1
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Choi H, Bissell JNR, Edelbach BM, Paea J, Omosor E, Raghavan R, Gospodarev V, Lopez-Gonzalez MA. Giant primary intracranial multi-fossa leiomyosarcoma involving the frontal sinus, ethmoid air cells, anterior fossa, middle fossa, and intraventricular space: A case report and literature review. Surg Neurol Int 2023; 14:384. [PMID: 37941634 PMCID: PMC10629320 DOI: 10.25259/sni_647_2023] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/11/2023] [Indexed: 11/10/2023] Open
Abstract
Background Leiomyosarcomas (LMSs) is a type of sarcoma that arises from smooth muscle and generally presents in the abdomen. Although intracranial LMS has been identified before, most reported presentations have been in immunocompromised patients. Here, we present an intracranial LMS in an immunocompetent patient. Case Description A 22-year-old male with a history of an atypical pineal parenchymal tumor of intermediate differentiation resected by suboccipital craniotomy at the age of 12 followed by adjuvant radiation therapy, presented with 3 weeks of decreased appetite, weight loss, and lethargy. He subsequently underwent transbasal approach skull base tumor resection. Histologic examination of the mass along with the patient's history of radiation was supportive of a low-grade, radiation-induced LMS arising from the anterior fossa of the skull or meninges and extends to the frontal sinus and ethmoid air cells. Conclusion Primary intracranial LMS is an extremely rare diagnosis and presenting symptoms vary with the location and size of the tumor. Due to the poor specificity of clinical symptoms, diagnosis is often based on histology. The most common treatment is surgical resection. Adjuvant chemotherapy with various agents has been found to be somewhat effective outside the central nervous system. When LMS does occur, a history of immunocompromised state or previous radiation exposure is often present. Pathological confirmation is required for an appropriate diagnosis.
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Affiliation(s)
- Hannah Choi
- Department of Neurosurgery, Loma Linda University Medical School, Loma Linda, California, United States
| | - Jorrdan N. R. Bissell
- Department of Neurosurgery, Loma Linda University Medical School, Loma Linda, California, United States
| | - Brandon Michael Edelbach
- Department of Neurosurgery, Loma Linda University Medical School, Loma Linda, California, United States
| | - Joel Paea
- Department of Neurosurgery, Loma Linda University Medical School, Loma Linda, California, United States
| | - Emmanuel Omosor
- Department of Neurosurgery, Loma Linda University Medical School, Loma Linda, California, United States
| | - Ravi Raghavan
- Department of Neurosurgery, Loma Linda University Medical School, Loma Linda, California, United States
| | - Vadim Gospodarev
- Department of Neurosurgery, Loma Linda University Medical Center, Loma Linda, California, United States
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2
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Jeon WJ, Dalal S, Moon JH, Joung B, Nguyen M, Castillo D, Hudson J, Park K, Raghavan R, Akhtari M, Patel A. Leukostasis With Isolated Central Nervous System Involvement in Chronic Phase of Chronic Myelogenous Leukemia. J Hematol 2023; 12:187-196. [PMID: 37692864 PMCID: PMC10482607 DOI: 10.14740/jh1150] [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: 06/01/2023] [Accepted: 07/11/2023] [Indexed: 09/12/2023] Open
Abstract
Chronic myelogenous leukemia (CML) is a hematologic malignancy with unique significance to the field of hematology and oncology, specifically due to the development of tyrosine kinase inhibitors (TKIs). CML often presents with nonspecific symptoms, and the quality of life in patients with CML has drastically improved as a result of TKIs. However, complications of CML including the risk of transforming into life-threatening blast crises continue to exist. Further, as most patients are asymptomatic in the chronic phase, patients often present with serious complications associated with noncompliance to TKIs. For example, central nervous system (CNS) manifestations of CML have been reported, both as the initial presentation of undiagnosed CML and as known complication of uncontrolled CML. Hyperleukocytosis is a manifestation of uncontrolled CML and leukostasis is a complication, occurring in cases of acute myeloid leukemia (AML). Here we present a rare case of leukostasis in a patient with known CML presenting on computed tomography (CT) as intracranial masses in the chronic phase. Our goal is to discuss this rare case of leukostasis in adult CML and describe its management.
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Affiliation(s)
- Won Jin Jeon
- Department of Internal Medicine, School of Medicine, Loma Linda University, Loma Linda, CA, USA
| | - Suhani Dalal
- Department of Internal Medicine, School of Medicine, Loma Linda University, Loma Linda, CA, USA
| | - Jin Hyun Moon
- Department of Internal Medicine, School of Medicine, Loma Linda University, Loma Linda, CA, USA
| | - Bowon Joung
- Department of Internal Medicine, School of Medicine, Loma Linda University, Loma Linda, CA, USA
| | - Michael Nguyen
- Division of Medical Oncology/Hematology, Department of Internal Medicine, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Dani Castillo
- Division of Medical Oncology, City of Hope, Duarte, CA, USA
| | - Jessica Hudson
- Division of Anatomic and Surgical Pathology, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Kiwon Park
- Department of Pharmacy, Loma Linda University, Loma Linda, CA, USA
| | - Ravi Raghavan
- Division of Anatomic and Surgical Pathology, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Mojtaba Akhtari
- Division of Medical Oncology/Hematology, Department of Internal Medicine, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Ami Patel
- Division of Medical Oncology/Hematology, Department of Internal Medicine, Loma Linda University Medical Center, Loma Linda, CA, USA
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3
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Daneshbod Y, Raghavan R. Down syndrome-associated transient abnormal myelopoiesis with placental involvement. EJHaem 2022; 3:1414-1415. [PMID: 36467804 PMCID: PMC9713048 DOI: 10.1002/jha2.495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/09/2022] [Accepted: 05/19/2022] [Indexed: 06/17/2023]
Affiliation(s)
- Yahya Daneshbod
- Department of Pathology and Laboratory MedicineLoma Linda University Medical CenterLoma LindaCaliforniaUSA
| | - Ravi Raghavan
- Department of Pathology and Laboratory MedicineLoma Linda University Medical CenterLoma LindaCaliforniaUSA
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4
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Mo H, Magaki S, Deisch JK, Raghavan R. Isocitrate Dehydrogenase Mutations Are Associated with Different Expression and DNA Methylation Patterns of OLIG2 in Adult Gliomas. J Neuropathol Exp Neurol 2022; 81:707-716. [PMID: 35856894 DOI: 10.1093/jnen/nlac059] [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: 11/13/2022] Open
Abstract
Isocitrate dehydrogenase (IDH) mutant gliomas are associated with a better prognosis in comparison to adult IDH wild-type glioma and glioma-CpG island methylator phenotypes. Although OLIG2 is mainly expressed in oligodendrocytes in normal adult brain, it is expressed in both astrocytomas and oligodendrogliomas. Utilizing the clinical, DNA methylation, and RNA-sequencing data from the Cancer Genome Atlas (TCGA) for lower-grade glioma and glioblastoma cohorts, we explored the association between IDH mutation status and OLIG2 expression on transcription, DNA methylation, and gene target levels. Compared to IDH wild-type gliomas, IDH mutant gliomas showed consistently higher expression of OLIG2 transcripts. OLIG2 overexpression is a good surrogate marker for IDH mutation with an AUC of 0.90. At the DNA methylation level, IDH-mutant gliomas showed hyper- and hypomethylation foci upstream of the OLIG2 transcription start site. Underexpressed OLIG2 target genes in IDH mutant glioma were enriched in cell cycle-related pathways. Thus, the differential expression of OLIG2 between IDH mutant and wild-type gliomas reflects involvement in multiple pathways in tumorigenesis.
