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Biomedical subjects

Atul Goel

Publications and source records attributed to Atul Goel.

32 records · Page 2Linked to original sources

Synthesis and biological properties of amino acid amide ligand-based pyridinioalkanoyl thioesters as anti-HIV agents.

Hyper-mutable retroviruses such as HIV can become rapidly resistant to drugs used to treat infection. Strategies for coping with drug-resistant strains of virus include combination therapies, using viral protease and reverse transcriptase inhibitors. Another approach is the development of antiviral agents that attack mutationally nonpermissive targets that have functions essential for viral replication. Thus, the highly conserved nucleocapsid protein, NCp7, was chosen as a prime target in our search for novel anti-HIV agents that can overcome the problem of viral drug resistance. Recently, we reported (J. Med. Chem. 1999, 42, 67) a novel chemotype, the pyridinioalkanoyl thioesters (PATEs), based on 2-mercaptobenzamides as the thiol component and having its amide nitrogen substituted with various phenylsulfonyl moieties. These compounds were identified as relatively nontoxic anti-HIV agents in the XTT cytoprotection assay. In this study, we wish to report a separate genre of active PATEs wherein the thiol component consists of an N-2-mercaptobenzoyl-amino acid derivative. Active derivatives (EC(50) < 10 microM) reported herein were confined to amino acid primary amides or methyl amides having side chains no larger than isobutyl. Amino acids terminating in free carboxyl or carboxylic acid ester groups were mostly inactive. Selected compounds were shown to be active on chronically infected CEM/SK-1, TNFalpha-induced U1, ACH-2 cells and virucidal on cell-free virus, latently infected U1 cells and acutely infected primary peripheral blood mononuclear cells (PBMCs).

Amino Acids↗

A convenient synthesis and hepatoprotective activity of imidazo[1,2-c]pyrimido[5,4-e]pyrimidine, tetraazaacenaphthene and tetraazaphenalene from cyclic ketene aminals through tandem addition-cyclization reactions.

A novel one-pot synthesis of imidazo[1,2-c]pyrimido[5,4-e]pyrimidinones (2), tetraazaacenaphthene-3,6-diones (4), tetarazaphenalene-1,7-dione (4d) is delineated from the reaction of cyclic ketene aminal (1) and alkyl or aryl isothiocyanate through tandem addition-cyclization reactions. However, reaction of ketene aminal (1a) with alkyl isothiocyanate only yielded angularly cyclized product 5 which did not react further to yield 6. The structure of 2c and 4d was ascertained by single crystal X-ray diffraction analysis which demonstrated a network of various inter- and intramolecular interactions, responsible for the stability and packing of the molecules in the crystalline state. Some of the compounds (2a--h) were screened for hepatoprotective activity but only 2a was found most effective.

Acenaphthenes↗

Basilar invagination and Chiari malformation associated with cerebellar atrophy: report of two treated cases.

We report two patients with an unusual complex of anomalies wherein the basilar invagination and Chiari malformation was associated with marked cerebellar atrophy. Both patients presented with relatively severe lower cranial nerve deficits and showed clinical improvement following a posterior foramen magnum bony decompression. The pathogenesis of the anomalies is discussed and the rationale of treatment is analysed.

Adult↗

Giant meningioma of the cranial vertex--case report.

A 55-year-old man was admitted with a swelling on the top of his head progressively growing for 2 years. The swelling had grown to a huge size with the appearance of a double head. A huge meningioma with predominantly extracranial growth and invasion into the superior sagittal sinus was subtotally excised. The excised tumor mass weighed 1380 g. The residual tumor was treated by irradiation. No recurrence was seen at one-year follow-up examination.

Combined Modality Therapy↗

Flare up of tuberculous abscess following stereotactic aspiration--case report.

A 16-year-old non-immunocompromised and otherwise healthy patient presented with a tuberculous brain abscess. The abscess was aspirated stereotactically. Following the aspiration the disease process flared up and multiple daughter abscess cavities were discovered. The daughter abscesses were removed via craniotomy. Stereotactic aspiration requires care to prevent such flare up of the disease.

Adolescent↗

Cerebellopontine angle epidermoid tumor presenting with 'tic convulsif' and tinnitus--case report.

