Biomedical subjects

A Raji

Publications and source records attributed to A Raji.

At least 19 recordsLinked to original sources

PubMed2006

Prevalence of primary hyperaldosteronism in mild to moderate hypertension without hypokalaemia.

Screening for primary hyperaldosteronism (PHA) is often indicated in individuals with resistant hypertension or hypokalaemia. However, in the far larger subset of the hypertensive population who do not fit into these criteria, the evidence for screening is conflicting and dependent on the disease prevalence. The purpose of this study was to examine the prevalence of PHA in a large population with mild to moderate hypertension and without hypokalaemia using a carefully controlled study protocol including a normotensive control population. Hypertensive subjects underwent medication washout and both hypertensive and normotensive subjects placed on a high-sodium diet prior to biochemical and haemodynamic testing. Study specific cutoff values were based on results from the normotensive population studied under identical conditions. A screening test (serum aldosterone/PRA ratio [ARR]>25 with a serum aldosterone level >8 ng/dl) was followed by a confirmatory test (urine aldosterone excretion rate [AER] >17 microg/24 h) to demonstrate evidence of PHA. An elevated ARR with a concomitant elevated serum aldosterone was present in 26 (7.5%) individuals. Of these, 11 (3.2%) had an elevated AER, consistent with evidence of PHA. Individuals with PHA had higher blood pressure and lower serum potassium levels while on a high-sodium diet. Sodium restriction neutralized these differences between PHA and essential hypertensives. The prevalence of PHA in this mild to moderate hypertensive population without hypokalaemia is at most 3.2%, a rate that might lead to excessive false positives with random screening in comparable populations. Hyperaldosteronism, when present, is responsive to sodium restriction.

Aldosterone↗

PubMed2006

Effect of pioglitazone on insulin sensitivity, vascular function and cardiovascular inflammatory markers in insulin-resistant non-diabetic Asian Indians.

AIMS: To determine the effects of pioglitazone (30 mg once daily for 16 weeks) on insulin sensitivity, insulin-mediated vasodilation, vascular inflammatory markers, fat distribution and lipids in Asian Indians and Caucasians of European ancestry. METHODS: Cross-sectional study. Eighteen non-diabetic Asian Indians and 17 Caucasians of comparable age (34 +/- 3 vs. 36 +/- 3 years) and body mass index (26.0 +/- 1.2 vs. 24.7 +/- 1.0 kg/m(2)) had measurements of insulin sensitivity (M, insulin clamp at 6 pmol/kg per min), abdominal fat (computed tomographic scan at L4-L5), endothelial-dependent (reactive hyperaemia, RH) and -independent (0.4 mg sublingual nitroglycerin, TNG) vasodilation using brachial artery ultrasound before and after the 2-h clamp at baseline and after pioglitazone therapy. RESULTS: Asian Indians were insulin resistant compared with Causasians during the baseline clamp (M = 25.6 +/- 1.7 vs. 41.1 +/- 2.2 micromol/kg per min, P < 0.0001) and improved significantly after pioglitazone (to 33.9 +/- 1.7 micromol/kg per min, P < 0.001). Vasodilatory responses to RH and TNG were similar in Asian Indians and Caucasians at baseline and did not change. Insulin-mediated vasodilation improved after pioglitazone in Asian Indians, but not in Caucasians, and correlated with the change in insulin sensitivity (r = 0.52, P = 0.03). C-reactive protein (CRP) was higher in Asian Indians vs. Caucasians (1.6 +/- 0.4 vs. 0.9 +/- 0.2 mg/l) and was negatively correlated with insulin sensitivity (r = -0.53, P = 0.02). In the Asian Indian group, CRP and plasminogen activator inhibitor-1 decreased and adiponectin increased after pioglitazone, but there were no significant changes in total or visceral fat. CONCLUSIONS: These results demonstrate that insulin-resistant Asian Indians respond favourably to an insulin sensitizer with improvements in insulin sensitivity, cardiovascular and inflammatory risk markers, and vascular responses to insulin. These agents may have a role in decreasing the risk of diabetes and cardiovascular disease in this high-risk population.

