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Sundararajan S, Abi Habib P, Tadbiri H, Aycan F, Mangione M, Chaves AH, Seger L, Turan O, Turan S. Factors that Influence Placement of Gastrostomy Tube in Infants with Complex Congenital Heart Disease: A Single Center Study. J Neonatal Perinatal Med 2023:NPM230012. [PMID: 37270816 DOI: 10.3233/npm-230012] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Factors that determine the need for Gastrostomy tube (G-tube) placement in infants with complex congenital heart defects (CHD) are variable. We aim to identify factors that improve counseling of expectant parents regarding postnatal outcomes and management. METHODS We performed a retrospective review of medical record of infants with prenatal diagnoses of complex CHD between 2015-2019 in a single tertiary care center and assessed risk factors for G-tube placement with linear regression. RESULTS Of the 105 eligible infants with complex CHD, 44 infants required G-tube (42% ). No significant association was observed between G-tube placement and chromosomal abnormalities, cardiopulmonary bypass time or type of CHD. Median days on noninvasive ventilation (4 [IQR 2-12] vs. 3 [IQR 1-8], p = 0.035), time at which gavage-tube feeds were started postoperatively (3 [IQR 2-8] vs. 2 [IQR 0-4], p = 0.0013), time to reach full-volume gavage-tube feeds (6 [IQR 3-14] vs. 5 [IQR 0-8], p = 0.038) and intensive care unit (ICU) length of stay (LOS) (41 [IQR: 21 - 90] vs. 18 [IQR: 7 - 23], p < 0.01) were associated with G-tube placement. Infants with ICU LOS duration longer than median had almost 7 times the odds of requiring a G-tube (OR: 7.23, 95% CI: 2.71-19.32; by regression). CONCLUSIONS Delay in initiation and in reaching full-volume gavage-tube feeds after cardiac surgery, increased number of days spent on non-invasive ventilation and in the ICU were found to be significant predictors for G-tube placement. The type of CHD and the need for cardiac surgery were not significant predictors for G-tube placement.
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Affiliation(s)
- S Sundararajan
- Division of Neonatology, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - P Abi Habib
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Science, University of Maryland School of Medicine, Baltimore, MD, USA
| | - H Tadbiri
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Science, University of Maryland School of Medicine, Baltimore, MD, USA
| | - F Aycan
- Division of Neonatology, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - M Mangione
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Science, University of Maryland School of Medicine, Baltimore, MD, USA
| | - A H Chaves
- Division of Pediatric Cardiology, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - L Seger
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Science, University of Maryland School of Medicine, Baltimore, MD, USA
| | - O Turan
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Science, University of Maryland School of Medicine, Baltimore, MD, USA
| | - S Turan
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Science, University of Maryland School of Medicine, Baltimore, MD, USA
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Youssef S, Iftikhar S, Haris M, Sundararajan S, Abid Q. 1008 Incidental Solitary Cystic Mediastinal Lymphangioma with Mass Effect Complications: A Case Report. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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
Cystic mediastinal lymphangiomas (CML) are exceedingly rare, representing <1% of cystic lymphangiomas (CL), and typically present before 2 years of age. Few cases describe adult presentations of solitary CML and none describe symptomatic cases with ‘mass-effect’ complications. We describe an incidental finding of a symptomatic solitary CML causing mass effect complications and our definitive surgical management.
Case Report
A 44-year-old Caucasian male presented with reduced responsiveness due to mixed drug overdose of fluoxetine and ibuprofen. Plain chest radiograph (CXR) revealed incidental new mediastinal widening. Thoracic computed tomography (CT) showed a well-defined lesion (75x63mm) in the right paratracheal region, with associated compression of the superior vena cava, left brachiocephalic vein and displacement of the azygos vein. Further questioning revealed 6-months history of non-productive cough, worsening dyspnoea on exertion and chest pain radiating to the right of the chest. Complete surgical resection was performed via posterolateral thoracotomy. It was seen compressing the 2nd and 3rd intercostal nerves. Enlarged lymph nodes at station 4 and 10 were excised and sent for analysis with aspirate from the excised lesion. Pathological gross examination showed a multiloculated cystic lesion containing thin straw-coloured fluid. Microscopically, it was thin walled with smooth muscle and scattered clusters of lymphocytes; its lining was markedly attenuated comprising bland flat endothelial cells, positive for CD-31. Lymph node samples showed reactive changes.
Conclusions
Although CMLs are benign, their location and growth in the mediastinum can result in compression of surrounding structures. Early detection and complete surgical resection are paramount to prevent such complications and lesion recurrence.
