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Biomedical subjects

R Sinniah

Publications and source records attributed to R Sinniah.

At least 37 records · Page 2Linked to original sources
PubMed1993

Study of renal tubular glycoconjugates in tubulointerstitial damage using conjugated lectins.

Changes in the glycoconjugates of renal tubules associated with tubular damage were studied by lectin histochemistry, and their possible significance was determined. The excretion of various saccharides in tubular casts may also serve as markers of renal tubular damage. Renal tissues from 55 cases with various glomerular diseases including ten controls were studied. The patients were divided into two groups: one with tubulointerstitial lesions (TILs) (30 cases), and the other without (15 cases). Our results showed a wide spectrum of changes, predominantly in the disease group with TILs. The brush border of the proximal tubules showed significantly increased staining with Triticum vulgaris (WGA) and decreased staining with Canavalia ensiformis (Con A) lectins in both disease groups. The distal tubules revealed a significant increase in the apical and a decrease in the basal staining with Arachis hypogaea (PNA) and WGA lectins, respectively, in cases with TILs. The significant decrease in the basal domain staining was also seen with WGA lectin in cortical ducts. The vulnerability of various segments of the tubules in the process of TILs was clearly demonstrable. It appeared that the distal tubules were the most vulnerable anatomical segments around which the TILs began and later spread to involve other segments of tubules.

Concanavalin A↗
PubMed1993

Morphometric study showing the importance of distal tubular damage in impaired creatinine clearance.

It is established that the glomerular filtration rate (GFR) is affected by tubulointerstitial lesions (TIL) in various glomerulonephritides. The fall in GFR is believed to be the result of damage to tubules, mainly the proximal tubules, and interstitial widening. We performed the morphometric point-counting study in 45 renal biopsies with various glomerular diseases, and 10 controls, to quantify interstitial widening, proximal and distal tubular damage, and to study their relation to serum creatinine clearance, and also to determine the best predictor, and the degree of damage in each component of the tubulointerstitium. There was a statistically significant correlation of serum creatinine clearance to interstitial widening (r = -0.748; p = 0.0001) and decrease in proximal (r = 0.611; p = 0.0001) and distal tubular area percentages, with a maximum value of the correlation coefficient for the distal tubules (r = 0.818; p = 0.0001). On the basis of relative mean difference values, it appeared that in the presence of tubulointerstitial damage, the distal tubule sustained greater damage. Therefore, distal tubular damage may serve as an important prognostic parameter.

Creatinine↗
PubMed1993

Renal cholesterol embolic disease. Case report and review of the literature.

Renal cholesterol embolization is a rare disease occurring usually in elderly men who had undergone an angiographic procedure or vascular surgery. We report a man who developed systemic cholesterol embolic disease and acute renal failure after coronary angiography. A review of the English literature for renal cholesterol embolic disease revealed a high incidence of eosinophilia (71%). Livedo reticularis and digital infarcts occurred in more than 30% of patients. Forty percent of patients required dialysis for acute renal failure of whom only one fifth recovered sufficient renal function to stop dialysis. The overall mortality was high at 64%. Skin, muscle and kidney biopsies remain the main tools for diagnosis.

Acute Kidney Injury↗
PubMed1993

Renal tubular antiproteinase (alpha-1-antitrypsin and alpha-1-antichymotrypsin) response in tubulo-interstitial damage.

We studied the role of proteinase inhibitors (Pls) alpha 1-antitrypsin and alpha 1-antichymotrypsin in relation to lysozyme (LZM), and membrane attack complex (C5b-9) in renal tubular damage by immunohistochemical techniques. Fifty-five cases, including 45 patients with glomerular diseases, and 10 controls were studied. The patients were divided into two groups; one with tubulo-interstitial lesions (TILs; 30 cases), and the other without (15 cases). Significant antiproteinase response was observed in the proximal tubules in both disease groups, indicating that they were subjected to proteolytic attack. This response correlated with proteinuria and occurred in tubules which showed protein reabsorption as demonstrated by the presence of LZM staining in consecutive serial sections. Increased deposition of membrane attack complex (C5b-9) was observed in the disease group with TILs, indicating direct damage to cell membranes. C5b-9 may also generate oxygen species, potent inhibitors of Pls, which allow the proteases to cause tubular damage.

Basement Membrane↗
PubMed1993

An in situ hybridization study of herpes simplex and Epstein Barr viruses in IgA nephropathy and non-immune glomerulonephritis.

Renal tissues from forty cases of IgA nephropathy, 20 Singapore and 20 British patients, and 38 patients with non-immune glomerulonephritis were studied by in situ hybridization using DNA probes for the herpes simplex virus (HSV) and Epstein Barr virus (EBV). Two Singapore patients with IgA nephropathy showed HSV antigens in the glomerular mesangium, with one of them having EBV coinfection. In the control non-immune glomerulonephritis cases, 4 patients had viral antigens; 2 with EBV, one with EBV and HSV coinfection, and one with HSV alone. The study indicates that in some cases of IgA nephropathy and in non-immune nephropathy there may be coincidental rather than causal persistent infection by the herpes group of viruses.

