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Biomedical subjects

M Goyal

Publications and source records attributed to M Goyal.

At least 109 records · Page 6Linked to original sources

Vascular adventitial cell expression of collagen I messenger ribonucleic acid in anti-glomerular basement membrane antibody-induced crescentic nephritis in the rabbit. A cellular source for interstitial collagen synthesis in inflammatory renal disease.

BACKGROUND: Scarring in the interstitial compartment of the renal cortex heralds a poor prognosis in many forms of renal injury, however, the mechanism through which glomerular inflammation leads to interstitial scarring is not understood. In a model of anti-GBM disease in the rabbit, development of crescentic glomerulonephritis is associated with marked interstitial fibrosis and decreased renal function. We previously demonstrated that collagen accumulation in the model was preceded by increases in collagen I and IV mRNA and that these changes were primarily extraglomerular at early time points when inflammation was predominantly intraglomerular. In order to identify the cellular origins of extraglomerular collagen synthesis in this model, in situ hybridization using an alpha 2(I) procollagen probe was performed. EXPERIMENTAL DESIGN: A 602 bp rabbit alpha 2(I) procollagen cDNA was cloned using a PCR strategy and sequenced. The nucleotide sequence of the coding region was 94% identical with the human alpha 2(I) procollagen sequence. Northern blots were performed to define conditions of specific hybridization of the anti-sense riboprobe. Tissue sections from normal rabbit kidneys and from kidneys 4, 5, 7, 10 and 14 days after injection of anti-GBM antibody were hybridized with 35S-labeled sense and anti-sense riboprobes. Cells containing alpha 2(I) mRNA were identified by autoradiography and mRNA abundance was quantitated by grain density. RESULTS: No specific hybridization was detected with the sense probe at any time. alpha 2(I) mRNA was undetectable with the anti-sense probe in normal kidney sections. In contrast, the anti-sense probe hybridized specifically at all time points after induction of anti-GBM disease. In agreement with previous filter hybridization studies, on day 4, when inflammation was predominantly intraglomerular, cells in the periarterial adventitial compartment of renal cortex hybridized strongly. At later time points, labeling was also present in the interstitial spaces, the periglomerular region, in Bowman's space and in the glomerular tuft itself. CONCLUSIONS: We conclude that perivascular adventitial cells are among the first to respond to glomerular inflammation and represent a pool of cells that subsequently contribute to interstitial and glomerular scarring.

Amino Acid Sequence↗

Myositis ossificans of medial pterygoid muscle. A cause for temporomandibular joint ankylosis.

An unusual case of myositis ossificans of the medial pterygoid muscle has been discussed. It is important to know the exact cause of the temporomandibular joint ankylosis, for successful treatment. Computed tomographic scan and panoramic radiographs are essential diagnostic aids for evaluating conditions such as myositis ossificans. Myositis ossificans can be one of the causes of extra-articular temporomandibular joint ankylosis.

Adult↗

A massive osteochondroma of the mandibular condyle.

A case is presented of a massive osteochondroma of the mandibular condyle leading to marked facial asymmetry, painful mastication, disturbed occlusion and impaired hearing on the affected side. The diagnosis was confirmed by radiological and histological examination. A tentative treatment plan including surgery on both jaws was proposed but had to be modified because of the patient's reluctance to undergo any surgery on the maxilla.

Adult↗

Magnetic resonance imaging in full-term infants with repetitive focal seizures.

We report two full-term infants who developed repetitive focal seizures within the first 48 hours of life. Neither infant had predisposing factors and there were no abnormalities on a computed tomography (CT) scan performed on day 2 of life. Magnetic resonance imaging (MRI) performed during the second week of life showed a focal hemorrhagic infarction in both patients. We conclude that either an MRI or a contrast-enhanced CT scan should be obtained within 1 week in patients in whom the initial imaging technique failed to reveal a focal lesion, at which time a cerebral infarction can be diagnosed with greater sensitivity.

Brain↗

Sudden deterioration of intubated newborn: four steps to the differential diagnosis and initial management.