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Affiliation(s)
- Huan Mo
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Shino Magaki
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Jeremy K Deisch
- Department of Pathology, Loma Linda University Medical Center and School of Medicine, Loma Linda, California, USA
| | - Ravi Raghavan
- Department of Pathology, Loma Linda University Medical Center and School of Medicine, Loma Linda, California, USA
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5
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Wernery U, Joseph S, Rodriguez M, Paily N, Thomas S, Raghavan R. Duration of MERS – Coronavirus Antibodies in a Small Closed Dromedary Camel Herd in Dubai. J CAMEL PRACT RES 2022. [DOI: 10.5958/2277-8934.2022.00039.x] [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: 12/28/2022]
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6
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Wernery U, Raghavan R, Paily NM, Thomas SM, Johnson B, Jose S. Camelid Brucellosis - Clinical Feature, Excretion Pattern, Serological and Bacteriological Diagnosis: Review*. J CAMEL PRACT RES 2022. [DOI: 10.5958/2277-8934.2022.00036.4] [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: 12/28/2022]
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7
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Hassan O, Ghanchi H, DeLos Reyes K, Raghavan R, Minasian T. Pediatric Temporal Lobe Meningioma With Meningioangiomatosis Mimicking Invasive Meningioma. Cureus 2021; 13:e18819. [PMID: 34804676 PMCID: PMC8592784 DOI: 10.7759/cureus.18819] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2021] [Indexed: 12/02/2022] Open
Abstract
Meningiomas combined with meningioangiomatosis (MA-M) present similarly to more invasive lesions because of their appearance on neuroimaging. These lesions are especially rare in pediatric patients and suggestive imaging can help identify them for differential diagnosis. An 11-year-old male child who presented with diplopia and a headache was found to have an edematous invasive appearing temporal lobe mass on magnetic resonance imaging. Despite the lesion’s appearance, it was completely resected and found to be a benign MA-M upon histopathologic examination. The present case demonstrated a rare meningioma with meningioangiomatosis that appeared to be a higher grade or invasive lesion upon initial imaging in a pediatric patient. A review of the literature was performed on patients who presented similarly. Despite the rarity of this condition in children, neuroimaging should be carefully examined prior to surgical resection of similar masses in preparation for highly vascular tissue, and post-operative course can be better anticipated when MA-M is considered during differential diagnosis.
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Affiliation(s)
- Omron Hassan
- Clinical Sciences, Touro University Nevada College of Osteopathic Medicine, Henderson, USA
| | - Hammad Ghanchi
- Neurosurgery, Riverside University Health System Medical Center, Moreno Valley, USA
| | | | - Ravi Raghavan
- Neuropathology, Loma Linda University Medical Center, Loma Linda, USA
| | - Tanya Minasian
- Neurosurgery, Loma Linda University Medical Center, Loma Linda, USA
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8
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Williamson T, Hughes K, Osborne-Grinter M, Philip V, Dall G, Raghavan R. 799 Do Not Attempt Cardiopulmonary Resuscitation Decisions in Neck of Femur Fractures – Is Documentation Adequate? Br J Surg 2021. [DOI: 10.1093/bjs/znab259.101] [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: 11/13/2022]
Abstract
Abstract
Introduction
‘Do not attempt cardiopulmonary resuscitation’ (DNACPR) documentation is essential to communicate decisions regarding ceilings of care for patients to the clinical team. Patients admitted to hospital with a fractured neck of femur (#NOF) are often elderly with multiple comorbidities, and so robust and clear anticipatory care plans are especially indicated.
Method
All patients admitted to a large district general hospital in Scotland with a #NOF over a three-week period between 23/10/2020 and 12/11/2020 were identified prospectively and included in this audit. Patients’ demographic information, DNACPR status and the quality of their DNACPR documentation was recorded.
Results
20 patients (85% Female, 15% Male) were identified and included. Median ASA grade was 3, with 77.8% of patients ASA grade 3 or 4. 63.2% of patients had DNACPR documentation in place, all of which were ASA grade 3 or above. Most DNACPR documentation had patient information clearly identifiable (91.7%), was completed preoperatively (90.9%), and involved either the patient or appropriate relative or power of attorney (91.6%). However, only 75% of patients’ documentation had the rationale for the DNACPR decision documented and only 25% of DNACPR decisions were reviewed by a senior clinician within 72 hours. No DNACPR decisions were documented as having been communicated to the wider healthcare team.
Conclusions
DNACPR documentation is a crucial for anticipatory care planning in #NOF patients. This audit shows improvement is needed in documenting whether decisions have been reviewed by senior clinicians, and if they have been communicated to the wider healthcare team.
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Affiliation(s)
- T Williamson
- University of Edinburgh, Edinburgh, United Kingdom
| | - K Hughes
- Borders General Hospital, Melrose, United Kingdom
| | | | - V Philip
- Borders General Hospital, Melrose, United Kingdom
| | - G Dall
- Borders General Hospital, Melrose, United Kingdom
| | - R Raghavan
- Borders General Hospital, Melrose, United Kingdom
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9
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Wernery U, Raghavan R, Wemery R. Prozone reaction in an antibody elisa of a brucellosis positive dromedary camel serum. J CAMEL PRACT RES 2021. [DOI: 10.5958/2277-8934.2021.00014.x] [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: 10/20/2022]
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10
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Chiang KC, Raghavan R, Gupta A. SARS-CoV-2 vaccination induced cerebral venous sinus thrombosis: Do megakaryocytes, platelets and lipid mediators make up the orchestra? Free Neuropathol 2021; 2:2-18. [PMID: 37284614 PMCID: PMC10209909 DOI: 10.17879/freeneuropathology-2021-3395] [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] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 07/01/2021] [Indexed: 06/08/2023]
Abstract
The COVID-19 vaccines comprised of adenoviral vectors encoding the Spike (S) glycoprotein of SARS-CoV-2 are highly effective but associated with rare thrombotic complications. The adenovirus vector infects epithelial cells expressing the coxsackievirus and adenovirus receptor (CAR). The S glycoprotein expressed locally stimulates neutralizing antibody and cellular immune responses. These vaccines have been associated with thromboembolic events including cerebral venous sinus thrombosis (CVST). S glycoprotein stimulates the expression of cyclooxygenase-2 (COX-2) and leads to massive generation of thromboxane A2 in COVID-19. Megakaryocytes express CAR and we postulate that S glycoprotein stimulated generation of thromboxane A2 leads to megakaryocyte activation, biogenesis of activated platelets and thereby increased thrombogenicity. Cerebral vein sinuses express podoplanin, a natural ligand for CLEC2 receptors on platelets. Platelets traversing through the cerebral vein sinuses could be further activated by thromboxane A2-dependent podoplanin-CLEC2 signaling, leading to CVST. A prothrombotic hormonal milieu, and increased generation of thromboxane A2 and platelet activation in healthy females compared to males is consistent with increased risk for CVST observed in women. We propose that antiplatelet agents targeting thromboxane A2 receptor signaling such as low-dose aspirin merit consideration for chemoprophylaxis when administering the adenovirus based COVID-19 vaccines to young adults at risk of thrombosis provided there are no contraindications.
