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Biomedical subjects

R R Sharma

Publications and source records attributed to R R Sharma.

At least 73 records · Page 4Linked to original sources

Assessment of exercise tolerance in chronic bronchitis and interstitial lung disease.

Cardiopulmonary exercise testing has a definitive place in objective evaluation of the subjective sensation of breathlessness. In the present study 21 patients with COPD, 10 with ILD and 17 normals were subjected to stage 1 exercise testing and correlations were sought between Vo2 and work, FVC, FeV1, Ve, respiratory rate and tidal volume and between VCO2 and work. In COPD and ILD the Vo2 correlated with work, Fev1, Fvc and Ve whereas in normals it correlated with the VE but not with the FeV1 and FVC. In COPD VO2 correlated with TV though this was not the case in ILD. Thus stage 1 exercise testing can be a useful additional method to assess the disability in COPD and ILD although differentiation between these two respiratory diseases on basis of exercise testing alone may not be possible.

Adult↗

Involvement of AP1 and PEA3 binding sites in the regulation of murine tissue inhibitor of metalloproteinases-1 (TIMP-1) transcription.

Transcription of tissue inhibitor of metalloproteinases-1 (TIMP-1), a secreted protein that regulates the activities of the metalloproteinases, collagenase and stromelysin, is activated by serum growth factors. Transient transfection experiments have revealed several regions of cis-acting regulatory sequences involved in the response of the murine TIMP-1 gene to serum. One area is in the vicinity of the promoter, consisting of a non-consensus binding site (5'-TGAGTAA-3' at -59/-53) for transcription factor AP1 and an adjacent 24 bp region of dyad symmetry that contains a PEA3-binding site. A second is an upstream region (-1020 to -780) that acts as an enhancer when linked to a heterologous promoter, and contains a consensus AP1 binding site (at -803/ -797). Gel retardation assays revealed differences between nuclear factors in mouse C3H10T1/2 cells that bound to the TIMP(-59/ -53)AP1 site and a consensus collagenase TRE (TPA-response element). The TIMP(-59/ -53)AP1 site is a promiscuous motif that binds c-Fos/c-Jun AP1 translated in vitro and is an effective competitor for binding of nuclear AP1 factors to the consensus TRE, but in addition it binds factors that do not associate with the consensus TRE. The TIMP(-59/ -53)AP1 motif and the dyad symmetry region stimulated expression from a thymidine kinase promoter in an additive fashion, and competition experiments showed that excess copies of these factor binding sites reduced expression from a reporter plasmid driven by the TIMP-1 promoter. Our data show that binding sites for AP1 and PEA3 transcription factors are involved in the regulation of TIMP-1 transcription, which suggests that the coordinated induction of TIMP-1, collagenase and stromelysin may be achieved through the actions of a shared set of nuclear transcription factors. However, the properties of the TIMP-1(-59/ -53)AP1 motif likely reflect an additional type of transcriptional regulation restricted to TIMP-1.

Animals↗

Differential regulation of TIMP-1 and TIMP-2 mRNA expression in normal and Ha-ras-transformed murine fibroblasts.

A cDNA containing the complete coding region of the murine tissue inhibitor of metalloproteinases-2 (TIMP-2) was isolated using reverse transcription-polymerase chain reaction amplification. The predicted murine TIMP-2 amino acid sequence shows 96% identity with human TIMP-2, but only 42% identity with murine TIMP-1. This high degree of evolutionary conservation between the human and mouse proteins suggests that TIMP-2 performs an essential biological function. The expression of the TIMP-1 and TIMP-2 mRNAs was examined in normal and ras-transformed murine fibroblasts. While TIMP-1 transcription was highly serum-inducible in normal murine C3H10T1/2 fibroblasts, TIMP-2 mRNA expression was largely constitutive. A series of ras-transformed derivatives of C3H10T1/2 fibroblasts showed great variability in TIMP-1 expression: some lines retained serum inducibility, others displayed constitutive expression at either high or low levels. In contrast, TIMP-2 expression was insensitive to transformation. Neither TIMP-1 nor TIMP-2 expression at the RNA level, or total TIMP activity in conditioned media could be correlated with the metastatic potential of the ras-transformed lines. Our data demonstrate that the mechanisms that regulate murine TIMP-1 and TIMP-2 expression are distinct arguing for different physiological roles for the two TIMPs.

Amino Acid Sequence↗

Effect of combined deficiency of fat and vitamin A on N-nitrosodiethylamine-induced lung carcinogenesis in mice.

