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Biomedical subjects

K Verma

Publications and source records attributed to K Verma.

At least 163 records · Page 9Linked to original sources
PubMedDate not supplied

Cytomorphology of adrenocortical carcinoma and comparison with renal cell carcinoma.

OBJECTIVE: To review the cytomorphologic features of adrenocortical carcinoma (ACC), correlate them with histology and compare them with the cytomorphologic features of very similar renal cell carcinoma (RCC) on fine needle aspiration (FNA) smears. STUDY DESIGN: Cytomorphologic features in 7 cases of ACC in FNA smears were analyzed and compared with those in 10 cases of RCC. Five cases of ACC and five of RCC were later confirmed on histopathology. Parameters analyzed pertained mainly to architectural, cytoplasmic and nuclear features. RESULTS: The presence of cells in sheets with a central, thin-walled vascular core (endocrine vascular pattern); monomorphic cell population; eccentric nuclei; focal dramatic anisonucleosis; and focal spindling with crushing was a prominent feature of ACC in contrast to RCC, which showed mainly an acinar pattern with only a focal endocrine pattern, well-defined cytoplasmic angles and projections, and cytoplasmic vacuolations; pleomorphism, if present, was gradual and seen uniformly in all the cells. Univariate analysis using the chi 2 test showed the presence of endocrine architecture; focal dramatic anisonucleosis; crushed spindle fragments; eccentric nuclei; and absence of cytoplasmic vacuolizations as significant differentiating features in favor of ACC (P < .05). CONCLUSION: A cytomorphologic comparison of ACC with RCC showed that differentiation is possible by a set of statistically significant features that not only have diagnostic value but, as with crushed spindle fragments, also have prognostic significance.

Adrenal Cortex Neoplasms↗
PubMedDate not supplied

Diagnosis of parasites in fine needle breast aspirates.

OBJECTIVE: To document the value of fine needle aspiration cytology (FNAC) in the diagnosis of parasites in breast aspirates. STUDY DESIGN: Review of 8,364 breast aspirates studied over 15 years (1978-1992) for parasitic infections. RESULTS: Eight cases of cysticercosis and nine of filariasis were detected among 4,714 benign breast aspirates. Diagnosis of cysticercosis was based on identification of parts of the parasite in aspirates (seven cases) and excisional biopsy (one case). Among the cases of filariasis in breast aspirates, gravid adult females of Wuchereria bancrofti were seen in three cases and microfilarial larvae in four. In the remaining two cases, an intense, eosinophilic infiltrate was seen in breast aspirates, while microfilariae were identified in aspirates from draining axillary lymph nodes. CONCLUSION: In rare cases, parasitic infections present as breast lumps and can be easily diagnosed by FNAC.

Adolescent↗
PubMedDate not supplied

Changes of the photosynthetic apparatus in Spirulina cyanobacterium by sodium stress.

Spirulina platensis trichomes grown in Zarrouks medium having total Na+ concentration as 0.14 M when transferred to fresh Zarrouks medium containing enhanced level of Na+ ions equal to 0.86 M showed 30% more accumulation of Na+ intracellularly as compared to the control. An inhibition of photosystem II activity to almost 66% was observed. Also due to this exposure to high Na+, the room temperature absorption characteristics of Spirulina trichomes and the thylakoid membrane preparations were altered indicating changes in the chromophore protein interactions and alterations in the phycocyanin/allophycocyanin ratio; there by affecting the energy harvest and energy transfer processes. An increase in the carotenoid absorption was two fold over the control in the treated sample. Similarly, room temperature and low temperature (77 K) fluorescence emission spectra collectively suggested alterations in the chlorophyll a emissions, F 726 of photosystem I reflecting changes in the lipid protein environment of the thylakoid. Our results indicate that in Spirulina the enhanced Na+ level alters the energy harvest and transfer processes. It also affected the emission characteristics of chlorophyll a of photosystem I.

Cyanobacteria↗
PubMedDate not supplied

Evaluation of endoscopy-based diagnostic methods for the detection of Helicobacter pylori.

