A case of ipsilateral shoulder and elbow dislocation: an easily missed injury.
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Accidental Falls↗
Biomedical subjects
S Krishnan
Publications and source records attributed to S Krishnan.
Partner violence and sexual HIV-risk behaviors among women in an inner-city emergency department.
This study examines the relationship between partner violence and sexual risk behaviors in a sample of predominantly Latina and African American women who sought medical care from a New York City hospital emergency department. Eligibility criteria selected women between the ages of 18 and 55, who were sexually active in the past 90 days, and were triaged to nonemergency care. The interview addressed demographics, partner violence, childhood abuse, sexual behavior, and drug and alcohol use. Multiple logistic regression analysis was used to assess the association between partner violence and history of having a sexually transmitted disease (STD) and of having sex with a risky partner. Nearly one half of the 143 respondents (46.1%, n = 66) reported that they had experienced physical, sexual, or life-threatening abuse by a boyfriend or spouse in the past and 17.5% reported that abuse had occurred within the past year. In the univariate analyses, abused women were more likely than nonabused women to report having had an STD; engaging in sex with a risky partner; having more than one sexual partner; and being tested for HIV. After controlling for confounding variables, abused women were almost five times more likely than their counterparts to have reported an STD and four times more likely to engage in sex with a risky sexual partner. The relationship between partner violence and sexual risk behaviors among women seeking treatment in an emergency department suggests the need for the development of HIV-risk reduction strategies that address the needs of women in abusive relationships.
Adolescent↗
Proficiency testing of creatine kinase and creatine kinase-2: the experience of the Ontario Laboratory Proficiency Testing Program.
The Ontario Laboratory Proficiency Testing Program has regularly monitored the analytical performance of total creatine kinase (CK) (approximately 230 participants) and CK isoenzyme-2 (CK-MB) (approximately 160 participants) throughout the entire province. Consistently, a wide dispersion of results has been observed not only between different analyzer systems but also among identical analyzers. Accordingly, the results of the last three proficiency surveys for these analytes were examined statistically to establish both the extent of these variations and the range of values reported for the male upper reference ranges. The results of many of the analyzer systems were significantly different from each other, as were many of the reference ranges. This unsatisfactory situation may only be remedied by the use of reference materials as shown by others. The consequences of these findings also effect the reliability of epidemiological surveys such as the WHO MONICA Project (Circulation 1994;90:583-612), which monitors deaths due to heart disease and includes cardiac enzyme results in its criteria.
Clinical Enzyme Tests↗
Primary hyperparathyroidism presenting with pathological fracture.
Primary hyperparathyroidism (PHPT) is an intriguing condition. Routine automated biochemical screening has made the diagnosis commonplace in developed countries and the disease is diagnosed early in its course when it is often asymptomatic. In developing countries or in recent immigrants from these countries, PHPT is often seen in an advanced stage with bone involvement. Associated dietary deficiencies may alter the biochemical profile and cause a diagnostic dilemma. It is important to include it in the differential diagnosis of pathological fractures. We report three cases of PHPT presenting with pathological fractures and discuss their diagnosis and management.
Adult↗
Larger increases in sensitivity to paracatalytic inactivation than in catalytic competence during experimental evolution of the second beta-galactosidase of Escherichia coli.
Second-order rate constants (M-1.s-1) at 25 degrees C and pH 7.5 for inactivation of first-generation (ebga and ebgb), second-generation (ebgab and ebgabcd) and third-generation (ebgabcde) experimental evolvants of the title enzyme by 2',4'-dinitrophenyl 2-deoxy-2-fluoro-beta-D-galactopyranoside are 0.042, 0.30, 10, 24 and 57 respectively. Only partial inactivation is observed, except for ebgabcde. At a single high inactivator concentration, inactivation of the wild-type ebgo is also seen. The changes in sensitivity to the paracatalytic inactivator (over a range of 10(3.3)) are larger than changes in kcat/Km for lactose (over a range of 10(2.7)) or nitrophenyl galactosides (over a range of only 10(1.3)), or changes in degalactosylation rate (over a range of 10(1.7)). These data raise the possibility that evolution in the reverse sense, towards insensitivity to a paracatalytic inactivator with a proportionally lower effect on transformation of substrate, may become a mechanism for the development of bacterial resistance to antibiotics that act by paracatalytic enzyme inactivation.
Binding Sites↗
Adaptive filtering, modelling and classification of knee joint vibroarthrographic signals for non-invasive diagnosis of articular cartilage pathology.
