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Biomedical subjects

V Misra

Publications and source records attributed to V Misra.

At least 37 records · Page 2Linked to original sources
PubMed2000

A topographic study of Helicobacter pylori density, distribution and associated gastritis.

BACKGROUND AND AIMS: The topographic distribution and density of Helicobacter pylori and associated gastritis in the stomach were studied in order to determine which biopsy sites are likely to provide the maximum yield so as to reduce the fallacious results due to sampling error. METHODS: Fifty patients with upper gastrointestinal symptoms were studied. Eleven gastric biopsies from predetermined sites were obtained and subjected to ultra-rapid urease test, imprint cytology and histology. Haematoxylin and eosin stain was used for defining gastritis and other associated histopathological details. Loeffler's methylene blue stain was used to confirm the presence of H. pylori in imprint smears and histological sections. RESULTS: All 50 patients had H. pylori infection and evidence of chronic gastritis at one or more of the 11 biopsy sites. Maximum and minimum percentage positivity were observed at A3 (antral lesser curvature) and B4 (corpus greater curvature), respectively. Various sites in decreasing order of percentage positivity were A3 > A2 > A1 > A4 > B3 > B1 > A5 > B6 > B5 > B2 > B4. Among the biopsies obtained from the corpus, B3 (corpus lesser curvature) was the site with maximum positivity. A3 and B4 had a statistically significant difference in percentage positivity (P < 0.0001) for H. pylori and gastritis. The maximum and minimum density scores of H. pylori and gastritis were found in A3 and the B4, respectively. A3 had a significantly higher (P < 0.0001) mean density score than any other site in the stomach. The difference in the grading of H. pylori between A3 and B3 (sites of maximum positivity in antrum and corpus) was statistically significant (P < 0.0001). A statistically significant (P < 0.001) positive correlation between increasing grades of H. pylori and gastritis was observed at the site of maximum density. Eighty per cent of the patients had antral predominant gastritis and in 82%, H. pylori was predominantly observed in antral biopsies. CONCLUSION: It is concluded that two biopsies taken from A3 are sufficient for confirmation of presence of H. pylori and associated gastritis for initiation of treatment. However, additional biopsies from B3 will help in deciding the topographic pattern of gastritis.

Adult↗
PubMed2000

Assessment of the relationship between genotypic status of a DT-diaphorase point mutation and enzymatic activity.

DT-diaphorase, a cytosolic reductase, has been implicated as an activator of chemotherapeutic prodrugs and a detoxifier of certain potentially carcinogenic xenobiotics. A common C to T nucleotide 609 substitution in DT-diaphorase cDNA has been associated with protein instability and reduced catalytic activity. The degree to which the allelic status of the substitution correlates with enzymatic activity was assessed in 45 normal human skin fibroblast strains using a PCR-RFLP assay. Included in this study was the 3437T strain, which is unique in that it is heterozygous for the polymorphism yet contains undetectable enzymatic activity. An allele-specific RT-PCR-RFLP technique attributed this phenomenon to exclusive DT-diaphorase mRNA expression from the variant allele. Overlap in activities was observed between individual strains homozygous for the wild-type allele and heterozygotes, but the former group displayed enzymatic activity that was on average 2-fold higher. Western blot analysis of the two strains in this panel that are homozygous for the variant allele revealed that they express relatively low amounts of DT-diaphorase protein, consistent with the role of the substitution in protein instability. This work confirms that genotypic status is a reliable initial estimate of DT-diaphorase activity.

Adolescent↗
PubMed2000

Potential role for luman, the cellular homologue of herpes simplex virus VP16 (alpha gene trans-inducing factor), in herpesvirus latency.

