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Biomedical subjects

H R Patel

Publications and source records attributed to H R Patel.

At least 19 recordsLinked to original sources
PubMed2006

The expression of xenobiotic-metabolizing enzymes in human prostate and in prostate epithelial cells (PECs) derived from primary cultures.

BACKGROUND: Dietary heterocyclic amines (HCAs) are carcinogenic in rodent prostate requiring activation by enzymes such as cytochrome P450 (CYP) and N-acetyltransferase (NAT). METHODS: We investigated by Western blotting and immunohistochemistry the expression of CYP1A1, CYP1A2, and NAT1 in human prostate and in prostate epithelial cells (PECs) derived from primary cultures and tested their ability to activate the dietary carcinogen 2-amino-3-methylimidazo[4,5-f]quinoline (IQ) and its N-hydroxy metabolite (N-OH-IQ) to DNA-damaging moieties. RESULTS: Western blotting identified CYP1A1, CYP1A2, and NAT1. Immunohistochemistry localized NAT1 to the cytoplasm of PECs. Inter-individual variation was observed in the expression levels of CYP1A1, 1A2, and NAT1 (11, 75, and 35-fold, respectively). PECs expressed CYP1A1 and NAT1 but not CYP1A2. When incubated with IQ or N-OH-IQ, PECs formed DNA adducts indicating their ability to metabolically activate these compounds. CONCLUSIONS: Prostate cells possess the capacity to activate dietary carcinogens. PECs may provide a useful model system to study their role in prostate carcinogenesis.

Arylamine N-Acetyltransferase↗
PubMed2004

Do we need to perform cystoscopy on all adults attending urology centres as outpatients?

INTRODUCTION: There has been considerable expansion in the use of flexible cystoscopy (FC) and people who can perform the procedure. Hence, there is a criticism that this procedure is being overused with no management benefit. MATERIALS AND METHODS: We audited the use of FC in a district hospital for a period of 1 year. The results of FC for non-standard indications (other than haematuria and check cystoscopy) were analysed for their diagnostic yield. RESULTS: Of the 1,390 FCs performed, 295 were done for non-standard indications. 46.14% of these cystoscopies had positive findings. Cancer detection rate was 6.10%. Cystoscopy altered the management in 14.08% of patients and was supportive to diagnosis and management in 32.06%. CONCLUSION: This procedure is certainly not overused and the ever-increasing requirement of this simple procedure has serious resource implications for the National Health Service.

Adult↗
PubMed2003

The patient's dilemma: prostate cancer treatment choices.

PURPOSE: We summarize the literature addressing factors that influence treatment decisions made by men with prostate cancer. MATERIALS AND METHODS: A MEDLINE search of the English language literature published between 1969 and 2000, using the combined MESH key words "prostatic neoplasms," "patient participation," "Internet" and "decision making," generated 181 abstracts. Only 23 of these publications addressed factors influencing treatment decisions made by men with prostate cancer. Nine additional relevant studies were identified from references in the original 23 articles. Subsequently a search for the term "prostate cancer" using several popular Internet search engines yielded more than 1 million hits. A further search was performed using the key words "prostate cancer" and "prostate" within on-line archives of the United Kingdom television channels BBC, ITV, and channels 4 and 5, and newspapers The Sun, The Daily Mail, The Observer, The Guardian and The Times. RESULTS: When there is poor quality evidence or little professional consensus to support a particular treatment over another, no clinical guidelines regarding treatment are possible. Patients are faced with a series of options, and the data reveal that the process of choosing between these options is based on input from a large number of sources. These sources differ in the way that benefits of treatment are emphasized over harms and vice versa. We identified little evidence regarding which type of input exerts the greatest influence on patients. It may be that the sources associated with the most bias have the greatest influence. CONCLUSIONS: There is a paucity of information on how patients with prostate cancer use different types of input in the treatment decision making process. The physician, as principal caregiver, still appears to have the most direct influence on patient choice. Just how long this status will continue is uncertain.

