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D Gupta

Publications and source records attributed to D Gupta.

At least 91 records · Page 5Linked to original sources
PubMed2001

Topoisomerase alpha II, retinoblastoma gene product, and p53: potential relationships with aggressive behavior and malignant transformation in recurrent respiratory papillomatosis.

Recurrent respiratory papillomatosis (RRP) has a juvenile aggressive form and an adult more indolent form. Most cases of RRP are cytologically benign; however, some undergo malignant transformation. At present, there are no known markers that help identify patients at risk for aggressive disease. We investigated by immunohistochemistry expressions of topoisomerase alpha II, MIB-1, p53, p21, E-cadherin, retinoblastoma (RB) gene protein product, HER-2/neu, and steroid hormone receptors in a case of juvenile respiratory papillomatosis with malignant transformation to determine whether these markers are associated with malignant transformation. Histologic examination of the pulmonary lobectomy specimen revealed well-differentiated squamous carcinoma and invasive papillomatosis. Increased staining was found in areas of invasive papillomatosis for topoisomerase alpha II, p53, and MIB-1, with highest labeling indices in areas of squamous carcinoma. Staining intensity for RB gene protein product showed gradual decline from benign papilloma (3+) and invasive papillomatosis (2+) to squamous carcinoma (0-1+). Expression of p21 was similar in benign papilloma and invasive papillomatosis but showed reduction in squamous carcinoma. Expressions of E-cadherin, HER-2/neu, and steroid hormone receptors did not appear to correlate with biologic behavior. Increased topoisomerase alpha II and p53 expression along with reduced RB gene protein product and p21 expression may serve as markers of transformation to invasive papillomatosis and squamous carcinoma.

Adolescent↗
PubMed2001

Value of different cut-off points of tuberculin skin test to diagnose tuberculosis among patients with respiratory symptoms in a chest clinic.

OBJECTIVE: To assess the utility of various cut-off points of tuberculin skin test in making a diagnosis of tuberculosis in patients with respiratory symptoms. METHODS: Tuberculin skin test was conducted on consecutive new patients attending chest clinic for various respiratory symptoms. All subjects were then investigated to establish diagnosis, and categorized into tuberculous and nontuberculous groups. Receiver operating characteristic (ROC) curve was plotted to evaluate discrimination by tuberculin skin test. Sensitivity, specificity and predictive value were also calculated at various cut-off points. RESULTS: Of 250 patients, 59 (23.6%) had tuberculosis on clinical and microbiological criteria (other than the tuberculin test). Sensitivity and specificity of tuberculin test at readings greater than 5, 10 and 15 mm were 0.8136 and 0.7068, 0.6271 and 0.8901, and 0.2034 and 0.9738 respectively. Area under ROC curve for this test was 0.80. CONCLUSION: A cut-off point of 10 mm is likely to be useful in supporting a diagnosis of tuberculosis in patients with strong clinical suspicion of tuberculosis, in other patients, 15 mm cut-off may be more suitable.

Adolescent↗
PubMed2001

Management of respiratory failure in severe neuroparalytic snake envenomation.

Fourteen patients with severe neuroparalytic snake envenomation, resulting in acute type II respiratory failure, admitted to respiratory critical care unit for mechanical ventilation during one year period, were studied. Ventilatory requirements, amount of anti snake venom (ASV) infused, period of neurological recovery and hospital survival were evaluated. All patients had severe manifestations such as ptosis, extraocular muscle paresis and limb weakness along with dyspnoea. Seven patients (50%) had additional complaints of dysphagia and dysphonia. ASV was administered to all, with a median requirement of 900 ml. Mechanical ventilation was required for a median duration of 17 hours and all except one patient, who had suffered irreversible hypoxic cerebral injury prior to resuscitation, survived with complete neurological recovery. We conclude, that the timely institution of ventilatory support and anti-venom therapy in such patients, is associated with an excellent outcome.

Adolescent↗
PubMed2001

Near total transection of the trachea following percutaneous dilatational tracheostomy.

The bedside procedure of percutaneous dilatational tracheostomy (PDT) in the intensive care unit continues to gain popularity. Percutaneous dilatational tracheostomy is recommended as simple, safe and cost-effective. The procedure can be associated with serious life-threatening complications. We report a case of near total transection of the trachea following PDT.

