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Biomedical subjects

R K Gupta

Publications and source records attributed to R K Gupta.

At least 919 records · Page 51Linked to original sources
PubMedDate not supplied

Association of HLA phenotype with primary non-response to recombinant hepatitis B vaccine: a study from north India.

The hepatitis B vaccine is considered to be highly immunogenic and has a good safety profile. In adults, it has a primary non-response rate of 5%-10%. Causes of nonresponse to hepatitis B vaccine include age, sex, obesity smoking. Certain human leucocyte antigen (HLA) phenotypes have been known to be associated with responsiveness to the vaccine, and found to be different in different ethnic groups, such as Caucasians and Orientals. The study was designed to identify the HLA phenotypes that are associated with non-responsiveness to hepatitis B virus (HBV) vaccination amongst a cohort of Indian subjects who agreed to participate in the vaccination programme. The study was offered to 107 volunteers, of whom 102 were found to be negative for HBV markers (hepatitis B surface antigen [HBsAg], anti-HBc, anti-HBe, anti-HBs, hepatitis Be antigen [HBeAg]) . All 102 volunteers were offered recombinant hepatitis B vaccine (20 microg) at 0, 1, and 6 months. Anti-HBs antibody titres were tested on days 90 and 210 of the first vaccine dose. HLA typing was done using standard microlymphotoxicity tests. The seroconversion rate of the hepatitis B vaccine was 86.3% (88/102). Fifteen nonresponders (15/102) and 15 of the 88 responders were randomly selected after age and sex matching for the purpose of studying the HLA phenotypes. HLA subtypes A1, B15, B40, A10 and DQ2 were found to be increased among nonresponders while HLA- A11, C3, DR10, DR51 (p>0.05) were the most common phenotypes amongst the responders. Further studies are needed to characterize the HLA phenotypes amongst the responders in different ethnic groups in India with respect to HBV vaccination.

Adult↗
PubMedDate not supplied

Carcinoma of the breast with malignant epithelial giant cells. Needle aspiration cytology, immunocytochemistry and electron microscopy in a rare case in a woman under 30.

Needle aspiration cytology, immunocytochemistry and electron microscopic findings are described in a case of rare breast carcinoma with bizarre, malignant giant cells in a young female under age 30. The malignant tumors were found in both breasts; the first one was diagnosed when the patient was 23 years of age and the second one in the contralateral breast four years later. Based on our present findings, and in keeping with a similar case recently described by us as occurring in an elderly female, we thought that the bizarre giant cells in this rare breast carcinoma were of epithelial origin. The differential diagnosis of other conditions that may be associated with giant cells in breast aspirates is discussed.

Adult↗
PubMedDate not supplied

Osteitis fibrosa cystica (brown tumor) in a patient with renal transplantation. Report of a case with aspiration cytodiagnosis.

The cytologic findings from fine needle aspiration of a left shoulder mass are described for a woman who had undergone renal transplantation and on whom an orthopedic consultation suggested the clinical possibility of a soft tissue sarcoma. The aspirate samples from multiple sites in the mass showed several multinucleate, osteoclast-type giant cells, spindly or fibrillary cells with ovoid nuclei and a significant amount of granular calcium. The needle aspiration cytodiagnosis was of critical importance since it saved the patient from invasive surgical intervention. This case emphasizes the role of needle aspiration cytology in providing a rapid cytodiagnosis of osteitis fibrosa cystica with a minimally invasive method.

Adult↗
PubMedDate not supplied

Value of fine needle aspiration cytology of the breast, with an emphasis on the cytodiagnosis of colloid carcinoma.

The fine needle aspiration (FNA) cytologic evaluation of 6,941 lesions of the breast was reviewed, with an emphasis on the cytodiagnosis of colloid carcinoma. The most common benign breast diseases in this series were fibroadenomas, cysts and fibrocystic conditions. All cases with an FNA diagnosis of suspicious were biopsied; a number of these were found to be carcinoma of the breast. In cases with an FNA diagnosis of carcinoma of the breast, a plan of management was immediately adopted on the basis of that diagnosis. Thirteen cases of colloid (mucinous) carcinoma of the breast were diagnosed by FNA cytology; in all, the cytodiagnosis was confirmed by the subsequent histologic diagnosis. The distinctive cytologic criteria that may be useful for making an FNA diagnosis of colloid carcinoma of the breast are discussed, and the FNA differences between the pure and mixed types of colloid carcinoma are noted.

