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Ravindhran B, Lim AJM, Kurian T, Walshaw J, Hitchman LH, Lathan R, Smith GE, Carradice D, Chetter IC, Pymer S. Supervised Exercise Therapy for Intermittent Claudication: A Propensity Score Matched Analysis of Retrospective Data on Long Term Cardiovascular Outcomes. Eur J Vasc Endovasc Surg 2024; 67:480-488. [PMID: 38040103 DOI: 10.1016/j.ejvs.2023.11.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 10/18/2023] [Accepted: 11/23/2023] [Indexed: 12/03/2023]
Abstract
OBJECTIVE This study aimed to explore the long term outcomes of patients with intermittent claudication (IC) who completed supervised exercise therapy (SET) vs. those who declined or prematurely discontinued SET, focusing on the incidence of chronic limb threatening ischaemia (CLTI), revascularisation, major adverse limb events (MALE), and major adverse cardiovascular events (MACE). METHODS A retrospective registry analysis of consecutive patients with IC who were referred for SET between March 2015 and August 2016 and followed up for a minimum of five years. Serial univariable analysis and logistic regression were performed to identify the statistically significant clinical variables that were independent predictors of each outcome measure. The resulting statistically significant variables were used to guide 1:1 propensity score matching (PSM) using the nearest neighbour method with a calliper of 0.2. Cox proportional hazards regression was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) for the association between SET and the outcomes of interest. RESULTS Two hundred and sixty-six patients were referred to SET between March 2015 and August 2016. Of these, 64 patients completed SET and 202 patients did not. After PSM, 49 patients were analysed in each cohort. The Cox proportional hazards analysis revealed a significant association between completion of SET and revascularisation requirement (HR 0.46 95% CI 0.25 - 0.84; p = .011), completion of SET and progression to CLTI (HR 0.091, 95% CI 0.04 - 0.24; p < .001), completion of SET and MACE (HR 0.52; 95% CI 0.28 - 0.99; p = .05) and completion of SET and MALE (HR 0.28, 95% CI 0.13 - 0.65; p = .003). The Harrell's C index for all of these models was greater than 0.75, indicating good predictive accuracy. CONCLUSION Completion of SET is associated with better outcomes in patients who completed SET compared with patients who declined or discontinued SET with respect to clinically important cardiovascular outcomes over seven years.
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Affiliation(s)
- Bharadhwaj Ravindhran
- Academic Vascular Surgical Unit, Allam Diabetes Centre, Hull Royal Infirmary, Hull, UK.
| | - Arthur J M Lim
- Academic Vascular Surgical Unit, Allam Diabetes Centre, Hull Royal Infirmary, Hull, UK
| | - Thomas Kurian
- Academic Vascular Surgical Unit, Allam Diabetes Centre, Hull Royal Infirmary, Hull, UK
| | - Josephine Walshaw
- Academic Vascular Surgical Unit, Allam Diabetes Centre, Hull Royal Infirmary, Hull, UK
| | - Louise H Hitchman
- Academic Vascular Surgical Unit, Allam Diabetes Centre, Hull Royal Infirmary, Hull, UK
| | - Ross Lathan
- Academic Vascular Surgical Unit, Allam Diabetes Centre, Hull Royal Infirmary, Hull, UK
| | - George E Smith
- Academic Vascular Surgical Unit, Allam Diabetes Centre, Hull Royal Infirmary, Hull, UK
| | - Daniel Carradice
- Academic Vascular Surgical Unit, Allam Diabetes Centre, Hull Royal Infirmary, Hull, UK
| | - Ian C Chetter
- Academic Vascular Surgical Unit, Allam Diabetes Centre, Hull Royal Infirmary, Hull, UK
| | - Sean Pymer
- Academic Vascular Surgical Unit, Allam Diabetes Centre, Hull Royal Infirmary, Hull, UK
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Vakharia RJ, Jani I, Yadav S, Kurian T. To Study Acute Changes in Brain Oxygenation on MRI in Healthcare Workers Using N95 Mask and PPE Kits for Six Hours a Day. Indian J Radiol Imaging 2022; 31:893-900. [PMID: 35136502 PMCID: PMC8817801 DOI: 10.1055/s-0041-1741086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background
Due to long working hours wearing an N95 mask and PPE kit during the COVID-19 pandemic, the healthcare workers (HCWs) complained of headaches, confusion, and exhaustion. This study was therefore performed to study the changes in brain oxygenation.
