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Biomedical subjects

R Agrawal

Publications and source records attributed to R Agrawal.

At least 19 recordsLinked to original sources
PubMed1995

Effects of balloon mitral valvuloplasty on left ventricular muscle function.

Echocardiographically determined ventricular load and performance were compared in 40 consecutive patients with severe mitral stenosis before and 24 h after successful and uncomplicated balloon mitral valvuloplasty in order to clarify the role of loading conditions in causation of reduced left ventricular ejection fraction. After valvuloplasty, mitral valve area increased 2-fold. A modest increase in ejection fraction (53 +/- 11% to 57 +/- 8%, P = 0.021) occurred with an insignificant increase in end-diastolic volume (44 +/- 10 to 48 +/- 16 ml/m2, P = 0.063) and no change in wall stress (61 +/- 19 to 59 +/- 19 kdynes/cm3, P = 0.85) (10(5) dynes = 1 N). There was no correlation between changes in fractional shortening and wall stress (r = 0.07) and between changes in end-diastolic volume and fractional shortening (r = 0.12). Contractile performance estimated by a performance-afterload relation was unchanged after the valvuloplasty. Factors other than a change in loading conditions might be responsible for a modest improvement in ejection performance following mitral valvuloplasty.

Adolescent↗
PubMed1994

[Endocardial fibrosis in neuroendocrine tumors of the gastroenteropancreatic system].

Clinical characteristics, echocardiographic and Doppler echocardiographic findings, as well as serum levels of chromogranin A were recorded on 62 patients (27 women, 35 men; mean age 55 [11-83] years) with histologically confirmed tumours of the gastroenteropancreatic (GEP) system. Changes in the right heart were found in 14 patients (22%), club-like thickening of tricuspid leaflets in 13, tricuspid regurgitation in 14, stenosis in 2 and right atrial or right ventricular dilatation in 11 and 5, respectively. There was no difference between the patients with or without right-heart changes in regard to age, presence of carcinoid syndrome, duration of symptoms, primary tumour site, pattern of metastases, treatment or chromogranin A level. Two patients with nonfunctioning tumours had right-heart changes. While clinical and biochemical parameters did not identify patients with right-heart changes, echocardiography demonstrated all haemodynamically significant endocardial changes. Even patients with nonfunctioning GEP tumours should be regularly monitored by echocardiography.

Adolescent↗
PubMed1994

Improved Doppler assessment of the Bjork-Shiley mitral prosthesis using the continuity equation.

To assess whether derivation of an effective mitral prosthetic valve area using the continuity equation provides an improved functional assessment of the Bjork-Shiley mitral prosthesis over the pressure half-time method, Doppler echocardiographic studies were performed in 43 patients 12 +/- 7 months following the valve replacement. Effective valve orifice area used as the standard for comparison was determined by a hydraulic formula validated in vitro over a wide range of flow rates. All patients were clinically stable, without evidence of prosthetic dysfunction or aortic regurgitation. Prosthetic mitral valve orifice area determined by the hydraulic formula, by the continuity equation and by pressure half-time method for all prostheses sizes averaged 1.6 +/- 0.46 cm2, 1.83 +/- 0.56 cm2 and 2.34 +/- 0.48 cm2, respectively. Effective valve orifice area by the hydraulic formula had a strong correlation with that derived by the continuity equation (r = 0.86; P < 0.0001; standard error of estimate (S.E.E.), 0.12 cm2), but an insignificant correlation with the area calculated by the pressure half-time method (r = 0.24). Prosthetic mitral valve areas determined by the continuity equation and by pressure half-time method also correlated poorly (r = 0.24). Pressure half-time was affected by heart rate, diastolic filling period, left ventricular fractional shortening and presence of atrial fibrillation (P < 0.001). Thus, using the standard continuity equation to determine the orifice area of the Bjork-Shiley prosthesis in the mitral position provides improved assessment compared with the pressure half-time method.