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Affiliation(s)
| | - Ravi Raghavan
- Department of Pathology, Loma Linda University Medical Center, Loma Linda, CA 92354, USA
| | - Ajay Gupta
- KARE Biosciences, Orange, CA 92869, USA
- Department of Medicine, University of California Irvine (UCI) School of Medicine, Orange, CA 92868, USA
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11
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Schuster R, Raghavan R, Ringu M, Mheiri Al F, Quassim Al M, Wernery U. Trypanosoma evansi In a dromedary camel herd in the UAE-PART II. J CAMEL PRACT RES 2021. [DOI: 10.5958/2277-8934.2021.00021.7] [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: 10/20/2022]
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12
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Wongworawat YC, Liu YA, Raghavan R, White CL, Dietz R, Zuppan C, Rosenfeld J. Aggressive FUS-Mutant Motor Neuron Disease Without Profound Spinal Cord Pathology. J Neuropathol Exp Neurol 2020; 79:365-369. [PMID: 32142142 DOI: 10.1093/jnen/nlaa011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 05/31/2019] [Revised: 08/07/2019] [Indexed: 12/11/2022] Open
Abstract
A 29-year-old man presented with rapidly progressive severe neck weakness, asymmetrical bilateral upper extremity weakness, bulbar dysfunction, profound muscle wasting, and weight loss. Within 1 year, his speech became unintelligible, he became gastrostomy- and tracheostomy/ventilator-dependent, and wheelchair bound. Electrophysiology suggested motor neuron disease. Whole exome sequencing revealed a heterozygous pathogenic variant in the fused in sarcoma gene (FUS), c.1574C>T,p. R525L, consistent with autosomal dominant amyotrophic lateral sclerosis. Autopsy revealed extensive denervation atrophy of skeletal musculature. Surprisingly, there was only minimal patchy depletion of motor neurons within the cervico-thoracic spinal cord anterior horn cells, and the tracts were largely preserved. TDP-43 inclusions were absent. Abnormal expression of FUS mutation product (cytoplasmic inclusions) was demonstrated by immunohistochemistry within anterior horn motor neurons. The most prominent finding was a disparity between profound neck weakness and relatively low-grade anterior horn cell loss or tract degeneration in the cervico-thoracic cord.
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Affiliation(s)
- Yan Chen Wongworawat
- Department of Pathology and Laboratory Medicine, Loma Linda University Medical Center
| | - Yin Allison Liu
- Department of Pediatrics/Child Neurology, Loma Linda University Children's Hospital, Loma Linda, California
| | - Ravi Raghavan
- Department of Pathology and Laboratory Medicine, Loma Linda University Medical Center
| | - Charles L White
- Department of Pathology/Neuropathology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Robin Dietz
- Department of Pathology and Laboratory Medicine, Loma Linda University Medical Center
| | - Craig Zuppan
- Department of Pathology and Laboratory Medicine, Loma Linda University Medical Center
| | - Jeffrey Rosenfeld
- Department of Neurology, Loma Linda University Medical Center, Loma Linda, California
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13
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Wernery U, Raghavan R, Ringu M, Kinne J, Rodriguez M, Al Qassim M, Al Mheiri F. Trypanosoma evansi Abortion in a dromedary camel herd in the UAE - Part I. J CAMEL PRACT RES 2020. [DOI: 10.5958/2277-8934.2020.00042.9] [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]
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14
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Wernery U, Caveney MR, Jose S, Johnson B, Raghavan R, Christopher J, Syriac G, Thomas SM, Paily NM. Serological response of dromedary camels vaccinated with Brucella abortus RB51 and Brucella melitensis REV 1 Vaccines. J CAMEL PRACT RES 2019. [DOI: 10.5958/2277-8934.2019.00018.3] [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: 10/25/2022]
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15
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Mao XW, Sandberg LB, Gridley DS, Herrmann EC, Zhang G, Raghavan R, Zubarev RA, Zhang B, Stodieck LS, Ferguson VL, Bateman TA, Pecaut MJ. Proteomic Analysis of Mouse Brain Subjected to Spaceflight. Int J Mol Sci 2018; 20:ijms20010007. [PMID: 30577490 PMCID: PMC6337482 DOI: 10.3390/ijms20010007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 12/11/2018] [Accepted: 12/17/2018] [Indexed: 01/01/2023] Open
Abstract
There is evidence that spaceflight poses acute and late risks to the central nervous system. To explore possible mechanisms, the proteomic changes following spaceflight in mouse brain were characterized. Space Shuttle Atlantis (STS-135) was launched from the Kennedy Space Center (KSC) on a 13-day mission. Within 3–5 h after landing, brain tissue was collected to evaluate protein expression profiles using quantitative proteomic analysis. Our results showed that there were 26 proteins that were significantly altered after spaceflight in the gray and/or white matter. While there was no overlap between the white and gray matter in terms of individual proteins, there was overlap in terms of function, synaptic plasticity, vesical activity, protein/organelle transport, and metabolism. Our data demonstrate that exposure to the spaceflight environment induces significant changes in protein expression related to neuronal structure and metabolic function. This might lead to a significant impact on brain structural and functional integrity that could affect the outcome of space missions.
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Affiliation(s)
- Xiao Wen Mao
- Department of Basic Sciences, Division of Biomedical Engineering Sciences, Loma Linda University School of Medicine, Loma Linda, CA 92354, USA.
| | - Lawrence B Sandberg
- Department of Biochemistry, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA.
| | - Daila S Gridley
- Department of Basic Sciences, Division of Biomedical Engineering Sciences, Loma Linda University School of Medicine, Loma Linda, CA 92354, USA.
| | - E Clifford Herrmann
- Department of Biochemistry, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA.
| | - Guangyu Zhang
- Department of Biochemistry, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA.
| | - Ravi Raghavan
- Department of Pathology and Human Anatomy, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA.
| | - Roman A Zubarev
- Department of Medical Biochemistry and Biophysics, Biomedicum, Karolinska Institutet, SE 17177 Stockholm, Sweden.
- Department of Pharmacological and Technological Chemistry, I.M. Sechenov First Moscow State Medical University, Moscow 119991, Russia.
| | - Bo Zhang
- Department of Medical Biochemistry and Biophysics, Biomedicum, Karolinska Institutet, SE 17177 Stockholm, Sweden.
- Department of Pharmacological and Technological Chemistry, I.M. Sechenov First Moscow State Medical University, Moscow 119991, Russia.
| | - Louis S Stodieck
- BioServe Space Technologies, University of Colorado at Boulder, Boulder, CO 80303, USA.
| | - Virginia L Ferguson
- BioServe Space Technologies, University of Colorado at Boulder, Boulder, CO 80303, USA.
| | - Ted A Bateman
- Department of Bioengineering, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Michael J Pecaut
- Department of Basic Sciences, Division of Biomedical Engineering Sciences, Loma Linda University School of Medicine, Loma Linda, CA 92354, USA.