Aim
To compare brain oxygenation in health care workers wearing an N95 mask with a PPE kit versus a three-ply mask during an intensive care setting for 6 hours.
Materials and Methods
Thirty clinicians and 30 paramedical staff participated in the study. The control (three-ply mask) and subject (N95 mask with PPE) groups included 15 clinicians and 15 paramedical staff. A comparative analysis of brain oxygenation using a 3T magnetic resonance imaging (MRI) machine was performed in these two groups at the beginning and the end of their work shift.
Results
The mean age of the individuals in the control and subject groups was 30.8 and 30.13 years, respectively. The median value of brain oxygenation in the control and subject groups in the pre-shift was between 33 and 31 and post-shift was 30 and 24. The drop in brain oxygenation in subjects was more than the controls (
p
= 0.004) in the post-shift assessments. The cerebral blood flow (CBF) in the bilateral middle cerebral artery (MCA) using arterial spin labeling (ASL) showed a rise in CBF in both groups post-shift as compared with the pre-shift values. The median values of the right and left MCA in the control and subject groups pre-shift were 82.75/83.45 and 89.75/106.65. The post-shift median values of both MCAs of the control and subject groups were 115.65/115.55 and 109.60/119.49.
Conclusion
MRI-BOLD imaging revealed a significant drop in brain oxygenation in the subject group as compared with the control group. Multiphasic-ASL showed a compensatory rise in CBF in both groups.
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Affiliation(s)
| | - Ishaan Jani
- Department of Radiodiagnosis, Wockhardt Hospital, Mumbai, Maharashtra, India
| | - Shashibala Yadav
- Department of Radiodiagnosis, Wockhardt Hospital, Mumbai, Maharashtra, India
| | - Thomas Kurian
- MRI Applications, Philips India Limited, Mumbai, Maharashtra, India
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Saghir N, Aggarwal A, Soneji N, Ben-Nun D, Fanous H, Kessel S, Rodgers G, Heinzman K, Hong M, Kurian T. CORRELATION OF ELECTROCARDIOGRAPHIC RHYTHM INTERPRETATIONS IN KNOWN ATRIAL FIBRILLATION OR ATRIAL FLUTTER PATIENTS USING THE APPLE WATCH. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)04591-5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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4
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Sreejith K, Prasad S, Bagavathiappan R, Prasanth C, Jeenu R, Paul Murugan J, Kurian T, Mansu N, Harikrishnan R, Levin G, Eswaran V. Design, Development, Static and Flight Tests of Reverse Flow Multiple Nozzle Solid Rocket Motor with High Burn Rate Propellant. CURR SCI INDIA 2021. [DOI: 10.18520/cs/v120/i1/116-121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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5
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Shelat R, Bhatt LK, Paunipagar B, Kurian T, Khanna A, Chandra S. Regeneration of hyaline cartilage in osteochondral lesion model using L-lysine magnetic nanoparticles labeled mesenchymal stem cells and their in vivo imaging. J Tissue Eng Regen Med 2020; 14:1604-1617. [PMID: 32840054 DOI: 10.1002/term.3120] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 05/18/2020] [Revised: 07/24/2020] [Accepted: 08/04/2020] [Indexed: 12/16/2022]
Abstract
Treatment of osteochondral defects continues to pose a major challenge for patients and orthopedic surgeons due to the limited healing potential of articular cartilage. Mesenchymal stem cells (MSCs) possess therapeutic potential for the treatment of osteochondral pain and pathology. However, it is necessary to use proper labeling and imaging agent of stem cells that can decipher its role posttransplantation. A major limitation of routinely used contrast agents is signal dilution over a period of time which limits its use for further studies. At the same time, regeneration of fibrocartilage over native hyaline cartilage also limits the use of conventional therapies. The present study evaluates the efficacy of bone marrow-derived mesenchymal stem cells (BMSCs) for the treatment of osteochondral defect in rats with the regeneration of hyaline cartilage in situ and in vivo monitoring of the stem cells using L-lysine functionalized magnetic iron oxide nanoparticles (lys-IONPs). L-lysine stabilizes the iron oxide nanoparticles, enhances the biocompatibility, and provides functionalities for efficient stem cell labeling. in vitro toxic effects of lys-IONPs on mitochondrial impairment, morphological alterations, and actin cytoskeleton reveal minimum damage to BM-MSCs. Histological data (H and E, Masson's trichrome and immunohistochemistry) describe the early initiation of healing and regeneration of hyaline-like cartilage over fibrocartilage in stem cell treated groups. MR scans demonstrate generation of hypointense signals in lys-IONPs-BMSCs with improved signal intensity and minimum loss over 28 days revealing its use as a long-term stem cell labeling and imaging agent.
