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Sen S, Thomas SS, Cherian A, Abraham D, Hepzhibah J, John R, Therese M, Reka K, Paul MJ. Thyroglossal Duct Cyst Carcinoma: Lessons from a 20-Case Series. Indian J Surg Oncol 2023; 14:609-618. [PMID: 37900628 PMCID: PMC10611691 DOI: 10.1007/s13193-023-01720-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 02/13/2023] [Indexed: 03/06/2023] Open
Abstract
Aims and Objectives Thyroglossal duct cyst (TDC) is a common congenital cyst with an incidence of about 7%. Thyroglossal duct cyst carcinoma (TDCC) is a rare sequel which arises from TDC and has an incidence of about 1%. As these are rare, they do not have well-defined management guidelines. The aim of this study was to analyse the clinical profile and pathological characteristics of patients with thyroglossal duct cyst carcinoma and to propose a protocol for their treatment and follow-up. Materials and Methods A retrospective study was done from January 2000 to December 2019. All the clinical details, imaging characteristics, treatment and histopathology were analysed. Results The mean age group in our study was 37.9 years with a female preponderance. The clinical features like rapid increase in size, fixity of the lump and lymph node metastasis were not very common. Seventy-five percent of our patients who underwent imaging had suspicious characteristics. Fifty-six percent of our patients had FNAC suggestive of TDCC. Fifty percent of our patients had concomitant thyroid carcinoma. None of our patients had distant metastasis at follow-up. Conclusions TDCC is rare and a disease of young adulthood and usually has good prognosis. It may be a clinical surprise or a small lesion which can be detected with ultrasound and targeted FNAC. There is high rate of concomitant thyroid carcinoma and hence needs careful assessment. Sistrunk's procedure with total thyroidectomy either staged or simultaneously has good outcome and permits adjuvant treatment.
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Affiliation(s)
- Supriya Sen
- Department of Endocrine Surgery, CMC Hospital Vellore, Vellore, 632004 Tamil Nadu India
| | - Shawn Sam Thomas
- Department of Endocrine Surgery, CMC Hospital Vellore, Vellore, 632004 Tamil Nadu India
| | - Anish Cherian
- Department of Endocrine Surgery, CMC Hospital Vellore, Vellore, 632004 Tamil Nadu India
| | - Deepak Abraham
- Department of Endocrine Surgery, CMC Hospital Vellore, Vellore, 632004 Tamil Nadu India
| | - Julie Hepzhibah
- Department of Nuclear Medicine, CMC Hospital Vellore, Vellore, 632004 Tamil Nadu India
| | - Reetu John
- Department of Radiology, CMC Hospital Vellore, Vellore, 632004 Tamil Nadu India
| | - Marie Therese
- Department of Pathology, CMC Hospital Vellore, Vellore, 632004 Tamil Nadu India
| | - K. Reka
- Department of Biostatistics, CMC Hospital Vellore, Vellore, 632004 Tamil Nadu India
| | - M. J. Paul
- Department of Endocrine Surgery, CMC Hospital Vellore, Vellore, 632004 Tamil Nadu India
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Siems C, John R, Jackson S, Alexy T. Impact of Bridge-to-Transplant Left Ventricular Assist Device Support Duration on Candidate Characteristics and Post-Heart Transplant Complications. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.655] [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: 04/05/2023] Open
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3
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Kandasamy D, Gulati A, Simon B, John R, Goyal A. Imaging Recommendations for Diagnosis, Staging, and Management of Adrenal Tumors. Indian J Med Paediatr Oncol 2023. [DOI: 10.1055/s-0042-1759714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
AbstractAdrenal glands are affected by a wide variety of tumors apart from infective and inflammatory lesions and their noninvasive characterization on imaging is important for the management of these patients. Incidentalomas form the major bulk of adrenal tumors and differentiation of benign adenomas from other malignant lesions, especially in patients with a known malignancy, guide further management. Imaging is an integral part of management along with clinical and biochemical features. The cornerstone of clinical and biochemical evaluation of adrenal tumors is to determine whether the lesion is functional or nonfunctional. Computed tomography (CT) is considered as the workhorse for imaging evaluation of adrenal lesions. CT densitometry and CT contrast washout characteristics are quite reliable in differentiating adenomas from malignant lesions. CT is also the modality of choice for the evaluation of resectability and staging of primary adrenal tumors. Magnetic resonance imaging (MRI) has superior contrast resolution compared to other morphological imaging modalities and is generally used as a problem-solving tool. MRI chemical shift imaging can also be used to reliably detect adrenal adenomas. Ultrasonography (USG) is used as a screening tool that is usually followed by either CT or MRI to better characterize the tumor and it is not routinely used for assessing the resectability, staging, and characterization of adrenal tumors. Another important role of USG is in image-guided sampling of tumors. Fluorodeoxyglucose positron emission tomography-computed tomography and other nuclear medicine modalities are a valuable addition to morphological imaging modalities. Image-guided interventions also play an important role in obtaining tissue samples where diagnostic imaging is not able to characterize adrenal tumors. In the functioning of adrenal tumors, adrenal venous sampling is widely used to accurately lateralize the secreting tumor.