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16
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Nguyen AL, Kamal M, Raghavan R, Nagaraj G. Acquired factor VII deficiency causing severe bleeding disorder secondary to AL amyloidosis of the liver. Hematol Rep 2018; 10:7235. [PMID: 30344985 PMCID: PMC6176396 DOI: 10.4081/hr.2018.7235] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 05/23/2017] [Accepted: 06/29/2018] [Indexed: 11/23/2022] Open
Abstract
A 52 year-old male presented with neck pain after undergoing thyroidectomy for a goiter three weeks prior which was complicated by a neck hematoma requiring evacuation. Computed tomography (CT) scan showed a neck hematoma requiring evacuation and he received desmopressin with cessation of bleeding. Coagulation studies were normal. He returned eighteen months later with severe oral mucosal bleeding after a dental procedure and required transfusions with red blood cells, platelets, and fresh frozen plasma (FFP) in addition to desmopressin, Humate-P, aminocaproic acid, and surgical packing. A comprehensive bleeding diathesis workup was normal. He was readmitted six months later due to abdominal pain and distention and found to have massive hepatosplenomegaly on CT. A new coagulopathy workup revealed prolonged INR to 1.5, corrected prothrombin time mixing study, and a low factor VII level (29%), suggesting acquired factor VII deficiency. A transjugular liver biopsy revealed extensive involvement by ALamyloidosis- Kappa type. He then developed a large right retroperitoneal hematoma which required multiple transfusions with FFP, cryoprecipitate, aminocaproic acid, and vitamin K with slight success. Hemorrhage was subsequently stabilized with recombinant factor VIIa administered every four hours which corresponded with correction of factor VII levels and PT and eventual cessation hemorrhage. Acquired factor VII deficiency causing severe coagulopathy was attributed to hepatic amyloidosis ALkappa subtype. We started treatment with bortezomib, dexamethasone, and cyclophosphamide, however, the patient succumbed to uncontrolled hemorrhage. Acquired factor VII deficiency is extremely rare and to our knowledge, this is the only known case of factor VII deficiency secondary to amyloidosis involving the liver.
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Affiliation(s)
| | | | - Ravi Raghavan
- Department of Pathology and Human Anatomy, Loma Linda University Medical Center, Loma Linda, CA, USA
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17
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Raghavan R, Coope J. 6.10-P8Mental health of internal migrants in India: an examination of current strengths and gaps in current data. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky048.214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- R Raghavan
- Mary Secole Research Centre, De Montfort University, United Kingdom
| | - J Coope
- Mary Secole Research Centre, De Montfort University, United Kingdom
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18
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Raghavan R, Farooqi A, Jutlla K, Patel N, Desai B, Uddin S. 2.3-O6Recruitment and research participation of black and ethnic minority citizens in health research in the UK: a toolkit for good practice. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky047.059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- R Raghavan
- Mary Seacole Research Centre, De Montfort University, Leicester, United Kingdom
| | - A Farooqi
- Mary Seacole Research Centre, De Montfort University, Leicester, United Kingdom
| | - K Jutlla
- Mary Seacole Research Centre, De Montfort University, Leicester, United Kingdom
| | - N Patel
- Mary Seacole Research Centre, De Montfort University, Leicester, United Kingdom
| | - B Desai
- Mary Seacole Research Centre, De Montfort University, Leicester, United Kingdom
| | - S Uddin
- Mary Seacole Research Centre, De Montfort University, Leicester, United Kingdom
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Raghavan R, Patel N. 6.10-P23Multi-ethnic conceptualisation of dementia in the UK. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky048.228] [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: 11/14/2022] Open
Affiliation(s)
- R Raghavan
- Mary Seacole Research Centre, De Montfort University, United Kingdom
| | - N Patel
- Mary Seacole Research Centre, De Montfort University, United Kingdom
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Salway S, Katikireddi V, Raghavan R, Orton L. 7.8-W1What can health humanities contribute to understanding and tackling ethnic and racial health inequities? Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky049.031] [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: 11/13/2022] Open
Affiliation(s)
| | - S Salway
- University of Sheffield, United Kingdom
| | | | | | - L Orton
- University of Liverpool, United Kingdom
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Raghavan R, Ncube N. 6.10-P19Perspectives of Black and ethnic minority citizens in the UK on spirituality and mental health recovery. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky048.224] [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: 11/15/2022] Open
Affiliation(s)
- R Raghavan
- Mary Seacole Research Centre, De Montfort University, United Kingdom
| | - N Ncube
- Mary Seacole Research Centre, De Montfort University, United Kingdom
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22
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Bannout F, Harder S, Lee M, Zouros A, Raghavan R, Fogel T, De Los Reyes K, Losey T. Epilepsy Surgery for Skull-Base Temporal Lobe Encephaloceles: Should We Spare the Hippocampus from Resection? Brain Sci 2018. [PMID: 29534521 PMCID: PMC5870360 DOI: 10.3390/brainsci8030042] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 11/16/2022] Open
Abstract
The neurosurgical treatment of skull base temporal encephalocele for patients with epilepsy is variable. We describe two adult cases of temporal lobe epilepsy (TLE) with spheno-temporal encephalocele, currently seizure-free for more than two years after anterior temporal lobectomy (ATL) and lesionectomy sparing the hippocampus without long-term intracranial electroencephalogram (EEG) monitoring. Encephaloceles were detected by magnetic resonance imaging (MRI) and confirmed by maxillofacial head computed tomography (CT) scans. Seizures were captured by scalp video-EEG recording. One case underwent intraoperative electrocorticography (ECoG) with pathology demonstrating neuronal heterotopia. We propose that in some patients with skull base temporal encephaloceles, minimal surgical resection of herniated and adjacent temporal cortex (lesionectomy) is sufficient to render seizure freedom. In future cases, where an associated malformation of cortical development is suspected, newer techniques such as minimally invasive EEG monitoring with stereotactic-depth EEG electrodes should be considered to tailor the surrounding margins of the resected epileptogenic zone.
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Affiliation(s)
- Firas Bannout
- Department of Neurology, Loma Linda University Health, Loma Linda, CA 92354, USA.
| | - Sheri Harder
- Department of Radiology (Division of Neuroradiology); Loma Linda University Health, Loma Linda, CA 92354, USA.
| | - Michael Lee
- Department of Radiology, Los Angeles County and University of Southern California Medical Center, Los Angeles, CA 90033, USA.
| | - Alexander Zouros
- Department of Neurosurgery, Loma Linda University Health, Loma Linda, CA 92354, USA.
| | - Ravi Raghavan
- Department of Pathology, Human Anatomy & Neurosurgery, Loma Linda University Health, Loma Linda, CA 92354, USA.
| | - Travis Fogel
- Loma Linda Physical Medicine and Rehabilitation, Neuropsychology; Loma Linda University Health, Loma Linda, CA 92354, USA.
| | - Kenneth De Los Reyes
- Department of Neurosurgery, Loma Linda University Health, Loma Linda, CA 92354, USA.
| | - Travis Losey
- Department of Neurology, Loma Linda University Health, Loma Linda, CA 92354, USA.