DNA, Viral↗
PubMed1992

The surgical treatment of multiple small bowel strictures in Crohn's disease by combined resection and stricturoplasty.

Crohn's disease is extremely rare among Asians. Resection of strictures causing obstruction has traditionally been the accepted choice in surgical therapy. This may lead to problems such as iatrogenic short bowel syndrome and its sequelae. Stricturoplasty is an acceptable and safe alternative. We report a case where combined stricturoplasty and resection was performed safely and advocate its use.

Adult↗
PubMed1990

Ultrastructural study of Helicobacter pylori-associated gastritis.

Endoscopic biopsies of antral mucosa from 26 patients with Helicobacter pylori-associated gastritis were studied by electron microscopy (EM). Scanning electron microscopy (SEM) showed clustering of H. pylori in the intercellular areas, being entrapped by the microvilli which were decreased at the sites where the bacilli were seen. The observations of SEM were confirmed by transmission electron microscopy (TEM), which showed adherence of the bacilli to the cell surface, producing cup-shaped depressions in the epithelial cells, and occasionally intracellular infiltration by H. pylori. There were also depletion of mucus granules, degenerative changes, and disruption of intercellular junction complexes of the epithelial cells. Post-treatment biopsies showed complete disappearance of the bacilli, and ultrastructural changes associated with H. pylori infection were resolved.

Campylobacter↗
PubMed1990

Effect of dietary palm oil on lipoprotein lipases: lipoprotein levels and tissue lipids in rat.

The aims of our study were to investigate the effect of dietary palm oil on the levels of lipoprotein lipase, hepatic lipase, fat distribution (in the aorta and liver), and total cholesterol, HDL, LDL, and triacylglycerol levels in young rats (70 g body wt) over a period of 10 weeks. Palm oil-fed rats showed higher growth rate and lower triacylglycerol levels than the control group. Hepatic lipase activity was correlated to the liver fat distribution (correlation coefficient, r = +0.682) as seen by histopathological sections and was similar for both the palm oil and the control diets. Palm oil-fed rats exhibited a significantly higher HDL cholesterol to total plasma cholesterol ratio when compared to animals fed the control diet. The triacylglycerol levels correlated inversely to the HDL cholesterol levels (r = -0.536) while the lipoprotein lipase (LPL) activity correlated directly to the LDL level (r = +0.617) for both groups of animals. The fatty acid profiles of adipose and liver tissues and plasma revealed that saturated fatty acids--palmitic and stearic--were preferentially incorporated in liver and adipose tissues and less in the plasma. This accounts for lack of deposition in the arterial wall and for the antithrombotic tendency of palm oil. Thus, our present findings suggest that dietary palm oil may not contribute to the risk for coronary heart disease.

Animals↗
PubMed1990

Spontaneous hematic cysts of the orbit presenting with acute proptosis. A report of three cases.

Three cases of spontaneous hematic cyst of the orbit are described. All cases presented with acute onset of proptosis, conjunctival chemosis, choroidal folds, restricted ocular movement, and optic nerve compression syndrome with very poor vision. A computed tomography scan demonstrated a cystic lesion situated in the upper part of the orbit. Exploration revealed a cyst containing chocolate-colored fluid. Visual recovery was complete in two of three cases. There was no definite history of trauma in all three cases. Chronic hematic cysts have been described recently, but cases with acute onset such as ours have not to our knowledge been described clearly.

Acute Disease↗
PubMed1990

Reye and Reye-like syndromes: results of a pilot study in Peninsular Malaya, 1986.

A pilot epidemiologic study of all cases of Reye and Reye-like syndromes was undertaken at 8 representative major hospitals in Peninsular Malaya from January 1st to December 31st 1986. The cases were classified as definitive Reye's syndrome, clinical Reye's syndrome and encephalo-hepatopathies. Less than 50% of cases reviewed fulfilled the National Center for Disease Control criteria for clinical Reye's syndrome. Causes of Reye-like syndromes/encephalo-hepatopathies included fulminant hepatitis, Japanese B encephalitis, dengue, septicaemia, and complex febrile fits. It was not possible to differentiate clinical Reye's syndrome from the other encephalo-hepatopathies by either the clinical features (except for jaundice) or biochemical parameters. Liver biopsy is necessary for a definitive diagnosis of Reye's syndrome in Malaysia, because of the high prevalence of Reye-like diseases. The mortality rate in the 2 groups of patients is similar. Ingestion of salicylates was not found to be significantly associated with Reye and Reye-like syndromes in this study.

Diagnosis, Differential↗
PubMed1990

Evaluation of the possible role of glucose, carnitine, coenzyme Q10 and steroids in the treatment of Reye's syndrome using the margosa oil animal model.

