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Biomedical subjects

S Gupta

Publications and source records attributed to S Gupta.

At least 523 records · Page 29Linked to original sources
PubMed1999

Columnar and metaplastic cells in vault smears: cytologic and colposcopic study.

Vault smears (n = 250) were examined as routine follow up of hysterectomized individuals. Although the majority of these smears were normal, 14 of them revealed the presence of columnar cells or metaplastic cells. None of these patients had any known cause which could account for the presence of these cells in a post-hysterectomy smear. The possible explanations could be (i) the common mullerian origin of the upper vaginal mucosal cells, (ii) exfoliated reparative squamous parabasal and basal cells mimicking columnar cells, (iii) goblet cell metaplasia in atrophic vaginal epithelium.

Adult↗
PubMed1999

Fine needle aspiration biopsy of the spleen in pyrexia of unknown origin.

To evaluate the diagnostic utility, value and potential risk of fine needle aspiration biopsy of spleen (sFNAB) in patients with splenomegaly in pyrexia of unknown origin (PUO), a retrospective analysis of medical records and cytological material of 31 patients on whom FNAB was performed between April 1994 and October 1997 was done. The patients were HIV- and presented with PUO. All other relevant investigations were negative. The spleen was either palpable or detected to have space-occupying lesions on ultrasonography (USG). The splenic aspirates showed tuberculosis in 11 patients (35.4%) and inconclusive or reactive changes in nine patients (25.8%). One case out of this group proved to be Kaposi's sarcoma on autopsy. The other diseases encountered were leishmaniasis (n = 3), non-Hodgkin's lymphoma (n = 4), fungal infections (n = 2), Hodgkin's lymphoma (n = 1). The patients who were diagnosed as having tuberculosis had epithelioid cells, giant cells, necrosis and inflammatory cells in various combinations. AFB positivity was 63.6%. The other cases which showed granulomas but no AFB were diagnosed on empirical grounds and all responded to the anti-tuberculosis therapy. No complications were encountered with the procedure. Therefore the authors conclude that sFNAB is rewarding in patients where all other non-invasive modalities of diagnosis have failed.

Adult↗
PubMed1999

Modified technique of suction blistering for epidermal grafting in vitiligo.

BACKGROUND: Suction blister epidermal grafting is a useful modality of treatment of resistant and stable vitiligo; however, it requires expensive and heavy suction apparatus. This study is an attempt to develop a cheap and small apparatus which can be assembled in the physician's own office. PATIENTS AND METHODS: The method was tried in 22 vitiligo/leukoderma patients. The apparatus consisted of a cylindrical funnel connected with a three-way tap, and suction was given by a 50-mL syringe. The pressure inside the suction cup was retained by changing the position of lock of the three-way tap. The pressure was measured by connecting the three-way tap to a vacuum gauge. The apparatus remained adhered to the donor area because of negative pressure. The blister was formed in about 1.5 h. The roof of the blister was grafted onto the dermabraded recipient site. RESULTS: The pigmentation was complete in 20 out of 22 patients. There were no complications. CONCLUSIONS: The technique is inexpensive and easy and obviates the need of cumbersome and heavy equipment.

Adolescent↗
PubMed1999

Fluid-fluid levels in intracranial schwannomas.

Intracranial cystic neurogenic tumours constitute an uncommon subset of tumours with a distinct clinico-biological behaviour. The presence of fluid-fluid levels within the tumours, although rare, confirms the cystic nature of the neoplasms. Barring the acoustic schwannomas, cystic cranial nerve schwannomas are exceptionally uncommon. Imaging findings of fluid-fluid levels in two non-acoustic cranial nerve schwannomas are described; one was a cystic trigeminal schwannoma and the other was a glossopharyngeal nerve schwannoma. The causes of the fluid-fluid level and its implications are analysed.

Adult↗
PubMed1999

Suction blister epidermal grafting versus punch skin grafting in recalcitrant and stable vitiligo.