Interpretation of vibrations or sound signals emitted from the patellofemoral joint during movement of the knee, also known as vibroarthrography (VAG), could lead to a safe, objective, and non-invasive clinical tool for early detection, localisation, and quantification of articular cartilage disorders. In this study with a reasonably large database of VAG signals of 90 human knee joints (51 normal and 39 abnormal), a new technique for adaptive segmentation based on the recursive least squares lattice (RLSL) algorithm was developed to segment the non-stationary VAG signals into locally-stationary components; the stationary components were then modelled autoregressively, using the Burg-Lattice method. Logistic classification of the primary VAG signals into normal and abnormal signals (with no restriction on the type of cartilage pathology) using only the AR coefficients as discriminant features provided an accuracy of 68.9% with the leave-one-out method. When the abnormal signals were restricted to chondromalacia patella only, the classification accuracy rate increased to 84.5%. The effects of muscle contraction interference (MCI) on VAG signals were analysed using signals from 53 subjects (32 normal and 21 abnormal), and it was found that adaptive filtering of the MCI from the primary VAG signals did not improve the classification accuracy rate. The results indicate that VAG is a potential diagnostic tool for screening for chondromalacia patella.
Adult↗
A histopathological study of liver and kidney in male Wistar rats treated with subtoxic doses of t-butyl alcohol and trichloroacetic acid.
Tertiary butyl alcohol and trichloroacetic acid are known to be contaminants in drinking water. In order to evaluate the interactive toxicity of t-butyl alcohol with trichloroacetic acid, young male Wistar rats were dosed through water at a dose level of t-butyl alcohol (TBA)-0.5% (v/v), trichloroacetic acid (TCA)-25 ppm and a combined dose of TBA + TCA (0.5% v/v TBA-25 ppm TCA) for a period of 10 weeks ad libitum and were maintained on normal diet. The control animals received plain water and normal diet. The liver and kidney histology was undertaken to see whether subtoxic administration of TBA and TCA individually as well as combined administration for a period of 10 weeks would bring about any histological alterations. It was observed that TBA, TCA and TBA + TCA caused histological alterations in the liver such as centrilobular necrosis, vacuolation in hepatocytes and loss of hepatic architecture. TBA and TBA + TCA caused periportal proliferation and lymphocytic infiltration. Hypertrophy of hepatocytes in the periportal area was a characteristic feature in the liver of TCA treated rats. Moreover, in the histology of the kidney, in the three treated groups, degeneration of renal tubules, with syncitial arrangements of the nucleus of renal tubular epithelial cells was evident. In addition to this, degeneration of the basement membrane of the Bowmans capsule, diffused glomeruli and vacuolation of glomeruli was also evident in the three treated rat kidneys. Renal tubular proliferation in certain areas was also evident in certain areas of the kidney in TCA treated rats. The results indicate that, TBA and TCA do bring about alterations in histology of liver and kidney, but on combined administration, do not show enhanced toxicity in the form of increased hepatic and renal injury.
Animals↗
Parametric representation and screening of knee joint vibroarthrographic signals.
We have been investigating analysis of knee joint vibration or vibroarthrographic (VAG) signals as a potential tool for noninvasive diagnosis and monitoring of cartilage pathology. In this paper, we present a comprehensive comparative study of different parametric representations of VAG signals. Dominant poles and cepstral coefficients were derived from autoregressive models of adaptively segmented VAG signals. Signal features and a few clinical features were used as feature vectors in pattern classification experiments based on logistic regression analysis and the leave-one-out method. The results using 51 normal and 39 abnormal signals indicated the superior performance of cepstral coefficients in VAG signal classification with an accuracy rate of 75.6%. With 51 normal and 20 abnormal signals limited to chondromalacia patella, cepstral coefficients again gave the highest accuracy rate of 85.9%.
Algorithms↗
Adaptive aberration correction of abdominal images using PARCA.
Clinical images of the abdomen may be degraded by aberrations due to propagation through the abdominal wall, resulting in loss of contrast and reduction in overall image quality. The Parallel Adaptive Receive Compensation Algorithm (PARCA) uses multiple receive beams to compensate for these aberrations. Previous studies have demonstrated that PARCA can restore image quality in tissue-equivalent phantoms scanned with controlled phase and amplitude fluctuations. In this study, PARCA is used to improve clinical images of the abdomen. PARCA processed images show both improved contrast of structures and improved overall image quality.
Abdomen↗
Urokinase in the management of complicated parapneumonic effusions in children.
