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Biomedical subjects

A Joshi

Publications and source records attributed to A Joshi.

At least 145 records · Page 8Linked to original sources
PubMed1995

"Quilty" revisited: a 10-year perspective.

The goals of this study were to better define Quilty lesions, facilitating differentiation from other endocardial infiltrates; to correlate Quilty lesions with clinical parameters; and to assess whether classification into Quilty A (noninvasive lesions) and Quilty B (invasive lesions) had clinical utility. Two hundred seventeen adults who received transplants between 1981 and 1987 and 22 children who received transplants between 1981 and 1989 were studied. Allograft survival for over 1 year was the selection criterion. Clinical, angiographic, and biopsy data were reviewed up to 1992, obtaining a minimum follow up of 5 years for adults and 3 years for children. All 7,439 endomyocardial biopsy cases were allotted an International Society for Heart and Lung Transplantation (ISHLT) grade for rejection, and Quilty was classified as Quilty A or B. Quilty was correlated with transplant recipient age and gender, cytomegalovirus and Epstein-Barr virus (EBV) infection, treatment protocols, allograft rejection, graft vascular disease (GVD), and lymphoma. Immunohistochemistry was performed to determine Quilty cell composition. Quilty incidence was 49.77% in adults and 68.18% in children, and did not appear to be influenced by cyclosporine dosage. Quilty showed no gender variation nor association with cytomegalovirus (CMV) or EBV infection or lymphoma. A total of 74.04% of adults developed Quilty within the first year posttransplant and 81.48% had multiple Quilty-positive biopsies. One hundred eight of 217 Quilty-positive adults had 456 Quilty-positive endomyocardial biopsies, 82.24% of which were associated with an ISHLT grade of 0 or I, and only 12.28% being associated with a grade III rejection. Histological division into Quilty A and Quilty B did not appear to have clinical significance. Graft vascular disease appears to have decreased significantly more in Quilty-positive patients. Although our findings in children were similar to those in the adults, we were unable to draw definite conclusions, the number of children being too small to permit valid statistical correlations.

Adolescent↗
PubMed1995

Differential inhibition of platelet aggregation induced by adenosine diphosphate or a thrombin receptor-activating peptide in patients treated with bolus chimeric 7E3 Fab: implications for inhibition of the internal pool of GPIIb/IIIa receptors.

OBJECTIVES: This study sought to describe in detail the pharmacokinetics and pharmacodynamics of chimeric monoclonal 7E3 Fab (c7E3 Fab) and to compare platelet responses to adenosine diphosphate (ADP) and the 11-amino acid thrombin receptor-activating peptide (TRAP [SFLLRNPNDKY-NH2]) in patients undergoing elective coronary angioplasty. BACKGROUND: Inhibition of platelet aggregation with monoclonal antibody c7E3 Fab directed against glycoprotein (GP) IIb/IIIa has been shown to reduce ischemic complications after angioplasty and is being considered for treatment of other acute ischemic syndromes. METHODS: Patients undergoing elective coronary angioplasty received aspirin (325 mg orally), heparin (12,000 U intravenously) and a bolus of c7E3 Fab (0.25 mg/kg body weight). Surface GPIIb/IIIa receptor blockade and aggregation in response to 20 mumol/liter ADP, 5 micrograms/ml collagen and 7.5 and 15 mumol/liter TRAP were assessed. RESULTS: Surface GPIIb/IIIa receptor blockade by c7E3 Fab was 80% 2 h after injection and decreased to 50% at 24 h. Platelet aggregation in response to 20 mumol/liter ADP was inhibited by 73% at 2 h, and this inhibition decreased to 27% at 24 h. Platelet aggregation in response to 7.5 mumol/liter TRAP was inhibited by 53% at 2 h and 30% at 24 h. In contrast, aggregation in response to 15 mumol/liter TRAP was inhibited only 37% at 2 h and 10% at 24 h (p < 0.001 and p = 0.006, respectively vs. 20 mumol/liter ADP). Addition of exogenous c7E3 Fab to platelet-rich plasma led to more complete inhibition of 7.5 mumol/liter TRAP-induced aggregation. CONCLUSIONS: After c7E3 Fab treatment, inhibition of platelet aggregation depends on the agonist and can be overcome by increased thrombin activity but is restored if additional c7E3 Fab is added to block additional GPIIb/IIIa receptors. This phenomenon may be related to an internal pool of GPIIb/IIIa receptors joining the surface membrane and has implications concerning the duration of therapy with c7E3 Fab for patients with unstable angina or acute myocardial infarction.

