PubMed Health⌕ Search

Biomedical subjects

R K Gupta

Publications and source records attributed to R K Gupta.

At least 901 records · Page 50Linked to original sources
PubMedDate not supplied

Chordoma metastatic to the breast diagnosed by fine needle aspiration. A case report.

BACKGROUND: Metastatic breast tumors are rare but need differentiation from primary malignant and even benign tumors of the breast to ensure appropriate treatment. CASE: A 51-year-old female with chordoma developed a lump in the breast 3.5 years after the primary diagnosis. Fine needle aspiration of the lump showed classic physaliferous cells with a bubbly appearance and anaplastic cells in a magenta, fibrillary background. CONCLUSION: The presence of classic physaliferous cells on fine needle aspiration is diagnostic of chordoma, even in metastatic lesions.

Biopsy, Needle↗
PubMedDate not supplied

Fine needle aspiration cytodiagnosis of toxoplasmic lymphadenitis.

OBJECTIVE: To study six cases of toxoplasmic lymphadenitis in which the diagnosis was made by fine needle aspiration cytology and confirmed by subsequent serology. STUDY DESIGN: For cytologic study the material was received as needle and syringe washings, air-dried smears and alcohol-fixed smears, which were prepared and appropriately stained. Additionally, cell blocks were made, processed, cut and stained. RESULTS: The cytohistologic features were characterized by a polymorphous population of cells, germinal centers, a few epithelioid-type cells and histiocytes with intracellular organisms resembling Toxoplasma gondii. Serologic testing for toxoplasma in all the cases revealed elevated titers. CONCLUSION: Lymphadenitis due to Toxoplasma infection is common and should be considered in the diagnosis of unexplained lymphadenopathy at all sites, especially the cervical region. Serologic confirmation should be recommended for all suspected cases of this self-limited condition, for which no treatment is necessary. Fine needle aspiration cytodiagnosis can eliminate the need for hospitalization and surgery.

Adult↗
PubMedDate not supplied

Fine needle aspiration cytology of tubular carcinoma of the breast.

OBJECTIVE: To analyze six cases of tubular carcinoma involving the breast in which the diagnosis was made by fine needle aspiration cytology (FNAC). STUDY DESIGN: All patients were females between the ages of 28 and 67 years. The aspiration findings were confirmed by subsequent cell blocks of the aspirates and tissue examination of the breast mass. The aspirate was obtained using multiple passes in the breast masses while maintaining negative pressure. RESULTS: The cytohistologic features in all cases were characterized by a bland and orderly appearance of cells, few cell atypias, variable numbers of myoepithelial cells, tubular structures and somewhat angular epithelial clusters. The value of immunocytochemical study in the diagnosis was uncertain. CONCLUSION: The uncommon occurrence of tubular carcinoma of the breast, the bland and orderly appearances of cells in FNAC samples (as in tissue) and the difficulties in the cytodiagnosis can be found in other breast conditions. A cautious attitude toward the diagnosis of tubular carcinoma from FNAC samples is necessary, and cell atypias, when seen, should be reported with a recommendation for removal of the breast lump for detailed tissue examination.

Adenocarcinoma↗
PubMedDate not supplied

Value of image-guided needle aspiration cytology in the assessment of thoracolumbar and sacrococcygeal masses.

OBJECTIVE: To investigate tumors and nontumorous processes in the thoracolumbar and sacrococcygeal region by the noninvasive method of needle aspiration cytology (NAC) and whether such preoperative assessment is useful in deciding between conservative and radical management. STUDY DESIGN: NAC was performed under computed tomographic guidance on 22 patients suspected of having a thoracolumbar-sacrococcygeal mass. Cytologic examination was performed on site after staining smears with the Papanicolaou method. In addition, air-dried smears, fixed smears, filter preparations from needle washings and cell blocks were studied. The NAC diagnosis in all cases was supported by examining cell blocks, which illustrated the reliability of histologic architecture; further support was obtained with a tissue biopsy in eight cases. Additionally, immunoperoxidase and/or histochemical studies were done in cases with a NAC diagnosis of chordoma and some cases of metastatic carcinoma. RESULTS: Five cases were diagnosed as inflammatory/degenerative lesions, and in one case NAC diagnosis of neurofibroma was made. In 14 cases a variety of metastatic tumors were diagnosed, while in two cases a NAC diagnosis of chordoma was made. Immunohistochemical staining results were useful in supporting the cytohistologic diagnosis. CONCLUSION: NAC, as the first line of investigation, is not only useful in the diagnosis of space-occupying lesions of the thoracolumbar-sacrococcygeal region but can also save the patient from a radical surgical procedure to obtain tissue for diagnosis. Also, histologic architecture from cell blocks can be correlated with cytology, and such material can be used for histochemical and immunomarker studies.

