Treatment of subcutaneous phycomycosis with ketoconazole.
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Administration, Oral↗
Biomedical subjects
S Sharma
Publications and source records attributed to S Sharma.
Clinical presentation and pathophysiology of meatal stenosis following circumcision.
OBJECTIVE: To describe the clinical presentation and pathophysiology of meatal stenosis occurring after circumcision. PATIENTS AND METHODS: The clinical presentation and operative findings are reported in 12 children who presented with meatal stenosis over a period of 3 years. RESULTS: The cardinal symptoms of meatal stenosis were penile pain at the initiation of micturition (12 of 12), narrow, high velocity stream (8 of 12) and the need to sit or stand back from the toilet bowl to urinate (6 of 12). Following surgical correction with meatotomy there was no recurrence of stenosis after a mean follow-up of 13 months. Traumatic meatitis of the unprotected post-circumcision urethral meatus and/or meatal ischaemia following damage to the frenular artery at circumcision are suggested as possible causes of meatal stenosis. CONCLUSION: Preservation of the frenular artery at circumcision, or the use of an alternative procedure (preputial plasty), may be advisable when foreskin surgery is required, to avoid meatal stenosis after circumcision.
Child↗
The Kropp-onlay procedure (Pippi Salle procedure): a simplification of the technique of urethral lengthening. Preliminary results in eight patients.
OBJECTIVE: To lengthen the urethra to increase bladder outlet resistance in adolescent girls with a neurogenic bladder. PATIENTS AND METHODS: During a 2-year period (1992-94), eight girls (mean age 13.5 years, range 9-19) underwent a Kropp-onlay urethral lengthening associated, for six of them, with a bladder augmentation. Seven of the eight patients patients were spina bifida and confined to a wheelchair. One patient had had a previous transverse myelitis. A Benchekroun hydraulic value (in three cases) and a Malone procedure (in two cases) were performed at the same stage. The technique of Kropp-onlay urethral lengthening, which creates a flap value mechanism which leaks when the bladder is too full, is described and illustrated. RESULTS: Seven of eight patients were dry during the day and four were occasionally damp during the second part of the night. One could not be dry for more than 2 h during the day but had a very hyperactive detrusor. She developed two bladder stones which required an open vesicotomy. One developed a urethral fistula requiring a second Kropp-onlay procedure and became dry afterwards. Two patients, who did not undergo a bladder augmentation, needed oxybutinin therapy to obtain a satisfactory result. Post-operative urodynamic measurements are discussed. CONCLUSION: The Knopp-onlay urethral lengthening is easier to perform than the original Kropp procedure. The preliminary results are similar to those of alternative techniques (e.g. urethral suspension) but long-term reliability of this technique remains unknown.
Adolescent↗
Hypospadias repair: current principles and procedures.
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Humans↗
Coronary angioplasty in high risk patients: comparison of elective intraaortic balloon pump and percutaneous cardiopulmonary bypass support--a randomized study.
Forty patients undergoing percutaneous transluminal coronary angioplasty (PTCA) with severely impaired left ventricular ejection fraction (LVEF) < 30% were randomized between prophylactic intraaortic balloon pump (IABP) support (N = 20) and percutaneous cardiopulmonary bypass (PCPB) support (N = 20). The indications for both groups were left ventricular (LV) dysfunction and a large area of myocardium (> 50%) being perfused by the target vessel. The IABP and PCPB supported groups were comparable in LVEF (20% +/- 6.4% vs 22.8% +/- 8.1%), mean pulmonary artery pressure (46.5 +/- 10.5 mmHg vs 42.6 +/- 12.6 mmHg), average number of vessels dilated (1.4 vs 1.3), mean inflation time (2.8 +/- 0.3 min vs 3.1 +/- 0.5 min), and hospital stay after PTCA (5.6 +/- 1.2 days vs 5.2 +/- 1.4 days). The primary success rate (95% vs 95%) and hospital mortality (5% vs 5%) were also similar in the two groups. Two patients required surgical exploration of the femoral artery and eight patients required blood transfusion in the PCPB group. IABP patients had no vascular complications and did not require blood transfusion. High risk PTCA is equally effective whether using prophylactic IABP or PCPB support. PCPB support, however, has a higher rate of vascular complications and need for blood transfusions. IABP has the additional advantage of ease of insertion and the support can be used for a longer period after PTCA, if required.
Adult↗
Effect of oleanolic acid on complement in adjuvant- and carrageenan-induced inflammation in rats.
The present work was aimed at evaluating the influence of oleanolic acid on complement-related inflammation. In adjuvant-induced arthritis and carrageenan-induced paw oedema in rats, oleanolic acid was found to possess significant anti-inflammatory and complement-inhibitory activities. The intraperitoneal injection of oleanolic acid (60 mg kg-1, twice a day), before and after Freund's Complete Adjuvant challenge and thereafter repeated for several days, significantly reduced foot-pad thickness of experimental animal models and simultaneously reduced complement activity. Oleanolic acid also produced marked reduction in complement levels and inflammatory effects on carrageenan-induced paw oedema in rats when injected intraperitoneally (60 mg kg-1, twice a day).