OBJECTIVE: Use of intrapleural fibrinolytic agents in the management of complicated parapneumonic effusions has been widely reported in adults. Such agents promote drainage of fluid through the thoracostomy tube and may obviate surgery. Both streptokinase and urokinase have been used for this purpose, but there are few reports of their use in the children. The objective of this study was to evaluate the role of intrapleural urokinase in the management of complicated parapneumonic effusions in children. METHODS: We reviewed the hospital course of nine children, ages 6 months to 6 years, with complicated parapneumonic effusions who received intrapleural urokinase after failing to respond to I.V. antibiotics and closed-tube thoracostomy drainage. Four subjects had additional thoroscopic adhesiolysis before intrapleural instillation of urokinase; 20,000 IU of diluted urokinase was instilled three times a day via the thoracostomy tube for 3 days. RESULTS: Eight subjects responded to 3 days of urokinase instillation, with increased thoracostomy tube drainage and clinical resolution of symptoms. The remaining subject responded to a second course of instillation. Two subjects needed oral analgesic for transient chest pain. All subjects tolerated the procedure well. No bleeding, fever, anaphylaxis, or allergic reactions were noted. The coagulation parameters remained unchanged. CONCLUSION: Intrapleural instillation of urokinase appears to be a useful and safe adjunct in the management of complicated parapneumonic effusions in children. Its use may be considered in potential decortication patients in an effort to prevent surgery and possibly shorten hospitalization.
Chest Tubes↗
Prosthetic valve endocarditis due to Staphylococcus saccharolyticus.
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Drug Resistance, Microbial↗
Nontoxigenic Vibrio cholerae 01 serotype Inaba biotype El Tor associated with a cluster of cases of cholera in southern India.
Thirteen strains of Vibrio cholerae 01 belonging to the Inaba serotype El Tor biotype isolated from patients during an outbreak of cholera in the town of Warangal in southern India were found to be nontoxigenic (NT), since they did not produce cholera toxin or hybridize with DNA probes specific for cholera toxin, Zot, or Ace. The unheated and heated culture supernatants of the NT V. cholerae 01 evoked a rapid cell-rounding effect when introduced on confluent layers of CHO and HeLa cells which could not be inhibited by antiserum against known toxins. Culture supernatants of two representative NT V. cholerae 01 strains caused an increase in short-circuit current in rabbit ileal tissue mounted on an Ussing chamber, and the pattern of increase in short-circuit current was consistent with the presence of a quickly acting toxin like stable toxin. None of the strains of NT V. cholerae 01 hybridized with a DNA probe specific for the heat-stable enterotoxin of V. cholerae non-01, nor did the factor produced by NT V. cholerae 01 resemble the recently described heat-stable enterotoxin produced by enteroaggregative Escherichia coli as determine by a PCR assay. To our knowledge, this is the first report of NT V. cholerae 01 being associated with a cluster of cases of cholera, and it appears that a clone of NT V. cholerae 01 has the potential to cause localized outbreaks of cholera.
Animals↗
Hearing results following modified radical versus canal-up mastoidectomy.
Modified radical mastoidectomy (MRM) provides relatively safe surgical access for the removal of chronic middle ear and mastoid disease and gives reproducible results. However, it had been suggested that hearing may not be as good as that after "intact canal wall mastoidectomy" (ICWM). This paper reviews 153 tertiary referrals suffering from extensive disease who underwent MRM and compares their hearing results with those obtained by other authors using ICWM and MRM and a variety of reconstructive techniques. In this study there were no dead ears and no significant changes in bone conduction despite prolonged drilling and extensive disease. Hearing results after MRM were found to be better after primary surgery than after revision and better in the presence of an intact stapes. No rigid prostheses were used at first-stage surgery. There were no significant differences found between hearing results obtained by MRM in this series and other published results of canal wall down mastoidectomy and ICWM, irrespective of the use of ossicular replacement prostheses.
Adolescent↗
Transmit aperture processing for nonlinear contrast agent imaging.
Nonlinear contrast agents, such as bubbles, are used in ultrasound to enhance backscatter from blood. To increase contrast between these agents and tissue, nonlinear imaging methods, such as harmonic imaging or difference frequency imaging, can be used. For these, power is transmitted at one frequency and received at a different frequency. Nonlinear imaging methods, however, suffer from reduced contrast because of signal transmitted by the array at the receive frequency that linearly reflects off tissue. In this paper, transmit aperture processing is proposed to improve contrast in nonlinear imaging by suppressing signal transmission at the desired receive frequency. A specific method, known as alternate phasing, is presented as an example of this approach. Simulation results show that alternate phasing greatly improves contrast between tissue and bubbles.
Blood Flow Velocity↗
Reducing delays in the laboratory diagnosis of tuberculosis.
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California↗
Catalytic consequences of experimental evolution: catalysis by a 'third-generation' evolvant of the second beta-galactosidase of Escherichia coli, ebgabcde, and by ebgabcd, a 'second-generation' evolvant containing two supposedly 'kinetically silent' mutations.
