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Biomedical subjects

M Kumar

Publications and source records attributed to M Kumar.

At least 127 records · Page 7Linked to original sources
PubMed1998

Respiratory syncytial virus induces the expression of 5-lipoxygenase and endothelin-1 in bronchial epithelial cells.

Respiratory syncytial virus (RSV) infection causes and exacerbates asthma, yet the mechanism by which RSV triggers asthma is poorly understood. Herein, an in vitro model of RSV infection was established using HEp-2 and BEAS-2B bronchial epithelial cell lines, and the expression of 5-lipoxygenase (5-LO), and endothelin-1 (ET-1) was examined. RSV infection increased the expression of 5-LO mRNA and protein in both cell lines, as detected by RT-PCR and western blot analysis, respectively. The levels of leukotrienes also increased in the supernatants of RSV infected cells. Furthermore, RSV infection increased the expression of ET-1 mRNA and protein following RSV infection in a time-dependent manner. It is concluded that RSV infection upregulates the expression of ET-1 and 5-LO in the epithelial cells leading to the production of leukotrienes, which may mediate the consequent exacerbation of asthma.

Arachidonate 5-Lipoxygenase↗
PubMed1998

Cocaine abuse and HIV-1 infection: epidemiology and neuropathogenesis.

The epidemiology of cocaine abuse and potential relationships of cocaine withdrawal to human immunodeficiency virus type 1 (HIV-1)-associated dementia (HAD) are discussed. Neuroendocrinological changes in HIV-1 infection of the central nervous system (CNS) are discussed with the relevant impact of cocaine abuse. HIV-1 load in the brain tissue of infected substance users is described along with possible associations with neuropathology and HAD. Finally, the molecular epidemiology and sequence heterogeneity of HIV-1 and their implications for neuropathogenesis are summarized. The complex context of addressing cocaine abuse in the setting of HIV-1 infection appears more tractable when decomposed into its components.

AIDS Dementia Complex↗
PubMed1998

Cognitive-behavioral intervention effects on mood and cortisol during exercise training.

The purpose of the present study was to assess the effect of a time limited cognitive-behavioral stress management program (CBSM) on mood state and serum cortisol among men and women rowers (N = 34) undergoing a period of heavy exercise training. After controlling for life-event stress (LES), CBSM was hypothesized to reduce negative mood state and cortisol among rowers during a period of heavy training; mood and cortisol changes over the intervention period were hypothesized to be positively correlated. LES was positively associated with negative affect at study entry. After covariance for LES, rowing athletes randomly assigned to the CBSM group experienced significant reductions in depressed mood, fatigue, and cortisol when compared to those randomized to a control group. Decreases in negative affect and fatigue were also significantly associated with cortisol decrease. These results suggest that CBSM may exert a positive effect on athletes' adaptation to heavy exercise training.

Adolescent↗
PubMed1998

The utility of hemodynamic measurements acquired by pulmonary artery catheterization.

BACKGROUND: Concerns about the utility of pulmonary artery catheters (PAC) stimulated us to assess the impact of one of the parameters measured by the PAC, the pulmonary capillary wedge pressure (PCWP), on our clinical practice. METHODS: The PCWP was recorded at 4- to 6-hour intervals on 50 patients for the first 48 hours following aortic aneurysm repair. We then reviewed the patients' records looking for evidence that the PCWP measurements were used to guide therapy. For the purpose of the study, we anticipated the administration of diuretics for PCWP > or =218 mm Hg and volume resuscitation for PCWP < or =8 mm Hg. Data were correlated using Pearson rank correlation coefficient using a P < 0.05 to determine statistical significance. RESULTS: Patients with PCWPs <8 mm Hg were more likely to be treated with volume resuscitation (P < 0.05). There was no other correlation between PCWP measurements and fluid or pharmacologic management. CONCLUSIONS: Data derived from the PAC are infrequently used to guide therapy in patients who undergo abdominal aortic reconstructive surgery.

Aged↗
PubMed1998

Systemic antibiotic prophylaxis in elective cesarean delivery.

OBJECTIVE: To test the value of using prophylactic antibiotics at elective cesarean delivery. METHOD: One-hundred and twenty women delivered by elective cesarean in the absence of labor and before the rupture of membranes were randomized to receive either 1.5 g of cefuroxime intravenously at cord clamping (n = 59) or no prophylaxis (control group, n = 61). RESULTS: Twelve women developed febrile morbidity (six study, six control, P = 0.09). Of these, five had endometritis (two study, three control, P = 0.09) and two had wound infection (one study, one control, P = 0.09). Ten more women had microbiological evidence of endometritis and wound infection (six study, four control, P = 0.08). There was no significant difference in the hospital stay (6.5 days study, 6.8 days control, P = 0.06). Staphylococcus aureus was the commonest pathogen accounting for 14 infection episodes. Amniotic fluid culture could not predict the development of infection. CONCLUSION: Administration of prophylactic antibiotics at elective cesarean deliveries was not associated with decreased postoperative morbidity.

