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Biomedical subjects

M K Gupta

Publications and source records attributed to M K Gupta.

At least 19 recordsLinked to original sources
PubMed1992

Elimination kinetics of maternally derived thyrotropin receptor-blocking antibodies in a newborn with significant thyrotropin elevation.

OBJECTIVE: To determine the course of maternally derived elevations in thyrotropin-binding inhibitory immunoglobulins in a neonate. DESIGN: Case report. SETTING: University pediatric endocrinology clinic and endocrine immunology laboratory in Ohio. PARTICIPANTS: An infant with elevated thyrotropin levels but near-normal total thyroxine levels, and her mother. INTERVENTIONS: None. MEASUREMENTS/MAIN RESULTS: Thyroid hormone, thyrotropin, and thyrotropin-blocking immunoglobulin concentrations were serially measured in a woman and her infant, who was found to have elevated thyrotropin levels (234 mU/L) and borderline low thyroxine levels (95 nmol/L). As infant thyroxine concentrations remained normal (125 to 145 nmol/L), no thyroxine supplementation was given. Thyrotropin levels decreased concomitantly with thyrotropin-blocking inhibitory immunoglobulin levels, and normalized by day 56 of life. The apparent elimination half-life of thyrotropin-blocking immunoglobulins was 7.5 days. CONCLUSIONS: The observed parallel elimination kinetics suggest that the thyrotropin receptor antibody acts as a thyrotropin antagonist, resulting in compensatory thyrotropin elevations. The duration of such elevations may be predicted on the basis of such elimination.

Autoantibodies↗
PubMed1992

Thyrotropin receptor antibodies: advances and importance of detection techniques in thyroid diseases.

The study of autoimmune thyroid disorders (AITD) has greatly contributed to our knowledge of autoimmunity. Graves' disease and Hashimoto's thyroiditis represent two ends of the range of autoimmune responses seen in AITD. Autoantibodies reactive to cytoplasmic antigens are associated with cell damage, and thyrotropin (TSH)-receptor antibodies (TRAb) influence the function and growth of the gland and play a major role in pathogenesis. The heterogeneous nature of TRAb is well accepted. Besides their long-known thyroid stimulating activity, TRAb can act as blocking antibodies or growth-promoting antibodies and, thus, cause hypothyroidism (primary myxedema) or endemic and sporadic goiters, respectively. Advanced methodologies for detection of these antibodies with the TSH-receptor assay and thyroid cell bioassay allow various activities to be measured. Current data using these assays confirm the presence of heterogeneity of functional activities of TRAb(s) in vivo. The activity of predominating antibody may relate to clinical presentation. This indicates a need for paired determinations of both TSH-binding inhibitory immunoglobulin (TBII) and thyroid-stimulating immunoglobulin (TSI) for accurate clinical correlations. Cloning the TSH-receptor gene has clarified its structure and function. The future identification of its epitopes will further delineate the clinical role of these antibodies and may allow development of new diagnostic and therapeutic approaches.

Animals↗
PubMed1992

Neuroendocrine, fluid balance, and thirst responses to alcohol in alcoholics.

This study simultaneously evaluated multiple circulating neurohormones, osmolality, thirst, and fluid balance in eight actively drinking, alcoholic males and seven controls before and 12 hr after an ethanol challenge. Basal levels of serum osmolality and thirst were significantly higher in alcoholics compared with controls, yet actively drinking alcoholics at the start of the study had normal vasopressin (AVP) levels, plasma angiotensin II (Ang II), plasma renin activity, plasma aldosterone (Aldo), and plasma catecholamines. In response to ethanol, serum osmolalities rose significantly higher while plasma AVP levels became significantly suppressed in alcoholics. After the ethanol stimulus, plasma Ang II levels of alcoholics were significantly higher than those of controls at 11 AM (12.15 +/- 4.49 vs. 1.83 +/- 0.6 pg/ml, p less than 0.02) and 12 noon (14.93 +/- 6.81 vs. 1.37 +/- 0.17 pg/ml, p less than 0.04). Neither plasma renin activity nor Aldo changed in accordance with the elevated plasma Ang II in alcoholics. Diuresis in the alcoholics, assessed by the sum of urine output following the challenge dose, was significantly less than that of controls. Thirst scores and fluid intakes after the ethanol challenge did not differ between alcoholics and controls. The lack of an Ang II-mediated increase in plasma Aldo or thirst response suggests that ethanol may have a specific blunting effect on Ang II receptors. This study demonstrates that ethanol can be used as a provocative test in chronic alcoholics to uncover aberrant hormonal responses for two systems, namely, Ang II and AVP.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Disappearance of Q waves following thrombolysis for acute myocardial infarction.

