Biomedical subjects
Publications and source records attributed to V Sharma.
Thermal injury is known to induce alterations in the immune system. Sixty-four patients of thermal burns have been studied for serum immunoglobulins. Concentrations of IgG, IgA and IgM were decreased immediately after injury and gradually increased up to normal limits on the 30th postburn day.
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The uncommon variants amongst 619 cases of craniospinal dysraphism have been studied between 1987 to 1993. Lateral cervical meningocele is an extremely rare condition as to date only ten cases are traceable in the world literature. Its pathogenesis is discussed in detail. Similarly, this case of lateral frontal encephalocele is the second such example. Orbital meningocele may be congenital or following trauma to the orbital roof. Besides other unusual locations like the vertex, posterior fontanelle and anterior sacral are also encountered. Thus this paper focuses on the aetiology, clinical presentation and management of uncommon types of craniospinal meningo-encephaloceles.
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Poncet's disease is a rare polyarthritis occurring in patients with tuberculous infection. We describe two cases of polyarthritis, one secondary to pulmonary tuberculosis, the other secondary to tuberculous infection of lymph nodes. In both cases the arthritis rapidly subsided with chemotherapy.
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Among the various infrequent causes of Pancoast's syndrome, Hodgkin's disease is one. A 26 year old man was diagnosed as Hodgkin's disease. Five years later the disease relapsed producing Pancoast's syndrome. The importance of precise aetiological diagnosis before treatment of such cases with similar presentation is emphasized.
Transport substrates and modulators of the human multidrug resistance (MDR1) P-glycoprotein (Pgp) are generally lipophilic cationic compounds, many with substituted aryl moieties. We sought to synthesize aromatic technetium-isonitrile complexes to enable functional detection in vivo of Pgp expression in tissues. A series of substituted aromatic isonitrile analogs were synthesized from their corresponding amines by reaction with dichlorocarbene under phase transfer-catalyzed conditions, and the non-carrier-added hexakis(areneisonitrile)Tc-99m(I) complexes were produced by reaction with pertechnetate in the presence of sodium dithionite. Cellular accumulation in vitro, whole body biodistribution, and the imaging properties of these lipophilic, monocationic organometallic complexes were determined in Chinese hamster lung fibroblasts expressing MDR Pgp, in normal rats, and in rabbits, respectively. For this initial series, verapamil (50 microM), the classical Pgp modulator, significantly enhanced cellular accumulation or displaced binding of Tc complexes of 1b, 1d, 1h, 2a, 2d, 3a, and 3b, indicative of targeted interactions with Pgp. Most complexes, despite their modestly high lipophilicity, were excluded by the blood/brain barrier, and several complexes displayed simultaneously high hepatobiliary and renal excretion in vivo, consistent with the physiological expression pattern of Pgp in these tissues. Selected Tc- and Re-areneisonitrile complexes of this class have potential applicability to the functional imaging and modulation, respectively, of MDR Pgp in human tissues.
Cytokine responses are dramatically affected when HIV-1 infected cells are activated with certain antigenic stimuli. We report the effects of HIV-1 tat gene in cytokine modulation, using HIV-1 tat transfected T (Jurkat) and B (Raji) cell lines. Studying the effect of tat and/or PMA + PHA on mRNA expression of 14 cytokines (IL-1 alpha, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12, TNF-alpha, TNF-beta, GM-CSF, TGF-beta, IFN-gamma and MIP-1 alpha) illustrated differential effects. In addition to the varied effects of tat on the steady state levels of cytokine mRNAs, tat induced the secretion of TNF-beta preferentially in both B and T cell lines, either by itself as in Raji B cell line or synergistically upon PMA + PHA stimulation as in Jurkat T cell line.
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Lack of a conduit of adequate length or quality poses a dilemma in the occasional patient. We report such a case in whom we applied a modified anastomotic technique using the normal right coronary artery for the proximal anastomotic site of a free right internal mammary artery graft.
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This study examined whether children who initiate physical fights are impulsive as measured by a continuous performance test. A series of 111 7-13-year-old psychiatric patients were diagnosed using DSM-III-R criteria and divided according to whether they showed a persistent pattern of initiating physical fights. Children who initiated fights were impulsive irrespective of whether ADHD was present or not, although ADHD was also associated with increased impulsivity. Oppositional-defiant disorder and conduct disorder diagnoses were not associated with impulsivity. These findings are discussed in terms of an underlying impulsive personality trait and its possible relationship to outcome in children with disruptive behavior disorders.
