinal hernia.

Adult↗