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Biomedical subjects

S Kumar

Publications and source records attributed to S Kumar.

At least 1,153 records · Page 64Linked to original sources
PubMed1996

Informed consent in Indian patients.

It is commonly believed that patients in India do not need to be told about their operations as they are unable to understand the complexities and forget the salient facts soon afterwards. Obtaining informed consent is therefore considered to be an unnecessary ritual. We studied 100 consecutive patients undergoing elective major abdominal operations and asked them 5 days after their operations to recall certain details about the procedure which had been explained to them preoperatively. Seventy per cent of the patients recalled the relevant data. The ability was the same in males and females (67% and 69%) but the older, less educated and poorer patients performed worse than the others. Ninety-eight per cent of the patients appreciated being given the information as it reduced their anxiety about the operation. Indian patients are able to comprehend and should be informed about the details of their operation. Particular care should be taken during explanation to the old, poor and illiterate. In these informed consent should be a continuous process rather than a single event and the information should also be given to a younger and more educated relative.

Abdomen↗
PubMed1996

Plasminogen activator activity is decreased in rat gingiva during diabetes.

Diabetes produces extensive alterations of collagen metabolism including enhanced gingival collagenase activity. However, the mechanism for this enhanced enzyme activity is unclear. Collagenase is secreted from cells in a latent form and plasmin has been proposed as an important in vivo activator of procollagenase. Plasmin is converted from its precursor, plasminogen, by the proteolytic action of a serine proteinase, plasminogen activator (PA). The current study was therefore undertaken to determine the effect of diabetes on gingival PA activity in the rat. Since doxycycline is a potent collagenase inhibitor, the effect of doxycycline on gingival PA activity was also investigated. Eighteen male, Sprague-Dawley rats were made diabetic by streptozotocin injection (7 mg/100 g). Control rats (N = 8) were sham-treated. Doxycycline (5 mg/day/rat) was administered to 9 of the 18 diabetic rats by gavage on a daily basis. The other 9 diabetic rats were administered with saline. After 3 weeks, blood and gingival tissue were collected from each rat for the determination of glucose level and gingival PA activity. The tissues were then minced and extracted with 5 mM sodium phosphate containing 1% Triton X-100. PA assay was performed using chromatogenic substrate to determine PA activity in the extracts. Gingival PA activity in the diabetic rats was significantly reduced compared to the control (13.5 +/- 1.6 vs. 36.0 +/- 3.3 microunits/100 micrograms protein, P < 0.01). Doxycycline administration to diabetic rats had no effect on the already reduced gingival PA activity (10.4 +/- 3.5 in doxycycline-treated rats vs. 13.5 +/- 1.6 mu units/100 micrograms protein in untreated diabetic rats). PA activities in gingival tissues from the diabetic, nondiabetic control and doxycycline-treated diabetic groups were also demonstrated on zymographs as lytic bands. Regarding the well-known fact that gingival collagenase activity is enhanced during diabetes, our results did not support the notion that this biochemical alteration is attributed to increased activation of procollagenase by PA.

Animals↗
PubMed1996

Assessing mothers' attitudes about the physician's role in child health promotion.

OBJECTIVE: This study assessed maternal attitudes about the physician's role in child health promotion. METHODS: Home interviews were conducted with 200 Massachusetts mothers (with one child age 2 to 3 years) enrolled in a health maintenance organization. RESULTS: Mothers chose growth and nutrition, physical development, and illness as the most important topics and felt that providers have the ability to prevent problems and to help. Psychosocial and safety issues were less important, although mothers felt susceptible to these issues and believed they greatly affected children's health. CONCLUSIONS: On all issues, mothers believed physicians were more effective in helping families after, not before, problems arose. The Health Belief Model provided insight into attitudes and possible interventions.

Adult↗
PubMed1996

Feasibility of non-cisplatin-based induction chemotherapy and concurrent chemoradiotherapy in advanced head and neck cancer.

