Non-insulin-dependent (type II) diabetes mellitus and obesity in Asians in UK--scope for future studies.
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Asia↗
Biomedical subjects
K Bose
Publications and source records attributed to K Bose.
Value of gait analysis in the assessment of surgery in cerebral palsy.
Twenty-three ambulatory children with cerebral palsy were assessed preoperatively by a detailed clinical examination and by gait analysis using a video-based gait analysis system (VICON). Surgery was then performed based on either the clinical assessment alone or a combination of clinical evaluation and gait analysis. About one year after surgery, a postoperative clinical and gait analysis assessment was performed. Sixteen children had improved and seven children had not improved after surgery. Most of the children who had not improved were found to have had operations that differed from those recommended by gait analysis. Dynamic EMG studies were found to be useful in preoperative planning but did not show any consistent improvement even in the children with good results. The combination of a careful clinical assessment and gait analysis can produce better results in surgery for children with cerebral palsy.
Adolescent↗
Gastric ulcer healing: a comparison of enprostil versus ranitidine.
Enprostil is a synthetic prostaglandin E2 analogue with gastric antisecretory and mucosal protective properties. We compared the effects of enprostil and ranitidine on the healing of gastric ulcers and the subsequent relapse rates over 6 months. Patients (N = 156) were recruited for a double-blind study from 12 centers in Europe; 71 were randomly assigned to oral treatment with 35 micrograms enprostil twice daily and 85 to 150 mg ranitidine twice daily for up to 8 weeks. Both groups were of similar demography; their healing rates were also similar. Cumulative intent-to-treat healing rates were at 4 weeks enprostil 48%, ranitidine 41%: at 6 weeks enprostil 65%, ranitidine 68%; and at 8 weeks enprostil 72%, ranitidine 80%. Of those patients who met all protocol criteria and completed treatment, and were endoscoped at the prescribed times, healing rates were at 4 weeks enprostil 55%, ranitidine 54%, at 6 weeks enprostil 75%, ranitidine 84%; and at 8 weeks enprostil 80%, ranitidine 90%. Relief of pain was rapid and similar in both groups. The incidence of adverse events was low and similar in the two groups. The treatment-free relapse rate at 6 months was enprostil 64%, ranitidine 49%; the median times to relapse were 169 and 203 days, respectively. Enprostil and ranitidine appear to be equally effective in healing gastric ulcers.
Antacids↗
Healing of non-vascularised diaphyseal bone transplants. An experimental study.
Four different experiments were performed to study the healing of a large, non-vascularised, diaphyseal, bone segment in adult cats. In the first experiment, a 4 cm segment of tibia with its periosteum was excised and replaced in its bed. The other experiments were similar, except that in the second, the periosteum of the segment was removed, in the third its medullary canal was blocked with a Silastic rod, and in the last group the segment was isolated from its muscle bed by a Silastic sheet. The reparative processes were quantified by estimating the resorption index, the cortical new bone formation index, the callus encasement index, and the osteocyte count. Bone resorption and apposition occurred in the segment even when the periosteum was absent or the medullary canal was blocked, with osseous union at both ends by eight to 12 weeks, provided the segment was not isolated from its muscle bed. Thus, the muscle bed played a significant role in these reparative processes.
Animals↗
Characterization of potentially pathogenic free-living amoebae in sewage samples of Calcutta, India.
1. It is widely accepted that foul or polluted environments are the principal sources of potentially pathogenic species of free-living amoebae. The present paper is the first report of occurrence of potentially pathogenic free-living amoebae in sewage samples of Calcutta, India. 2. We describe the occurrence, isolation, specific identification and comparative mouse pathogenicity test of two pathogenic amoebae, viz., Naegleria fowleri (N. aerobia) Carter, 1970, causing human meningoencephalitis and Acanthamoeba castellanii Douglas, 1930, causing granulomatous amoebic encephalitis, and one non-pathogenic amoeba, viz., A. astronyxis Ray and Hayes, 1959, in sewage samples of Calcutta, India. 3. The existence of both pathogenic and non-pathogenic amoebae living side by side is of considerable epidemiological relevance.
