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Biomedical subjects

S K Bhatnagar

Publications and source records attributed to S K Bhatnagar.

At least 37 records · Page 2Linked to original sources
PubMed1991

Postburn contracture of the neck--our experience with a new dynamic extension splint.

Twenty-eight examples of postburn contracture of the neck managed during the last 5 years gave us a better understanding of the problems of anaesthesia, contracture release, skin grafting, splintage and maintenance of the fully release state. The severe contracture should be incised before intubation under a local anaesthetic agent. The release should include the adjoining contractures of mandibular and pectoral regions lest the skin graft is pulled by the existing contracture. Haemostasis should be meticulously secured to avoid graft loss. Splintage should be a static splint for 4-6 weeks followed by a dynamic splint until the applied graft becomes soft, supple and wrinkle free. Ideally, however, contractures should be prevented by nursing the patient with a neck extension in the acute phase and wearing a cervical collar during the subacute phase of wound healing.

Adolescent↗
PubMed1991

Parascapular fasciocutaneous flap for covering an above-elbow amputation stump.

The successful use of a parascapular fasciocutaneous flap to cover an above-elbow amputation stump with exposed bone is described. Better stability of the stump to pressure (or manipulations), a relatively early one-stage surgical procedure and diminished possibility of later contracture leads to a better long-term outcome.

Amputation Stumps↗
PubMed1991

Tessier number 2 cleft, a variation. Case report.

The number 2 craniofacial cleft as described by Tessier is an extremely rare cleft of unknown aetiology with distinct soft tissue and bony characteristics. The location of the deformity on the nostril rim is a distinguishing feature of the cleft. It traverses the alveolar arch at the level of the lateral incisor, middle third of the alar rim, the junction between the nasal bone and the frontal process of the maxilla and continues cranially as a number 12 cleft. One such patient with bilateral interruption of the middle third of the alar rim and mild asymmetrical hypertelorism is described.

Child↗
PubMed1991

Significance of a mitral regurgitation systolic murmur complicating a first acute myocardial infarction in the coronary care unit--assessment by colour Doppler flow imaging.

To determine the prevalence and significance of a systolic mitral murmur heard after a first acute myocardial infarction (MI), we studied 186 consecutive patients in the coronary care unit (CCU) during a one-year period. Fifteen patients had a murmur as a result of mitral regurgitation (MR) (prevalence 8%) documented by colour Doppler flow imaging. It was heard before the third day of hospitalization in 10 (67%) patients, and on the third day itself in the remainder. The severity of MR was graded semi-quantitatively: moderate in 12 (80%) patients, and mild, moderate to severe and severe in three respectively. The direction of the MR jet, determined by colour flow imaging, improved the information obtained by two-dimensional echocardiography (2D echo) that could only diagnose mitral leaflet abnormality in seven (47%) patients. In 10 of 15 (67%) patients, the 2D echo ejection fraction was greater than or equal to 40% and in eight (53%) the wall motion score obtained by analysing 11 left ventricular (LV) segments was less than or equal to 8. Two (13%) patients died in the CCU, four (27%) had LV failure, one angina and eight (53%) remained asymptomatic in the hospital. Of 171 patients without a systolic murmur, 22 (13%) had LV failure, 13 (8%) angina and 25 (15%) died during the in-hospital stay (P-NS for these complications between patients with and without MR murmur). During a follow-up of 12-24 months, one MR patient died, and seven (47%) remained asymptomatic. We conclude that the prevalence of MR systolic murmurs in acute MI patients is low.(ABSTRACT TRUNCATED AT 250 WORDS)

Coronary Care Units↗
PubMed1990

Primary structure of the deoxyguanosine triphosphate triphosphohydrolase-encoding gene (dgt) of Escherichia coli.

The complete nucleotide sequence has been determined for a 2027-bp region that encompasses the structural gene (dgt) encoding deoxyguanosine triphosphate triphosphohydrolase (dGTPase) from Escherichia coli. The gene resides between the htrA and dapD loci at 3.75-3.8' on the bacterial chromosome. Using homologous recombination in a recD recipient, a dgt- bacterial strain was constructed that was deficient in producing functional dGTPase. Comparison of dGTP pools in this and other strains revealed that dGTPase synthesized in vivo does to some degree modulate the level of dGTP in the bacterial cell, yet the magnitude of this modulation may be insufficient to explain the physiological function of dGTPase.