Adolescent↗
PubMed1994

Renal cell carcinoma developing in the pediatric recipient of an adult cadaveric donor kidney.

Renal cell carcinoma is an uncommon renal tumor in children, comprising between 1.8% and 6.3% of all malignant renal tumors of childhood (whereas renal cell carcinoma is the commonest renal tumor in adults). We describe a 15-year-old girl with chronic renal failure secondary to renal dysplasia and branchio-oto-renal syndrome, who received a cadaveric renal transplant at 8 years of age from a 25-year-old male donor. She developed severe chronic rejection 4 years after the transplant. A transplant nephrectomy was performed because of persistent gross hematuria. Histopathology of this graft showed chronic severe rejection and papillary necrosis. A fortuitous finding was a 1.5-cm renal cell carcinoma at one of the poles. We suggest that tumors which occur more commonly in adults and less commonly in children must be considered in children receiving adult organ transplants.

Adolescent↗
PubMed1994

Improvement of endocardial border delineation in suboptimal stress-echocardiograms using the new left heart contrast agent SH U 508 A.

Recent studies have shown that the saccharide based echocardiographic contrast agent SH U 508 A opacifies the left ventricle after i.v. injection, thus possibly improving endocardial border definition. This study was performed to determine whether SH U 508 A can enhance the wall motion analysis in suboptimal echocardiographic images at rest and following pharmacological stress. Ten male patients (mean 58 years) exhibiting > or = 30% endocardial border dropout were examined prior to a diagnostic left heart catheterization. Five patients were stressed with Dobutamine, 5 with Dipyridamole. The wall motion was assessed visually (qualitatively) as well as computer-aided (quantitatively). The concordance between left ventricular angiography as 'gold standard' and resting echocardiography regarding the wall motion analysis was significantly improved from 64.5% to 90.3% following the injection of SH U 508 A (p < 0.05). A delineation score (0 = not delineated, 1 = delineated) of 12 individual wall segments was used. The mean delineation score at baseline was 6.1 +/- 1.4 at rest and 6.6 +/- 1.9 during stress. SH U 508 A significantly (p < 0.01) increased the score to 9.6 +/- 1.9 and 10.3 +/- 1.7, respectively. The intraobserver variability for assessing the delineation score was significantly (p < 0.04) improved by SH U 508 A. SH U 508 A, however, did not improve the quantitative assessment of the left ventricular function. Only 40% of the patients could be analyzed following SH U 508 A injection. No severe adverse reactions were seen. SH U 508 A led to a significant, clinically important, improvement in the interpretation of stress echocardiograms in patients with inconclusive routine echocardiograms.

Adult↗
PubMed1994

The free radical system in ischemic heart disease.

The present work was conducted to evaluate the oxygen free radical system in 29 patients and comparing them with nine matched healthy controls of acute and chronic myocardial ischemic syndromes. The parameters assessed for oxidative stress were superoxide anion and malonyldialdehyde, and for the antioxidant defence system were superoxide dismutase, catalase and glutathione reductase. Both oxidative stress and the antioxidant defence system were altered in myocardial ischemia. Subset analysis revealed that in unstable angina and acute myocardial infarction, superoxide anion, malonyldialdehyde and glutathione reductase were elevated while superoxide dismutase and catalase levels were reduced. In stable angina only increased levels of superoxide anion and decreased levels of superoxide dismutase were found. However, this alteration was less marked than in unstable angina and acute myocardial infarction. In the post myocardial infarction group there was no alteration in any of these parameters.

Antioxidants↗
PubMed1993

Iatrogenic pulsatile tinnitus.

We present an unusual case of iatrogenic arteriovenous malformation following a myringoplasty and its treatment by embolization. Thorough examination and investigation of patients with pulsatile tinnitus is stressed. Angiography is essential to diagnose life-threatening and treatable lesions in the presence of normal otoscopy, audiologic assessment and enhanced computed tomography.