Adipose Tissue↗

PubMed2004

Clusterin as a possible predictor for biochemical recurrence of prostate cancer following radical prostatectomy with intermediate Gleason scores: a preliminary report.

Disease recurrence following radical prostatectomy is a major concern in prostate cancer patients. Gleason scores are useful in predicting recurrence. Low Gleason scores are usually associated with long disease-free intervals, while high Gleason scores are suggestive of early recurrence. However, prediction of recurrence has been difficult with intermediate Gleason scores. Clusterin is a ubiquitous secretory sulfated glycoprotein. It is also an antiapoptotic mediator in prostate cancer. The objective of the present study is to determine if clusterin can serve as a predictive biomarker for recurrence of prostate cancer with intermediate Gleason scores in patients following radical prostatectomy. Prostatic specimens with Gleason score of 6 (3+3) or 7 (3+4) were obtained from the archival bank. Three groups of specimens were investigated. The first group was from nine patients who developed recurrent disease according to a persistent rise of serum PSA within 3 years following radical prostatectomy. Those in the second group and the third group were from patients who showed no evidence of disease recurrence for at least 5 y (11 patients) and 10 y (eight patients), respectively following the surgery. Histological sections were subjected to immunohistochemical staining using a monoclonal antibody specific for clusterin. The staining intensity was scored as 0, 1, 2, and 3, with 0 being no staining, 1 showing less than 25% positive staining, 2 being 25-50% positive, and 3 showing greater than 75% positive staining. One-way ANOVA with Bonferroni correction was used for statistical analysis. Evaluation of the scores of clusterin staining was carried out according to four specific areas in each specimen. They were (a) benign epithelial cells, (b) malignant epithelial cells (cancer epithelia), (c) stromal cells surrounding benign cells, and (d) stromal cells surrounding malignant cells (cancer stroma). Staining score in prostatic epithelial cells, benign as well as malignant, showed no significant relationship among the three patient groups. However, when staining scores in stromal cells were compared, there was a significant difference between patients with recurrent disease and those showed no evidence of disease recurrence for at least 10 y. Results of this preliminary study support the important role of clusterin in the stromal component for prostate cancer progression. Clusterin immunostaining may be useful to aid the prediction of chance of disease recurrence in patients with Gleason score 6 or 7 prostate cancer following radical prostatectomy. Further studies with a large number of cases are warranted to verify this preliminary finding.

Biomarkers, Tumor↗

PubMed2002

[Mandibular metastasis revealing thyroid carcinoma. Two cases].

Although thyroid cancer is not the first cause of bone metastases, this diagnosis must be always entertained because when it is found to be the cause of the metastasis, the survival is good. Bone metastases can take on different appearances and thyroid cancer discovered secondarily. We report two cases of mandibular metastases revealing a thyroid cancer and we stress on diagnosis and therapeutic difficulties.

Angiography↗

PubMed2002

[Cervicofacial lymphangioma in adults (10 case reports)].

INTRODUCTION: Cystic cervico-facial lymphangioma (DDFL) are relatively rare. Because of their size and site, they pose a real problem in treatment. The authors present a retrospective study about 10 cases. MATERIALS & METHODS: The mean age of this series of patients was 31 years, with a slight female preponderance. Ultrasound scanning is sufficient to establish the diagnosis. CT or MRI scan helps to show whether there is parapharyngeal or mediastinal extension. RESULTS: Every patient in this series underwent operation. We had one recurrence and two postoperative neurological sequelae. DISCUSSION: Although there is little difficulty in the diagnosis of this condition, it is difficult to treat because of extension which involve the face, the floor of mouth and tongue base, and also the major structures in neck. Current interest is centred on treating these lesions with sclerosis agents, either for recurrence or, according to some authors, as a first therapeutic option.

Adult↗

PubMed2001

Insulin resistance in hypertensives: effect of salt sensitivity, renin status and sodium intake.