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Affiliation(s)
- S Youssef
- University of Nottingham, Nottingham, United Kingdom
- University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, United Kingdom
| | - S Iftikhar
- University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, United Kingdom
| | - M Haris
- University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, United Kingdom
| | - S Sundararajan
- University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, United Kingdom
| | - Q Abid
- University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, United Kingdom
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Sundararajan S, Jayachandran I, Subramanian SC, Anjana RM, Balasubramanyam M, Mohan V, Venkatesan B, Manickam N. Decreased Sestrin levels in patients with type 2 diabetes and dyslipidemia and their association with the severity of atherogenic index. J Endocrinol Invest 2021; 44:1395-1405. [PMID: 33048307 DOI: 10.1007/s40618-020-01429-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 09/16/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE We earlier reported that Sestrin2 regulates monocyte activation and atherogenic events through AMPK-mTOR nexus under high-glucose and dyslipidemic conditions. However, the statuses of Sestrins in diabetes and dyslipidemia are not known. We report here on the status of Sestrins and their association with diabetic dyslipidemia and atherosclerosis. METHODS Individuals with normal glucose tolerance (NGT) (n = 46), dyslipidemia (n = 42), and patients with Type 2 diabetes with (n = 41) and without dyslipidemia (n = 40) were recruited from a tertiary diabetes centre, Chennai, India to study the mRNA expression levels of Sestrins (1, 2, and 3) in monocytes by RT-qPCR. Serum levels of Sestrins were measured using ELISA. Atherogenic index of plasma was calculated as log (triglyceride/HDL). RESULTS mRNA expressions of Sestrin1 and Sestrin3 were significantly reduced in monocytes under dyslipidemic conditions but not in diabetes condition. Interestingly, Sestrin2 mRNA expression was significantly reduced in all disease conditions including dyslipidemia, and diabetes with and without dyslipidemia. Sestrin2 mRNA levels were negatively correlated with glycemic and lipid parameters and plasma atherogenic index. Furthermore, circulatory Sestrin2 was also found to be significantly decreased in dyslipidemia (415.2 ± 44.7 pg/ml), diabetes (375 ± 45 pg/ml), and diabetes with dyslipidemia (319.2 ± 26.3 pg/ml) compared to NGT (706.3 ± 77 pg/ml) and negatively correlated with glycemic, lipid parameters, and plasma atherogenic index. CONCLUSION We report for the first time that Sestrins levels are significantly decreased in diabetes and dyslipidemic conditions. More strikingly, Sestrin2 had a strong association with atherogenic risk factors and severity of atherogenic index and we suggest that Sestrin2 may be used as a biomarker for assessing atherogenesis.
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Affiliation(s)
- S Sundararajan
- Department of Vascular Biology, Madras Diabetes Research Foundation and ICMR Centre for Advanced Research On Diabetes, Chennai, India
| | - I Jayachandran
- Department of Vascular Biology, Madras Diabetes Research Foundation and ICMR Centre for Advanced Research On Diabetes, Chennai, India
| | - S C Subramanian
- Clinical Epidemiology, Madras Diabetes Research Foundation, Chennai, India
| | - R M Anjana
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Who Collaborating Centre for Non-Communicable Diseases Prevention and Control, Chennai, India
| | - M Balasubramanyam
- Department of Cell and Molecular Biology, Madras Diabetes Research Foundation, Chennai, India
| | - V Mohan
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Who Collaborating Centre for Non-Communicable Diseases Prevention and Control, Chennai, India
| | - B Venkatesan
- Department of Vascular Biology, Madras Diabetes Research Foundation and ICMR Centre for Advanced Research On Diabetes, Chennai, India.
- Science and Engineering Research Board, New Delhi, India.
| | - N Manickam
- Department of Vascular Biology, Madras Diabetes Research Foundation and ICMR Centre for Advanced Research On Diabetes, Chennai, India.
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Schecter LV, Medina AE, Alexander JL, Sundararajan S. Impact of early postnatal exposure of red blood cell transfusions on the severity of retinopathy of prematurity. J Neonatal Perinatal Med 2021; 14:527-535. [PMID: 34120920 DOI: 10.3233/npm-200679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 11/15/2022]
Abstract
BACKGROUND Postnatal exposure to red blood cell transfusion (RBCT) in premature infants is an important risk factor for Retinopathy of Prematurity (ROP) progression. We hypothesized that higher number and earlier timing of RBCT are associated with worse ROP severity and result in laser treatment at an earlier postmenstrual age (PMA) in very low birth weight (≤1500 g, VLBW) infants. METHODS A retrospective medical record review of 631 VLBW infants over a 5-year period was performed. Demographic features and potential clinical risk factors including number of RBCT, ROP severity, and progression to laser treatment were collected to evaluate predictors of severe ROP. ANCOVA, pairwise post-hoc analyses, and multivariate regression were used to determine associations between frequency and timing of RBCT and ROP severity. RESULTS Of the 456 eligible infants, 61 developed severe ROP (13%). There was significant correlation between number of RBCTs and ROP severity, adjusted for gestational age and birthweight (Adjusted R2 = 0.53; p < 0.001). Compared to infants with No/Mild and Type 2 ROP, infants with Type 1 ROP received more RBCTs, with higher number of RBCTs per week during the first month of life (mean RBCT in ROP No/Mild 5.7±0.4 vs Type 2 16.3±1.8 vs Type 1 22.4±1.5, p = 0.042). Laser-treated infants received a higher number of RBCTs than non-treated infants (mean RBCT 22.3 vs. 6.5, p < 0.001) but no correlation was observed between number of RBCTs and PMA at time of laser treatment. CONCLUSION Higher number of RBCTs in early postnatal life of VLBW infants was associated with more severe ROP.