Abciximab↗
PubMed1995

Dietary models for root caries.

A stepwise multiple logistic regression was computed to assess which of the nutritional variables differentiate the healthy and diseased group of participants in the Forsyth Specialized Caries Center (n = 275). Variables considered as candidates for the model included the consumption per week of sugars, starch, cheese, fruits and fruit juices, noncariogenic foods, and dairy products. Two variables--sugars and cheese--were statistically significant by the stepwise procedure. Increased intake of sugar was associated with being in the root caries group, whereas high intake of cheese was negatively associated with root caries. Thus, cheese seems to have a protective effect after sugar intake is controlled for. Odds ratios were computed to quantify the influence of the variables. An increase of two exposures of sugar per day corresponded with an odds ratio of 1.26. The odds ratio continues to increase with sugar intake so that an increase to five exposures per day gives an odds ratio of 1.79. This model is consistent with past in vitro studies suggesting that cheese protects against caries formation when sugar intake is controlled for and that increasing frequency of sugar intake increases the odds of root caries.

Dairy Products↗
PubMed1995

Relationship of diet to root caries.

A Nutrition and Oral Health Study was conducted on 141 middle-aged and elderly adults (54% female and 46% male; aged 47-83 y, mean = 67; 51% college educated; and 89% white). This study reports on the relationship between root caries and diet. Nutritional composition was derived from two 3-d food diaries. Root caries was measured according to the 1985 Adult Survey Diagnostic Criteria of the National Institute of Dental Research. When the individuals were segregated by their root DFS (decayed and filled surfaces) status into highest (> or = 7) and lowest (< or = 1) quartiles, the sucrose consumption was significantly higher in the higher DFS group. Mean energy consumption and mean number of teeth were the same in both groups. When the individuals were segregated by sucrose consumption into highest (> or = 89 g) and lowest (< or = 31 g) quartiles, DFS root status was significantly higher (P < 0.01) in the highest quartile group (7 g) vs the lowest group (4 g). By using data from subjects with two food diaries, a stepwise-linear-regression model for root caries showed that 4.2% of the variance for root caries was explained by sucrose, 2.8% by plaque, 3.8% by total number of teeth, and 5.6% by gingival recession. These data suggest that root caries has a similar dietary etiology to coronal caries.

Aged↗
PubMed1995

Emblica officinalis: a novel therapy for acute pancreatitis--an experimental study.

Acute necrotising pancreatitis is associated with an unacceptably high mortality for which no satisfactory remedy exists. Emblica officinalis (E.o.) is a plant prescribed in Ayurveda, the Indian traditional system of medicine, for pancreas-related disorders. This study was carried out to evaluate the protective effect of E.o. against acute necrotising pancreatitis in dogs. Pancreatitis was induced by injecting a mixture of trypsin, bile and blood into the duodenal opening of the pancreatic duct. Twenty eight dogs were divided into 4 groups (n = 6-8 each): GpI--control, GpII--acute pancreatitis, GpIII--sham-operated, GpIV--pretreatment with 28 mg E.o./kg/day for 15 days before inducing pancreatitis. Serum amylase increased from 541.99 +/- 129.13 IU/ml to 1592.63 +/- 327.83 IU (p <0.02) 2 hrs after the induction of pancreatitis in GpII. The rise in serum amylase in both GpIII and GpIV was not significant. On light microscopic examination, acinar cell damage was less and the total inflammatory score was significantly lower in the E.o. treated group as compared to GpII. Electron microscopy confirmed this and showed an increased amount of smooth endoplasmic reticulum and small, condensed granules embedded in a vacuole. More studies are needed to explore the clinical potential of E.o. and its mechanism of action.

