Biomedical subjects
Publications and source records attributed to V Jain.
The role of total gastrectomy in adenocarcinoma of the stomach has been controversial due to the high morbidity and mortality rates associated with the procedure. A retrospective analysis of all total gastrectomies performed for adenocarcinoma of the stomach, between January 1975 and December 1986 at the Tata Memorial Hospital was undertaken to evaluate the results and establish the usefulness of the procedure.
The intraocular penetration of three current bactericidal broad-spectrum antibiotics, namely, gentamicin sulphate, sisomicin sulphate (Ensamycin) and cephaloridine, following subconjunctival injection was studied in 95 patients undergoing elective cataract surgery. Rapid and high penetration of all three drugs was evidenced by the fact that the first samples assayed by modified disc diffusion technique 15 minutes after injection showed drug levels effective against all susceptible pathogens. Peak levels of gentamicin, sisomicin and cephaloridine attained one hour after injection were 14.913 +/- 0.310, 19.000 +/- 0.408 and 30.830 +/- 1.195 micrograms/ml, respectively. Such high drug titres would provide drug concentrations 6 to 8 times the minimum inhibitory concentration necessary against susceptible organisms. The duration of the effective bioavailability of the drugs studied varied from 12 to 18 hours. We believe our study is the first to document the excellent penetration of sisomicin and the little-studied drug cephaloridine, and hope our results will open an avenue for in vivo studies to evaluate their clinical use.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
We report the results of two phase II trials of ifosfamide in very high risk patients with either partially responsive or recurrent non-Hodgkin's lymphomas. In the first study, in which patients were extremely heavily pretreated (50 per cent had received a very intensive salvage regimen containing very high dose cyclophosphamide), there were two complete responses, two partial responses and one objective (minimal) response among 14 patients treated. Toxicity was acceptable even in this end-stage patient group. We concluded that ifosfamide is an active agent even in patients with tumours resistant to cyclophosphamide. The second trial was a pilot study in 13 patients of a regimen incorporating VP16, ifosfamide/mesna, and high dose ara-C (VIPA). There were four complete responses, five partial responses and two objective responses. Two patients died in complete remission from toxic complications, while a third, with a stably regressed mediastinal mass died after completion of the protocol. While very toxic, we considered that this regimen was highly effective, and have since incorporated a slightly less intensive combination of the same drugs into the primary therapy of high risk patients. Since the primary toxicity of the VIPA combination was myelosuppression, the use of a modified protocol incorporating colony stimulating factors to ameliorate the side-effects and possibly increase dose rate is worthy of further exploration in patients with recurrent B cell tumours.
OBJECTIVE: To identify and localize the receptor(s) responsible for modulating vascular effects of corticotropin-releasing factor (CRF) during pregnancy. METHODS: Reverse transcriptase-polymerase chain reaction (RT-PCR), competitive RT-PCR, and Western blot analyses were used to study the expression of CRF receptors (CRFR(1), CRFR(2alpha), and CRFR(2beta)) in the aorta and uterine vascular bed of nonpregnant and late (day 18) and term pregnant (day 22) Sprague-Dawley rats. Immunohistochemistry was done to localize the CRF receptor in the aortic wall. There were six rats in each study group. RESULTS: Only CRFR(2beta) was identified in the aorta and uterine vascular bed by RT-PCR and Western blot analyses. The PCR product was sequenced to confirm its identity. Competitive RT-PCR and Western blot analyses showed that expression of CRFR(2beta) is not different in late pregnancy compared with the nonpregnant but is decreased at term. Immunohistochemistry showed high expression of CRFR(2beta) on the aortic endothelial surface but low expression in the smooth-muscle layer. CONCLUSION: Only CRFR(2beta) is expressed in vasculature of nonpregnant and pregnant rats and may mediate the vasorelaxant effect of CRF. This receptor is present predominantly in the vascular endothelium and to a lesser extent in the smooth muscle. The expression of CRF receptor in pregnant rat vasculature is down-regulated at term of gestation.
