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Parker S, Nagra NS, Kulkarni K, Pegrum J, Barry S, Hughes R, Ghani Y. Inadequate pelvic radiographs: implications of not getting it right the first time. Ann R Coll Surg Engl 2017; 99:534-539. [PMID: 28682132 DOI: 10.1308/rcsann.2017.0095] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction Pelvic radiography is a frequent investigation. European guidelines aim to ensure appropriate use and adequate quality. When initial images are inadequate, repeat radiographs are often required, which may have significant patient safety and economic implications. Objectives The study aimed to assess the adequacy of pelvic imaging across three orthopaedic centres, to identify causes for inadequate imaging and to establish the cost of inadequate imaging from financial and patient safety perspectives. Methods Pelvic radiographs were identified on Picture Archiving and Communication System software at three UK hospitals. Radiographs were assessed against European guidelines and indications for repeat imaging were analysed. Results A total of 1,531 sequential pelvic radiographs were reviewed. The mean age of patients was 60 years (range 5 months to 101 years). Of this total, 51.9% of images were suboptimal, with no significant difference across the three hospitals (P > 0.05). Hospital 3 repeated radiographs in 6.3% of cases, compare with 18.1% and 19.7% at hospitals 1 and 2, respectively (P > 0.05). Hospital 3 identified pathology missed on the initial radiograph in 1% of cases, compared with 5.4% and 5.5% at hospitals 1 and 2, respectively (P > 0.05). Out-of-hours imaging is associated with a higher rate of suboptimal quality (69.1%) compared with normal working hours (51.3%; P = 0.006). Adequacy rates vary with age (χ 2 = 43.62, P < 0.001). Risk of having a suboptimal radiograph increases above the age of 60-years (χ 2 = 4.45, P < 0.05). The annual cost of repeat radiographs was £56,200 per hospital. Discussion and conclusion High rates of pelvic radiograph inadequacy can lead to missed pathology and the requirement for repeat imaging, which has significant patient safety and financial implications. Risk factors for inadequate radiographs include older patients and those having out-of-hours imaging.
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Kulkarni K, Khorjekar G, Mete M, Van Nostrand D. Number of Foci of Functioning Thyroid Tissue Remaining after Thyroidectomy for Differentiated Thyroid Cancer: Institutional Experience. World J Nucl Med 2017; 16:122-125. [PMID: 28553178 PMCID: PMC5436317 DOI: 10.4103/1450-1147.203066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Radioiodine imaging of the neck with a pinhole collimator (PinC) is frequently performed in differentiated thyroid cancer (DTC) patients for visualizing individual, and a total number of foci (NOF) of functioning residual thyroid tissue (FRTT) within the thyroid bed in postthyroidectomy patients. The objective of this study was to determine our experience regarding the NOF of FRTT visualized on pretherapy radioiodine PinC images. We performed a retrospective review of radioiodine PinC images of the neck of patients with very low-risk DTC and who had thyroidectomy performed by selected surgeons at MedStar Washington Hospital Center. For each patient's image, the NOF of FRTT was determined by two blind readers. Statistical analysis was performed. One hundred and twenty-six patients met the criteria. Surgeon (S1, S2, S3, and S4) performed 17, 10, 86, and 13 thyroidectomies, respectively. The analysis (mean, range, and standard deviation) of NOF of FRTT was: S1: (2.2, 0-5, 1.3); S2: (1.6, 1–3, 0.8); S3: (2.6, 0–7, 1.5); S4: (3.3, 1–5, 1.3). The percentages of < 2, ≤3, ≤4, and <5 foci remaining were 4.9%, 21.5%, 77.0%, and 91.3%, respectively. For the selected surgeons, the NOF of FRTT in the thyroid bed or neck in postthyroidectomy patients never exceeded 7, rarely exceeded 5 (2.4%), and infrequently exceeded 4 (8.7%). Based on these data, our thresholds of the NOF for which we perform further workup for possible locoregional disease are ≥5. Each facility is encouraged to establish their own criteria for their facility and preferably for each of their surgeons.