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Affiliation(s)
- Ruchita Shelat
- Department of Biological Sciences, Sunandan Divatia School of Science, NMIMS University, Mumbai, India
| | - Lokesh Kumar Bhatt
- Department of Pharmacology, SVKM's Dr. Bhanuben Nanavati College of Pharmacy, Mumbai, India
| | | | | | - Aparna Khanna
- Department of Biological Sciences, Sunandan Divatia School of Science, NMIMS University, Mumbai, India.,Computational Biology and Translational Research, Amity University, Mumbai, India
| | - Sudeshna Chandra
- Department of Biological Sciences, Sunandan Divatia School of Science, NMIMS University, Mumbai, India
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Saghir N, Aggarwal A, Soneji N, Valencia V, Rodgers G, Kurian T. A comparison of manual electrocardiographic interval and waveform analysis in lead 1 of 12-lead ECG and Apple Watch ECG: A validation study. Cardiovasc Digit Health J 2020; 1:30-36. [PMID: 35265871 PMCID: PMC8890353 DOI: 10.1016/j.cvdhj.2020.07.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 11/18/2022] Open
Abstract
Background The Apple Watch Series 4 (AW) can detect atrial fibrillation and perform a single-lead electrocardiogram (ECG), but the clinical accuracy of AW ECG waveforms compared to lead 1 of a 12-lead ECG is unclear. Objective The purpose of this study was to assess the accuracy of interval measurements on AW ECG tracings in comparison to lead 1 on a 12-lead ECG. Methods We obtained ECGs at a university hospital of healthy volunteers age >18 years. ECG waveforms were measured with calipers to the nearest 0.25 mm. When possible, 3 consecutive waveforms in lead 1 were measured. Waveform properties, including intervals, were recorded. Concordance correlation coefficients and Bland-Altman plots were used to assess level of agreement between devices. Results Twelve-lead (n = 113) and AW (n = 129) ECG waveforms from 43 volunteers (mean age 31 years; 65% female) were analyzed. Sinus rhythm interpretation between devices was 100% concordant. No arrhythmias were recorded. Mean difference (d) for heart rate was 1.16 ± 4.33 bpm (r = 0.94); 3.83 ± 113.54 ms for RR interval (r = 0.79); 5.43 ± 17 ms for PR interval (r = 0.83); –6.89 ± 14.81 ms for QRS interval (r = 0.65); –11.27 ± 22.9 ms for QT interval (r = 0.79); and –11.67 ± 27 ms for QTc interval (r = 0.57). There was moderate (d <40 ms) to strong (d <20 ms or < 5 bpm) agreement between devices represented by Bland-Altman plots. Conclusion The AW produces accurate ECGs in healthy adults with moderate to strong agreement of basic ECG intervals.