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Affiliation(s)
- Devasenathipathy Kandasamy
- Department of Radiodiagnosis & Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Ajay Gulati
- Department of Radiodiagnosis, PGIMER, Chandigarh, India
| | - Betty Simon
- Department of Radiodiagnosis, Christian Medical College, Vellore, Tamil Nadu, India
| | - Reetu John
- Department of Radiodiagnosis, Christian Medical College, Vellore, Tamil Nadu, India
| | - Alpesh Goyal
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
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Rymbai ML, Paul A, M J A, Anantrao AS, John R, Simon B, Joseph AJ, Raju RS, Sitaram V, Joseph P. Post cholecystectomy benign biliary stricture-isolated hepatic duct stricture: a proposed modification of the BISMUTH classification. ANZ J Surg 2023; 93:1306-1313. [PMID: 36694342 DOI: 10.1111/ans.18281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 12/11/2022] [Accepted: 01/09/2023] [Indexed: 01/26/2023]
Abstract
BACKGROUND Post-cholecystectomy, benign biliary strictures are challenging for both patients and surgeons. Bismuth classified benign biliary strictures into 5 types. This study aimed to review these isolated hepatic duct strictures which were not included in Bismuth classification. METHODS The case records of all patients who presented with post-cholecystectomy benign biliary strictures between January 2005 and December 2020 at our centre were reviewed. Data regarding demography, type of stricture, and treatment strategy were entered into the standard proforma. RESULTS There were 242 patients [type I-3.7%, type II-41.7%, type III-38.0%, type IV-6.6%, and type V-7.8%]. Five (2.1%) patients did not fit the Bismuth classification and were the focus of this study. In each of these patients, an isolated hepatic duct stricture (first-or second-order hepatic duct) was present, with no involvement of the common hepatic duct or hilar confluence. CONCLUSIONS The addition of isolated hepatic duct stricture [type VI] to the Bismuth classification will enhance the original classification, help in reporting and management of this sub-set of patients.
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Affiliation(s)
- Manbha L Rymbai
- Department of HPB Surgery, Christian Medical College, Vellore, India
| | - Anoop Paul
- Department of HPB Surgery, Christian Medical College, Vellore, India
| | - Aparna M J
- Department of HPB Surgery, Christian Medical College, Vellore, India
| | | | - Reetu John
- Department of Radiodiagnosis, Christian Medical College, Vellore, India
| | - Betty Simon
- Department of Radiodiagnosis, Christian Medical College, Vellore, India
| | | | | | | | - Philip Joseph
- Department of HPB Surgery, Christian Medical College, Vellore, India
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Augustine A, Patel PG, Augustine A, John R, Simon B, Eapen A, Mittal R, Chandramohan A. MRI of Recurrent Fistula-in-Ano: Is it Different from Treatment-Naïve Fistula-in-Ano and How Does it Correlate with Anal Sphincter Morphology? Indian J Radiol Imaging 2022; 33:19-27. [PMID: 36855724 PMCID: PMC9968521 DOI: 10.1055/s-0042-1758202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Objectives The main aim of this study was to compare magnetic resonance imaging (MRI) findings of recurrent and treatment-naïve fistula-in-ano and to correlate imaging findings with anal sphincter morphology in recurrent fistula-in-ano. Methods This is a retrospective study of adult patients who underwent MRI for suspected fistula-in-ano in 2018. After excluding patients with alternative diagnosis, patients were stratified into recurrent ( n = 103) and treatment-naïve ( n = 106) fistula-in-ano groups. Two blinded radiologists reread MRI scans in consensus for fistula characteristics and anal sphincter morphology. We compared imaging features of recurrent and treatment-naïve fistula-in-ano, assessed the incidence of anal sphincter scarring among patients with recurrent fistula-in-ano, and studied its association with fistula features. Results Two-hundred nine patients (187 males) with mean age of 40.6 (standard deviation: 12.2) years were included. Trans-sphincteric, inter-sphincteric, extra-sphincteric, and supra-sphincteric fistula-in-ano were seen in 63.6, 33, 2.9, and 0.5%, respectively. There were secondary tracts, supralevator extension, and secondary cause for fistula in 49.3, 12.9, and 14.8%, respectively. There was no difference between the fistula features of recurrent and treatment-naïve fistula-in-ano, except for significantly fewer external openings among recurrent fistula-in-ano ( p = 0.005). Among patients with recurrent fistula-in-ano, MRI detected anal sphincter defect/scarring was seen in 53.4% ( n = 55) and was significantly associated with posterior fistula-in-ano ( p = 0.031), collections and/or supralevator extension ( p = 0.010), and secondary tracts ( p = 0.015). Conclusion Fistula features of recurrent and treatment-naïve patients were mostly similar. There was high incidence (53.4%) of MRI-identified anal sphincter scarring/defect among recurrent fistula-in-ano, which was significantly associated with posterior fistula, collections, supra or translevator extension, and secondary tracts. Key Points MRI-identified anal sphincter scarring is very common among patients with recurrent fistula-in-ano and seen in more than half of them.There was significantly higher incidence of sphincter scarring among patients who had posterior fistula, collections, supralevator/translevator extension, and secondary tracts.
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Affiliation(s)
- Antony Augustine
- Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Ann Augustine
- Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Reetu John
- Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Betty Simon
- Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Anu Eapen
- Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Rohin Mittal
- Department of Colorectal Surgery, Christian Medical College, Vellore, Tamil Nadu, India
| | - Anuradha Chandramohan
- Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India,Address for correspondence Anuradha Chandramohan, MD, FRCR Professor of Radiology, Christian Medical CollegeVellore 632004, Tamil NaduIndia
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Chandramohan A, Patra A, Eapen A, John R, Simon B, Masih D, Jesudason MR, Mittal R. MDT stage migration in MRI of significant rectal polyps and early rectal cancers. Abdom Radiol (NY) 2022; 47:2760-2769. [PMID: 35674786 DOI: 10.1007/s00261-022-03570-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/18/2022] [Accepted: 05/19/2022] [Indexed: 01/18/2023]
Abstract
PURPOSE To audit the diagnostic accuracy of MRI for staging early and polyp rectal cancers with the purpose of identifying scope for service improvement. METHODS This is an IRB approved retrospective study of patients who underwent staging MRI for rectal growths followed by upfront TME type surgery or local excision without neoadjuvant therapy between 2018 and 2021. MR-T-stage was compared with surgical histopathology. The degree of stage migration in the multidisciplinary team meetings (MDT) was assessed and training needs were identified. RESULTS 53 patients (32 males) with a mean (SD) age of 56.7 (13.6) years with 54 rectal lesions and underwent trans-anal excision (n = 18) or upfront surgery (n = 35) were included. Pathology showed < / = pT1 stage in n = 18 and > / = pT2 stage in n = 36. Radio-pathological concordance rate was 38.9% and 74.1%, respectively, for primary reports and MDT reads, respectively, and during MDT, the rates improved by 44.5% and 30.5% for < / = pT1 and > / = pT2 stages ,respectively. The overall T-stage migration rate at MDT was 44.6% (25/54) and the migration rate was higher (61.1%) for < / = pT1 stage lesions. The best sensitivity, specificity, PPV, NPV and accuracy of MRI for T-staging was 83.3%, 91.6%, 83.3%, 91.6% and 88.8%, respectively. CONCLUSION Radio-pathological correlation for MRI T-stage is excellent for MDT reads by experienced radiologists. MDT reads lead to significant down-staging of T-stage in polyp and early rectal cancer thereby improving radio-path correlation.