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Kulkarni K, Arasappa R, Prasad K, Zutshi A, Chand P, Murthy P, Kesavan M. Comorbid depressive symptoms in persistent delusional disorder: A retrospective study from India. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.02.210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BackgroundPrevious studies have reported depressive symptoms in patients with persistent delusional disorder (PDD). Patients with PDD and depression may need antidepressants for treatment.AimThe aim of the study was to compare the sociodemographic profile, clinical presentation and treatment response in patients with PDD with and without comorbid depressive symptoms.MethodsWe conducted a retrospective chart review of patients diagnosed with PDD (ICD-10) from 2000 to 2014 (n = 455). We divided the patients into PDD + depression (n = 187) and PDD only (n = 268) for analysis.ResultsOf the 187 patients with PDD + D, only eighteen (3.9%) were diagnosed with syndromal depression. There were no significant differences in sociodemographic profile including sex, marital and socioeconomic status (all P > 0.05). PDD + D group had a significantly younger age at onset ([PDD + D: 30.6 9.2 years vs. PDD: 33.5 11.1 years]; t = 2.9, P < 0.05). There was no significant difference between the clinical presentation including mode of onset, the main theme of their delusion and secondary delusions (all P > 0.3). However, comorbid substance dependence was significantly higher in patients with PDD only. (χ2 = 5.3, P = 0.02). In terms of treatment, response to antipsychotics was also comparable ([> 75% response: PDD + D = 77/142 vs. PDD = 106/179); χ2 = 1.9, P = 0.3). There was a significant difference between the two groups in terms of antidepressant treatment ([PDD + D = 32/187; 17% vs PDD: 17/268; 6%), χ2 = 12.9, P = 0.001).DiscussionPatients with PDD + D had significantly earlier onset of illness. These patients may require antidepressants for treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Shukla T, Jabeen Taj R, Kulkarni K, Shetty P, Viswanath B, Purushottam M, Reddy Y, Jain S. Pharmacogenetic Association Between Glutamatergic Genes and Sri Treatment Response in Obsessive Compulsive Disorder. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.1886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
IntroductionPharmacogenetic studies in obsessive-compulsive disorder (OCD) primarily focussing on serotonergic and dopaminergic polymorphisms, provided inconsistent findings. There is recent evidence for glutamatergic abnormalities in OCD.AimsExamine the association glutamatergic genes with serotonin reuptake inhibitor (SRI) response in OCD.ObjectivesTo study pharmacogenetic association between SLC1A1 and GRIN2B polymorphisms with SRI response in OCD.MethodsDSM-IV OCD patients were recruited from a specialty OCD clinic and evaluated using the Yale-Brown obsessive compulsive scale (YBOCS), Mini International Neuropsychiatric Interview (MINI) plus, Clinical Global Impression scale (CGI). They were subsequently reassessed with YBOCS and CGI. To study extreme phenotypes, we included only full responders (> 35% YBOCS improvement and CGI-I score of 1 or 2) to any SRI (n = 191) and non-responders (< 25% YBOCS improvement and CGI-I score ≥ 4) to adequate trial of at least two SRIs (n = 84). Partial responders were excluded. Genotyping was performed using an ABI9700 PCR machine.ResultsGenotype frequencies did not deviate significantly from the values predicted by the Hardy-Weinberg equation. Case-control association analyses revealed no significant association between genotype/allele frequencies with SRI response.ConclusionOur data does not show any association between polymorphisms in glutamatergic genes and SRI response in OCD though such associations have been found in other studies. More SNP's in the same gene could be responsible for the pharmacogenetic associations. More homogenous sample considering symptom dimensions and other phenotypic variables may be needed. It may be critical to go beyond “usual suspect” candidate gene research. In this regard, a novel approach to identify SRI response biomarkers is the use of cellular models.