Aged↗
PubMed2001

Risk factors of lung cancer in Chandigarh, India.

BACKGROUND & OBJECTIVES: There is a paucity of data from India on the risk factors for lung cancer. In the present paper results of a case-control study on lung cancer undertaken at Chandigarh, north India, are described. METHODS: Two hundred and sixty five (235 men, 30 women) histologically confirmed patients of lung cancer and 525 (435 men, 90 women) hospital controls matched for age and sex were interviewed according to a pre-designed questionnaire. Effects of individual variables defining the various aspects of tobacco smoking, indoor and outdoor air pollution and occupational exposures were assessed using unconditional logistic regression models. RESULTS: Eighty nine per cent of men and 33 per cent of women among the patients were ever-smokers as compared to 60 per cent of men and 20 per cent of women among controls. The Odds Ratio (OR) for ever-smoking was 5.0 (CI 3.11-8.04) among men and 2.47 (CI 0.79-7.75) among women. Among the patients, men were found to smoke a higher average number of cigarette-equivalents per day, for longer duration and started at an earlier age as compared to controls. Smoking of bidi and hooka as well as cigarettes had similar ORs for cumulative consumption. ORs for female smokers were lower than those for male smokers. Cumulative exposure of > 45 yr in women to indoor air pollution from use of coal or wood for cooking or heating showed an OR of 1.43 (CI 0.33-6.30). Residence in urban areas did not entail an increased risk for developing lung cancer. Very few subjects studied were employed in high-risk occupations. INTERPRETATION & CONCLUSIONS: Smoking (cigarettes or bidis) was the principle risk factor for causation of lung cancer among men. In women there could be several other risk factors besides smoking, as the association with smoking was not as strong.

Adult↗
PubMed2001

Palivizumab.

Explore the source record for details and available documents.

Antibodies, Monoclonal↗
PubMed2000

Intraoperative scrape cytology: comparison with frozen sections, using receiver operating characteristic (ROC) curve.

The diagnostic role of intraoperative cytology (IC) has been demonstrated by many comparative studies. These studies have used sensitivity and specificity as statistical tools, based on binary principles. Statistical methods based on binary principles appear to be inappropriate for comparing anatomic pathology studies which involve significant human judgment with a range of subjective nonbinary result patterns. In this study, we applied the receiver operating characteristic (ROC) curve, which is based on probabilistic principles for the comparison of diagnostic accuracy with IC and frozen sections (FS). Seven observers studied a variable number of IC alone, FS alone, and IC/FS together from a pool of 446 specimens. The results were analyzed by ROC curve, using the MEDCALC software program (MedCalc Software, Mariakerke, Belgium). The accuracy with IC alone and FS alone was comparable. IC alone was diagnostic for many lesions, offering the choice of not freezing the tissue, and thus avoiding the introduction of artifacts. This strongly favors the routine practice of preparing IC during intraoperative consultation.

Area Under Curve↗
PubMed2000

Fine-needle aspiration findings in nodular myositis: a case report.

Fine-needle aspiration (FNA) is frequently the initial diagnostic modality for the workup of suspected metastatic disease in subcutaneous or deeper soft tissues. The technique is less well-accepted for the diagnosis of primary soft-tissue lesions. Occasionally during the investigation of suspected metastatic disease, primary processes of the soft tissues will undergo FNA. Thus, familiarity with the cytomorphology of soft-tissue reparative and neoplastic lesions is important. A variety of reparative and degenerative entities exist within the soft tissues, one of which is localized nodular myositis. This lesion may be a precursor of generalized polymyositis, including polymyositis associated with graft vs. host disease, or it may remain a localized process. Aspirates from localized nodular myositis demonstrate fragments of striated muscle including degenerating and regenerative myocytes, a mixed inflammatory background, and necrotic debris. Cytologic identification of this lesion can be therapeutically important, particularly in post-bone marrow transplant patients.

Adult↗
PubMed2000

Expression of DNA topoisomerase I in neoplasms of the kidney: correlation with histological grade, proliferation, and patient survival.