The cascade of herpes simplex virus (HSV) gene expression that results in viral replication begins with the activation of viral immediate-early (IE) genes by the virion-associated protein VP16. VP16 on its own is inefficient at associating with complexes formed on IE gene promoters and depends upon the cellular factor HCF for its activity. In this respect VP16 mimics the host basic leucine zipper (bZIP) protein Luman, which also requires HCF for activating transcription. Our objective is to explore interactions between Luman and HCF and to determine if they play a role in the biology of herpesviruses. In this report we show that in cultured cells ectopically expressed Luman was retained in the cytoplasm, where it colocalized with Calnexin, a protein normally associated with the endoplasmic reticulum (ER). Retention of Luman in the ER depends on a hydrophobic segment of the protein that probably serves as a transmembrane domain. Deletion of this domain changed the intracellular location of Luman so that most of the mutant protein was in the nucleus of cells. While HCF was present in the nucleus of most cells, in cells expressing Luman it was retained in the cytoplasm where the two proteins colocalized. This cytoplasmic association of Luman and HCF could also be demonstrated in neurons in trigeminal ganglia removed from cattle soon after death. Cells in tissue culture that expressed Luman, but not a mutant form of the protein that fails to bind HCF, were resistant to a productive infection with HSV type 1 (HSV-1). We hypothesize that similar Luman-HCF interactions in sensory neurons in trigeminal ganglia result in the suppression of viral replication and the establishment of latency. Interestingly, Luman could activate the promoters of IE110 and LAT, two genes that are critical for reactivation of HSV-1 from latency. This suggests a role for Luman in the reactivation process as well.

Amino Acid Sequence↗
PubMed2000

Clinico-histopathological concordance in leprosy.

Histopathological examination of biopsies from 111 patients with clinically diagnosed leprosy was carried out in order to observe the clinico-histopathological correlation. Clinical diagnosis was based on Ridley and Jopling (R-J) classification and World Health Organization (WHO) classification. The concordance rate between the two clinical classifications was 73.8%. Sections were stained with haematoxylin and eosin (H&E) and Ziehl-Neelsen's (Z-N) stains. The histological classification was as per the R-J criteria. Skin biopsy showed evidence of leprosy in 104 cases (93.69%). Overall concordance was observed in 58.6% (R-J) and 85.6% (WHO classification). The kappa test, when applied, showed significant agreement between clinical and histopathological diagnosis (z=11.775; P<0.001). Individual subtypes showed variable concordance rates which were again higher using WHO classification. When some of the subtypes were combined, the concordance rate was 83.02% for TT+BT; 72.58% for BT+BB+BL; 73.91% for BL+LL; 80.77% for BL+HL and 100% for LL+HL. (See Introduction for definitions of abbreviations.) The present study highlights the importance of histopathological examination for exact subtyping of leprosy, so as to facilitate the institution of accurate mode of therapy and regular follow-up of patients to prevent undesirable complications.

Biopsy↗
PubMed2000

Gall stones and carcinoma gall bladder.

One hundred and fifty surgically resected gall bladder specimens were included in the study to evaluate the relationship between the prevalence of gall stones and histochemical alteration in sequential changes of metaplasia, dysplasia and neoplasia in gall bladder epithelium. Multiple sections were processed and stained with haematoxylin and eosin, Periodic acid Schiff's stain, Alcian blue (pH 2.5)/Periodic acid, Orcein/Alcian blue (pH 2.5) and Alcian Blue/Periodic acid/Potassium borohydride saponifications stains. Details of gall stones present were also noted. Prevalence of gall stones in gall bladders with metaplastic, dysplastic and neoplastic mucosal changes was significantly higher (P < 0.001) than those gall bladders which had no epithelial changes. Increase in sialomucin with a corresponding decrease in sulphomucin was observed from metaplasia to malignancy. Neutral mucin increased in metaplastic cells but was significantly reduced in neoplastic cells. Loss of O-acylation in sialmucin was also present in neoplastic cells. The histochemical changes suggest that chronic injury due to cholelithiasis induces appearance of neutral mucin positive metaplastic cells, which may further dedifferentiate to sialomucin containing dysplastic or neoplastic cells if the stimulation persists.