The purpose of the present study was to determine the safety and efficacy of induction chemotherapy followed by concomitant chemoradiotherapy. Thirty-eight patients were randomised to receive induction chemotherapy, consisting of cyclophosphamide and methotrexate followed by concomitant 5-fluorouracil and irradiation (study group) or irradiation alone (control group). There were non-significant differences in the initial tumor clearance rates in the two groups. Median disease-free survival (in complete responders) was 17 months (6-60+) vs 11 months (5-60+) (p = 0.407) and overall survival 11 months (1-60+) vs 14 months (2-60+) (p = 0.428) in the study and control groups respectively. Acute morbidity and deaths during intervention were higher in the study group (p = 0.007). This study suggests that induction along with concomitant chemoradiotherapy is too toxic for routine use and also fails to provide a survival benefit.

Adult↗
PubMed1996

An ergonomic perspective on accommodation in accessibility for people with disability.

While accessibility has increasingly become a concern in today's society, the implementation of this concern has failed to address many issues. This paper discusses the components of exclusivity, safety, and reasonability in accessibility. Common problems in the implementation of these factors are addressed. These elements in both design for accessibility and evaluation of accessibility, constitute the principle of accommodation in accessibility. The application of ergonomic principles to improve the accommodation of accessibility is proposed.

Anthropometry↗
PubMed1996

Psychological factors in disabling low back pain: causes or consequences?

Low back pain (LBP) is a common problem that is costly in both financial and human terms. The impact of LBP on an individual varies greatly. For some, LBP is a minor inconvenience; but for others LBP is associated with significant disability and with psychosocial dysfunction for the individual and for the family. Whether psychosocial factors are causes or consequences has been the subject of debate. This paper is a review of psychosocial factors associated with disabling LBP. It addresses the question of whether these factors are causes or consequences of the disability due to LBP. Based on this review it was concluded that there is little evidence in support of the concept of a pain-prone personality. Once LBP has occurred, the impact of the LBP on the individual and the family is influenced by the health-beliefs and coping strategies of the individual and the family. Distress appears to be secondary to physical restriction rather than pain, but the distress may aggravate the pain and thus the disability. The paper concludes with a discussion of the impact of health practitioners on pain-related disability.

Chronic Disease↗
PubMed1996

Worker assessment for future back disability using prediction factors.

The prevalence and economic cost of the low-back pain problem hardly needs to be mentioned in this journal. Disability ensuing from bouts of low-back pain claims a significant proportion of payments by Worker's Compensation Boards and national treasuries. Any attempt which may enhance our understanding of any aspect of this debilitating affliction, and perhaps more so its predictive capability, will go a long way towards optimization of management strategies. These management strategies, when refined and properly implemented, will have the potential not only of reducing the cost, but also of enhancing the health and safety of workers.

Female↗
PubMed1996

Molecular aspects of pesticide degradation by microorganisms.

Microorganisms are able to degrade a large variety of compounds, including pesticides under laboratory conditions. However, methods have yet to be developed to decontaminate the environment from residues of pesticides. Pesticidal degradative genes in microbes have been found to be located on plasmids, transposons, and/or on chromosomes. Recent studies have provided clues to the evolution of degradative pathways and the organization of catabolic genes, thus making it much easier to develop genetically engineered microbes for the purpose of decontamination. Genetic manipulation offers a way of engineering microorganisms to deal with a pollutant, including pesticides that may be present in the contaminated sites. The simplest approach is to extend the degradative capabilities of existing metabolic pathways within an organism either by introducing additional enzymes from other organisms or by modifying the specificity of the catabolic genes already present. Continuous efforts are required in this direction, and at present several bacteria capable of degrading pesticides have been isolated from the natural environment. Catabolic genes responsible for the degradation of several xenobiotics, including pesticides, have been identified, isolated, and cloned into various other organisms such as Streptomyces, algae, fungi, etc. In addition, recombinant DNA studies have made it possible to develop DNA probes that are being used to identify microbes from diverse environmental communities with an unique ability to degrade pesticides.

Ascomycota↗
PubMed1996

The ICE family of cysteine proteases as effectors of cell death.