OBJECTIVE: Homeostasis Model Assessment (HOMA index) is predictive of insulin sensitivity in normal and diabetic patients. This study was designed to see if insulin resistance in hypertensives, measured using the HOMA index, differs, based on salt sensitivity, renin status and sodium intake. METHODS: Fasting insulin and glucose were determined in subsets of 426 essential hypertensives, and normotensives. HOMA was calculated as fasting glucose (mmol) x fasting insulin (muU/ml)/22.5. RESULTS: Four hundred and twenty-six essential hypertensives and normotensives from four HERMES centers form the basis of this report. There was no difference in the HOMA index between hypertensives and normotensives (P= 0.291) or between hypertensives grouped according to blood pressure salt sensitivity (P = 0.153). However, when essential hypertensives were subgrouped by renin status, the low-renin group had significantly lower (P< 0.01) HOMA index than the normal/high-renin group. When normal/high-renin group was divided into modulators and non-modulators, the nonmodulators had significantly higher HOMA index (P< 0.001) than other hypertensive subsets. The effect of sodium intake on the HOMA index was significant only for non-modulators (P< 0.002), with salt restriction increasing insulin resistance. CONCLUSION: Insulin sensitivity differs among subsets of essential hypertension, non-modulators being most insulin resistant and the low-renin subset insulin sensitive. Salt restriction might have an adverse effect on insulin sensitivity in non-modulators. The reduction in cardiovascular risk seen in low-renin hypertensives may be related to their increased insulin sensitivity; in contrast, the clustering of cardiovascular risk factors seen in nonmodulators may be due to increased insulin resistance.

Adult↗

PubMed2001

Body fat distribution and insulin resistance in healthy Asian Indians and Caucasians.

Previous studies have shown that Asian Indians (AIs) are insulin resistant and at high risk for developing diabetes and coronary heart disease, compared with Caucasians. To examine whether differences in body fat distribution contribute to this risk, 12 healthy AIs and 12 Caucasians matched for age and body mass index (BMI) underwent a 75-g oral glucose tolerance test, 2-h euglycemic hyperinsulinemic clamp, abdominal (L2-3) computed tomography scan, and fasting lipid and plasminogen activator inhibitor-1 (PAI-1) levels. Despite similar fasting plasma glucose levels, AIs exhibited fasting hyperinsulinemia (P = 0.001), higher glucose (P = 0.03) and insulin (P = 0.004) levels during the oral glucose tolerance test, and reduced glucose disposal rate (R(d)) (4.7 +/- 0.4 vs. 7.5 +/- 0.3 mg/kg per min, P < 0.0001) during the clamp. AIs had significantly lower high-density lipoprotein, higher low-density lipoprotein, and significantly higher PAI-1 levels (P = 0.01). Despite similar BMI, AIs had significantly greater total abdominal fat (P = 0.04) and visceral fat (P = 0.04). In all subjects, measures of fat mass were inversely correlated with R(d) during the clamp (r = -0.47 to -0.61, P < 0.01-0.001). Visceral fat mass was correlated with triglycerides, low-density lipoprotein, and high-density lipoprotein (P < 0.002-0.0001). PAI-1 was inversely correlated with R(d) in AIs (r = -0.70, P < 0.01) and not in Caucasians (r = -0.24, P = 0.44). For comparable BMI and age, healthy AIs have physiologic markers for insulin resistance, dyslipidemia, and increased cardiovascular risk, compared with Caucasians. Alterations in body fat distribution--particularly increased visceral fat--may contribute to these abnormalities.

Adipose Tissue↗

PubMed2001

[Laryngeal tuberculosis: apropos of 15 cases].

Based on a retrospective study over a six year period, we report 15 cases of tuberculosis of the larynx, confirmed histologically. Dysphonia was the main symptom. The diagnosis rests on direct laryngoscopy and biopsy, with histology. Medical treatment achieves a good outcome.

Adult↗

PubMed2001

[Unusual benign tumors of the larynx: report of 17 cases].

Rare benign tumours of the larynx (RBTL) form a heterogeneous group. The clinical picture is non-specific. Based on a series of 17 cases of RBTL treated in our department, we wish to draw attention to the diagnosis, treatment and clinical course of these tumours. The mean age of the patients was 37 years, with the male sex predominating. The presenting symptom was most commonly progressive dysphonia, while 5 patients were admitted in respiratory distress. Examination and special investigations revealed 8 cases of laryngocoele, 6 cases of angioma, 2 cases of schwannoma, and one of chondroma. Treatment was surgical, by an external approach in 10 cases and endoscopically in 7. The postoperative course was satisfactory. No long-term recurrences were encountered. Conservative surgery by an external or endoscopic approach has revolutionised the functional outcome in these benign tumours.