The kinetics of hydrolysis of a series of synthetic substrates by two experimentally evolved forms ('evolvants'), ebgabcd and ebgabcde, of the second beta-galactosidase of Escherichia coli have been measured. The ebgabcd enzyme differs from the wild-type (ebgo) enzyme by Asp92-->Asn (a) and Trp977-->Cys (b) changes in the large subunit, as well as two changes hitherto considered to have no kinetic effect, Ser979-->Gly in the large subunit (c) and Glu122-->Gly in the small subunit (d). The enzyme ebgabcde contains in addition a Glu93-->Lys change in the large subunit (e). Comparison of ebgabcd with ebgab [Elliott, K, Sinnott, Smith, Bommuswamy, Guo, Hall and Zhang (1992) Biochem. J. 282, 155-164] indicates that the c and d changes in fact accelerate the hydrolysis of the glycosyl-enzyme intermediate by a factor of 2.5, and also decrease the charge on the aglycone oxygen atom at the first transition state; the charge on the glycone, however, is unaltered [see K, Konstantinidis, Sinnott and Hall (1993) Biochem. J. 291, 15-17]. The e mutation causes a fall in the degalactosylation rate of about a factor of 3, and its occurrence only together with c and d mutations [Hall, Betts and Wootton (1989) Genetics 123, 635-648] suggests that degalactosylation of a hypothetical ebgabe enzyme would be so slow that the enzyme would have no biological advantage over the ancestral ebgab. The transfer products from galactosyl-ebgabcd and galactosyl-ebgabcde to high concentrations to glucose have been measured; the predominant product is allolactose, but significant quantities of lactose are also formed; however, at apparent kinetic saturation of the galactosyl-enzyme, hydrolysis rather than transfer is the preponderant pathway. A knowledge of the rates of enzyme-catalysed exchange of 18O from [1-18O]galactose to water permits the construction of the free-energy profiles for hydrolysis of lactose by begabcd and ebgabcde. As with the other evolvants, changes in the profile away from the rate-determining transition state are essentially random, and there is no correlation between the changes in the free energies of intermediates and of their flanking transition states. We consider the aggregate of our kinetic data on the ebg system to be telling experimental support for the theoretical objections of Pettersson [Pettersson (1992) Eur. J. Biochem. 206, 289-295 and previous papers] to the Albery-Knowles theory of the evolution of enzyme kinetic activity.
Catalysis↗
Administration of subtoxic doses of t-butyl alcohol and trichloroacetic acid to male Wistar rats to study the interactive toxicity.
Tertiary butyl alcohol and trichloroacetic acid (TCA) are known to be contaminants in drinking water. In order to evaluate the interactive toxicity of t-butyl alcohol (TBA) with TCA, young male Wistar rats were dosed through water at a dose level of TBA (0.5% v/v), 25 ppm TCA and a combined dose of TBA+TCA (0.5% v/v TBA, 25 ppm TCA) for a period of 10 weeks ad libitum and were maintained on normal diet. The control animals received plain water and normal diet. There was remarkable loss of body weight and significantly decreased liver triglycerides in the treatment groups in the order of TBA+TCA, TCA, TBA and increased liver weights were observed. Serum succinate dehydrogenase (SDH) levels were significantly increased in TCA- and TBA+TCA-treated groups. There was no significant change in serum alanine (GPT), aspartate (GOT) aminotransferase, serum alkaline (ALP) and acid (ACP) phosphatase levels as well as liver glutathione (GSH) and liver and serum cholesterol levels in the treated groups. But serum triglycerides, liver glycogen, serum glucose (only in TBA- and TCA-treated animals) were significantly high in the treated groups. Lipid peroxidation measured by diene conjugation was significant in TBA+TCA-treated group and kidney GSH levels were significantly low in the treated groups. These results show that interaction of TBA+TCA does bring about alteration in biochemical parameters which may play a pivotal role in toxic responses on long-term exposure.
Alanine Transaminase↗
Cadmium accumulation in follicular fluid of women in in vitro fertilization-embryo transfer is higher in smokers.
OBJECTIVE: To assess cadmium, a heavy metal in cigarette tobacco, in follicular fluid (FF) of women in IVF-ET, who smoke. DESIGN: Controlled clinical study. SETTING: Infertile patients in a hospital IVF-ET program. PATIENTS: Fifty-one women selected in groups according to smoking habits: nonsmokers (n = 10), passive smokers (n = 17), light smokers (< 15 cigarettes per day, n = 19), and heavy smokers (> or = 15 cigarettes per day, n = 5). INTERVENTIONS: Ovarian hyperstimulation with GnRH agonist. RESULTS: The mean +/- SEM level of FF cadmium was higher in smokers (7.93 +/- 0.16 ng/mL) than in nonsmokers (6.73 +/- 0.31 ng/mL), and with a dose-effect of smoking. The individual levels in passive, light, and heavy smoking women also were higher than in nonsmoking women. CONCLUSIONS: Despite lack of vascularization of the follicle, cadmium accumulation was detectable in FF. Cadmium also could accumulate in oocytes of smokers; it does so, in a dose-dependent manner, in oocytes of cadmium-treated rats. Access to cadmium and other contaminants of cigarette smoke in FF may compromise the quality of oocytes, becoming a risk factor.
Adult↗