Amino Acid Sequence↗
PubMed1990

The lateral thoracic region flap.

The lateral thoracic region flap is based at the level of the 3rd rib on multiple direct cutaneous perforators. It has an excellent vascularity with a dependable length/width ratio of 3:1. The donor area, which lies in a concealed region, can often be closed primarily. The flap is hairless and can be used anteriorly to cover raw areas over breast and axilla and posteriorly over scapula and chest wall. As a distant flap it can be used to resurface raw areas on the ipsilateral upper arm and forearm and contralateral hand. The successful use of the flap in 40 cases in this series confirms its reliability, versatility and convenience.

Adult↗
PubMed1990

Significance of blood taurine levels in patients with first time acute ischaemic cardiac pain.

We studied blood taurine levels of 91 consecutive patients admitted with first time cardiac pain suggestive of myocardial ischaemia. Blood taurine levels of patients with coronary arterial disease, but without a recent myocardial infarction (n = 36), at rest and after a maximal treadmill stress testing were also determined. The blood taurine level at the time of admission was significantly elevated (P less than 0.001) in patients with an acute myocardial infarction (n = 63) (271 +/- 98 mumol/l) and those with unstable angina (n = 22) [214 +/- 81 mumol/l] compared to that of normal subjects (n = 75) at rest (140 +/- 40 mumol/l). Patients with a myocardial infarction had a higher level than those with unstable angina (P less than 0.01) and non-ischaemic chest pain (n = 6) [P less than 0.05]. The levels peaked after 12-48 hours only in patients with infarction [367 +/- 140 mumol/l] (P less than 0.001) and unstable angina (273 +/- 82 mumol/l) (P less than 0.02). The levels of creatine kinase within the serum at the time of admission did not correlate well with those of blood taurine, but the peak levels of the former did correlate with the latter (P less than 0.02). Patients with known coronary arterial disease had a higher resting [236 +/- 69 mumol/l] level of blood taurine than normal subjects (P less than 0.001), which was further elevated [269 +/- 80 mumol/l] following exercise (P less than 0.001). Thus, an elevated level of taurine in whole blood at the time of admission of patients with an acute cardiac pain suggested the diagnosis of either a myocardial infarction or unstable angina. The level of taurine may be utilised to differentiate the two conditions.

Adult↗
PubMed1990

Fasciocutaneous flaps for burn contractures of the axilla.

Fasciocutaneous flaps do not compromise the function of joints, are less bulky and are easier to dissect. Their use prevents the uncomfortable prolonged splintage of the axilla with the shoulder in abduction which follows split skin grafting. Fasciocutaneous flaps are reliable and failure is minimal, if at all, unlike split skin grafting. Parascapular, lateral thoracic and cervicohumeral fasciocutaneous flaps have been used in 23 patients (aged 8-36 years) with a total of 30 flaps. The mean hospital stay was 12 days and no recurrence of the contracture was observed in the follow-up period of 3-18 months.

Adolescent↗
PubMed1990

Bacteriophage T4 deoxynucleotide kinase: gene cloning and enzyme purification.

Gene 1 of bacteriophage T4 has been cloned into a lambda pL expression vector, resulting in the overproduction of deoxynucleotide kinase. A procedure that includes affinity chromatography on Cibacron Blue F3GA-agarose has been used to purify milligram quantities of enzymes from a 2-liter culture. The enzyme has been partially characterized in vitro and in vivo, and it appears to be identical to the deoxynucleotide kinase isolated from T4-infected Escherichia coli. These results prove the earlier contention that the phosphorylation of three dissimilar deoxynucleotides (5-hydroxymethyldeoxycytidylate, dTMP, and dGMP), to the exclusion of most others, is catalyzed by a single protein.

Amino Acid Sequence↗
PubMed1989

Location and molecular cloning of the structural gene for the deoxyguanosine triphosphate triphosphohydrolase of Escherichia coli.

