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Gwynne S, Wills L, Joseph G, John G, Staffurth J, Hurt C, Mukherjee S. Respiratory movement of upper abdominal organs and its effect on radiotherapy planning in pancreatic cancer. Clin Oncol (R Coll Radiol) 2009; 21:713-9. [PMID: 19733469 DOI: 10.1016/j.clon.2009.07.015] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2008] [Revised: 07/16/2009] [Accepted: 07/20/2009] [Indexed: 12/22/2022]
Abstract
AIMS Radiotherapy for pancreatic cancer is complicated by the frequent overlapping of the planning target volume (PTV) and the organ at risk (OAR), limiting the dose that can be safely delivered to the tumour. Individualising the margins applied to the clinical target volume (CTV) may reduce OAR irradiation without increasing the risk of geographical miss. We quantified the movement of the pancreas with respiration and evaluated whether individualised margins based on this motion reduced the dose to OARs. MATERIALS AND METHODS Planning computed tomography scans were acquired in quiet breathing, held expiration and held inspiration. Organ motion was evaluated from displacement of a reproducible point within the pancreas in all directions. Two sets of plans (standard plan: P(stan); individualised plan incorporating movement data: P(ind)) were generated for each patient. The PTV and doses to OARs were evaluated for both sets of plans. RESULTS The mean (standard deviation) movement of the pancreas in the superior-inferior, lateral and anterior-posterior directions were 15.3 mm (4.3), 5.2 mm (3.5) and 9.7 mm (6.1), respectively. The use of individualised margins reduced the mean PTV volume by 33.5% (9.8) (P=0.0051). The proportional reductions in the percentage of kidney receiving >10 Gy, small bowel >45 Gy and liver >30 Gy were 63.7% (P=0.0051), 29.3% (P=0.0125) and 29.2% (P=0.0107), respectively. For the same level of OAR constraints, individualised margins allowed dose escalation in six of the 10 patients to a mean dose of 63.2 Gy. CONCLUSIONS The present study shows a simple way of incorporating organ motion into the planning process and can be adopted by any centre without major strain on healthcare resources. The use of individualised margins reduced PTV volume and the dose to OARs. This may offer an opportunity for dose escalation to try and further improve local control.
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Moses V, Mahendri NV, John G, Peter JV, Ganesh A. Early hypocaloric enteral nutritional supplementation in acute organophosphate poisoning--a prospective randomized trial. Clin Toxicol (Phila) 2009; 47:419-24. [PMID: 19492933 DOI: 10.1080/15563650902936664] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Early institution of enteral feeds may be associated with improved outcomes in the critically ill. This study evaluated the effect of hypocaloric enteral nutritional supplementation in acute organophosphate(OP)-poisoned patients requiring invasive mechanical ventilation. SETTINGS AND DESIGN Prospective randomized controlled trial conducted in the medical intensive care unit (ICU) of a tertiary care university teaching hospital. PATIENTS AND METHODS During a 13-month period, 87 OP-poisoned patients were admitted. Twenty-seven patients who were not ventilated were excluded. Thirty patients were randomized to the control arm and 29 to the intervention arm. The intervention arm received hypocaloric nasogastric feeds within 48 h of intubation whilst the control arm received intravenous fluids. Primary outcome was infectious complications. Secondary outcomes included hospital mortality, duration of ventilation, ICU stay, and hospital stay. RESULTS An infectious complication occurred in 14 patients (48%) in the intervention group and 15 patients (50%) in the control group (p = 0.898). Three patients in each group died (p = 0.965). Duration of ventilation (p = 0.19) and ICU stay (p = 0.41) were similar. Duration of hospital stay was shorter in the control group (p = 0.05). Gastric stasis occurred in two patients (6.9%) receiving enteral feeds. Feeding related complications were less frequent than in other published trials. CONCLUSIONS In OP-poisoned patients, early hypocaloric enteral feeding was not associated with improvements in clinical endpoints, albeit longer hospital stay was observed in the enterally fed group. Feeding related complications were infrequent. Further studies would help define the status of early enteral feeding in this subset of patients.