Renal cell carcinoma is an inherently chemotherapeutically resistant neoplasm. Because of this, new drugs targeting this tumor are needed. One class of new anticancer drug targets the enzyme DNA topoisomerase I. Laboratory data indicate that cells sensitive to topo I targeting drugs contain high topo I levels. To determine whether some renal cell carcinomas contain elevated topo I and might therefore be targets of topo I active antitumor agents, we used a new immunohistochemical stain for topo I to determine the expression of the enzyme in 51 tumors of the kidney. Increased topo I expression was found in 4 of 11 (36%) grade 3 renal cell carcinomas and in 8 of 8 (100%) grade 4 renal cell carcinomas. Normal topo I expression was observed in all adenomas, oncocytomas, and grade 1 and grade 2 renal cell carcinomas. Because topo I targeted anticancer drugs are S-phase specific, topo II-alpha and MIB-1 proliferation indices also were performed. Topo II-alpha correlates well with MIB-1 (correlation coefficient = 0.96). Of the 12 tumors with elevated topo I, only 3 had topo II-alpha proliferation indices greater than 40, indicating a tumor with elevated topo I expression and a large growth fraction. We hypothesize that these tumors might be susceptible to topo I anticancer drug therapy. In addition, we found that the average topo II-alpha proliferation index of tumors from patients who died of disease was 27.4 +/- 19.8, which was statistically different from the average topo II-alpha index of 5.8 +/- 6.5 observed in tumors from patients who remained alive during our follow-up.

Adenoma↗
PubMed2000

Clinical significance of patent paraumbilical vein in patients with liver cirrhosis.

A patent paraumbilical vein (PUV) is a frequent finding in patients with cirrhosis when studied by duplex Doppler ultrasound. There is controversy regarding the clinical significance of this finding. We studied 50 patients with cirrhosis and portal hypertension as evidenced by the demonstration of esophageal varices on endoscopy. All 50 patients were evaluated for a significant PUV (diameter of > or =3 mm) using duplex Doppler sonography. The patients were divided into two groups based on the size of esophageal varices (group A with small varices, N = 30; group B with large varices, N = 20). A significant PUV was seen in 21 (42%) patients. The patients with portosystemic encephalopathy had a significantly greater prevalence of PUV (70%) than those without (32%, P < 0.02). Of the group with large esophageal varices, 6 (30%) had a significant PUV, while in the group with small varices, 15 (50%) had a significant PUV (P > 0.05). In no patient with large varices did the PUV diameter exceed 6 mm, while in as many as six patients with small varices, the PUV diameter exceeded 6 mm. A significantly enlarged PUV seen on duplex Doppler ultrasound in cirrhotics may have important hemodynamic consequences. Besides predisposing the patient to portosystemic encephalopathy, it may also offer some protection against formation of large varices. In particular, a very large patent PUV (> or =6 mm) might identify a subgroup of patients with small varices and thus a lesser likelihood of variceal bleeding.

Adolescent↗
PubMed2000

Small lymphocytic lymphoma with perifollicular, marginal zone, or interfollicular distribution.

Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) typically involves nodal or extranodal tissues as a diffuse proliferation with pseudofollicular growth centers obliterating normal architecture. We describe 16 cases of CLL/SLL in which the neoplasm was confined to the marginal zone, perifollicular, or interfollicular regions surrounding benign lymphoid follicles in either nodal or extranodal sites. Twelve of 12 (100%) patients with adequate staging data had disseminated disease (Stage III or IV) at presentation. Eight of the 16 (50%) patients had absolute peripheral lymphocytosis (range, 5 to 30 x 10(9)/L). Pseudofollicular growth centers were identified in 14 of 16 cases (87.5%). Immunophenotypic studies revealed that the tumor cells were positive for CD20 (16/16) and CD5 (11/11) in all cases examined. CD23 was positive in 12 of 14 (86%) interpretable cases. IgM and IgD were positive in 13 of 14 (93%) and 10 of 10 (100%) interpretable cases, respectively. All cases were negative for CD3 (16/16), CD45RO (16/16), CD10 (15/15), and cyclin D1 (15/15). We conclude that CLL/SLL can have unusual patterns of involvement, including marginal zone, perifollicular, and interfollicular patterns that can be difficult to recognize histologically. Thirteen of 16 (81%) cases in this study were misinterpreted by the referring pathologists. Recognition of proliferation centers coupled with demonstration of a CD5+ CD23+ B-cell immunophenotype establishes the correct diagnosis of CLL/SLL.

Adult↗