Adenocarcinoma, Mucinous↗
PubMedDate not supplied

Myelomatous pleural effusion.

Pleural effusion due to myelomatous involvement is rare. We are describing such a case who also had soft tissue extension from iliac bone with congestive heart failure.

Biopsy, Fine-Needle↗
PubMedDate not supplied

Malignant lymphoma of stomach associated with duodenal carcinoid.

We report a 73-year-old man with diffuse large B-cell lymphoma of the stomach in whom distal gastrectomy specimen revealed coexisting carcinoid tumor of the duodenum. Postoperatively the patient received six cycles of chemotherapy (CHOP regimen) and was asymptomatic nine months later.

Aged↗
PubMedDate not supplied

Alcohol intoxication results in rapid loss in free magnesium in brain and disturbances in brain bioenergetics: relation to cerebrovasospasm, alcohol-induced strokes, and barbiturate anesthesia-induced deaths.

In vivo 31P-nuclear magnetic resonance (31P-NMR) spectroscopy and ion-selective electrode measurements were undertaken to determine if administration of acute doses of alcohol (ALC, 0.2-6.6 g/kg), and lethal doses of barbiturate anesthesia, exert any influence on: (1) brain cellular bioenergetics, intracellular free Mg ([Mg2+]i) and intracellular pH (pHi), and (2) serum levels of ionized Mg (IMg2+), ionized calcium (ICa2+) and K+. Approximately 20-30 min after intraperitoneal administration of ALC to anesthetized rats, brain phosphocreatine (PCr)/ATP and PCr/inorganic phosphate (P(i)) ratios dropped from 2.5 to 1.7 and from 6.6 to 2.2, respectively, P(i) rose 20-200% (depending upon ALC dose), and free ADP and creatine rose significantly. ALC induced rapid decreases in the cytosolic phosphorylation potential (CPP) and free energy of ATP hydrolysis (-delta G/delta E). Following ALC administration, brain [Mg2+]i dropped rapidly (within 4-30 min) and significantly; the greater the dose of ALC, the greater the loss in brain [Mg2+]. Correlations were found between [Mg2+]i, PCr/ATP, CPP and delta G/delta E after ALC but not in control brains. Rats that exhibited ALC-induced strokes and death (unlike barbiturate death) exhibited huge elevations in [Mg2+]i. Although ALC administration does not alter brain pHi at least (up to 70 min), ALC- and barbiturate-induced death produces rapid brain intracellular acidosis. Concomitant with ALC-induced alterations in [Mg2+]i and brain cellular bioenergetics, we noted that ALC administration results in rapid elevations in serum IMg2+ and K+ but not ICa2+. These results suggest that ALC administration and heavy or binge-drinking of ALC (1) can result in rapid alterations in brain bioenergetics, [Mg2+]i and pHi, and (2) result in rapid elevations in serum IMg2+ and K+ in rats. In addition, ALC- and barbiturate-induced deaths do not appear to produce identical alterations in brain bioenergetics and [Mg2+]i, and lastly binge or heavy drinking of ALC may result in stroke-like events and sudden death via rapid alterations in brain cellular bioenergetics.

Alcoholic Intoxication↗
PubMedDate not supplied

Depletion of intracellular free magnesium in rat hearts during acute alcohol perfusion: a 31P nuclear magnetic resonance study.

The effect of acute ethanol perfusion on the intracellular free magnesium level, intracellular pH, and high energy phosphate levels of isolated adult rat hearts (n = 13) were studied using 31P nuclear magnetic resonance (NMR) spectroscopy. Perfusion with 1% ethanol solution resulted in a 43% decrease in the intracellular free magnesium level in Langendorff perfused rat hearts while intracellular pH was not significantly altered. In most hearts ethanol perfusion also resulted in increased intracellular inorganic phosphate and reduced phosphocreatine and ATP levels, corresponding to a significant reduction in phosphorylation potential. The implications of these results in the pathogenesis of alcohol-induced hypertension are discussed in light of our previous studies on spontaneously hypertensive and normotensive rats which demonstrated a correlation between cardiac free magnesium levels and blood pressure.

Animals↗
PubMedDate not supplied

Influence of Mg2+ on cardiac performance, intracellular free Mg2+ and pH in perfused hearts as assessed with 31P nuclear magnetic resonance spectroscopy.

