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R VC, C R, Sridhar P, Ramachandra C, Kumar M. Barriers related to Oral Cancer Screening, Diagnosis and Treatment in Karnataka, India. Gulf J Oncolog 2023; 1:19-24. [PMID: 37732523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2022] [Indexed: 09/22/2023]
Abstract
BACKGROUND The most predominant cancer in India is Oral cancer. Annually 130,000 people yield to oral cancer in India, which translates into about 14 deaths per hour and 60-80% of patients present with advanced disease as compared to 40% in developed countries. AIM To decide factors associated with primary, secondary and tertiary delays and identify reasons for a lack of follow-up. MATERIALS AND METHODS This study was conducted at the Kidwai Memorial Institute of Oncology, Bengaluru. A hospitalbased cross-sectional study using the direct personal interview method was done. A total of 200 oral cancer patients were included in the study. RESULTS 34.5% were men and 65.5% were women. About 97.5% of patients were engaged with either one of the habits like smoking, chewing or alcohol consumption. 84% of patients were not aware of the risk of getting oral cancer. 29% of people agreed that tobacco and alcohol are risk factors for oral cancer and they know about the signs of oral cancer. If detected early, cure rates were higher compared to illiterate people and this difference is statistically significant p< 0.05. 83.5% of patients did not know that oral cancer can be diagnosed early by regular screening of the oral cavity. The cost of staying near a Regional cancer centre, job security, and the social and economic burden on relatives were significant barriers to incomplete treatment and a decreased follow-up rate. CONCLUSION Low awareness is the main barrier to oral cancer detection. Conducting cancer awareness and screening camps frequently will detect oral cancers at an early stage. KEY WORDS Oral Cancer, Barriers, Cancer awareness, Oral Screening.
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Affiliation(s)
- Vijay C R
- Department of Epidemiology and Biostatistics, Kidwai Memorial Institute of Oncology, Bangalore-29
| | - Ramesh C
- Department of Epidemiology and Biostatistics, Kidwai Memorial Institute of Oncology, Bangalore-29
| | - P Sridhar
- Department of Radiation Oncology, Kidwai Memorial Institute of Oncology,Bangalore-29
| | - C Ramachandra
- Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bangalore-29
| | - Madhu Kumar
- Department of Epidemiology and Biostatistics, Kidwai Memorial Institute of Oncology, Bangalore-29
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Suresh GM, Yeshwanth R, Arjunan R, Ramachandra C, Altaf S. Who Needs Level III Lymph Node Dissection in Carcinoma Breast-Study from a Tertiary Care Center. Indian J Surg Oncol 2023; 14:324-330. [PMID: 37324309 PMCID: PMC10267033 DOI: 10.1007/s13193-020-01243-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 09/24/2020] [Indexed: 10/23/2022] Open
Abstract
In Indian females, breast cancer is the most common cancer with a late stage of presentation leading to one-third of patients undergoing modified radical mastectomy (MRM). Our study is undertaken to find out predictors of level III axillary lymph node metastasis in breast cancer and who needs complete axillary lymph node dissection (ALND). Retrospective study of 146 patients who undergone MRM or breast-conserving surgery (BCS) with complete ALND at Kidwai Memorial Institute of Oncology was done, and data was analyzed to find out the frequency of level III lymph nodes and the demographic relation and its relation to positive lymph nodes in level I + II. Positive metastatic level III lymph node was found in 6% of patients, with the median age of the patient in our study with level III positivity was 48.5 years with 63% pathological stage II with 88% perinodal spread (PNS)- and lymphovascular invasion (LVI)-positive. Involvement of level III lymph node was associated with gross disease in level I + II lymph node having more than four lymph node-positive and with pT3 stage or more which has higher chances of level III lymph node involvement. Level III lymph node involvement, though rare in early-stage breast cancer, is associated with larger clinical and pathological sizes (T3 or more), more than 4 lymph node-positive in level I + II and with PNS and LVI. Hence, based on these results, we recommend that for inpatient with more than 5-cm tumor size and those with the gross disease in axilla, complete ALND is recommended.
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Affiliation(s)
- Girish Mysore Suresh
- Department of surgical oncology, Kidwai Memorial Institute of Oncology (KMIO), Dr. MH Mariagowda road, Near Bangalore Dairy, Bengaluru, Karnataka 560029 India
| | - R. Yeshwanth
- Department of surgical oncology, Kidwai Memorial Institute of Oncology (KMIO), Dr. MH Mariagowda road, Near Bangalore Dairy, Bengaluru, Karnataka 560029 India
| | - Ravi Arjunan
- Department of surgical oncology, Kidwai Memorial Institute of Oncology (KMIO), Dr. MH Mariagowda road, Near Bangalore Dairy, Bengaluru, Karnataka 560029 India
| | - C. Ramachandra
- Department of surgical oncology, Kidwai Memorial Institute of Oncology (KMIO), Dr. MH Mariagowda road, Near Bangalore Dairy, Bengaluru, Karnataka 560029 India
| | - Syed Altaf
- Department of surgical oncology, Kidwai Memorial Institute of Oncology (KMIO), Dr. MH Mariagowda road, Near Bangalore Dairy, Bengaluru, Karnataka 560029 India
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Ramachandra C, Sugoor P, Karjol U, Arjunan R, Altaf S, Halkud R, Krishnappa R, Chavan P, Siddappa KT, Shetty R, Pallavi VR, Rathod P, Shobha K, Sabitha KS. Outcomes of Cancer Surgery During the COVID-19 Pandemic: Preparedness to Practising Continuous Cancer Care. Indian J Surg Oncol 2023; 14:440-444. [PMID: 33100778 PMCID: PMC7569097 DOI: 10.1007/s13193-020-01250-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 10/06/2020] [Indexed: 02/08/2023] Open
Abstract
The COVID-19 pandemic has placed unprecedented pressure on healthcare services. Deprioritisation of nonemergency clinical services and growing concerns of adverse outcomes of COVID-19 in cancer patients is having a deleterious impact across oncologic practice. We report cancer surgery outcomes taking into account the acuity of the COVID-19 situation. A prospectively maintained database of the Department of Surgical Oncology was analysed from 1st May to 30th June, 2020, to evaluate the perioperative outcomes, morbidity and mortality following major surgical procedures. A total of 359, preoperatively, tested negative for COVID-19 underwent surgery. Median age was 52 years with 26.7% (n = 96) above the age of 60 years. Sixty-one percent (n = 219) patients were American Society of Anaesthesiology grades II-III. As per surgical complexity grading, 36.8% (n = 132) cases were lower grades (I-III) and 63.2% (n = 227) were complex surgeries (IV-VI). 5.3% (n = 19) had ≥ grade III Clavien-Dindo complication, and the postoperative mortality rate was 0.27% (n = 1). Major complication rates in patients > 60 years were 9.3% in comparison to 4.1% in < 60 years (p = 0·63). The median hospital stay was 1-10 days across subspecialties. Postoperatively, repeat COVID 19 testing in 2 suspected patients were negative. Our study showed that after screening, triaging and prioritisation, asymptomatic cases may undergo cancer surgeries without increased morbidity during COVID-19 pandemic.