A 22-year-old female presented with a cerebellopontine angle epidermoid tumor manifesting as a rare combination of hemifacial spasm, trigeminal neuralgia, and tinnitus. Magnetic resonance imaging demonstrated the tumor distorting the brainstem and the fourth ventricle. The tumor was almost completely resected and the seventh-eighth cranial nerve complex was decompressed by mobilizing the anterior inferior cerebellar artery loop. No arterial loop was related to the trigeminal nerve. The patient was completely relieved of the "tic convulsif" and tinnitus after the surgery. The inflammatory nature of epidermoid tumor may be involved in the etiology of the syndrome. Microvascular decompression may be needed in addition to tumor removal in such cases.

Adult↗

Intraventricular tuberculoma.

A 38-year-old female presented with headaches, fever, and malaise. Computed tomography showed an intraventricular peripheral ring-enhanced lesion with central necrosis. The lesion was totally excised. Histological examination revealed a tuberculoma. The patient was treated with antituberculous chemotherapy. The patient was asymptomatic at 9 months. Ventricular involvement in neurotuberculosis is rare, but should be considered in the presence of other indicators of tuberculous infection.

Adult↗

Thoracic intramedullary cysticercosis--two case reports.

A 36-year-old male and a 20-year-old male presented with intramedullary cysticercosis in the thoracic spinal cord. Magnetic resonance imaging clearly identified the cysts. Surgery was performed to decompress the spinal cord, as both patients had progressive and severe worsening of their neurological condition. Intramedullary cysticercosis can be treated successfully by surgery and/or medical therapy.

Adult↗

Atlantoaxial fixation using plate and screw method: a report of 160 treated patients.

OBJECTIVE: We review our experience with the use of the plate and screw method of fixation in the treatment of 160 patients with atlantoaxial instability during a 14-year period at our center. We previously described this method of fixation in 1994. METHODS: Between 1988 and 2001, 160 patients with atlantoaxial instability were treated with the use of a plate and screw method of fixation at the Department of Neurosurgery at King Edward Memorial Hospital in Bombay, India. The study group was composed of 91 males and 69 females (mean age, 23 yr; age range, 18 mo-79 yr). Atlantoaxial instability was a result of congenital abnormality in 132 patients (83%) and occurred after trauma in 28 patients (17%). All patients had mobile, completely reducible atlantoaxial dislocation. For 3 months postoperatively, a hard cervical collar was used. The mean follow-up period was 42 months (range, 4 mo-14 yr). RESULTS: Three patients died in the postoperative phase. Successful stabilization of the atlantoaxial region was documented with dynamic radiography in the other 157 patients. There was no incidence of implant rejection. In one patient, one screw was found to be broken 18 months after surgery; however, firm bony fusion was documented in this patient. There were no neurological, vascular, or infective complications. CONCLUSION: The plate and screw method of fixation with the use of intra-articular bone grafts in patients with atlantoaxial instability yielded a 100% fusion rate with a low incidence of complications.

Adolescent↗

Tuberculum sellae meningioma: a report on management on the basis of a surgical experience with 70 patients.

OBJECTIVE: The surgical strategies and outcomes for 70 patients operated on for tuberculum sellae meningioma were analyzed retrospectively. The analysis was based on factors that probably determined the difficulties encountered during surgery, assisted in predicting the extent of resectability, and helped in predicting the surgical outcome. METHODS: Seventy patients with tuberculum sellae meningiomas were operated on in the neurosurgery department at King Edward Memorial Hospital and Seth Gordhandas Sunderdas Medical College, Bombay, India, between 1991 and May 2001. The patients were analyzed retrospectively on the basis of clinical and radiological factors that appeared to affect the outcome. Each factor was given points, and for each tumor, the points were added to obtain a score. On the basis of the score, the tumors were then divided into three grades. The grades determined the difficulties that could be anticipated during surgery. The majority of patients were operated on by use of unifrontal craniotomy on the side of worse vision by standard dissection techniques. RESULTS: Total tumor resection was achieved in 59 patients, and subtotal tumor resection with less than 7% of tumor left behind was achieved in 11 patients. All patients with subtotal resection had higher-grade tumors. Preoperative visual status had a bearing on the visual outcome after surgery. Four patients were misdiagnosed as having a pituitary tumor. Two patients died in the immediate postoperative period. The average follow-up was 46 months (range, 6 mo to 9 yr). There was symptomatic recurrence in one patient in whom a subtotal resection had been performed. CONCLUSION: The extent and duration of visual symptoms, encasement of the anterior cerebral artery complex, and size of the tumor were the more important factors that affected the surgery. The grading system gave a reasonable assessment concerning the possible surgical problems.

Adult↗