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Kulkarni K, Lee SW, Tolkacheva EG. Pro-arrhythmic effect of heart rate variability during periodic pacing. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2017; 2016:149-152. [PMID: 28268301 DOI: 10.1109/embc.2016.7590662] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Clinically, healthy hearts have been associated with a high ventricular heart rate variability (HRV) while diseased hearts have been known to exhibit low ventricular HRV. Hence, low HRV is suggested to be a marker of cardiac ventricular arrhythmias. Over the past few years, there has been considerable amount of interest in incorporating HRV in pacing to emulate healthy heart conditions and re-stabilize the electrical activity in diseased hearts. Recently, we used single cell numerical simulations to demonstrate that HRV incorporated into periodic pacing promotes alternans formation and thus, can be pro-arrhythmic. Here, we performed high-resolution optical mapping experiments on Langendorff perfused, healthy whole mice hearts to validate our numerical findings. Our results indeed demonstrate that HRV promoted the onset of cardiac alternans, which is believed to be a precursor of fatal cardiac rhythms. Hence, our present study suggests that incorporating HRV into periodic pacing while addressing several clinical needs may not be safe. There is a pressing need to better understand paced cardiac dynamics and develop anti-arrhythmic pacing techniques that would prevent cardiac arrhythmias.
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Kulkarni K. Much more than just another guidance document. J Thromb Haemost 2016; 14:2093-2094. [PMID: 27627728 DOI: 10.1111/jth.13509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Indexed: 11/28/2022]
Abstract
As a pediatric hematologist oncologist with clinical and research interests in thrombosis in high-risk pediatric populations, and also as a member of the ISTH Early Career Task Force, I had the opportunity to develop a guidance document on 'Thromboprophylaxis for central venous catheters in the pediatric population' for the 'Guidelines and Guidance Documents' committee. In this communication, I share my experiences to date; I discuss my excitement and initial success, the steep learning curve required to build research acumen, the lessons learnt, and the opportunities and challenges faced. My experience with preparing the guidance document was much more than writing 'just another guidance document'.
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Kulkarni K, Tolkacheva EG. Real-time feedback based control of cardiac restitution using optical mapping. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2016; 2015:5920-3. [PMID: 26737639 DOI: 10.1109/embc.2015.7319739] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Cardiac restitution is the shortening of the action potential duration with an increase in the heart rate. A shorter action potential duration enables a longer diastolic interval which ensures that the heart gets adequate time to refill with blood. At higher rates however, restitution becomes steep and thus, can lead to unstable electrical activity (alternans) in the heart, leading to fatal cardiac rhythms. It has been proposed that maintaining a shallow slope of cardiac restitution could have potentially anti-arrhythmic effects. Previous studies involved the control of action potential duration (APD) or diastolic interval (DI) in isolated tissue samples based on the feedback from single microelectrode recordings. This limited the spatial resolution of the feedback system. Here, we aimed to develop a real time feedback control system that enabled the detection of APDs from various single pixels based on optical mapping recordings. Stimuli were applied after a predefined fixed DI after detection of an APD. We validated our algorithm using optical mapping movies from an ex-vivo rabbit heart. Thus, we provide an optical mapping based approach for the control of cardiac restitution and a potential means to validate its anti-arrhythmic effects.
