Levels of evidence.
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Evidence-Based Medicine↗
Biomedical subjects
A Gambhir
Publications and source records attributed to A Gambhir.
Survivorship analysis of 3234 primary knee arthroplasties implanted over a 26-year period: a study of eight different implant designs.
We conducted a survivorship analysis of 3234 primary total knee replacements performed at our hospital between 1969 and 1995. Each knee replacement was entered once only. Revision was defined as the end point. Data were collected both from patient records and by postal questionnaire. Eight types of knee prostheses were evaluated with best-case and worst-case scenarios compared over a 5-, 10- and 15-year period. The evidence suggests that the "Condylar type devices" which include the Total Condylar, Press Fit Condylar (PFC), Kinematic, Kinemax and Anatomic Modular Knee (AMK) have very similar survivorship curves and in the main have performed well up to a 10-year period. The LCS mobile bearing knee performed well at 5 years. The earlier design prostheses had a poor result in terms of survivorship and are hence were discontinued.
Aged↗
Chronic sialadenitis with pleomorphic adenoma of the parotid: coincidental or causal?
A 12-year-old boy with a pleomorphic adenoma of the parotid is reported. The excised gland specimen also showed evidence of chronic sialadenitis. The co-existence of these two entities has not been previously reported in the literature surveyed by us. The authors feel that the two conditions may have a common underlying etiology.
Adenoma, Pleomorphic↗
Ulnopalmar dislocation of the fifth carpometacarpal joint. A rare injury.
Volar dislocation of the carpometacarpal joint of the little finger is an uncommon injury. It is subdivided in ulnopalmar and radiopalmar dislocations. The injury can easily be missed on standard x-rays. Closed reduction and K-wire fixation has commonly been used in the treatment, although closed reduction and casting has been reported. Only 10 cases of an ulnopalmar dislocation were published previously. We report a case of a simultaneous dislocation of the 4th metacarpophalangeal joint and an ulnopalmar dislocation of the 5th carpometacarpal joint. The combination of these injuries has not been reported yet. We review the available literature and discuss the methods of treatment.
Bone Wires↗
Does temporary clamping of drains following knee arthroplasty reduce blood loss? A randomised controlled trial.
In a randomised, blinded study 76 patients undergoing primary total knee arthroplasty were assigned to either immediate drain opening (n = 45) or drains opened at 2 h (n = 31). No significant differences were found between the groups for the volume of drained blood, transfusion requirements, knee motion or wound status. The authors conclude that the practice of clamping drains has no benefit in routine knee arthroplasty. However, when faced with immediate brisk blood loss, the results suggest that drains can be clamped without any excess morbidity.
Arthroplasty, Replacement, Knee↗
Multiple steady states with distinct cellular metabolism in continuous culture of mammalian cells.
Mammalian cells have the ability to proliferate under different nutrient environments by utilizing different combinations of the nutrients, especially glucose and the amino acids. Under the conditions often used in in vitro cultivation, the cells consume glucose and amino acids in great excess of what is needed for making up biomass and products. They also produce large amounts of metabolites with lactate, ammonia, and some non-essential amino acids such as alanine as the most dominant ones. By controlling glucose and glutamine at low levels, cellular metabolism can be altered and can result in reduced glucose and glutamine consumption as well as in reduced metabolite formation. Using a fed-batch reactor to manipulate glucose at a low level (as compared to a typical batch culture), cell metabolism was altered to a state with substantially reduced lactate production. The culture was then switched to a continuous mode and allowed to reach a steady-state. At this steady-state, the concentrations of cells and antibody were substantially higher than a control culture that was initiated from a batch culture without first altering cellular metabolism. The lactate and other metabolite concentrations were also substantially reduced as compared to the control culture. This newly observed steady-state was achieved at the same dilution rate and feed medium as the control culture. The paths leading to the two steady-states, however, were different. These results demonstrate steady-state multiplicity. At this new steady-state, not only was glucose metabolism altered, but the metabolism of amino acids was altered as well. The amino acid metabolism in the new steady-state was more balanced, and the excretion of non-essential amino acids and ammonia was substantially lower. This approach of reaching a more desirable steady-state with higher concentrations of cells and product opens a new avenue for high-density- and high-productivity-cell culture.
Amino Acids↗
Lipoblastoma of the neck.
Lipoblastoma and lipoblastomatosis are benign tumours arising from embryonal fat cells. These rare tumours essentially occur in infancy and early childhood. The males are affected more than females often in the ratio of 3:1. These tumours usually arise in extremities. The involvement of neck is rare with only 10 cases reported so far in English literature. We herein report lipoblastoma of the neck in a 3 year old girl.
Child, Preschool↗
Electrostatic properties of membranes containing acidic lipids and adsorbed basic peptides: theory and experiment.