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Imbert Y, Foulks GN, Brennan MD, Jumblatt MM, John G, Shah HA, Newton C, Pouranfar F, Young WW. MUC1 and estrogen receptor α gene polymorphisms in dry eye patients. Exp Eye Res 2009; 88:334-8. [DOI: 10.1016/j.exer.2008.05.019] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2008] [Revised: 05/20/2008] [Accepted: 06/29/2008] [Indexed: 11/29/2022]
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Henke MO, John G. Die Oberflächenexpression von TLR-4 ist bei CF Bronchialepithelzellen reduziert. Pneumologie 2009. [DOI: 10.1055/s-0029-1202413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ramakrishnan N, John G, Ray B, Todi SK, Samaddar DP. Quality indicators for ICU: ISCCM guidelines for ICUs in India. Indian J Crit Care Med 2009. [DOI: 10.5005/ijccm-13-4-173] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Jyothish K, Vemula PK, Jadhav SR, Francesconi LC, John G. Self-standing, metal nanoparticle embedded transparent films from multi-armed cardanol conjugates through in situ synthesis. Chem Commun (Camb) 2009:5368-70. [DOI: 10.1039/b900208a] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
To date, a wide range of industrial materials such as solvents, fuels, synthetic fibers, and chemical products are being manufactured from petroleum resources. However, rapid depletion of fossil and petroleum resources is encouraging current and future chemists to orient their research toward designing safer chemicals, products, and processes from renewable feedstock with an increased awareness of environmental and industrial impact. Advances in genetics, biotechnology, process chemistry, and engineering are leading to a new manufacturing concept for converting renewable biomass to valuable fuels and products, generally known as the biorefinery concept. The swift integration of crop-based materials synthesis and biorefinery manufacturing technologies offers the potential for new advances in sustainable energy alternatives and biomaterials that will lead to a new manufacturing paradigm. This Account presents a novel and emerging concept of generating various forms of soft materials from crops (an alternate feedstock). In future research, developing biobased soft materials will be a fascinating yet demanding practice, which will have direct impact on industrial applications as an economically viable alternative. Here we discuss some remarkable examples of glycolipids generated from industrial byproducts such as cashew nut shell liquid, which upon self-assembly produced soft nanoarchitectures including lipid nanotubes, twisted/helical nanofibers, low-molecular-weight gels, and liquid crystals. Synthetic methods applied to a "chiral pool" of carbohydrates using the selectivity of enzyme catalysis yield amphiphilic products derived from biobased feedstock including amygdalin, trehalose, and vitamin C. This has been achieved with a lipase-mediated regioselective synthetic procedure to obtain such amphiphiles in quantitative yields. Amygdalin amphiphiles showed unique gelation behavior in a broad range of solvents such as nonpolar hexanes to polar aqueous solutions. Importantly, an enzyme triggered drug-delivery model for hydrophobic drugs was demonstrated by using these supramolecularly assembled hydrogels. Following a similar biocatalytic approach, vitamin C amphiphiles were synthesized with different hydrocarbon chain lengths, and their ability to self-assemble into molecular gels and liquid crystals has been studied in detail. Such biobased soft materials were successfully used to develop novel organic-inorganic hybrid materials by in situ synthesis of metal nanoparticles. The self-assembled soft materials were characterized by several spectroscopic techniques, UV-visible, infrared, and fluorescence spectrophotometers, as well as microscopic methods including polarized optical, confocal, scanning, and transmission electron microscopes, and thermal analysis. The molecular packing of the hierarchically assembled bilayer membranes was fully elucidated by X-ray analysis. We envision that the results summarized in this Account will encourage interdisciplinary collaboration between scientists in the fields of organic synthesis, soft materials research, and green chemistry to develop functional materials from underutilized crop-based renewable feedstock, with innovation driven both by material needs and environmentally benign design principles.
