Biomedical subjects
Publications and source records attributed to J Sethi.
Flow volume loop and its various indices can be used to diagnose UAO. Change in posture from sitting to horizontal position per se causes a decrease in effort dependent inspiratory and expiratory flow rates but no significant change in upper airway obstruction indices. Thus, measurement of FVL in supine posture may be used to detect UAO as it may be missed if spirometry is performed in sitting posture.
UNLABELLED: Circulating IL-6 levels are elevated in obesity. Although IL-6 is expressed in adipose tissue, neither its regulation nor cell of origin is well characterized. Here we investigated the beta-adrenergic regulation of IL-6 release in a combination of studies on humans and animals in vivo and cultured adipocytes in vitro. Human in vivo study: Human volunteers were infused with isoproterenol, norepinephrine, or saline [4 M:4F; mean (SD) age 35.5 (5.8) yr; body mass index 24.6 (4.2) kg/m(-2)]. Plasma IL-6 levels increased during a 3-h infusion of isoproterenol (P = 0.01) and fell 2 h post infusion (P = 0.05). IL-6 levels did not change significantly with either norepinephrine or saline. Murine in vivo study: C57BL6/J male mice were injected ip with dobutamine (beta(1) agonist), clenbuterol (beta(2)), CL316243 (beta(3)), or saline placebo. Plasma IL-6 levels at 3 h were increased by clenbuterol (P = 0.02) and CL316243 (P = 0.02) but not dobutamine (P = 0.51), compared with placebo. IN VITRO STUDIES: In human peripheral blood cells, lipopolysaccharide treatment enhanced secretion of IL-6 (vs. controls; P < 0.001), whereas isoproterenol inhibited IL-6 secretion (P = 0.012) and norepinephrine had no significant effect. In contrast, isolated human adipocytes and differentiated 3T3F442A adipocytes all rapidly secreted IL-6 in response to adrenergic agonists (P < 0.01, compared with untreated cells). We conclude that beta 2/beta 3 adrenoceptor stimulation on adipocytes, rather than macrophages, may be responsible for the increases in plasma IL-6 concentrations observed during sympathetic activation and in obesity.
OBJECT: The aim of this study was to assess whether outcomes from excision of acoustic neuroma vary among patients and have a material impact on their quality of life (QOL). METHODS: A questionnaire concerning postoperative symptoms and the Short Form 36 (SF-36) QOL instrument were mailed to 97 consecutive patients who had undergone acoustic neuroma surgery via the translabyrinthine approach. The survey response rate was 78% and the symptomatology was consistent with other reports, supporting the representativeness of the sample. The respondents' QOL was rated significantly below published norms and their work capacity was reportedly reduced. Specifically, the following SF-36 dimensions were reduced: physical functioning and role-physical, together with vitality, general health, and social functioning. Greater numbers of postoperative symptoms and larger tumors were associated with a worse rating of physical functioning. More severe balance problems were associated with lower ratings of social functioning. The disparity between the patient's self-estimate and self-measurement and the clinician's assessment of the patient's facial functioning raises doubts about the validity of subjective reports and assessment. CONCLUSIONS: The present study supports the use of generic QOL measures to assess outcome and to draw comparisons between different populations.