The interaction of heptalysine with vesicles formed from mixtures of the acidic lipid phosphatidylserine (PS) and the zwitterionic lipid phosphatidylcholine (PC) was examined experimentally and theoretically. Three types of experiments showed that smeared charge theories (e.g., Gouy-Chapman-Stern) underestimate the membrane association when the peptide concentration is high. First, the zeta potential of PC/PS vesicles in 100 mM KCl solution increased more rapidly with heptalysine concentration (14.5 mV per decade) than predicted by a smeared charge theory (6.0 mV per decade). Second, changing the net surface charge density of vesicles by the same amount in two distinct ways produced dramatically different effects: the molar partition coefficient decreased 1000-fold when the mole percentage of PS was decreased from 17% to 4%, but decreased only 10-fold when the peptide concentration was increased to 1 microM. Third, high concentrations of basic peptides reversed the charge on PS and PC/PS vesicles. Calculations based on finite difference solutions to the Poisson-Boltzmann equation applied to atomic models of heptalysine and PC/PS membranes provide a molecular explanation for the observations: a peptide adsorbing to the membrane in the presence of other surface-adsorbed peptides senses a local potential more negative than the average potential. The biological implications of these "discreteness-of-charge" effects are discussed.
2-Naphthylamine↗
Alteration of cellular metabolism by consecutive fed-batch cultures of mammalian cells.
The metabolism of myeloma cells was altered to reduce lactate production in consecutive fed-batch cultures. The glucose concentration was maintained at low levels (0.28-0.55 mM) by employing a dynamic nutrient feeding method based on on-line measurement of the oxygen uptake rate (OUR) to estimate the metabolic demand of the cells. This strategy has been previously reported to be applied to cultures of hybridoma cells, in which the production of lactate was significantly reduced by thus maintaining the glucose concentration at low levels. However, for this cell line, a single fed-batch culture was not sufficient to alter the cellular metabolism, even at a glucose concentration of 0.28 mM. Two consecutive fed-batch cultures were employed to ensure that the cells were cultivated under a low glucose concentration for a sufficiently prolonged period of time to allow a switch of the cellular metabolism from a glycolytic (high lactate production) to oxidative (low lactate production) state.
Journal Article↗
Omphalopagus parasite: a rare congenital anomaly.
Omphalopagus parasite is a very rare congenital anomaly. Presented here is a case in which an extra truncus was attached to an infant in the region of the epigastrium. The truncus had well-formed extremities, an abdomen, and a hypoplastic thorax. The infant had a small omphalocoele in addition to the truncus. Surgery performed in the neonatal period helped to achieve a successful separation of the truncus from the host.
Humans↗
Bowel perforation with Taenia saginata.
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Animals↗
Transients in multivariable dynamical systems depend on which parameter is switched as illustrated in lasers.
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Journal Article↗
Kocher Debre Semelaigne syndrome mimicking primary muscle disease.
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Child, Preschool↗
Porencephaly--a potentially avoidable complication of neonatal meningitis.
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Brain Diseases↗
The problem of transition from the chemical to the biological evolution: some possible solutions.
On the basis of evidence that several low-molecular-weight substances as well as enzymes are compartmentalised within the so-called soluble phase of the cell, and other considerations, it is argued that DNA may not contain information for certain types of organisation found in living cells. It may be necessary for a cell to possess the "non-DNA-controlled" organisation for performance of its minimum functions; such organisation would then also serve as a "template" for its appearance in the daughter cell. The problem of transition from chemical to biological evolution (that is, the formation of the "first cell") may be essentially the problem of emergence of such intracellular organisation for which information may not reside in DNA. Two possible mechanisms through which this may have happened are stated.
Animals↗
Cybernetic modeling and regulation of metabolic pathways in multiple steady states of hybridoma cells.
Hybridoma cells utilize a pair of complementary and partially substitutable substrates, glucose and glutamine, for growth. It has been shown that cellular metabolism shifts under different culture conditions. When those cultures at different metabolic states are switched to a continuous mode, they reach different steady states under the same operating conditions. A cybernetic model was constructed to describe the complementary and partial substitutable nature of substrate utilization. The model successfully predicted the metabolic shift and multiple steady-state behavior. The results are consistent with the experimental observation that the history of the culture affects the resulting steady state.
Cell Culture Techniques↗
Coimmobilization of urease and glutamate dehydrogenase in electrochemically prepared polypyrrole-polyvinyl sulfonate films.
Immobilization of urease and glutamate dehydrogenase enzymes in electrochemically prepared polypyrrole-polyvinyl sulfonate films (PPY-PVS) was carried out using physical adsorption and electrochemical entrapment techniques. Detailed studies on optimum pH, Fourier transform infrared spectroscopy, cyclic voltammetry, and scanning electron microscopy of the enzymes in the immobilized state were conducted. The value of the apparent Michaelis-Menten constant was experimentally determined to be 2.5 and 2.7 for physically adsorbed and electrochemically entrapped urease in PPY-PVS films, respectively.
Biosensing Techniques↗