Synthesis, modification with N-acetoxy-2-acetylaminofluorene and physicochemical studies of DNA model compound d(TACGTA)

The deoxyhexanucleotide d(TACGTA) was synthesized by a modified phosphotriester method. The modified procedure made rapid synthesis of deoxyoligonucleotide possible in gram quantity. N-Acetoxy-2-acetylaminofluorene (AAAF) modified d(TACGTA). Thin layer chromatography and UV analysis of the acid treated AAF modified hexanucleotide showed that the covalent modification with AAF took place exclusively at C(8) of guanine in d(TACGTA). d(TACGTA) and AAF modified d(TACGTA) were purified by preparative high performance liquid chromatography (HPLC). The pure products were characterized by 1H and 31P-NMR. The circular dichroism (CD) spectrum of d(TACGTA) was consistent with DNA in the B form even in the presence of 4 M NaCl whereas the modified hexamer had nearly inverted spectrum in the absence of any added salt. Both NMR and CD analyses indicated profound alteration of conformation of d(TACGTA) upon covalent modification with AAF. The stabilization of the Z-like conformation in the modified hexamer under physiological conditions of salt and temperature suggests biological relevance.

Effect of renal failure on laudanosine excretion in man

Patients with renal failure and undergoing a cadaver renal transplant were found to have plasma concentrations of laudanosine, following the administration of a single bolus dose of atracurium 0.5 mg kg-1, higher than those found in patients without renal failure. Since laudanosine is a known central nervous system stimulant in a variety of animal species, its actions should be investigated further in man, and particularly in patients with renal failure.

A comparative study of conventional vs rapid speed of blood transfusion in cases of chronic severe anemia

Pulmonary capillary 'wedge' pressure (PCWP) was studied in 20 cases of chronic severe anemia before and after transfusing one unit of blood. They were divided into 2 groups of 10 age and sex matched cases. Blood was transfused at a speed of 2 ml/min in group A and 5 ml/min in group B. Pretransfusion PCWP was normal in all the cases. Following blood transfusion (BT) 'wedge' pressure increased significantly (p less than 0.001) in both the groups being 17.2% and 29.2% in group A and B respectively. The difference in the rise of PCWP between the two groups was not statistically significant (p greater than 0.05). All the cases tolerated BT very well. It is therefore, concluded that transfusion of one unit of blood at a speed of 5 ml/min is nearly as safe as when it is transfused at a rate of 2 ml/min (conventional speed) so far as the cardiopulmonary haemodynamics are concerned.

Effect of prolonged starvation and refeeding on fuel metabolism in rats

Body and liver weights, Liver lipids, glycogen, aspartate aminotransferase (EC 2.6.1.1), alanine aminotransferase (EC 2.6.1.2) and blood glucose levels were determined in starved and starved-refed rats. Decrease in body and liver weights was rapid during the initial stage of starvation and slowed down thereafter. Water was the major liver constituent lost in early fast. Following 10 days of starvation, body weight was reduced by nearly 20%, liver weight 43%, liver glycogen 93% and blood glucose 34%. Liver lipids and the activities of the two transaminases however, were increased by about 30-50%. On refeeding body weight and its water content increased and became nearly double of the initial fasting value on day 2. Blood glucose, liver glycogen, liver lipids and transaminases were significantly altered and got normalised within 5-8 days.

A nonimmunomodulatory effect of chronic cadmium exposure on lymphocyte transformation response in rhesus monkeys (Macaca mulatta)

The immunomodulatory effects of cadmium, an environmental pollutant, were assessed in male rhesus monkeys orally exposed to 5 mg cadmium/kg body weight for a period of 4 months. A lymphocyte transformation test was carried out in peripheral blood lymphocytes using different concentrations of phytohemagglutinin (PHA), concanavalin A (Con A) and pokeweed mitogen (PWM). Cadmium exposure of monkeys resulted in a statistically nonsignificant increase in [3H]thymidine incorporation in PHA- and Con-A-stimulated lymphocytes. However, there was a nonsignificant decrease in [3H]thymidine incorporation in PWM-stimulated lymphocytes. These results suggest that cadmium may not have immunosuppressive effects in primates which are phylogenetically close to man.