Cholelithiasis↗
PubMed2000

Cytohistological study of urinary bladder neoplasms.

Eighty patients presenting with painless hematuria and 24 patients of transitional cell carcinoma bladder coming for follow up were included in this study to assess the role of exfoliative (voided urine) and lavage (saline lavage) cytology in initial diagnosis and follow up of the patient with carcinoma bladder. Freshly voided urine samples and saline lavage bladder washing samples were collected. A thorough cystoscopic examination was done and biopsy was taken from any apparent growth. Cytological smears were stained with hematoxylene and eosin and PAP's stain, histology sections were stained with hematoxylene and eosin. A statistically significant correlation (p < 0.001) was observed between the increasing grade of malignancy and cytopositivity. A good association was observed between histology and two methods of cytology (p < 0.01). The sensitivity, specificity and overall diagnostic accuracy of lavage cytology was more as compared to exfoliative cytology (71.05%, 56.0%, 78.85% Vs 47.37%, 41.18% and 61.54%). Cystopositivity was more with single large sessile tumour as compared to multiple small pedunculated tumours. Cytohistological discrepancy was observed in patients of transitional cell carcinoma with recurrence. It is concluded that cytology may act as a good adjuvant to histology in picking up early flat lesions and/or follow up of patients with transitional cell carcinoma.

Carcinoma, Transitional Cell↗
PubMed2000

Clinical and ultrasonographic findings of carcinoma of gallbladder in Indian patients.

OBJECTIVE: To determine the clinical and ultrasound appearances of carcinoma gallbladder in Indian patients. METHODS: The study included all patients suspected to have gallbladder malignancy, attending the gastroenterology department from January 1989 to February 1997. These patients underwent ultrasonographic examination with a grey scale sector scanner (Aloka SSD-630) with a 3.5 MHz transducer after an overnight fast. Histological confirmation was done at surgery, by US guided fine needle aspiration cytology or by direct biopsy/aspiration of the palpable mass. RESULTS: There were a total of 92 cases of cytologically and histologically proven carcinoma of gallbladder. A distinct female preponderance was seen with a male:female ratio of 1:3.6. The mean +/- SD age was 47.9 +/- 19.6 years (range 25-75 years). The histological confirmation was done at surgery in 10% of patients, by US guided fine needle aspiration cytology in 50 cases (54%) or by direct biopsy/aspiration of the palpable mass in 33 (36%) of cases. Pain in the right hypochondrium was the commonest presenting symptom (91%) followed by anorexia (88%) and weight loss (67%). Surgical obstructive jaundice was observed in 54% cases while 10.9% presented with biliary sepsis. A mass of mixed echogenicity protruding in the lumen of the gallbladder was seen in the majority of cases (52.8%). Less commonly infiltration of the gallbladder wall (33.7%) or a mass replacing the gallbladder (14.1%) was encountered. Gallstones were associated in 57% of patients with gallbladder malignancy. The elevated stone sign and peripancreatic nodal spread were important clues for gallbladder malignancy. CONCLUSION: A high index of suspicion of gallbladder malignancy in elderly Indian female patients presenting with features of choletithiasis, and awareness of the ultrasound findings may lead to early diagnosis and radical resection of this highly lethal malignancy.

Adult↗
PubMed1999

Colonic tuberculosis: clinical features, endoscopic appearance and management.