BACKGROUND: Among various surgical therapies for replenishment of melanocytes in recalcitrant and stable vitiligo, punch skin grafting (PSG) and suction blister epidermal grafting (SBEG) are the simplest ones. Literature is lacking on a comparison of both. OBJECTIVE: We compared the results of both techniques in small patches of vitiligo. METHODS: Fifty stable vitiligo (focal, segmental, and generalized) patients were selected for study. One patient was lost to follow-up and excluded. PSG was done in 48 patches of 25 patients and SBEG was done in 38 patches of 24 patients. All patients were kept on psoralen ultraviolet-A (PUVA)/psoralen sunrays (PUVASOL). Results were evaluated after a follow-up of 4-7 months. RESULTS: Thirty-two (67%) patches of the PSG group and 31 (82%) patches of the SBEG group showed greater than 75% pigmentation. The difference in both groups was not statistically significant. Cobblestone appearance (23%) over the recipient area (RA) and superficial scarring of the donor area (DA) (100%) were seen in PSG. No serious complications were seen in both groups. CONCLUSION: Both techniques are simple and effective, however, SBEG gives cosmetically better and rapid results.

Adolescent↗
PubMed1999

Mechanisms of cell engraftment during liver repopulation with hepatocyte transplantation.

Hepatocyte transplantation has excited much interest among investigators for applications in cell therapy and studies of fundamental mechanisms concerning liver biology. Progress in these areas has been greatly facilitated by the development of novel animal models. An understanding of early events during engraftment of transplanted cells is essential for optimal repopulation of the liver. Insights into how transplanted cells integrate in the parenchyma of the liver with reconstitution of specific plasma membrane structures is critical in devising therapeutic strategies for specific disorders. Moreover, these insights are necessary for understanding mechanisms concerning regulation of cell proliferation and gene expression in transplanted hepatocytes. Finally, analysis of the safety of cell transplantation is necessary for clinical applications of liver repopulation with cell transplantation. This review highlights selected advances in related areas concerning liver repopulation.

Animals↗
PubMed1999

Wandering intraspinal bullet.

A case of gun shot injury to the spine, with the bullet entering the thecal sac via the right side of the lower chest and wandering freely in the subarachnoid space, is reported. The patient was neurologically intact initially and developed radicular symptoms with foot drop and urinary retention on the third day after injury. The radiological findings and the problems faced at surgery are discussed, and the relevant literature of this uncommon condition is reviewed.

Adult↗
PubMed1999

Aggrecan degradation in chondrocytes is mediated by reactive oxygen species and protected by antioxidants.

Reactive oxygen species (ROS) are implicated in aging of cartilage and in the pathogenesis of osteoarthritis. However, the biological role of chondrocytes-derived ROS has not been elucidated. An in-vitro model was developed to study the role of chondrocyte-derived ROS in cartilage matrix degradation. The primary articular chondrocytes were cultured and the aggrecan matrix was radiolabeled with 35-sulfate. The labeled aggrecan matrix was washed to remove unincorporated label and chondrocytes were returned to serum free balanced salt solution. The cell-monolayer-matrix sensitivity to oxidative damage due to either hydrogen peroxide or glucose oxidase was established by monitoring the release of labeled aggrecan into the medium. Lipopolysaccharide (LPS) treatment of chondrocyte-monolayer enhanced the release of labeled aggrecan. Catalase significantly prevented the release of labeled aggrecan in LPS-chondrocyte cultures, suggesting a role for chondrocyte-derived hydrogen peroxide in aggrecan degradation. Superoxide dismutase or boiled catalase had no such inhibitory effect. The effect of several antioxidants on LPS-chondrocyte-dependent aggrecan degradation was examined. Hydroxyl radical scavengers (mannitol and thiourea) significantly decreased aggrecan degradation. A spin trapping agent N-tert-butyl-phenylnitrone (but not its inactive analog tert-butyl-phenylcarbonate) significantly decreased aggrecan degradation. Butylated hydroxytoluene also inhibited aggrecan degradation, whereas the other lipophilic antioxidant tested, propyl gallate, had a marked dose-dependent inhibitory effect. These data indicate that general antioxidants, hydroxyl radical scavengers, antioxidant vitamins, iron chelating agents, lipophilic antioxidants, and spin trapping agents can influence chondrocyte-dependent aggrecan degradation. These studies support the role of a chondrocyte-dependent oxidative mechanism in aggrecan degradation and indicate that antioxidants can prevent matrix degradation and therefore may have a preventive or therapeutic value in arthritis. The enhancement of oxidative activity in chondrocytes and its damaging effect on matrix may be an important mechanism of matrix degradation in osteoarthritis.