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Kulkarni K, Arasappa R, Prasad K, Zutshi A, Chand P, Muralidharan K, Murthy P. A comparison of risperidone and olanzapine in the acute treatment of persistent delusional disorder: Data from a retrospective chart review. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.2011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
IntroductionThere is a lack of pharmacological trials studying drug response in Persistent Delusional Disorder (PDD) to guide clinical practice. Available reviews of retrospective data indicate good response to second-generation antipsychotics, but even such data from India is sparse.Objectives and aimsWe aimed to compare the response of acute PDD to risperidone and olanzapine in our retrospective review.MethodsWe conducted a retrospective chart review of patients diagnosed with PDD (ICD-10) from 2000 to 2014 (n = 455) at our Center. We selected the data of patients prescribed either olanzapine or risperidone for the purpose of this analysis. We extracted data about dose, drug compliance and response, adverse effects, number of follow-up visits and hospitalizations. The study was approved by the Institute Ethics Committee.ResultsA total of 280/455 (61%) were prescribed risperidone and 86/455 (19%) olanzapine. The remaining (n = 89; 20%) had received other antipsychotics. The two groups were comparable in socio-demographic and clinical characteristics of PDD. Compliance was good and comparable in both groups (> 80%, P = 0.2). Response to treatment was comparable in both groups (85% partial response and > 52% good response, all P > 0.3). Olanzapine was effective at lower mean chlorpromazine equivalents than risperidone (240 vs. 391, P < 0.05).ConclusionOur study indicates a good response to both risperidone and olanzapine, if compliance to treatment can be ensured. In the absence of specific treatment guidelines for PDD, second-generation antipsychotics like risperidone and olanzapine offer good treatment options for this infrequently encountered and difficult to treat psychiatric disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Kulkarni K, Holly B. Evaluation and management for interventionalists: how to appropriately document and capture billing for clinical services. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Motamed S, Del Borgo MP, Kulkarni K, Habila N, Zhou K, Perlmutter P, Forsythe JS, Aguilar MI. A self-assembling β-peptide hydrogel for neural tissue engineering. SOFT MATTER 2016; 12:2243-2246. [PMID: 26853859 DOI: 10.1039/c5sm02902c] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
We report a new class of β-peptide based hydrogel for neural tissue engineering. Our β-peptide forms a network of nanofibres in aqueous solution, resulting in a stable hydrogel at physiological conditions. The hydrogel shows excellent compatibility with neural cells and provides a suitable environment for cells to adhere and proliferate.
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Hamer SE, Kulkarni K, Cohen SN. Shiitake dermatitis with oral ulceration and pustules. Clin Exp Dermatol 2015; 40:332-3. [DOI: 10.1111/ced.12500] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2014] [Indexed: 02/01/2023]
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Patel AN, Kulkarni K, Perkins W. A friable peristomal lesion. Clin Exp Dermatol 2015; 39:420-2. [PMID: 24635094 DOI: 10.1111/ced.12287] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2013] [Indexed: 11/30/2022]
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Toth P, Hamon S, Jones S, Martin S, Joshi P, Kulkarni K, Banerjee P, Hanotin C. Proprotein convertase subtilisin/kexin 9 monoclonal antibody therapy significantly reduced apoprotein cii and ciii levels in serum in phase 2 studies. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.05.290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kulkarni K, Namazi IJ, Deshpande S, Goel R. Cervical epidural anaesthesia with ropivacaine for modified radical mastectomy. Kathmandu Univ Med J (KUMJ) 2014; 11:126-31. [PMID: 24096219 DOI: 10.3126/kumj.v11i2.12487] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Cervical epidural anaesthesia (CEA) using local anesthetics (LA) is a well established technique for the surgeries in the neck, chest and upper arms. Recently ropivacaine is introduced with better safety profile. OBJECTIVES The aim was to observe the safety of Cervical epidural anaesthesia as an anaesthetic technique and to compare the efficacy of epidural 0.25% bupivacaine with 0.375% ropivacaine for radical mastectomies. METHODS A double blind study was conducted on 40 ASA grade I / II females who received CEA with 10 ml of 0.25% of bupivacaine +25μg of fentanyl in group B (n=20) and 10 ml of 0.375% of ropivacaine +25μg of fentanyl in group R (n=20) epidurally. Assessment of the block, vital monitoring and complications noted. RESULTS No significant differences observed in the onset of sensory block (5.05 min and 5.4 min in group B and R respectively, P>0.05).The mean motor blockade score, time to achieve complete blockade and time to grade I motor recovery was significantly longer in group B (2.3, 22.5 and 79.5 minutes respectively) as compared to group R (1.5, 18.3 and 66.3 minutes respectively, P<0.05). Respiratory distress developed in two patients of group B that required general anaesthesia (GA) with intubation. CONCLUSION Use of 0.37% ropivacaine is safer than 0.25% bupivacaine for CEA for radical mastectomy. It provides good surgical anaesthesia with lesser degree of motor blockade and the respiratory effects.