Compact Disks↗
PubMed2003

Testicular torsion: a twist to the tale.

Testicular torsion is a surgical emergency that requires prompt exploration if testicular viability is to be maintained. Although rare, it is essential to be aware that it may occur despite previous fixation (orchidopexy). Testicular torsion occurring after previous orchidopexy is rare, but recognition of this possibility is essential to prevent testicular infarction and subsequent orchidectomy. During scrotal exploration a wide variety of methods for orchidopexy exist. We present a case of testicular torsion despite previous fixation and discuss the merits of various techniques available for orchidopexy.

Acute Disease↗
PubMed2001

The hormone resistin links obesity to diabetes.

Diabetes mellitus is a chronic disease that leads to complications including heart disease, stroke, kidney failure, blindness and nerve damage. Type 2 diabetes, characterized by target-tissue resistance to insulin, is epidemic in industrialized societies and is strongly associated with obesity; however, the mechanism by which increased adiposity causes insulin resistance is unclear. Here we show that adipocytes secrete a unique signalling molecule, which we have named resistin (for resistance to insulin). Circulating resistin levels are decreased by the anti-diabetic drug rosiglitazone, and increased in diet-induced and genetic forms of obesity. Administration of anti-resistin antibody improves blood sugar and insulin action in mice with diet-induced obesity. Moreover, treatment of normal mice with recombinant resistin impairs glucose tolerance and insulin action. Insulin-stimulated glucose uptake by adipocytes is enhanced by neutralization of resistin and is reduced by resistin treatment. Resistin is thus a hormone that potentially links obesity to diabetes.

3T3 Cells↗
PubMed2001

The self-expanding metallic ureteric stent in the long-term management of benign ureteric strictures.

OBJECTIVE: To evaluate and assess the long-term complications of using the thermo-expandable, nickel-titanium alloy stent (Memokath 051, Engineers & Doctors A/S, Hornbaek, Denmark) for managing benign ureteric strictures. PATIENTS AND METHODS: Over a 3-year period, 13 Memokath stents were inserted in 11 patients (mean age 58 years, range 35-85) with 12 lower ureteric strictures. The cause of the stricture was benign in all cases, i.e. radiation fibrosis in three, retroperitoneal fibrosis, ischaemic uretero-ileal anastomosis and scarring after ureteroscopy in two each, and diathermy damage, extraluminal endometriosis and stone passage in one each. Four stents were 9 F with proximal expansion to 17 F and the other nine used were 10.5 F with proximal expansion to 20 F. The patients were followed for a mean (range) of 18 (1.5-33) months. RESULTS: No complications or side-effects occurred with nine stents; four stents were removed at a mean (range) of 16.3 (4-33) months. Three of these had become encrusted, two of which had been placed in patients who had either a history of stone disease or recurrent urinary tract infection. The other stent had migrated. CONCLUSION: The Memokath stent appears to have a useful role in managing benign ureteric strictures, but it must be closely monitored in patients who are predisposed to encrustation.

Adult↗
PubMed2001

Calcified seminal vesicles and vasa deferentia: "beware or be aware".

Calcification of the seminal vesicles and vasa deferentia is rare. Only the second idiopathic case recorded is presented herein. This case highlights the need to exclude serious, but treatable diseases associated with this condition, which are not generally considered on initial presentation.

Calcinosis↗
PubMed2001

High prevalence of G6PD deficiency in Vataliya Prajapati community in western India.

