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Biomedical subjects

R Gupta

Publications and source records attributed to R Gupta.

At least 451 records · Page 25Linked to original sources
PubMed1996

Bisindolylmaleimides linked to DNA minor groove binding lexitropsins: synthesis, inhibitory activity against topoisomerase I, and biological evaluation.

The synthesis, characterization, inhibitory activity against topoisomerase I, and biological evaluation of a series of oligopeptide-substituted bisindolylmaleimides 7-12 are described. Compounds 7-9, which contain a basic C-terminus function such as (dimethylamino)propyl and bind to DNA with C(50) values of 200, 160, and 135 microM, respectively, exhibited inhibition of topoisomerase I in a concentration dependent manner. Also, the relative order of observed topoisomerase I inhibition is 9 > 8 > 7 at < or = 100 microM concentration, corresponding to the increase of the number of pyrrole units in the oligopeptide moiety. Compounds 10-12, which contain an electrostatically neutral moiety, such as methyl ester, did not bind to DNA templates nor inhibit topoisomerase I. However, the cytotoxicity activities of these compounds were 1.5 times greater than those of compounds 7-9.

Antineoplastic Agents↗
PubMed1996

Precocious puberty with pituitary gland hyperplasia: two cases in one family.

Children with central precocious puberty have pituitary gland size comparable to that of pubertal children (pituitary gland height 6.1 +/- 1.1 mm). We present of two sisters with precocious puberty and a pituitary gland height of more than 1 cm. On contrast enhanced MRI, there was homogeneous enhancement of the pituitary gland. There was no increase in pituitary gland size during the follow-up period (6 years and 2 years). These cases are reported for their rarity.

Child↗
PubMed1996

Gelation of fractionated canine submaxillary mucin in a chaotropic solvent.

Rheological measurements have been performed on three molecular weight fractions of purified canine submaxillary mucin (CSM) dissolved in the chaotropic solvent 6 M guanidine hydrochloride (GdnHCI). Solutions of the lower molecular weight fractions are viscoelastic sols, and their dynamic moduli can be scaled with respect to molecular weight and concentration according to linear viscoelasticity theory. In contrast, preparations of the highest molecular weight fraction form viscoelastic gels that exhibit an equilibrium shear modulus, Ge', which scales with mucin concentration as Ge' approximately c3. Amino acid and carbohydrate analyses of all three fractions are similar; thus, the differences in rheological behavior are attributed to molecular weight differences, which affect the degree of coil overlap in solutions of a given concentration. These observations demonstrate conclusively that mucin glycoproteins of high molecular weight form gels under conditions in which the mucin chains physically interpenetrate, even when non-covalent intermolecular interactions are extensively disrupted. A comparison of these results with previous studies of purified submaxillary and tracheobronchial mucins indicates that the carbohydrate side-chain length, in addition to molecular weight, is an important determinant of the observed elastic response and the ability to form physical gels.

Animals↗
PubMed1996

Coeliac artery aneurysm: a case report.

Coeliac artery aneurysms are rare. A case of coeliac artery aneurysm treated successfully by endoaneurysmorrhaphy is presented. Although excision with arterial reconstruction is usually recommended, endoaneurysmorrhaphy can also be considered in selected cases.

Aneurysm↗
PubMed1996

Intercondylar fractures of the distal humerus in adults.

Intercondylar fractures of the distal humerus in adults are difficult fractures to treat because of their rarity and associated significant comminution. The results of managing these fractures non-operatively are limited by failure to get anatomical reduction and early mobilization, which often results in painful stiff elbow and/or pseudarthrosis. Hence an operative management with anatomical reduction of the fragments becomes the treatment of choice for these fractures. The experience of managing 20 such fractures by open reduction and internal fixation with early mobilization is presented. Nineteen of these fractures attained acceptable results, 15 of which were graded as excellent in the final outcome. This study attempts to rationalize the operative management of these fractures regarding choice of surgical approach, choice of implants and timing of mobilization of elbow.

Adolescent↗
PubMed1996

An unusual cause of penetrating cardiac injury in a child.