Aggrecans↗
PubMed1999

Measuring brain tissue oxygenation compared with jugular venous oxygen saturation for monitoring cerebral oxygenation after traumatic brain injury.

UNLABELLED: Jugular bulb oximetry is the most widely used method of monitoring cerebral oxygenation. More recently, measurement of brain tissue oxygenation has been reported in head-injured patients. We compared the changes in brain tissue oxygen partial pressure (PbO2) with changes in jugular venous oxygen saturation (SjVO2) in response to hyperventilation in areas of brain with and without focal pathology. Thirteen patients with severe head injuries were studied. A multiparameter sensor was inserted into areas of brain with focal pathology in five patients and outside areas of focal pathology in eight patients. A fiberoptic catheter was inserted into the right jugular bulb. Patients were hyperventilated in a stepwise manner from a PaCO2 of approximately 35 mm Hg to a PaCO2 of 22 mm Hg. There was no significant change in cerebral perfusion pressure or arterial partial pressure of oxygen with hyperventilation. In areas without focal pathology, there was a good correlation between changes in SjVO2 and PbO2 (deltaSjVO2 and deltaPbO2; r2 = 0.69, P < 0.0001). In areas with focal pathology, there was no correlation between deltaSjVO, and APbO2 (r2 =0.07, P = 0.23). In this study, we demonstrated that measurement of local tissue oxygenation can highlight focal differences in regional cerebral oxygenation that are disguised when measuring SjVO2. Thus, monitoring of PbO2 is a useful addition to multimodal monitoring of patients with traumatic head injury. IMPLICATIONS: Brain oxygenation is currently monitored by using jugular bulb oximetry, which attracts a number of potential artifacts and may not reflect regional changes in oxygenation. We compared this method with measurement of brain tissue oxygenation using a multiparameter sensor inserted into brain tissue. The brain tissue monitor seemed to reflect regional brain oxygenation better than jugular bulb oximetry.

Adult↗
PubMed1999

Confirmation of caudal needle placement using nerve stimulation.

BACKGROUND: The study was designed to examine a new method of confirming proper caudal needle placement using nerve stimulation. METHODS: Thirty-two pediatric patients were studied. A 22-gauge insulated needle was inserted into the caudal canal via the sacral notch until a "pop" was felt. The needle placement was classified as correct or incorrect depending upon the presence or absence of anal sphincter contraction (S2-S4) to electrical simulation (1 to 10 mA). RESULTS: Three patients were excluded, two because they inadvertently received neuromuscular blockers and one because the patient's anatomy precluded any attempt at a caudal block. The sensitivity and specificity of the test were both 100% in predicting clinical outcomes of the caudal block. Six patients had a negative stimulation test after the first attempt to place the needle. Four of these went on to receive a second attempt of needle insertion after a subcutaneous bulge or resistance to local anesthetic injection were observed. Following needle reinsertion, positive stimulation tests were elicited. These patients received the local anesthetic injection with ease and had good analgesia postoperatively. No attempt was made to reinsert the needle in the remaining two patients with a negative stimulation test, as they did not show subcutaneous bulge or resistance upon injection. These patients had poor analgesia postoperatively. The positive predictive value of the test was greater than the presence of a "pop" alone (P < 0.05) but not significantly different (P = 0.492) over the presence of "pop" and easy injection. CONCLUSION: This test may be used as a teaching and adjuvant tool in performing caudal block.

Anesthesia, Caudal↗
PubMed1999

Twice weekly 5 mg dexamethasone oral pulse in the treatment of extensive alopecia areata.

Thirty patients (20 males, 10 females) with widespread alopecia areata (25 extensive alopecia areata, 5 alopecia areata) for a mean period of 4.2 years were included in the study. All patients above 12 years were administered 5 mg dexamethasone oral pulse on two consecutive days every week. Three children (< 12 years) received 2.5 mg to 3.5 mg dexamethasone oral biweekly pulse. Patients who had received treatment for a minimum period of 12 weeks were evaluated for terminal hair growth. Complete to excellent (75-95%) hair growth was observed in 16 (63.3%) patients. Growth was good (50-74%) in 2 cases and poor (< 50%) in 3 (10%) cases. Six (20%) patients has no growth of terminal hair. Complete to excellent growth of hair was obtained after a mean period of 5.35 months (range 3-10 months). Relapse occurred in one case each after three and six months but hair regrew with re-treatment. Side effects of corticosteriods were frequent, seen in 8 (26.6%) patients, but were mild. In only one case, treatment had to be discontinued. We propose that twice weekly 5 mg dexamethasone oral pulse for six months may be considered as one of the modalities in the treatment of extensive long standing alopecia areata.