BACKGROUND: Although rare in the West, colonic tuberculosis is not an uncommon disease in developing countries. However, the clinical manifestations and radiological appearance of the disease are non-specific. In recent years, colonoscopy has been found to be very useful in diagnosing patients with colonic tuberculosis. METHODS: Clinical features, colonoscopic findings, histology and response to treatment were recorded in 50 patients with colonic tuberculosis. RESULTS: Abdominal pain, fever, anorexia, weight loss and diarrhoea were the common symptoms. The colonoscopic features consisted of ulcers (92%), nodules (88%), deformed caecum and ileocecal valve (42%), strictures (25%), multiple fibrous bands (8%) and polypoid lesions (6%). Segmental tuberculosis and lesions simulating carcinoma were seen in 22 and 16% of patients, respectively. Histological examination of the colonic biopsy specimens showed well-formed, non-caseating granulomas in 18%, collection of loosely arranged epithelioid cells in 40% and chronic non-specific inflammatory changes in 42% of the patients. Six patients needed surgical intervention. The other 44 patients responded well to anti-tuberculous therapy and became asymptomatic. CONCLUSIONS: It is concluded that colonoscopy is a useful method for diagnosing colonic tuberculosis. It is suggested that if the clinical picture and colonoscopic appearance are suggestive of tuberculosis and target biopsies reveal non-caseating granulomas, a collection of loosely arranged epithelioid cells, or even non-specific changes, then a therapeutic trial of anti-tuberculous drugs should be given and continued if there is clinical improvement.

Adult↗
PubMed1999

Effect of esophageal variceal sclerotherapy on hemorrhoids, anorectal varices and portal colopathy.

BACKGROUND AND STUDY AIMS: Endoscopic sclerotherapy (EST) results in an increase in the prevalence of portal hypertensive gastropathy (PHG). However, the effects of sclerotherapy on hemorrhoids, anorectal or colonic varices and portal hypertensive colopathy are not known. The aim of this study was to investigate these effects. PATIENTS AND METHODS: A total of 39 patients with portal hypertension were studied. Upper gastrointestinal endoscopy and full-length colonoscopy were carried out before the patients underwent EST for esophageal varices, and after obliteration of the varices following sclerotherapy. RESULTS: The obliteration of esophageal varices by EST did not significantly affect the prevalence of hemorrhoids (32 % before and after), anorectal varices (45% before and after) or portal hypertensive colopathy (60.5 % before and 66 % after, P > 0.05). CONCLUSION: Obliteration of esophageal varices does not affect the prevalence of hemorrhoids, anorectal varices, or portal hypertensive colopathy.

Adult↗
PubMed1999

Decreased sensitivity of the ultrarapid urease test for diagnosing Helicobacter pylori in patients with chronic renal failure.

Fifty patients with chronic renal failure and 50 asymptomatic healthy volunteers were studied to determine the prevalence of Helicobacter pylori in the two groups and to compare the results of ultrarapid urease test (URUT) and gastric histology for detecting H. pylori infection. Four gastric antral biopsy specimens were taken. Two specimens were used for the URUT and two were processed routinely. Sections were stained with H&E and Loeffler's methylene blue. Histological examination showed presence of H. pylori in 56% of patients with chronic renal failure (CRF) and in 78% of the controls. The difference was statistically significant (p < 0.05). The URUT was positive in only 16% of patients with CRF compared to 74% in the controls (p < 0.0001). The sensitivity and overall diagnostic accuracy of the URUT to diagnose H. pylori infection were 94.8 and 96%, respectively, in controls but were only 29 and 60%, respectively, in patients with CRF. It is concluded that the prevalence of H. pylori is significantly less in patients with CRF and that the URUT is less sensitive than gastric histology for diagnosing H. pylori infection in these patients.

Adolescent↗
PubMed1999

Evaluation of the one-minute ultra-rapid urease test for diagnosing Helicobacter pylori.