Depressive disorders in the developing world

In order to find out whether the finding of different prevalence rates for depression in rural and urban areas of India is supported by a difference in symptomatology as well, 30 rural and 42 urban hospitalized MDP-Depressed patients were compared on Hamilton Depression Scale and Schedule for Standardized Assessment of Patients with Depressive Disorders. Symptoms of guilt, loss of concentration and memory were significantly more in urban patients whereas gastrointestinal somatic symptoms were significantly higher in rural subjects. The difference is probably due to urban subjects being more sophisticated, expressive and familiar with mental disorders as compared to rural patients who being more familiar with somatic illnesses tend to somatize their psychic distress.

The pharmacokinetics and pharmacodynamics of atracurium in patients with and without renal failure

To determine the influence of renal function on the pharmacology of atracurium, 10 patients with normal renal function and 10 with renal failure (scheduled for cadaver kidney transplant) were anesthetized with nitrous oxide and halothane. Atracurium besylate, 0.5 mg . kg-1, was given as an iv bolus and plasma samples were collected over a 4-h period. These samples were assayed for atracurium (all patients) and laudanosine, one of the principal metabolites (eight of the normal group), using an ion-exchange liquid chromatographic assay. The plasma concentrations of atracurium for each patient were fitted to a two-compartment pharmacokinetic model. The onset time, duration of action, and recovery time of atracurium neuromuscular blockade were measured. There were no differences found in the pharmacokinetics or pharmaco-dynamics of atracurium between patients with normal renal function and those with renal failure. There were measurable levels of laudanosine following atracurium administration with peak levels of 199 +/- 31 ng . ml-1 at 2 min. The authors conclude that the pharmacokinetics and pharmacodynamics of atracurium are not altered by renal failure.

Metabolites of neostigmine and pyridostigmine do not contribute to antagonism of neuromuscular blockade in the dog

The authors sought to determine whether the metabolites of neostigmine and pyridostigmine contribute to antagonism of neuromuscular blockade. Accordingly, the dose-response relationship, onset and duration of action (n = 60), and pharmacokinetics (n = 22) of neostigmine, pyridostigmine, their metabolites 3-hydroxyphenyltrimethylammonium (PTMA) and 3-hydroxy-N-methylpyridinium (MP), and edrophonium were determined in dogs anesthetized with sodium pentobarbital. The force of contraction of the anterior tibialis muscle was maintained at constant 90% depression by infusing pancuronium. Then, a single iv bolus dose of one of the drugs under study was injected while the pancuronium infusion was continued. Venous blood, urine, and bile were sampled for four hours. Concentrations were determined by liquid chromatographic techniques; a three-compartment pharmacokinetic model was fitted to the serum concentration data. The doses producing 50% antagonism were 6.5, 52, 69, and 40 micrograms/kg for neostigmine, pyridostigmine, edrophonium, and PTMA, respectively. MP was inactive as an antagonist. By comparing approximately equipotent doses, time to peak antagonism (onset) and until 30% of peak antagonism remained (duration) were shorter for both edrophonium and PTMA than for neostigmine and pyridostigmine. Slow distribution and elimination half-lives, volume of distribution at steady state (VDss), and total plasma clearance (Cl) were similar for the drugs except for a smaller Vdss and lower Cl for MP. More than 60% of the dose of each drug was recovered unchanged from urine; less than 1% was recovered from bile. Less than 10% of the dose of neostigmine was recovered as PTMA.(ABSTRACT TRUNCATED AT 250 WORDS)

The biological approach to the radiotherapy of the oral cancers of South India

Two-thirds of all cancers in South India are squamous cell carcinomas, of which 78% to 93% are late cases requiring radiotherapy. Oral cancers, which constitute the majority of these, provided an excellent clinical model for studies in radiotherapeutic biology. Their characteristics made them ideally suited for our clinical trials. The paper reviews the special biology of these lesions, the factors involved in their radiation non-response, the therapeutic postulations that suggested themselves, the implementation of these therapeutic protocols and the mixed story of failure and success that has marked the two decades of these studies. It discovers the fact that radiation response is not just a factor of tumor extent but involves several biological subtleties in both tumor and its host environment. It also discusses possible future approaches to bridge a gap of about 30% failure in these lesions, especially in the context of a poor economy.

Family jointness, social interaction and neuroses : a rural urban comparison

The association between family patterns and neurotic illness has been reported variously in India. Previous work from our centre seems to suggest that a joint family provides better support and security to vulnerable individuals. The present work is a community based project conducted in a selected rural and an urban area. The door to door survey by the research team identified index subjects who were screened for presence of psychotic illness before being included. Non psychotic psychiatric disorders were identified using the Cornell Medical Index and Khatri's scale was used for typing the family pattern. The social interaction schedule was the major instrument to quantify the type and duration of interaction, and life events were scaled using the modified Life Events inventory.Our results indicate that whereas the joint family system was prevalent in the rural areas, the major family constellation in the urban areas was nuclear. Though the primary group of the rural respondent was richer, the average member of the urban area spent more time in interaction and thus utilized the support system better. The results are discussed for their relevance to the understanding of the genesis of neurotic disorders.