Adult↗
PubMed1993

Effect of gamma-interferon or cycloheximide treatment on viral and c-myc transcripts in bovine-papillomavirus-type-1-transformed primary mouse fibroblasts.

We have studied the effect of gamma-interferon (IFN-gamma) treatment on the transcription of viral and c-myc oncogenes in bovine papillomavirus type 1 (BPV-1)-transformed mouse fibroblast cell lines. Upon IFN-gamma treatment, viral transcripts always decreased in cell lines containing episomal BPV-1 DNA, while the effect was variable in cell lines containing integrated BPV-1 DNA. Two series of tumour cell lines established by in vivo passage of B6B71 (episomal) and B6B31-J (integrated) cells via nude mice (NuTu A) into immunocompetent C57BL/6 mice (NuTuA B6Tul) also showed a decrease and an increase, respectively, in viral transcripts upon IFN-gamma treatment. IFN-gamma also reduced c-myc transcription in all cell lines derived from tumours, but increased it in the transformed cell cultures. There was selection of c-myc oncogene transcripts in all the tumour-derived cell lines as compared to their transformed cell cultures. Cycloheximide treatment increased both viral and c-myc gene transcripts 3- to 20-fold in all cell lines. These results imply that IFN-gamma produced locally by immunological mechanisms may influence the expression of Papillomavirus oncogenes, and the response to IFN-gamma treatment may change when the viral DNA is integrated into the host genome.

Animals↗
PubMed1992

The open access ENT casualty service.

The ENT specialist's experience of emergencies is usually influenced by a process of prior selection in the GP surgery or in a general Casualty Department. A survey of 1,000 consecutive patients presenting to a 24 hour open access ENT Casualty service is presented. For a variety of reasons, over half of these patients had never sought their G.P.'s advice for their ENT complaint but preferred the hospital service. The value of even a brief exposure to ENT casualty work for GP trainees is demonstrated.

Adolescent↗
PubMed1992

Integration of bovine papillomavirus type 1 DNA and analysis of the amplified virus-cell junctions in transformed primary mouse fibroblasts.

We have analysed the site of bovine papillomavirus type 1 (BPV-1) DNA integration in clones originating from a transformed primary mouse fibroblast cell line established by transfection of linear BPV-1 DNA. Viral DNA was integrated at a single site in the host genome with an intact early region and an almost complete long control region. Sequence analysis showed that the BPV-1 DNA was integrated at the HindIII site (the enzyme used to linearize the BPV-1 DNA for transfection) with short deletions at both ends. These deletions correspond to a 534 bp segment spanning the 3' end of the L1 open reading frame and the replication enhancer element in the BPV-1 genome. The cellular sequences 5' to the viral integration site exhibited 85 to 97% identity to several sequences belonging to the mouse L1 family of long interspersed repetitive sequences. Cellular sequences 3' to the viral DNA exhibited no significant similarity to any known sequence. The BPV-1 sequences and the cellular flanking sequences were found to be amplified 45- to 50-fold. All the cell clones shared an identical integration site but one of the clones had an additional population of amplified and integrated BPV-1 DNA molecules with an internal deletion of 1136 bp in the late region. The significance of viral DNA integration at a murine long interspersed repetitive sequence containing an amplification-promoting sequence is discussed.

Animals↗
PubMed1992

Bovine papillomavirus type 1-transformed primary mouse fibroblasts show no correlation between tumorigenicity and viral gene expression, but c-myc gene expression is elevated in tumorigenic cell lines.