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Affiliation(s)
- Nabeel Saghir
- Dell Medical School at The University of Texas at Austin, Austin, Texas - Department of Internal Medicine
| | - Arjun Aggarwal
- Dell Medical School at The University of Texas at Austin, Austin, Texas - Department of Internal Medicine
| | - Nisha Soneji
- Dell Medical School at The University of Texas at Austin, Austin, Texas - Department of Internal Medicine
| | - Victoria Valencia
- Dell Medical School at The University of Texas at Austin, Austin, Texas - Department of Internal Medicine
| | - George Rodgers
- Dell Medical School at The University of Texas at Austin, Austin, Texas - Department of Internal Medicine
| | - Thomas Kurian
- Dell Medical School at The University of Texas at Austin, Austin, Texas - Department of Internal Medicine.,Ascension Seton Medical Center, Austin, Texas
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Saghir N, Aggarwal A, Soneji N, Valencia V, Rodgers G, Kurian T. APPLE WATCH SERIES 4 VS. 12-LEAD ECG: A COMPARISON OF MANUAL ELECTROCARDIOGRAPHIC WAVEFORM ANALYSIS. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)31005-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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8
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Rajawat GS, Singh AK, Kurian T, Koolwal S. A Rare Differential Diagnosis of Crazy Paving Pattern. Indian J Med Paediatr Oncol 2018. [DOI: 10.4103/ijmpo.ijmpo_140_16] [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: 11/04/2022] Open
Affiliation(s)
- Govind Singh Rajawat
- Department of Respiratory Medicine, Institute of Respiratory Diseases, SMS Medical College, Jaipur, Rajasthan, India
| | - Aashish Kumar Singh
- Department of Respiratory Medicine, Institute of Respiratory Diseases, SMS Medical College, Jaipur, Rajasthan, India
| | - Thomas Kurian
- Department of Respiratory Medicine, Institute of Respiratory Diseases, SMS Medical College, Jaipur, Rajasthan, India
| | - Suresh Koolwal
- Department of Respiratory Medicine, Institute of Respiratory Diseases, SMS Medical College, Jaipur, Rajasthan, India
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Affiliation(s)
- Anand K
- Technical Consultancy Division, Rubber Research Institute of India, Kottayam, Kerala, India
- Department of Basic Sciences, Kanjirappally, Kerala, India
| | - Siby Varghese
- Technical Consultancy Division, Rubber Research Institute of India, Kottayam, Kerala, India
| | - Thomas Kurian
- Department of Polymer Science and Rubber Technology, Cochin University of Science and Technology, Kochi, Kerala, India
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10
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Anand K, Varghese S, Kurian T. Preparation of ultra-fine dispersions of zinc oxide by simple ball-milling: Optimization of process parameters. POWDER TECHNOL 2015. [DOI: 10.1016/j.powtec.2014.11.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [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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11
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Kurian T, Doshi A, Kessman P, Nguyen B, Edwards J, Pieper S, Efimov I, Janardhan AH, Sanchez M. Rotors in patients with persistent atrial fibrillation: case report of a left atrial appendage rotor identified by a novel computational mapping algorithm integrated into 3-dimensional mapping and termination of atrial fibrillation with ablation. Card Electrophysiol Clin 2014; 7:157-63. [PMID: 25784031 DOI: 10.1016/j.ccep.2014.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Recent clinical trials using panoramic mapping techniques have shown success in targeting rotors and focal impulses in atrial fibrillation (AF). Ablations directed toward these organized sources improve outcomes in AF. The left atrial appendage (LAA) has been suspected as a possible extrapulmonary source of AF, and ablation within the LAA or electrical isolation of the LAA improves outcomes in certain cases. This case highlights a unique example of panoramic imaging created with a computational mapping algorithm integrated in 3-dimensional mapping, which identified rotors within the LAA. Furthermore, ablations performed near an identified rotor core within the LAA terminated AF.
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Affiliation(s)
- Thomas Kurian
- Division of Cardiac Electrophysiology, Mercy Heart & Vascular Center, St Louis, 625 South New Ballas Road, Suite 2030, St Louis, MO 63141, USA.
| | - Amit Doshi
- Division of Cardiac Electrophysiology, Mercy Heart & Vascular Center, St Louis, 625 South New Ballas Road, Suite 2030, St Louis, MO 63141, USA
| | - Paul Kessman
- CardioNXT, Inc, 10955 Westmoor Drive, Westminster, CO 80021, USA
| | - Bao Nguyen
- CardioNXT, Inc, 10955 Westmoor Drive, Westminster, CO 80021, USA
| | - Jerome Edwards
- CardioNXT, Inc, 10955 Westmoor Drive, Westminster, CO 80021, USA
| | - Stephen Pieper
- Division of Cardiac Electrophysiology, Mercy Heart & Vascular Center, St Louis, 625 South New Ballas Road, Suite 2030, St Louis, MO 63141, USA
| | - Igor Efimov
- Department of Biomedical Engineering, Washington University in St Louis, 360 Whitaker Hall, 1 Brookings Drive, St Louis, MO 63130, USA
| | - Ajit H Janardhan
- CardioNXT, Inc, 10955 Westmoor Drive, Westminster, CO 80021, USA
| | - Mauricio Sanchez
- Division of Cardiac Electrophysiology, Mercy Heart & Vascular Center, St Louis, 625 South New Ballas Road, Suite 2030, St Louis, MO 63141, USA
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Affiliation(s)
- Neena George
- Department of Polymer
Science
and Rubber Technology, Cochin University of Science and Technology, Kochi 22, Kerala, India