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Soellner NK, Kinne J, Schuster R, Johnson B, Jose S, Raghavan R, Syriac G, Muttathpaily N, John J, Raja S, Mareena R, Khazanehdari K, Wernery U. Evaluation of serological tests for the diagnosis of brucellosis in Brucella melitensis experimentally infected dromedary camels. J CAMEL PRACT RES 2018. [DOI: 10.5958/2277-8934.2018.00003.6] [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: 10/28/2022]
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24
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Yang G, Eishi Y, Raza A, Rojas H, Achiriloaie A, De Los Reyes K, Raghavan R. Propionibacterium acnes
-associated neurosarcoidosis: A case report with review of the literature. Neuropathology 2017; 38:159-164. [DOI: 10.1111/neup.12411] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Revised: 07/24/2017] [Accepted: 07/25/2017] [Indexed: 12/23/2022]
Affiliation(s)
- Guang Yang
- Department of Pathology and Laboratory Medicine; Loma Linda University Medical Center; Loma Linda California USA
| | - Yoshinobu Eishi
- Department of Human Pathology; Tokyo Medical and Dental University Graduate School; Tokyo Japan
| | - Anwar Raza
- Department of Pathology and Laboratory Medicine; Loma Linda University Medical Center; Loma Linda California USA
| | - Heather Rojas
- Department of Pathology and Laboratory Medicine; Loma Linda University Medical Center; Loma Linda California USA
| | - Adina Achiriloaie
- Department of Radiology; Loma Linda University Medical Center; Loma Linda California USA
| | - Kenneth De Los Reyes
- Department of Neurosurgery; Loma Linda University Medical Center; Loma Linda California USA
| | - Ravi Raghavan
- Department of Pathology and Laboratory Medicine; Loma Linda University Medical Center; Loma Linda California USA
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Wernery U, Gyuranecz M, Kinne J, Raghavan R, Syriac G, Johnson B, Kreizinger Z, Dénes B, Felde O, Magyar T, Jose S, Raja S, John J, Wernery R. Laboratory Investigations after Eye Drop Immunisation of Dromedaries with Live Attenuated Brucellamelitensis Rev 1 Vaccine. J CAMEL PRACT RES 2017. [DOI: 10.5958/2277-8934.2017.00002.9] [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: 10/19/2022]
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27
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Abstract
People with learning disabilities experience anxiety disorders, as do the general population. Many studies have highlighted the incidence of anxiety disorders in this population, but they have fallen short of addressing prevalence and issues associated with anxiety disorders and its impact. This paper brings together major published studies of anxiety disorder on people with learning disabilities. Its purpose is to raise awareness among health professionals in the field of learning disabilities, and to highlight the need for continued research to address this issue effectively.
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Abstract
Intradural extramedullary nerve root metastasis is extremely unusual with only a handful of cases reported, and it presents most commonly in the thoracic and lumbosacral regions. We report the first case of metastasis to a ventral cervical nerve root in a patient with low-grade follicular thyroid carcinoma thought to be in remission for several years. Histopathology demonstrated malignant transformation and invasion of the nerve root. This case underscores that any history of malignancy regardless of staging, grading, or remission status should raise the suspicion of metastasis as it can mimic other spine and nerve sheath tumors and represent malignant transformation. Gross total resection can be safely achieved with intraoperative neuromonitoring and result in improved function; however, treatment is likely palliative.
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Affiliation(s)
- Joseph Keen
- Department of Neurosurgery, Loma Linda University Medical Center
| | | | - George Hanna
- Department of Neurosurgery, Loma Linda University Medical Center
| | | | - Ravi Raghavan
- Department of Neuropathology, Loma Linda University Medical Center
| | - Samer Ghostine
- Department of Neurosurgery, University of California Riverside
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29
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Gospodarev V, Câmara J, Chakravarthy V, Perry A, Wood M, Dietz R, Wang J, De Los Reyes K, Raghavan R. Treatment of IgG4-related pachymeningitis in a patient with steroid intolerance: The role of early use of rituximab. J Neuroimmunol 2016; 299:62-65. [DOI: 10.1016/j.jneuroim.2016.08.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 08/01/2016] [Accepted: 08/08/2016] [Indexed: 12/17/2022]
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30
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Achiriloaie A, Michelson D, Lei L, Denham L, Oberg K, Raghavan R. Acute Postviral Encephalopathy: Pathologic and Radiologic Correlation in an Atypical Case. Child Neurol Open 2016; 3:2329048X16658845. [PMID: 28503611 PMCID: PMC5417279 DOI: 10.1177/2329048x16658845] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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: 03/03/2016] [Revised: 04/28/2016] [Accepted: 06/05/2016] [Indexed: 12/02/2022] Open
Abstract
The authors report a case of fatal acute encephalopathy following influenza infection, with slightly atypical pathological and imaging findings. A healthy 8-year-old boy with probable recent influenza A/B infection admitted for refractory seizures was placed on phenobarbital coma and later developed hemodynamic instability. Magnetic resonance imaging revealed bilateral cerebral and cerebellar white matter lesions and microhemorrhages. Following his demise, the autopsy revealed a large area of necrosis in the right centrum semiovale with similar lesions in the temporal and cerebellar regions. Microscopically, there was extensive coagulative necrosis, compatible with necrotizing white matter encephalopathy, and neuronal loss suggesting superimposed hypoxic–ischemia. The acute progressive neurologic deterioration was partly reminiscent on acute necrotizing encephalopathy, a condition recently associated with influenza A. In acute necrotizing encephalopathy, typical brain findings are characterized by bilateral thalamic necrosis/petechiae with variable white matter edema. The somewhat atypical findings in our case can relate to superadded cardiovascular collapse and hypoxic–ischemic effects.
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Affiliation(s)
- Adina Achiriloaie
- Department of Radiology, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - David Michelson
- Department of Neurology, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Li Lei
- Department of Pathology, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Laura Denham
- Department of Pathology, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Kerby Oberg
- Department of Pathology, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Ravi Raghavan
- Department of Pathology, Loma Linda University Medical Center, Loma Linda, CA, USA
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31
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Katwate U, Jadhav S, Kumkar P, Raghavan R, Dahanukar N. Pethia sanjaymoluri, a new species of barb (Teleostei: Cyprinidae) from the northern Western Ghats, India. J Fish Biol 2016; 88:2027-2050. [PMID: 27098090 DOI: 10.1111/jfb.12980] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Accepted: 03/04/2016] [Indexed: 06/05/2023]
Abstract
Pethia sanjaymoluri, a new cyprinid, is described from the Pavana and Nira tributaries of Bhima River, Krishna drainage, Maharashtra, India. It can be distinguished from congeners by a combination of characteristics that includes an incomplete lateral line, absence of barbels, upper lip thick and fleshy, 23-25 lateral series scales, 7-12 lateral-line pored scales, 10 predorsal scales, 11-14 prepelvic scales, 17-20 pre-anal scales, 4½ scales between dorsal-fin origin and lateral line, four scales between lateral line and pelvic-fin origin, 8-15 pairs of serrae on distal half of dorsal-fin spine, 12-14 branched pectoral-fin rays, 4 + 26 total vertebrae, 4 + 5 predorsal vertebrae, 4 + 13 abdominal vertebrae, 13 caudal vertebrae and a unique colour pattern comprising a humeral spot positioned below the lateral line and encompassing the third and fourth lateral-line scales and one scale below, one caudal spot on 17th-21st lateral-line scales with a yellow hue on its anterior side and apical half of dorsal fin studded with melanophores making the fin tip appear black. Genetic analysis based on the mitochondrial cytochrome b gene sequence suggests that the species is distinct from other known species of Pethia for which data are available.
