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Biomedical subjects

A Gupta

Publications and source records attributed to A Gupta.

At least 433 records · Page 24Linked to original sources
PubMed1998

Management of presumed intraocular tuberculosis: possible role of the polymerase chain reaction.

PURPOSE: A highly selective technique of polymerase chain reaction (PCR) was performed for detection of Mycobacterium tuberculosis from aqueous samples of 45 patients to evaluate its role in initiating antituberculosis treatment in patients with presumed intraocular tuberculosis. METHODS: Forty-five patients were divided into three groups. Group I included 17 patients of presumed intraocular tuberculosis, group II 13 disease controls and group III had 15 normal controls. Patients with positive PCR were offered antituberculosis chemotherapy and followed up for a minimum of 18 months. RESULTS: Ten patients in group I, 3 in group II and none in group III were positive for Mycobacterium tuberculosis by PCR. Ten patients with positive PCR for Mycobacterium tuberculosis (8 in group I and 2 in group II) were treated with antituberculosis chemotherapy and all showed resolution of inflammation without any recurrence over 18 months of follow-up. Two PCR positive patients treated with steroids alone, however, did not show complete resolution and had recurrent attacks. CONCLUSION: These results suggest that antituberculosis treatment in PCR positive patients leads to resolution of inflammation and elimination of recurrences, most likely by eliminating Mycobacterium tuberculosis from the intraocular tissues.

Adolescent↗
PubMed1998

Interleukin-6-mediated autocrine growth promotion in human glioblastoma multiforme cell line U87MG.

Human glioblastoma multiforme cell lines, brain tumor biopsy tissue, and normal human fetal brain synthesize interleukin (IL)-6 and IL-6 receptor (IL-6R). Neither of these is expressed in human neurons or neuroblastoma cell lines in culture. Astrocytes from fetal brain grown in culture retain the ability to synthesize IL-6 but do not express IL-6R as inferred from RT-PCR and Southern blot studies. Coexpression of IL-6 and IL-6R in the glioblastoma cell line U87MG is confirmed by immunofluorescence staining. Both specific monoclonal antibodies against IL-6 and IL-6R and antisense oligonucleotide to IL-6 mRNA inhibit the growth of U87MG cells in culture, suggesting the existence of a functional autocrine growth loop. Anti-IL-6 antibodies also inhibit the growth of glioblastoma cell lines U373 and U118. The expression of IL-6 by human fetal astrocytes in culture is highly suggestive of its role as an oncofetal protein responsible for rapid proliferation of fetal and tumor cells but not cells of adult brain.

Animals↗
PubMed1998

Treatment of Postcraniotomy Tension Pneumocephalus via Endoscopic Closure of the Nasofrontal Recess.

Tension pneumocephalus can be a life-threatening complication following cranial surgery. We report a 14-year-old female who developed tension pneumocephalus following her most recent external approach to a recurrent pilocytic astrocytoma of the skull base and clivus. Because the risk of devascularization of the recently placed bone grafts was a concern, an endoscopic approach was chosen instead of a cramotomy. Endoseopic decompression was accomplished by opening the anterior ethmoid and frontal recess air cells after performing an uncinectomy. The nasofrontal recess areas were then packed from below with grafts of muscle and fascia lata. Follow-up magnetic resonance imaging (MRI) at three and eight months showed complete resolution of the intracranial air. At two-year follow-up, the patient is still asymptomatic. This case report presents treatment of tension pneumocephalus through endoscopic decompression and closure of the nasofrontal recess as a viable option if significant risks are associated with craniotomy and the status of the mucosa of the nasal frontal recess is known.

Case Reports↗
PubMed1998

Perinephric abscess (presenting as abdominal pain) due to Listeria monocytogenes.

A 5-year-old malnourished child was admitted with a 1-week history of paroxysmal abdominal pain. Evaluation finally revealed a left-sided perinephric abscess caused by Listeria monocytogenes. The child was successfully treated by drainage of the abscess and antibiotic therapy. Renal abscess should be kept in mind in the differential diagnosis of abdominal pain, and Listeria, an unusual pathogen, should be considered as a possible aetiology.

Abdominal Pain↗
PubMed1998

Cardiff repair of incisional hernia: a university hospital experience.

OBJECTIVE: To analyse our results of the "Cardiff' (far and near) repair in incisional hernias. DESIGN: Prospective study. SETTING: University hospital, Varanasi, India. SUBJECTS: 50 patients who presented with incisional hernias between January 1990 and December 1994. INTERVENTION: Interrupted far-and-near sutures inserted after excision of the sac. The contents were pushed into the abdomen and the peritoneum sutured with non-absorbable polypropylene (prolene). MAIN OUTCOME MEASURES: Early and late morbidity. Six patients developed postoperative complications (wound infection, n=3; flap necrosis, n=2; and wound sinus, n=1). No patient has been lost to follow up and there have been no signs of recurrence after a mean follow up of 52 months. CONCLUSION: The meticulous application of this simple surgical technique has low morbidity and is cost effective. We recommend it for small and medium size defects.