The ovary is a relatively frequent site of metastases from malignant neoplasia arising elsewhere in the body, the majority of these originating from the gastrointestinal tract. The best-known tumor of this type is signet ring cell adenocarcinoma (Krukenberg tumor) of gastric origin and large bowel. The gall bladder and bile ducts are extremely rare sources of these metastases. The casuistic describes a female patient, presented with pelvic mass and jaundice. While clinical and imaging results suggested a primary ovarian carcinoma with incidental cholelithiasis and choledocholithiasis, the final diagnosis was obtained on the basis of histopathologic findings of resected specimen.
These cases had been discussed having massive coronal fracture, rotation and intrusion of teeth. In case one, both the central incisors, i.e. 11 and 21 were fractured only one-third of tooth material was remaining. In case two, 21 was fractured and intruded. In case three, 12 and 21 were avulsed and 11 was rotated and intruded. These cases were successfully treated by multidisciplinary approach. Fractured crown with periapical pathology were endodontically treated and then rotated and intruded teeth were repositioned by removable or fixed orthodontic appliance. Subsequent to endodontic and orthodontic treatment prosthodontic rehabilitation was done.
OBJECTIVE: To test the hypothesis that vascular relaxation kinetics are prolonged in pregnant rats treated chronically with N omega-nitro-L-arginine methyl ester (L-NAME). METHODS: Timed pregnant rats (on day 15 of a 22-day gestation) were implanted with infusion pumps containing vehicle (controls) or L-NAME (50 mg/d). L-NAME pumps were retained until day 22 (group 1), or removed on day 20 (group 2). All rats were killed at term. Aortic rings were mounted in organ chambers containing physiologic salt solution (PSS) for isometric tension recording, contracted with high-K+ PSS (60 mM), and allowed to relax in normal-K+ PSS. Relaxation kinetics were quantified as time for 50% and 80% relaxation. After contraction with phenylephrine, responses to cumulative concentrations of methacholine were studied in the absence and presence of L-arginine (L-Arg) (10(-3) M). RESULTS: Responses to methacholine were inhibited completely in group 1 and partially in group 2 (P < .05). The inhibition in both groups was reversed by L-Arg. The rate of relaxation was significantly slower in groups 1 and 2 (P < .05) as compared with controls. Mechanical removal of the endothelium caused prolongation of relaxation in controls and group 2 (P < .05), but not in group 1. Preincubation of aortic rings from untreated controls with L-NAME (in vitro, 10(-4) M) did not affect relaxation. CONCLUSION: The endothelium modulates the rate of vascular relaxation by a factor other than nitric oxide. N omega-nitro-L-arginine methyl ester (L-NAME) prolongs vasorelaxation by endothelium-dependent and -independent mechanisms. Prolongation of vascular relaxation kinetics may be a mechanism to elevate blood pressure and peripheral vascular resistance in preeclampsia.
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Hepatitis B virus (HBV) infection is an occupational risk for health care personnel (HCP). Vaccination is an important preventive measure but high cost of vaccination limits the feasibility of giving vaccine to all HCP. To find an optimum approach for vaccination we conducted a study on HCP in Maulana Azad Medical College and associated LNJPN hospital. A total of 162 subjects were screened. Eight were excluded because of prior vaccination against HBV. Two groups of subjects were selected namely preclinical and clinical. The preclinical group comprised first year medical students and the clinical group comprised of HCP who have been exposed to clinical departments. The subjects were screened for HBsAg, anti HBs and anti HBc viral markers. 86 subjects were screened in the preclinical group. Two (2.3%) were positive for HBsAG; 16 (18%) and 9 (10.4%) were positive for anti HBs and anti HBc respectively. In the clinical group a total of 68 subjects were screened. Amongst them 1.4% were positive for HBsAg; 47 (69%) and 38 (55%) were positive for anti HBs and anti HBc respectively. The study revealed that there was a significant difference in the titre of the viral markers in the preclinical group as compared to the clinical group. Seventy (82%) of preclinical subjects were at high risk for the infection as they moved into clinical departments. Few subjects will be excluded from the vaccination schedule based on anti HBs screening and hence screening prior to vaccination is not cost effective. However in the clinical group 69% will be excluded from the vaccination schedule based on anti HBs positivity and screening will save up to 60% of cost involved in vaccination.