Acute Disease↗
PubMed1995

Leiomyosarcoma of the duodenum.

Leiomyosarcoma of the duodenum is a rare tumor. These tumors manifest with unexplained melena, anemia and sometimes partial duodenal obstruction. Diagnosis is difficult on account of inaccessibility for biopsy. Treatment involves excision of the duodenum with reconstruction, a difficult task with high morbidity and mortality. However, if the tumor is successfully treated, its prognosis is usually good because of its non-aggressive nature.

Duodenal Neoplasms↗
PubMed1995

Helicobacter pylori gastritis masquerading as gastric lymphoma.

A 30-year-old man presented with acute acid-peptic symptoms. Endoscopy and radiological studies revealed generalized thickening of gastric folds with multiple superficial ulcerations and infiltration of the distal stomach simulating gastric neoplasm. Endoscopic biopsies revealed acute gastritis with foveolar hypertrophy with numerous Helicobacter pylori. The symptoms and endoscopy findings resolved completely with combination triple-drug therapy for H pylori.

Adult↗
PubMed1994

Human immunodeficiency viruses regulated by alternative trans-activators: genetic evidence for a novel non-transcriptional function of Tat in virion infectivity.

Thirteen genetically altered HIV-1 proviruses were created. These various genomes can be segregated into three groups: (i) a set of tat(-) viruses that have a functional HTLV-I Tax inserted in nef; (ii) a set of tat(-) viruses with Gal4 binding sites inserted in U3 and a Gal4-VP16 cDNA inserted in nef; and (iii) a set of tat(+) HIV genomes that are 5' and 3' TAR(-) and are Gal4-binding-site(+) in U3 and Gal4-VP16(+) in nef. We found that viruses in groups (i) and (ii), although tat(-), were fully complemented for viral gene expression based on quantitative measurements of viral protein synthesis and on the visualization by electron microscopy of the proper assembly of morphologically correct virions. Interestingly, group (i) and (ii) virions were defective in a spreading cytopathic infection when assayed in T-lymphocytes. Group (iii) viruses, although capable of producing intact Tat protein, also could not use Tat for transcription/gene expression because of the TAR(-) genotype. However, this class of viral genomes produced viruses that were highly infectious and cytopathic in primary and in continuously propagated T-lymphocytes. These three groups of viruses are all transcriptionally Tat-TAR independent. Their distinct differences in infectivity/cytopathicity provide genetic evidence that Tat provides a transcriptionally independent function in determining infectivity and cytopathicity in the setting of a spreading viral infection. Given that all HIV virions normally contain four intact copies of TAR RNA, our findings suggest a re-examination of whether Tat could be a virion-TAR-associated protein and the possible implications of this for virus infectivity/cytopathicity.

Base Sequence↗
PubMed1994

A 150-kDa molecule of macrophage membrane stimulates interleukin-2 and interferon-gamma production and proliferation of ovalbumin-specific CD4+ T cells.

In the present study, we describe the potential co-stimulatory role of a macrophage membrane-associated protein of 150 kDa (M150). The protein was isolated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and was found to be a single molecule on two-dimensional gel electrophoresis. The molecule was re-constituted in phosphatidyl choline vesicles and tested for its ability to promote the proliferation and the secretion of lymphokines from T helper (Th) cells. The reconstituted M150 induced a significant proliferation of anti-CD3 monoclonal antibody (mAb)-stimulated ovalbumin-specific CD4+ T cells. Further, Th cells activated with this molecule in the presence of anti-CD3 mAb mainly secreted interleukin (IL)-2 and interferon-gamma but not IL-4. M150 could not promote the proliferation of Th cells, or lymphokine secretion in the absence of anti-CD3 mAb. These observations suggest that M150 acts by selectively activating a Th1-like immune response.