Programmed cellular suicide follows a set of distinct morphological events involving profound cytoplasmic and nuclear changes. The recent discovery of a family of mammalian homologues of the Caenorhabditis elegans cell death protein CED-3 is now providing insight into how these events might be brought about. These mammalian proteins encode cysteine proteases with homology to the interleukin-1beta converting enzyme (ICE). CED-3 and seven of its currently known mammalian homologues cleave their substrates after an aspartate residue, a property shared only by the cytotoxic T cell (CTL) protease granzyme B which is necessary for the CTL-mediated killing of target cells. A number of proteins previously known to be cleaved in cells undergoing apoptosis have now been shown to be targeted by ICE-like proteases. Although many questions remain, it is becoming increasingly clear that this unique group of proteases play a central effector role in the process of physiological cell death. This article reviews various aspects of the ICE family of proteases.

Journal Article↗
PubMed1996

Induction of tissue inhibitor of metalloproteinase and its mitogenic response to endothelial cells in human atherosclerotic and restenotic lesions.

INTRODUCTION: Expression of extracellular matrix (ECM), including collagens and proteoglycans, is increased following atherosclerosis and restenosis. OBJECTIVE: To understand the Mechanism of ECM induction and accumulation, the balance among neutral matrix metalloproteinases (MMP), tissue inhibitor of metalloproteinase (TIMP) and activator (tissue plasminogen activator (tPA)) following atherosclerosis and restenosis was measured in human normal artery, and native atherosclerotic and restenotic lesions. DESIGN AND RESULTS: Based on zymographic analysis, a correlation between the increase in latent and intrinsic MMP activity and an increase in the duration from first angioplasty to restenotic atherectomy was found, suggesting decreased MMP activity from normal tissue to restenotic tissue. ELISA was carried out to measure the level of TIMP. Inhibition of collagenase activity, against fluorescein-conjugated type I collagen degradation, by normal, de novo and restenotic extracts was determined. TIMP levels were found to be increased in restenotic lesions (0.38+/-0.04 ng/mL) compared with normal arterial tissue (0.27+/-0.05 ng/mL) and with tissue derived from de novo (0.30+/-0.02 ng/mL atherosclerotic lesions. Mitogenic activity of tissue extracts, against normal human heart endothelial (HHE) cells, was measured using acid phosphatase assay as the marker of cell number. Based on neutralizing antibody to TIMP, mitogenic activity was observed in restenotic tissue to HHE cells. Using plasminogen/gelatin zymographic analysis, no significant change was observed in the level of tPA in extracts from all three groups (i.e., 8.1+/-1.2, 8.7+/-0.6, and 8.6+/-0.3 (arbitrary unit) in normal, de novo and restenotic tissue, respectively). CONCLUSIONS: These results suggest that accumulation of ECM in restenotic tissue following mechanical revascularization may in part be due to repression in MMP expression, and may be associated with increased level of TIMP and its mitogenic activity.

Animals↗
PubMed1996

A cephalometric evaluation of the dental and facial-skeletal effects using the Bionator with stepwise protrusive activations.

A study was conducted to ascertain dental effects of step-wise mandibular advancement with Bionator therapy. A sample of 24 girls in the age group of 9 to 12 years having Class II Division 1 malocclusion was well matched for age, severity of malocclusion and craniofacial morphology. The sample was divided into three groups. Eight girls underwent step-wise mandibular advancement in three stages, while eight were treated with single step advancement. Eight girls acted as control who did not undergo any treatment. The total treatment/observation period was 9 months. The cephalometric analysis revealed that the progressive mandibular advancement enhances favorable facio-skeletal changes, more so in the mandible. The sagittal correction was predominantly of skeletal type with step-wise advancement, while with single step advancement it was due to both skeletal and dental changes.

Activator Appliances↗
PubMed1996

Expression of the vascular endothelial growth factor receptor, KDR, in human placenta.

