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Biomedical subjects

T Sinha

Publications and source records attributed to T Sinha.

14 recordsLinked to original sources

Intravesical Explosion during Transurethral Resection of Prostate - a reminder.

Intravesical explosion during transurethral resection of the prostate (TURP) is an extremely rare but dreaded complication and results in rupture of the bladder. It is believed that intravesical explosion occurs due to formation of explosive gases in the bladder during TURP and its admixture with air. A case of intravesical explosion during TURP resulting in bladder rupture at our institution is described. Though the management of this catastrophe is relatively straightforward, it has the potential for dire consequences. We emphasize that, despite its rare occurrence, it is preventable and suggest measures to avoid it.

Humans↗

The joint contributions of saccades and ocular drift to repeated ocular fixations.

We measured the joint contributions of different sized saccades and ocular drift to overall performance in an alternating fixation task. Subjects repeatedly shifted fixation between the centres of a pair of bars of width 2 degrees -2 arc min, either mentally selected or electronically cut from a stationary sine grating display. Eye movement patterns exhibited consistent features across all displays, and pairs of widely separated bars were studied most. Variability (S.D.) and relative accuracy (under/overshooting bias) were estimated from the concentration of eye positions over the two target bars. Overall variability, i.e. for eye movements as a whole, reached a minimum of 5 min for bar widths less than 20 min across subjects, displays and tasks. This was consistent, as were several other aspects of the study, with a constant 20-min diameter goal zone hypothesis. For wide bars, overall variability increased nearly as the square root of bar width, and for narrow bars, was independent of bar separation. A typical between-bar crossing saccade was tightly constrained in departure point but widely scattered in landing position, the associated variability increasing with bar separation. The final high overall precision was achieved largely by within-bar saccades of greater than 7.5 min effective amplitude that were present at a rate of 1 (range 0.3-3) per crossing saccade. This is consistent with views that very small saccades (the smaller microsaccades) make little obvious contribution to oculomotor performance.

Adult↗

High-level resistance to 3'-azido-3'-deoxythimidine due to a deletion in the reverse transcriptase gene of human immunodeficiency virus type 1.

A variant of human immunodeficiency virus type 1 (HIV-1) possessing a deletion in the reverse transcriptase (RT) gene at codon 67 was identified in a patient who had failed combination antiretroviral therapy. This deletion initially emerged under the selective pressure of combination therapy with 3'-azido-3'-deoxythymidine (AZT) plus 2',3'-dideoxyinosine. It has persisted for more than 3 years in association with the accumulation of a variety of other well-described drug resistance mutations and an uncharacterized mutation at RT codon 69 (T69G). Phenotypic studies demonstrated that the codon 67 deletion by itself had little effect on AZT sensitivity. However, in the context of the T69G mutation and three other mutations known to be associated with AZT resistance (K70R, T215F, and K219Q), this deletion led to a increase in AZT resistance from 8. 5-fold to 445-fold. A further increase in resistance (up to 1, 813-fold) was observed when two mutations associated with nonnucleoside RT inhibitor resistance (K103N and L74I) were added to the deletion T69G K70R T215F K219Q construct. Hence, these results establish that a deletion at RT codon 67 may be selected for in the presence of antiretroviral therapy and may lead to high-level resistance to AZT.

Anti-HIV Agents↗

Relationship between latitude and melanoma incidence: international evidence.

We investigate the relationship between latitude and incidence of melanoma among Whites in different age groups using data from different continents. Relevant data for Whites were obtained for 59 regions around the world. A statistical analysis was carried out using regional dummy variables to eliminate spurious statistical correlation due to clustering. Simple correlation between latitude and incidence of melanoma is strongly negative for almost all age groups. However, once the regional dummies were introduced in the analysis, the relation between latitude and incidence rates disappeared for all age groups but the explanatory power of the regression equation increased substantially.

Adolescent↗

Effect of forward lean on postural ankle dynamics.