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Affiliation(s)
| | - A E Medina
- Department of Pediatrics, University of Maryland School Of Medicine, USA
| | - J L Alexander
- Department of Ophthalmology and Visual Sciences, University of Maryland School Of Medicine, USA
| | - S Sundararajan
- Department of Pediatrics, University of Maryland School Of Medicine, USA
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Sundararajan S, Chepuri R, Lambert D, Lohr N, Ishizawar D, Gaglianello N. Objective Nutritional Index is Associated with Worse Cardiopulmonary Exercise Test Performance in Advanced Heart Failure Patients. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.616] [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] Open
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6
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McDermott D, Vaishampayan U, Matrana M, Rha S, Saavedra AZ, Ho T, Keam B, Lee JL, Joseph R, Ali S, Stadler W, Haas N, Sundararajan S, Park S, Mowat R, Picus J, Dudek A, Zakharia Y, Gan L, Atkins M. Safety and efficacy of the oral CXCR4 inhibitor X4P-001 + axitinib in advanced renal cell carcinoma patients: An analysis of subgroup responses by prior treatment. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz253.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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7
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Elumalai S, Kannan K, Gopal R, Sundararajan S. Clinical spectrum and treatment outcomes of HIV associated cancers in a tertiary care center in South India. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy442.008] [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] Open
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Wang CC, Tan KL, Chen CT, Lin YH, Keerthi SS, Mahajan D, Sundararajan S, Lin CJ. Distributed Newton Methods for Deep Neural Networks. Neural Comput 2018; 30:1673-1724. [PMID: 29652589 DOI: 10.1162/neco_a_01088] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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
Deep learning involves a difficult nonconvex optimization problem with a large number of weights between any two adjacent layers of a deep structure. To handle large data sets or complicated networks, distributed training is needed, but the calculation of function, gradient, and Hessian is expensive. In particular, the communication and the synchronization cost may become a bottleneck. In this letter, we focus on situations where the model is distributedly stored and propose a novel distributed Newton method for training deep neural networks. By variable and feature-wise data partitions and some careful designs, we are able to explicitly use the Jacobian matrix for matrix-vector products in the Newton method. Some techniques are incorporated to reduce the running time as well as memory consumption. First, to reduce the communication cost, we propose a diagonalization method such that an approximate Newton direction can be obtained without communication between machines. Second, we consider subsampled Gauss-Newton matrices for reducing the running time as well as the communication cost. Third, to reduce the synchronization cost, we terminate the process of finding an approximate Newton direction even though some nodes have not finished their tasks. Details of some implementation issues in distributed environments are thoroughly investigated. Experiments demonstrate that the proposed method is effective for the distributed training of deep neural networks. Compared with stochastic gradient methods, it is more robust and may give better test accuracy.
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Affiliation(s)
- Chien-Chih Wang
- Department of Computer Science, National Taiwan University, Taipei 10617, Taiwan
| | - Kent Loong Tan
- Department of Computer Science, National Taiwan University, Taipei 10617, Taiwan
| | - Chun-Ting Chen
- Department of Computer Science, National Taiwan University, Taipei 10617, Taiwan
| | - Yu-Hsiang Lin
- Department of Physics, National Taiwan University, Taipei 10617, Taiwan
| | | | | | - S Sundararajan
- Microsoft Research India, Bangalore, Karnataka 56001, India
| | - Chih-Jen Lin
- Department of Computer Science, National Taiwan University, Taipei 10617, Taiwan
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Sundararajan S, Avignon G, Madoff D, Browne W, Winokur R. Abstract No. 644 Venous intervention guidance with overlay of 3D vessel center lines from preoperative CT/MR imaging. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.689] [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] Open
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10
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Rao SR, Sundararajan S, Subbarayan R, Murugan Girija D. Cyclosporine-A induces endoplasmic reticulum stress and influences pro-apoptotic factors in human gingival fibroblasts. Mol Cell Biochem 2017; 429:179-185. [PMID: 28324237 DOI: 10.1007/s11010-017-2945-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 01/17/2017] [Indexed: 10/19/2022]
Abstract
Cyclosporine-A (CsA) induces gingival overgrowth. Cyclosporine's anti-apoptotic activity in human gingival fibroblast is due to desensitization of mitochondrial permeability transition pore (MPTP) and augmentation of anti-apoptotic, Bcl2. Alternative mechanisms of apoptosis exist involving enzymes like calcium-dependent Calpain and signaling events related to apoptosis, like Glycogen synthase kinase 3β (GSK3β) and protein kinase A (PKA). Cyclosporine-A in renal tubular cells induces endoplasmic reticulum stress (ER stress) which has not been explored in gingival overgrowth. Hence, this study was carried out to assess the influence of Cyclosporine-on ER stress and on the alternate anti-apoptotic mechanisms. Human gingival fibroblasts were treated with CsA, and expression of ER stress markers, such as binding immunoglobulin protein and CCAAT/enhancer-binding protein homologous protein (CHOP), MPTP, and expression of Calpain & GSK3β /PKA were estimated. The results showed CsA-added fibroblast significantly increasing the expression of Endoplasmic reticulum stress markers. Contrary to usual ER stress outcome of apoptosis, we observed Cyclosporine's anti-apoptotic action in spite of augmented ER stress markers. We conclude that CsA's independent action on different organelles may alter the conventional outcome of ER stress.
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Affiliation(s)
- Suresh Ranga Rao
- Department of Periodontology and Implantology, Faculty of Dental Sciences & Centre for Regenerative Medicine and Stem Cell Research, Sri Ramachandra University, Porur, Chennai, India.
