Biomedical subjects
Publications and source records attributed to T V Rao.
We are reporting two cases of intramedullary cysticercus cysts. Both patients presented with a clinical picture of progressive cord compression. One of them also had bilateral radicular pain. In the female patient the symptoms became exaggerated during her two consecutive pregnancies which is a rare and interesting observation. Excision of cyst resulted in significant improvement in both the patients.
An unusual case of neurotuberculosis presenting with tuberculous meningitis, tuberculous abscess and multiple tuberculomas is reported. The patient showed a dramatic response and resolution of tuberculomas with antituberculous therapy only after excision of the abscess.
A case of intra-angiography rupture of an aneurysm, a rarity, is reported. It was confirmed by CT Scan and autopsy. The aneurysm ruptured despite taking all precautions recommended in the literature. This complication may be reduced by the use of non-ionic contrast media and slow flow rate injections.
Strain relatedness and switching were monitored in Candida albicans strains isolated from different body locations through three episodes of recurrent vulvovaginal candidiasis separated by two treatment-latency periods in a single patient. Strain relatedness was assessed by comparing Southern blot hybridization patterns with the relatively immobile mid-repeat sequence Ca3. The following conclusions are demonstrated. (i) Three different strains of C. albicans colonized the mouth, the area under the breasts, and the vulvovaginal, anal, and rectal regions, respectively, at the time of the first infection. (ii) The same strain of C. albicans was responsible for the three vaginal infections. (iii) Switching of colony phenotype occurred with each new vaginal infection. (iv) Enrichment of drug-resistant switch phenotypes (assessed in vitro) was unlikely the basis for the changes in the switch phenotypes of the strain found in the vulvovaginal, anal, and rectal areas after treatment of the first infection with clotrimazole. (v) The same strain of C. albicans was responsible for the recurrent increases in mouth colonization and was distinct from the recurrent vaginal strain. The results of this case study demonstrate the need for further detailed analyses of full-body mycofloras, strain relatedness, switching repertoires, and changes in drug susceptibility during successive episodes of recurrent vulvovaginal candidiasis.
Intraorbital paragangliomas are rare. A case of intraorbital paraganglioma with extension to the middle cranial fossa is reported. Progressive throbbing, hemicranial headaches, unilateral proptosis, and visual failure are the presenting symptoms. The computed tomographic and operative findings suggested a meningioma. Surgical removal of the tumor resulted in total relief of symptoms and recovery of vision. The pathogenesis and pathological findings are discussed.
We report a case of Balo's concentric sclerosis, a rare and acute variant of multiple sclerosis, which coexisted with an oligodendroglioma. The demyelinating lesion was clinically silent and was detected at necropsy. The pathogenesis of concentric sclerosis and the relationship of the demyelinating lesion to the evolution of the glial neoplasm is briefly discussed.
The biopsy material obtained from lesions of CNS are subjected to squash smear technique for rapid diagnosis as it is easier to make and the cytological features of cells are well preserved. During the year 1982-1983 one hundred and seventy eight squash smears were made to offer rapid diagnosis to the operating surgeon. The diagnosis was verified on paraffin sections. Correct diagnosis was made in 87% of cases. Various lesions have distinct cytomorphological features on smears. These distinct characters and efficacy of the method are discussed.
Species and strain variabilities have been monitored during the history of a prolonged Candida infection in a single compromised bone marrow transplant patient by analyzing sugar assimilation patterns, high-frequency switching repertoires, and Southern blot hybridization patterns with two cloned mid-repeat sequences (Ca3 and Ca7) which are species specific for Candida albicans and one cloned mid-repeat sequence (Ct13-8) which is species specific for Candida tropicalis. Evidence is presented that during the course of this infection (i) two strains of C. albicans and three strains of C. tropicalis were distinguished by their switching repertoires, Southern blot hybridization patterns, and sugar assimilation patterns; (ii) the three C. tropicalis strains were in a high-frequency mode of switching; (iii) two C. tropicalis strains coexisted in the blood and three C. tropicalis strains coexisted in the throat at different times during the history of the infection; (iv) amphotericin B treatment selectively removed one of two C. tropicalis strains coexisting in the blood and this strain exhibited greater susceptibility to amphotericin B in vitro (the remaining strain was subsequently removed from the blood by flucytosine treatment); and (v) both the strain removed from the blood by amphotericin B and the strain removed from the blood by flucytosine reappeared several days later at another site of infection. It is demonstrated for the first time that C. tropicalis is capable of high-frequency switching of colony morphology just as C. albicans is, that there is more than one strain-specific switching repertoire in C. tropicalis, and that a C. tropicalis mid-repeat sequence can be used for discriminating species and assessing strain relatedness, as previously demonstrated for C. albicans mid-repeat sequences.
