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Biomedical subjects

Sunil Kumar

Publications and source records attributed to Sunil Kumar.

At least 37 records · Page 2Linked to original sources
PubMed2005

Intraoperative bile cytology of the dysplasia-carcinoma in situ sequence of gallbladder carcinoma.

BACKGROUND: The preoperative diagnosis of noninvasive and early carcinoma of the gallbladder is considered to be both difficult and exceptional. In the current study, the authors conducted a cytologic analysis of bile in the intraoperative diagnosis of clinically unsuspected gallbladder carcinoma. METHODS: Bile samples collected from 40 patients at the time of elective cholecystectomy were centrifuged. Smears prepared from the sediments were stained with May-Grünwald-Giemsa and Papanicolaou stains. Lesions were categorized as hyperplasia with or without metaplasia, dysplasia, carcinoma in situ, and invasive carcinoma. Cytologic diagnoses were compared with histopathology. RESULTS: Two cases of carcinoma in situ and one case of invasive carcinoma diagnosed on bile cytology were confirmed by histopathology. No false-positive diagnoses were made based on cytologic examination of aspirated bile. Cytohistologic concordance in cases of hyperplasia, dysplasia, and chronic cholecystitis varied from 56-60%. CONCLUSIONS: Intraoperative bile cytology was found to be a reliable method for the detection of in situ and early invasive carcinoma of the gallbladder.

Adult↗
PubMed2005

Atomic force microscopy: a powerful tool for high-resolution imaging of spermatozoa.

Atomic force microscopy (AFM) has emerged as the only technique capable of real-time imaging of the surface of a living cell at nano-resolution. Since AFM provides the advantage of directly observing living biological cells in their native environment, this technique has found many applications in pharmacology, biotechnology, microbiology, structural and molecular biology, genetics and other biology-related fields. AFM has also proved to be a valuable tool for reproductive biologists. An exhaustive review on the various applications of AFM to sperm cells is presented. AFM has been extensively applied for determining the structural and topological features of spermatozoa. Unstained, unfixed spermatozoa in their natural physiological surroundings can be imaged by this technique which provides valuable information about the morphological and pathological defects in sperm cells as three-dimensional images with precise topographical details. Sperm head defects and the acrosome at the tip of the head responsible for fertilization, can be examined and correlated with the lack of functional integrity of the cell. Considerable amount of work is reported on the structural details of the highly condensed chromatin in sperm head using AFM. Detailed information on 3D topographical images of spermatozoa acquired by AFM is expected to provide a better understanding of various reproductive pathways which, in turn, can facilitate improved infertility management and/or contraceptive development.

Journal Article↗
PubMed2005

Effects on sleep of microdialysis of adenosine A1 and A2a receptor analogs into the lateral preoptic area of rats.

Evidence suggests that adenosine (AD) is an endogenous sleep factor. The hypnogenic action of AD is mediated through its inhibitory A1 and excitatory A2A receptors. Although AD is thought to be predominantly active in the wake-active region of the basal forebrain (BF), a hypnogenic action of AD has been demonstrated in several other brain areas, including the preoptic area. We hypothesized that in lateral preoptic area (LPOA), a region with an abundance of sleep-active neurons, AD acting via A1 receptors would induce waking by inhibition of sleep-active neurons and that AD acting via A2A receptors would promote sleep by stimulating the sleep-active neurons. To this end, we studied the effects on sleep of an AD transport inhibitor, nitrobenzyl-thio-inosine (NBTI) and A1 and A2A receptor agonists/antagonists by microdialyzing them into the LPOA. The results showed that, in the sleep-promoting area of LPOA: 1) A1 receptor stimulation or inhibition of AD transport by NBTI induced waking and 2) A2A receptor stimulation induced sleep. We also confirmed that NBTI administration in the wake promoting area of the BF increased sleep. The effects of AD could be mediated either directly or indirectly via interaction with other neurotransmitter systems. These observations support a hypothesis that AD mediated effects on sleep-wake cycles are site and receptor dependent.