This paper provides guidelines to determine the differential diagnosis and treatment of sudden deterioration of an endotracheally intubated newborn infant. Since such an event is most often secondary to a mechanical problem, simple adjustment of the ventilator in response to blood gas analysis will only rarely be sufficient to stabilize the infant. The proposed algorithm integrates history, physical examination, investigations, and therapeutic intervention (of which manual ventilation is the keystone). We hope that such an algorithm may help training physicians, nurses, and respiratory therapists to minimize the risk for the infant as well as the time required to provide an efficient resuscitation. This algorithm may be used both in the neonatal intensive care unit and in the delivery room as a complement to the recommendations of the American Heart Association, in case of poor response to the resuscitation. Modifications to this protocol should be allowed according to specific characteristics of each infant and to the equipment available.

Algorithms↗

Fibronectin mRNA and protein accumulation, distribution, and breakdown in rabbit anti-glomerular basement membrane disease.

Fibronectin is a multifunctional matrix protein which by immunofluorescence appears to be present in increased amounts during glomerular injury. To examine fibronectin metabolism in glomerular injury, an anti-glomerular basement membrane model that progresses to severe glomerular crescent formation, glomerulosclerosis, and interstitial fibrosis was used. Fibronectin was purified from rabbit plasma, and a monoclonal antibody raised against rabbit fibronectin was used for immunolocalization and quantitation of fibronectin protein. RNA and protein were extracted from isolated glomeruli and whole renal cortex at various times during progression of disease. At day 4, there was a 2.5-fold increase in fibronectin protein which by immunofluorescence appeared to be in the glomerular mesangial area. There was no increase in glomerular fibronectin mRNA at this time. This discrepancy is consistent with the conclusion that, at this early time point, the increased glomerular fibronectin comes predominantly from plasma. By day 7, glomerular fibronectin mRNA and extractable fibronectin protein were increased in association with bright immunofluorescence along the inner aspect of Bowman's capsule where early crescents were forming. Similarly, at day 14, crescents stained very brightly for fibronectin. These results are consistent with the conclusion that, at later time points, fibronectin is synthesized in glomeruli in association with cell division and crescent formation. Degradation of fibronectin in glomerular and cortical extracts was demonstrated under normal and nephritic conditions by finding fibronectin proteolytic fragmentation by Western blot.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Analysis of T cells and major histocompatibility complex class I and class II mRNA and protein content and distribution in antiglomerular basement membrane disease in the rabbit.

The major interacting components of the immune system, major histocompatibility complex (MHC) class I and class II proteins and T cells were analyzed in a model of anti-GBM (glomerular basement membrane) disease in the rabbit that progresses to develop cellular crescents and glomerular and interstitial fibrosis. Class I and II mRNA and protein were measured in isolated glomeruli and whole renal cortex using cDNA probes and monoclonal antibodies. The distribution of T cells and class I and II proteins was assessed by immunofluorescence. Normal glomeruli contained no T cells and were class II negative. By day 4, glomeruli contained MHC class I and II mRNA and protein and class II positive T cells. Although some animals had T cells in the periglomerular area, these cells were class II negative. By day 7 periglomerular T cells were largely class II positive (activated) and there was increased MHC class I and II mRNA and protein in whole renal cortex. Later T cells accumulated in the tubulo-interstitial compartment, which became diffusely positive for MHC classes I and II, but to a variable extent in different animals. Those with high class II mRNA expression also had detectable T cell antigen receptor mRNA by Northern analysis. The authors conclude 1) in this model there was a close association between mRNA abundance and protein expression for both MHC classes I and II in glomeruli and renal cortex as a whole; 2) in this model of glomerular injury there are three phases of activation. The first phase takes place in the glomerulus and is associated with accumulation of activated T cells and MHC class I and II protein in the glomerulus. Phase 2 is associated with the accumulation of periglomerular T cells and their becoming class II positive. There is subsequent dissemination (phase 3) of activated T cells and accumulation of class I and II mRNA and protein throughout the interstitial compartment. This spacial progression of glomerulocentric inflammation is likely associated with degree of injury and permanent loss of renal function.

Animals↗

The effect of gonadal steroids on the behavioral and biochemical effects of hippocampal sympathetic ingrowth.