| | - Thomas Kurian
- Department of Polymer
Science
and Rubber Technology, Cochin University of Science and Technology, Kochi 22, Kerala, India
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Krishnan S, Alex R, Kurian T. HAF/SILICA/NANOCLAY “TERNARY” MASTERBATCH AND HAF/SILICA BINARY MASTERBATCH FROM FRESH NATURAL RUBBER LATEX. Rubber Chemistry and Technology 2014. [DOI: 10.5254/rct.13.87908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
ABSTRACT
A process for production of carbon black/silica/nanoclay ternary filler masterbatch from fresh natural rubber (NR) latex was standardized. The fillers, nanoclay, carbon black, and silica were incorporated in fresh NR latex by a modified coagulation process. The latex, mixed with filler dispersions, coagulated immediately on addition of acids. The coagulum containing fillers was dried at 70 °C in an air oven to get the latex filler masterbatch, which was further processed in the conventional way. The masterbatch compounds containing only silica/carbon black showed a higher level of vulcanization as compared with the corresponding dry mixes. The mechanical properties, such as tensile strength, modulus, tear strength, abrasion resistance, and hardness, increased with the proportion of nanoclay in the mixes up to 5 phr, and with a greater amount, the change was only marginal. Lower tan delta values were observed for all of the masterbatches containing nanoclay in the ranges of 3 to 10 phr compared with the control dry mix containing 25/25 carbon black/silica. The improvement in mechanical properties and dynamic properties shown by the masterbatches over the conventional mill-mixed compounds was attributed to factors related to filler dispersion, as evidenced from the data from dispersion analyzer images, X-ray diffractograms, and a higher level of vulcanization.
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Affiliation(s)
| | - Rosamma Alex
- Rubber Research Institute of India, Kottayam-686009, Kerala, India
| | - Thomas Kurian
- Department of Polymer Science & Rubber Technology, Cochin University of Science & Technology, Kochi-686022, Kerala, India
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15
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Spiess P, Kim T, Kurian T, Sexton W, Powsang J, Armstrong P, Mangar D. UP-01.205 Is Obesity an Important Predictor of Outcome in Patients Undergoing Radical Nephrectomy with Concomitant IVC Thrombectomy for Renal Cell Carcinoma (RCC)? Urology 2011. [DOI: 10.1016/j.urology.2011.07.755] [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: 11/16/2022]
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16
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Abstract
The atrioventricular node (AVN) has mystified generations of investigators over the last century and continues today to be at the epicenter of debates among anatomists, experimentalists, and electrophysiologists. Over the years, discrepancies have remained in regard to correlating components of AVN structure to function, as evidenced by studies from microelectrodes, optical mapping, and the electrophysiology laboratory. Historically, the AVN has been defined by classical histological methods; however, with recent advances in molecular biology techniques, a more precise characterization of structure is becoming attainable. Distinct molecular compartments are becoming apparent based on connexin staining and genotyping, providing new insight into previously characterized functional aspects of the AVN and its surrounding structures. Advances in optical mapping have provided a unique opportunity for correlating structure and function--unmasking properties of the native AVN pacemaker and providing further insight into basic mechanisms involved in AV conduction. Additionally, procurement of explanted human hearts have provided a unique opportunity to further characterize the human AVN structurally and functionally with both molecular biology techniques and optical mapping. With the elucidation of basic elements of both structure and function via molecular investigation and optical mapping, new opportunities are becoming apparent in utilizing the unique properties of the AVN for pursuing novel clinical applications relevant to clinical electrophysiology.
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Affiliation(s)
- Thomas Kurian
- Washington University, St. Louis, Missouri 63130, USA
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17
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Efimov IR, Fedorov VV, Glukhov A, Lou Q, Ambrosi C, Janks D, Hucker WJ, Kurian T, Schuessler RB, Moazami N. Multiscale imaging of the human heart: Building the foundation for human systems physiology and translational medicine. Annu Int Conf IEEE Eng Med Biol Soc 2010; 2010:5177-80. [PMID: 21095821 PMCID: PMC3748588 DOI: 10.1109/iembs.2010.5626151] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The development of human cardiovascular systems physiology is inhibited by the lack of multiscale functional physiological data, which represents human heart physiology at the molecular, cellular, tissue, organ, and system levels. We have developed an experimental approach to study explanted human hearts in vitro at multiple physiological scales with a wide array of imaging modalities. This approach has already yielded data indicating significant differences between animal models of diseases and actual human heart disease. Our data provides a quantitative foundation for multiscale physiological models of the cardiovascular system and will allow improvement in translation of medical technology and pharmacology from animal models to therapy.