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Aly SM, Abd-El-Rahman AM, John G, Mohamed MF. Characterization of Some Bacteria Isolated from Oreochromis niloticus and their Potential Use as Probiotics. AQUACULTURE 2008; 277:1-6. [DOI: 10.1016/j.aquaculture.2008.02.021] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Kumar A, Vemula PK, Ajayan PM, John G. Silver-nanoparticle-embedded antimicrobial paints based on vegetable oil. NATURE MATERIALS 2008; 7:236-41. [PMID: 18204453 DOI: 10.1038/nmat2099] [Citation(s) in RCA: 540] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2007] [Accepted: 12/03/2007] [Indexed: 05/22/2023]
Abstract
Developing bactericidal coatings using simple green chemical methods could be a promising route to potential environmentally friendly applications. Here, we describe an environmentally friendly chemistry approach to synthesize metal-nanoparticle (MNP)-embedded paint, in a single step, from common household paint. The naturally occurring oxidative drying process in oils, involving free-radical exchange, was used as the fundamental mechanism for reducing metal salts and dispersing MNPs in the oil media, without the use of any external reducing or stabilizing agents. These well-dispersed MNP-in-oil dispersions can be used directly, akin to commercially available paints, on nearly all kinds of surface such as wood, glass, steel and different polymers. The surfaces coated with silver-nanoparticle paint showed excellent antimicrobial properties by killing both Gram-positive human pathogens (Staphylococcus aureus) and Gram-negative bacteria (Escherichia coli). The process we have developed here is quite general and can be applied in the synthesis of a variety of MNP-in-oil systems.
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Kaul S, Brahmadathan KN, Jagannati M, Sudarsanam TD, Pitchamuthu K, Abraham OC, John G. One year trends in the gram-negative bacterial antibiotic susceptibility patterns in a medical intensive care unit in South India. Indian J Med Microbiol 2008; 25:230-5. [PMID: 17901640 DOI: 10.4103/0255-0857.34764] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
PURPOSE To describe the changes in antibiotic susceptibility patterns of common intensive care unit pathogens with time from the medical intensive care unit of a tertiary care hospital. METHODS A prospective observational study was conducted in the medical intensive care unit (MICU) of a 2100 bed tertiary care hospital in South India. All data regarding patient characteristics, disease characteristics, infective agents, identified along with their antibiotic sensitivity patterns and patient outcomes were prospectively recorded in MICU data base. Various bacterial pathogen antibiotic sensitivity patterns from August 2004 to May 2005 were prospectively documented. During this period 491 patients were admitted to the MICU. Data were analyzed using excel spreadsheets. RESULTS Ceftazidime resistance reduced in Klebsiella spp. while cefotaxime resistance increased. In E. coli however, ceftazidime and cefotaxime resistance increased. Klebsiella resistance to cefotaxime and ceftazidime ranged from 25-50% and 14-91%, while E. coli resistance to these antibiotics ranged from 50-70% and 50 to 80% respectively. In Pseudomonas and the non-fermenting gram-negative bacteria (NFGNB) ceftazidime resistance decreased. Third generation cephalosporin resistance seemed to be reducing in the NFGNB, however, carbapenem resistance appeared to be increasing, possibly due to their increasing use. CONCLUSIONS This study demonstrates the trend in antibiotic susceptibility pattern (AST) of common gram negative infections seen in intensive care units. It demonstrates the changes seen especially after a change in the protocol antibiotic. Changes in the AST patterns of Klebsiella, E. coli, Pseudomonas and non-fermenting gram negative bacteria were seen. The data on the changing antibiotic susceptibility trends we believe is an important pillar in our efforts at infection control especially in intensive care settings.