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Affiliation(s)
- C. Ramachandra
- Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, 560029 India
| | - Pavan Sugoor
- Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, 560029 India
| | - Uday Karjol
- Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, 560029 India
| | - Ravi Arjunan
- Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, 560029 India
| | - Syed Altaf
- Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, 560029 India
| | - Rajshekar Halkud
- Department of Head and Neck Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, 560029 India
| | - R. Krishnappa
- Department of Head and Neck Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, 560029 India
| | - Purushotham Chavan
- Department of Head and Neck Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, 560029 India
| | - K. T. Siddappa
- Department of Head and Neck Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, 560029 India
| | - Rathan Shetty
- Department of Head and Neck Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, 560029 India
| | - V. R. Pallavi
- Department of Gynec-oncology, Kidwai Memorial Institute of Oncology, Bengaluru, 560029 India
| | - Praveen Rathod
- Department of Gynec-oncology, Kidwai Memorial Institute of Oncology, Bengaluru, 560029 India
| | - K. Shobha
- Department of Gynec-oncology, Kidwai Memorial Institute of Oncology, Bengaluru, 560029 India
| | - K. S. Sabitha
- Department of Oral Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, 560029 India
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Bharadwa KR, Dasgupta K, Narayana SM, Ramachandra C, Babu SM, Rangarajan A, Kumar RV. PD-1 and PD-L1 Expression in Indian Women with Breast Cancer. Eur J Breast Health 2022; 18:21-29. [DOI: 10.4274/ejbh.galenos.2021.2021-5-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 08/14/2021] [Indexed: 12/24/2022]
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Somashekhar SP, Saklani A, Dixit J, Kothari J, Nayak S, Sudheer OV, Dabas S, Goud J, Munikrishnan V, Sugoor P, Penumadu P, Ramachandra C, Mehendale S, Dahiya A. Clinical Robotic Surgery Association (India Chapter) and Indian rectal cancer expert group’s practical consensus statements for surgical management of localized and locally advanced rectal cancer. Front Oncol 2022; 12:1002530. [PMID: 36267970 PMCID: PMC9577482 DOI: 10.3389/fonc.2022.1002530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 09/16/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction There are standard treatment guidelines for the surgical management of rectal cancer, that are advocated by recognized physician societies. But, owing to disparities in access and affordability of various treatment options, there remains an unmet need for personalizing these international guidelines to Indian settings. Methods Clinical Robotic Surgery Association (CRSA) set up the Indian rectal cancer expert group, with a pre-defined selection criterion and comprised of the leading surgical oncologists and gastrointestinal surgeons managing rectal cancer in India. Following the constitution of the expert Group, members identified three areas of focus and 12 clinical questions. A thorough review of the literature was performed, and the evidence was graded as per the levels of evidence by Oxford Centre for Evidence-Based Medicine. The consensus was built using the modified Delphi methodology of consensus development. A consensus statement was accepted only if ≥75% of the experts were in agreement. Results Using the results of the review of the literature and experts’ opinions; the expert group members drafted and agreed on the final consensus statements, and these were classified as “strong or weak”, based on the GRADE framework. Conclusion The expert group adapted international guidelines for the surgical management of localized and locally advanced rectal cancer to Indian settings. It will be vital to disseminate these to the wider surgical oncologists and gastrointestinal surgeons’ community in India.
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Affiliation(s)
- S. P. Somashekhar
- Department of Surgical Oncology, Manipal Hospital, Bengaluru, Karnataka, India
- *Correspondence: S. P. Somashekhar,
| | - Avanish Saklani
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Jagannath Dixit
- Department of GI Surgery, HCG Hospital, Bengaluru, Karnataka, India
| | - Jagdish Kothari
- Department of Surgical Oncology HCG Hospital, Ahmedabad, Gujarat, India
| | - Sandeep Nayak
- Department of Surgical Oncology, Fortis Hospital, Bengaluru, Karnataka, India
| | - O. V. Sudheer
- Department of GI Surgery and Surgical Oncology, Amrita Institute of Medical Science, Kochi, Kerala, India
| | - Surender Dabas
- Department of Surgical Oncology, BL Kapur-Max Superspeciality Hospital, Delhi, India
| | - Jagadishwar Goud
- Department of Surgical Oncology, AOI Hospital, Hyderabad, Telangana, India
| | | | - Pavan Sugoor
- Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | | | - C. Ramachandra
- Director and Head, Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - Shilpa Mehendale
- Director and Head, Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - Akhil Dahiya
- Department of Clinical and Medical Affairs, Intuitive Surgical, California, CA, United States
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Palled SR, Venugopal BK, Nihanthy DS, Khanum H, Vijay CR, Viswanath L, Ramachandra C. Clinical profile and outcomes in cervical cancer: An audit from a tertiary cancer center. Indian J Cancer 2022; 0:355615. [PMID: 36861703 DOI: 10.4103/ijc.ijc_211_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Background Carcinoma cervix contributes to a major proportion of cancer treatment in tertiary oncology centers. The outcomes are dependent on multiple factors. We conducted an audit to establish the pattern of treatment practiced for carcinoma cervix at the institute and suggest changes thereof to improve the quality of care. Methodology A retrospective observational study of 306 diagnosed cases of carcinoma cervix was carried out for the year 2010. Data was collected with regards to diagnosis, treatment, and follow-up. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) version 20. Results Out of 306 cases, 102 (33.33%) patients received only radiation therapy and 204 (66.66%) patients received concurrent chemotherapy. The most common chemotherapy used was weekly cisplatin 99 (48.52%), followed by weekly carboplatin 60 (29.41%) and three weekly cisplatin 45 (22.05%). Disease-free survival (DFS) at 5 years was 36.6% with patients of overall treatment time (OTT) of <8 weeks and >8 weeks showing DFS of 41.8% and 34% (P = 0.149), respectively. Overall survival (OS) was 34%. Concurrent chemoradiation improved overall survival by a median of 8 months (P = 0.035). There was a trend towards improved survival with three weekly cisplatin regimen, however, insignificant. Stage correlated with improved overall survival significantly with stage I and II showing 40% and stage III and IV showing 32% (P < 0.05) OS. Acute toxicity (grade I-III) was higher in the concurrent chemoradiation group (P < 0.05). Conclusion This audit was a first of its kind in the institute and threw light on the treatment and survival trends. It also revealed the number of patients lost to follow-up and prompted us to review the reasons for it. It has laid the foundation for future audits and recognized the importance of electronic medical records in the maintenance of data.