Acanthamoeba↗
Principles and applications of Computer-Aided Design and Computer-Aided Manufacturing (CAD/CAM) technology in orthopaedics.
The principles involved in Computer-Aided Design (CAD) and Computer-Aided Manufacturing (CAM) technology is presented in this article. It also highlights the current advances and capability of this technology. Application of the CAD/CAM technology in orthopaedics is relatively new. Three broad areas of applications can be defined: (1) three-dimensional reconstructions of skeletal structure based on any of the imaging technique, i.e. CT scan, MRI or X-ray, to analyse, simulate, design and evaluate orthopaedic procedures without having to actually perform the surgery; (2) the production of plastic or wax models for surgeons to have global impressions and understanding of complex cases of bone and joint disorders and the possibility of using the physical models as templates to sculpt allograft pre-operatively; and (3) to design and manufacture geometrically optimal standard and customised implants. CAD/CAM technology is also rapidly developing in the field of prosthetics, orthotics and orthopaedics footwear. The advantages offered include shorter delivery time, more consistent design, quantifiable rectification and "modern" or remote manufacturing. Apart from these applied usage, the CAD/CAM technology is also an effective tool for education and training. The application of CAD/CAM technology in orthopaedics and its related fields has been shown to have tremendous potential, but may appear to be too esoteric, complex and costly at the present moment. However, with improved generality, simplicity and cost-effectiveness of the system, it will become more practical.
Computer Simulation↗
Changing pattern of admissions and operations for duodenal ulcer.
The admission rates for duodenal ulcer (DU) and the effect of H2-receptor antagonists (H2RA), introduced in the Trent Region of the UK in 1977, were examined. The admission rates are expressed per 10(6) of resident population. The use of H2RA has risen 3.7-fold (from 1978 to 1983), yet overall admission rates for perforation have changed little: 99 in 1972-76 (pre-H2RA period) compared with 103 in 1977-84 (H2RA period). Admission rates for haemorrhage have risen by 8 per cent, from 130 to 140 (P less than 0.01). However, the overall rates conceal large increases (P less than 0.01) in the admission rates for those aged greater than or equal to 65 years, of 33 per cent (from 264 to 352) for perforation and of 28 per cent (from 381 to 489) for haemorrhage. Emergency admissions for uncomplicated DU were unchanged: 88 in 1972-76 and 89 in 1977-84. However, the proportions operated on fell by 58 per cent (P less than 0.01), from 30 per cent of admissions in the pre-H2RA period compared with only 12 per cent in the H2RA period. Waiting-list admissions for uncomplicated DU fell by 43 per cent, from 187 to 106 (P less than 0.01), and the proportions operated on fell from 162 to 76; the combined effect resulted in a reduction of 53 per cent in the operation rates (P less than 0.01). In Rotherham, the use of H2RA has risen 6.2-fold (from 1978 to 1983) and they were generally used intermittently in 1976-78 and later for maintenance therapy and high-dose treatment. Yet admissions for perforation and for haemorrhage were unchanged. Emergency admissions for uncomplicated DU rose by 40 per cent, from 130 in 1972-75 to 182 in 1976-84, but the proportions operated on fell markedly, from 20 to 6 per cent (P less than 0.01); waiting-list admissions fell in 1976-78 by 29 per cent and in 1979-84 by 73 per cent. The proportions operated on in the three periods fell from 74 to 53 per cent and 25 per cent respectively and these two factors led to decreases in elective surgery of 50 per cent in 1976-78 and 91 per cent in 1979-84 (P less than 0.01).(ABSTRACT TRUNCATED AT 400 WORDS)
Adult↗
Membrane carbohydrate characterization of Acanthamoeba astronyxis, A. castellanii and Naegleria fowleri by fluorescein-conjugated lectins.