| | - Shiyamali Sundararajan
- Department of Periodontology and Implantology, Faculty of Dental Sciences & Centre for Regenerative Medicine and Stem Cell Research, Sri Ramachandra University, Porur, Chennai, India
| | - Rajasekaran Subbarayan
- Centre for Regenerative Medicine and Stem Cell Research, Central Research Facility, Sri Ramachandra University, Chennai, India
| | - Dinesh Murugan Girija
- Centre for Indian Systems of Medicine Quality Assurance and Standardization, Central Research Facility, Sri Ramachandra University, Chennai, India
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Sundararajan S, Khadanga MK, Kumar JPPJ, Raghumaran S, Vijaya R, Jena BK. Ecological risk assessment of trace metal accumulation in sediments of Veraval Harbor, Gujarat, Arabian Sea. Mar Pollut Bull 2017; 114:592-601. [PMID: 27817889 DOI: 10.1016/j.marpolbul.2016.09.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 04/22/2016] [Revised: 08/28/2016] [Accepted: 09/10/2016] [Indexed: 06/06/2023]
Abstract
In this study, different types of indices were used to assess the ecological risk of trace metal contamination in sediments on the basis of sediment quality guidelines at Veraval Fishery Harbor. Sediment samples were collected from three sectors in pre-, post-, and monsoon seasons in 2006. Trace metal concentrations were higher in the inner sector during post-monsoon, and it showed the highest statistical significance (p<0.01) among the stations. Pollution load index was higher than unity, indicating alternation by effluent discharge from industries. Enrichment factor and geo-accumulation index showed that Cd, Pb, and Zn were enriched in the northern part of the harbor and Pb had accumulated in the harbor sediment. The ecological risk assessment index revealed that Ni, Zn, and Pb were higher than the effect range median values, indicating their potential toxicity to the aquatic environment in the Veraval Harbor. Hence, the harbor is dominated by anthropogenic activities rather than natural process.
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Affiliation(s)
- S Sundararajan
- ESSO-National Institute of Ocean Technology, Tambaram-Velachery Main Road, Pallikaranai, Chennai 600100, India.
| | - Mukunda Kesari Khadanga
- ESSO-National Institute of Ocean Technology, Tambaram-Velachery Main Road, Pallikaranai, Chennai 600100, India.
| | - J Prince Prakash Jeba Kumar
- ESSO-National Institute of Ocean Technology, Tambaram-Velachery Main Road, Pallikaranai, Chennai 600100, India
| | - S Raghumaran
- ESSO-National Institute of Ocean Technology, Tambaram-Velachery Main Road, Pallikaranai, Chennai 600100, India
| | - R Vijaya
- ESSO-National Institute of Ocean Technology, Tambaram-Velachery Main Road, Pallikaranai, Chennai 600100, India
| | - Basanta Kumar Jena
- ESSO-National Institute of Ocean Technology, Tambaram-Velachery Main Road, Pallikaranai, Chennai 600100, India
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Rangarao S, Sundararajan S, Muthukumar S. A case-control study assessing depression in patients with periodontitis. Indian J Soc Psychiatry 2017. [DOI: 10.4103/0971-9962.200091] [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: 11/04/2022] Open
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Rao S, Muthukumar S, Ajit P, Sundararajan S. Reconstruction of interdental papilla using autogenous bone and connective tissue grafts. J Indian Soc Periodontol 2016; 20:464-467. [PMID: 28298832 PMCID: PMC5341325 DOI: 10.4103/0972-124x.193164] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Previous studies have reported the management of Class I and II papillary defects, but knowledge on Class III defects, estimated to have a poor periodontal prognosis, remains minimal. In this case report, a Class III papillary defect reconstruction was attempted mainly since the patient reported with difficulty in phonetics. In Stage I, autogenous bone graft from the maxillary tuberosity and subepithelial connective tissue graft was augmented to decrease the distance between the interdental bone crest and contact point, simultaneously achieving a switch in the periodontal biotype. In Stage II, subepithelial connective tissue graft was augmented to achieve papillary fill. To avoid manual errors associated with quantifying the posttreatment outcomes, image data processing ImageJ software was used to assess the length, perimeter, and surface area of papillary loss using the preoperative images.
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Abstract
In structured output learning, obtaining labeled data for real-world applications is usually costly, while unlabeled examples are available in abundance. Semisupervised structured classification deals with a small number of labeled examples and a large number of unlabeled structured data. In this work, we consider semisupervised structural support vector machines with domain constraints. The optimization problem, which in general is not convex, contains the loss terms associated with the labeled and unlabeled examples, along with the domain constraints. We propose a simple optimization approach that alternates between solving a supervised learning problem and a constraint matching problem. Solving the constraint matching problem is difficult for structured prediction, and we propose an efficient and effective label switching method to solve it. The alternating optimization is carried out within a deterministic annealing framework, which helps in effective constraint matching and avoiding poor local minima, which are not very useful. The algorithm is simple and easy to implement. Further, it is suitable for any structured output learning problem where exact inference is available. Experiments on benchmark sequence labeling data sets and a natural language parsing data set show that the proposed approach, though simple, achieves comparable generalization performance.
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Affiliation(s)
| | - Shirish Shevade
- Computer Science and Automation, Indian Institute of Science, Bangalore 560012, India
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15
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Sundararajan S, Muthukumar S, Rao SR. Relationship between depression and chronic periodontitis. J Indian Soc Periodontol 2015; 19:294-6. [PMID: 26229270 PMCID: PMC4520114 DOI: 10.4103/0972-124x.153479] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 02/05/2015] [Indexed: 11/17/2022] Open
Abstract
Background: Periodontitis is a chronic, multifactorial, polymicrobial disease causing inflammation in the supporting structures of the teeth. There is a plethora of nonoral risk factors which can be quoted to aid in the development of chronic periodontitis. According to WHO, depression is a common mental disorder that presents with depressed mood, loss of interest or pleasure, feelings of guilt, disturbed sleep or appetite, low energy and poor concentration. Depression is associated with negligent oral health care and another mechanism proposed disturbance in the hypothalamic-pituitary axis system and hypothalamic-pituitary-thyroid system, which can affect the periodontal status by affecting the immune system. Aim: The aim of this study was to assess the association between periodontal clinical parameters and depression rating. Materials and Methods: The study design is a case–control study with 35 patients each in case and control group. The periodontal parameters taken for measurement were probing depth and clinical attachment loss. Depression was calculated using Beck's depression scale. Statistical Analysis: The statistical analysis was performed by means of SPSS software (SPSS Inc., Chicago, IL, USA; version 17.0 under windows 2000). Student's t-test was used to determine the relationship between the clinical periodontal parameters and depression. Results: Self-reported scoring of depression by using Beck's depression inventory has shown that periodontal patients had a significantly higher total depression score than normal controls. Conclusion: This study reveals that there is a direct correlation between the severity of periodontal disease and the severity of depression in patients.