Following cholinergic denervation of the hippocampal formation, via medial septal lesions, sympathetic fibers, originating from the superior cervical ganglia, grow into the hippocampus. Previous studies have demonstrated a detrimental effect of these fibers on recovery of a spatial-learning task in male but not female animals. In this study we assessed the role of circulating male sex hormones on the behavioral and biochemical effects of hippocampal sympathetic ingrowth (HSI). For the behavioral studies male Sprague-Dawley rats underwent either sham gonadectomy or gonadectomy and were taught a standard radial 8-arm maze task. Following attainment of criterion animals underwent one of three surgical procedures: sham surgery, MS lesions, MS lesions + ganglionectomy. MS lesions, regardless of the presence of HSI, were found to severely impair reacquisition of the task in both sham-gonadectomized and gonadectomized animals. As expected, in the sham-gonadectomized group, MSGx animals reacquired the task faster than the MS group. However, gonadectomy was found to block the detrimental effect of HSI on behavior. For the biochemical studies hippocampal norepinephrine (NE) and choline acetyltransferase (ChAT) were measured eight weeks after surgery in sham-gonadectomized and gonadectomized animals. MS lesions were found to significantly reduce the ChAT activity, regardless of circulating sex hormones. Gonadectomy was found to significantly reduce the level of NE associated with HSI, while having no effect on central NE in CON or MSGx animals. These studies suggest that circulating male sex hormones can influence both the behavioral and biochemical processes associated with HSI.

Acetylcholinesterase↗

Prostaglandin F2 alpha inhibits the ammoniagenic response to acute acidosis in LLC-PK1 cells.

A kidney epithelial cell line, LLC-PK1, which does not synthesize prostaglandins, provides an ideal in vitro model system to investigate the effect of prostaglandins in the regulation of renal ammoniagenesis. Previous studies from our laboratory have demonstrated significant increases in glutamine-dependent ammonia and alanine production by rocked cultures of LLC-PK1 cells subjected to either acute metabolic or respiratory acidosis. In the study presented here, experiments were conducted to investigate the role of prostaglandin F2 alpha (PGF2 alpha) and prostaglandin E2 (PGE2) in the response of ammonia metabolism to acute metabolic acidosis by LLC-PK1 cells. A low dose of PGF2 alpha (0.1 ng/mL) dramatically inhibited the stimulatory effect of a low pH (pH 6.8) on ammonia production. In contrast, the inhibition of cytosolically generated alanine was less dramatic and averaged only 20% of the effect on ammonia production. Furthermore, PGF2 alpha increased cellular alpha-ketoglutarate concentration, suggesting an increase in intramitochondrial pH. Thus, the cellular mechanism of PGF2 alpha action appears to involve either interference with the cytosolic pH signal or its translation to the intramitochondrial compartment. The inhibitory response of PGF2 alpha on pH-stimulated ammoniagenesis was progressively lost at higher concentrations. Both low-dose (0.1 ng/mL) and high-dose (10 ng/mL) PGF2 alpha had no significant effect on the basal rates of ammonia and alanine production at pH 7.4. PGE2, on the other hand, did not exhibit any significant response on ammonia or alanine production at either pH 6.8 or 7.4 when given in a wide range of doses.(ABSTRACT TRUNCATED AT 250 WORDS)

Acidosis↗

Effect of chemotherapy on cell counts in peripheral blood & bronchoalveolar lavage of patients with pulmonary tuberculosis.

Cell counts in peripheral blood and bronchoalveolar lavage fluid were estimated in 38 patients with active tuberculosis; 12 patients with tuberculosis who had successfully completed more than 9 months of chemotherapy with isoniazid, rifampicin, and ethambutol; 10 Mantoux negative bronchitic subjects; and 6 control subjects. There were 50 males and 16 females aged 16-50 yr. Age, haemoglobin, total and differential serum proteins, were comparable in the various groups. Patients with active tuberculosis had higher ESR and significantly raised absolute (2.24 +/- 0.13 x 10(3); P less than 0.05), B (0.56 +/- 0.03 x 10(3); P less than 0.01) and Null lymphocyte counts (0.56 +/- 0.05 x 10(3); P less than 0.01) in blood. After chemotherapy there was no significant change in lymphocyte counts (2.43 +/- 0.21; P greater than 0.05). In bronchoalveolar lavage (BAL) total cell counts were increased five fold in patients with active disease (40.8 +/- 5.79 x 10(4)/ml) and although these showed considerable reduction after therapy they were higher (18.33 +/- 4.73 x 10(4)/ml) than those in controls (8.3 +/- 1.2 x 10(4)/ml; P greater than 0.05). In bronchitic subjects, total cell counts and macrophage counts in BAL fluid were elevated (P less than 0.01; less than 0.05 respectively) but lymphocyte counts were comparable to controls (3.4 +/- 1.35 x 10(4)/ml vs 1.09 +/- 0.19 x 10(4)/ml; P greater than 0.05). Lymphocytosis in the bronchoalveolar lavage fluid of patients with pulmonary tuberculosis persisted even after adequate treatment.