A comparative study of membrane carbohydrate characteristics of pathogenic and non-pathogenic trophozoites and cysts of free-living Acanthamoeba castellanii, Naegleria fowleri and A. astronyxis, respectively from sewage sludge in India was carried out by means of fluorescein-conjugated lectin binding using eight lectins. Two lectins, viz. Concanavalin A and Phytohaemagglutinin P, could bind all free-living amoebae at different concentrations. The most notable feature of the study is that peanut agglutinin (PNA) and wheatgerm agglutinin (WGA) can differentiate between the pathogenic A. castellanii and non-pathogenic A. astronyxis strain, respectively. However, Ulex agglutinin I (UEA I) was the only lectin positive to both pathogenic A. castellanii and N. fowleri. During in vitro conversion from trophozoites to cysts, A. castellanii and N. fowleri cysts gained WGA-specific saccharide whereas A. castellanii; A. astronyxis and N. fowleri lost or reduced Dolichos biflorus agglutinin, PNA; WGA and ConA, and UEA I-specific saccharides, respectively. Neuraminidase could not alter the fluorescein-lectin binding to WGA and PNA. These demonstrated that only two lectins can recognize the factors giving Acanthamoeba their pathogenic (PNA-specific) and non-pathogenic (WGA-specific) status. More interestingly, UEA I can only differentiate between pathogenic and non-pathogenic amoebae. It is also suggested that during stage conversion the surface of the organism exhibited replacement of saccharides.
Acanthamoeba↗
Duodenal and antral mucosal prostaglandin E2 synthesis in a study of normal subjects and all stages of duodenal ulcer disease treated by H2 receptor antagonists.
We tested the hypothesis that the production of prostaglandin E2 (PGE2) is impaired in duodenal ulcer disease and affected by treatment and healing. This was investigated by a study of maximal PGE2 synthesis rates in duodenal and antral mucosal biopsies obtained at endoscopy. The patients were divided into three groups. Group (a): endoscopically normal controls (n = 56); group (b): treatment controls (non-DU disease: gastric ulcer or oesophagitis treated by histamine H2 receptor antagonists) (n = 41); and group (c): patients with DU disease (n = 183) further subdivided into group (c1) active ulcer not on treatment (n = 47), (c2) treated active ulcer (n = 35), (c3) healed ulcer on treatment (n = 86), and (c4) healed ulcer not on treatment (n = 15). Group (a) synthesised (mean (SD] 106.6 (39.0) pg PGE2/mg wt of tissue from the duodenal bulb and 129.9 (56.9) from the second part of the duodenum. No difference was found between group (a) and (b) at either site. Group (c1) ulcer rim made 49.8 (22.7) and at all stages ulcer rim and scar made less than the control duodenal bulb (p less than 0.02). Uninvolved duodenal bulb form groups (c1) (63.4 (31.0], (c2) (83.6 (38.5], and (c3) (81.5 (31.1], however, also made significantly less than controls (p less than 0.02) and a similar though non-significant trend was seen in group (c4). Biopsies from the second part of the duodenum did not synthesise significantly less than the control group but a similar trend was noticed at each stage of ulcer treatment. Biopsies of control antrum synthesised 124.5 (32.2) but only 93.7 (44.2) in group (cl) (p < 0.005). All stages of duodenal ulcer healing were associated with a decreased capacity to synthesise the major prostaglandin PGE2 at the ulcer site and the uninvolved duodenal bulb and, in acute untreated duodenal ulcer, the uninvolved antrum. This decreased capacity may be the consequence of the disease process itself and not secondary to the treatment, indicating a basic pathophysiological abnormality which may explain the characteristic tendency of the disease to relapse.
Adult↗
An improved method of preparing nuclei for absorption cytophotometry.