Adolescent↗
PubMed1998

Identification of novel transmembrane gene sequence and its use for cell-surface targeting of beta subunit of human chorionic gonadotropin.

We identified a 685-nucleotide gene fragment that codes for the transmembrane and cytoplasmic domains of glycoprotein of the LEP strain rabies virus and carried out experiments designed to express a novel fusion protein on the cell surface. The cDNA encoding the membrane anchor sequence was fused in the correct reading frame to the 3' end of the cDNA encoding the beta subunit of human chorionic gonadotropin (beta(h)CG), a secretory glycoprotein that is used as an antigen for a contraceptive vaccine being developed in our laboratory. The fusion gene cassette was placed under the control of a vaccinia virus early promoter and cloned in a host-restricted fowlpox viral vector. The recombinants, when used to infect mammalian cells that do not allow the replication of fowlpox virus, expressed the N-terminal 135 amino acid residues of beta(h)CG anchored in the cell membrane by the 75-amino acid C-terminal sequence derived from rabies virus glycoprotein. This hybrid protein is correctly processed post-translationally and transported efficiently to the plasma membrane of non-permissive cells such that the anchored beta(h)CG molecule retains the correctly folded native antigenic epitope(s).

Amino Acid Sequence↗
PubMed1998

11Beta-hydroxysteroid dehydrogenase type 2 in human pregnancy and reduced expression in intrauterine growth restriction.

The type 2 isoform of 11beta-hydroxysteroid dehydrogenase (11beta-HSD2), which inactivates cortisol (F) to cortisone (E), has been suggested to play a role in the ontogeny of the fetal pituitary-adrenal axis and also protect the developing fetus from the deleterious effects of circulating maternal glucocorticoids. The abundance of 11beta-HSD2 in the placenta and other fetal tissues was inferred from the F/E ratio in 17 term deliveries in both umbilical arterial (1.73 +/- 0.24, mean +/- SE) and umbilical venous blood (1.16 +/- 0.14) compared with adult peripheral venous blood (7.76 +/- 0.57, n = 70). Using sensitive assays for 11beta-HSD2 and an in-house human 11beta-HSD2 antibody, the expression and activity of this enzyme in fresh frozen human placenta increased progressively from first (8-12 weeks, n = 16) and second (13-20 weeks, n = 9) to third trimester (term) pregnancies (39-40 weeks, n = 50). Placental 11beta-HSD2 activity was significantly reduced in deliveries complicated by intrauterine growth restriction (IUGR) [25-36 weeks, n = 12, activity 380 pmol/mg/h median (225-671; 95% confidence interval)], compared with the term deliveries [888 (725-1362)] and with appropriately grown pre-term deliveries [27-36 weeks, n = 14, activity 810 (585-1269)], P < 0.05. In human pregnancy placental 11beta-HSD2 activity increases markedly in the third trimester of pregnancy at a time when maternal circulating levels of glucocorticoid are rising. The finding of attenuated placental 11beta-HSD2 activity in IUGR suggests that glucocorticoids may, in part, contribute to impaired fetal growth and that this is closely controlled in normal gestation through placental 11beta-HSD2 expression.

11-beta-Hydroxysteroid Dehydrogenases↗
PubMed1998

Beta transforming growth factors (TGFss) at the porcine conceptus-maternal interface. Part I: expression of TGFbeta1, TGFbeta2, and TGFbeta3 messenger ribonucleic acids.

Spatial and temporal mRNA expression of beta transforming growth factors (TGFbeta1, TGFbeta2, and TGFbeta3) in porcine uterus and conceptuses was determined during the peri-implantation period (Days 10-14 of gestation). Northern blotting identified a major 3. 5-kilobase (kb) and a minor 2.5-kb transcript for TGFbeta1 mRNA. TGFbeta2 transcripts were 6.2 kb, 5.4 kb, and 2.7 kb, and a single 3. 5-kb transcript was detected for TGFbeta3. With semiquantitative in situ hybridization analysis, progressive increases were detected in TGFbetas 1, 2, and 3 mRNA expression in uterine luminal epithelium (ULE), uterine glands (UGs), and underlying stroma (stroma spongiosum, SS) from Days 10 through 14 of gestation (p < 0.05). In myometrium, TGFbeta mRNA expression did not differ between Days 10 through 14 of gestation. In porcine conceptuses, TGFbetas 1, 2, and 3 mRNA expression was detected in trophectoderm, endoderm, embryonic ectoderm, and mesoderm. For the three TGFbeta isoforms examined, mRNA expression increased 2- to 4-fold in trophectoderm and endoderm between Days 10 and 14 of gestation. TGFbeta1 mRNA levels increase significantly in embryonic ectoderm, but not mesoderm, between Days 12 and 14 of gestation; during that same time, TGFbeta2 mRNA levels increased, but no change was detected in TGFbeta3 mRNA levels, in embryonic ectoderm and mesoderm. Progressive increases in TGFbeta mRNA expression in conceptus trophectoderm, endoderm, ULE, UGs, and SS suggest important roles for these growth factors in porcine conceptus development during the peri-implantation period.