A total of 1070 men and women aged 65 years and over living in the community in Liverpool were interviewed using the Geriatric Mental State. Diagnoses of depression at case and subcase level were made using the GMS-AGECAT package from an initial interview and at follow-up three years later. Data relating to blood pressure at year 0 was available on 748 subjects. Men not taking anti-hypertensives or antidepressants with diastolic blood pressure greater than 85 mmHg were significantly less likely to be subcases than men with low or normal diastolic pressure. People in this group were also significantly less likely to be cases 3 years later. There were no other significant findings. These results do not support an association between low blood pressure and coincidental or future subcase- or case-level depressive illness.
Murine macrophage inflammatory protein 1 alpha (MIP-1 alpha) and its human equivalent (GOS19, LD78, or AT464) are members of the -C-C family of low-molecular-weight chemokines. Secreted from activated T cells and macrophages, bone marrow-derived MIP-1 alpha/GOS19 inhibits primitive hematopoietic stem cells and appears to be involved in the homeostatic control of stem cell proliferation. It also induces chemotaxis and inflammatory responses in mature cell types. Therefore, it is important to understand the mechanisms which control the expression of MIP-1 alpha/GOS19. Previous work has shown that in Jurkat T cells, a set of widely expressed transcription factors (the ICK-1 family) affect the GOS19 promoter. One member, ICK-1A, behaves as a strong negative regulator. In this communication, we provide evidence that the pathway of induction in the macrophage cell line U937 is different from that in Jurkat cells. Furthermore, we show that the ICK-1 binding site does not confer negative regulation in U937 cells. We provide evidence for an additional binding site, the MIP-1 alpha nuclear protein (MNP) site, which overlaps the ICK-1 site. Interaction of nuclear extracts from various cell lines and tissue with the MNP site leads to the formation of fast-migrating protein-DNA complexes with similar but distinct electrophoretic mobilities. A mutation of the MNP site which does not abrogate ICK-1 binding inactivates the GOS19.1 promoter in U937 cells and reduces its activity by fourfold in Jurkat cells. We propose that the MNP protein(s) binding at the MNP site constitutes a novel transcription factor(s) expressed in hematopoietic cells.
OBJECTIVE: To examine the occurrence of concomitant psychiatric disorders in patients with treatment-resistant unipolar and bipolar depression. METHOD: Forty-nine patients participated as subjects. Twenty-four (49%) had unipolar depression and 25 (51%) had bipolar depression using DSM-III-R criteria. Structured clinical interviews were conducted with all patients. Chart reviews and interviews with family members were also carried out. Information relating to both current and lifetime diagnoses was obtained. RESULTS: Of the entire sample, 75.5% were found to have at least one other Axis I diagnosis and 46.9% had at least two additional Axis I diagnoses. The unipolar group had significantly more current comorbid diagnoses. When type of diagnoses was examined, unipolar patients had significantly more anxiety diagnoses at the time of the index episode, and over their entire lifetime. Bipolar patients had significantly more lifetime substance abuse diagnoses. CONCLUSIONS: Axis I comorbidity appears to be differentially associated with treatment resistance in unipolar and bipolar depression.
Optical properties of the eye contribute to the reduced visibility of spatial patterns at low luminance. To study the limits of spatial vision when optical factors are minimized, we measured contrast-sensitivity functions (CSF's) for 543.5-nm laser interference fringes imaged directly on the retina. Measurements were made in the fovea at four luminance levels, ranging from 0.3 to 300 photopic trolands (Td). At each luminance the fraction of coherent light in the stimulus pattern was varied to assess the masking effects of laser speckle, which is visible as spatial noise in fields of coherent light. Compared with published CSF's obtained under natural viewing conditions, interferometric CSF's were similar in height but broader, with the range of visibility being extended to higher spatial frequencies. The masking effects of speckle were greatest at the highest luminance and were negligible at the lowest luminance. For low coherent fractions, contrast sensitivity improved over the entire luminance range at a rate consistent with a square-root law; with purely coherent light, sensitivity tended to level off at approximately 30 Td because of speckle masking. The results indicate that the optical quality of the eye reduces the spatial bandwidth of vision even at luminances near the foveal threshold. The change in interference fringe visibility with luminance is consistent with noise-limited behavior, and the masking effects of speckle noise diminish as luminance decreases.
Case histories of three bipolar II disorder patients who had periods of sustained euthymia during all their pregnancies are described. The clinical and research implications of these observations are discussed.