The cellular bioenergetic responses of isolated perfused working rat hearts to alterations in hemodynamic function caused by acute exposure to elevated levels of extracellular magnesium ions ([Mg2+]o) were examined using 31P nuclear magnetic resonance (31P NMR) spectroscopy. Results showed that in hearts working against 90 cm H2O afterload, an increase in [Mg2+]o from 1.2 to 4.8 mM reduced the heart rate by 35%, while coronary flow was increased by 38%. Unexpectedly, despite the pronounced bradycardia, the rate-pressure product was reduced only slightly (from 2.36 x 10(4) to 2.08 x 10(4) mm Hg/min) due to a significant increase (36%) in systolic pressure. In addition, cardiac output actually increased by 23%, owing to a > 100% increase in stroke volume, indicating that the performance of the heart was improved and suggesting that the efficiency of the heart was improved as well. In a separate series of experiments, 31P NMR measurements performed on hearts perfused in the Langendorff mode revealed that elevated levels of [Mg2+]o increase phosphocreatine (PCr) levels by 23% (from 9.2 to 11.3 mM), while Pi levels declined by a corresponding amount. Perfusion of hearts in the working mode with elevated [Mg2+]o was also observed to increase PCr levels from 6.3 to 9.0 mM, while ATP levels declined by 17%. Measurement of the chemical shift difference between Pi and PCr and that between the alpha and beta phosphate resonances of ATP were used to determine intracellular pH and the cytosolic levels of free Mg2+ ([Mg2+]i), respectively. These results showed that acute exposure of hearts, perfused in either the working or Langendorff mode, to increased levels of [Mg2+]o increased intracellular pH by 0.12-0.13 units, while free Mg2+ nearly doubled to a level of 1.1-1.2 mM. The latter observation may suggest that acute variations in the level of [Mg2+]o can influence a multitude of cellular processes requiring Mg2+ as an essential cofactor. Using the above data and assuming equilibrium of the creatine kinase reaction, the levels of ADP, cytosolic phosphorylation potential ([ATP]/[ADP][Pi]) and free energy change from ATP hydrolysis (-delta G/delta E) were also calculated. Results obtained illustrate that in the presence of elevated [Mg2+]o, ADP levels declined by 33-48%, the cytosolic phosphorylation potential increased from 41 to 112 mM-1 and -delta G/delta E increased from 56.7 to 59.3 kJ/mol. These changes are not completely accountable by the known bradycardia and vasodilatory effects of elevated [Mg2+]o and strongly argue for a direct action of [Mg2+]o on the myocyte as well.(ABSTRACT TRUNCATED AT 400 WORDS)

Adenosine Triphosphate↗
PubMedDate not supplied

Fine needle aspiration cytology, immunocytochemistry and electron microscopy in a rare case of carcinoma of the breast with malignant epithelial giant cells.

The cytohistologic findings in a fine needle aspirate from a case of the rare breast carcinoma with bizarre tumor giant cells are described, along with the results of immunocytochemical and ultrastructural studies. The observations in this case suggest that the bizarre malignant giant cells in this type of breast cancer are of an epithelial origin, rather than a histiocytic-stromal origin. The other conditions that may yield giant cells in needle aspirates of breast masses are briefly discussed.

Aged↗
PubMedDate not supplied

Liesegang rings in a needle aspirate from a breast cyst.

Ringlike structures of various sizes, resembling Liesegang rings (LRs), were found in the needle aspirate from a breast cyst in an elderly woman. They were characterized by a double-layer outer wall with striations and an amorphous central nidus. Immunohistochemical stains for calcium, iron, mucus, glycogen, amyloid, cytokeratin and epithelial membrane antigen yielded negative results. Since LRs can be mistaken for ova, larvae or parasites, it is important that cytologists be aware of their occurrence, albeit infrequent, in aspirated material to avoid a misdiagnosis.

Aged↗
PubMedDate not supplied

Preoperative diagnosis of bilateral renal oncocytoma by needle aspiration cytology. A case report.

The cytohistologic and ultrastructural findings in a case of bilateral renal oncocytoma diagnosed by needle aspiration cytology are presented. This case appears to be the first reported example in which the preoperative needle aspiration cytologic diagnosis of bilateral renal oncocytoma was made due to the presence of characteristic tumor cells that were seen singly or in small clusters with rounded polygonal shapes and abundant eosinophilic granular cytoplasm. The preoperative diagnosis of bilateral oncocytoma permitted a timely decision as to the appropriate management in this case.

Adenoma↗