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Affiliation(s)
- Shiyamali Sundararajan
- Department of Periodontics, Sri Ramachandra University, Porur, Chennai, Tamil Nadu, India
| | | | - Suresh Ranga Rao
- Department of Periodontics, Sri Ramachandra University, Porur, Chennai, Tamil Nadu, India
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Bhat G, Yost G, Sundararajan S, Mohamedali B. Use of Theophylline to Avoid Permanent Pacing in Post Heart Transplant Sinus Node Dysfunction. Transplantation 2014. [DOI: 10.1097/00007890-201407151-01421] [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: 11/25/2022]
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17
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Gamboa J, Blankenship DA, Niemi JP, Landreth GE, Karl M, Hilow E, Sundararajan S. Extension of the neuroprotective time window for thiazolidinediones in ischemic stroke is dependent on time of reperfusion. Neuroscience 2010; 170:846-57. [PMID: 20691766 DOI: 10.1016/j.neuroscience.2010.07.063] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2009] [Revised: 07/19/2010] [Accepted: 07/30/2010] [Indexed: 12/23/2022]
Abstract
Stroke is a leading cause of death and disability but has limited therapeutic options. Thiazolidinediones (TZDs), agonists for the nuclear receptor, peroxisome proliferator-activated receptor (PPAR)γ, reduce infarct volume and improve neurologic function following transient middle cerebral artery occlusion (MCAO) in rats. Translation of these findings into clinical therapy will require careful assessment of dosing paradigms and effective time windows for treatment. Understanding the mechanisms by which TZDs protect the brain provides insight into how time windows for neuroprotection might be extended. We find that two TZDs, pioglitazone and rosiglitazone, significantly reduce infarct volume at doses similar to those used clinically (1 mg/kg for pioglitazone and 0.1 mg/kg for rosiglitazone). We also find that pioglitazone reduces infarction volume in a transient, but not a permanent MCAO model suggesting that reperfusion plays an important role in TZD mediated neuroprotection. Since PPARγ agonists reduce inflammation and oxidative stress, both of which are exacerbated by reperfusion, we hypothesized that TZDs would be most effective if administered prior to reperfusion. We administered TZDs 3 h after MCAO and found that infarction volume and neurologic function are significantly improved in animals reperfused at 3 h and 15 min (after TZD treatment), but not in animals reperfused at 2 h (before TZD treatment) when assessed either 24 h or 3 weeks after MCAO. While TZDs reduce intercellular adhesion molecule (ICAM) expression to a similar extent regardless of the time of reperfusion, leukocyte entry into brain parenchyma is more dramatically reduced when reperfusion is delayed until after drug treatment. The finding that delaying reperfusion until after TZD treatment is beneficial despite a longer period of ischemia, is dramatic given the widely held view that duration of ischemia is the most important determinate of injury.
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Affiliation(s)
- J Gamboa
- Department of Clinical Pharmacology, Vanderbilt University, Nashville, TN 37232, USA
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18
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Abstract
Gaussian processes (GPs) are promising Bayesian methods for classification and regression problems. Design of a GP classifier and making predictions using it is, however, computationally demanding, especially when the training set size is large. Sparse GP classifiers are known to overcome this limitation. In this letter, we propose and study a validation-based method for sparse GP classifier design. The proposed method uses a negative log predictive (NLP) loss measure, which is easy to compute for GP models. We use this measure for both basis vector selection and hyperparameter adaptation. The experimental results on several real-world benchmark data sets show better or comparable generalization performance over existing methods.
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Affiliation(s)
- Shirish Shevade
- Computer Science and Automation, Indian Institute of Science, Bangalore 560 012, India
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Meenakshi-Sundaram S, Anand TCV, Suriyakumar G, Sridhar R, Sundararajan S, Sundar B. Recombinant factor VIIa in a case of pontine hemorrhage. J Assoc Physicians India 2008; 56:719-720. [PMID: 19086362] [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: 05/27/2023]
Abstract
A 59-year-old lady presented with hypertensive hemorrhage involving the pons. Since she presented within 3 hours of onset of the stroke, recombinant factor VIIa was administered. From a state of altered sensorium there was a rapid recovery of consciousness followed by gradual improvement in limb weakness. Serial CT scans of the brain revealed no further expansion of the hematoma. The hematoma progressively resolved. Recombinant factor VIIa could be an attractive therapeutic option in treating hemorrhages at critical sites like brainstem where expansion of hematoma could be fatal.