Animals↗
Hemodynamics of the Fontan connection: an in-vitro study.
The Fontan operation is one in which the right heart is bypassed leaving the left ventricle to drive the blood through both the capillaries and the lungs, making it important to design an operation which is hemodynamically efficient. The object here was to relate the pressure in Fontan connections to its geometry with the aim of increasing the hemodynamically efficiency. From CT or magnetic resonance images, glass models were made of realistic atrio-pulmonary (AP) and cavo-pulmonary (CP) connections in which the right atrium and/or ventricle are bypassed. The glass models were connected to a steady flow loop and flow visualization, pressure and 3 component LDA measurements made. In the AP model the large atrium and curvature of the conduit created swirling patterns, the magnitude of which was similar to the axial velocity. This led to an inefficient flow and a subsequent large pressure loss (780 Pa). In contrast, the CP connection with a small intra-atrial chamber had reduced swirling and a significantly smaller pressure loss (400 Pa at 8 l.min) and was therefore a more efficient connection. There were, however, still pressure losses and it was found that these occurred where there was a large bending of the flow, such as from the superior vena cava to the MPA and from the MPA to the right pulmonary artery.
Atrial Function, Right↗
The pancreatic islet factor STF-1 binds cooperatively with Pbx to a regulatory element in the somatostatin promoter: importance of the FPWMK motif and of the homeodomain.
A number of homeodomain proteins have been shown to regulate cellular development by stimulating the transcription of specific target genes. In contrast to their distinct activities in vivo, however, most homeodomain proteins bind indiscriminately to potential target sites in vitro, suggesting the involvement of cofactors which specify target site selection. One such cofactor, termed extradenticle, has been shown to influence segmental morphogenesis in Drosophila melanogaster by binding cooperatively with certain homeodomain proteins to target regulatory elements. Here we demonstrate that STF-1, an orphan homeodomain protein required for pancreatic development in mammals, binds cooperatively to DNA with Pbx, the mammalian homolog of extradenticle. Cooperative binding with Pbx requires a pentapeptide motif (FPWMK) which is well conserved among a large subset of homeodomain proteins. The FPMWK motif is not sufficient to confer Pbx cooperativity on other homeodomain proteins, however; the N-terminal arm of the STF-1 homeodomain is also essential. As cooperative binding with Pbx occurs on only a subset of potential STF-1 target sites, our results suggest that Pbx may specify target gene selection in the developing pancreas by forming heterodimeric complexes with STF-1.
Amino Acid Sequence↗
Plasma clearance, tissue uptake and expression of pituitary peptide 23/pancreatitis-associated protein in the rat.
The secretion of peptide 23 by rat pituitary cells is stimulated by growth hormone-releasing hormone and inhibited by somatostatin. Recent cloning of the cognate cDNA for peptide 23 revealed that it is identical to pancreatitis-associated protein (PAP). In the present study, the clearance and tissue uptake of recombinant peptide 23/PAP in normal adult male rats was assessed. The plasma half-life of recombinant peptide 23/PAP was 4.8 +/- 1.4 (S.D.) min. Maximal accumulation of radio-labelled peptide 23/PAP was observed in the kidney, stomach, small intestine and pancreas whereas negligible uptake was seen in the liver, lung or heart. Peptide 23/PAP was detected in a variety of tissue extracts using a radioimmunoassay. Extracts of ileum contained the highest concentrations of peptide 23/PAP. In situ hybridization analysis showed that peptide 23/PAP mRNA was highly expressed in the columnar epithelial cells of ileum, jejunum and duodenum. These observations demonstrate that peptide 23/PAP, a protein previously thought to be of pituitary origin, is widely expressed in the gastrointestinal tract and that it is rapidly removed from the circulation by the kidney and by tissues which express peptide 23/PAP.
Animals↗
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↗
Detection of twin-twin transfusion syndrome by first trimester ultrasonography.
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Adult↗
Drought, mortality and social structure.
The social aspects of drought-induced morbidity and mortality in India are analyzed in this study. "As a sample study, mortality trends in Rajasthan State in India in the 1980s were analysed to correlate the increased death rate with the drought of 1987. It is demonstrated that drought-induced malnutrition is the root cause of death. Sociologically, populations are divided into three sections--fragile, resilient and potent--which are differently affected by droughts, the fragile section suffering worst."
Asia↗
Examination of the conjunctival microbiota after 8 hours of eye closure.
We investigated the effect of overnight eye closure on the levels and types of microbiota in the external eye, the conjunctiva, and lid margins of 40 normal subjects during the day and immediately after eye opening following 8 hours of sleep over 3 consecutive days. Overall, clinically important levels of gram-positive bacteria were isolated from 22.1% of samples; 2.3% of samples yielded gram-negative bacterial growth. The incidence of clinically important levels of gram-positive bacteria was greater in closed-eye compared with open-eye samples. There was no significant increase in the incidence of gram-negative bacteria or fungi with eye closure. There was no difference between the open- and closed- eye samples with regard to types of microorganisms isolated. Our results suggest that eye closure may promote the growth of normal external ocular microbiota. These findings have implications for extended contact lens wear and ocular surgery.