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Affiliation(s)
- Igor R Efimov
- Department of Biomedical Engineering, Washington University in St. Louis, MO 63130, USA.
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Hamza ZP, Anna Dilfi KF, Kurian T, Bhat SG. Biodegradability Studies on LDPE-Starch Blends Using Amylase-Producing Vibrios. INT J POLYM MATER PO 2009. [DOI: 10.1080/00914030902719386] [Citation(s) in RCA: 6] [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: 10/21/2022]
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19
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Hamza ZP, Dilfi KFA, Muralidharan MN, Kurian T. Microwave Oven for the Rapid Determination of Total Solids Content of Natural Rubber Latex. INT J POLYM MATER PO 2008. [DOI: 10.1080/00914030802153066] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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20
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Kim C, Kim H, Kurian T, Kobayashi T, Hirohito K. Protein Microarray Analysis in Patients with Asthma: Elevation of the Chemokine PARC/CCL18 in Sputum. J Allergy Clin Immunol 2007. [DOI: 10.1016/j.jaci.2006.11.664] [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: 11/30/2022]
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21
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Kurian T, Nishio M, Nishioka A, Takahashi T, Koyama K. Dynamic Melt Rheological Properties of Ionomers Based on Poly(Ethylene-co-Acrylic Acid) and Poly(Ethylene-co-Methacrylic Acid). INT J POLYM MATER PO 2006. [DOI: 10.1080/00914030600754842] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Thomas Kurian
- a Department of Polymer Science and Rubber Technology , Cochin University of Science and Technology , Kochi , India
| | - Mihoko Nishio
- b Department of Polymer Science and Engineering , Yamagata University , Yonezawa , Japan
| | - Akihiro Nishioka
- a Department of Polymer Science and Rubber Technology , Cochin University of Science and Technology , Kochi , India
| | - Tatsuhiro Takahashi
- a Department of Polymer Science and Rubber Technology , Cochin University of Science and Technology , Kochi , India
| | - Kiyohito Koyama
- a Department of Polymer Science and Rubber Technology , Cochin University of Science and Technology , Kochi , India
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22
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He R, Guo DC, Estrera AL, Safi HJ, Huynh TT, Yin Z, Cao SN, Lin J, Kurian T, Buja LM, Geng YJ, Milewicz DM. Characterization of the inflammatory and apoptotic cells in the aortas of patients with ascending thoracic aortic aneurysms and dissections. J Thorac Cardiovasc Surg 2006; 131:671-8. [PMID: 16515922 DOI: 10.1016/j.jtcvs.2005.09.018] [Citation(s) in RCA: 232] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2005] [Revised: 08/11/2005] [Accepted: 09/08/2005] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The histopathologic abnormality underlying ascending aortic aneurysm and dissection is medial degeneration, a lesion that is described as the noninflammatory loss of smooth muscle cells and elastic fibers. This study sought to determine whether inflammatory cells are present in medial degeneration and assess any possible contribution of these cells to apoptosis of smooth muscle cells. METHODS Aortic specimens were obtained from patients undergoing prophylactic surgical repair of an ascending aortic aneurysm (n = 9) and type A dissection (n = 7), along with control patients dying of causes unrelated to aortic disease (n = 5). Immunohistochemical staining was performed to evaluate the presence of lymphocytes and macrophages, and markers of apoptosis were assessed in the aortas of patients with ascending aortic aneurysm and dissection. RESULTS Immunohistochemical study indicated significantly more CD3+ cells in the aortas of patients with aneurysms or dissections than in control aortas (P = .020 and P = .0022, respectively). In addition, aortas of patients with aneurysms or dissections had more CD68+ cells (P = .01 and P = .005, respectively). CD3+ cells were localized in the media and surrounding the vasa vasorum in the adventitia. Cells yielding a positive result on in situ terminal transferase-mediated deoxyuridine triphosphate nick end-labeling were found in increased numbers in the aortas of patients with aneurysms or dissections relative to control aortas (P = .005 and P = .002, respectively). Furthermore, Fas and FasL were increased in the aortic samples from patients with aneurysms and dissections relative to control aortas. CONCLUSION The coexistence of inflammatory cells with markers of apoptotic vascular cell death in the media of ascending aortas with aneurysms and type A dissections raises the possibility that activated T cells and macrophages may contribute to the elimination of smooth muscle cells and degradation of the matrix associated with thoracic aortic aneurysms and dissections.