Vascular endothelial growth factor (VEGF) is a heparin-binding growth factor known to act directly on vascular endothelial cells by promoting cell proliferation and permeability. To date, 3 structurally related cell surface receptors for VEGF, Flt-1, Flt-4 and KDR, have been identified and shown to be human type III receptor tyrosine kinases. The establishment of a vascular network is crucial to the development of the placenta and occurs through both angiogenesis and vasculogenesis. The signals controlling these processes are unclear. Immunohistochemical and in situ hybridisation techniques have localised VEGF in the trophoblast layers and VEGF binding to placental vascular endothelial cells and haemangioblasts has been shown, suggesting a role for VEGF and its receptors in development of the vascular network. In this study we have used specific antibodies to localise KDR and endothelial cells in 1st and 3rd trimester human placenta. The staining showed a colocalisation of KDR with endothelial cells and haemangioblasts. No staining of trophoblast cells was observed, but strong staining of the endothelial cells was seen in the villous stroma adjacent to areas of trophoblast proliferation.

Antigens, Differentiation, Myelomonocytic↗
PubMed1996

Right-sided low inguinal pain in young women.

Young women with right iliac fossa pain are commonly referred to general surgeons as possible acute appendicitis. The differential diagnosis that includes pelvic visceral disease may be very difficult to determine clinically, especially when the history and physical signs are equivocal. We believe that diagnostic accuracy may be improved by eliciting precisely the site of abdominal pain. Right-sided low inguinal pain may be referred from the female pelvic viscera in the same way as testicular pain may be referred to the groin, as these viscera derive their autonomic nerve supply from the T10-L2, mainly T12-L1, spinal segments in both sexes. There are no previous reports of the value of the symptom of right-sided low inguinal pain in differentiating pelvic visceral disease from acute appendicitis in young women. This paper reports a prospective study of the discriminant value of this symptom in such patients.

Abdominal Pain↗
PubMed1996

Absence of p18 mutations or deletions in lymphoid malignancies.

p18 is a recently described cyclin-dependent kinase inhibitor (CDK-I) wih homology to p16 and p15. The latter two CDK-Is have been implicated as possible tumor suppressor genes in a wide variety of human tumors, including hematological malignancies. Because of p18's structural and functional homology to p16 and p15, we hypothesized that it may also function as a tumor suppressor gene in some lymphoid malignancies. To explore this possibility we examined 81 primary lymphoid tumors for deletion and mutation p18. The primary tumors included 40 T cell malignancies and 41 B cell malignancies. None of the lymphoid tumors studied possessed deletions of p18, including a group of lymphoblastic lymphomas which we previously reported to have deletions of p16 and p15. PCR-SSCP analysis of the p18 gene identified a single polymorphism of codon 114, but failed to demonstrate mutations in any of the lymphoid tumors. These results do not support a role for p18 in the pathogenesis of the lymphoid neoplasms studied.

Base Sequence↗
PubMed1996

Malignant hypertension in children in India.

BACKGROUND: Malignant hypertension is now an uncommon entity in the western world but still remains a significant problem in India. Therefore we studied the aetiological spectrum, management, and outcome of these patients. METHODS: Forty consecutive children (<16 years) with malignant hypertension were admitted and investigated to exclude or confirm the secondary causes of hypertension. For acute control of blood pressure sublingual nifedipine was used in dosage of 0.3-0.6 mg/kg, failing which intravenous nitroglycerin was used. In patients with aortoarteritis with active disease, steroids were used. Angioplasty was carried out for renal artery stenosis whenever possible. RESULTS: Renoparenchymal disease was the commonest cause of malignant hypertension, and was seen in 25 cases, renovascular hypertension in 13 cases (11 aortoarteritis and two fibromuscular dysplasia) and two had essential hypertension. For acute control of severe hypertension, sublingual nifedipine was effective in 92.5% of patients. Of the patients with renoparenchymal disease five became normotensive with treatment of the underlying disease, four received renal allograft, seven died, and nine are stable on antihypertensive drugs. Renal angioplasty was carried out in seven patients with renovascular hypertension (4 cured, 3 improved) and six are controlled on drugs. CONCLUSIONS: We conclude that apart from renoparenchymal disease, aortoarteritis is a common cause of malignant hypertension in children. Sublingual nifedipine is effective for the rapid control of severe hypertension, and angioplasty is effective in aortoarteritis for short-term preservation of renal function and control of hypertension.

Adolescent↗