The authors report on a 7-year-old boy who suffered an unintentional penetrating cardiac injury while misusing a lawn toy in a predictable way. The boy was hemodynamically stable, with abdominal pain and tenderness. The pericardial effusion was first noted on upper abdominal computerized tomographic images and was confirmed by echocardiography. A puncture wound of the anterior right ventricle was found. As in this case, children may not have the typical signs and symptoms of cardiac tamponade, making the diagnosis difficult and delaying appropriate care. This child's injury could have been prevented through increased parental supervision or a modified toy design that takes into account predictable patterns of misuse.

Cardiac Tamponade↗
PubMed1996

Hypolipidaemic effect of Myristica fragrans fruit extract in rabbits.

The ethanolic extract of nutmeg (Myristica fragrans) was studied in albino rabbits for its effects on experimentally induced hyperlipidaemia. After inducing hyperlipidaemia in 12 rabbits a dose of 500 mg/kg of the extract was administered orally daily for a period of 60 days in 6 rabbits (experimental group); the rest of the rabbits were observed as controls. When compared with the control of rabbits the levels of lipoprotein lipids were significantly lower in the experimental group after 60 days; total cholesterol 573 +/- 61 vs. 209 +/- 27 mg/dl, low density lipoprotein (LDL) cholesterol 493 +/- 57 vs. 131 +/- 25 mg/dl, and triglycerides 108 +/- 14 vs. 67 +/- 9 mg/dl P < 0.001). High density lipoprotein (HDL) cholesterol levels were not significantly different (59 +/- 7 vs. 65 +/- 4 mg/dl, P = n.s.). Total cholesterol:HDL ratio and LDL:HDL ratio were significantly lower in the experimental group. The Myristica fragrans extract showed platelet anti-aggregatory ability. There were significantly lower levels of total cholesterol in heart (3.7 +/- 0.5 vs. 2.2 +/- 0.5 mg/100 g) and liver (11.9 +/- 1 vs. 1.5 +/- 0.4 mg/100 g). The toxicity studies showed absence of any adverse effects on various haematological and biochemical parameters.

Animals↗
PubMed1996

Balloon mitral commissurotomy: an intraoperative assessment.

OBJECTIVE: Advances in balloon catheter technology have revolutionized the management of obstructive cardiovascular diseases. For lesions like mitral stenosis, balloon commissurotomy has emerged as an alternative to surgical relief showing definite functional benefits in a few clinical trials, albeit with variable results. Such variability necessitated objective evaluation of the efficacy of balloon mitral commissurotomy. METHODS: The balloon mitral commissurotomy was carried out in 11 patients suffering from isolated mitral stenosis, under vision in a surgical setting. All patients were in NYHA class III/IV. Initially single balloon was used for mitral commissurotomy followed by double balloon, before completing the mitral valvotomy with surgical instruments whenever required. The commissural split was measured by firmly stretching the two commissures using nerve hooks and measuring the distance between the two hooks with the help of a caliper. Assessment of balloon dilation was made by calculating exact percentage of residual commissural split following balloon dilation as compared with completed mitral valvotomy. The exact percentage of commissural split was thus obtained by subtracting residual commissural split following balloon dilation from commissural split obtained after surgical open mitral valvotomy. RESULTS: Complete commissurotomy using the balloon technique was possible in two (18.2%) patients. In the remaining nine (81.8%) patients, balloon expansion provided only 50% to 80% of commissural split and required instrumental completion with good results. CONCLUSIONS: Balloon mitral commissurotomy, by virtue of its circumferential force, helps to develop a good cleavage and attains good hemodynamic improvement which may be life saving in critical mitral stenosis in selected group of patients with pliable mitral leaflets and minimal subvalvular pathology.

Adolescent↗
PubMed1996

The effect of antecedent ischemia on the tolerance of skeletal muscle to increased interstitial pressure.