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Laxminarayan R, Kulkarni K, Kolhe N. AB1010 Comparing Digital Tomogram and Ultrasound in Established Rheumatoid Arhritis: Table 1. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.1314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Kulkarni K, Yuen Tan S, Tolkacheva EG. Miniaturized Radio Frequency Telemetric Pacemaker With Anti-Arrhythmic Pacing Protocol1. J Med Device 2014. [DOI: 10.1115/1.4027009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Foo S, Cheng S, Varma S, Kulkarni K. Sequestrated meningocoele within a naevus sebaceous of Jadassohn on the scalp of a child. Clin Exp Dermatol 2014; 39:304-6. [PMID: 24635065 DOI: 10.1111/ced.12279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2013] [Indexed: 11/28/2022]
Abstract
Sequestrated meningocoele is an uncommon developmental anomaly in which meningothelial elements are found in the skin or subcutaneous tissue without underlying bony defect. By contrast, naevus sebaceous of Jadassohn (NSJ) is a circumscribed hamartomatous lesion occurring in about 0.3% of newborns. We report a child with a histologically confirmed sequestrated meningocoele within an NSJ on his scalp vertex. Such an occurrence has not been reported previously.
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Kulkarni K, Van Nostrand D, Mete M, Burman K, Wartofsky L. Detectability of foci of radioiodine uptake in the thyroid bed and neck comparing pinhole with parallel-hole collimators. Nucl Med Commun 2011; 32:369-74. [PMID: 21394048 DOI: 10.1097/mnm.0b013e3283428d62] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The objective of this study was to evaluate the detection of the foci of radioiodine (RAI) uptake in the thyroid bed and neck of patients with well-differentiated thyroid cancer using a pinhole collimator (PiHC) compared with either whole-body images (WBIs) or individual images obtained using a parallel-hole collimator (PaHC). METHODS A retrospective review was conducted of all RAI scans done at the Washington Hospital Center between June 2000 and December 2006 on patients who had (i) well-differentiated thyroid cancer, (ii) an RAI scan of the thyroid bed and neck before their first RAI ablation or treatment, (iii) individual spot images of the neck (II) taken using both PiHC and PaHC as part of this pretreatment scan, and (iv) WBIs taken using a PaHC. To test for significant differences between the numbers of foci detected by different methods, two sample t-tests for paired groups were used. RESULTS Of the 325 patients meeting the above criteria, the mean age was 46 years (range = 15-83 years). The mean (range) number of foci identified on WBIs, IIs-PaHC, and IIs-PiHC images was 2.14 (0-8), 2.82 (0-11), and 3.32 (0-14), respectively. The total number of foci detected on WBIs, IIs-PaHC, and IIs-PiHC images was 694, 916, and 1079, respectively. The means (ranges; P values) of the differences in the number foci detected with II-PiHC versus II-PaHC and II-PiHC versus WBI-PaHC were 0.502 (-3 to 6; P < 0.001) and 1.185 (-2 to 8; P < 0.001), respectively. II-PiHCs showed additional foci of uptake relative to II-PaHCs and WBI-PaHCs in 10% (32) and 33% (108) of patients, respectively. CONCLUSION II-PiHC showed more foci of RAI uptake in the thyroid bed and neck than either II-PaHC or WBI-PaHC. Pinhole imaging offers the potential to better identify cervical metastases, possibly modify the empiric prescribed activity of RAI, and/or provide a better baseline for future comparison.