To determine the diagnostic accuracy of the one-minute ultra-rapid urease test for diagnosing Helicobacter pylori infection, two biopsies were taken from both the gastric corpus and antrum from 1000 patients undergoing upper gastrointestinal endoscopy. All the biopsies were subjected to the one-minute ultra-rapid urease test before imprint smears were prepared from them. Thereafter, the biopsies were fixed in 10% formalin and histological sections were examined for the presence of H pylori by a pathologist who was not aware of the clinical details or the results of the urease test. The prevalence of H pylori in the gastric antrum and corpus was 86.7% and 53.3%, respectively. The sensitivity, specificity, positive and negative predictive value and the overall diagnostic accuracy of the ultra-rapid urease test to diagnose H pylori infection in the gastric antrum were 92%, 100%, 100%, 66%, and 93%, respectively. The corresponding figures for the gastric corpus were 83%, 100%, 100%, 85%, and 91%, respectively. It is concluded that the one-minute ultra-rapid urease test has a high sensitivity and specificity and may be used as a rapid and cheap method to diagnose H pylori infection.

Bacteriological Techniques↗
PubMed1999

Effect of a carbon dioxide laser on periodontally involved root surfaces.

BACKGROUND: The purpose of this in vitro study was to evaluate the effect of CO2 laser on the periodontally involved root surface, and to compare its efficacy with citric acid, EDTA and hydrogen peroxide in removal of root surface smear layer after root planing. METHODS: The study was conducted on 50 periodontally involved single rooted human teeth with poor prognosis. Immediately after extraction the teeth were scaled and root planed with Gracey curets; 50 specimens were obtained from the proximal side of each tooth which were assigned randomly to 1 of the 4 groups. Group A (35 specimens) was divided into 7 subgroups of 5 specimens each and irradiated with CO2 laser using a defocused mode at 3-watt power for 0.2, 0.4, 0.6, 0.8, 1.0, 1.2, or 1.4 seconds, respectively. Groups B, C, and D (5 specimens each) were treated with 6% hydrogen peroxide, EDTA solution (pH 7.4), or saturated citric acid solution (pH 1), respectively for 3 minutes. The specimens were then fixed and scanned using SEM. RESULTS: It was observed that surface smear layer was present on root surfaces of teeth that were root planed; the CO2 laser was not able to remove the smear layer on the sites that were irradiated for 0.2, 0.4 or 0.6 seconds at 3W power. Irradiation time of 0.8 seconds at 3W power was able to remove the smear layer, but the dentinal tubules were partially exposed. The surface irradiated for 1 second showed a flat appearance with many clear orifice of dentinal tubules. No change in diameter of exposed dentinal tubules was observed and their diameter was nearly equal that of normal dentinal tubules. Irradiation time of 1.2 and 1.4 seconds produced surface charring and carbonization and was totally ineffective in exposing the dentinal tubules; 6% hydrogen peroxide did not remove the smear layer completely and the exposed dentinal tubules orifice was not clear. EDTA (pH 7.4) and citric acid (pH 1) were found to be effective in removing the smear layer and exposing the dentinal tubules, which showed funnel shaped widening. CONCLUSIONS: Surface smear layer was present on root surfaces of teeth that were root planed. Laser irradiation of 1 second at 3W completely removed the smear layer with minimal change in the diameter of the dentinal tubules. EDTA and citric acid were also effective in removing smear layer, but the exposed dentinal tubules showed funnel-shaped widening.

Anti-Infective Agents, Local↗
PubMed1999

Testicular biopsy in infertility.

Eighty-eight infertile couples attended the infertility clinic. Semen analysis was abnormal in 64 cases. The cases were divided into 3 groups according to sperm count:Group I (count zero), group II (count < 20 million/ml) and group III (20-50 million/ml). The morphology of testicular biopsy categorised into 5 groups were normal--10(15.63%), hypospermatogenesis--42(65.63%), the Sertoli cell only syndrome--2(3.13%), maturation arrest--2(3.13%) and tubular hyalinization--8(12.50%). Quantitative analysis of biopsies was done using mean Johnson score(MJS) and Silber score(SS). The morphology in any single section was not uniform but of mixed type. Normal spermatogenesis in azoospermics indicated bilateral ductal obstruction. As compared to MJS, SS showed a more direct correlation between number of mature spermatids per tubular cross section and sperm count in unobstructed cases.