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George IA, John G, John P, Peter JV, Christopher S. An evaluation of the role of noninvasive positive pressure ventilation in the management of acute respiratory failure in a developing country. INDIAN JOURNAL OF MEDICAL SCIENCES 2007; 61:495-504. [PMID: 17785885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
OBJECTIVE Noninvasive positive pressure ventilation (NIPPV) has been shown to decrease the need for invasive mechanical ventilation (MV) in patients presenting with acute respiratory failure (ARF). We conducted a prospective study to assess if NIPPV use, in a developing country, was associated with clinical and physiological improvements. DESIGN Prospective observational study. MATERIALS AND METHODS Forty patients admitted to a medical intensive care unit during a 2-year period who fulfilled criteria for inclusion formed the study cohort to receive NIPPV. FINDINGS Baseline (mean +/- SD) pH, PaCO 2 and PaO 2 were 7.25 +/- 0.08, 76.6 +/- 20.9 and 79.18 +/- 40.56 mmHg respectively. The primary indication for NIPPV was hypercapnic respiratory failure (n = 36, 90%). The success rate with NIPPV was 85%, with 34 of 40 patients weaned successfully. Significant improvements were observed at 1 hour following institution of NIPPV in pH (7.31 +/- 0.09, P 2 (65 +/- 17.9, P 2 54.7 +/- 20) and maintained (within 12 h) postweaning from the ventilator (pH 7.39 +/- 0.08, PaCO 2 51.9 +/- 12.4). No significant change in the PaO 2 was observed during NIPPV; PaO 2 after 1 h, prior to weaning and after weaning was 90.53 +/- 42.85, 84.80 +/- 33.76, 78.71 +/- 43.81 respectively. CONCLUSION This study has demonstrated benefits of NIPPV in avoiding the need for invasive MV in patients presenting with ARF of diverse etiology, with results comparable to developed nations. Increased use of NIPPV in ARF is likely to impact favorably in nations with limited resources.
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Gallardo T, Shirley L, John G, Castrillon DH. Generation of a germ cell-specific mouse transgenic Cre line, Vasa-Cre. Genesis 2007; 45:413-7. [PMID: 17551945 PMCID: PMC2597027 DOI: 10.1002/dvg.20310] [Citation(s) in RCA: 266] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Cell type-specific genetic modification using the Cre/loxP system is a powerful tool for genetic analysis of distinct cell lineages. Because of the exquisite specificity of Vasa expression (confined to the germ cell lineage in invertebrate and vertebrate species), we hypothesized that a Vasa promoter-driven transgenic Cre line would prove useful for the germ cell lineage-specific inactivation of genes. Here we describe a transgenic mouse line, Vasa-Cre, where Cre is efficiently and specifically expressed in germ cells. Northern analysis showed that transgene expression was confined to the gonads. Cre-mediated recombination with the Rosa26-lacZ reporter was observed beginning at approximately e15, and was >95% efficient in male and female germ cells by birth. Although there was a potent maternal effect with some animals showing more widespread recombination, there was no ectopic activity in most adults. This Vasa-Cre transgenic line should thus prove useful for genetic analysis of diverse aspects of gametogenesis and as a general deletor line.
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Shamsul H, Saw A, John G. Anterior Displacement of Ulnar Nerve at the Elbow in Children Based on Ultrasonography. Malays Orthop J 2007. [DOI: 10.5704/moj.0705.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Mallia V, Vemula P, John G, Kumar A, Ajayan P. In Situ Synthesis and Assembly of Gold Nanoparticles Embedded in Glass-Forming Liquid Crystals. Angew Chem Int Ed Engl 2007. [DOI: 10.1002/ange.200604218] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Mallia VA, Vemula PK, John G, Kumar A, Ajayan PM. In Situ Synthesis and Assembly of Gold Nanoparticles Embedded in Glass-Forming Liquid Crystals. Angew Chem Int Ed Engl 2007; 46:3269-74. [PMID: 17385773 DOI: 10.1002/anie.200604218] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Chu TT, Fink MY, Mong JA, John G, Auger AP, Ge Y, Sealfon SC. Effective use of microarrays in neuroendocrine research. J Neuroendocrinol 2007; 19:145-61. [PMID: 17280588 DOI: 10.1111/j.1365-2826.2006.01523.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
The development of microarray technology makes it possible to simultaneously assay the expression level of hundreds to tens of thousands of mRNA transcripts in one experiment. Genome-wide transcriptional analysis has increasing importance for many areas of neuroendocrinology research. The expense and technical complexity of microarray experiments can make it difficult to navigate the terrain of rival platforms and technologies. In this review, we provide a practical view and comparison of various microarray technologies. Affymetrix arrays, high-density cDNA arrays, membrane arrays and experimental design and data analysis are all discussed by researchers currently using these techniques to study gene regulation in neuroendocrine tissues.