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Affiliation(s)
- Rumin He
- Department of Internal Medicine, The University of Texas Medical School at Houston, Houston, Tex 77030, USA
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Samuel J, Manjooran KB, Kurian T. Reprocessable ionic elastomers based on styrene-butadiene rubber. INT J POLYM MATER PO 2003. [DOI: 10.1080/714975852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Jacob Samuel
- a Department of Polymer Science and Rubber Technology , Cochin University of Science and Technology , Kochi , Kerala , India
| | - Kochu Baby Manjooran
- a Department of Polymer Science and Rubber Technology , Cochin University of Science and Technology , Kochi , Kerala , India
| | - Thomas Kurian
- a Department of Polymer Science and Rubber Technology , Cochin University of Science and Technology , Kochi , Kerala , India
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Abstract
A very large number of therapeutic trials of antidepressant drugs have been reported in the scientific literature. Until now, the comparison of one drug with another, or with placebo, has been performed typically by comparing the scores on depression rating scales of the two groups of patients at fixed points of time after the beginning of therapy. It was postulated in 1989 that the curves of the recovery scores followed an exponential curve of the formula y = ae-bx + c. This hypothesis was tested in a double-blind controlled trial of the antidepressant minaprine, with the use of the scores on the Hamilton Rating Scale for Depression (HAM-D). We found that the correlation coefficient, Pearson's r, between the log of the HAM-D value and the week number of the study was -0.99. This gives a coefficient of determination of 0.98, which makes it clear that the model adequately fits the data. We conclude that the use of the formula gives a method of testing the statistical significance of the difference between treatments as a valuable alternative to traditional tests. We believe that this would give a much more sensitive discrimination between treatments because all of the data points are used to calculate a single parameter--the slope of the curve.
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Affiliation(s)
- R G Priest
- Department of Psychiatry, St. Mary's Hospital Medical School, London, England
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Abstract
We examined the length of stay of inpatients admitted to a psychiatric unit in central London. The commonest length of stay (mode) was less than 1 week. In general, subsequent weeks showed successively fewer discharges, so that the distribution curve of the number of patients by length of stay showed a smooth decline. Analyzing the first 13 weeks of stay, the distribution curve corresponded very closely to a theoretical exponential decay curve. This has implications for recording the average length of stay and thus for comparing one hospital unit with another. It may also have implications for planning for acute psychiatric services. A plea is made for using the median rather than the mean for recording the average length of admission for some purposes.
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Affiliation(s)
- R G Priest
- St Mary's Hospital Medical School, Imperial College of Science, Technology and Medicine, University of London, Department of Psychiatry, United Kingdom
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McCarron M, Mills A, Whittaker D, Kurian T, Verghese J. Comparison between green and black pepper oils fromPiper nigrum L. Berries of Indian and Sri Lankan origin. FLAVOUR FRAG J 1995. [DOI: 10.1002/ffj.2730100108] [Citation(s) in RCA: 7] [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: 11/10/2022]
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Smeyatsky N, Baldwin D, Botros W, Gura R, Kurian T, Lambert MT, Patel AG, Steinert J, Priest RG. The treatment of sleep disorders. S Afr Med J 1992; Suppl:1-8. [PMID: 1585214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Narcolepsy is clinically associated with cataplexy, sleep paralysis and hypnagogic hallucinations. It is treated by reassurance (that there is no physical disease) and by stimulants such as ephedrine and amphetamine on an intermittent basis. The special tricyclic antidepressant clomipramine is also used, and mono-amine oxidase inhibitors (MAOIs) are useful in theory. Obstructive sleep apnoea is an important and often unrecognised cause of daytime somnolence. It is treated by weight reduction (pickwickian syndrome), hormones, or recently, with continuous positive pressure apparatus. Night terrors (pavor nocturnus) and sleepwalking typically occur during deep sleep (stage 3 and 4 throughout the episode) in children. In a night terror the child sits up with a scream, with eyes open, but inaccessible. He eventually falls asleep calmly. Sleepwalking, too, shows the features of inaccessibility and subsequent amnesia for the episode. Both conditions are normally treated with reassurance (to the parents) but may occasionally warrant benzodiazepines. Enuresis usually occurs in non-rapid eye