Clinical pharmacology of edrophonium in infants and children

The dose-response relationship, onset, duration of action, atropine requirement, and pharmacokinetic variables of edrophonium were determined in infants and children during N2O-halothane anesthesia. The technique of steady state infusion of d-tubocurarine anesthesia. The technique of steady state infusion of d-tubocurarine (dTc) was used to determine the ED50 for edrophonium (i.e., the dose producing 50% antagonism of 90% neuromuscular depression) in 4 infants (145 micrograms/kg) and 12 children (233 microgram/kg). The reported values for ED50 for edrophonium (obtained under similar anesthetic conditions) is 128 micrograms/kg for adults. These three dose-response curves do not differ statistically; however, there was greater variability among infants and children than adults. Time to peak antagonism was similar for all three age groups. Duration of antagonism was determined in six infants and six children and did not differ from the reported value for adults. The optimal dose and time of administration of atropine were established by administering edrophonium (1 mg/kg) and atropine (10-20 micrograms/kg) to 24 infants and children. The smallest changes in heart rate and systolic blood pressure occurred when atropine (10 micrograms/kg) was given 30 s before edrophonium. The pharmacokinetics of edrophonium (1 mg/kg) were studied in four infants and four children and were compared with published values for adults: distribution and elimination half-lives and distribution volumes were similar for the three groups. Total clearance (ml.kg-1.min-1) was greatest for infants (17.8 +/- 1.2) compared with children (14.2 +/- 7.3) and adults (8.3 +/- 2.9). The authors conclude that the dose of edrophonium required toantagonize dTc-induced neuromuscular blockade is similar or possibly greater for infants and children than for adults.(ABSTRACT TRUNCATED AT 250 WORDS)

Serum zinc levels in subtypes of leprosy

Serum zinc levels were estimated in 146 patients with different types of leprosy and 40 control subjects. Tuberculoid patients were found to have normal serum zinc levels. A gradual reduction in serum zinc levels was observed from TT to LL. Serum zinc levels were not significantly higher in patients treated with dapsone for approximately 18 months. The cause of hypozincemia is not clear, but the findings suggest that there are correlations among bacillary load, immune status, and serum zinc. Zinc deficiency could be one of the factors involved in the nonspecific suppression of cell-mediated immunity in lepromatous leprosy.

Determinants of the community living arrangements of older unmarried women

Data from the nationally representative 1976 Survey of Income and Education provide the opportunity to examine the joint effects of age, marital status, personal income, and the need for functional assistance on living arrangements of older unmarried white women. A particular interest in this research is testing the hypothesis that the effects of income and functional health are interactive. This hypothesis implies that the effect of functional disability on living arrangements is contingent on level of personal income. Log-linear model analyses indicate that, although the main effects of all independent variables except marital status are significant, none of the interaction effects are significant. Odds calculated under the best-fitting model show that an unimpaired older woman has seven times the chance of living alone as one who requires frequent assistance, whereas those in the lowest income group have only a quarter of the likelihood of living alone as someone in the highest income group.

Multiple benign strictures of the oesophagus in the paediatric age-group--modified technique of antegrade dilatation

Accidental ingestion of strong acids and alkalines still remains the commonest cause of benign strictures of the oesophagus in our country, particularly in children from the poor socio-economic strata, who are left alone to fend for themselves. Once the stricture is well-formed, repeated antegrade dilatations are required in order to dilate the lumen gradually. The procedure is done with the utmost care and gentleness in order to avoid rupture of the cicatricial wall of the oesophagus. The present series consisting of 10 cases of multiple, benign, mostly permeable, strictures of the oesophagus were successfully managed with Jackson's antegrade dilatation technique. During one of the dilatation sessions we observed that instead of pushing the bougie gently, it seemed to be sucked down entirely on its own, a few millimeters at a time (described in case 3) and traversed the entire stricture. This procedure appears safer for the patient and has now become routine with us. There was no mortality in our series. In all, a total of 168 dilatations have been done. The average lumen achieved in all our cases was 6 mm (Jackson's bougie No. 18) which was well maintained in all our cases on a permanent basis.