Adolescent↗

Monocyte/macrophage functions & humoral response in blood & bronchoalveolar lavage fluid of pulmonary tuberculosis patients.

Subsegmental bronchoalveolar lavage (BAL) was performed in 33 patients with active pulmonary tuberculosis and five control subjects. Phagocytosis by monocytes and alveolar macrophages was studied, and in addition serum and BAL immunoglobulin and complement levels were also determined. The phagocytic activity of blood monocytes was depressed in pulmonary tuberculosis patients as compared to controls, 37.8 +/- 2.3 per cent; 50.7 +/- 4.2 per cent and 32.9 +/- 3.6 per cent for sheep RBC's, latex and Staphylococcus aureus respectively compared to 66.7 +/- 6, 54.8 +/- 2.2 and 68.3 +/- 3.5 per cent respectively in controls; the differences being significant for sheep RBC's (P less than 0.05) and Staph. aureus (P less than 0.001). However, phagocytosis was not impaired in BAL macrophages (P greater than 0.05). In patients no significant alteration in serum immunoglobulin and complement levels was observed except that levels of C4 component of complement were increased in patients with far advanced lesions (98.5 +/- 33.7 mg/dl compared to 78.7 +/- 7.9 mg/dl; P less than 0.05). While IgM and C4 component of complement could not be detected in BAL fluid the levels of IgA were significantly increased in pulmonary tuberculosis patients (65.5 +/- 50.5 mg/dl compared to 39.9 +/- 13.3 mg/dl in control; P less than 0.05). Since IgA secreted in the BAL fluid is mostly synthesised locally, increased levels of this immunoglobulin could be of value in determining activity of the disease.

Adult↗

Immunological response in experimentally reactivated toxoplasmosis in mice.

Both humoral and cell-mediated immune responses were studied in reactivated toxoplasma infection in mice. The infection was established by immunosuppressing chronically infected animals by thymectomy followed by irradiation. The reactivated infection was confirmed by reappearance of toxoplasma tachyzoites in peritoneal exudate. The animals survived until the 8th day post thymectomy. The percentage of splenic T lymphocytes was depressed after 4th day post thymectomy in both the uninfected thymectomized and infected immunosuppressed animals as compared to the intact uninfected controls and intact chronically infected animals. However, there was no significant change (P greater than 0.05) between the uninfected immunosuppressed control and infected immunosuppressed mice. When the infection progressed to more acute phase there was significant depression (P less than 0.01) in the percentage of T lymphocytes in comparison to the uninfected thymectomized mice. However, there was no change in the percentage of B lymphocytes (P greater than 0.05). The function of lymphocytes as assessed by blast transformation was depressed in the presence of nonspecific mitogens, i.e. phytohemagglutinin and concanavalin A until the end of the study. The response to toxoplasma antigen was increased during early stages in the infected immunosuppressed mice (stimulation index = 4.15 +/- 0.1 and 4.5 +/- 0.15 on 4th and 6th day post thymectomy). On the 8th day post thymectomy, there was a sudden fall in the stimulation index (3.5 +/- 0.11). The antitoxoplasma antibodies as detected by indirect hemagglutinin and fluorescence analysis and enzyme-linked immunosorbent assay (ELISA) tests and toxoplasma-specific IgM antibodies as detected by ELISA test were present throughout the study period though at low levels. The significance of these findings is discussed.

Animals↗

Cytotoxic activity of monocytes against Toxoplasma gondii in acute, chronic and reactivated murine toxoplasmosis.

The phagocytic activity and cytotoxicity of peripheral blood monocytes (against toxoplasma tachyzoites) was studied in acute, chronic and reactivated toxoplasma infected Swiss albino mice. During acute infection, a low phagocytic activity was observed on the 4th day post infection (dpi) (P less than 0.01) and a low monocyte cytotoxicity was noticed after the 2nd dpi (P less than 0.01) which further decreased till the 8th dpi. In contrast, both the parameters were significantly increased during chronic infection. Increase in monocytic cytotoxicity was manifested on the 3rd dpi (P less than 0.001) whereas phagocytosis showed an increase on the 12th dpi (P less than 0.05). The reactivated group showed no change in both the parameters when compared with the control immunosuppressed group (P greater than 0.05).