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Affiliation(s)
- Siddanna R Palled
- Department of Radiotherapy, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - Bindu K Venugopal
- Department of Radiotherapy, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - D S Nihanthy
- Department of Radiotherapy, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - Hashmath Khanum
- Department of Radiotherapy, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - C R Vijay
- Department of Statistics, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - Lokesh Viswanath
- Department of Radiotherapy, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - C Ramachandra
- Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
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Patil Okaly GV, Akshatha C, Sandhya N, Prakash A, Suma MN, Nargund A, Anand S, Ramachandra C, Cherian LB. Revisiting Metaplastic Carcinoma of Breast: An Emphasis on the Clinico-pathological and Immunohistochemical Variables Analyzed at a Tertiary Cancer Centre in South India. Iran J Pathol 2022; 17:268-274. [PMID: 36247506 PMCID: PMC9508532 DOI: 10.30699/ijp.2022.541798.2757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 07/11/2022] [Indexed: 11/18/2022]
Abstract
Background & Objective: Metaplastic carcinoma is a diverse variant of invasive breast carcinomas (IBC) characterized by dedifferentiation of malignant cells towards squamous and/or mesenchymal elements. It accounts for 0.3-1.2% of all IBC. These tumors are typically triple-negative by hormonal profiling with a high proliferation index and a dismal prognosis. Lymph node metastasis is an unusual feature in metaplastic carcinoma. Methods: The present study analyses 30 cases (26 cases of modified radical mastectomy and 4 cases of lumpectomy) of metaplastic carcinoma over 2018-2020 (3 years). Four oncopathologists reviewed routine histopathologic and immunohistochemical-stained slides. The clinical details were collected from the Medical Records Department of the Cancer Institute. Results: A total of 20 (66.67%) cases were patients >50 years of age, 21(70%) out of which were diagnosed as invasive carcinoma, grade 3 according to the Nottingham histological score. Five (16.7%) cases presented with lymph node metastasis. While immunohistochemically 28 (93.3%) cases were triple-negativeCK5/6, P63, EGFR, and Ki-67 (more than 40%) positivity was noted in 25 (83.3%) , 26 (86,7%) , 20 (66.7%), and 25 (83.3%) cases, respectively. Conclusion: Metaplastic carcinoma is characteristically triple-negative breast malignancies (TNBC) exhibiting a high Ki-67 index and a lower rate of lymph node metastasis. CK5/6, p63, and EGFR are pertinent immunohistochemical markers that may aid in diagnosis. However, those markers are non-specific for the disease and morphologic features are always the key to diagnosis of the process.
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Affiliation(s)
- Geetha V Patil Okaly
- Department of Pathology, Kidwai Memorial Institute of Oncology, Bangalore, India
| | - C Akshatha
- Department of Pathology, Kidwai Memorial Institute of Oncology, Bangalore, India
| | - N Sandhya
- Department of Pathology, Kidwai Memorial Institute of Oncology, Bangalore, India
| | - Akina Prakash
- Department of Pathology, Kidwai Memorial Institute of Oncology, Bangalore, India
| | - M N Suma
- Department of Pathology, Kidwai Memorial Institute of Oncology, Bangalore, India
| | - Ashwini Nargund
- Department of Pathology, Kidwai Memorial Institute of Oncology, Bangalore, India
| | - Shankar Anand
- Department of Pathology, Kidwai Memorial Institute of Oncology, Bangalore, India
| | - C Ramachandra
- Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, India
| | - Libin Babu Cherian
- Department of Pathology, Kidwai Memorial Institute of Oncology, Bangalore, India
- Corresponding Information: Libin Babu Cherian, Department of Pathology, Kidwai Memorial Institute of Oncology, Bangalore, India
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Crespo-Avilan G, Hernandez-Resendiz S, Ramachandra C, Liehn E, Preissner K, Hausenloy D. Mitochondrial division inhibitor 1 (mdivi-1) as a potential pharmacological strategy to prevent vascular restenosis. Cardiovasc Res 2022. [DOI: 10.1093/cvr/cvac066.198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Singapore National Medical Research Council
Background
New treatments are needed to prevent post-angioplasty and stent restenosis in coronary artery disease (CAD) and peripheral arterial disease (PAD) patients. Accumulated findings have shown that mitochondrial dysfunction is involved in the pathophysiology mechanisms underlying several cardiovascular conditions, however, in the scenario of vascular remodelling after injury, the role of mitochondrial dynamics is not completely understood.
Purpose
In this study, we investigate the effect of mdivi-1 on neointimal hyperplasia and plaque development in a wire-induced endothelial injury animal model.
Methods
Using ApoE-/- mice on a background of hyperlipidaemia, we investigated weather in vivo administration of mdivi-1 (1.2mg/kg/d) could reduce atherosclerotic plaque volume, plaque complexity and inflammation in a carotid-wire injury model of neointimal hyperplasia. Also, THP-1 monocytes (T-M) and THP-1-derived Macrophages (T-DM) were stimulated in vitro with LPS + IFN-gamma to induce M1 polarization and then subjected to gene expression and protein analysis in the presence or absence of mdivi-1 (50µM). Transmigration and 3D chemotaxis assays were performed in T-M cells and Human peripheral blood monocytes, to evaluate the effect of mdivi-1 on cell migration in response to M-CSF and MCP-1. Finally, we investigated the effects of Mdivi-1 on mitochondrial respiration using Seahorse assay in T-M and T-DM.
Results
In vivo treatment with mdivi-1 reduced neointimal hyperplasia by 37% when compared to control, and was associated with a significant decrease of vascular smooth muscle cells and macrophages cell numbers, as well as reduction of the pro-inflammatory mediators TNF-α and ICAM-1 in the plaque. In vitro M1 polarization of T-M and T-DM induced both up-regulation and production of pro-inflammatory mediators and mdivi-1 significantly suppressed this effects. In addition, monocyte chemotaxis response to M-CSF and MCP-1 was significantly reduced in the presence of mdivi-1. Lastly, mdivi-1 reduced oxygen consumption rate in T-M and T-DM, and prevented M1-cell polarization.
Conclusions
We show that mdivi-1 significantly reduces vessel wall thickness, neointimal hyperplasia, monocyte recruitment, and inflammation after vascular endothelial injury, positioning Mdivi-1 as a potential pharmacological strategy to reduce restenosis following angioplasty and stenting in CAD and PAD patients.
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Affiliation(s)
- G Crespo-Avilan
- Duke-NUS Graduate Medical School Singapore, Cardiovascular and Metabolic Disorders , Singapore , Singapore
| | - S Hernandez-Resendiz
- Duke-NUS Graduate Medical School Singapore, Cardiovascular and Metabolic Disorders , Singapore , Singapore
| | - C Ramachandra
- National Heart Centre Singapore, NHRIS , Singapore , Singapore
| | - E Liehn
- University of Southern Denmark , Odense , Denmark
| | - K Preissner
- Justus-Liebig University of Giessen, Department of Biochemistry , Giessen , Germany
| | - D Hausenloy
- Duke-NUS Graduate Medical School Singapore, Cardiovascular and Metabolic Disorders , Singapore , Singapore
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Kanthaje A, Amirtham U, Babu MCS, Maregowda S, Adiga P, Ramachandra C. Penile Ulcer as the Unusual Initial Presentation of Nasal NK/T Cell Lymphoma. Journal of Health and Allied Sciences NU 2022. [DOI: 10.1055/s-0042-1744440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AbstractExtranodal natural killer (NK)/T cell lymphoma is a highly aggressive non-Hodgkin lymphoma that predominantly affects the upper aerodigestive tract. The nasal type accounts for ∼80% of cases of NK/T cell lymphomas. In advanced stages, the disease can disseminate to various sites such as skin, testis, eyes, gastrointestinal tract, and soft tissue. NK/T cell lymphoma presenting as lesion in penis is extremely rare. While reviewing the published literature, we found only three reported cases of NK/T cell lymphoma involving the penis. Among them, none was primary NK/T cell lymphoma of penis. We report a 60-year-old NK/T cell lymphoma patient who presented with destructive penile ulcer as the initial presenting symptom, who subsequently was found to have a nasal mass also with features of NK/T cell lymphoma. He underwent partial penectomy elsewhere and chemotherapy with steroid, methotrexate, ifosfamide, L-asparaginase, and etoposide protocol was given.