Adult↗
PubMed1998

Double epiglottis in Weyer's acrofacial dysostosis.

While evaluating a 61-year-old patient for stridor we incidentally detected a double epiglottis. The patient was also diagnosed of having Weyer's acrofacial dysostosis which is characterized by hexadactyly affecting all four extremities, small and deeply set nails, dental deformities with small, conical teeth and mandibular hypoplasia. The double epiglottis was not the cause for the stridor. Because of the covert symptomatology of double epiglottis it is suggested that the association with Weyer's syndrome is common. Embryological evidence and a review of the literature on laryngeal abnormalities is discussed.

Epiglottis↗
PubMed1998

Xanthogranulomatous cholecystitis.

Xanthogranulomatous cholecystitis exists in a small but significant proportion of routine cholecystectomy specimens. A few recent reports have shown a possible association of this disease with carcinoma of the gallbladder. All cholecystectomized specimens were prospectively evaluated over a period of two and half years in a single surgical unit to examine the incidence of xanthogranulomatous cholecystitis and its association, if any, with carcinoma of the gallbladder in an area that is prone to gallbladder diseases. A total of 460 cholecystectomies were performed for various gallbladder diseases. Histological confirmation revealed chronic cholecystitis in 311 (67.6%) cases, carcinoma of the gallbladder in 62 (13.5%), acute cholecystitis in 29 (6.3%), xanthogranulomatous cholecystitis in 41 (8.9%), and xanthogranuloma and carcinoma of the gallbladder in one case (0.2%) only. Almost all cases were suspected to have chronic cholecystitis on clinical and ultrasonographic features. Two specimens on gross examination showed mass lesions, and hence were suspected to be carcinoma of the gallbladder. Subsequent frozen section and histopathology demonstrated xanthogranulomatous cholecystitis. Only one case of xanthogranuloma was found to be associated with carcinoma of the gallbladder but no firm association could be established between xanthogranulomatous cholecystitis and carcinoma of the gallbladder.

Acute Disease↗
PubMed1998

Sensitivity of food pathogens to garlic (Allium sativum).

The inhibitory activity of garlic (Allium sativum) against Staphylococcus aureus, Salmonella typhi, Escherichia coli and Listeria monocytogenes was measured by the 'turbidity' method. Minimum inhibitory concentration (MIC) of garlic at 80% inhibition level was calculated for these bacteria. All bacterial pathogenic strains tested were inhibited by garlic; E. coli was most sensitive and Listeria monocytogenes was least sensitive. Therefore, garlic has potential for the preservation of processed foods.

Anti-Bacterial Agents↗
PubMed1998

Does voided urine cytology have biological significance?

OBJECTIVE: To (i) define any correlation between the result of voided urine cytology (VUC) at presentation and the biological behaviour of Ta/T1 transitional cell carcinoma (TCC) of the bladder; and (ii) observe the natural history of Ta/T1 bladder cancer in relation to new prognostic groupings. PATIENTS AND METHODS: The study comprised 109 patients with newly diagnosed Ta/T1 TCC of the bladder, all of whom had VUC assessed at presentation. Information on the number of tumours at presentation and the subsequent tumour recurrence rate during clinical follow-up was compared with the outcome of VUC. RESULTS: Of the 109 patients, 67 (61%) had Ta and 42 (39%) had T1 tumours. At presentation, there were 75 (69%) solitary (Ta=50, T1=25) and 34 (31%) multifocal (Ta=17, T1=17) tumours. At presentation, VUC was negative in 71 (65%), suspicious in 22 (20%) and positive for urothelial carcinoma in 16 (15%) patients. During follow-up, 58% of patients with Ta tumours and 83% of patients with T1 tumours developed recurrences (median follow-up 43.5 months, P=0.01), although there was no significant difference in the recurrence rate between these groups (P=0.096). In addition, for those patients with Ta tumours that were multifocal at presentation, there was a significantly higher recurrence rate (P=0.003). Although there was no correlation between the result of VUC and the number of tumours at presentation, there was a significantly higher tumour recurrence rate for those patients with suspicious/positive VUC than for those whose VUC was negative (P<0.05). CONCLUSION: This study shows the impact of tumour multifocality at presentation on subsequent tumour recurrence rate. In addition, the VUC result at presentation correlated with tumour recurrence in patients with Ta/T1 TCC of the bladder.

Adult↗
PubMed1998

Acute cholecystitis in AIDS patients: correlation of Tc-99m hepatobiliary scintigraphy with histopathologic laboratory findings and CD4 counts.