Adenosine↗
PubMed2005

Benzbromarone therapy in management of refractory gout.

AIM: To assess the efficacy and safety of benzbromarone in patients with renal impairment and severe tophaceous gout (despite receiving optimal conventional therapy). METHODS: Six patients with refractory gout (despite optimal therapy) were treated with benzbromarone. Uric acid levels and number of gout attacks were recorded monthly. Adverse events to medications were also recorded. RESULTS: After 1 year of treatment with benzbromarone, average uric acid level reduced from 0.61 mmol/L to 0.46 mmol/L. Repeated measures tests on the changes in uric acid were clinically significant (p=0.01). The frequency of acute attacks of gout was reduced from 16 (8-20) to 7.3 (1-16); p=0.01. None of the patients reported adverse events with the medications. There were no acute flares resulting from initiation of medications. CONCLUSION: Benzbromarone is effective in lowering uric acid levels and in reducing the number of acute attacks of gout in patients who have failed optimal treatment. Making this drug more readily available will increase our therapeutic choices for urate reduction and help decrease the morbidity associated with gout.

Adult↗
PubMed2005

An unusual presentation of a malignant jejunal tumor and a different management strategy.

BACKGROUND: Malignant small bowel tumors are very rare and leiomyosarcoma accounts for less than 15% of the cases. Management of these tumors is challenging in view of nonspecific symptoms, unusual presentation and high incidence of metastasis. In this case report, an unusual presentation of jejunal sarcoma and management of liver metastasis with radiofrequency ablation (RFA) is discussed. CASE PRESENTATION: A 45-year-old male presented with anemia and features of small bowel obstruction. Operative findings revealed a mass lesion in jejunum with intussusception of proximal loop. Resection of bowel mass was performed. Histopathological findings were suggestive of leiomyosarcoma. After 3-years of follow-up, the patient developed recurrence in infracolic omentum and a liver metastasis. The omental mass was resected and liver lesion was managed with radiofrequency ablation. CONCLUSION: Jejunal leiomyosarcoma is a rare variety of malignant small bowel tumor and a clinical presentation with intussusception is unusual. We suggest that an aggressive management approach using a combination of surgery and a newer technique like RFA can be attempted in patients with limited metastatic spread to liver to prolong the long-term survival in a subset of patients.

Journal Article↗
PubMed2005

Malassezia furfur in a case of onychomycosis: colonizer or etiologic agent?

The etiologic role of Malassezia furfur in onychomycosis is a contentious diagnostic problem because its keratinolytic ability has never been verified. This case report describes the isolation of M. furfur from the infected nails of a child clinically diagnosed with onychomycosis, and discusses the role of this organism as an etiologic agent/colonizer. The patient presented with subungual hyperkeratosis and onycholysis without associated paronychia. Budding yeast cells compatible with M. furfur were repeatedly demonstrated in KOH wet mounts of damaged nails, histopathology of hematoxylin and eosin (H&E) and periodic acid-Schiff (PAS) stained sections showed penetration of fungal elements between deeper layers of keratin, and numerous colonies of M. furfur were isolated on three consecutive occasions from nail specimens collected from different areas of hand and toenail lesions. No evidence of nail invasion by dermatophytic or nondermatophytic filamentous fungi were found by direct microscopy or culture. Microscopy and culture were negative following 12 weeks of ketoconazole treatment, which resulted in growth of healthy nail plates with normal beds. We can infer from these observations that M.furfur was an etiologic agent rather than a colonizer in the patient's nails even though direct keratinolytic character of this fungus was not demonstrated.

Adolescent↗
PubMed2005

Semen quality of industrial workers occupationally exposed to chromium.