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Affiliation(s)
- Apoorva Kanthaje
- Department of Pathology, KS Hegde Medical Academy, Mangaluru, Karnataka, India
| | - Usha Amirtham
- Department of Pathology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - M. C. Suresh Babu
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | | | - Pramod Adiga
- Department of Urology, Institute of Nephrology, Bengaluru, Karnataka, India
| | - C. Ramachandra
- Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
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Shanthala S, Kavitha BL, Kumari P, Vijay C, Lokanatha D, Appaji L, Babu G, Premalata CS, Ramachandra C. Erratum to: A Retrospective Observational Study of Dicentric (9;12): A Unique, Nonrandom Translocation Defining a Cytogenetic Subgroup with Favorable Outcome in Acute Lymphoblastic Leukemia. Indian J Med Paediatr Oncol 2022. [DOI: 10.1055/s-0042-1743292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- S. Shanthala
- Cytogenetics Unit-Department of Pathology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - B. L. Kavitha
- Cytogenetics Unit-Department of Pathology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - Prasanna Kumari
- Cytogenetics Unit-Department of Pathology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - C.R. Vijay
- Department of Biostatistics, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - D. Lokanatha
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - L. Appaji
- Department of Pediatric Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - Govind Babu
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - C. S. Premalata
- Department of Pathology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - C. Ramachandra
- Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
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Shanthala S, Kavitha BL, Kumari P, Vijay C, Lokanatha D, Appaji L, Babu G, Premalata CS, Ramachandra C. A Retrospective Observational Study of Dicentric (9;12): A Unique, Nonrandom Translocation Defining a Cytogenetic Subgroup with Favorable Outcome in Acute Lymphoblastic Leukemia. Indian J Med Paediatr Oncol 2021. [DOI: 10.1055/s-0041-1732859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Abstract
Introduction Cytogenetic abnormalities are integral to the risk stratification of acute lymphoblastic leukemia (ALL).
Objectives The present study aimed to highlight a rare, yet nonrandom cytogenetic abnormality notably dicentric (9;12), which was observed in ALL patients who presented to our institute. The study analyzed the frequency, clinicohematological features, and treatment response of these patients.
Materials and Methods A single-group observational study was conducted from April 2014 to April 2020. Cytogenetic analysis was done on bone marrow aspirate samples of the patients referred to the cytogenetics laboratory with clinical diagnosis of acute leukemia. Cytogenetic, clinical, and hematological data were collected from respective departmental records, case files, and patients.
Results Dic(9;12) was identified in 1.2% of ALL (19 out of 1,544 patients). They showed striking preponderance in teen and young adult males with characteristic precursor B cell immunophenotype. Majority of these patients displayed favorable risk profiles such as low total count, mild lymphadenopathy and splenomegaly, mild-to-moderate elevation of lactate dehydrogenase, and good response to first induction chemotherapy. Rare coexistence of dic(9;12) with well-established cytogenetic markers such as t(9;22) and t(1;19) was observed.
Conclusion Dic(9;12) is one of the most specific cytogenetic markers of precursor B cell (pre-B) ALL. It defines a subgroup with favorable clinical and biological profile. We suggest inclusion of dic(9;12) in cytogenetic risk stratification of precursor B cell ALL. Long-term follow-up studies are recommended to establish the prognostic significance of this cytogenetic subgroup, which may benefit from less intensive chemotherapy.
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Affiliation(s)
- S. Shanthala
- Cytogenetics Unit-Department of Pathology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - B. L. Kavitha
- Cytogenetics Unit-Department of Pathology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - Prasanna Kumari
- Cytogenetics Unit-Department of Pathology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - C.R. Vijay
- Department of Biostatistics, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - D. Lokanatha
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - L. Appaji
- Department of Pediatric Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - Govind Babu
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - C. S. Premalata
- Department of Pathology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - C. Ramachandra
- Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
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Viswanathan A, Kumar A, Kaushik PS, Thumallapalli A, Ramachandra C, Aruna Kumari BS, Appaji L, Kumar N. Administration and Toxicity Profile of the Capizzi Interim Maintenance—Retrospective Study from a Tertiary Care Cancer Centre. Indian J Med Paediatr Oncol 2021. [DOI: 10.1055/s-0041-1740442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Abstract
Introduction The Capizzi-style methotrexate (MTX) is an integral part of acute lymphoblastic leukemia (ALL) treatment. The escalating dose of MTX originally used in the United Kingdom and Children’s Oncology Group protocols along with L-asparaginase has been modified in the Indian Childhood Collaborative Leukemia (ICiCLe) group protocol where L-asparaginase has been omitted. The data regarding the incidence of toxicities and ease of administration on the Capizzi-style interim maintenance is not robust.
Objectives We have compiled our experience with administration and toxicity profile in children with intermediate-risk ALL.
Materials and Methods A retrospective data collection of all children diagnosed with intermediate-risk ALL as per the ICiCLe risk stratification in the year 2019 was included in the analysis. Each cycle of MTX was started after ensuring an absolute neutrophil count of >750/mm3 and transaminases <2 upper limit of normal. As a unit protocol, pre- and post-MTX hydration was administered in all our children. No urine pH or midcycle biochemical parameter monitoring was done. Statistical analysis was done using Microsoft Excel and SPSS version 24 IBM Corp. in Armonk, New York, United States.
Results Forty-six children were included in the study. The median age of children in our study was 6 years (range: 1 year 2 months–12 years). Undernutrition was associated with a significant increase in toxicity (p = 0.02). Fifty-two percent of children had evidence of toxicity, elevated transaminases being the most common. There were recurring symptoms resulting in 53 episodes of toxicities overall. Incidence of toxicity was more in the early cycles (<3).
Conclusion The pre- and post-MTX hydration is an effective way to reduce toxicities with the Capizzi-style MTX and this course can be administered with ease on outpatient basis with minimal need for monitoring or admission.