Adult↗

PubMed2000

The antrochoanal polyp.

The antrochoanal polyp is a particular pathology of nasal fossae and sinuses. Since the first description made by Killian, several pathogenic mechanisms and surgical techniques have been reported. The polyp exeresis is classically made using the Caldwell-Luc approach. The aim of our study is to lay stress on the interest of endonasal surgery compared to other surgical procedures. Between 1996 and 1998, we operated on 12 cases by endonasal approach. Diagnosis is made upon clinical, CT-scan and pathological data. In all cases, an extended middle meatotomy is performed. In 3 cases, it is associated with an inferior meatotomy. The polyp pedicle is systematically coagulated at level of its maxillary implantation area. No recurrence, nor operative complication are noted. The average follow-up is 12 months.

Adolescent↗

PubMed2000

[Endonasal surgery: results of surgery of ethmoido-frontal mucoceles].

The intranasal approach for mucoceles of the sinuses represents an advance in the techniques of sinus surgery. The object of our study is to show the value of this type of surgery by reviewing 16 cases of fronto-ethmoidal mucoceles undergoing surgery in our department. The approach was purely intranasal. Surgery consisted of wide marsupialisation of the nasal cavities. The immediate postoperative progress was good. There were no complication in this series; neither was there any recurrence. The follow up period was from 3 months to 5 years. As the follow-up period was too short in some of the cases, no firm conclusions can be drawn. Yet despite this limitation, it seems that the intranasal approach is to be preferred in dealing with mucoceles of the sinuses.

Adolescent↗

PubMed1998

[Parotid tumors: a report of 120 cases].

The treatment of the parotid tumors was clarified for a majority of the tumors, in spite of her histology diversity. The authors report in a retrospective study 120 cases of a parotid gland tumors during ten years over. They insist on the difficult of therapeutics, the histological diversity and the complications and sequelles of the surgery. The diagnosis was especially clinical and completed by scan and or a sialography. The superficial or total parotidectomy with preservation of facial nerve was realized in eighty-nine percent. The functional courage and the radiotherapy were associated respectively in eleven and seventeen patients. The histology was dominated by the benign tumors. The complications and sequelles were a facial paralysis definitive and a Frey's syndrome respectively in three percent cases. The ninety-seven percent patients were controlled with a mean follow up of three years. After results we must know every histologic type for to adapt his treatment. And the same complications and the sequelles were noted in all surgery type.

Adenocarcinoma↗

PubMed1997

[Repair of substance losses of the nose: apropos of 45 cases].

The authors report 45 cases of tissue loss in the nose, in most cases secondary to cancer ablation, and in a few (2 cases) to trauma. The reconstructive techniques were mainly the classical ones using local flaps, usually at the same time as the tumour removal. Where the reconstruction was a total one, this involved the use of a compound extended Converse flap, which has the advantage of bringing in sufficient tissue associated with the bone graft, and also avoids the risks of thinning or exposure of the graft. The indications depend on anatomical factors, and on the extent and depth of the tissue loss. The cospetic results are very satisfactory, but it is necessary to revise the flaps in order to obtain the best final results.

Adolescent↗

PubMed1996

[Mandibular reconstruction in benign tumors of the mandible].

The authors report ten cases of reconstruction in the mandibular interrupter substance wast after excision of the large benign tumors which dominated by ameloblastoma. The reparation is realised by free no vascularized bone graft, of ten with the iliac crest, rarely with costochondral graft. The lateral mandibular interrupter substance waste concerning the temporo-mandibular joint (type III) is frequent. The reparation often immediate, is realised by the iliac crest graft fixed to mandibular stump with miniatures plaques and intermaxillar blocking. The fonctioning and morphology results in majority is qualified to be mean with a follow-up between 14 and 24 months.

