Biomedical subjects

Vijay K Shukla

Publications and source records attributed to Vijay K Shukla.

8 recordsLinked to original sources

PubMed2005

Apoptosis: a basic physiologic process in wound healing.

Apoptosis, or programmed cell death, is a complex network of biochemical pathways for controlling such events in a cell. Apoptosis is essential, as its failure can lead to disease. Because apoptosis concerns the regulation of sequential events, including the removal of inflammatory cells and the evolution of granulation tissue into scar tissue, it has an essential role in wound repair. This article examines the literature and proposes that apoptosis features in the development of diabetic foot wounds. Hyperglycemia deregulates the sequential apoptotic events by multiple mechanisms, leading to delayed wound healing. Deregulated apoptosis is emerging as a prominent cause of delayed wound healing, especially in diabetic wounds, along with the well-known triad of peripheral vascular disease, neuropathy, and infection.

Apoptosis↗

PubMed2004

Cholelithiatic human gallbladders in vitro fail to respond to cholecystokinin but are responsive to carbachol, histamine, or electrical stimulation.

The present investigation was undertaken to delineate the in vitro responsiveness of cholelithiatic gallbladders to cholecystokinin (CCK) and compared with those evoked by carbachol, histamine, or electrical stimulation. Gallbladder muscular strips (2-3 mm wide and 15-20 mm long) from patients undergoing cholecystectomy were used for recording the in vitro contractions evoked by electrical and chemical (carbachol, histamine, or cholecystokinin) stimulation. Stimulation of strips with trains of pulses (5-msec duration, 70 V at 100 Hz) of varying train durations (0.01 to 9 sec) elicited duration-dependent increase in the amplitude of contractions and the maximal contractions were seen with 5 sec. Atropine (0.4 microM) significantly attenuated these contractions, leaving about 34% of contractions, which in turn was abolished by xylocaine. Carbachol produced a concentration-dependent (0.004-0.4 microM) increase in force of contraction and the maximal response was seen at 0.4 microM and abolished by atropine (0.4 microM). Histamine also produced contractions and the maximal contractions were about 35% of the maximal carbachol response. Histamine-induced contractions were not abolished by atropine but were abolished by xylocaine. CCK up to 10 microM failed to evoke any contraction, even though the strips were responsive to carbachol. The results indicate that cholelithiatic gallbladders exhibited responses to electrical stimulation through cholinergic and histaminergic plexuses and they were insensitive to CCK.

Atropine↗

PubMed2003

Erythrocyte membrane fatty acid profile and saturation index in gallbladder carcinogenesis: a case-control study.

BACKGROUND: Gallbladder cancer is a common neoplasm of biliary tract, with an unknown etiology. PATIENTS AND METHODS: This study was carried out to evaluate the changes in the membrane fatty acid profile and saturation index in patients with gallbladder cancer. The study sample consisted of 50 newly diagnosed cases of gallbladder cancer and 50 patients undergoing cholecystectomy for cholelithiasis were recruited as controls. The fatty acid estimation was carried out by high performance liquid chromatography (HPLC). Statistical analysis was carried out by student 't' test and one-way ANOVA. Pearson's correlation coefficient was also obtained. RESULTS: A significant lowering of erythrocyte membrane stearic acid (p = 0.000), arachidonic acid (p = 0.001), and saturation index (p = 0.001) was observed in patients with gallbladder cancer compared to controls. A significant inverse relation was observed between stearic and oleic acid (r = -0.269 p = 0.007). CONCLUSION: Results of the present study suggest an increase in the delta 9 desaturation in cancer patients compared to controls however, a possible role of biliary stasis due to altered gallbladder motility or derangements of signal transduction secondary to altered membrane lipid bilayer cannot be ruled out.

Journal Article↗

PubMed2003

Cytochrome P-450 expression and lipid peroxidation in gallbladder cancer.

BACKGROUND AND OBJECTIVES: Carcinoma of the gallbladder is the commonest neoplasm of the biliary tract; however, the etiology of this tumor remains unclear. METHODS: A case-control study was carried out comprising 50 patients with gallbladder cancer and 50 patients with cholelithiasis. Cytochrome P-450 estimation was carried out in the gallbladder tissue, and lipid peroxide product melonaldehyde (MDA) was measured in gallbladder bile. Statistical analysis was carried out by Student's t-test, and one-way analysis of variance (ANOVA). The Pearson correlation coefficient was calculated, and linear regression analysis was performed. RESULTS: The mean cytochrome P-450 concentration was significantly higher in patients with carcinoma of the gallbladder than in controls (t = 3.9, P < 0.001; F = 15.2, P = 0.002). Similarly, the mean concentration of melonaldehyde was significantly higher among cancer patients than in patients with gallstones (t = 2.7, P < 0.003; F = 7.37, P = 0.0078). No significant correlation was observed between tissue MDA and cytochrome P-450 levels (Pearson r = 0.1, P = 0.28). CONCLUSIONS: The results of the present study show that the rise in concentration of MDA is independent of the rise in concentration of cytochrome P-450; however, this is statistically insignificant. This could be due to biliary stasis leading to a rise in biliary concentration of melonaldeyde that is disproportionate to its production.

Adult↗

PubMed2003

Alefacept: potential new therapy for patients with moderate-to-severe psoriasis.

Alefacept is a new biotechnology product designed for the treatment of patients with chronic plaque-type psoriasis who have disease severe enough to make them eligible for phototherapy or systemic therapy. In two randomized controlled phase III trials of patients with moderate-to-severe disease, alefacept showed a modest but statistically significant increase in the number of responders compared to placebo. Alefacept's dose-dependent CD4+ T lymphocyte-depleting effect requires monitoring; however, no association has been found between this adverse effect and serious adverse events, particularly infection. Due to lack of direct comparative data, it is difficult to predict exactly how alefacept will fit into the current rotational psoriasis therapy paradigm.

Canada↗

PubMed2003

Treating osteoporosis with teriparatide: many unknowns?

In the US, teriparatide is indicated for the treatment of patients with osteoporosis who are "at high risk for fracture." Although placebo-controlled trials show that teriparatide can reduce fractures, there is little information on its efficacy compared to available alternatives. In the US, the Food and Drug Administration highlighted concerns about teriparatide's carcinogenic effects in rats. Company-sponsored studies have been voluntarily stopped.

Adult↗

PubMed2002

Leg ulcers in the tropics.

Leg ulcers are an important clinical condition and are often difficult to treat. The treatment has to continue for long periods, and the associated morbidity leads to significant loss of work. The successful treatment of leg ulcers or chronic wounds depends upon accurate diagnosis and treatment of the underlying cause. In Western societies, most leg ulcers are due to venous insufficiency, arterial disease, neuropathy (usually diabetic), or some combination of these factors. In tropical countries, however, there have been no large series of leg ulcers reported. The prevalence of leg ulcers and etiology are unknown. In this article, a short review is presented of the etiology and management of lower extremity ulcers as seen in the tropical countries.

Journal Article↗

PubMed2002

Tiotropium: a potential replacement for ipratropium in patients with COPD.

Inhaled tiotropium provides a sustained bronchodilator effect over a 24-hour period in patients with chronic obstructive pulmonary disease (COPD). There is some evidence that tiotropium 18 micro g once daily is more efficacious than ipratropium bromide 40 micro g four times daily, for patients with COPD, as measured by improvements in lung function, dyspnea disease-specific quality of life and reductions in hospitalization due to COPD. Dry mouth is a more frequent problem with tiotropium than with ipratropium bromide.

Bronchodilator Agents↗