The structural gene for deoxyguanosine triphosphate triphosphohydrolase (dGTPase) (EC 3.1.5.1) and its regulator, optA, have been located on a lambda phage carrying a 17.5kb Escherichia coli DNA insert. The DNA fragment has been excised and ligated into pBR325 and also transferred to another lambda vector. From the results of transduction and transformation experiments, we find that the structural gene for dGTPase is very closely linked to optA and dapD, which locates it at approximately 3.6 minutes on the genetic map of E. coli K12. We propose the mnemonic dgt as the designation for the structural gene for this enzyme.

Bacteriophage lambda↗
PubMed1988

Studies on the mutator gene, mutT of Escherichia coli. Molecular cloning of the gene, purification of the gene product, and identification of a novel nucleoside triphosphatase.

The mutator gene, mutT, has been cloned into an expression vector and overproduced in Escherichia coli. The gene product has been purified to over 90% homogeneity as judged by gel electrophoresis and amino acid analysis. The amino acid composition of the protein and the sequence of the 20 amino acids of the N-terminal region agree well with the nucleotide sequence of the gene reported by Akiyama et al. (Akiyama, M., Horiuchi, T., and Sekiguchi, M. (1987) Mol. Gen. Genet. 206, 9-16) and indicate that the first of the potential initiation codons (position 164) of the open reading frame in the PvuII fragment carrying the mutT gene is the site of initiation of translation of the 15,000-Da polypeptide. A novel nucleoside triphosphatase activity which has a preference for dGTP is associated with the purified protein, and preliminary experiments are consistent with the notion that the mutT gene product is the enzyme responsible for this activity.

Amino Acid Sequence↗
PubMed1988

The purification and properties of deoxyguanosine triphosphate triphosphohydrolase from Escherichia coli.

Deoxyguanosine triphosphate (dGTP) triphosphohydrolase (EC 3.1.5.1) has been purified approximately 16,000-fold to apparent homogeneity from extracts of Escherichia coli. The enzyme has a native molecular weight of 230,000 and a sedimentation coefficient of 9.3 S. Its subunit molecular weight derived from electrophoresis in denaturing polyacrylamide gels is 58,900, and it has a unique N-terminal sequence for the first 25 amino acids, which indicate that the native enzyme is composed of 4 homologous subunits. It is insensitive to sulfhydryl reagents and EDTA and can be heated to 60 degrees C for 60 min without loss of activity. The enzyme requires Mg2+ for activity, is highly specific for dGTP among the canonical deoxynucleoside triphosphates, and has a unique activity among nucleoside triphosphatases in that the products of the reaction are deoxyguanosine and inorganic tripolyphosphate. Preliminary evidence suggest that this enzyme is responsible for the optA mutant phenotype first described by Saito and Richardson (Saito, H., and Richardson, C.C. (1981) J. Virol. 37, 343-351).

Amino Acids↗
PubMed1988

Left ventricular function of survivors of a first complicated acute myocardial infarction. A prehospital discharge cross-sectional echocardiographic study.

To assess the left ventricular function of patients who suffer from post-infarction angina and left ventricular failure in the coronary care unit, 79 consecutive survivors (mean age 48 years) of a first acute myocardial infarction were prospectively studied and followed-up for a mean 18- (10-34) month period. Forty-seven had an uncomplicated infarction, 17 suffered from post-infarction angina and 15 had left ventricular failure. The left ventricular function of these patients prior to discharge from hospital was assessed by cross-sectional echocardiography and radionuclide angiography. Analysis of left ventricular wall motion was performed in all patients using a 11-segment model of the left ventricular. The ejection fraction was determined by echocardiography in 47 patients and by radionuclide angiography in 50. The mean echocardiographic wall motion score of post-infarction angina patients (4.8 +/- 0.8) (+/- SEM) was lower than that of patients with left ventricular failure (9.5 +/- 0.5) (P less than 0.001), but was not different from patients suffering uncomplicated infarctions (4.6 +/- 0.3). The mean echocardiographic ejection fraction was also similar in post-infarction angina (45.3 +/- 4.0; n = 16) and patients with uncomplicated infarction (51.9 +/- 2.7; n = 17), but was lowest in the group of patients with left ventricular failure (35.1 +/- 3.3; n = 14). Similarly, the radionuclide ejection fraction of patients with post-infarction angina (41.4 +/- 3.4; n = 17) and patients with uncomplicated infarction (45.6 +/- 2.7; n = 19) did not differ, but was lower in patients with left ventricular failure (25.9 +/- 2.8; n = 14). The echocardiographic ejection fraction correlated with that obtained by radionuclide angiography in all 46 patients (r = 0.71, P less than 0.001). The wall motion score correlated with the radionuclide ejection fraction in all 50 patients (r = -0.73, P less than 0.001) and with the echocardiographic ejection fraction in 47 patients (r = -0.55, P less than 0.001). During follow-up, 3 (18%) patients suffering post-infarction angina and 2 (13%) with left ventricular failure died. New infarction was seen in 2 (12%) and 1 (7%) patients in these groups, respectively. We conclude that the left ventricular function of patients who suffer from post-infarction angina in the coronary care unit is good, but is impaired in those with even transient left ventricular failure. Echocardiographic assessment of cardiac function prior to hospital discharge was highly successful and may be performed in all such patients.