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Kumar A, Murugesan S, Pushparaj V, Xie J, Soldano C, John G, Nalamasu O, Ajayan PM, Linhardt RJ. Conducting organic-metallic composite submicrometer rods based on ionic liquids. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2007; 3:429-33. [PMID: 17262867 DOI: 10.1002/smll.200600442] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
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Ewing G, Giglia J, Vusirikala M, Ye F, Shyr Y, Chinratanalab W, Ruffner K, Kassim A, Jagasia M, Engelhardt B, Brandt S, Morgan D, Stein R, John G, Schuening F, Goodman S. 233: CD34 dose and chronic graft versus host disease (cGVHD) affect survival in allogeneic peripheral blood stem cell transplantation (alloPBSCT) following non-myeloablative (NM) conditioning. Biol Blood Marrow Transplant 2007. [DOI: 10.1016/j.bbmt.2006.12.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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George I, John G, John P, Peter J, Christopher S. An evaluation of the role of noninvasive positive pressure ventilation in the management of acute respiratory failure in a developing country. ACTA ACUST UNITED AC 2007. [DOI: 10.4103/0019-5359.34518] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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John G, Vemula PK. Design and development of soft nanomaterials from biobased amphiphiles. SOFT MATTER 2006; 2:909-914. [PMID: 32680178 DOI: 10.1039/b609422h] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Design and development of different forms of soft matter from renewable (biomass) feedstocks is gaining attention in current research. This highlight summarizes our continuing efforts towards the effective utilization of renewable resources for new chemicals, fuels and soft materials, and selected successful stories in that direction. Cashew nut shell liquid, an industrial by-product, was used as a raw material to synthesize aryl glycolipids which upon self-assembly generated an array of soft materials such as lipid nanotubes, twisted/helical nanofibers, low-molecular-weight hydro/organogels and liquid crystals. These soft architectures were fully characterized by using different techniques. In another example, amygdalin, a by-product of the apricot industry, was used to develop novel amphiphiles, which showed unprecedented gelation properties in a wide range of solvents. To take these soft nanomaterials to a second level, we successfully demonstrated the utility of these hydrogels as drug delivery vehicles. Intriguingly, enzyme catalysis was used as a tool to make and break the hydrogels, which apparently triggered controlled drug delivery. We believe these results and this highlight will motivate us and others in the field of biobased materials research, green chemistry and soft material development through self-assembly processes, to design and develop new functional materials from plant/crop-based renewable resources, otherwise underutilized.
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John G. Yet another steal syndrome. CRIT CARE RESUSC 2006; 8:260. [PMID: 16930121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
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Sudarsanam TD, Pichaimuthu K, Zachariah A, John G. Oximes in acute organophosphate poisoning. Crit Care Med 2006; 34:2265; author reply 2265-6. [PMID: 16883212 DOI: 10.1097/01.ccm.0000229681.55355.42] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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John G, Zhu G, Li J, Dordick JS. Cover Picture: Enzymatically Derived Sugar-Containing Self-Assembled Organogels with Nanostructured Morphologies (Angew. Chem. Int. Ed. 29/2006). Angew Chem Int Ed Engl 2006. [DOI: 10.1002/anie.200690100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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John G, Zhu G, Li J, Dordick JS. Enzymatically Derived Sugar-Containing Self-Assembled Organogels with Nanostructured Morphologies. Angew Chem Int Ed Engl 2006; 45:4772-5. [PMID: 16763957 DOI: 10.1002/anie.200600989] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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