Biomedical subjects
Publications and source records attributed to V Shetty.
The management of teeth in the line of fracture is still controversial. This lack of consensus about what is appropriate therapy led to a review of the literature. The various opinions expressed are reappraised in the context of the new treatment modalities available today, and recommendations are made to help the surgeon in his decision making.
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This article provides the clinical evaluation of a simple but effective method of maxillomandibular fixation that eliminates the morbidity attendant to the conventional methods of maxillomandibular fixation. The indications have been defined on the basis of the clinical experience with this technique.
Various methods have been advocated for the treatment of fractures of the angle of the mandible, emphasizing the complexity of the problem. A functionally stable osteosynthesis can be achieved in such fractures with a solitary lag screw. This technique meets the principles of rigid internal fixation and achieves maximum stability with a minimum of implant material. It obviates the need for maxillomandibular fixation, as well as the morbidity associated with the conventional methods of treatment. A review is presented of 50 patients who were treated by this method. The data show that the procedure is an effective and predictable modality of treatment with a low rate of morbidity.
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The present study is of quantitative histology in immunologically intact mice inoculated with M. leprae. Total twelve sciatic nerves are studied. The fibres are grouped as large, medium and small sized fibres. Initially there is loss of small size fibres. At later stages there is involvement of all sized fibres and ultimately Wallerian type of degeneration sets in. The process of regeneration is more active than that of human leprosy of tuberculoid type. This study adds a new dimension in understanding the pathogenesis of leprosy.
Extensive apoptosis or programmed cell death (PCD) of both hematopoietic (erythroid, myeloid, megakaryocytic) and stromal cells in myelodysplastic syndromes (MDS) cancels the high birth-rate resulting in ineffective hematopoiesis and has been demonstrated as the probable basis for peripheral cytopenias in MDS by our group. It is proposed that factors present in the microenvironment are inducing apoptosis in all the cells whether stromal or parenchymal. To investigate this hypothesis further, bone marrow biopsies from 46 MDS patients and eight normal individuals were examined for the presence of three cytokines, tumor necrosis factor-alpha (TNF-alpha), transforming growth factor-beta (TGF-beta) and granulocyte macrophage-colony stimulating factor (GM-CSF) and one cellular component, macrophages, by the use of monoclonal antibodies immunohistochemically. Results showed the presence of TNF-alpha and TGF-beta in 41/46 and 40/46 cases of MDS respectively, while only 15 cases showed the presence of GM-CSF. Further a significant direct relationship was found between the degree of TNF-alpha and the incidence of PCD (p= 0.0015). Patients who showed high PCD also had an elevated TNF-alpha level. Thus, the expression of high amounts of TNF-alpha and TGF-beta and low amounts of the viability factor GM-CSF may be responsible for the high incidence of PCD leading to ineffective hematopoiesis in MDS. Future studies will be directed at attempting to reverse the lesion in MDS by using anti-TNF-alpha drugs such as pentoxifylline.
BACKGROUND: Myelodysplastic syndromes (MDS) are a group of disorders characterized by ineffective and dysplastic haemopoiesis. Previous studies in the lab have shown extensive apoptosis and high levels of transforming growth factor (TGF-beta) and tumor necrosis factor (TNF-alpha) in the stromal layer of MDS bone marrow. The current study focuses on the cytokines expressed in the bone marrow parenchymal cells. MATERIALS AND METHODS: Bone marrow aspirate from 5 normal donors and 26 patients with myelodysplastic syndromes were examined for mRNA expression of tumor necrosis factor alpha (TNF-alpha), macrophage colony stimulating factor (M-CSF), Flt-3 Ligand (Flt-3L), Flt-3 receptor(Flt-3 rec), interleukin 1 beta (IL 1 beta) and interleukin 1 receptor antagonist (IL-1 ra). RESULTS: Comparison of 26 MDS marrows with 5 normals showed a significantly higher value for Flt-3 rec and IL 1 beta (p = 0.031 and p = 0.031) in the former, while only Flt-1 beta rec was considerably higher (p = 0.016) in newly diagnosed patients. In previously diagnosed group, Flt-3 rec (p = 0.001), TNF-alpha (p = 0.04) and IL-1 beta (p = 0.016) were higher than normal while there was no statistically significant difference in the newly versus previously diagnosed MDS cases: CONCLUSION: mRNA expression of all six cytokines measured were considerably higher in MDS when compared to normal and that these levels tend to increase with disease duration. The precise source of these cytokines as well as their role in MDS pathogenesis remains to be determined, but this study confirms our previous reports that there is no dearth of cytokines in these bizarre myelosuppressive states.
The index branch of the radial cutaneous nerve has been demonstrated as a constant nerve which can readily biopsied under local anesthesia and yields a nerve which is of suitable size for quantitative and qualitative studies both by light and electron microscopy. It supplies a limited but constant area where the sensory loss does not disturb the patient. Definite ultrastructural changes have been demonstrated in the clinically normal nerves of leprosy patients. These nerves have also revealed a loss in the small myelinated and unmyelinated fibers, which correlated with the common clinical findings of the absence of sweating and dissociated sensory loss in this disease. Gross damage has been encountered in nerves which showed only early signs of clinical damage even with refined methods of sensory testing. These nerves would have passed as normal on routine testing by No. 5 nylon. Regeneration of small fibers was noted following loss of large size fibers. Nerve conduction velocity may be a useful tool in early diagnosis.
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