This study used an experimental model (canine hind limb) of compartment syndrome, monitored with phosphorus 31 nuclear magnetic resonance spectroscopy, to determine the pressure threshold for metabolic deterioration in skeletal muscle previously subjected to ischemia. Our results show that muscle subjected to 6 h of antecedent ischemia has a lower tolerance to increased tissue pressure than otherwise normal muscle. The threshold was found to occur at a delta P (difference between mean blood pressure and limb compartment pressure) of 40 mm Hg, compared with a delta P of 30 mm Hg in muscle that was not subjected to antecedent ischemia. In addition, once the critical pressure threshold of postischemic muscle was crossed, there was a more rapid rate of high-energy phosphate depletion than that seen in normal muscle pressurized to the same degree beyond its delta P threshold. For compartment syndromes that appear after relatively atraumatic ischemia (i.e., drug overdose-induced limb compression, proximal arterial trauma causing distal limb ischemia, etc.), of < or = 6 h, fasciotomy should be performed at a delta P < or = 40 mm Hg. Compartment pressure elevation after local blunt muscle trauma and ischemia may well require earlier or even prophylactic fasciotomy. Fasciotomy in ongoing postischemic compartment syndromes should be considered particularly urgent owing to the rapid rate of metabolic deterioration that is observed once the critical delta P threshold is crossed. The type of compartment syndrome should always be considered when interpreting tissue pressure measurements as indications for fasciotomy.

Animals↗
PubMed1996

Portal hypertensive gastropathy in children with extrahepatic portal venous obstruction: role of variceal obliteration by endoscopic sclerotherapy and Helicobacter pylori infection.

We aimed to determine the frequency of portal hypertensive gastropathy (PHG) in children with extrahepatic portal venous obstruction (EHPVO) and to find out the role of esophageal variceal obliteration by endoscopic injection sclerotherapy (EIS) and Helicobacter pylori (H. pylori) infection in the pathogenesis of PHG. Twenty consecutive children were studied before EIS and 20 after esophageal varices obliteration. Diagnosis of PHG was established by endoscopic assessment. Helicobacter pylori infection was diagnosed by rapid urease test, H. pylori culture, smear, and histopathologic examination of antral biopsy specimens. Portal hypertensive gastropathy was characterized and graded by endoscopy according to previously established criteria. In the pre-EIS group, eight (40%) had PHG (mild in all) compared with 16 (80%; mild in eight, severe in eight) in the post-EIS group (p < 0.05). Portal hypertensive gastropathy was more extensive in the post-EIS group. There was no significant difference between frequency of gastric varices and H. pylori infection in the pre-EIS and post-EIS groups. We conclude that PHG is common in children with EHPVO; its frequency, extent, and severity increase after esophageal variceal obliteration by EIS, and H. pylori infection does not play any role in its development.

Adolescent↗
PubMed1996

Endosonographic evaluation of the rectum in children with extrahepatic portal venous obstruction.

Rectal endoscopic ultrasonography (REUS) was performed using an Olympus EU-M3 ultrasound fiberscope in 25 children with extrahepatic portal venous obstruction (median age of 8, range 3-16 years) and in eight control subjects (median age of 8, range 6-13). Rectal varices (tortuous or nodular distended veins seen beneath the mucosa) and portal hypertensive rectopathy were diagnosed endoscopically. At rectal endosonography, rectal varices were seen as rounded, oval, or longitudinal echo-free structures in the submucosa. Perirectal veins outside the rectal wall were also seen in REUS. Portal hypertensive rectopathy was endoscopically observed in nine (36%) patients. Rectal varices were detected by endoscopy in nine (36%) and by endosonographic examination in 19 (76%) patients with extrahepatic portal venous obstruction. The number (2, range 0-10) and size (3, range 0-4.5 mm) of submucosal veins seen on endosonography in patients were greater than in controls (0, range 0-1, and 0, range 0-2 mm; p < 0.001 for both). The size of perirectal veins was greater in patients than in controls (3.5, range 3-5 mm versus 2.5, range 2-3 mm; p < 0.001). Communicating veins between the submucosal and perirectal veins were seen in nine (36%) patients. Rectal endoscopic ultrasonography was superior to endoscopy in detecting the presence of rectal varices (76% versus 35%, p < 0.005). Our study suggests that endosonography is useful in detecting changes in the rectal and perirectal vasculature in patients with extrahepatic portal venous obstruction.