Adult↗
PubMed1988

Median cleft lip with bimanual hexadactyly and bilateral accessory toes. Report of two cases in the same family.

The present paper presents two brothers with a median upper lip cleft, associated with postaxial hexadactyly of both hands and feet. Very few similar cases have previously been reported in the literature by various workers. The similarity between the cases reported in the literature and the two cases presented here indicates the existence of a median cleft lip-hexadactyly-syndrome.

Child↗
PubMed1988

The effect of a hot dry climate on the haemorrheology of healthy males and patients with acute myocardial infarction.

We studied the influence of an extremely hot dry summer and temperate winter on the haemorrheology of 82 healthy males (controls) and 101 male patients with acute myocardial infarction (AMI). The haematocrit (Hct), blood viscosity (B1V) and Hct/B1V ratio were measured in these subjects working 'outdoors' and in an air-conditioned environment ('indoors'). The 'summer outdoor' controls had a higher B1V and a lower Hct/B1V when compared to the 'winter outdoor' controls (P less than 0.01), and the 'summer indoor' controls had a lower Hct and Hct/B1V when compared to the 'winter indoor' control group (P less than 0.02). The haemorrheology of 'winter indoor' AMI patients was not different from the controls, except for the Hct/B1V. The 'summer indoor' group had a higher Hct (P less than 0.05) and B1V (P less than 0.001) and a lower Hct/B1V (P less than 0.02) when compared to the controls. 'Summer outdoor' AMI patients had the most abnormal haemorrheology of all groups. AMI patients with Hct/B1V less than 7 had a significantly higher prevalence of hypotension and shock syndrome compared to those whose Hct/B1V was greater than or equal to 7 (P less than 0.05). We conclude that in healthy males, there was a seasonal difference in haemorrheology which was due to acclimatization to heat. During summer, AMI patients working outdoors had the most abnormal haemorrheology on admission and the occurrence of complications was also higher in them. We believe that these abnormalities resulted due to inadequate adjustments to heat.

Acclimatization↗
PubMed1987

Abnormal autonomic function in diabetic and nondiabetic patients after first acute myocardial infarction.

We performed autonomic function testing in 68 patients, 34 with diabetes mellitus (group A) and 34 without (group B), at 72 h after a first acute myocardial infarction (MI) to determine the prevalence of autonomic dysfunction in these patients. Heart rate (HR) variation during 6 breaths/min obtained from mean of longest RR interval during expiration(E)/mean of shortest RR interval during inspiration (I) (E:I ratio), immediate HR response to standing = RR at 30th beat/RR at 15th beat (30:15 ratio) and postural fall of blood pressure were evaluated. In group A, 25 (78 percent) of 32 patients had an abnormal expiration-inspiration ratio compared with 28 (85 percent) of 33 in group B. Twenty-six (76 percent) patients in group A and 16 (47 percent) in group B had an abnormal 30:15 ratio. Abnormal postural fall of blood pressure was seen in 16 (47 percent) patients in group A compared with ten (29 percent) in group B. During follow-up, four women in group A with an initial autonomic dysfunction died, and in group B, three patients with a normal autonomic function died. Thus, autonomic dysfunction does not seem to contribute to the high mortality among diabetics after an acute MI.

Adult↗