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Affiliation(s)
- Aarthi Viswanathan
- Department of Pediatric Oncology, Kidwai Memorial Institute of Oncology, D.H. Marigowda Road, Bengaluru, Karnataka, India
| | - Arun Kumar
- Department of Pediatric Oncology, Kidwai Memorial Institute of Oncology, D.H. Marigowda Road, Bengaluru, Karnataka, India
| | - Prakruthi S. Kaushik
- Department of Pediatric Oncology, Kidwai Memorial Institute of Oncology, D.H. Marigowda Road, Bengaluru, Karnataka, India
| | - Avinash Thumallapalli
- Department of Pediatric Oncology, Kidwai Memorial Institute of Oncology, D.H. Marigowda Road, Bengaluru, Karnataka, India
| | - C. Ramachandra
- Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, D.H. Marigowda Road, Bengaluru, Karnataka, India
| | - B. S. Aruna Kumari
- Department of Pediatric Oncology, Kidwai Memorial Institute of Oncology, D.H. Marigowda Road, Bengaluru, Karnataka, India
| | - Lingappa Appaji
- Department of Pediatric Oncology, Kidwai Memorial Institute of Oncology, D.H. Marigowda Road, Bengaluru, Karnataka, India
| | - Nuthan Kumar
- Department of Pediatric Oncology, Kidwai Memorial Institute of Oncology, D.H. Marigowda Road, Bengaluru, Karnataka, India
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Nargund A, Mohan RH, Pai MM, Sadasivan B, Dharmalingam P, Chennagiri P, Ramachandra C. Demystifying Breast FNAC’s Based on the International Academy of Cytology, Yokohama Breast Cytopathology System- A Retrospective Study. J Clin Diagn Res 2021. [DOI: 10.7860/jcdr/2021/45366.14606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Introduction: Breast cancer affects 2.1 million women each year and is the most common cancer among females, followed by lung, colorectum, uterus, and cervix. Breast cancer accounted for 6,26,679 (6.6%) deaths in 2018. Breast cancer incidence is on the rise in every part of the globe, including developed countries. Fine Needle Aspiration Cytology (FNAC) shows high sensitivity, specificity, and accuracy in evaluation of breast lesions. FNAC is part of the triple test and is the gold standard for assessment. The new reporting system for breast FNAC, proposed by the International Academy of Cytology (IAC) Yokohama Breast Cytopathology System, has standardised the reporting system to categorise breast lesions and as unmasked the diagnostic dilemma faced by reporting cytopathologist. Aim: The study aimed to categorise the samples according to IAC Yokohama Breast Cytopathology System and assess the Risk of Malignancy (ROM) for each category and increase the diagnostic yield of breast FNAC. Materials and Methods: A retrospective cohort study included 1,467 breast FNAC cases, which were retrieved and reclassified based on the newly proposed IAC Yokohama System into five categories during January 2017-December 2018 in Kidwai Memorial Institute of Oncology (KMIO), Bangalore. Histopathology correlation was done, and the Risk of Malignancy (ROM) was assessed whenever possible. The study results were analysed using Microsoft excel 2007, sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV), and accuracy ratios were calculated using the MedCalc diagnostic test evaluation calculator, keeping histologic diagnosis as the gold standard. Results: Re-categorisation of 1,467 cases was done according to the Yokohama breast cytopathology system as insufficient material, benign, atypical, suspicious for malignancy, and malignant. The histopathology diagnosis was available in 1,069 cases. The respective ROM for each category was, 7.6% for category 1 (Insufficient), 15.26% for category 2 (Benign), 65.38% for category 3 (Atypical), 83.33% for category 4 (Suspicious) and 99.18% for category 5 (Malignant). Considering malignant cases as positive, sensitivity-86.75%, specificity-97.32%, PPV-99.19%, NPV-66.06% and accuracy of 88.96% was deduced. Conclusion: It is recommended to incorporate the IAC Yokohama system to categorise breast cytopathology with uniform terminologies. This will help diagnose breast lesions more consistently and accurately, which in turn helps the clinician manage the disease and predict the ROM and the patient outcome.
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Ramachandra C, Sugoor P, Karjol U, Arjunan R, Altaf S, Patil V, Kumar H, Beesanna G, Abhishek M. Robotic Complete Mesocolic Excision with Central Vascular Ligation for Right Colon Cancer: Surgical Technique and Short-term Outcomes. Indian J Surg Oncol 2020; 11:674-683. [PMID: 33281407 PMCID: PMC7714811 DOI: 10.1007/s13193-020-01181-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 07/17/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Minimally invasive colorectal surgery has demonstrated to have the same oncological results as open surgery, with better clinical outcomes. Robotic assistance is an evolution of minimally invasive technique. PURPOSE The study aims to present technical details and short-term oncological outcomes of robotic-assisted complete mesocolic excision (CME) with central vascular ligation (CVL) for right colon cancer. METHODOLOGY Fifty-two consecutive patients affected by right colon cancer were operated between May 2016 and February 2020 with da Vinci Xi platform. Data regarding surgical and short-term oncological outcomes were systematically collected in a colorectal specific database for statistical analysis. RESULTS Thirty-seven (71.15%) and 15 (28.85%) patients underwent right and extended right hemicoletomy with an extracorporeal anastomosis. Median age was 55 years. Mean operative time was 182 ± 36 min. Mean blood loss was 110 ± 90 ml. Conversion rate was 3.84% (two cases). 78.84% (41 cases) were pT3 and mean number of harvested lymph nodes was 28 ± 4. 1/52 (1.92%) had a documented anastomotic leak requiring exploratory laparotomy and diversion proximal ileostomy. Surgery-related grade IIIa-IIIb Calvien Dindo morbidity were noted in 9.61% and 1.92%, respectively. CONCLUSION Robotic assistance allows performance of oncological adequate dissection of the right colon with radical lymphadenectomy as in open surgery, confirming the safety and oncological adequacy of this technique, with acceptable results and short-term outcomes.
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Affiliation(s)
- C. Ramachandra
- Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka India
| | - Pavan Sugoor
- Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka India
| | - Uday Karjol
- Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka India
| | - Ravi Arjunan
- Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka India
| | - Syed Altaf
- Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka India
| | - Vijay Patil
- Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka India
| | - Harish Kumar
- Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka India
| | - G. Beesanna
- Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka India
| | - M. Abhishek
- Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka India
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Girish S, Arjunan R, Ramachandra C, Altaf S. Mean Platelet Volume (MPV) is it a new prognostic marker in resectable carcinoma stomach? Ann Oncol 2019. [DOI: 10.1093/annonc/mdz422.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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16
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Suresh GM, Ramachandra C, Arjunan R, Halkud R. CLO19-049: Central Lymph Node Dissection in the Clinically Node-Negative (cN0) Papillary Thyroid Carcinoma: Is it Necessary? J Natl Compr Canc Netw 2019. [DOI: 10.6004/jnccn.2018.7143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Surgery is the treatment of choice in papillary thyroid cancer (PTC), which is the most common thyroid malignancy and frequently has metastases in the central compartment lymph nodes (CLN). There is debate among surgeons whether removing normal-appearing lymph nodes in the central neck (prophylactic lymph node dissection) is better than removing only the abnormal-appearing lymph nodes. Herein, we review the potential utility of central compartment lymph nodal dissection (CLND) on surgical outcome and disease-free follow-up of PTC and 5-year survival of patients operated on at our center. Methods: A total of 246 patients from February 2009 to March 2012 who were treated for PTC in our Kidwai Cancer Institution was analyzed retrospectively. 135 patients who underwent total thyroidectomy and CLND were assigned to Group A, which was compared with 111 patients who received total thyroidectomy, without CLND, who were assigned to Group B by evaluation of postoperative complications (recurrent laryngeal nerve damage, hoarseness, hypocalcemia, and hemorrhage rates) and recurrence at the time of Iodine131 treatment and subsequently at 60 months follow-up. Results: In the present study, Mean DFS and OS did not differ in both groups. Male gender and age more than 45 years had statistically significant DFS but without any impact on OS. There was a significant postoperative complication in group A compared to group B (P≤.001), with a very minimal recurrence in the central neck. 4 patients (3.6%) had recurrences in CLN. Conclusion: Considering the significant postoperative complication, which outweighs benefit, we conclude that for cN0 PTC, routine CLND is not necessary.