Administration, Oral↗
PubMed1999

Evaluation of thyroid function in north Indians with alopecia areata: response to intravenous injection of 100 micrograms thyrotropin releasing hormone (TRH).

There is a lack of agreement on the overall prevalence of thyroid disease and thyroid function abnormalities in alopecia areata. Only one study is available from the Indian subcontinent. All patients with alopecia areata attending a dermatology outpatient clinic between 1983 and 1997 were screened for the presence of clinical thyroid disease. Sixty-two consecutive patients during the year 1994 were evaluated in detail for thyroid functions by measuring T3, T4, TSH levels and testing for antithyroid and antimicrosomal antibodies. Twenty-two patients randomly selected from the above-mentioned sixty two were studied for TSH response to intravenous injection of 100 micrograms TRH at -20, 0 and 20, 60, and 120 minutes after TRH injection. Thyroid disease was clinically evident in 16 (0.85%) of the 1700 patients with alopecia areata seen over the last fifteen years. All sixty-two patients evaluated for thyroid functions were clinically euthyroid. Seven (11.3%) out of these 62 patients had abnormal thyroid hormone levels. Antithyroid and antimicrosomal antibodies were found in five patients; all five had abnormalities in thyroid function. TSH response to TRH was suggestive of hypothyroidism in 4 (18%) of the 22 patients studied. Manifest thyroid disease is infrequently associated with alopecia areata. Abnormalities in thyroid functional status were more frequent; they were found in 7 (11.3%) out of 62 patients. TSH response to intravenous TRH was abnormal in an even higher proportion [4 (18%) out of 22 patients]. There was no apparent correlation with duration or type of alopecia areata.

Adolescent↗
PubMed1999

Monocyte expression of tissue factor and adhesion molecules: the link with accelerated coronary artery disease in patients with chronic renal failure.

OBJECTIVE: To investigate the expression of monocyte tissue factor (MTF) and adhesion molecules in patients with chronic renal failure (CRF) and to look for any correlation with thrombin generation and Lp(a) lipoprotein. DESIGN: A study of MTF expression and adhesion molecules, prothrombin fragments 1+2 (PTf1+2), an index of thrombin generation, and lipoproteins in patients with CRF and in normal control subjects. BACKGROUND: Patients with end stage renal failure have an increased risk of coronary artery disease despite advances in therapy. Stimulated monocytes are potent activators of blood coagulation through the generation of MTF, which was recently implicated in the aetiology of acute coronary ischaemic syndromes. METHODS: MTF expression and adhesion molecules were measured in whole blood using immunofluorescence of monocytes labelled with anti-tissue factor antibody and CD11b and c by flow cytometry. PTf1+2 and Lp(a) lipoprotein in plasma were measured by enzyme linked immunosorbent assay (ELISA). PATIENTS: 70 patients with CRF without documented coronary artery disease (30 patients with CRF undialysed, 20 patients undergoing chronic ambulatory peritoneal dialysis (CAPD), and 20 undergoing haemodialysis (HD)), together with 20 normal controls, were studied. RESULTS: The (mean (SD)) increased MTF of CRF (48.0 (29) v 33.3 (7.2) mesf unit/100 monocytes in controls, p = 0.04) was more pronounced in patients undergoing dialysis (HD 73.1 (32.8) (p < 0.003) and CAPD 62.8 (28.9) mesf unit/100 monocytes, p < 0.04). MTF activity showed a positive correlation with both PTf1+2 and serum creatinine (p < 0.003) but not with Lp(a) lipoprotein. Lp(a) lipoprotein was significantly increased in both dialysis groups compared with controls (p < 0.005) and non-dialysis CRF groups (p < 0.02). Monocyte adhesion molecule (CD11b) was significantly higher in all three CRF groups than in the controls (p = 0.006). CONCLUSION: This study has demonstrated a hypercoagulable state in patients with CRF. This was especially pronounced in the dialysis patients. These findings provide a possible explanation for the increased cardiovascular and cerebrovascular morbidity and mortality in these patients.

Case-Control Studies↗