The present investigation shows the effect of combined dietary deprivation of fat and vitamin A on N-nitrosodiethylamine (NDEA) induced lung carcinogenesis in male Swiss NMRI mice. Lung tumors were induced by three intragastric administrations of NDEA (80, 80, 40, mg/kg body wt.) in normal saline with a gap of 4 weeks between each administration. The tumor incidence and tumor burden in control animals were found to be 39.1 and 3.9%, respectively. Fat deficiency decreased the tumor incidence to 30.4% and tumor burden to 3.7%. On the other hand, vitamin A deficiency increased them to 95.6 and 6.8%, respectively. Fat deprivation in the diet of animals fed with vitamin A deficient diet decreased the tumor burden and tumor incidence to 59.0 and 4.0%, respectively which were still more than in the control animals. This study suggests a protective role for low intake of fat in vitamin A deficiency.

Animals↗

Effect of bromhexeine on sputum amoxycillin levels in lower respiratory infections.

Bromhexeine has been widely used as an adjunct in the management of lower respiratory infections and is useful in altering the physical characteristics of sputum. Its effect on the sputum penetration of an antibiotic has been sparsely studied. The present study highlights the improvement in sputum amoxycillin (amoxy) levels when a combination tablet, amoxy 500 mg plus bromhexeine 8 mg, is administered as compared to plain amoxy 500 mg. Sputum amoxy levels were significantly higher in the combination group (0.674 +/- 0.588 micrograms ml-1) as compared to 0.272 +/- 0.19 micrograms ml-1 in the amoxy group (P = 0.028). The clinical responses assessed by the physician as well as the patient were significantly better in the amoxy plus bromhexeine group as compared to the amoxy group. The radiological and bacteriological responses were similar in both groups. There was no increase in the side-effects due to bromhexeine and, overall, its use can be recommended in the treatment of acute lower respiratory infections.

Adult↗

Cerebral infarction due to Aspergillus arteritis following glioma surgery.

Cerebral infarction due to fungal arteritis is an uncommon complication of neurosurgical operations and adjuvant immunosuppressive therapy, including long-term steroids. If unrecognized, the neurological deterioration which ensues may be mistreated by increasing the dose of steroids. A case of a 38-year-old Caucasian male who had no obvious immune deficiency or fungal infection prior to a craniotomy for cerebral tumour is described in whom perioperative aspergillus infection resulted in cerebral arteritis and extensive cerebral infarction with a fatal outcome. Long-term steroid therapy used in the management of cerebral tumours may carry an increased risk of systemic or cerebral fungal infection. The possibility of cerebral mycosis (arteritis) and dangers of its non-recognition are highlighted.

Adult↗

Primary cerebral lymphoma: report of 24 patients and review of the literature.

A retrospective study of 24 patients with primary non-Hodgkin's cerebral lymphoma (non-immunocompromised) is presented. All patients were seen at the Royal Preston Hospital, Lancashire between 1976 and 1991. Fifteen patients were over the age of 50 years (range 27-84). The commonest clinical presentation, seen in 16 patients was of an expanding space-occupying lesion. The diagnosis was suspected from the radiological findings but confirmation in every case was by histological examination of biopsy or necropsy material. The tumours were treated either by surgical excision or by biopsy and radiotherapy. Chemotherapy was given in two patients. Despite these measures the mean survival time was 3.6 months. The clinical radiological and pathological features of these tumours are highlighted with particular emphasis on the use of stereotactic biopsy, immunohistochemistry and chemotherapy in diagnosis and treatment.

Adult↗

Influence of ellagic acid on antioxidant defense system and lipid peroxidation in mice.

Addition of ellagic acid (EA) to liver microsomes of mice resulted in a steady increase in inhibition of NADPH-dependent lipid peroxidation up to 2 mM concentration. The maximum of 70% inhibition of ascorbate-dependent lipid peroxidation was achieved at 1 mM concentration of EA. Feeding of EA significantly increased the levels of reduced glutathione and glutathione reductase in liver and lungs of male and female mice. However, there were no changes in the activities of catalase and superoxide dismutase. On the other hand, microsomes from liver and lungs of EA fed animals showed significantly suppressed NADPH- and ascorbate-dependent lipid peroxidation.

Animals↗

Shunt surgery in growing skull fractures: report of two cases.

Growing skull fractures indicate underlying brain damage which is an important aetiological factor in their development. Two cases of growing skull fractures managed successfully with shunt surgery are presented. In one, the growing skull fracture was associated with an underlying tense occipital porencephalic cyst and in the other with cystic encephalomalacia and hydrocephalus. Following shunt surgery, signs of raised intracranial pressure were relieved, improvement in neurological status was noted, regrowth of the bone edges was seen and major surgery including brain debridement was avoided. The role of shunt surgery in growing skull fractures in infants is discussed and relevant details highlighted.