BACKGROUND: Helicobacter pylori is an etiological factor in duodenal ulcer. Few studies have objectively assessed the accuracy of diagnostic methods for the detection of H. pylori. METHODS: The sensitivity and specificity of histology, touch smear, rapid urease test (RUT) and brush cytology of endoscopic antral biopsy from patients with duodenal ulcer were compared. Forty-nine patients were evaluated before, and 34 after, eradication therapy. Each time, sampling was done for all 4 tests. The infection status for each sample was established by a positive concordance of results of three of four tests. RESULTS: The highest degree of agreement was between RUT and cytology (kappa = 0.69). Brush cytology (100%) followed by RUT (94.5%) were the most sensitive tests. Histology had the highest specificity (89.3%). A combination of RUT or brush cytology with histology had the maximum chance of detecting H. pylori. As single tests, brush cytology and touch smear had high diagnostic accuracies with a Youdin J value of 1.79 and 1.78, respectively. CONCLUSION: The best method for diagnosis of H. pylori is a combination of the rapid urease test or brush cytology with histology. Brush cytology or touch smear are diagnostic tests of choice if a single test is desired.

Adult↗
PubMedDate not supplied

The use of diagnostic bronchoscopy in lung cancer.

BACKGROUND: The role of fibreoptic bronchoscopy in the diagnosis of bronchogenic carcinoma is well established. However, in developing countries, where the burden of illness is large and diagnostic facilities are limited, only a small number of patients are diagnosed at a stage when they might benefit from operation. We felt it would be desirable to identify subsets of patients suspected of harbouring lung cancers, in whom bronchoscopy would have not only a high diagnostic yield but also provide useful information which might influence treatment, the patient's quality of life and duration of survival. METHOD: We analysed the records of 588 patients, who had been bronchoscoped for suspected lung cancer, over a period of 8 years at a tertiary referral centre in north India. The patients were divided into different clinical subgroups on the basis of their clinical and radiological presentation, and the diagnostic yield from bronchoscopy in each group was calculated. A decision analysis model was constructed and the expected value of clinical information was determined for each group. RESULTS: A tissue diagnosis was established by bronchoscopy in 177 (30%) patients and by additional investigations in 43 (7.3%) patients. A positive tissue diagnosis was obtained most often in patients with clinical and radiological evidence of pulmonary collapse (50%) and mass lesions (38-42%). Only 12% of patients with malignancy underwent resection and 70% of them belonged to the above two groups. The expected value of clinical information was greatest in patients with collapse (0.077) or mass lesions (0.067-0.065). CONCLUSIONS: A diagnostic work-up including fibreoptic bronchoscopy is indicated early in patients with collapse or mass lesions of the lung. Patients with non-resolving pneumonia, pleural effusion, metastatic disease and non-specific lesions on chest X-ray should receive a low priority for bronchoscopy.

Adolescent↗
PubMedDate not supplied

Visual inspection for cervical cancer screening: evaluation by doctor versus paramedical worker.

BACKGROUND: In the absence of an effective cervical cancer screening programme, efforts are being made to explore the feasibility of using the existing infrastructure to develop effective low-cost screening methods. AIMS: To evaluate and compare test performance of visual inspection of the cervix by a doctor and a paramedical worker. SETTING AND DESIGN: Gynaecology outpatient department (OPD), All India Institute of Medical Sciences, New Delhi; cross-sectional study. MATERIAL AND METHODS: One hundred women with complaints of vaginal discharge, irregular bleeding, post coital bleeding or unhealthy cervix underwent visual inspection with acetic acid (VIA) and Lugol's iodine (VILI) by a doctor and nurse, followed by colposcopy and biopsy. STATISTICAL ANALYSIS USED: Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for each test and compared. Concordance was determined by kappa statistics. RESULTS: VIA by nurse had a higher sensitivity (100% versus 87.5%), but lower specificity (53% versus 63%) when compared with the doctor, but it was not statistically significant. There was moderate agreement between their VIA findings (kappa=0.56). VILI findings were comparable to that of the VIA, both by the doctor and nurse. There was almost perfect agreement (kappa=0.89) between VILI by the doctor and nurse. CONCLUSION: Visual inspection can be performed reliably by trained paramedical workers and doctors and is an effective screening option in low resource settings.