Glucose and steroids have been used in the treatment of children with Reye's syndrome, while carnitine and coenzyme Q10 have been the subject of some recent studies which suggest that these agents may have a role in the treatment of Reye's syndrome and Reye-like syndrome due to margosa oil poisoning. Because of the paucity of causes of Reye's syndrome seen at any one centre, the clinical variability of the disease, and limited knowledge of definite aetiologic factors, controlled clinical trials are not easy to carry out or to interpret in human cases. These caveats were overcome by evaluation of these four treatment modalities in an established margosa-oil-induced animal model of Reye's syndrome. Effectiveness of the treatment modalities was determined from clinical response and histopathologic parameters (grading of light microscopic fatty changes and ultrastructural changes in the hepatocytes). Results show that carnitine per se produces a small improvement in survival, but statistically, more significant benefit is seen with glucose administration. Carnitine plus 10% dextrose appears to produce better results. Evaluation of coenzyme Q10 and carnitine on histopathologic parameters in the liver after a sublethal dose of margosa oil showed no obvious ameliorating effect on liver pathology. Steroids (dexamethasone/methylprednisolone) had no beneficial effects in reducing mortality, affecting glycogen storage or lipid accumulation. Changes in the mitochondria, ribosomes and endoplasmic reticulum were unaltered from the groups treated with margosa oil alone. While glucose and carnitine supplements appear to be beneficial, the other modes of therapy do not seem to hold much promise in the treatment of Reye-like syndrome in the margosa-oil-induced animal model.

Animals↗
PubMed1990

IgA nephropathy in Pakistan.

A light, electron and immunofluorescence microscopy study was performed on 102 consecutive patients on whom suitable percutaneous renal biopsies were obtained. In this selected group of patients primary IgA glomerulonephritis was diagnosed in 6 (5.9%) cases. On light microscopy the glomerular lesions were predominantly focal (WHO class III) and diffuse mesangial proliferative glomerulonephritis (Class IV). The mesangial deposits showed high association with IgM deposits and presence of early complement components (C1q, C4) indicative of both classical and alternative pathways of C3 activation in our patients. The high incidence of nephrotic syndrome with microhaematuria (5 cases) is due to patient selection when compared to other studies. This study shows the existence of IgA nephropathy in Pakistan and larger number of cases need to be investigated to determine the true prevalence of this disease and its clinical manifestations and importance in Pakistan.

Adolescent↗
PubMed1990

Idiopathic bronchiolitis obliterans with organizing pneumonia in Singapore--first case report.

Idiopathic bronchiolitis obliterans organizing pneumonia (BOOP) has become accepted as a distinct disease entity. We report a patient who presented with the classical clinical, radiological and pathologic features of this uncommon condition. To our knowledge, this is first case to be reported in Singapore. This case also illustrates the difficulty of making a definitive diagnosis and emphasizes its therapeutic importance.

Aged↗
PubMed1989

Cellular and humoral immune responses in Campylobacter pylori-associated chronic gastritis.

Gastric cellular and humoral immune response investigated by immunoperoxidase staining of 53 antral biopsies showed significant differences in Campylobacter pylori-associated gastritis as compared with non-bacterial chronic gastritis and normal controls. IgA, secretory component, and complement C3 coated bacilli were seen in all cases of active chronic gastritis. C3 was always associated with coating by IgA, IgM, or both, which were rarely seen in gastritis without polymorphonuclear neutrophil infiltration. Intraepithelial mononuclear cellular infiltration was seen in 18 of 26 cases of C. pylori-associated chronic gastritis. The intraepithelial mononuclear cells stained positively for T cells and histiocytes.

Antibody Formation↗
PubMed1989

Animal model of margosa oil ingestion with Reye-like syndrome. Pathogenesis of microvesicular fatty liver.

The aetiology and pathogenesis of Reye's syndrome (RS) are incompletely understood. A number of environmental toxins and biological agents, including viruses, have been postulated to cause RS, either acting alone or synergistically. Most investigations have suggested that the primary insult is in the liver mitochondria, leading to a complex biochemical catastrophe, with death from encephalopathy. Margosa oil (MO), a long-chain fatty acid compound, has been shown to cause a Reye-like syndrome with death from hepatoencephalopathy, in children in Malaysia and India. The present time-course study performed in MO-administered mice showed the development of hepatic lesions with many features of RS. MO acts rapidly, within 30 min, on the nuclei of hepatocytes inducing mitoses and binucleated cells. This is followed by mitochondrial injury, with swelling, rarefaction of matrix, loss of dense bodies, pleomorphism, and loss of ribosomes starting at 60 min. There is loss of liver glycogen, and proliferation and hypertrophy of the endoplasmic reticulum (ER), followed by the presence of lipid droplets in the hyaloplasm, and globules within dilated cisterns of the ER. Additional fatty acids from lipolysis of body adipocytes, and fat globules from intestinal MO ingestion further aggravate the liver fatty change. There is evidence of fat globule ingestion by endocytosis into hepatocytes at the level of the sinusoids. The development of microvesicular liver steatosis and glycogen depletion due to involvement of liver cell organelles occur rapidly as in RS.

Animals↗
PubMed1989

Spindle and epithelioid cell nevus of tongue at an unusual site.

A case of spindle and epithelioid cell nevus of the tongue is presented. It shows unusual and distinctive desmoplasia and cells containing melanosomes identified by histochemical and electron microscopic techniques. We believe this is the second case, but the first fully documented report, of this unusual nevus of tongue reported in the literature.

Adult↗