Adolescent↗
PubMed1996

Computed tomography morphology of the adrenal glands of patients with Addison's disease.

To study the morphology of the adrenal glands of patients with Addison's disease an ultrasound and a computed tomographic scan of the adrenal glands were performed in 28 patients with Addison's disease. Thirteen patients had bilateral, asymmetric adrenal enlargement. In six of these patients, areas of necrosis and calcification were also seen. Six patients had atrophic glands with calcification and nine patients had normal/atrophic glands without calcification. After instituting appropriate treatment, computed tomography (CT) was repeated between 6 months and 3 years later in 10 of the 13 patients with adrenal enlargement. A reduction in gland size was noted in all patients and one had functional recovery. We conclude that the appearance of the adrenal glands on CT depends not only on the nature of the underlying disease but also on the duration of the illness and the type of treatment.

Addison Disease↗
PubMed1996

Endoscopic management of postoperative bile leak.

Significant bile leak is an uncommon but serious complication of biliary tract surgery. Of twenty-five patients presenting with postoperative bile leak, 11 had complete tie-off of common bile duct and required surgery, while the remaining 14 had injury without complete obstruction and could be managed by endoscopic methods. Of these 14 cases, bile leak occurred from the cystic duct in 11 patients and from the common hepatic duct, right hepatic duct and left hepatic duct in one patient each. Endoscopic procedures performed included sphincterotomy alone (four patients), sphincterotomy and stent placement (seven patients) and sphincterotomy followed by nasobiliary catheter drainage (three patients). There was no technical failure and bile leak was stopped in all patients. One patient died of haemobilia 5 days after stent placement. When technically feasible, postoperative bile leak can be managed safely and effectively by endoscopic methods, obviating the need for surgical reexploration.

Adult↗
PubMed1996

Frequency and factors influencing portal hypertensive gastropathy and duodenopathy in cirrhotic portal hypertension.

Portal hypertensive gastropathy and duodenopathy are distinct clinical and endoscopic entities. Data on factors influencing the development of these lesions are still emerging. Data on portal hypertensive duodenopathy are scarce. We prospectively studied 230 patients with liver cirrhosis and oesophageal varices attending the liver clinic of the Sanjay Gandhi Post Graduate Institute of Medical Sciences. One hundred and forty-two patients had no history of upper gastrointestinal bleeding, while the remainder had bled in the past. Endoscopic appearances were recorded before starting patients on a sclerotherapy programme. Forty-four patients were re-evaluated after variceal eradication. The frequency of portal hypertensive gastropathy (PHG) and duodenopathy (PHD) was 61 and 14%, respectively. Mild PHG was present in 85% and was severe in the rest. Portal hypertensive duodenopathy was mild in 50%, while in the other half it was severe. There was no relationship of PHG and PHD to: (i) a history of upper gastrointestinal bleed; (ii) size of oesophageal varices; (iii) aetiology of liver cirrhosis; or (iv) liver function status as assessed by Child Pugh's scores (P = NS for all). The prevalence of PHG was higher in those patients with oesophagogastric varices (74 of 107; 69%) compared with patients with oesophageal varices alone (68 of 123; 55%; P < 0.05). However, no such increase in frequency of PHD was noted in patients with oesophagogastric varices. Sclerotherapy increased the frequency of PHG. Twenty-four patients had PHG before starting sclerotherapy, while it was noted in 33 patients 1-3 months after variceal eradication (P < 0.05). In contrast, there was no increase in the prevalence of portal hypertensive duodenopathy after sclerotherapy (P = NS). There was no correlation between endoscopic and histological changes of PHG and PHD. In conclusion, PHG is quite frequent in patients with cirrhosis and its frequency increases with the presence of oesophagogastric varices and after sclerotherapy. However, the frequency of PHD is low and is not affected by the factors studied.

Adult↗
PubMed1996

Abdominal pain in a young girl.

A 14-year-old girl was admitted to our hospital with peri-umbilical pain associated with obstipation and vomiting. Plain erect X-rays of the abdomen revealed multiple air fluid levels. A supine X-ray is shown in this figure.

Abdominal Pain↗