Animals↗
PubMed1994

Microparticulates for ophthalmic drug delivery.

Microparticulates are drug-containing small polymeric particles (erodible, non-erodible or ion-exchange resins) that are suspended in a liquid carrier medium. Upon administration of particle suspension in the eye, the particles reside at the delivery site (cul-de-sac, sub conjunctiva or vitreous cavity) and the drug is released from the particles through diffusion, chemical reaction, polymer degradation, or ion-exchange mechanism. Several distinct approaches have been used to formulate drugs in microparticulate dosage form for intraocular and topical application. These include erodible microparticulates, swelling mucoadhesive particulates, pH responsive microparticulates, nanoparticles/latex systems, ion-exchange resins, etc. Injection of bioerodible microparticulates in the vitreous for treating infections of posterior segment and the release of acceptable levels of drug up to two weeks has been demonstrated. Both corneal and non-corneal routes of drug entry in the eye from topical instillations are postulated. The in vitro and in vivo studies have shown that this dosage form holds great promise for sustained drug release in the eye. However, several formulation challenges, including production of stable suspensions, uniform dose per unit volume, efficient drug entrapment, reproducible and large scale manufacturing, uniform particle size, etc., have to be addressed. Fruitful resolution of technological challenges will result in a superior dosage form for both topical and intraocular ophthalmic application. Recent developments and future challenges of microparticulate ophthalmic drug delivery system are discussed in this review.

Administration, Topical↗
PubMed1994

The distribution of root caries in community-dwelling elders in New England.

An in-home examination of a probability sample of elders aged 70 and older living in the six New England states was conducted to estimate the prevalence and extent of root caries. Oral examinations were conducted by the visual-tactile method using a portable lamp, explorer, and a mouth mirror. Fifty-two percent of the study participants showed root caries experience and 22 percent had untreated root caries. In contrast to previous studies, this analysis showed that buccal root surfaces were no more likely than proximal surfaces to be affected by root caries. Logistic regression analysis showed that gingival recession and number of teeth were positively associated with root caries, while better oral hygiene maintenance and regular dental visits were negatively associated with root caries lesions (all factors: P < .05). The prevalence of root caries was found to increase with higher numbers of teeth except for a minority subgroup--i.e., those who retained 25 or more teeth. This study provides much-needed data on prevalence and extent of root caries in a probability sample of the oldest old in an entire region of the United States.

Age Distribution↗
PubMed1994

Aortic cobwebs: an anatomic marker identifying the false lumen in aortic dissection--imaging and pathologic correlation.

PURPOSE: To describe and estimate the frequency of fibroelastic cords or bands projecting from the false lumen wall ("aortic cobwebs") in acute and chronic dissections. MATERIALS AND METHODS: Pathologic specimens (n = 23), routine magnetic resonance (MR) images (n = 27), and intravascular (n = 5) and transesophageal (n = 3) ultrasound (US) images from 43 patients with aortic dissection were reviewed, and the presence and configuration of cobwebs were noted. RESULTS: Aortic cobwebs usually bridge the junction of the dissection flap with the outer wall of the false lumen (the line of dissection) but occasionally project like small tendrils from the false lumen wall remote from the line of dissection. Cobwebs were found in 17 of 23 pathologic specimens and on six of 27 MR images, two of five intravascular US scans, and one of three transesophageal US scans. CONCLUSION: Aortic cobwebs most likely represent residual ribbons of media that have been incompletely sheared from the aortic wall during the dissection process. As such, they can serve as an anatomic marker of the false lumen. They are occasionally seen on routine aortic images and may, therefore, prove useful for orientation during percutaneous or surgical interventional procedures to relieve ischemic complications of aortic dissection.

Aortic Dissection↗