A total of sixty-one subjects occupationally exposed to chromium in an industry which manufactures chromium sulphate and fifteen control subjects from a nearby industry which does not manufacture any chromium related compounds were studied. The history of each subject was recorded on pre-designed form through interview and a routine medical examination was carried out. Blood samples (5-6 ml) were collected for the estimation of chromium and semen samples were collected for semen analysis and the determination of copper and zinc levels in the seminal plasma. Clinical examination revealed nasal perforation in 10 subjects (out of 61) in the exposed group as compared to none in the control group. A significantly higher level of chromium was observed in the blood of the exposed workers as compared to the control. The concentration of zinc in seminal plasma was lower while the level of copper was higher in the exposed group as compared to the control. However, these changes were not statistically significant. Statistically significant higher numbers of morphologically abnormal sperms were noticed in the exposed group with respect to the control. Further analysis of the data indicated that about 53% of the exposed subjects showed less than 30% normal forms as compared to 10% in control subjects. However, no significant alterations in semen volume, liquefaction time, mean pH value, sperm viability, concentration or motility, were noticed between chromium exposed and unexposed workers. The data also indicates that exposure to chromium has some effect on human sperm as a significant positive correlation (r=0.301) was observed between percentages of abnormal sperm morphology and blood chromium levels (p=0.016) after pooling all the data of the control and exposure groups.

Adult↗
PubMed2005

Tuberculin specific T cell responses in BCG vaccinated children.

The effector mechanisms of BCG protection were examined 5-7 years after vaccination. The in vitro lymphoproliferation, following stimulation with tuberculin, in normal, (A) vaccinated and (B) unvaccinated children and children with tuberculosis (C), were assayed. The mean stimulation index (SI) of lymphocyte transformation in normal subjects were significantly (P < 0.05) higher than those with tuberculosis. The ratio of tuberculin-specific CD4 to CD8 cells in short-term cultures were significantly (P less than 0.05) higher in the vaccinees. In group (A), 70 % had positive ratios as against 20 %and 0 %in groups (B) and (C), respectively. Secretion of IL-2 by the cells was significantly (P < 0.05) high in the vaccinated. None of the unvaccinated children had positive levels of IL-2. The vaccinees also had highly significant (P < 0.01) levels of IFN-)in the supernatants of cell-cultures, following tuberculin stimulation. In majority of the BCG vaccinated children, the stimulation of specific TH1 cells seem to be considerably high, in short-term in vitro cultures. While these responses were not so marked in the unvaccinated, they were almost totally absent in the patients.

BCG Vaccine↗
PubMed2005

Endoscopic variceal ligation using multiband ligator.

Esophageal variceal bleed in children is treated with endoscopic sclerotherapy (EST), which is associated with significant complications. Endoscopic variceal ligation (EVL) was found to be more effective and safe in adults. Use of EVL in children has not been studied much. Thirteen consecutive children (mean age 9.4 years) with variceal bleed were subjected to EVL by multi band ligator. Varices were eradicated in 2.8 sessions (range 2-4) and one patient had bleed during procedure. No other complications were noted. EVL could not be performed in 2 children less than 3 years of age.

Adolescent↗
PubMed2004

GABA-mediated control of hypocretin- but not melanin-concentrating hormone-immunoreactive neurones during sleep in rats.