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Affiliation(s)
- S Meenakshi-Sundaram
- Department of Neurosciences, Apollo Speciality Hospitals, Lake View Road, KK Nagar, Madurai, Tamil Nadu, India-625 020
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20
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Sundararajan S, Tohno E, Kamma H, Ueno E, Minami M. Role of ultrasonography and MRI in the detection of wide intraductal component of invasive breast cancer—a prospective study. Clin Imaging 2007. [DOI: 10.1016/j.clinimag.2007.06.004] [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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21
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Sundararajan S, Tohno E, Kamma H, Ueno E, Minami M. Role of ultrasonography and MRI in the detection of wide intraductal component of invasive breast cancer—a prospective study. Clin Radiol 2007; 62:252-61. [PMID: 17293219 DOI: 10.1016/j.crad.2006.09.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2005] [Revised: 09/03/2006] [Accepted: 09/07/2006] [Indexed: 10/23/2022]
Abstract
AIM To compare the role of ultrasound (US) and magnetic resonance imaging (MRI) in the detection of extent and direction of intraductal components around invasive breast cancer in comparison with histopathological findings. MATERIALS AND METHODS In 60 invasive breast cancers (59 patients), US features of the intraductal components were classified as: (a) solid ductal dilatation radiating from the tumour, (b) the presence of a satellite lesion in the same segment without ductal dilatation, (c) ductal dilatation between the main tumour and the satellite lesion. The criteria for the detection of intraductal components by MRI were as follows: (a) strand-like enhancement on the margin of the main tumour, (b) satellite lesions around the main tumour, or (c) bridging enhancement between the main tumour and the satellite lesion. The direction of the intraductal components was classified as towards the nipple and towards the periphery. RESULTS Wide intraductal components (>or=15 mm) towards the nipple were proven histopathologically in 17 of 59 (28.8%) cancers, and wide intraductal components towards the periphery were proven histopathologically in three out of 60 (5.0%) cancers. One cancer was located too close to the nipple and it was not possible to measure the intraductal component towards the nipple. US and MRI could accurately detect wide intraductal components towards the nipple in 14 and 8 cancers, respectively, out of 17 cancers. Sensitivity, specificity and accuracy for detection of wide intraductal components towards the nipple by US were 87.5, 88.3, and 88.1%, respectively. Sensitivity, specificity and accuracy for detection of wide intraductal components towards the nipple by MRI were 50, 79.1, and 72.1%, respectively. When the results of both diagnostic methods namely US and MRI were combined, sensitivity rose to 93.7%, specificity was 72.1% and accuracy was 78.0%. CONCLUSION Although ultrasound is more sensitive than MRI in the delineation of intraductal extension towards the nipple, there is no statistically significant difference in overall accuracy between the two modalities.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Breast Neoplasms/diagnosis
- Breast Neoplasms/diagnostic imaging
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/diagnosis
- Carcinoma, Ductal, Breast/diagnostic imaging
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/surgery
- Epidemiologic Methods
- Female
- Humans
- Magnetic Resonance Imaging/methods
- Mastectomy/methods
- Middle Aged
- Neoplasm Invasiveness
- Nipples/pathology
- Ultrasonography, Mammary/methods
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Affiliation(s)
- S Sundararajan
- Graduate School of Comprehensive Human Sciences, Advances in Biomedical Applications, University of Tsukuba, Japan.
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22
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Abstract
We propose a fast, incremental algorithm for designing linear regression models. The proposed algorithm generates a sparse model by optimizing multiple smoothing parameters using the generalized cross-validation approach. The performances on synthetic and real-world data sets are compared with other incremental algorithms such as Tipping and Faul's fast relevance vector machine, Chen et al.'s orthogonal least squares, and Orr's regularized forward selection. The results demonstrate that the proposed algorithm is competitive.
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Affiliation(s)
- S Sundararajan
- Philips Electronics India Ltd., Ulsoor, Bangalore, India.
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Victor NA, Wanderi EW, Gamboa J, Zhao X, Aronowski J, Deininger K, Lust WD, Landreth GE, Sundararajan S. Altered PPARgamma expression and activation after transient focal ischemia in rats. Eur J Neurosci 2007; 24:1653-63. [PMID: 17004929 DOI: 10.1111/j.1460-9568.2006.05037.x] [Citation(s) in RCA: 113] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Stroke is a devastating disease with limited treatment options. Recently, we found that the peroxisome proliferator-activated receptor-gamma (PPARgamma) agonists troglitazone and pioglitazone reduce injury and inflammation in a rat model of transient cerebral ischemia. The mechanism of this protection is unclear, as these agents can act through PPAR-gamma activation or through PPAR-gamma-independent mechanisms. Therefore, we examined PPAR-gamma expression, DNA binding and transcriptional activity following stroke. In addition, we used a PPAR-gamma antagonist, T0070907, to determine the role of PPAR-gamma during ischemia. Using immunohistochemical techniques and real-time PCR, we found low levels of PPAR-gamma mRNA and PPAR-gamma immunoreactivity in nonischemic brain; however, PPAR-gamma expression dramatically increased in ischemic neurons, peaking 24 h following middle cerebral artery occlusion. Interestingly, we found that in both vehicle- and agonist-treated brains, DNA binding was reduced in the ischemic hemisphere relative to the contralateral hemisphere. Expression of a PPAR-gamma target gene, lipoprotein lipase, was also reduced in ischemic relative to nonischemic brain. Both DNA binding and lipoprotein lipase expression were increased by the addition of the PPAR-gamma agonist rosiglitazone. Finally, we found that rosiglitazone-mediated protection after stroke was reversed by the PPAR-gamma antagonist T0070907. Interestingly, infarction size was also increased by T0070907 in the absence of PPAR-gamma agonist, suggesting that endogenous PPAR-gamma ligands may mitigate the effects of cerebral ischemia.