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Affiliation(s)
- U Katwate
- Bombay Natural History Society, Hornbill House, Opp. Lion Gate, Shaheed Bhagat Singh Road, Mumbai, 400 001, Maharashtra, India
| | - S Jadhav
- Zoological Survey of India (ZSI), Western Regional Center, Akurdi, Pune, 411 044, Maharashtra, India
| | - P Kumkar
- Department of Zoology, Modern College of Arts, Science and Commerce, Ganeshkhind, Pune, 411 053, Maharashtra, India
| | - R Raghavan
- Center for Taxonomy of Aquatic Animals, Department of Fisheries Resource Management, Kerala University of Fisheries and Ocean Studies (KUFOS), Kochi, 682 506, Kerala, India
| | - N Dahanukar
- Systematics, Ecology & Conservation Laboratory, Zoo Outreach Organization (ZOO), 96 Kumudham Nagar, Vilankurichi Road, Coimbatore, 641 035, Tamil Nadu, India
- Indian Institute of Science Education and Research, G1 Block, Dr. Homi Bhabha Road, Pashan, Pune, 411 008, Maharashtra, India
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Raghavan R, Syriac G, Wernery R, Elschner M, Mawhinney I, Wernery U. Comparative test performance of different serological tests for glanders. J Equine Vet Sci 2016. [DOI: 10.1016/j.jevs.2016.02.038] [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]
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33
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Yang G, Qin H, Raza A, Saukel GW, Solomon N, Michelotti M, Raghavan R. Pyloric gland adenoma of gallbladder-reports of two cases and a brief review of literature. J Gastrointest Oncol 2016; 7:S81-7. [PMID: 27034818 DOI: 10.3978/j.issn.2078-6891.2015.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Adenomas of the gallbladder are uncommon benign epithelial neoplasms. Rarely, they can give rise to gallbladder cancer, which is the most common malignancy of the biliary tract, carrying a poor prognosis and decreased survival. Here we report the case histories of two patients, 40-year-old and 53-year-old males who presented with >1 cm gallbladder polyps, which were detected and confirmed using various imaging studies. Cholecystectomy was performed on both patients and the subsequent pathologic exam revealed 1.2 and 1.6 cm polyps in the lumen. Histopathologically, both polyps showed features reminiscent of "pyloric" gland type of adenoma. The differences between the two cases in regard to histopathological and immunohistochemical characteristics will be discussed. We will also briefly review the latest nomenclature on such low-grade polypoid gallbladder entities.
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Affiliation(s)
- Guang Yang
- 1 Department of Pathology, 2 Department of Medicine, 3 Division of General Surgery, Loma Linda University Medical Center, Loma Linda, California 92354, USA
| | - Haixia Qin
- 1 Department of Pathology, 2 Department of Medicine, 3 Division of General Surgery, Loma Linda University Medical Center, Loma Linda, California 92354, USA
| | - Anwar Raza
- 1 Department of Pathology, 2 Department of Medicine, 3 Division of General Surgery, Loma Linda University Medical Center, Loma Linda, California 92354, USA
| | - George W Saukel
- 1 Department of Pathology, 2 Department of Medicine, 3 Division of General Surgery, Loma Linda University Medical Center, Loma Linda, California 92354, USA
| | - Naveenraj Solomon
- 1 Department of Pathology, 2 Department of Medicine, 3 Division of General Surgery, Loma Linda University Medical Center, Loma Linda, California 92354, USA
| | - Marcos Michelotti
- 1 Department of Pathology, 2 Department of Medicine, 3 Division of General Surgery, Loma Linda University Medical Center, Loma Linda, California 92354, USA
| | - Ravi Raghavan
- 1 Department of Pathology, 2 Department of Medicine, 3 Division of General Surgery, Loma Linda University Medical Center, Loma Linda, California 92354, USA
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34
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Khan F, Khawar R, Ansari Z, Syriac G, Muttathpaily N, Raghavan R, Christopher J, Wernery U. Comparative performance study of four different serological tests for the diagnosis of dromedary brucellosis. J CAMEL PRACT RES 2016. [DOI: 10.5958/2277-8934.2016.00036.9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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35
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Kainickal C, George P, Kumar R, Rafi M, Sudha A, Raghavan R, Ramadas K. OP0008 Conventional radiotherapy versus altered fractionation for patients receiving radical radiotherapy for oral cancer: A randomised phase 2b trial. Eur J Cancer 2015. [DOI: 10.1016/j.ejca.2015.06.010] [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: 10/23/2022]
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36
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Pinder AC, Raghavan R, Britton JR. The legendary hump-backed mahseer Tor sp. of India’s River Cauvery: an endemic fish swimming towards extinction? ENDANGER SPECIES RES 2015. [DOI: 10.3354/esr00673] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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37
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Berlin M, Joseph M, Jose S, Raghavan R, Syriac G, Paily N, Wernery U. Production of A Caseous Lymphadenitis Vaccine for Dromedaries. J CAMEL PRACT RES 2015. [DOI: 10.5958/2277-8934.2015.00026.0] [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]
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38
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Raghavan R, Krishnamurthy S, Ganesh RN, Kumar RR, Mahadevan S. Takayasu arteritis: Association with mesangioproliferative glomerulonephritis in a 9-year-old child. Indian J Nephrol 2014; 24:407-8. [PMID: 25484544 PMCID: PMC4244730 DOI: 10.4103/0971-4065.134685] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- R Raghavan
- Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - S Krishnamurthy
- Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - R N Ganesh
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - R R Kumar
- Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - S Mahadevan
- Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Kumar R, Haridas G, Kainickal C, Sudha A, Rafi M, Raghavan R, Ramadas K. Phase 2b Randomized Trial Comparing Concurrent Chemoradiation With Weekly Versus 3 Weekly Cisplatinum in Locally Advanced Head and Neck Squamous Cell Carcinoma. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.1709] [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: 10/24/2022]
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40
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Raghavan R, Alexander A, Prabhu J, Korlimarla A, Correa M, Raman N, Prasad MSN, Manjunath S, Shivananda S, Gopinath KS, Srinath BS, Sridhar TS. Abstract P6-08-12: Gains in women’s education has not led to commensurate gains in seeking health-care early in breast cancer patients in urban India. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p6-08-12] [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: 11/16/2022]
Abstract
Abstract
Introduction:
Breast cancer is the leading cancer diagnosed in urban Indian women. Historically the proportion of women presenting with advanced disease has been in excess of 50% at most regional cancer centres. The past 20 years has witnessed rapid economic growth and urbanization with significant gains in women's education and access to health. However, it is not clear if this has translated to earlier seeking of care in the educated.