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Ramya P, Chaubal A, Kulkarni K, Gupta L, Kadoo N, Dhaliwal HS, Chhuneja P, Lagu M, Gupta V. QTL mapping of 1000-kernel weight, kernel length, and kernel width in bread wheat (Triticum aestivum L.). J Appl Genet 2011; 51:421-9. [PMID: 21063060 DOI: 10.1007/bf03208872] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Kernel size and morphology influence the market value and milling yield of bread wheat (Triticum aestivum L.). The objective of this study was to identify quantitative trait loci (QTLs) controlling kernel traits in hexaploid wheat. We recorded 1000-kernel weight, kernel length, and kernel width for 185 recombinant inbred lines from the cross Rye Selection 111 × Chinese Spring grown in 2 agro-climatic regions in India for many years. Composite interval mapping (CIM) was employed for QTL detection using a linkage map with 169 simple sequence repeat (SSR) markers. For 1000-kernel weight, 10 QTLs were identified on wheat chromosomes 1A, 1D, 2B, 2D, 4B, 5B, and 6B, whereas 6 QTLs for kernel length were detected on 1A, 2B, 2D, 5A, 5B and 5D. Chromosomes 1D, 2B, 2D, 4B, 5B and 5D had 9 QTLs for kernel width. Chromosomal regions with QTLs detected consistently for multiple year-location combinations were identified for each trait. Pleiotropic QTLs were found on chromosomes 2B, 2D, 4B, and 5B. The identified genomic regions controlling wheat kernel size and shape can be targeted during further studies for their genetic dissection.
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Garcia C, Bandaru V, Van Nostrand D, Chennupati S, Atkins F, Acio E, Kulkarni K, Majd M. Effective reduction of brown fat FDG uptake by controlling environmental temperature prior to PET scan: an expanded case series. Mol Imaging Biol 2011; 12:652-6. [PMID: 20237858 DOI: 10.1007/s11307-010-0298-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Brown fat uptake of 2-deoxy-2-[F-18]fluoro-D: -glucose (FDG) on a positron emission tomography (PET) scan may limit the ability to assess for cancer. Previously, Garcia et al. demonstrated in ten patients a significant decrease in brown fat uptake of 2-deoxy-2-[F-18]fluoro-D: -glucose (FDG) after controlling the patient's environmental temperature. OBJECTIVE The objective of the current study is to validate the effectiveness of controlled environmental temperature (CET) to reduce physiologic brown fat (BF) FDG uptake on a PET scan in a larger series. METHOD A retrospective review was performed from January 2002 to October 2007 of patients who had (1) a pattern of FDG uptake on PET scan consistent with BF, (2) no evidence of cancer by computed tomography in the regions of interest noted below, (3) repeat scan with CET within 4 months of the 1st PET scan, and (4) no use of drugs reported to reduce BF FDG uptake (e.g., benzodiazepine, beta-blockers, reserpine) unless they were used identically prior to and during both studies. The FDG-PET and controlled environmental temperature-positron emission tomography (CET-PET) scans were performed as per protocol. The non-CET and CET-PET images were blinded/randomized, and three physicians assessed three regions (right neck, left neck, and paraspinal area) semiquantitatively using the following scale: "0" (background [bkgd]), 1 + (> bkgd < liver), 2 + (equal to liver), 3 + (> liver). Standard uptake value (SUV) data was recorded. Results were analyzed using a two-tailed t test. RESULTS Of 8,640 FDG-PET scans performed, 30 patients (four male, 26 female) met the above criteria. The median age was 36 years (range, 12-60 years). The mean (± 1 standard deviation) of differences in the scores between the two studies for right neck, left neck, and paraspinal regions, respectively, were for reader 1:(2.1 ± 1.37), (1.95 ± 1.43), and (1.85 ± 1.26); reader 2 (2.3 ± 1.40), (1.70 ± 1.13), and (1.77 ± 1.13); reader 3 (2.17 ± 1.17), (2.20 ± 1.18), and (0.50 ± 1.30); for maximum SUV score (3.4 ± 2.9), (3.3 ± 2.9), and (1.77 ± 1.13). All p values were <0.001. CONCLUSION In this larger series, CET effectively reduced the false-positive (18)FDG uptake in BF on PET scans without the use of drugs.