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Affiliation(s)
- N A Victor
- Department of Neurology, Case Western Reserve University, 11100 Euclid Ave., Cleveland, Ohio 44106, USA
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Sundararajan S, Ostojic NS, Rushton DI, Cox PM, Acland P. Diaphragmatic pathology: a cause of clinically unexplained death in the perinatal/paediatric age group. Med Sci Law 2005; 45:110-4. [PMID: 15895635 DOI: 10.1258/rsmmsl.45.2.110] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Sudden unexpected death in infancy and childhood requires a 'full' post-mortem investigation. Guidance from the Royal College of Pathologists recommends sampling of all the major organs. However, the diaphragm does not feature in this or in most lists of routine histology. Our aim is to emphasize the importance of sampling the diaphragm for histological examination during autopsy. We describe three autopsy cases of clinically unexplained death in the perinatal and paediatric age group that showed significant pathology of the diaphragm. In Case 1, a previously healthy five-year-old girl collapsed suddenly and died four days later. In Case 2, an eight-month-old infant had repeated episodes of respiratory arrest that culminated in death. Autopsy demonstrated a predominantly diaphragmatic myositis. In Case 3 a female neonate had a respiratory arrest three days after birth and died less than a month later. Autopsy showed multiple large calcified necrotic fibres in the diaphragm. The diaphragm is seldom sampled at autopsy. In the first two cases a predominantly diaphragmatic myositis was either the direct or underlying cause of death. In the third case long-standing diaphragmatic pathology of uncertain cause may have contributed to the original respiratory arrest. Had the diaphragm not been examined histologically, the cause of death would have remained unascertained in these cases. In cases of sudden death in infancy and childhood, failure to reach a diagnosis may lead to undue suspicion falling upon the child's carers. This underscores the need for full histology at post-mortem in child deaths, including diaphragmatic sampling.
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Affiliation(s)
- S Sundararajan
- Department of Histopathology, Birmingham Women's Hospital, Birmingham B15 2TG
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25
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Sundararajan S, Gamboa JL, Victor NA, Wanderi EW, Lust WD, Landreth GE. Peroxisome proliferator-activated receptor-γ ligands reduce inflammation and infarction size in transient focal ischemia. Neuroscience 2005; 130:685-96. [PMID: 15590152 DOI: 10.1016/j.neuroscience.2004.10.021] [Citation(s) in RCA: 227] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2004] [Indexed: 01/25/2023]
Abstract
Newly developed insulin-sensitizing agents, which target the nuclear receptor peroxisome proliferator-activated receptor-gamma have recently been appreciated to exhibit potent anti-inflammatory actions. Since stroke is associated with an intense inflammatory response, we reasoned that these agents may ameliorate injury from stroke. We report that administration of troglitazone or pioglitazone 24 h before and at the time of cerebral infarction dramatically reduced infarction volume and improved neurological function following middle cerebral artery occlusion in rats. Furthermore, we find that delayed therapy also significantly reduced infarct volume. The brains of the drug-treated animals displayed reduced inflammation as evidenced by decreased immunoreactivity for microglial/macrophage markers and reduced protein and mRNA for interleukin-1beta, cyclooxygenase-2 and inducible nitric oxide synthase. We argue that the beneficial effects of these drugs are likely due to reduced expression of these inflammatory mediators, which are known to exacerbate ischemic injury following stroke. These results are of particular relevance to diabetic patients chronically treated with these agents who may benefit from the neuroprotective actions of these drugs.
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MESH Headings
- Animals
- Blood Glucose/metabolism
- Brain Chemistry/drug effects
- Brain Chemistry/genetics
- Cell Count
- Cerebrovascular Circulation/physiology
- Chromans/therapeutic use
- Dose-Response Relationship, Drug
- Encephalitis/drug therapy
- Encephalitis/etiology
- Encephalitis/pathology
- Immunohistochemistry
- Infarction, Middle Cerebral Artery/drug therapy
- Infarction, Middle Cerebral Artery/etiology
- Infarction, Middle Cerebral Artery/pathology
- Ischemic Attack, Transient/drug therapy
- Ischemic Attack, Transient/metabolism
- Ischemic Attack, Transient/pathology
- Ligands
- Macrophages/drug effects
- Male
- Microglia/drug effects
- Middle Cerebral Artery/physiology
- Nerve Tissue Proteins/biosynthesis
- Nerve Tissue Proteins/genetics
- PPAR gamma/drug effects
- Pioglitazone
- Psychomotor Performance/drug effects
- Psychomotor Performance/physiology
- RNA, Messenger/biosynthesis
- RNA, Messenger/genetics
- Rats
- Rats, Wistar
- Reverse Transcriptase Polymerase Chain Reaction
- Thiazolidinediones/therapeutic use
- Troglitazone
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Affiliation(s)
- S Sundararajan
- Department of Neurology, Case Western Reserve University and University Hospitals of Cleveland, 11100 Euclid Ave, Cleveland, OH 44106, USA.
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26
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Yoon SH, Collins JH, Musale D, Sundararajan S, Tsai SP, Hallsby GA, Kong JF, Koppes J, Cachia P. Effects of flux enhancing polymer on the characteristics of sludge in membrane bioreactor process. Water Sci Technol 2005; 51:151-7. [PMID: 16003973] [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: 05/03/2023]
Abstract
A newly developed membrane performance enhancer (MPE) was used to prevent membrane fouling in a membrane bioreactor (MBR) process. It transpired that 1,000 mg/l of MPE reduced polysaccharide levels from 41 mg/I to 21 mg/I on average under the experimental condition. Repeated experiments also confirmed that 50-1,000 mg/l of MPE could reduce membrane fouling significantly and increase the intervals between membrane cleanings. Depending on MPE dosages and experimental conditions, trans-membrane pressure (TMP) increase was suppressed for 20-30 days, while baseline TMP surged within a few days. In addition, MPE allowed MBR operation even at 50,000 mg/l of total solid and reduced permeate COD. However, no evidence of toxicity for sludge was found from respiratory works.