Bovine papillomavirus type 1 (BPV-1)-transformed primary mouse fibroblasts containing episomal or integrated BPV-1 sequences were analysed for virus-specific transcripts and c-myc gene expression. Total BPV-1-specific expression was high in cell lines containing episomal BPV-1 DNA in comparison to lines containing integrated BPV-1 sequences, mainly due to higher expression of the E6/E7 sequences. No correlation was found between the viral transcription and tumorigenicity, although BPV-1 gene expression occurred in all cell lines. High levels of c-myc expression were found in all cell lines exhibiting a tumorigenic phenotype as compared to the nontumorigenic lines. These data suggest that expression of BPV-1 genes may be essential for transformation but not tumorigenicity, whereas high levels of expression of cellular oncogenes like c-myc may be associated with tumorigenicity.

Animals↗
PubMed1992

Risk factors for coronary artery disease in lean and obese women with the polycystic ovary syndrome.

OBJECTIVE: The evidence that some women with the polycystic ovary syndrome (PCOS) are hyperinsulinaemic has brought into question their risk of developing early coronary artery disease. We have focused on three cardiac risk factors which have been associated with hyperinsulinaemia by measuring glucose tolerance, fasting serum lipid concentrations and blood pressure in women with PCOS. DESIGN: Comparison of clinical and biochemical measurements in lean and obese women with PCOS and in women with normal ovaries. Determinants of the risk factors for coronary artery disease were assessed by multiple regression analysis. PATIENTS: One hundred and two women with ultrasound diagnosed PCOS and 19 lean women with normal ovaries were studied. Patients were recruited from a reproductive endocrine clinic. MEASUREMENTS: Fasting total cholesterol, triglycerides, high density lipoproteins (HDL), HDL2, glucose tolerance, fasting and stimulated insulin, gonadotrophins, testosterone and androstenedione were measured during a 2-hour oral glucose tolerance test. Recumbent blood pressure was measured automatically. RESULTS: Lean women with PCOS were found to be hyperinsulinaemic and have reduced serum HDL and HDL2 concentrations compared to women with normal ovaries; serum insulin concentrations correlated positively with plasma glucose and blood pressure measurements in multiple regression analysis. Obese women with PCOS were in addition found to have higher systolic blood pressure, serum triglyceride and plasma glucose concentration than lean women with PCOS and controls. CONCLUSIONS: These results support the evidence that hyperinsulinaemic women with PCOS have an increased risk of developing cardiovascular disease and therefore form a population in whom metabolic screening is advisable.

Adult↗
PubMed1992

Unusual presentation of verrucous carcinoma of maxillary antrum.

Verrucous carcinoma is a rare type of squamous cell carcinoma that is most often seen in the oral cavity and larynx. This paper describes a case report of a rare tumor with an unusual presentation. This patient presented with recurrent pyoceles and was diagnosed by chance. Carcinoma of maxilla is rarely diagnosed until the bony walls are eroded. This condition should be kept in mind in patients presenting with recurrent pyocele and a biopsy carried out from the maxilla.

Carcinoma, Papillary↗
PubMed1991

Alterations in plasma sodium and potassium levels following chronic oral ingestion of lead, mercury and cadmium in male albino rats.

Adult male albino rats were orally administered 0, 25, 50 and 100 ppm of lead nitrate, mercuric chloride and cadmium chloride for 60, 120 and 180 days. The plasma sodium levels were decreased in rats exposed to varying doses of lead and mercury up to 180 days, while animals which consumed cadmium chloride showed an increase in sodium levels. In lead and mercury treated animals, plasma potassium levels were increased up to 180 days. The levels were decreased in cadmium exposed rats. These observations suggest that chronic exposure to these heavy metals considerably influences plasma sodium and potassium levels depending on the dose and duration of exposure.

Administration, Oral↗
PubMed1990

Serum protein changes in lead exposed mice infected with Hymenolepis nana.

Significant decrease in serum globulin took place in Hymenolepis nana mouse model treated with lead prior to infection. Decrease of alpha, beta and gamma globulins was maximum on day 4 in comparison to that of control, gradually tapering off by day 100 when suppression was minimum with the experimental values almost reaching the same level as those of the control. Thus, suppression of globulins was neither total nor permanent.

Animals↗