Animals↗
PubMed1998

Beta transforming growth factors (TGFbeta) at the porcine conceptus-maternal interface. Part II: uterine TGFbeta bioactivity and expression of immunoreactive TGFbetas (TGFbeta1, TGFbeta2, and TGFbeta3) and their receptors (type I and type II).

Porcine uterine tissues were collected from Days 10 to 14 of gestation (peri-implantation period) or corresponding days of the estrous cycle. Results indicated a marked increase in beta transforming growth factors (TGFbeta1, TGFbeta2, and TGFbeta3) and TGFbeta receptor (type I and type II) immunostaining in uterine luminal epithelium (ULE) between Days 10 and 14 of gestation, but there was no increase in ULE immunostaining on the corresponding days of the estrous cycle. Uterine glands and stroma were intensely immunopositive in pregnant gilts for TGFbeta isoforms and their receptors, but immunostaining was weak to undetectable in cycling gilts. No differences were detected in myometrium, in which immunostaining was moderate in both cycling and pregnant gilts. Additionally, TGFbeta2 and TGFbeta receptor (type I and type II) immunostaining was detected in uterine monocyte/macrophage-like cells. Western blotting detected the presence of all three TGFbeta isoforms in uterine luminal flushings. The CCL64 cell TGFbeta bioassay detected bioactive TGFbetas++ in uterine luminal flushings on Days 12, 13, an 14 of gestation. These results strongly indicate that uterine expression of TGFbetas and their receptors is pregnancy specific and that bioactive TGFbetas are present at the conceptus-maternal interface in the peri-implantation period in pigs. Thus TGFbetas are likely to be involved in autocrine-paracrine interactions between the maternal uterus and the conceptus.

Animals↗
PubMed1998

Sequential use of intravenous and oral acyclovir in the therapy of varicella in immunocompromised children.

BACKGROUND: Immunocompromised children are at risk for disseminated varicella infections. Standard management involves hospitalization and intravenous acyclovir for 7 to 10 days. This approach is expensive, is inconvenient and may not be necessary. We undertook a pilot study to assess the safety and efficacy of an alternative approach that utilized a combination of intravenous (i.v.) followed by oral (p.o) acyclovir in a cohort of immunocompromised children. METHODS: The cohort consisted of 26 immunocompromised children between the ages of 1.5 and 12.7 years (mean, 6.3). Therapy was commenced with i.v. acyclovir (1500 mg/m2/day in 3 divided doses). Concurrent management included holding or reducing immunosuppressive therapy (by 50%) and administering varicella-zoster immunoglobulin in 69% (11 of 16) of cases where exposure to chickenpox was recognized. Patients were eligible to switch to p.o therapy after receiving a minimum of 48 h of i.v. acyclovir therapy provided they were afebrile; had no new lesions for 24 h; had no internal organ involvement and were able to tolerate oral medications. Patients were observed in hospital for a further 24 h and then discharged provided they remained well. Oral acyclovir was continued for a total of 7 to 10 days (i.v. plus p.o). RESULTS: Of the 26 patients 25 were successfully switched from i.v. to p.o after 4.1 +/- 1.2 days (mean +/- SD) (range, 2.3 to 6) Children had fever for a mean of 2.0 +/- 1.6 days (range, 0 to 5) and developed new lesions for 2.9 +/- 0.7 days (range, 2 to 4). All 25 patients switched to p.o therapy had resolution of their disease and no patient required resumption of i.v. therapy. CONCLUSIONS: The sequential use of i.v. followed by p.o acyclovir is feasible in the treatment of varicella in immunocompromised children and results in a reduction in duration of intravenous therapy and hospitalization.

Acyclovir↗
PubMed1998

Anaesthesia for videoarthroscopy of the knee. A comparison between desflurane and sevoflurane.