OBJECTIVE: Sporadic cases of drug-induced haemolytic anaemia due to glucose-6-phosphate dehydrogenase (G6PD) deficiency in patients belonging to Vataliya Prajapati community prompted us to study the prevalence of G6PD deficiency in the community. METHODS: Screening for G6PD deficiency was carried out using the dichlorophenol-indophenol (DPIP) dye decolorization method. RESULTS: A total of 471 individuals were screened. Of these, 385 unrelated individuals were considered to calculate the prevalence of G6PD deficiency. Among 272 unrelated males, 76 persons (27.94%) and among 113 unrelated females, 11 individuals (9.73%) were found to be G6PD deficient. A quantitative assay on 41 of the G6PD deficient samples showed the enzyme activity ranged from 0-0.5 unit/ml RBC/min. CONCLUSION: The prevalence of G6PD deficiency in Vataliya Prajapatis community was found to be the highest ever reported in the Indian caste-groups population studied so far.

Anemia, Hemolytic↗
PubMed2001

The urinary catheter: 'a-voiding catastrophe'.

A quarter of all patients admitted to hospital are catheterized. This is associated with significant morbidity and occasional mortality. This article reviews the risks of urinary catheterization and suggests preventative measures.

Aged↗
PubMed2001

Adrenal masses: the investigation and management of adrenal incidentalomas.

Most general surgeons will face at sometime in their career an 'incidentaloma' of the adrenal gland. How should a surgeon approach an incidentaloma found during routine investigation for other unrelated disease processes? This paper discusses the investigation and management of adrenal incidentalomas and includes guidelines for the non-specialist.

Adrenal Gland Neoplasms↗
PubMed2000

Effect of acute administration of isoproterenol on submandibular salivary gland of female rat.

The functions of salivary glands are under the regulation of both sympathetic as well as parasympathetic nerve fibers. Further, it has also been demonstrated that chronic administration of a beta-adrenergic agonist isoproterenol (IPR) results in hypertrophy and hyperplasia of submandibular gland [Schneyer C A, Am J Physiol, 203 (1962) 232]. Specific purpose of the present attempt was to look for metabolic responses of submandibular gland of oestrous female rats at very short intervals after 10 min of administration of 5, 10 and 15 micrograms of IPR to females in oestrous condition; pharmacological action and clearance time being only 8 min. The results indicated significant reduction in case of enzymic activities of phosphorylase, total ATPase and Na(+)-K+ ATPase. Cyclic AMP-specific phosphodiesterase and succinate dehydrogenase activities were suppressed only with 5 micrograms dose, but with rising dose levels the effect was not so apparent. Protein content of the gland was reduced slightly by administration of IPR. Hence, it became clear that submandibular gland responds rapidly to IPR administration. Implications of these observations are discussed.

3',5'-Cyclic-AMP Phosphodiesterases↗
PubMed1999

Expression of growth regulatory genes in a SCID mouse-human model of intestinal epithelial regeneration.

Analysis of human intestinal epithelial regeneration has been limited. This study has used a novel SCID mouse-human model to test the hypothesis that distinct stages of human intestinal epithelial regeneration are accompanied by differential expression of growth regulatory genes. Disaggregated epithelium, which included crypt cell aggregates, was isolated from human fetal small intestine and transplanted subcutaneously in SCID mice. This method induced a coordinated regeneration response and enabled temporal separation of cell populations at different stages of histogenesis and cytodifferentiation. Graft epithelium was identified using a specific anti-human monoclonal antibody (MAb 5D3) against cytokeratins 8 and 18. Functional epithelial lineages were identified by appropriate markers. Growth regulatory genes relevant to proliferation and apoptosis, including Bcl-2, p53 and Ki67, were assayed at different stages of regeneration. During early regeneration, Bcl-2, p53, and Ki67 were expressed throughout the epithelial compartment. On completion of regeneration, these genes were expressed only in crypt epithelium and were absent from villi. This study has established a novel SCID mouse-human model of intestinal epithelial regeneration. During early regeneration, increased Bcl-2 and Ki67 expression may indicate suppression of apoptosis and enhanced proliferation respectively, consistent with expansion of the stem cell fraction. The p53 gene may influence pathways of differentiation during regeneration, analogous to its role during development.

Animals↗