The development of Q waves on the surface electrocardiogram generally is considered indicative of myocardial infarction. Such Q waves are usually permanent, though may regress and disappear over months to years. Transient Q waves have been described during myocardial ischemia without evidence of infarction. More recently, Q waves have been noted to develop transiently during the acute phases of infarction, possibly representing stunned myocardium. In this case report, a patient with an evolving anterior myocardial infarction and new septal Q waves was treated with intravenous thrombolytic therapy. Three hours following treatment the patient was clinically improved, and the septal Q waves had been replaced by small but obvious R waves. Despite a large area of myocardium at risk of infarction on the initial electrocardiogram, the resultant infarction was enzymatically and echocardiographically small. Early Q waves in acutely evolving myocardial infarction may represent severely ischemic, rather than irreversibly damaged, myocardium which may still be salvaged with thrombolytic therapy.

Adult↗
PubMed1992

Mechanisms of Bacillus cereus enteropathy.

Three strains of Bacillus cereus isolated from sausages (Salami and Trekker, RANBAC, Ranchi) produced enterotoxin which caused vascular permeability in skin and haemorrhage in the ligated ileal loops of rabbits. Histopathological studies revealed haemorrhage and congestion in submucosa, mononuclear cell infiltration in lamina propria and submucosa and villous atrophy. Histochemical studies ruled out the effect on mitochondrial enzymes of intestinal epithelial cells. Purified enterotoxin given intradermally to rabbits caused severe necrotic reaction at the site of injection and death within 4 hr. Histopathological changes observed in liver included congestion of portal veins and sinusoids, vacuolar degeneration of hepatocytes, and hyperplasia of bile ducts. These suggested that B. cereus enterotoxin affected the capillaries of blood vessels locally and also systemically resulting into release of proteinaceous exudates and red blood cells.

Animals↗
PubMed1991

Clinical chemistry.

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Chemistry, Clinical↗
PubMed1990

Treatment of androgenic disorders with dexamethasone: dose-response relationship for suppression of dehydroepiandrosterone sulfate.

Glucocorticoids are effective in suppressing androgens in many women whose levels of these steroids are elevated. Their use has been controversial because of inconsistent reports about efficacy and concern about safety. We investigated the dose-response relationship for suppression of dehydroepiandrosterone sulfate (DHEAS) with the use of dexamethasone. Thirty women with an initial DHEAS value of greater than or equal to 300 micrograms/dl were studied. All had cystic or inflammatory acne, hirsutism, or androgenic alopecia. Dexamethasone was given as a single bedtime dosage of 0.125, 0.250, or 0.375 mg. Mean dosage required for suppression was 0.256 mg daily. Suppression of the DHEAS level to less than or equal to 200 micrograms/dl was achieved with 0.125 mg in 25% of women, 0.250 mg in an additional 50%, and 0.375 mg in a further 20%. Most patients were taking spironolactone when the study was performed. Effective suppression is attained with dexamethasone doses significantly lower than previously thought. Use of these doses was not associated with a significant incidence of adverse effects.

Acne Vulgaris↗
PubMed1990

Androgen assessment in hirsutism and alopecia.