BACKGROUND: AIDS patients are susceptible to opportunistic gastrointestinal infections including ascending cholangitis and cholecystitis, especially if CD4 count is < 200. Incidence of acalculous cholecystitis has not been reported previously. PURPOSE: We aim to evaluate the incidence of acalculous cholecystitis in AIDS patients and to identify causative organisms and mortality rate following cholecystectomy. MATERIALS AND METHODS: We reviewed the files of 46 patients in order to meet the objectives of this study. RESULTS: CD4 counts were < 200 in 31 patients and > 200 in 15 patients. HIDA imaging was performed in 31 patients; in 8, the CD4 count was > 200 and all had calculous cholecystitis. The gallbladder was visualized in 3 patients for a sensitivity of 63% and no organisms were found in the gallbladder specimens. In 23 patients, the CD4 count was < 200; the gallbladder was visualized in 5 patients for a HIDA sensitivity of 78%; 16 (52%) had acalculous cholecystitis; and 15 had calculous cholecystitis. In acalculous cholecystitis, Cryptosporidium was found in six cases, cytomegalovirus (CMV) in six cases, and fungus, yeast, tuberculosis, and mycobacterium avium intracellular each in one case. The thirty day mortality rate was 18%; 5 of 28 who underwent open cholecystectomy died within 30 days, 4 of them with a CD4 count < 200. There was no mortality in the 26 patients who underwent laparoscopic cholecystectomy. CONCLUSION AND RECOMMENDATIONS: (1) Because of the high incidence of 52% of acalculous cholecystitis in AIDS patients with a CD4 count < 200, we recommend using intravenous cholecystokinin if the gallbladder is visualized on hepatobiliary scintigraphy in order to determine gallbladder ejection fraction and exclude acalculous cholecystitis. (2) Laparoscopic rather than open cholecystectomy should be the surgical procedure of choice in AIDS patients especially if the CD4 count is < 200.

AIDS-Related Opportunistic Infections↗
PubMed1998

SPECT brain perfusion abnormalities in mild or moderate traumatic brain injury.

The purpose of this atlas is to present a review of the literature showing the advantages of SPECT brain perfusion imaging (BPI) in mild or moderate traumatic brain injury (TBI) over other morphologic imaging modalities such as x-ray CT or MRI. The authors also present the technical recommendations for SPECT brain perfusion currently practiced at their center. For the radiopharmaceutical of choice, a comparison between early and delayed images using Tc-99m HMPAO and Tc-99m ECD showed that Tc-99m HMPAO is more stable in the brain with no washout over time. Therefore, the authors feel that Tc-99m HMPAO is preferable to Tc-99m ECD. Recommendations regarding standardizing intravenous injection, the acquisition, processing parameters, and interpretation of scans using a ten grade color scale, and use of the cerebellum as the reference organ are presented. SPECT images of 228 patients (age range, 11 to 88; mean, 40.8 years) with mild or moderate TBI and no significant medical history that interfered with the results of the SPECT BP were reviewed. The etiology of the trauma was in the following order of frequency: motor vehicle accidents (45%) followed by blow to the head (36%) and a fall (19%). Frequency of the symptoms was headache (60.9%), memory problems (27.6%), dizziness (26.7%), and sleep disorders (8.7%). Comparison between patients imaged early (<3 months) versus those imaged delayed (>3 months) from the time of the accident, showed that early imaging detected more lesions (4.2 abnormal lesions per study compared to 2.7 in those imaged more than 3 months after the accident). Of 41 patients who had mild traumatic injury without loss of consciousness and had normal CT, 28 studies were abnormal. Focal areas of hypoperfusion were seen in 77% (176 patients, 612 lesions) of the group of 228 patients. The sites of abnormalities were in the following order: basal ganglia and thalami, 55.2%, frontal lobes, 23.8%, temporal lobes, 13%, parietal, 3.7%, insular and occipital lobes together, 4.6%.

Adolescent↗
PubMed1998

No difference exists in the alteration of circadian rhythm between patients with and without intensive care unit psychosis.

OBJECTIVE: To determine if a difference exists in the circadian rhythm entrainment between patients with and without intensive care unit (ICU) psychosis. DESIGN: Retrospective chart reviews from 149 consecutive patients admitted to our ICU during the period of January 1993 to August 1993. Twelve patients with a history of mental illness or alcohol or substance abuse were excluded from the study. SETTING: A 20-bed surgical ICU at a large teaching hospital. PATIENTS: Patients who remained in the ICU for a minimum of 2 days after undergoing thoracic or vascular operations. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Hourly temperature and urine output were ascertained from the patient records. The time of temperature and urine output nadir was used as a marker of circadian rhythm. Of the 137 patients included in the study, 17 (12.4%) developed ICU psychosis as defined by standard criteria. The time of temperature nadir was randomly distributed around the clock for each group. Cosinar rhythmometry analysis of temperature data showed a lack of circadian rhythm entrainment in most patients up to the third postoperative day. No statistically significant difference exists in the deviation of such impairment between the groups. CONCLUSION: Either patients who develop ICU psychosis have an increased sensitivity to an alteration of their circadian rhythm, or ICU psychosis develops independent of circadian rhythm abnormalities.

Adaptation, Physiological↗