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Affiliation(s)
- S H Yoon
- Nalco Company, 1601 West Diehl Rd., Naperville, 11 60563-1198, USA.
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Sundararajan S, Wehry EL. Photoredox chemistry of bis(2,9-dimethyl-1,10-phenanthroline)copper(II) complexes in aqueous and methanolic media. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100655a006] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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28
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Abstract
Gaussian processes are powerful regression models specified by parameterized mean and covariance functions. Standard approaches to choose these parameters (known by the name hyperparameters) are maximum likelihood and maximum a posteriori. In this article, we propose and investigate predictive approaches based on Geisser's predictive sample reuse (PSR) methodology and the related Stone's cross-validation (CV) methodology. More specifically, we derive results for Geisser's surrogate predictive probability (GPP), Geisser's predictive mean square error (GPE), and the standard CV error and make a comparative study. Within an approximation we arrive at the generalized cross-validation (GCV) and establish its relationship with the GPP and GPE approaches. These approaches are tested on a number of problems. Experimental results show that these approaches are strongly competitive with the existing approaches.
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Affiliation(s)
- S Sundararajan
- Department of Computer Science and Automation, India Institute of Science, Bangalore-560012, India
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29
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Almazan G, Liu HN, Khorchid A, Sundararajan S, Martinez-Bermudez AK, Chemtob S. Exposure of developing oligodendrocytes to cadmium causes HSP72 induction, free radical generation, reduction in glutathione levels, and cell death. Free Radic Biol Med 2000; 29:858-69. [PMID: 11063911 DOI: 10.1016/s0891-5849(00)00384-1] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Primary cultures of oligodendrocytes were used to study the toxic effects of cadmium chloride. Cell viability was evaluated by the mitochondrial dehydrogenase activity and confirmed by propidium iodide (PI) fluorescence staining. The expression of the 72 kDa stress protein, HSP72, was assayed by Western blot analysis. The results showed that Cd(2+)-induced toxicity was dependent on the time and dose of exposure, as well as on the developmental stage of the cultures. Oligodendrocyte progenitors were more vulnerable to Cd(2+) toxicity than were mature oligodendrocytes. Mature oligodendrocytes accumulated relatively higher levels of Cd(2+) than did progenitors, as determined by (109)CdCl(2) uptake; treatment with the metal ion caused a more pronounced reduction in intracellular glutathione levels and significantly higher free radical accumulation in progenitors. The latter could explain the observed differences in Cd(2+) susceptibility. HSP72 protein expression was increased both in progenitors and in mature cells exposed to Cd(2+). Pretreatment with N-acetylcysteine, a thiocompound with antioxidant activity and a precursor of glutathione, prevented Cd(2+)-induced (i) reduction in glutathione levels and (ii) induction of HSP72 and diminished (i) Cd(2+) uptake and (ii) Cd(2+)-evoked cell death. In contrast, buthionine sulfoximine, an inhibitor of gamma-glutamyl-cysteine synthetase, depleted glutathione, and potentiated the toxic effect of Cd(2+). These results strongly suggest that Cd(2+)-induced cytotoxicity in oligodendrocytes is mediated by reactive oxygen species and is modulated by glutathione levels.
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Affiliation(s)
- G Almazan
- Department of Pharmacology and Therapeutics, McGill University, Montreal, Quebec, Canada.
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30
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Sundararajan S, Morgenstern LB. Thrombolysis for acute stroke: is it for everyone? Curr Atheroscler Rep 2000; 2:97-103. [PMID: 11122731 DOI: 10.1007/s11883-000-0102-4] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
To date, there is only one US Food and Drug Administration-approved treatment for stroke. Many patients have benefited after receiving rt-PA within 3 hours of acute stroke. Although the risk of hemorrhagic conversion is real, the patients at high risk for this complication are often the same patients most at risk for poor outcome secondary to their ischemic events. In this article, we review the data supporting the use of thrombolytics, both intravenously and intra-arterially, as well as patient selection criteria. Furthermore, we provide a framework for administering rt-PA and discuss the future of thrombolytic therapy.
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Affiliation(s)
- S Sundararajan
- Department of Neurology at University Hospitals of Cleveland and Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
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31
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Sundararajan S. Safe blood. A technologist's history of the Canadian Red Cross Blood Transfusion Service. Can J Med Technol 1999; 53:75-8. [PMID: 10112875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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32
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Chandramukhi A, Shankar P, Rao TV, Sundararajan S, Swamy HS. Acute leptomeningitis due to Bacillus anthracis. A case report. Trop Geogr Med 1983; 35:79-82. [PMID: 6612776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
A fatal case of anthrax meningitis in a 45-year-old woman is presented from Karnataka State, South India. The clinical, microbiological and histopathological profile is presented.
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Krishnaswamy S, Keshavamurthy B, Sundararajan S. The use of the direct immunoperoxidase test to detect the multiplication of rinderpest virus in bovine kidney cell culture. Vet Microbiol 1981. [DOI: 10.1016/0378-1135(81)90040-7] [Citation(s) in RCA: 3] [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: 10/27/2022]
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Wehry EL, Sundararajan S. Intersystem crossing and internal conversion from the lowest charge-transfer singlet excited state of the (2,9-dimethyl-1,10-phenanthroline)copper(I) cation. ACTA ACUST UNITED AC 1972. [DOI: 10.1039/c39720001135] [Citation(s) in RCA: 5] [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: 11/21/2022]
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Bhat T, Sundararajan S. The extraction of gallium chloride by tributyl phosphate and the recovery of gallium from bayer liquor. ACTA ACUST UNITED AC 1967. [DOI: 10.1016/0022-5088(67)90118-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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