Adult↗
PubMedDate not supplied

Aspiration cytodiagnosis of dermal analogue tumor, a rare subtype of salivary gland monomorphic adenoma: a case report.

BACKGROUND: Fine needle aspiration (FNA) cytology can be used to diagnose a rare subtype of monomorphic adenoma, dermal analogue tumor. CASE: A 70-year-old male presented with a mass in the parotid gland. An FNA aspirate was obtained using multiple passes in the mass. Filter preparations from aspirated material were made and stained by the Papanicolaou method, while cell blocks from aspirate and excised tissue were stained by hematoxylin-eosin after processing. The cytohistologic features in the cellular sample were characterized by aggregates of uniform epithelial cells with regular nuclei; fine chromatin; a few, regular nucleoli; scanty, ill-defined cytoplasm; no nuclear pleomorphism or mitotic activity; and cell groups bordered by thick, basement membrane-like material. CONCLUSION: Dermal analogue tumor of the salivary gland mimics dermal cylindroma and can recur. This was true in the case presented since the tumor recurred after 11 months. An analogy between adenomas of salivary glands and those of skin adnexa is not surprising since both arise in germinal epithelium of ectodermal origin. Also, the biologic behavior of these adenomas is similar, with a close histogenetic relationship. The findings suggest that the cytomorphologic expression of dermal analogue tumor is distinctive and that diagnosis of this neoplasm by FNA cytology is possible.

Adenoma↗
PubMedDate not supplied

Captopril for prevention of contrast-induced nephropathy in diabetic patients: a randomised study.

Contrast-induced nephrotoxicity is an important cause of hospital-acquired acute renal insufficiency. Different modalities have been used to prevent contrast induced-nephrotoxicity namely saline infusion, mannitol, furosemide, calcium channel blockers, atrial natriuretic factor and dopamine infusion with variable success. The possible role of medullary ischaemia mediated by renin angiotensin system in genesis of contrast-induced nephrotoxicity prompted us to investigate the role of captopril (a sulfhydryl group containing angiotensin-converting enzyme inhibitor) in its prevention. Seventy-one patients of diabetes mellitus undergoing coronary angiography were included in the study. Patients randomised to receive captopril, received the drug in a dose of 25 mg thrice a day for three days, starting one hour prior to angiography while the patients in the control group underwent angiography in a routine manner without receiving captopril. Following angiography, patients in the control group developed a significant increase in serum creatinine and blood urea nitrogen levels, as compared to those who received captopril. Contrast-induced nephrotoxicity (i.e. a rise of 0.5 mg/dL in serum creatinine) developed in 29 percent of the control group. Administration of captopril reduced the risk of development of contrast-induced nephrotoxicity by 79 percent. Glomerular filtration rate as measured by Tc DTPA renal scanning prior to and 24-72 hours following angiography demonstrated a mean fall of 9.6 ml/min in the control group while those in the captopril group had a mean increase of 13 ml/min in glomerular filtration rate. We conclude that abnormalities of renal perfusion possibly mediated by renin angiotensin system are responsible for development of contrast-induced nephrotoxicity. Administration of the angiotensin-converting enzyme inhibitor, captopril, offers protection against development of contrast-induced nephrotoxicity.

Acute Kidney Injury↗
PubMedDate not supplied

Immunogenicity and reactogenicity of an inactivated hepatitis A vaccine in Indian adults.

BACKGROUND: In India, a possible decrease in the prevalence of anti-HAV (hepatitis A virus) antibodies in adults has increased their susceptibility to HAV infection. We evaluated the immunogenicity and reactogenicity of an inactivated hepatitis A vaccine administered in a 3-injection protocol. METHODS: Thirty-five healthy adult volunteers, seronegative for anti-HAV IgG, were administered 720 ELISA units/ml of the inactivated hepatitis A vaccine intramuscularly at days 0, 30 and 180. Anti-HAV IgG was determined at days 30, 60, 90 and 180 to assess the efficacy of the vaccine and adverse reactions were noted to evaluate its reactogenicity. RESULTS: The mean (SD) age of the volunteers was 33.1 (12.3) years and the man:woman ratio was 19:16. An overall seroprotection of 37.2% (13/35) was obtained at day 30, 57.1% (20/35) at day 60 and 85.7% (30/35) at day 90. By day 180, all the vaccinees (35/35; 100%) achieved protective seroconversion. The vaccine in general was well tolerated and no serious side-effects were observed. Only 8.6% (3/35) of subjects developed minor self-resolving adverse reactions such as local pain, erythema and/or low-grade fever. CONCLUSIONS: The inactivated hepatitis A vaccine in a three-injection protocol (0, 30 and 120 days) is safe, well tolerated and highly immunogenic in adult Indian subjects.