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Van Nostrand D, Bandaru V, Chennupati S, Wexler J, Kulkarni K, Atkins F, Mete M, Gadwale G. Radiopharmacokinetics of radioiodine in the parotid glands after the administration of lemon juice. Thyroid 2010; 20:1113-9. [PMID: 20883172 DOI: 10.1089/thy.2009.0429] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND The ability of sialagogues to increase or decrease radiation induced-sialoadenitis and/or xerostomia after therapeutic administration of ¹³¹I is controversial. To evaluate this we measured the radiopharmacokinetics of ¹²³I in the parotid glands (PGs) after its administration of lemon juice (LJ). METHODS A retrospective review was performed on all patients who had a salivary gland scan performed before ¹³¹I therapy between July 2008 and April 2009 at the Washington Hospital Center. Two hours after ¹²³I was given orally, dynamic scintigraphy was initiated. Five milliliters of LJ was given 5 minutes later. Then, the patient was imaged for 1 hour (phase 1) at which point the sequence was repeated (phase 2). Twenty-three patients were studied. For each PG, the presence or absence of uptake was assessed, and based on background corrected counts, the mean, range, and standard deviation were determined for multiple radiopharmacokinetic parameters such as (i) percent radioiodine washout, (ii) time from LJ administration to re-accumulation of radioiodine to pre-LJ activity, and (iii) percent reduction in radiation absorbed dose to the PGs if LJ had been re-administered at the time the radioiodine activity re-accumulated to the pre-LJ activity. RESULTS The mean ± one standard deviation and range for percent washout were 84% ± 18% (35%-100%) and 83% ± 21% (37%-100%) in phase 1 and 2, respectively. The times from LJ to re-accumulation of the radioiodine to the pre-LJ activity were 21 ± 10 minutes (4-45 minutes) and 40 ± 14 minutes (12-62 minutes) for phase 1 and 2, respectively. The estimated percent reduction in radiation absorbed dose to the PGs following the first and second administration of LJ was 37% ± 14% (13%-93%) and 47% ± 16% (21%-97%), respectively. CONCLUSIONS The washout of radioiodine from the PGs is rapid but transient. Early repeat administration may result in continued and cumulative reduction of radiation absorbed dose in the PGs.
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Foo SH, Kulkarni K, Varma S. A rare case of misplaced turban. Cylindroma. Clin Exp Dermatol 2010; 35:797-8. [PMID: 20831606 DOI: 10.1111/j.1365-2230.2010.03804.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Klubo-Gwiezdzinska J, Van Nostrand D, Burman KD, Vasko V, Chia S, Deng T, Kulkarni K, Wartofsky L. Salivary gland malignancy and radioiodine therapy for thyroid cancer. Thyroid 2010; 20:647-51. [PMID: 20470209 DOI: 10.1089/thy.2009.0466] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND The risk of second primary malignancies in patients with well-differentiated thyroid cancer is of special interest because of the common use of radioactive iodine (RAI) ablation and/or treatment of these patients and the theoretical risk of subsequent nonthyroid malignancies associated with the radiation exposure. This brief report focuses specifically on the occurrence of second primary malignancies of the salivary glands. RAI residency within salivary tissues is known to have both acute and chronic consequences on salivary function, but secondary neoplasia is quite unusual. SUMMARY We present a very rare case of a patient with papillary thyroid cancer treated with 600 mCi of RAI, who subsequently developed salivary gland cancer. CONCLUSIONS We recommend salivary gland protection to diminish potential side effects after the exposure to radioiodine. On the basis of our experience we suggest administration of sialogogues (such as lemon juice) continuously, every 30-60 minutes for 24 hours, after RAI administration.
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Kaur S, Kulkarni K. Joubert syndrome type I: neuroimaging findings in addition to the 'molar tooth' sign. CASE REPORTS 2010; 2010:2010/apr29_1/bcr1120092464. [DOI: 10.1136/bcr.11.2009.2464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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