The aim of this study was to examine if higher education (College) was a determinant in the time of seeking first medical consultation, and whether there were significant differences between women under the age of 40 versus women over 60 years old at the time of diagnosis.
Methods:
The data for analysis were obtained from a prospective longitudinal observational study conducted between 2008-2013 at a medical teaching hospital and a tertiary specialized cancer care centre. A total of 460 patients have been enrolled so far. All patients provided informed consent and the study has been reviewed and approved by the institutional ethics committees at these institutions. We have collected from the patients and their medical records information about their age at diagnosis, educational level, stage of disease, histopathology reports and clinical details.
Results:
Data from 194 patients have been used for the analysis. Patients were divided into one group of < = 40Y of age (Group I, N = 58) and the second of > = 60 years of age (Group II, N = 136). Mean age at presentation for the groups was 35 and 68 years respectively. As expected almost 1.5 times as many women under the age of 40 (36%) were college educated compared to the women over 60 (22%) (p = 0.05). The proportion of LABC in the two groups was not different with group I having 27% and group II 25%. The proportion of older women with LABC and a college degree was 20%. However, rather than the expected decrease in proportion of women with high education and LABC, 31% of young women with LABC had a college degree. LABC in the college educated was not different in the group I when compared to group II. (p = 0.39).
Conclusion:
The determinants of seeking health care are complex and influenced by a variety of factors including socio-economic status, access to health care, education, cultural beliefs, and personal preferences. While urban India's steady economic growth has been highlighted by the scholarly as well as the lay press, the data presented here suggest that there is not an automatic and linear transfer between education, economics and healthcare seeking behaviours. We suggest that while a lot of attention has been paid to awareness and screening, we may need to focus on local cultural factors, and perhaps provide support from female counsellors and care providers as critical components of attempting to bring our women to the hospital at the earliest.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P6-08-12.
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Affiliation(s)
- R Raghavan
- St. John's Research Institution, Bangalore, Karnataka, India; St. John's Medical College & Hospital, Bangalore, Karnataka, India; St. John's Medical College, Bangalore, Karnataka, India; Sri Shankara Cancer Hospital & Research Centre, Bangalore, Karnataka, India; Sri Rangadore Memorial Hospital, Bangalore, Karnataka, India
| | - A Alexander
- St. John's Research Institution, Bangalore, Karnataka, India; St. John's Medical College & Hospital, Bangalore, Karnataka, India; St. John's Medical College, Bangalore, Karnataka, India; Sri Shankara Cancer Hospital & Research Centre, Bangalore, Karnataka, India; Sri Rangadore Memorial Hospital, Bangalore, Karnataka, India
| | - J Prabhu
- St. John's Research Institution, Bangalore, Karnataka, India; St. John's Medical College & Hospital, Bangalore, Karnataka, India; St. John's Medical College, Bangalore, Karnataka, India; Sri Shankara Cancer Hospital & Research Centre, Bangalore, Karnataka, India; Sri Rangadore Memorial Hospital, Bangalore, Karnataka, India
| | - A Korlimarla
- St. John's Research Institution, Bangalore, Karnataka, India; St. John's Medical College & Hospital, Bangalore, Karnataka, India; St. John's Medical College, Bangalore, Karnataka, India; Sri Shankara Cancer Hospital & Research Centre, Bangalore, Karnataka, India; Sri Rangadore Memorial Hospital, Bangalore, Karnataka, India
| | - M Correa
- St. John's Research Institution, Bangalore, Karnataka, India; St. John's Medical College & Hospital, Bangalore, Karnataka, India; St. John's Medical College, Bangalore, Karnataka, India; Sri Shankara Cancer Hospital & Research Centre, Bangalore, Karnataka, India; Sri Rangadore Memorial Hospital, Bangalore, Karnataka, India
| | - N Raman
- St. John's Research Institution, Bangalore, Karnataka, India; St. John's Medical College & Hospital, Bangalore, Karnataka, India; St. John's Medical College, Bangalore, Karnataka, India; Sri Shankara Cancer Hospital & Research Centre, Bangalore, Karnataka, India; Sri Rangadore Memorial Hospital, Bangalore, Karnataka, India
| | - MSN Prasad
- St. John's Research Institution, Bangalore, Karnataka, India; St. John's Medical College & Hospital, Bangalore, Karnataka, India; St. John's Medical College, Bangalore, Karnataka, India; Sri Shankara Cancer Hospital & Research Centre, Bangalore, Karnataka, India; Sri Rangadore Memorial Hospital, Bangalore, Karnataka, India
| | - S Manjunath
- St. John's Research Institution, Bangalore, Karnataka, India; St. John's Medical College & Hospital, Bangalore, Karnataka, India; St. John's Medical College, Bangalore, Karnataka, India; Sri Shankara Cancer Hospital & Research Centre, Bangalore, Karnataka, India; Sri Rangadore Memorial Hospital, Bangalore, Karnataka, India
| | - S Shivananda
- St. John's Research Institution, Bangalore, Karnataka, India; St. John's Medical College & Hospital, Bangalore, Karnataka, India; St. John's Medical College, Bangalore, Karnataka, India; Sri Shankara Cancer Hospital & Research Centre, Bangalore, Karnataka, India; Sri Rangadore Memorial Hospital, Bangalore, Karnataka, India
| | - KS Gopinath
- St. John's Research Institution, Bangalore, Karnataka, India; St. John's Medical College & Hospital, Bangalore, Karnataka, India; St. John's Medical College, Bangalore, Karnataka, India; Sri Shankara Cancer Hospital & Research Centre, Bangalore, Karnataka, India; Sri Rangadore Memorial Hospital, Bangalore, Karnataka, India
| | - BS Srinath
- St. John's Research Institution, Bangalore, Karnataka, India; St. John's Medical College & Hospital, Bangalore, Karnataka, India; St. John's Medical College, Bangalore, Karnataka, India; Sri Shankara Cancer Hospital & Research Centre, Bangalore, Karnataka, India; Sri Rangadore Memorial Hospital, Bangalore, Karnataka, India
| | - TS Sridhar
- St. John's Research Institution, Bangalore, Karnataka, India; St. John's Medical College & Hospital, Bangalore, Karnataka, India; St. John's Medical College, Bangalore, Karnataka, India; Sri Shankara Cancer Hospital & Research Centre, Bangalore, Karnataka, India; Sri Rangadore Memorial Hospital, Bangalore, Karnataka, India
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Raghavan R, Pawson N, Small N. Family carers' perspectives on post-school transition of young people with intellectual disabilities with special reference to ethnicity. J Intellect Disabil Res 2013; 57:936-946. [PMID: 22823005 DOI: 10.1111/j.1365-2788.2012.01588.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND School leavers with intellectual disabilities (ID) often face difficulties in making a smooth transition from school to college, employment or more broadly to adult life. The transition phase is traumatic for the young person with ID and their families as it often results in the loss of friendships, relationships and social networks. METHOD The aim of this study was to explore the family carers' views and experiences on transition from school to college or to adult life with special reference to ethnicity. Forty-three families (consisting of 16 White British, 24 Pakistani, 2 Bangladeshi and one Black African) were interviewed twice using a semi-structured interview schedule. The carers were interviewed twice, Time 1 (T1) and Time 2 (T2), T2 being a year later to observe any changes during transition. RESULTS The findings indicate that although transition planning occurred it was relatively later in the young person's school life. Parents were often confused about the process and had limited information about future options for their son or daughter. All family carers regardless of ethnicity, reported lack of information about services and expressed a sense of being excluded. South Asian families experienced more problems related to language, information about services, culture and religion. CONCLUSIONS The majority of families lacked knowledge and awareness of formal services and the transition process. Socio-economic status, high levels of unemployment and caring for a child with a disability accounted for similar family experiences, regardless of ethnic background. The three key areas relevant for ethnicity are interdependence, religion and assumptions by service providers.