Adolescent↗
PubMedDate not supplied

A multicentric evaluation of recombinant DNA hepatitis B vaccine of Cuban origin.

INTRODUCTION: Hepatitis B infection is an important public health problem all over the world. As no specific treatment is available, greatest emphasis is placed on prevention through immunization. OBJECTIVE: To evaluate the immunogenicity (sero-protection rate) and reactogenicity of a novel recombinant DNA hepatitis B vaccine of Cuban origin (Enivac HB). POPULATION AND METHODS: The study was conducted at two independent centres (New Delhi and Jaipur) and 111 healthy volunteers without any symptomatic or serological evidence of HBV infection were administered the vaccine intramuscularly in a dose of 20 ug at day 0, day 30 and day 180. Blood samples were collected for evaluation of sero-protection on days 30, 60, 90 and 210 at both centres and, in addition, at day 120 at New Delhi. All subjects were evaluated for any adverse event for 120 hours subsequent to each dose of the vaccine. RESULTS: The mean age of the volunteers was 24 years and the male:female ratio was 61:50. An overall sero-protection rate of 24.3% was obtained at day 30, 68.5% at day 60, 94.5% at day 90 and 99.1% by day 120. Following the third dose of the vaccine (at day 180), we lost one subject to follow up and further evaluation could be done in a total of 110 volunteers. The sero-protection rate by day 210 was found to be 100% (110/110). The vaccine was well tolerated with no serious adverse reactions. Minor side effects such as injection site tenderness, erythema and/or low grade fever were observed in 4.5% of the subjects. CONCLUSIONS: The recombinant DNA hepatitis B vaccine of Cuban origin is safe, well tolerated and highly immunogenic.

Adolescent↗
PubMedDate not supplied

Allergic bronchopulmonary aspergillosis with cavitary lesion simulating a lung abscess.

A 48-year-old female patient was diagnosed as a case of allergic bronchopulmonary aspergillosis (ABPA) on the basis of clinical, immunological and radiological criteria. In addition to central bronchiectasis, computed tomography (CT) of the thorax revealed hilar lymphadenopathy and cavitary lesions simulating a lung abscess, a presentation not described earlier. The patient responded to treatment with corticosteroids and the CT repeated after 14 months of treatment showed complete resolution of the cavitary lesions.

Adrenal Cortex Hormones↗
PubMedDate not supplied

Intracranial neurothekeoma--a rare parenchymal nerve sheath myxoma of the middle cranial fossa.

Neurothekeomas are rare, benign nerve sheath tumors, usually arising from cutaneous nerves in the head and neck region. So far, only 4 cases of the intracranial counterpart have been reported and these were located in the posterior fossa, sellar and parasellar region. We report here the first case of neurothekeoma located deep inside the brain parenchyma. Histologically, the tumor had lobular appearance with bland morphology in spite of cellular pleomorphism, myxoid background and variable S-100 positivity, characteristics of neurothekeomas. The schwannian origin was further confirmed ultrastructurally by demonstrating basal lamina and Luse bodies. Because of its benign nature, the lesion does not need postoperative radiotherapy. Histogenesis of neurothekeoma arising in the parenchyma remains enigmatic. The probable cell of origin could be the Schwann cell or perineurial cell of the nerve twigs around the blood vessels or by extreme differentiation of the precursor cell resting in a suitable microenvironment to the schwannian phenotype.

Adolescent↗
PubMedDate not supplied

Cardiotoxic effects of high doses of cyclophosphamide in albino rats.

A histopathological study of cyclophosphamide-induced cardiotoxicity has been conducted in 43 Swiss albino rats. Multiple interstitial myocardial haemorrhage, multifocal myofibre necrosis, inflammatory reaction, vascular changes, pericarditis and valvulitis, mainly in the heart ventricles, have been observed. Previous results have suggested that cyclophosphamide directly damages the vascular endothelium, followed by the extravasation of blood containing high levels of the drug, and resulting into a toxic damage of the muscle cells. Our results are in favor of this hypothesis.

Animals↗