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Affiliation(s)
| | | | - Ravi Arjunan
- Kidwai Memorial Institute of Oncology, Bengaluru, India
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Avinash T, Appaji L, Ramachandra C, Ramesh C, Prabha S, Chandran R. Road map to good quality childhood anti cancer procurement policy and mechanism of reporting of suspected sub-standard drugs. Pediatric Hematology Oncology Journal 2019. [DOI: 10.1016/j.phoj.2019.08.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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18
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Ramachandra C, Vikas S, Krishnamurthy S, Ramesh S, Appaji L, Kumar RV. Extended Right Hepatectomy by Liver Hanging Maneuver in an Infant with Hepatoblastoma. Indian J Surg Oncol 2017; 8:411-413. [DOI: 10.1007/s13193-016-0555-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Accepted: 08/30/2016] [Indexed: 10/20/2022] Open
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19
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Prahalada GD, Shivakumar N, Lohithaswa HC, Sidde Gowda DK, Ramkumar G, Kim SR, Ramachandra C, Hittalmani S, Mohapatra T, Jena KK. Identification and fine mapping of a new gene, BPH31 conferring resistance to brown planthopper biotype 4 of India to improve rice, Oryza sativa L. Rice (N Y) 2017; 10:41. [PMID: 28861736 PMCID: PMC5578944 DOI: 10.1186/s12284-017-0178-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 08/11/2017] [Indexed: 05/19/2023]
Abstract
BACKGROUND Rice (Oryza sativa L.) is the staple food for more than 3.5 billion people, mainly in Asia. Brown planthopper (BPH) is one of the most destructive insect pests of rice that limits rice production. Host-plant resistance is one of the most efficient ways to overcome BPH damage to the rice crop. RESULTS BPH bioassay studies from 2009 to 2015 conducted in India and at the International Rice Research Institute (IRRI), Philippines, revealed that the cultivar CR2711-76 developed at the National Rice Research Institute (NRRI), Cuttack, India, showed stable and broad-spectrum resistance to several BPH populations of the Philippines and BPH biotype 4 of India. Genetic analysis and fine mapping confirmed the presence of a single dominant gene, BPH31, in CR2711-76 conferring BPH resistance. The BPH31 gene was located on the long arm of chromosome 3 within an interval of 475 kb between the markers PA26 and RM2334. Bioassay analysis of the BPH31 gene in CR2711-76 was carried out against BPH populations of the Philippines. The results from bioassay revealed that CR2711-76 possesses three different mechanisms of resistance: antibiosis, antixenosis, and tolerance. The effectiveness of flanking markers was tested in a segregating population and the InDel type markers PA26 and RM2334 showed high co-segregation with the resistance phenotype. Foreground and background analysis by tightly linked markers as well as using the Infinium 6 K SNP chip respectively were applied for transferring the BPH31 gene into an indica variety, Jaya. The improved BPH31-derived Jaya lines showed strong resistance to BPH biotypes of India and the Philippines. CONCLUSION The new BPH31 gene can be used in BPH resistance breeding programs on the Indian subcontinent. The tightly linked DNA markers identified in the study have proved their effectiveness and can be utilized in BPH resistance breeding in rice.
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Affiliation(s)
- G. D. Prahalada
- Plant Breeding Division, International Rice Research Institute, DAPO Box 7777, Metro Manila, Philippines
| | - N. Shivakumar
- Zonal Agricultural Research Station, VC Farm, Mandya, Karnataka India
| | | | | | - G. Ramkumar
- Plant Breeding Division, International Rice Research Institute, DAPO Box 7777, Metro Manila, Philippines
| | - Sung-Ryul Kim
- Plant Breeding Division, International Rice Research Institute, DAPO Box 7777, Metro Manila, Philippines
| | - C. Ramachandra
- Zonal Agricultural Research Station, VC Farm, Mandya, Karnataka India
| | | | | | - Kshirod K. Jena
- Plant Breeding Division, International Rice Research Institute, DAPO Box 7777, Metro Manila, Philippines
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Mura M, Mehta A, Ramachandra C, Pisano F, Ciuffreda M, Crotti L, Schwartz P, Shim W, Gnecchi M. The KCNH2-IVS9-28A/G mutation causes aberrant isoform expression and hERG trafficking defect in cardiomyocytes derived from patients affected by long QT syndrome type 2. Cytotherapy 2017. [DOI: 10.1016/j.jcyt.2017.02.265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Dev K, Gurawalia J, Krishnamurthy S, Kumar V, Ramachandra C. Role of lateral lymph node dissection in improving survival in low rectal cancer. A single institute, prospective study. Eur J Cancer 2017. [DOI: 10.1016/s0959-8049(17)30293-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Dev K, Veerendrakumar K, Krishnamurthy S, Ramachandra C. 96. Role of lateral pelvic lymph node dissection in improving survival in low rectal cancer. Eur J Surg Oncol 2016. [DOI: 10.1016/j.ejso.2016.06.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Mehta A, Ramachandra C, Mura M, Crotti L, Schwartz P, Gnecchi M, Shim W. Symptomatic and Asymptomatic Discrimination by Single Nucleotide Polymorphisms in LQTS2 Patients: A DNA-Based Patient Stratification. Cytotherapy 2016. [DOI: 10.1016/j.jcyt.2016.03.279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
Constitutional mismatch repair deficiency syndrome is a rare autosomal recessive syndrome caused by homozygous mutations in mismatch repair genes. This is characterized by the childhood onset of brain tumors, colorectal cancers, cutaneous manifestations of neurofibromatosis-1 like café au lait spots, hematological malignancies, and occasionally other rare malignancies. Here, we would like to present a family in which the sibling had glioblastoma, and the present case had acute lymphoblastic lymphoma and colorectal cancer. We would like to present this case because of its rarity and would add to literature.
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Affiliation(s)
- C Ramachandra
- Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - Vasu Reddy Challa
- Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - Rachan Shetty
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
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Ramachandra C, Mel B. Natural image statistics based population coding for local edge probability. J Vis 2012. [DOI: 10.1167/12.9.846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Kwon M, Ramachandra C, Mel BW, Tjan BS. Contour enhancement benefits peripheral vision task for older adults. J Vis 2012. [DOI: 10.1167/12.9.94] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Manjunath S, Ramachandra C, Murthy V, Murthy PS, Prabhakaran PS, Attili VSS. Surgical resection for locally invasive renal cell carcinoma: Is it worthwhile? Indian J Urol 2011; 23:246-9. [PMID: 19718323 PMCID: PMC2721599 DOI: 10.4103/0970-1591.33444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Many patients with renal cell carcinoma (RCC) present with disease involving the adjacent viscera. Although survival in such patients is poor, surgery remains the only proven modality of treatment. We describe our experience with radical nephrectomy for locally invasive RCC over a five-year period. STUDY DESIGN A retrospective analysis of the records of all patients who had undergone surgery for locally invasive RCC between January 1999 and December 2004 at our institute. MATERIALS AND METHODS During the study period, 102 patients with RCC underwent surgery at our institute, out of which 18 (17.6%) patients had adjacent organ involvement. The survival and outcomes in terms of symptom relief are described. STATISTICAL ANALYSIS The survival rates were calculated by the Kaplan-Meier method using EGRET statistical software package. RESULTS Of the 18 patients, two patients had inoperable disease. Fifteen out of the 18 patients succumbed to their disease after a median period of 7.5 months. Three patients are still alive, having survived for 13, 16 and 25 months. Most patients derived considerable benefit with respect to relief of symptoms, which was long-lasting. CONCLUSION For selected patients with locally invasive RCC, radical nephrectomy with en bloc resection of involved organs may provide the opportunity for long-term survival. In others, it may provide considerable symptomatic relief.
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Affiliation(s)
- Suraj Manjunath
- Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Karnataka, India
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Abstract
Colorectal cancers have potential for lymphatic and hematogenous metastases. Surgery is the definitive treatment, but the prognosis can be improved with the addition of chemotherapy, radiotherapy or both. However, the incidence of recurrence, both local and distant, remains significant. Distant metastases occur most often in the liver and lung; however, metastases to bone, adrenals, lymph nodes, brain, skin and the oral region have been reported. Metastases to the oral region are uncommon and may occur in the oral soft tissues or jaw bones. The prognosis in such patients is usually very poor. We report a case of colorectal carcinoma with metastasis to the floor of the mouth. This is probably the first reported case of metastasis to the floor of the mouth in a patient with colorectal cancer.