OBJECTIVE: To determine the effects of tamoxifen on the growth and differentiation of normal human cervical cells and compare those effects with those of a synthetic estrogen, diethylstilbestrol (DES). In addition, the effects of these compounds on immortalized cervical cells and cervical tumor cells were ascertained. METHODS: Growth curves were used to determine the effects on cell proliferation. The expression of several proteins was used to determine the effects on cell differentiation. Binding assays and Western analysis were used to determine estrogen receptor levels. RESULTS: Both tamoxifen and DES inhibited the proliferation of normal cervical cells. This growth inhibition was coincident with an increase in cell differentiation as determined by cornified envelope formation. The increase in envelope number was not accompanied by an increase in involucrin or cornifin, two protein precursors of the envelope. The activity of transglutaminase, which enzymatically incorporates precursor proteins into the envelope, was not stimulated following treatment. Diethylstilbestrol did not alter the growth or differentiation of the human papillomavirus 16-immortalized cell line ECE16-1 or any of the cervical tumor cell lines. Of all the immortalized or cancer cell lines, only Caski cells were growth inhibited by tamoxifen. Normal ectocervical epithelial cells and Caski cells expressed the high-affinity 56-kDa estrogen receptor, but 3H-estradiol binding was not detected in cell extracts from either ME180 or ECE16-1 cells. Nevertheless, extracts from ME180 cells contained an immunoreactive band at the appropriate molecular weight for the estrogen receptor. CONCLUSIONS: These results suggest that tamoxifen and DES act similarly in normal cervical cells to promote cervical cell differentiation. However, because Caski cell growth was inhibited by tamoxifen and not DES, the effects of tamoxifen in these cells may be mediated by non-estrogen receptor mechanisms.
OBJECTIVE: To examine the hypothesis that kinetics of vasorelaxation are altered during pregnancy. METHODS: Rings of aorta from rats at different stages of pregnancy (early, late, and term) and from nonpregnant female rats were precontracted with high-K+ and then allowed to relax in normal-K+ physiologic saline solution. The time to reach 50% and 80% relaxation were determined in the absence or presence of a cyclooxygenase inhibitor (indomethacin) and a nitric oxide synthase inhibitor (N omega-nitro-L-arginine methyl ester) or after removal of the endothelium. RESULTS: The aortic relaxation was progressively faster in later stages of gestation. N omega-nitro-L-arginine methyl ester and indomethacin had no significant effect whereas removal of the endothelium caused a slowing of relaxation in all the groups. Even in the presence of N omega-nitro-L-arginine methyl ester and indomethacin or after de-endothelization, the relaxation remained faster at term as compared with the other groups. CONCLUSION: Aortic relaxation is faster in the presence of endothelium. The effect of endothelium on relaxation is independent of nitric oxide synthase or cyclooxygenase systems. Progression of gestation is associated with acceleration of aortic relaxation, which cannot be totally ascribed to an endothelial factor and may involve a change intrinsic to the vascular smooth muscle. Faster relaxation kinetics of the vasculature during pregnancy may be a mechanism to decrease peripheral vascular resistance.
The purpose of this study was to determine the safety of treating melanoma patients with retroviral vector-mediated interferon (IFN)-gamma gene-transduced autologous tumor cells. We designed a phase I study, in which irradiated, autologous, transduced melanoma cells expressing the IFN-gamma gene were injected subcutaneously every 2 weeks with escalating cell doses for six injections. Tumor tissue was harvested from 58 patients with metastatic melanoma. Twelve patients had sufficient expansion of autologous tumor (0.56-160 x 10(7) cells) and adequate IFN-gamma expression after gene transduction (2-79,000 U/10(6) cells/24 hours) for injections. Five patients received injections. No toxicity was attributed to the IFN-gamma retroviral vector in the patients injected. One of the injected patients remains disease-free after 13 injections, following the surgical removal of brain, adrenal, and lung metastases. We found that injections of autologous tumor cells transduced by IFN-gamma gene were well tolerated. However, the ability to develop primary autologous melanoma cell lines was limited, and only a minority of patients were injected.