Brain Diseases↗

A double-blind, randomised comparison of fluvoxamine with dothiepin in the treatment of depression in elderly patients.

The efficacy and tolerability of the selective 5-HT reuptake inhibitor fluvoxamine were compared with the tricyclic dothiepin in 52 elderly (age greater than 64 years) hospital patients in a multi-centre double-blind randomised trial. Patients met DSM-III criteria for 'major depressive episode' and scored greater than 29 on the Montgomery Asberg Depression Rating Scale (MADRS) after a one-week placebo baseline. Active treatment was for six weeks. The dosage of both drugs was 50 mg nocte for three days, 100 mg nocte for the remainder of the first week, thereafter increasing to a maximum of 200 mg/day according to response/tolerance. MADRS scores improved by 63.5% with fluvoxamine and 60.0% with dothiepin; there were no significant differences between treatments at any assessment. Nausea, dizziness, headache, somnolence and constipation in both groups, plus dry mouth and asthenia in the dothiepin group were more frequent than single reports. Two patients in each group discontinued treatment owing to unwanted effects. There were no clinically significant changes in haematological, biochemical or cardiovascular parameters.

Aged↗

Effect of cigarette smoke inhalation on benzo[a]pyrene-induced lung carcinogenesis in vitamin A deficiency in the rat.

Vitamin A deficiency caused a significant increase (P less than 0.05) in benzo[a]pyrene (BP)-induced lung tumor incidence and tumor burden in male Wistar rats. Inhalation of cigarette smoke during initiation and post-initiation phases of carcinogenesis resulted in higher tumor burden as compared to the same observed in the animals exposed to cigarette smoke during the post-initiation phase only. Stimulation in tumor burden by cigarette smoke was increased further by vitamin A deficiency.

Administration, Inhalation↗

Transient hydrocephalus and acute lead encephalopathy in neonates and infants. Report of two cases.

In the Sultanate of Oman acute lead encephalopathy in neonates is common. Brain oedema in acute lead encephalopathy occurs predominantly in the cerebellar vermis and may act as a midline posterior fossa mass, occluding the fourth ventricle. The resultant transient obstructive hydrocephalus may need emergency drainage of cerebro-spinal fluid. The hydrocephalus is transient as vermis oedema subsides with medical treatment. Two such cases are reported and discussed.

Cerebrospinal Fluid Shunts↗

Extradural brucellosis granuloma with 'subtle' spondylosis: a rare cause of spinal cord compression.

A rare case of an extradural brucellosis granuloma in the thoracic region is presented. Medical treatment delayed surgical intervention and led to total paraplegia with sphincteric disturbance despite improving serum antibody titres. However, delayed neurosurgical intervention resulted in near-total clinical recovery. Early surgical intervention in cases of significant spinal cord compression due to an extradural brucellosis granuloma with a progressive neurological deficit is recommended.

Adult↗

Diencephalic syndrome of emaciation in an adult associated with a suprasellar craniopharyngioma--a case report.

An unusual association of diencephalic syndrome of emaciation, pituitary insufficiency for 2 years and suprasellar craniopharyngioma is described in a 45-year-old male. The tumour was found to be adherent to the anterior hypothalamic structures. Following partial excision, irradiation and hormonal replacement he regained his appetite, subcutaneous fat and body weight gradually.

Brain Neoplasms↗

Differential effects of fat deficiency on hepatic and pulmonary drug metabolizing enzymes in rat and mouse.

In the present study, we have evaluated the effect of dietary fat deprivation on the carcinogen/drug metabolizing enzymes in rats and mice. In rats, hepatic AHH, Cyt.P-450 Cyt.b5 and Cyt.c-reductase were significantly decreased due to fat deficiency, whereas in lungs, AHH and Cyt.c-reductase were decreased without any change in Cyt.P-450 level. In mice, feeding of fat-free diet did not cause any alteration in hepatic AHH and Cyt.P-450, but the levels of Cyt.b5 and Cyt.c-reductase were significantly reduced. In contrast to liver, Cyt.P-450 and Cyt.b5 were increased in lungs. Activity of UDPGT was lowered both in liver and lungs of rats whereas GST and GSH were increased in liver only. In mice, a decrease in UDPGT and appreciable increases in GST and GSH in liver were observed. However, in lungs, UDPGT activity was enhanced by feeding fat-free diet. These observations suggest that mice and rats respond differentially to the depletion of fat in the diet.

Animals↗