Advances in technology, such as saturation analysis and nonisotopic immunoassays, have improved the measurement of androgens, binding proteins, and hormone receptors, and clarified the diagnosis of idiopathic hirsutism. Immunoassay methods in steroid biochemistry enable accurate measurement of low concentrations of various androgens and their metabolites; and high-specificity antisera with chemical blocking agents allow measurement of these steroid directly in plasma without resorting to extraction methods. The future may bring the capacity to measure free concentrations.

Alopecia↗
PubMed1990

Pyogenic meningitis.

Fifty cases with pyogenic meningitis, aged 15 to 72 years, with a male:female ratio of 5:1, were studied. The majority of cases (70%) were in the 15 to 25 years age group. The organisms detected in the 29 culture-positive cases included S aureus (12), pneumococci (9) and meningococci (8). Thirteen patients died; the poor prognostic factors included old age, the presence of coma or shock, CSF sugar below 10 mg/dl or protein above 750 mg/dl and the presence of gram negative organisms in the CSF.

Adolescent↗
PubMed1990

Evaluation of cell-mediated immunity during chronic organophosphate pesticide intoxication in mice and goats.

The status of cell-mediated immunity (CMI) after pesticide exposure was assessed in mice with the help of skin sensitivity and graft versus host reaction tests. It was observed that at 24 hours post-challenge CMI values did not differ significantly from the control, indicating no effect of quinalphos treatment in mice. Goats receiving monocrotophos at a dose rate of 1.0 mg kg-1 body mass for 40 days gave a similar result when CMI was tested with the help of the chemical sensitizer dinitrofluorobenzene (DNFB). Thus the results clearly indicate that the tested organophosphates do not interfere with cellular immunity in the intoxicated animals.

Animals↗
PubMed1990

Alterations in immunoglobulin & complement levels in chronic obstructive pulmonary disease.

Thirty patients of chronic obstructive pulmonary disease (COPD; all smokers) and an equal number of controls (15 smokers) were studied. The COPD patients were further divided into group A (predominantly emphysema) and group B (predominantly bronchitis) of 15 patients each. Serum and sputum IgG, IgA and IgM and serum C3 and C4 were estimated. IgG, IgA, IgM and C3 and C4 were similar in smoker and non-smoker controls. Mean (+/- SD) serum IgG (IU/ml) was significantly higher in COPD patients (207.78 +/- 62.73) than in control (177.25 +/- 43.5; P less than 0.05), serum IgA (IU/ml) was also significantly higher in COPD (205.04 +/- 46.56) than in control (108.21 +/- 33.3; P less than 0.01). IgM was similar in the 2 groups. Sputum IgA (IU/ml) was higher in COPD (4.68 +/- 3.51) than in control (2.25 +/- 1.03; P less than 0.05). IgG and IgM were similar in the 2 groups. Both serum C3 (IU) and C4 (IU) were lower in COPD patients (C3 = 95.9 +/- 33.11, C4 = 113.6 +/- 62.4) than in control (C3 = 167.3 +/- 25.42, C4 = 205 +/- 76.5; P less than 0.05). Serum IgA in type B COPD (212.25 +/- 50.06) was higher than in type A (197.52 +/- 43.3; P less than 0.05) IgG and IgM were similar in these 2 groups. In COPD patients, immunoglobulins were either normal or higher indicating that deficiency of immunoglobulin is not a predisposing factor in development of COPD. Similar immunoglobulin values in smoker and nonsmoker controls indicated that smoking was not the cause of rise of immunoglobulins in COPD.(ABSTRACT TRUNCATED AT 250 WORDS)

Complement C3↗
PubMed1990

In vivo and in vitro measurement of cell mediated immunity in Marek's disease: role of reticuloendothelial system.

Dinitrofluorobenzene (DNFB) contact-sensitivity test and leucocyte adherence inhibition (LAI) test were performed in this study as in vivo and in vitro tests to measure the cell-mediated immunity (CMI) in chickens subjected to stimulation of reticuloendothelial (RE) system, depletion of RE system and other experimental groups after being challenged with Marek's disease (MD) virus. It was found that CMI was lower in the birds with depleted RE system and infected control birds, whereas CMI was higher in the birds with activated RE system and vaccinated birds as revealed by DNFB contact-sensitivity test. In cases of LAI test, the number of LAI-positive birds were highest in the chicks with depleted RE system particularly in 3rd and 4th month of age, when the incidence of MD was also maximum.