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Affiliation(s)
- Tejinder Singh
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, India
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Ramachandra C, Mel B. Distance dependent contextual interactions in natural images. J Vis 2010. [DOI: 10.1167/10.7.1356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Singh T, Premalatha CS, Satheesh CT, Lakshmaiah KC, Suresh TM, Babu KG, Ramachandra C. Rectal carcinoma metastasizing to the breast: a case report and review of literature. J Cancer Res Ther 2010; 5:321-3. [PMID: 20160374 DOI: 10.4103/0973-1482.59904] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Extramammary breast metastases (from non-breast primaries) are rare, constituting only about 2% of all breast metastases, although autopsy studies show that it may occur in up to 6% of cases. Lymphoma, metastatic melanoma, and bronchial carcinoma are the malignancies that account for the majority of breast metastases. Breast metastases from a colorectal carcinoma have been described in only a small number of cases in the literature. We present a case of a 42-year-old woman with an incidental finding of a breast lump. She had a history of Dukes C rectal carcinoma for which she had undergone an anterior resection 11 months earlier. The breast deposit was the first clinical indication of relapse. The patient subsequently developed liver and brain metastases and deteriorated rapidly; she died 2 months after presenting with the breast mass.
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Affiliation(s)
- Tejinder Singh
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore-560 030, India
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Ramachandra C, Behabadi B, Jain R, Mel B. Optimal "multiplicative" interactions between local and long-range contour cues: Where natural image statistics meets single neuron computation. J Vis 2010. [DOI: 10.1167/9.8.1050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Attili VSS, Babu KG, Lokanatha D, Bapsy PP, Ramachandra C, Rajshekar H. Bone metastasis in hepatocellular carcinoma: need for reappraisal of treatment. J Cancer Res Ther 2008; 4:93-4. [PMID: 18688127 DOI: 10.4103/0973-1482.42257] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Bone is an uncommon site of metastasis in patients with hepatocellular carcinoma (HCC), and often overlooked. We report two cases that had isolated bone metastasis; one of them had prolonged disease-free survival. The present series, along with the literature review, reinforces the idea that HCC should be considered in the differential diagnoses in patients presenting with metastases in bone. The presence of isolated bone metastases need not necessarily indicate poor prognosis, and all such patients need to be offered chemotherapy and at least one of the bone-directed therapies (either local radiation in cases of localized disease or bisphosphonates in the presence of extensive disease) as they may have a better outcome with therapy.
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Affiliation(s)
- V Satya Suresh Attili
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Dr. M.H. Marigowda Road, Bangalore-560029, India.
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Chandy S, Sadananda Adiga MN, Ramaswamy G, Ramachandra C, Krishnamoorthy L. Effect of Vitamin B(12) and Folate on Homocysteine levels in colorectal cancer. Indian J Clin Biochem 2008; 23:258-61. [PMID: 23105766 DOI: 10.1007/s12291-008-0058-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Folate and cobalamin (Vitamin B(12)) are two essential micronutrients involved in one-carbon metabolism, which affects heart disease, neural tube defects and cancer. Methylenetetrahydrofolate reductase, the key enzyme involved in one carbon metabolism produces methyl tetrahydrofolate from methylene tetrahydrofolate, which in turn donates methyl group to homocysteine to generate methionine. There exist two common low function polymorphic variants of the methylenetetrahydrofolate reductase gene involving nucleotides 677 C→T and 1298 A→C, which are associated with hyperhomocysteinemia. These polymorphisms are also linked with increased risk for certain cancers such as breast cancer and at the same time providing a protective effect on colorectal cancer. In this case control study, we have evaluated levels of folic acid, vitamin B(12) and homocysteine in patients with colorectal cancer. Folate and homocysteine levels did not differ significantly between the two groups; however an increasing trend was noticed with increase in homocysteine levels. Vitamin B(12) levels were increased in cases compared to control group.
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Affiliation(s)
- Sunil Chandy
- Department of Biochemistry, Kidwai Memorial Institute of Oncology, Bangalore, 560 029 India
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Lamba M, Mukherjee G, Saini K, Ramachandra C, Rao C, Kumar R, Bapsy P, Babu K, Attili S, Batra U. Clinico-pathologic pattern of gastrointestinal stromal tumors (GIST) in southern India: A single-institution experience. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.20531] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
20531 Background: There have been major advances in understanding the behavioral pattern, pharmacological intervention, and clinical response of GIST; yet Indian data in this regard is sparse. This study analyses the clinico-pathologic features in 36 patients (21 male, 15 female) of GIST seen at our institution. Methods: GIST was defined as a mesenchymal spindle or epithelioid cell lesion arising in the GI tract with CD117 immuno-reactivity. Retrospective data from January 03 to March 06 was analyzed for age, tumor site, morphology, immuno- reactivity, prognostic factors, response to treatment (by RECIST), and recurrence or metastasis. All patients had surgery; those with residual, recurrent, or metastatic disease got imatinib till tumor progression. Results: GIST presented at a mean age of 48.2 yrs (SD 6.4, range 34–65). The mean tumor size was 13.9 cm (range 2–42). The most common site was the small intestine (ileum 8, jejunum 7, duodenum 4). 24 patients (66.7%) had localized disease at baseline. Of these, 14 had local recurrence after surgery, and were given imatinib. 5 of them are in complete remission, 4 had partial response (PR), 3 patients died, and 2 had stable disease. Most patients with recurrent GIST had a mitotic rate of >10/50hpf. 8 patients developed metastasis, and received imatinib. Of these, 2 got a PR, 3 had progressive disease and died, and 3 had stable disease. 12 patients (33.3%) had metastasis at baseline (to liver and abdominal cavity), and underwent debulking. Of these, 6 patients with stable disease are on treatment with imatinib, 3 died and 3 were lost to follow-up. Conclusions: Average age of presentation was less than in Western reports. The commonest site was the small intestine as opposed to stomach in western literature. Mitotic rate was a better prognostic factor than gross tumor size. GIST with a mixed cell morphology showed aggressive behavior. Imatinib mesylate is useful in the post-operative management of GIST. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- M. Lamba
- Kidwai Memorial Institute of Oncology, Bangalore, India
| | - G. Mukherjee
- Kidwai Memorial Institute of Oncology, Bangalore, India
| | - K. Saini
- Kidwai Memorial Institute of Oncology, Bangalore, India
| | | | - C. Rao
- Kidwai Memorial Institute of Oncology, Bangalore, India
| | - R. Kumar
- Kidwai Memorial Institute of Oncology, Bangalore, India
| | - P. Bapsy
- Kidwai Memorial Institute of Oncology, Bangalore, India
| | - K. Babu
- Kidwai Memorial Institute of Oncology, Bangalore, India
| | - S. Attili
- Kidwai Memorial Institute of Oncology, Bangalore, India
| | - U. Batra
- Kidwai Memorial Institute of Oncology, Bangalore, India
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Ramachandra C, Attili VSS. Feasibility, Safety, and Efficacy of the CT Guided Fine Needle Aspiration Cytology (FNAC) of Lung Lesions. Indian J Med Paediatr Oncol 2007. [DOI: 10.1055/s-0041-1733212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- C Ramachandra
- Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bangalore-560 029, India
| | - V Satya Suresh Attili
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore-560 029, India
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Bapsy P, Attili V, Lokanatha D, Ramachandra C, Govind babu K, Kamal S, Ullas B, Anupama G, Ankit J, Sajeevan K. P149 Quality-of-Life comparison in post menopausal women receiving chemotherapy vs. hormone therapy in receptor positive early breast cancer: A south Indian experience. Breast 2007. [DOI: 10.1016/s0960-9776(07)70209-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Attili V, Bapsy P, Batra U, Anupama G, Kamal S, Hemant D, Ramachandra C, Clementeena R, Srinivasa Rao S, Lokanatha D. P56 Age dependent variability in interaction of hormone receptors and HER2 neu and its prognostic implication in early breast cancer: A retrospective analysis in South Indian women. Breast 2007. [DOI: 10.1016/s0960-9776(07)70121-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Attili VS, Dadhich H, Kumari A, Appaji L, Giri GV, Mukharjee G, Ramachandra C. Extrarenal Wilms' tumor: A report of two cases and review of literature. J Indian Assoc Pediatr Surg 2007. [DOI: 10.4103/0971-9261.34956] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Ramachandra C, Manjunath S, Joseph B, Appaji L, Kumari BSA, Rao CR, Prabhakaran PS. Mixed exocrine-endocrine pancreatic carcinoma in childhood. Indian J Gastroenterol 2005; 24:116. [PMID: 16041106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
A 7-year-old boy with mixed exocrine-endocrine pancreatic cancer is presented. This may be the second reported case of such a tumor in childhood.