UNLABELLED: The Clozaril National Registry (CNR) was created to help protect patients from developing potentially fatal agranulocytosis secondary to treatment with the antipsychotic medicine clozapine. The CNR, designed and maintained by the manufacturer of the branded Clozaril (clozapine), has the principal goals of (1) prophylaxis-preventing inappropriate retreatment, and (2) quality assurance-overseeing adherence to a "no blood, no drug" policy. This article reviews the estimated impact of the CNR on clozapine-related morbidity and mortality over the first 5 years of commercial experience in the United States. METHOD: Complete data on leukopenia and agranulocytosis, gathered from the CNR database for the period of 1990-1994, were reviewed and compared with data from the pre-CNR period. RESULTS: Use of clozapine in 99,502 patients according to package labeling requirements (distribution of the medicine linked to mandated white blood cell count testing) was associated with a total of 382 cases of agranulocytosis (0.38%) versus an expected cumulative total of 995 cases (based on the pre-CNR rate of 1% to 2%). Based on the expected agranulocytosis rate, up to 149 deaths might have been anticipated. Instead, there were only 12 deaths attributed to complications of agranulocytosis. CONCLUSION: The CNR provides for universal rechallenge protection as well as controlled dispensing of clozapine. It also serves as an early warning system to promote the safe and effective use of clozapine. The CNR includes quality assurance mechanisms designed to enhance compliance. Despite the added logistic requirements this system places upon physician, pharmacist, and manufacturer, the CNR has helped to reduce substantially potential fatal outcomes. The CNR reinforces both patient and treatment system compliance. Based on this favorable experience concerning agranulocytosis and associated fatalities, the Neuropsychopharmacology Advisory Committee to the U.S. Food and Drug Administration has unanimously recommended a reduction in frequency of the white blood cell count testing requirement after 6 months to every 14 days, instead of weekly. Finally, the CNR database containing white blood cell count and demographic data on every patient in the United States who has received the medicine has served as a unique epidemiologic database.
This study examines the relative activity of various complement sources in a variety of antigen-antibody (Ag-Ab) complement fixation assay systems. Studied were Ag-Ab systems of cytomegalovirus, adenovirus, Pneumococcus, Coccidiodes, and guinea pig kidney. Ab titers in each system were determined by microcomplement fixation assay using two batches of titrated rabbit, monkey, cat, dog, human cord, human adult, and guinea pig sera as complement sources. Assay sensitivity and Ab titers proved to be strongly related to the complement sources. There was considerable variation in the ability of Ag-Ab complexes to bind the complement of each of the species tested. Guinea pig, rabbit, and monkey sera gave comparable titers in four of the five Ag-Ab systems tested. Cat serum complement was able to detect anti-adenovirus and anti-Pneumococcus reactivity only. Human adult, human cord, and dog sera exhibited anti-complementary activity. The study emphasizes the importance of complement source in determining both the specificity and sensitivity of complement fixation assays in a given Ag-Ab system.
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More than 120 patients with recent spinal cord injuries have been admitted to our hospital during the last 3 years. Intermittent catheterization has been the preliminary step in the urologic management of these patients. The transcutaneous suprapubic cystocath with intermittent aspiration of urine also has been used in 7 cases. A bladder outlet operation after 3 months was indicated 3 times more often in patients with complete than in those with incomplete neurologic lesions. Results and indications are discussed.
Efforts to establish human soft tissue and bone sarcomas in long-term cultures are described. Of 49 attempts 22 (45%) were successful, yielding cells that proliferated in vitro for 6 months or longer. Infrequent medium changes, maintenance of pH in physiologic range and avoidance of early trypsinization all appear to be important for survival of explanted cells and their initial growth under culture conditions. Cytologic criteria can be used to confirm that cells in established lines derive from malignant mesenchymal cells present in the tumors of origin.
Further investigation of the humoral immune responses of patients with sarcoma to their tumors revealed a sarcoma-associated antigen that was readily detected by complement fixation. Circulating levels of antibody to this antigen, tentatively labeled S3, rose markedly after surgical removal of the tumor. Antibody to S3, as to S1 and S2, was highly prevalent in patients with various malignant tumors other than sarcoma.
This discussion has been written to assist radiologic technology educators build better teacher-made tests. The systematic framework for test development has included defining cognitive learning objectives, constructing a test blueprint, writing clear test directions, and writing objective test items. This process enables the faculty to effectively monitor student progress, assess their own teaching effectiveness, and diagnose learning difficulties. It is hoped that this systematic approach to the assessment of cognitive learning will contribute to the education and development of a competent entry level radiologic technologist.