Anti-inflammatory activity of amino acyl benzoates

Nineteen new piperazino or morpholino amino acyl benzoates were synthesized and screened against carrageenin induced oedema in albino rats. Several compounds of the series showed potent anti-inflammatory activity. Compound 10 was found to be the most potent. This compound was further evaluated in detail and compared with phenylbutazone for its relative anti-inflammatory potency and ulcerogenic liability. The compound, in addition, was compared with acetyl salicylic acid for its analgesic activity. This compound showed potent ant-inflammatory activity with minimal ulcerogenic liability.

Markers in psychoses: studies from India

Genetic considerations are important in studying the pathogenesis of the psychoses. There are few reports from India, however, which have pursued a "biological marker" approach to functional illness of this type. A review of such few studies as do exist is presented to add to contemporary knowledge in the area. Recommendations are also made for evolving newer research strategies.

The dynamics of tetanus epidemiology and control in rural Uttar Pradesh studied through computer simulation

An epidemiological model is constructed for tetanus. The assumptions as well as the steps involved in the construction of the model, are detailed. The impact of alternate immunisation strategies to control tetanus in rural Uttar Pradesh, is studied using this model. The quantification of the expected decline in incidence and mortality over 30 years, for different control strategies, provides the health planner with valuable information. It is seen that the incidence of tetanus neonatorum and tetanus in adults, as well as deaths due to tetanus, progressively decreases as the level of coverage is increased. The most marked reduction is seen over the initial period of intervention. Mass immunisation of the total population, or of just the females in the reproductive age group, leads to temporary decline in the endemic level. Such models are useful for planning in the health sector in India since, they can be constructed with the limited information available.

Irradiation, bleomycin and hyperbaric oxygen in the treatment of oral carcinoma

The present report is the sixth in a series of combination therapy trials in oral carcinoma in South India conducted since 1960. In the fifth trial a combination of bleomycin (BLM) and irradiation was compared with irradiation alone. The results gained and the subsequent experience in an unselected series demonstrated in buccal mucosal squamous cell carcinomas a highly superior effect with the irradiation-BLM combination, but still revealed a failure rate around 30 per cent. The present clinical trial--irradiation + BLM was compared with irradiation + BLM + hyperbaric oxygen (HbO) and irradiation + placebo + HbO--was undertaken in an attempt to eliminate or at least reduce these failures. The results were unexpectedly disappointing in that the irradiation combined with BLM + HbO proved to be inferior to irradiation + BLM. An attempt has been made to elucidate the possible reasons for this surprising outcome.

Serology of Aspergillus granuloma

A total of 21 cases of granuloma caused by Aspergillus species were encountered during the period 1972-79. The organs involved were nasal and paranasal sinuses, brain, orbit, subcutaneous tissue of check, lungs and endocardial valve in the decreasing order of their frequency. Aspergillus flavus was the main etiological agent. Immunodiffusion tests with various Aspergillus species as antigen showed a positively of 17 out of 18 (94.4 per cent) cases. The role of precipitins in diagnosis and prognosis of the disease has been discussed.

Derivatives of n-aryl-N-amino piperazines as potential cardiovascular agents

24 new substituted piperazino guanidines and 34 substituted benzylideno- or benzylamino-4-phenyl piperazines were synthesized and evaluated for their cardiovascular activity. Several compounds of the above two series exhibited vasopressor or vasodepressor activity without modifying the carotid occlusion (CO) and noradrenaline (NA) induced pressor responses.

Interaction of prolactin and testosterone in the human prostate

Three experiments were performed to determine whether human prolactin (hPr) affects prostatic uptake and metabolism of testosterone (T). 1) Patients with prostatic cancer were infused twice with radio-labelled androgens, the first time with basal hPR, the second time with oral thyrotrophin-releasing hormone (TRH)-elevated hPr. In 5/7, significant increases in metabolic clearance of dihydrotestosterone (DHT) and in conversion of T to DHT accompanied increased hPR. 2) The incorporation of labelled T into minced benign prostatic hypertrophy (BPH) tissue from subjects with high (40 ng/ml) hPR was measured and was found to be more than twice the uptake into tissue from those with low hPR (6.5 +/- 1.9 ng/ml). 3) Uptake and metabolism in vivo of a bolus of 3H-T by BPH and carcinomatous prostates was measured and was far greater in subjects whose hPR was elevated by chlorpromazine than in untreated controls. It is concluded that prolactin increases prostatic uptake and metabolism of T. It is suggested that the best management of prostatic cancer should include depletion of prolactin as well as androgen.