The perifornical-lateral hypothalamic area (PF-LHA) has been implicated in the regulation of behavioural arousal. The PF-LHA contains several cell types including neurones expressing the peptides, hypocretin (HCRT; also called orexin) and melanin-concentrating hormone (MCH). Evidence suggests that most of the PF-LHA neurones, including HCRT neurones, are active during waking and quiescent during non-rapid eye movement (non-NREM) sleep. The PF-LHA contains local GABAergic interneurones and also receives GABAergic inputs from sleep-promoting regions in the preoptic area of the hypothalamus. We hypothesized that increased GABA-mediated inhibition within PF-LHA contributes to the suppression of neuronal activity during non-REM sleep. EEG and EMG activity of rats were monitored for 2 h during microdialytic delivery of artificial cerebrospinal fluid (aCSF) or bicuculline, a GABAA receptor antagonist, into the PF-LHA in spontaneously sleeping rats during the lights-on period. At the end of aCSF or bicuculline perfusion, rats were killed and c-Fos immunoreactivity (Fos-IR) in HCRT, MCH and other PF-LHA neurones was quantified. In response to bicuculline perfusion into the PF-LHA, rats exhibited a dose-dependent decrease in non-REM and REM sleep time and an increase in time awake. The number of HCRT, MCH and non-HCRT/non-MCH neurones exhibiting Fos-IR adjacent to the microdialysis probe also increased dose-dependently in response to bicuculline. However, significantly fewer MCH neurones exhibited Fos-IR in response to bicuculline as compared to HCRT and other PF-LHA neurones. These results support the hypothesis that PF-LHA neurones, including HCRT neurones, are subject to increased endogenous GABAergic inhibition during sleep. In contrast, MCH neurones appear to be subject to weaker GABAergic control during sleep.

Animals↗
PubMed2004

Vitronectin adsorption on surfaces visualized by tapping mode atomic force microscopy.

Vitronectin (Vn) is an abundant glycoprotein present in plasma and the extracellular matrix of most tissue and is an important medium required for bone cells to attach and spread on biomaterial surfaces. Hence, Vn adsorption is an initial and key step in implantation. In this study, adsorption of Vn molecules on mica and oxidized titanium substrates in Milli-Q water (pH 5.6) and in simulated body fluid (SBF, pH 7.4) has been investigated using tapping mode atomic force microscopy. Conformation of the adsorbed proteins was determined from the images. The effect of adsorption time was investigated on mica surfaces. The protein first attaches to the surface, then immediately spreads out with different lateral dimensions of adsorbed protein and becomes aggregated. After 15 min of adsorption, globular Vn molecules form clusters of aggregates in extended chains on the mica surface. Globular Vn molecules appear flatter (i.e., oblate ellipsoids) and coalesce on the ridges of the uneven oxidized titanium surface. From cross-sectional analyses of the Vn images, it was found that the contact areas of Vn molecules associated with Ti surfaces are larger than those with mica surfaces. This suggests that the different surface properties of substrates contribute to this different conformation of adsorbed Vn molecules. The larger contact areas of Vn associated with Ti substrates indicates higher affinity for the biomaterial oxidized titanium surface than for mica. In SBF, Vn interacted weakly with the mica surfaces and Vn molecules were easily desorbed during the imaging process. On oxidized titanium substrates, after 3 h of incubation time in Vn-SBF solution, images can be obtained showing adsorbed Vn aggregates on the oxidized titanium surface. In this case, the protein colloids are strongly adherent, with increased lateral dimensions compared with the adsorption on mica.

Adsorption↗
PubMed2004

Prediction of viability of porcine neurocysticercosis with proton magnetic resonance spectroscopy: correlation with histopathology.

Neurocysticercosis (NCC) is the most frequent parasitic disease of central nervous system. In our earlier study, we had observed creatine [(creatine + phosphocreatine); (tCr)] on ex vivo proton MR spectroscopy (1H MRS) in some of the cysticercus cyst fluid samples obtained from swine's brain parenchyma. In current study, swine brains of freshly slaughtered animals naturally infected with NCC were subjected to ex vivo magnetic resonance (MR) imaging on a 1.5Tesla MR system. Cysticercus cysts (n = 12) were removed from these brains and were labeled depending upon presence or absence of edema around cysts as observed on imaging. Cysticercus cyst fluid (100 microl) was subjected to different 1H MRS experiments and results were compared with histopathological examinations to look for any relationship between tCr and parameters like quantification of musculature, and cellular infiltration in wall of the parasite. Histopathology of cyst wall was categorized into two groups based on cellular characteristics and the amount of musculature. Grade I cysts (n = 5) with no or minimal inflammation and large amount of musculature showed tCr on 1H MRS. However, grade II cysts (n = 7) with profuse inflammation and less amount of musculature in the cyst wall lacked tCr. Higher amount of musculature in grade I cysts was associated with higher concentration of tCr in the cyst fluid (r2 = 0.93, P = 0.007). Creatine appears to be a marker of innocuous and viable NCC.