Previous studies investigating postural control using platform perturbations demonstrated that forward leaning occurs under certain experimental conditions. This study examined a potential benefit of forward leaning, investigating the hypothesis that forward lean acts to increase the effective stiffness of the postural ankle dynamics. A systems modeling approach was used to evaluate the effect of forward lean (4 degrees ankle flexion beyond normal stance) on dynamic postural responses to continuous random antero-posterior platform acceleration in four healthy young adults. Motion was limited to the ankle joint using a restraint device and responses were characterized in terms of center-of-pressure displacement. Also, EMG and kinematic data were used to partition measured ankle torque into impedance and activation (postural "reflex") components. The results failed to show a consistent effect, due to lean, on the ankle dynamics. A significant increase in phasic ankle torque due to increased muscle impedance during forward lean was counterbalanced by a comparable decrease in net "reflex" ankle torque. The change in "reflex" torque was apparently due to decreased phasic dorsiflexor activity in forward lean, since phasic plantarflexor activity did not change significantly. Functionally, the results suggest that forward lean occurs for reasons other than stiffening of the overall postural ankle dynamics.

Adult↗

Development and clinical application of a new method for the radioimmunoassay of arginine vasopressin in human plasma.

A radioimmunoassay has been developed that permits reliable measurements of plasma arginine vasopressin (AVP) at concentrations as low as 0.5 pg/ml in sample volumes of 1 ml or less. Nonhormonal immunoreactivity associated with the plasma proteins is eliminated by acetone precipitation before assay, leaving unaltered a component that is immunologically and chromatographically indistinguishable from standard AVP. Storage of plasma results in a decline in AVP concentration and, thus, must be carefully regulated. The plasma AVP values obtained by our method approximate the anticipated levels and vary in accordance with physiologic expections. In recumbent normal subjects, plasma AVP ranged from (mean +/-SD) 5.4+/-3.4 pg/ml after fluid deprivation to 1.4+/-0.8 pg/ml after water loading, and correlated significantly with both plasma osmolality (r=0.52; P<0.001) and urine osmolality (r=0.77; P<0.001). After fluid restriction, plasma AVP was uniformly normal relative to plasma osmolality in patients with nephrogenic diabetes insipidus and primary polydipsia but was distinctly subnormal in all patients with pituitary diabetes insipidus. The infusion of physiologic amounts of posterior pituitary extract caused a dose-related rise in plasma vasopressin that afterwards declined at the expected rate (t(1/2)=22.5+/-4 min). We conclude that, when used appropriately, our radioimmunoassay method provides a useful way of assessing AVP function in man.

Acetone↗

Effects of dibutyryl cyclic adenosine 3',5'-monophosphate and parathyroid extract on calcium and phosphorus metabolism in hypoparathyroidism and pseudohypoparathyroidism.

It has been proposed previously that the metabolic defect in pseudohypoparathyroidism which accounts for parathyroid hormone unresponsiveness is an absence or abnormal form of the adenyl cyclase system in kidney and presumably in bone. To determine whether there is an associated defect in the response mechanism to cyclic adenosine 3',5'-monophosphate (cyclic AMP), the effects of parathyroid extract (PTE), and dibutyryl cyclic AMP were compared in patients with either surgical hypoparathyroidism or pseudohypoparathyroidism. PTE and dibutyryl cyclic AMP both increased serum and urinary calcium, lowered the serum phosphorus, and increased urinary phosphorus in patients with hypoparathyroidism. PTE also increased urinary cyclic AMP in these patients. PTE increased serum and urinary calcium and urinary phosphorus but did not alter serum phosphorus or urinary cyclic AMP in the patients with pseudohypoparathyroidism. Dibutyryl cyclic AMP increased the serum and urinary calcium, lowered the serum phosphorus, and increased urinary phosphorus in all the patients with pseudohypoparathyroidism. The results indicate that (a) dibutyryl cyclic AMP can reproduce the effects of parathyroid hormone on calcium and phosphorus metabolism in man, (b) the response mechanism to cyclic AMP appears to be intact in pseudohypoparathyroidism, and (c) PTE apparently produces some of its characteristic effects on calcium and phosphorus metabolism in pseudohypoparathyroidism in the absence of an increase in urinary cyclic AMP.

Adolescent↗