Animals↗
PubMed1989

Combined clomiphene citrate (CC) and human menopausal gonadotropins (hMG) in a fixed schedule for follicular recruitment during in vitro fertilization: effects on premature luteinizing hormone (LH) surges.

Recognizing the association between plasma progesterone (P) and an imminent LH surge, we investigated the frequency of P elevation in our stimulation protocol (clomiphene citrate-human menopausal gonadotropins). P was measured retrospectively on the day before, the day of, and the day after human chorionic gonadotropin hCG administration. The means +/- 2 standard deviations for P were as follows: day before hCG, 0.58 +/- 0.86; day of hCG, 0.64 +/- 0.56; and day after hCG, 1.47 +/- 1.22. Seven patients (8%) had P levels greater than 2 SD above the mean. Significant P elevations prior to hCG are infrequent with this protocol, and in the few patients with raised P a trend toward lowered fertilization was noted. The low incidence of P elevation may be secondary to the administration of hCG in a timely manner on the sixth day of estradiol (E2) rise.

Chorionic Gonadotropin↗
PubMed1989

The role of the reticuloendothelial system in the immunopathology of Marek's disease.

The role of macrophages in immunity against Marek's disease (MD) was studied. Chickens of one group were subjected to depletion of macrophages using repeated doses of Francil amorphous silica and those of another group were subjected to activation of macrophages using repeated doses of brewer's thioglycollate broth. Chickens of a third group were vaccinated with herpesvirus of turkeys FC 126 vaccine followed by depletion of macrophages. Chickens of these three groups, as well as groups of healthy unvaccinated and healthy vaccinated chickens, were challenged with virulent MD virus. A sixth group of healthy uninfected chickens was kept as a control. The results, based on clinical signs, gross and histopathological studies and agar gel precipitation test (AGPT) for antibodies, indicated that activation of macrophages enhanced immunity against MD and depletion of macrophages had the opposite effect. The protective effect of vaccination against MD was also lowered by depletion of macrophages. The results of AGPT indicated retardation of MD virus replication by macrophage activation and the reverse on depletion.

Animals↗
PubMed1989

Lipid profile in smokers.

In this study we observed that all the lipids except HDL cholesterol were higher in heavy smokers and those making for longer duration. HDL cholesterol was lower in smokers than nonsmokers. The changes in lipid profile were similar in cigarette and bidi smokers.

Adult↗
PubMed1988

Measurement of immunoreactive myelin basic protein peptide (45-89) in cerebrospinal fluid.

To measure myelin basic protein (MBP)-like material in cerebrospinal fluid, we compared two radioimmunoassays, both using the same antiserum to MBP but one using peptide (45-89) as the radioligand and standard (peptide assay), and the other using purified MBP as the radioligand and standard (MBP assay), with respect to their diagnostic sensitivity. Cerebrospinal fluid specimens from 185 patients with definite multiple sclerosis (MS) (n = 27), possible MS (n = 63), probable MS (n = 24), and other neurological disease (n = 71) were analyzed using both assays. The diagnostic sensitivity of the peptide assay was significantly better than that of the MBP assay in those with definite MS (sensitivity 59% and 30%, respectively); there was no significant difference in specificity. The peptide assay also showed better correlation with disease activity than the MBP assay: 14 patients classified as having active MS showed significantly higher sensitivity (78.6% versus 38%, p less than 0.04) when compared to patients with inactive disease. The MBP assay showed no significant difference between these two groups. Besides the increase in sensitivity, the actual molar concentrations of immunoreactive MBP detected using this peptide assay were considerably higher than those found using the MBP assay. These results show that the use of MBP antisera capable of recognizing epitopes present in the carboxyl half of MBP peptide (45-89) results in more sensitive detection of immunoreactive MBP when used with MBP peptide (45-89) as radiolabeled ligand in the assay.

Humans↗