movement (NREM) sleep, especially stages 3 and 4. The reason for the efficacy of tricyclic antidepressants is not precisely known. Delirium tremens (DT) is treated as a rebound excess of REM sleep, with benzodiazepines and other drugs. It is the withdrawal syndrome (with or without major seizures) to the barbiturate-alcohol group of drugs, which includes alcohol, chloral, paraldehyde, glutethimide, methylprylone, ethchlorvynol, meprobamate and meprobamate-diphenhydramine. Insomnia may be treated by the above drugs, by analgesics, antidepressants, major tranquillisers (neuroleptics) and miscellaneous other compounds. For the majority of patients, however, the most suitable group seems to be the benzodiazepines. The benzodiazepines are much safer than their predecessors, in both acute and chronic usage.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- N Smeyatsky
- St Mary's Hospital Medical School, London, England
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Abstract
The effect of temazepam as a hypnotic was assessed with two different formulations, the solution-filled soft gelatin capsule and the more recently introduced elixir. Sixty psychiatric in-patients were included in the trial and 59 completed it. The study followed a double-blind crossover design for two consecutive nights. Patients took a capsule and elixir each night, but only one would contain the active ingredient (in a dose of 20 mg temazepam). In contrast to earlier work with volunteers, the elixir failed to reveal more of the characteristics of an ideal hypnotic. In fact, in those measures that were statistically significant, the balance favoured the capsule. We conclude that although there are many situations where an elixir is clearly clinically preferable, the essential hypnotic effect of the elixir is not conspicuously different to that of the capsule.
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Affiliation(s)
- A G Patel
- Ealing Hospital, Southall, Middx, UK
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Jesudason M, Kurian T, Pereira SM, Jayasheela M, Koshi G. Isolation of Salmonella agona (4, 12:f, g, s:) for the first time in India. INDIAN J PATHOL MICR 1988; 31:303-5. [PMID: 3229802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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Kurian T, Saidapur SK. Effects of cyproterone acetate, cyproterone and testosterone on HCG induced spermatogenesis in the Indian bullfrog Rana tigerina (Daud) during postbreeding regression phase. Indian J Exp Biol 1985; 23:556-60. [PMID: 2939026] [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: 01/03/2023]
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Kurian T, Saidapur SK. Changes in the Cytomorphology of Gonadotrophs during the Breeding Cycle of the Male Frog, Rana tigerina. J HERPETOL 1984. [DOI: 10.2307/1564111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Kurian T, Saidapur SK. Frequency Distribution of Cell Numbers in the Spermatocysts during the Annual Testicular Cycle in the Indian Frog Rana tigerina. J HERPETOL 1983. [DOI: 10.2307/1563584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Khaja F, Walton JA, Brymer JF, Lo E, Osterberger L, O'Neill WW, Colfer HT, Weiss R, Lee T, Kurian T, Goldberg AD, Pitt B, Goldstein S. Intracoronary fibrinolytic therapy in acute myocardial infarction. Report of a prospective randomized trial. N Engl J Med 1983; 308:1305-11. [PMID: 6341842 DOI: 10.1056/nejm198306023082201] [Citation(s) in RCA: 313] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
We performed a randomized trial comparing intracoronary administration of streptokinase versus dextrose placebo within six hours after the onset of symptoms of acute myocardial infarction in 40 patients. The base-line clinical, hemodynamic, and angiographic findings were similar in the control and streptokinase-treated groups. Reestablishment of flow occurred in 12 of 20 patients treated with streptokinase and in 2 of 20 given placebo (P less than 0.05). Left ventricular function, angiographic ejection fraction, and regional wall motion, measured before and immediately after intervention, and serial radionuclide ejection fractions, measured at treatment, at 12 days, and at 5 months, were compared according to type of treatment (streptokinase vs. placebo) and outcome of therapy (reperfusion vs. no reperfusion). No statistically significant differences between groups were found. Thus, although streptokinase was more effective than placebo in achieving reperfusion, we detected no improvement of left ventricular function as a result of reestablished coronary flow.
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Koshi G, Kurian T, Mathai R, Abraham J, Joseph LB, Selvapandian AJ. Diverse etiologic agents from mycetoma cases. Indian J Med Res 1981; 74:539-43. [PMID: 7338377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
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Kurian T. Nursing care study of a cholecystectomy. Nurs J India 1967; 58:69-70. [PMID: 5181882] [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: 01/14/2023]
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