Animals↗

Ocular penetration of subconjunctivally injected gentamicin, sisomicin and cephaloridine.

The intraocular penetration of three current bactericidal broad-spectrum antibiotics, namely, gentamicin sulphate, sisomicin sulphate (Ensamycin) and cephaloridine, following subconjunctival injection was studied in 95 patients undergoing elective cataract surgery. Rapid and high penetration of all three drugs was evidenced by the fact that the first samples assayed by modified disc diffusion technique 15 minutes after injection showed drug levels effective against all susceptible pathogens. Peak levels of gentamicin, sisomicin and cephaloridine attained one hour after injection were 14.913 +/- 0.310, 19.000 +/- 0.408 and 30.830 +/- 1.195 micrograms/ml, respectively. Such high drug titres would provide drug concentrations 6 to 8 times the minimum inhibitory concentration necessary against susceptible organisms. The duration of the effective bioavailability of the drugs studied varied from 12 to 18 hours. We believe our study is the first to document the excellent penetration of sisomicin and the little-studied drug cephaloridine, and hope our results will open an avenue for in vivo studies to evaluate their clinical use.

Aged↗

Urinary inhibitor of the ammoniagenic response to acute acidosis is a prostaglandin.

Both acute respiratory acidosis and acute metabolic acidosis stimulate NH3 production by the isolated perfused rat kidney. This stimulatory effect is abolished if the urine is drained back into the recirculating perfusate rather than collected. To determine whether the urinary inhibitor is a cyclooxygenase product, studies were carried out using prostaglandin synthetase inhibitors. Kidneys perfused with 0.5 mmol/L glutamine and urine reinfusion were subjected to acute respiratory acidosis (30% CO2, pH 6.8). With either indomethacin (20 mumol/L) or meclofenamate (20 mumol/L) in the perfusate, NH3 production increased significantly in response to acute respiratory acidosis despite urine reinfusion. The increment in NH3 production was comparable to that in studies with urine collection, indicating that a cyclooxygenase product can account completely for the urinary inhibitor. To further characterize the urinary prostaglandin inhibitor, studies were performed with both the isolated perfused kidney and renal cortical tubules. Prostaglandin E2 (PGE2) did not exhibit an inhibitory effect on NH3 production with either experimental model. Prostaglandin F2 alpha at low doses inhibited NH3 production in response to acute acidosis by the isolated kidney, but an effect was not apparent with higher concentrations. PGF2 alpha inhibited the stimulatory effect of a low pH (7.1) on NH3 production by isolated tubules, and had no effect on ammoniagenesis at pH 7.4. Thus a prostaglandin, which is not PGE2 and may be PGF2 alpha, appears to be the previously unidentified urinary inhibitor of the ammoniagenic response to acute acidosis found with the isolated perfused kidney.

Acidosis, Respiratory↗

Response of ammoniagenesis to acute alkalosis.

To examine the response of ammonia production to acute alkalosis, isolated rat kidneys were perfused with 5 mM glucose and 0.5 mM glutamine for an initial 45 min at pH 7.7, achieved by raising the perfusate HCO3 concentration or reducing the PCO2, followed by one or more 45-min periods at a normal pH. During the initial high pH period, respiratory alkalosis had no effect on NH3 production in comparison with perfusions at a normal pH. However, during the subsequent 45-min period at a normal pH, kidneys exposed initially to a high pH produced less NH3 than those perfused at a normal pH for the entire experiment. This suppression of ammoniagenesis abated during an additional 45 min of perfusion at a normal pH. Kidneys exposed to metabolic alkalosis produced more NH3 than controls during the initial 45 min of perfusion. However, similar to respiratory alkalosis, NH3 production was lower than controls during the subsequent 45 min of perfusion at a normal pH. Hence a high bicarbonate concentration can rapidly, but transiently, stimulate NH3 production by the isolated rat kidney. However, a high pH, whether produced by metabolic or respiratory manipulations, suppresses ammoniagenesis. This suppressive effect requires 45 min of exposure to an elevated pH to be manifest and at least 45 min of exposure to a normal pH for reversal. The delayed response to alkalosis contrasts strikingly with the immediate effects of acute acidosis on NH3 production by the perfused kidney and suggests that different mechanisms account for the regulation of ammoniagenesis in response to acute decrements and elevations in pH.

Acute Disease↗