Animals↗
PubMed2004

Correlative MR imaging and histopathology in porcine neurocysticercosis.

PURPOSE: To examine whether all the histopathologically seen features of cysticercus cysts excised from brain of swine naturally infected with neurocysticercosis during its evolution are actually visible on magnetic resonance imaging (MRI). MATERIALS AND METHODS: Five swine naturally infected with cerebral cysticercosis were subjected to fast spin-echo (SE) T2, SE T1, fluid attenuated inversion recovery imaging, T1-weighted magnetization transfer (MT), and postcontrast T1-weighted MT sequences on MRI. These animals were sacrificed after imaging and ex vivo imaging of the intact excised brain using the same imaging protocol was also performed. Grossing of these brains was done similar to the ex vivo imaging planes. Numeral density and external appearance of each cyst and scolex were evaluated on each pulse sequence. Amount of pericystic edema, if present, was also assessed. On histopathology, cellular characteristics, inflammatory response, and the extent of edema, if present, in the brain parenchyma around the cysts were graded. Cysts were categorized into viable, early, and late degenerated on histopathology. The MRI features of each cyst were correlated with their histopathologic findings. RESULTS: Out of 31 cysts, eight were found to be viable, 13 early degenerated, and 10 late degenerated on histopathology. T2-weighted imaging demonstrated all the cysts while T1-weighted imaging showed 97% of the cysts. Scolex was seen in 90.3% and 93.5% of the cysts on T2- and T1-weighted images, respectively. Minimal edema (grade I) and inflammation in degenerating cysts present on histopathology was not visible on MRI. All but one of eight degenerated cysts, which showed enhancement on postcontrast MRI, had edema on imaging as well as on histopathology. CONCLUSION: T2-weighted MRI demonstrated all the cysts that were visible on histopathology. Non-enhancement of some of the degenerated cysts along with absence of edema on MRI is likely to underestimate the staging of neurocysticercosis evolution, and these early degenerating cysts may be misdiagnosed as in viable stage.

Animals↗
PubMed2004

Phytotoxic and antimicrobial constituents of Bacopa monnieri and Holmskioldia sanguinea.

The phytochemicals betulinic acid (1), wogonin (2) and oroxindin (3) isolated from the aerial parts of Bacopa monnieri and Holmskioldia sanguinea showed significant antifungal activity against the two fungi Alternaria alternata and Fusarium fusiformis. Inhibition of root growth germination of wheat seeds was observed for all three compounds which showed 100% inhibition at 10 micro g/mL. Compounds (1) and (2) showed potent inhibition of Alternaria alternata compared with oroxindin at a concentration of 4 micro g/mL, whereas compound (2) was an effective inhibitor of both fungi. The structures of the compounds were established by spectral and chemical studies.

Antifungal Agents↗
PubMed2004

Primary leiomyosarcoma of the seminal vesicle.

A case of leiomyosarcoma of the seminal vesicle detected as a prerectal mass on routine per-rectal examination is described in a 37-year-old man. Computed tomography scan confirmed it to be arising from the right seminal vesicle. Per-rectal trucut biopsy showed malignant cells. Radical cystoprostatectomy with bilateral pelvic lymphadenectomy with anterior resection of rectum and urinary diversion with ileal conduit was performed. Microscopic examination of the resected specimen showed moderately differentiated leiomyosarcoma from the seminal vesicle. The patient received adjuvant chemotherapy and sandwiched radiotherapy. He is well and free of tumor 20 months after surgery.

Adult↗