BACKGROUND: The newer inhalational agents desflurane and sevoflurane have a low blood-gas partition coefficient and are not very fat soluble, and consequently recovery is rapid and smooth. Very few studies have been published concerning adults where a direct comparison has been made between sevoflurane and desflurane in the ambulatory setting. METHODS: This study was done to assess aspects of recovery following minor ambulatory videoarthroscopic knee surgery in 50 ASA I-II patients. Baseline values were obtained on the following psychomotor tests: digit symbol substitution test (DSST), perceptive accuracy test (PAT) and simple reaction time (SRT). The patients were then randomly allocated to one of two groups according to an open (unblinded) study design: Group D (Desflurane) were maintained on desflurane while Group S (Sevoflurane) were maintained on sevoflurane. Propofol was used as the induction agent in all patients and the larynx mask was used to maintain a free airway. Oxygen and air (FiO2 0.33) were used as the carrier gases. The concentration of desflurane or sevoflurane was adjusted in order to maintain adequate anaesthesia and stable haemodynamics. Alfentanil was given at induction and every 15 min as an analgesic. At the end of the operation, the gases were turned off abruptly and 100% oxygen was delivered at 6 L/min until eye-opening. Early recovery was measured by the time to eye-opening, giving name and date of birth. Intermediate recovery was measured by psychomotor testing every 30 min, and the time to sitting up in bed, drinking fluids and discharge home by a nurse who was blinded to the anaesthetic technique. RESULTS: Early recovery was quicker in the desflurane compared to the sevoflurane group (P<0.001). Psychomotor recovery as measured by the PAT occurred significantly earlier in the desflurane compared to the sevoflurane group at 15 and 45 min (P<0.001) and as measured by the DSST at 30 min (P<0.05). The number of patients who could not perform the SRT test at 15 min was greater in the sevoflurane compared to the desflurane group (13 vs 0) (P<0.01). No differences were found in other recovery parameters, including home discharge, between the groups. The incidence of pain and other minor postoperative complications was similar between the groups except for sore throat which was higher in the desflurane group. CONCLUSION: Early and intermediate (psychomotor) recovery is quicker in the desflurane compared to the sevoflurane group, but there is no difference in discharge times between the groups.

Adolescent↗
PubMed1998

Magnetic resonance image detection of coincidental sphenoid sinus aspergillosis and pituitary microadenoma: a potential surgical disaster.

While localizing the microadenoma in a patient with Cushing's disease on magnetic resonance imaging (MRI), fungal granuloma of the sphenoid sinus was coincidentally detected. This helped in the proper management of sphenoidal disease before undergoing trans-sphenoidal removal of the microadenoma, thus averting the possible catastrophe of direct intracranial spread of aspergillus infection.

Adenoma↗
PubMed1998

Effects of halides on plasmid-mediated silver resistance in Escherichia coli.

Silver resistance of sensitive Escherichia coli J53 and resistance plasmid-containing J53(pMG101) was affected by halides in the growth medium. The effects of halides on Ag+ resistance were measured with AgNO3 and silver sulfadiazine, both on agar and in liquid. Low concentrations of chloride made the differences in MICs between sensitive and resistant strains larger. High concentrations of halides increased the sensitivities of both strains to Ag+.

Drug Resistance, Microbial↗
PubMed1998

Effect of isovolaemic haemodilution on visual outcome in branch retinal vein occlusion.

AIMS: To assess the efficacy of isovolaemic haemodilution therapy (IHT) in the treatment of patients with branch retinal vein occlusion (BRVO). METHODS: Patients presenting with BRVO between 1 July 1991 and 31 August 1993 were eligible for inclusion and randomised into treatment and control groups. Patients randomised to receive IHT were treated for 6 weeks with venesection and volume replacement using hydroxyethylstarch, a plasma expander. The target haematocrit was 35%. Follow up was for 1 year. RESULTS: The baseline visual acuity of the two groups was similar at 0.74 and 0.75 logMAR units (Snellen 6/36), for the IHT and control groups, respectively. At 6 weeks, visual acuity in the IHT group had improved by 0.20 logMAR units (2 lines on the Bailey-Lovie chart) (p = 0.0001). Vision was unchanged in the control group. At 1 year, the IHT group exhibited an improvement of 0.43 logMAR units. By comparison, the improvement in the control group at 1 year was significantly less at 0.17 logMAR units (p = 0.03). The final visual acuity in the IHT and control groups was 0.30 (Snellen 6/12) and 0.60 (Snellen 6/24) logMAR units, respectively. CONCLUSIONS: The results support the theory that IHT has a positive effect on the visual outcome in patients with BRVO.

Adult↗
PubMed1998

A primary intrapelvic hydatid cyst presenting with foot drop and a gluteal swelling: a case report.

A primary hydatid cyst in the pelvis is rare, and usually presents with pressure symptoms affecting the adjacent abdominal organs. We describe such a cyst which protruded through the sciatic notch and presented as a gluteal swelling with a foot drop due to compression of the lumbosacral nerve roots. Surgical excision and postoperative treatment with albendazole for six weeks were effective in controlling the disease and preventing recurrence.

Adult↗