Adolescent↗
Effect of corticosteroid treatment on various serological & bronchoalveolar lavage abnormalities in patients with sarcoidosis.
Effect of daily oral prednisolone treatment was studied in 29 patients with pulmonary sarcoidosis. Twenty normal control subjects were also studied. Pretreatment absolute lymphocyte counts and proportion of lymphocytes in peripheral blood were significantly lower in patients with sarcoidosis as compared to normal controls. Total cell count and the proportion of lymphocytes in bronchoalveolar lavage (BAL) fluid were significantly higher in sarcoidosis. The proportion of CD3+ and CD4+ was significantly lower in peripheral blood and higher in BAL fluid in patients with sarcoidosis. Immunoglobulins (IgG, A and M) and complements (C3, C4 and CH50) were significantly higher both in peripheral blood and BAL fluid. Patients with sarcoidosis were treated with daily oral prednisolone (30 mg/day). Repeat studies were performed after an interval of 4-6 months in 20 patients with sarcoidosis. A significant increase in absolute lymphocyte counts in peripheral blood and decrease in the proportion of lymphocytes in BAL fluid occurred with prednisolone treatment. Proportion of CD3+, CD4+ and B cells increased in peripheral blood and decreased in BAL fluid. Complement and immunoglobulin levels revealed a significant reduction in peripheral blood and BAL fluid. It is concluded that patients with sarcoidosis have peripheral blood lymphopaenia and lymphocytic alveolitis. They have increased levels of complement and immunoglobulins both in the peripheral blood and BAL fluid. All these abnormalities show significant improvement with prednisolone treatment.
Adult↗
Evaluation of a hospital based cytology screening programme for reduction in life time risk of cervical cancer.
Hospital based cytology screening is one of the suggested alternative strategies for the developing countries. The present communication attempts to estimate the reduction in lifetime risk of cervical cancer initiated through a hospital based single lifetime screening programme. The percent reduction in cumulative incidence of cervical cancer during lifetime in different age groups of women was calculated after estimating the number of incident cases in the absence as well as presence of screening. Our analysis revealed that by introducing the single life time cytology screening in the group of hospital attending population, an overall reduction in the cumulative incidence of cervical cancer during lifetime was found to be 10.2%. It was further estimated that the reduction was much less in the early age groups (2.4-10.2% in 20-34 years) as compared to later age groups (11.2-55.6% in 35+ years).
Adult↗
Fetal faciocervical teratoma with anemia and thrombocytopenia. A case report.
A massive teratoma in the faciocervical region was found in a fetus at 21 weeks, with laboratory evidence of anemia and thrombocytopenia. Vaginal delivery was achieved by cardiocentesis followed by Laminaria tent insertion, dilation and evacuation.
Adult↗
Induction of short-term biomarkers of tumor promotion in skin of CD-1 mice by petroleum middle distillates: preliminary observations.
The induction of sustained epidermal hyperplasia in mouse skin has been shown to be a reliable predictor of tumor promoting activity for chemicals as diverse as phorbol esters, anthralins, n-dodecane and organic peroxides (DiGiovanni, 1992). The results contained herein demonstrate that API 81-07 and API 81-10, petroleum middle distillates that exhibit tumor promoting activity in mouse skin, induce epidermal hyperplasia and ODC activity. Other petroleum middle distillates (odorless light petroleum hydrocarbons, a light vacuum distillate, and a mineral seal oil) were also shown to share these activities. It should be emphasized that the relevance of these observations to human skin remains unresolved; however, the availability of these short-term biomarkers offers the opportunity to address the issue by performing comparative investigations on the effects of petroleum middle distillates on human skin xenografted to athymic (nude) mice. Such studies are being initiated.
Alkanes↗
Antimicrobial susceptibility pattern & biotyping of Helicobacter pylori isolates from patients with peptic ulcer diseases.
Antimicrobial susceptibility of 50 local isolates of Helicobacter pylori from patients with acid peptic diseases was investigated to commonly used antibiotics. The maximum resistance was (66%) detected to metronidazole (MIC > 8 micrograms/ml). The frequency of resistance to ampicillin, erythromycin, ciprofloxacin was in the range of 20-28 per cent; least resistance was observed to tetracycline (10%). The gradient disc diffusion method was found to give reproducible results and also correlated with agar dilution method for minimum inhibitory concentration (MIC). Study of the enzymatic activity of H. pylori isolates showed that all isolates had urease, catalase, oxidase, esterase-lipase, and naphthol-AS-beta-1-phosphohydrolase enzymes and were consistently negative for ten other enzymes tested. Majority of the isolates expressed alkaline phosphatase (17/18), esterase (17/18) and acid phosphatase (14/18). The acid phosphatase had the maximum mean enzymatic activity. There was no difference in enzymatic activity between H. pylori isolates from ulcer and gastritis patients. H. pylori isolates could be typed into five biotypes. Type III was found to be more common (44.4%). This study supports the existence of the strain variations among H. pylori on the basis of the enzyme profiles.
Adolescent↗