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Selection in ABO, Rh, and MN blood groups was studied in 216 matings and their children in an endogamous population. Incompatibility status with respect to these three systems was considered simultaneously. There is no effect of incompatibility on number of pregnancies. Analysis of variance between groups confirms that prenatal loss is associated with incompatibility, and it is greater when the matings are incompatible for any two systems. There is no significant intergenerational change in ABO and Rh polymorphisms. Segregation analysis for the ABO system suggests that there is no significant difference in the proportion of A, B, and O children, based on the compatibility of the parents, while analysis for Rh-D system showed a segregation distortion which is not related to the known antigenic specificities (mother-child incompatibility).
There are very few recorded instances of brain tumors with ipsilateral secondary brain atrophy. All 10 cases in the literature are from Japan. We report a case of primary cerebral hemiatrophy with ipsilateral glioblastoma. As far as we are aware, no such case has been described in the literature.
Birth weight and perinatal mortality of 11,241 single born infants in Visakhapatnam (Andhra Pradesh, South India) are studied by fitting multiple regression techniques, with the natural log of the ratio of survivors to non-survivors. The optimal birth weight values are almost 475 g above the corresponding means. Selection intensity and selective mortality are relatively high.
The percentage of low birth weight infants (LBWI) weighing less than 2270 g in Visakhapatnam (Andhra Pradesh) is relatively higher (12.8%) than in other parts of India. The frequency of LBWI is high at birth order 1 and 2. Thereafter the curve does not show any consistency although the mean per cent of LBWI is lesser than in birth order 1 and 2. The minimum frequency is at birth order 3. The maternal classes less than or equal to 20-29 years show a gradual decrease in the frequency of LBWI with increasing age. For mothers of greater than or equal to 30-39 years of age a general U-shaped relation is found. The overall distribution of neonatal deaths is bimodal, with a peak at less than 1350 g and at 1810 g.
Ten cases of neurofibromatosis, nine involving the lower extremity and one, the upper extremity, were analysed for growth and modelling errors. The elongated bones showed over-tubulation or under-tubulation. Long as well as short bones were affected. Modelling errors mostly affected the metaphysis but, in a few cases, especially where there was isolated involvement of the fibula, the diaphysis was also affected. In two patients the whole length of paired bones of the leg showed evidence of over-tubulation. The rule of polarity which influences growth and modelling was not applicable to these cases of neurofibromatosis. Soft-tissue masses of neurofibromatosis often determined the segment of the bone involved but, in cases without such an external influence, inherent mesodermal dysplasia was thought to be the causative factor.
Sensitivity to polyene antibiotics, e.g., nystatin, amphotericin B, and filipin, was determined in phosphatidylcholine (PC) or phosphatidylethanolamine (PE) or phosphatidylserine (PS) enriched Saccharomyces cerevisiae cells, using glutamic acid, phenylalanine, glycine, and lysine transport as an index of polyene antibiotic action. As compared with normal cells, phospholipid-enriched cells acquired resistance towards different polyenes. However, the sensitivity of glutamic acid transport towards nystatin remained unaffected in PC-, PE-, or PS-enriched cells. In contrast to nystatin, the other two polyenes were more effective in checking the influx of amino acids. Results demonstrated that the specific enrichment of PC, PE, or PS could selectively protect S. cerevisiae cells from polyene antibiotic action.
Opportunity for selection has been studied against their contrasting socioeconomic and cultural backgrounds in two endogamous populations, namely, Brahmins and Jalaris of Visakhapatnam, India. Total selection was slightly higher among the better off Brahmins than in Jalaris. But a marked qualitative and quantitative variation was found in the contributing components; the fertility differential was circa 60% in Brahmins while the mortality differential was circa 60% in Jalaris according to the Crow Index. The decreased mortality differential in Brahmins suggests that this component was directly affected by the better socio-economic level and reflects on the population's transitional phase. Further, the If value fell to a half in women who completed their fertility by family planning when compared to women who completed their fertility by menopause, thus reducing the variance in fertility component in the family planning group.
Variability in genetic load has been studied against their contrasting socioeconomic and cultural backgrounds in two endogamous populations, namely, the well-off Brahmins and the low income Jalaris of Visakhapatnam, India. The A (genetic and environmental damage) and B (hidden genetic damage) estimates are higher in Jalaris. Decreased A estimates indicate the better medical care in Brahmins; the value of B could be low since many of the deaths in consanguineous families due to infectious diseases are now rarer. The genetic load (B/A ratio) indicates that the average gamete carries 0.057 and 2.123 deleterious genes, respectively, in Brahmins and Jalaris, which, if made homozygous, would kill an individual before reproductive age. The load is 35 times higher in Jalaris; this may be due to their higher inbreeding level. Contrasting socioeconomic differences and meagre medical aid might add another bias towards relatively higher B/A in Jalaris. In general the observed genetic load in both populations are lower than in other studies which may be due to gradual elimination of deleterious genes by continued practice of inbreeding.
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