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Affiliation(s)
- C Ramachandra
- Department of Surgery, Kidwai Memorial Institute of Oncology, Bangalore, India
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Fischer TB, Arunachalam KV, Bailey D, Mangual V, Bakhru S, Russo R, Huang D, Paczkowski M, Lalchandani V, Ramachandra C, Ellison B, Galer S, Shapley J, Fuentes E, Tsai J. The binding interface database (BID): a compilation of amino acid hot spots in protein interfaces. Bioinformatics 2003; 19:1453-4. [PMID: 12874065 DOI: 10.1093/bioinformatics/btg163] [Citation(s) in RCA: 116] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
SUMMARY To make information about protein interactive function easily accessible, we are mining the primary scientific literature for detailed data about protein interfaces. The Binding Interface Database (BID) organizes the vast amount of protein interaction information into tables, graphical contact maps and descriptive functional profiles. Currently data on 170 interacting protein pairs are available with over 1300 mutations described. AVAILABILITY The BID database is freely available at http://tsailab.org/BID/ To have your protein of interest entered, contact Tiffany Fischer (tiffbrink@neo.tamu.edu) or Jerry Tsai at the email below
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Affiliation(s)
- T B Fischer
- Department of Biochemistry & Biophysics, Texas A&M University, USA
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Rani RS, Shenoi A, Nagesh NK, Ramachandra C. Inadvertent passage of infant feeding tube into the stomach through a tracheo-esophageal fistula. Indian Pediatr 2000; 37:96-7. [PMID: 10745397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Affiliation(s)
- R S Rani
- Neonatal Division, Department of Pediatrics, Manipal Hospital, Bangalore 560 017, India
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Singh B, Singh P, Singh V, Ramachandra C. Stabilisation Treatment of Titanium Alloy VT9. DEFENCE SCI J 1999. [DOI: 10.14429/dsj.49.3826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
We report on three children with pancreatic ascites confirmed by endoscopic retrograde cholangiopancreaticography (ERCP) and treated with surgery. The children presented with ascites, malnutrition and severe weight loss. Pancreatic ascites was diagnosed by elevated ascitic fluid and serum amylase levels. ERCP demonstrated a pseudocyst and the site of disruption of the pancreatic duct, but not the etiology of the pancreatitis. Following a period of nutritional support, surgery was carried out. Two of the children underwent a stented transgastric drainage of the pseudocyst; a recurrent pseudocyst in one of the children required a revision cystojejunostomy. The third child was treated with a Roux-en-Y cystojejunostomy. All the children are pain-free and without ascites and are doing well on long-term follow-up. We conclude that pancreatic ascites must be considered in the differential diagnosis of intractable ascites in children. An ERCP is essential in planning management and cystoenterostomy is the definitive treatment.
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Affiliation(s)
- A J D'Cruz
- Department of Pediatric Surgery, St John's Medical College Hospital, Bangalore, India
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D'Cruz AJ, Kamath PS, Ramachandra C, Jalihal A. Non-conventional portosystemic shunts in children with extrahepatic portal vein obstruction. Acta Paediatr Jpn 1995; 37:17-20. [PMID: 7754760 DOI: 10.1111/j.1442-200x.1995.tb03678.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Portal hypertension due to extrahepatic portal vein obstruction is ideally treated by the use of a selective shunt. In a four year period between July 1987 and June 1992, 50 surgical procedures were carried out in 48 children with portal hypertension-related variceal hemorrhage. The portal, splenic, mesenteric, or coronary vein was not available for anastomosis in four children who, therefore, underwent non-conventional shunts which are described here. There was no postoperative mortality. One patient had a repeat gastrointestinal hemorrhage, probably due to stenosis of the shunt and failure to ligate the coronary vein. No rebleeding occurred on follow-up of at least 18 months. We conclude that in selected children requiring surgery for portal hypertension due to extrahepatic portal venous obstruction, a non-conventional shunt may be used with beneficial results.
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Affiliation(s)
- A J D'Cruz
- Department of Pediatric Surgery, St John's Medical College Hospital, Bangalore, India
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Rekha S, Lewin S, Lilly S, Vincent S, Ramachandra C, Chandrasekhara MK, Yeshwanth M. Hemoperitoneum secondary to splenic rupture in a neonate. Indian Pediatr 1992; 29:1575-6. [PMID: 1291510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- S Rekha
- Department of Pediatrics and Pediatric Surgery, St. John's Medical College Hospital, Bangalore
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Rao SD, Lewin S, Shetty B, D'Cruz AJ, Ramachandra C, Chandrasekhara MK. Acute acalculous cholecystitis in typhoid fever. Indian Pediatr 1992; 29:1431-5. [PMID: 1294503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- S D Rao
- Department of Pediatrics, St. John's Medical College Hospital, Bangalore
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D'Cruz AJ, Ramachandra C, Rao C, Kamath P. Colonoscopically reduced intussusception and testicular involvement in Henoch-Schonlein purpura. Indian Pediatr 1992; 29:1141-3. [PMID: 1452311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- A J D'Cruz
- Department of Pediatric Surgery, St. John's Medical College Hospital, Bangalore
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Affiliation(s)
- E Dias
- Department of Paediatrics, St John's Medical College Hospital Bangalore, India
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Ojha SN, Pandey OP, Tripathi B, Kumar M, Ramachandra C. Microstructure and Wear Characteristics of an Al–4Cu–20Pb Alloy Produced by Spray Deposition. ACTA ACUST UNITED AC 1992. [DOI: 10.2320/matertrans1989.33.519] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- S. N. Ojha
- Department of Metallurgical Engineering, Institute of Technology, Banaras Hindu University
| | - O. P. Pandey
- Department of Metallurgical Engineering, Institute of Technology, Banaras Hindu University
| | - Bhauk Tripathi
- Department of Metallurgical Engineering, Institute of Technology, Banaras Hindu University
| | - M. Kumar
- Department of Metallurgical Engineering, Institute of Technology, Banaras Hindu University
| | - C. Ramachandra
- Department of Metallurgical Engineering, Institute of Technology, Banaras Hindu University
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