Acetic Acid↗
PubMedDate not supplied

Fiberoptic bronchoscopy in patients with haemoptysis and normal chest roentgenograms.

Over the last 10 years, 53 patients with hemoptysis, but with a normal chest radiograph underwent diagnostic fiberoptic bronchoscopy. Forty-three patients did not show any abnormal findings, the site of bleeding could be localised in five and non-specific mucosal changes were seen in the remaining five patients. Thirty-two patients were followed up clinically for a 3-18 months period. One patient on follow-up developed tubercular pleural effusion. Bronchogenic carcinoma was not detected in any of these patients during the procedure or at follow up. A review of literature revealed a 3 per cent incidence of bronchogenic carcinoma and the risk factors associated with higher incidence were age above 40 years, cigarette smoking and a longer duration of hemoptysis. We conclude that fiberoptic bronchoscopy has little role in this relatively benign condition (hemoptysis) especially when the risk factors are absent.

Adult↗
PubMedDate not supplied

Extramedullary involvement in acute lymphoblastic leukemia and its relation to therapy.

Extramedullary involvement (EMI) of various body sites was studied by doing CSF cytology anu FNAC of testes and lymph nodes in 82 children with acute lymphoblastic leukemia (ALL). Forty-five patients had received no therapy (group I) and 37 had been diagnosed and treated earlier and were now in remission (36) or relapse (group II). EMI was documented in 48.9% and 32.4% of patients of group I and II respectively. EMI was seen more frequently in patients with FAB-L 2 subtype (66.6%) as compared to FAB-L1 subtype (34.6%) in group I. Lymph nodes and testes were commonly involved in group I and II patients respectively. Successful remission after complete chemotherapy was achieved in 82.5% of group I patients. However, successful remission rates were 95.2% in patients without any evidence of EMI versus 68.4% in those with EMI. These differences were also observed when response to therapy was analysed separately for patients with FAB-L1 and FAB-L2 subtypes.

Adolescent↗
PubMedDate not supplied

Fine needle aspiration cytology of mucoepidermoid carcinoma. A diagnostic problem.

The cytomorphologic findings in fine needle aspirates from 18 cases of histologically confirmed primary mucoepidermoid carcinoma of the salivary gland were reviewed and correlated with the findings on the tissue sections. An accurate diagnosis of these tumors in fine needle aspirates was possible when all three components (i.e., epidermoid cells, intermediate cells and mucus-producing cells) were identified. The pitfalls in the cytologic diagnosis of this tumor are discussed.

Biopsy, Needle↗
PubMedDate not supplied

Pulmonary blastoma.

Pulmonary blastoma is a rare tumour of the lung. We report three cases of this tumour. In all three cases, a possibility of blastoma was considered on aspiration cytology of the tumours. The relevant literature including its pathogenesis is reviewed.

Adolescent↗
PubMedDate not supplied

Value of demonstration of cytokeratin and leukocyte common antigen in poorly differentiated malignant tumors in fine needle aspirates.

Immunoperoxidase staining for cytokeratin and leukocyte common antigen (LCA) was applied to aspirated material from 21 well-differentiated malignant tumors ("control cases," which could be cytologically categorized) and 32 poorly differentiated malignant tumors ("study cases," whose tumor type was not clearly evident from study of the aspirate). Fifteen (48%) of the 32 poorly differentiated malignant tumors were classified as carcinomas (12 cases) or lymphomas (3 cases) by positive staining for cytokeratin or LCA, respectively. Good cytohistopathologic correlation was observed in all 7 control cases and in 11 cases of the study cases for which histologic specimens were available. The addition of staining for desmin helped in categorizing one undifferentiated tumor as a rhabdomyosarcoma. Immunostaining for vimentin was not found to be valuable in the categorization of these tumors.

Adenocarcinoma↗