An improved method of isolating nuclei from tissue for Feulgen-DNA measurements has been developed. The optimal nuclear isolation medium (NIM) was found to be a solution of 2% polyethylene glycol (PEG) and 0.6% NP40 in phosphate-buffered saline. The disaggregation procedure consists of gentle mechanical disruption of the tissues, followed by a 10 min incubation in the NIM at room temperature. The mixture is then syringed four times through a 27-gauge needle, and the nuclei are placed onto slides with a cytocentrifuge. Nuclei prepared in NIM without PEG had obvious DNA leakage and tended to form clumps. Addition of PEG to the NIM led to separation of nuclei without any DNA leakage, thus greatly increasing the accuracy of the DNA cytophotometry results. G0/G1 nuclei at the appropriate ploidy levels were found for non-transformed and transformed tissues prepared with this technique. In addition, S-phase liver nuclei prepared in this manner showed the expected incorporation of (3H) thymidine after a 1/2 hr pulse in vivo.
Animals↗
A surgical approach for the infected diabetic foot.
Three hundred cases of major infection of the foot in diabetic patients are analysed. Based on our experience we have been able to define certain criteria which we have found useful in the management of these cases. It is felt that an aggressive surgical approach with careful surgical technique and the appropriate antibiotics can avert major radical amputation.
Abscess↗
Management of severely disabled children.
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Accident Prevention↗
The long term prospects of rehabilitation in cerebral palsy in Singapore.
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Adolescent↗
Repair of depurinated DNA in vitro by enzymes purified from human lymphoblasts.
Alkali-labile lesions introduced into T7 DNA by treatment with methyl methanesulfonate were removed and the DNA was repaired by incubation with DNA polymerase alpha and nuclease from a human lymphoblastoid line followed by the addition of DNA ligase. The nuclease preparation contains both apurinic endonuclease and 5'-3' exonuclease activities. Dinucleotides appear to be the first product of exonuclease action. Repair of methyl methanesulfonate-induced damage can occur by the insertion of only a few nucleotides per lesion as in vivo.
Burkitt Lymphoma↗
Detection of thymic surface antigens and radioactive labeling of mouse lymphoid cells.
A method for the permanent and simultaneous detection of tissue-specific surface antigens and internal radioactive labeling of mouse lymphoid cells is described. Target cells were first reacted with a mouse-derived "antithymocyte serum", incubated with peroxidase-conjugated rabbit serum against mouse immunoglobulins and placed in a substrate solution that leads to staining of the antigen-positive cells. Radioactive labeling was demonstrated by autoradiography performed after the antigen assay. More than 90% of antigen-positive thymocytes could be specifically stained in the assay without staining of similarly treated antigen-negative cells. Autoradiographic grains could be detected over both antigen-positive and antigen-negative cells.
Animals↗
Treatment of old unreduced dislocation of the elbow.
Twenty-six patients with old unreduced dislocation of the elbow treated by open reduction were reviewed. All patients improved after surgery. It is felt that any patient with an elbow dislocation which is less than 3 months old should be treated by open reduction. The operative technique using a medial and lateral approach and keeping the dissection extraperiosteal is described.
Adolescent↗
The clinical manifestations and pathomechanics of contracture of the extensor mechanism of the knee.
Experience with thirty-eight Asian children and adolescents who presented with either stiffness of the knee, genu recurvatum, habitual dislocation of the patella or congenital lateral dislocation of the patella showed that all those disorders were manifestations of contracture of the extensor mechanism, which fell into two groups according to the components involved. In Group I the main components affected were in the midline of the limb, namely rectus femoris and vastus intermedius; these patients presented with varying degrees of stiffness of the knee, or worse, with genu recurvatum. In Group II the main components involved were lateral to the midline of the limb, namely vastus lateralis and the ilio-tibial band; these patients presented with habitual dislocation of the patella, or worse, congenital lateral dislocation of the patella. In both groups untreated patients developed secondary adaptive changes such as subluxation of the tibia or marked genu valgum which made operative procedures more formidable and less effective. Release of the contracture should therefore be performed as early as possible.
Adolescent↗