Bone Transplantation↗

PubMed1995

[Paranasal sinus mucocele].

A retrospective study of 25 sinuses mucoceles over a ten year period is presented. The authors insist on epidemics and diagnostics characteristics of this pathology and discuss the various therapeutics means.

Adolescent↗

PubMed1995

[Apropos of an uncommon disease of the larynx: pyolaryngocele].

The laryngopyocele is a rare complication of laryngocele. About one case of laryngopyocele and review of literature, the authors recall the main characteristics of this affection. Its clinical picture is often alarming. The CT scan, not often made emmergenceley, give a characteristic image. The treatment is mainly surgical but also endoscopic, then facilitated by the use of laser. The fact of thinking to this diagnosis toward a laryngeal dyspnea with fever permit sometimes to avoid tracheotomy then usually made emmergencely.

Adult↗

PubMed1994

Synthesis, turnover, and release of peptides from the neurohypophysis of the Jerboa Jaculus orientalis.

Peptide contents of neural lobes from adult jerboas (Jaculus orientalis) under different states of hydration were determined by radioimmunoassay. The amounts of vasopressin, oxytocin, and their associated neurophysins in animals dehydrated for up to 4 weeks were not significantly different from those of controls. The different neurohypophyseal peptide were separated on two different types of gradient using reverse-phase high-performance liquid chromatography. The shape of the chromatograms suggests that, in contrast to the case of the rat, for which only three types of neurophysins have been shown, there are, in jerboa, many subspecies of neurophysins. This was also shown using two-dimensional electrophoresis. Injection of [35S]cysteine into the supraoptic nucleus followed by HPLC of extracts from the neural lobes from animals under different states of dehydration showed that the labeled material is not released any faster in dehydrated animals than in controls. Labeled vasopressin, oxytocin, and neurophysins could still be detected by HPLC 4 weeks after injection. Neural lobes from animals injected with [35S]cysteine were perfused in vitro and the release of neuropeptides was triggered by bursts of electrical pulses and also by K(+)-induced depolarization. The amplitude of the rate constant for release and the amounts of vasopressin and of radiolabeled material released were similar in animals dehydrated for up to 3 weeks and in controls. Under physiological conditions similar to those that would be expected to occur in their natural habitat, the jerboas appear to have a hypothalamoneurohypophyseal system which is down-regulated.

Animals↗

PubMed1994

Stimulus-secretion coupling in the neurohypophysis of the jerboa Jaculus orientalis.

1. In many mammals, severe dehydration is known to cause exhaustion of the vasopressin content of the neural lobe. Here, we have examined the physiological state of the neurohypophysis of the jerboa Jaculus orientalis, a rodent inhabitant of a semi-desert climate. 2. Isolated neurohypophyses and neurosecretory nerve endings were perfused in vitro and vasopressin and oxytocin release were determined by radioimmunoassay. 3. Electrical stimulation of the neurohypophysis with bursts of pulses mimicking the activity of hypersecreting neuroendocrine neurones induced similar increases of secretion in both control animals and animals dehydrated for up to 2 months. Neurohormone release was greatly potentiated when the bursts of pulses were separated by silent intervals. 4. Prolonged stimulation of neurohypophyses from both control and dehydrated animals induced a sustained increase of vasopressin release; in contrast, oxytocin release under similar conditions showed a biphasic secretory pattern consisting of a transient increase that subsequently decreased to a steady level whose amplitude was similar to that for vasopressin. 5. K(+)-induced secretion was largely inhibited by the Ca2+ channel blockers nicardipine and omega-conotoxin, suggesting that in this neurosecretory system both L- and N-type calcium channels play a major role in stimulus-secretion coupling. Depolarization of isolated nerve endings using a fast-flow perifusion system showed that there was no difference in the amplitude and the time course of the secretory response in dehydrated and hydrated animals. 6. The results demonstrate that, despite the climatic conditions in which the jerboas live, their neural lobes retain the capacity to release, upon depolarization of the plasma membrane of the nerve endings, large amounts of neurohormone. It is concluded that the neurohypophyseal peptidergic release system in the dehydrated jerboa functions adequately even under extreme environmental stress.

Animals↗