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Affiliation(s)
- R Raghavan
- School of Health, Community and Education Studies, Northumbria University, Newcastle, UK.
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Airy M, Raghavan R, Truong LD, Eknoyan G. Tubulointerstitial nephritis and cancer chemotherapy: update on a neglected clinical entity. Nephrol Dial Transplant 2013; 28:2502-9. [DOI: 10.1093/ndt/gft241] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [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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Raghavan R, Tripathy B. On Some Comparison Properties of Rough Sets Based on Multigranulations and Types of Multigranular Approximations of Classifications. ACTA ACUST UNITED AC 2013. [DOI: 10.5815/ijisa.2013.06.09] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Regish KM, Sharma D, Prithviraj DR, Nair A, Raghavan R. Evaluation and comparison of the internal fit and marginal accuracy of base metal (nickelchromium) and zirconia copings before and after ceramic veneering: a sem study. Eur J Prosthodont Restor Dent 2013; 21:44-48. [PMID: 23682510] [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] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This study compares the internal fit and marginal adaptation of copy milled Zirconia copings with Nickel-Chromium (Ni-Cr) copings fabricated using a lost wax technique before and after ceramic veneering. A standardized metal master die simulating a prepared crown was fabricated and twenty impressions of the metal die were made and poured with die stone. Wax patterns were made on ten dies and cast while light cure resin patterns were made on the other ten dies for copy milling the Zirconia copings. Five specimens from each group were subjected to ceramic veneering. All the test specimens were luted on to the fresh dies, embedded in dental plaster, sectioned and image analysis done using scanning electron microscopy. Thereafter statistical analysis is done using student t-test. The linear measurements for internal fit and marginal discrepancy were increased for Zirconia compared with Ni-Cr copings. The difference in the values of all the specimens of all the groups were not statistically significant (P > 0.05) except the values comparing the internal fit of Zirconia and Ni-Cr copings before ceramic veneering (P < 0.001) which was statistically significant. The internal fit and marginal adaptability of Ni-Cr copings were found to be better than the Copy milled Zirconia copings but internal fit and marginal adaptability deteriorated after ceramic veneering.
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Affiliation(s)
- K M Regish
- Coorg Institute of Dental Sciences, Virajpet, S-Coorg, Karnataka, India 571218.
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Sahoo GC, Raghavan R. Rhinosporidiosis on HIV - a case report. Indian J Otolaryngol Head Neck Surg 2012; 52:281-2. [PMID: 23119697 DOI: 10.1007/bf03006205] [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: 11/26/2022] Open
Abstract
Rhinosporidiosis is a chronic disease that classically presents with the involvement of nose and nasopharynx. However, it can be present in various other sites including conjunctiva, vulva, vagina, larynx and scalp. We report a case with a Rhinosporidial mass in the nose extending to oropharynx and multiple cutaneous lesions of Rhinosporidiosis in a patient with HIV, This case is the first of its kind where HIV has been associated with Rhinosporidiosis.
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Affiliation(s)
- G C Sahoo
- Dept. of ENT, Annamalai University, Chidamburam, Tamilnadu
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Raghavan R, Cheriyamundath S, Madassery J. 151 Andrographolide Induces Cell Cycle Arrest in THP-1 Cancer Cell Line and Inhibits Glutathione S-transferase Enzyme Directly. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)71949-4] [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: 11/26/2022]
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Kyle JR, Kyle MD, Raghavan R, Budak G, Ozkan CS, Ozkan M. Analysis of light scattering from human breast tissue using a custom dual-optical scanning near-field optical microscope. J Biophotonics 2011; 4:193-205. [PMID: 20740520 DOI: 10.1002/jbio.201000022] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2010] [Revised: 06/19/2010] [Accepted: 07/12/2010] [Indexed: 05/29/2023]
Abstract
In this paper we introduce a custom scanning near-field optical microscope (SNOM) that simultaneously collects reflection and transmission near-field images along with topography. This dual-optical SNOM uses a bent probe, which allows for axial reflection imaging, accurate surface scanning, and easy identification of topographic artifacts. Using this novel dual-optical SNOM, we image desiccated and non-desiccated human breast epithelial tissue. By comparing the simultaneous SNOM images, we isolate the effects of tissue morphology and variations in refractive indices on the forward- and back-scattering of light from the tissue. We find that the reduction in back-scattering from tissue, relative to the glass slide, is caused by dense packing of the scattering sites in the cytoplasm (morphology) in the desiccated tissue and a thin-film of water adhering to the glass slide (refractive index) in the non-desiccated tissue sample. Our work demonstrates the potential of our customized dual-optical SNOM system for label-free tissue diagnostics.
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Affiliation(s)
- Jennifer Reiber Kyle
- Department of Electrical Engineering, University of California-Riverside, Riverside, CA 92521, USA
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Sukov WR, Ketterling RP, Wei S, Monaghan K, Blunden P, Mazzara P, Raghavan R, Oliviera AM, Wiktor AE, Keeney GL, Van Dyke DL. Nearly identical near-haploid karyotype in a peritoneal mesothelioma and a retroperitoneal malignant peripheral nerve sheath tumor. ACTA ACUST UNITED AC 2010; 202:123-8. [PMID: 20875874 DOI: 10.1016/j.cancergencyto.2010.07.120] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2010] [Revised: 07/01/2010] [Accepted: 07/02/2010] [Indexed: 01/02/2023]
Abstract
The presence of a near-haploid karyotype is a rare finding in human malignancies, most frequently occurring in acute leukemia. In solid tumors, a near-haploid karyotype has been reported in fewer than 40 cases. We report two nearly identical near-haploid karyotypes from two distinctly different tumor types. The first case is a biphasic malignant mesothelioma from a 53-year-old white woman forming a large retroperitoneal mass. Cytogenetic evaluation revealed a primary hyperdiploid cell population as well as near-haploid and hypertetraploid populations with an overall karyotype of 27,XX,i(5)(p10),+7,add(15)(p11.2),+dic(1;20)(p13;p13)[2]/54,idemx2[90]/101-108,idemx4[19]. The second case is a large pelvic mass from a 48-year-old man. Histologic examination identified a malignant peripheral nerve sheath tumor displaying a karyotype of 26,X,+i(5)(p10),+7,der(15)t(1;15)(q12;p12),+20[5]/52,idemx2[20]. Herein we discuss the potential relationship between these two disparate neoplasms with nearly identical near-haploid karyotypes and present a literature review.
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Affiliation(s)
- William R Sukov
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
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