Biopsy↗
PubMed1999

HIV seroprevalence & awareness about AIDS among pregnant women in rural areas of Pune district, Maharashtra, India.

The present unlinked anonymous study was done among sexually active rural women to assess the extent of spread of HIV and its awareness. Peripheral blood samples were collected on filter paper strips from 1251 pregnant women residing in villages in three Primary Health Centres in Pune district of Maharashtra. Elutes were tested for HIV antibodies in two different ELISA systems. Awareness on HIV/AIDS was assessed using a structured questionnaire. Fifteen (1.2%) samples were detected to be HIV seropositive. HIV seroprevalence was significantly higher among villages situated close to highways (P < 0.025). Majority (> 95%) of the participating women were housewives. Although 70 per cent were aware of the existence of AIDS, only 33 per cent knew about all the main modes of HIV transmission. Their main sources of information on AIDS were health camps, health workers (70%) and television (45%). Awareness was associated with higher level of literacy (P < 0.001). Many women had misconceptions about the modes of spread of HIV. Greater emphasis needs to be placed on instituting long-term and sustainable strategies to create awareness among young couples with an emphasis on involvement of health workers in rural areas.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Bioreductive therapies: an overview of drugs and their mechanisms of action.

PURPOSE: Bioreductively activated drugs have been used as antimicrobials, chemotherapeutic agents, and radiation sensitizers. The present paper is an overview of their mechanism of action and application in the treatment of cancer. MATERIALS AND METHODS: Drugs such as nitroimidazoles, mitomycins, and benzotriazine di-N-oxides were a focus of this research. Studies have ranged from the chemistry of the reductive process of activation to in vitro and in vivo studies in rodent and human cells, through to clinical testing. The variety of techniques and test systems brought to bear on these compounds is a strength of this field of research. RESULTS: A detailed chemical understanding of the mechanism of action of a variety of bioreductives is now available. The enzymatic processes by which these drugs are activated and the cofactors involved in this activation are becoming well understood. Recent advances have been made in the design and use of dual-function bioreductives, bioreductive triggers of drug activation, and DNA-targeted bioreductives. Significant success has been demonstrated clinically with bioreductive drugs, used in combination with radiation and front-line chemotherapeutic agents. The areas of antibody-directed enzyme prodrug therapy (ADEPT) and gene-directed enzyme prodrug therapy (GDEPT) are identified as new directions for bioreductive therapy. CONCLUSION: The use of bioreductively-activated drugs for the treatment of cancer has made steady progress. The success obtained clinically and the new molecular approaches currently being implemented promise significant advances in the future.

Animals↗
PubMed1998

Diagnosing Helicobacter pylori by imprint cytology: can the same biopsy specimen be used for histology?

Imprint cytology of the gastric mucosa has been found to be very simple, inexpensive, and rapid for diagnosing Helicobacter pylori infection. However, there is a fear that preparing imprint smears may damage the biopsy specimen for subsequent histologic examination. This study was planned to investigate whether this damage happens. Four antral biopsy specimens were obtained from each of the 100 patients undergoing upper gastrointestinal endoscopy. Imprint smears were made from two biopsy specimens, which were then fixed in 10% formal saline and sent for histologic study. The third and fourth biopsy specimens were directed fixed in 10% formal saline for histologic examination. Two pathologists examined the imprint smears. Agreement between the two observers was observed in 97% of cases. Beyond-chance agreement was good with a kappa index of 0.90. H. pylori organisms were seen in 82% of biopsy specimens from which imprint smears were prepared and in the same percentage of biopsy specimens that were processed directly. The pathologists could not identify the histologic sections form which imprints were made. It is concluded that imprint cytology is an excellent method of diagnosing H. pylori infection and that preparing imprint smears does not alter the quality of the tissue. The same biopsy specimen can be used for histologic studies.

Cytodiagnosis↗