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Affiliation(s)
| | - Anurima Patra
- Department of Radiology, Christian Medical College, Vellore, 632004, India
| | - Anu Eapen
- Department of Radiology, Christian Medical College, Vellore, 632004, India
| | - Reetu John
- Department of Radiology, Christian Medical College, Vellore, 632004, India
| | - Betty Simon
- Department of Radiology, Christian Medical College, Vellore, 632004, India
| | - Dipti Masih
- Department of Pathology, Christian Medical College, Vellore, 632004, India
| | | | - Rohin Mittal
- Department of Colorectal Surgery, Christian Medical College, Vellore, 632004, India
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Schultz J, Masotti M, Shaaban A, Jedeon Z, Leonard J, Shaffer A, John R, Cogswell R. Investigation of D-dimer as an Alternative Biomarker of Thrombosis in HeartMate 3 Recipients. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Chandramohan A, Mittal R, Dsouza R, Yezzaji H, Eapen A, Simon B, John R, Singh A, Ram TS, Jesudason MR, Masih D, Karuppusami R. Prognostic significance of MR identified EMVI, tumour deposits, mesorectal nodes and pelvic side wall disease in locally advanced rectal cancer. Colorectal Dis 2022; 24:428-438. [PMID: 34954863 DOI: 10.1111/codi.16032] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 12/03/2021] [Accepted: 12/21/2021] [Indexed: 02/08/2023]
Abstract
AIM To study the prognostic significance of MRI identified tumour deposits (TD), extramural vascular invasion (EMVI), lymph node metastases (LNM) and pelvic sidewall (PSW) disease in rectal cancer. METHODS This IRB approved study was conducted on patients with stage IIA-IIIC rectal adenocarcinoma treated with neoadjuvant long course chemoradiotherapy (LCCRT) and total mesorectal excision (TME) type of surgery between 2012-2018. A radiologist blinded to outcome reviewed staging and restaging magnetic resonance imaging (MRI) for TD, EMVI, LNM and PSW. The agreement between four radiologists was studied and we obtained outcome data from a prospectively maintained database. The prognostic significance of imaging findings was assessed. RESULTS A total of 297 (186 males) patients with a mean age of 47.3 (SD14.4) years were included in the study. The majority had T3 (n = 206) or T4 (n = 59) stage disease. The mean duration of follow-up was 49.3 ± 25 months (6.6-101 months). 5-year overall (OS) and disease-free survival (DFS) was 84% and 74%, respectively. Staging and restaging MRI had EMVI in 49.5% and 31.3%; TD in 47.5% and 31.6%; LNM in 61.1% and 38.1% and PSW in 11.4% and 6.1%. OS was adversely affected by EMVI, TD and PSW with the adjusted HR (aHR) of 3.32, 3.31, 3.27 for staging MRI and 2.99, 3.1, 2.81 for restaging MRI, respectively, p < 0.05. DFS was affected by EMVI (aHR = 1.85, 2.33) and TD (aHR = 1.83, 2.19), p < 0.05. Persistence of these findings after LCCRT led to worst outcome. Intra- and interobserver agreement for EMVI, TD and LN was 0.789, 0.734, 0.406 and 0.449, 0.354, 0.376, respectively, p < 0.001. CONCLUSIONS MRI identified that TD, EMVI and PSW disease are independent poor prognostic indicators in rectal cancer patients. Interobserver agreement for these findings was moderate to fair.
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Affiliation(s)
| | - Rohin Mittal
- Department of Colorectal Surgery, Christian Medical College, Vellore, India
| | - Romina Dsouza
- Department of Radiology, Christian Medical College, Vellore, India
| | - Harish Yezzaji
- Department of Colorectal Surgery, Christian Medical College, Vellore, India
| | - Anu Eapen
- Department of Radiology, Christian Medical College, Vellore, India
| | - Betty Simon
- Department of Radiology, Christian Medical College, Vellore, India
| | - Reetu John
- Department of Radiology, Christian Medical College, Vellore, India
| | - Ashish Singh
- Department of Medical Oncology, Christian Medical College, Vellore, India
| | - Thomas S Ram
- Department of Radiation Oncology, Christian Medical College, Vellore, India
| | - Mark R Jesudason
- Department of Colorectal Surgery, Christian Medical College, Vellore, India
| | - Dipti Masih
- Department of Pathology, Christian Medical College, Vellore, India
| | - Reka Karuppusami
- Department of Biostatistics, Christian Medical College, Vellore, India
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Shaffer A, Cogswell R, Devos A, Joseph N, Ramirez D, Prisco A, Iles T, Iazzo P, John R. CT Derived Three Dimensional Modeling to Facilitate Minimally Invasive HVAD to HeartMate3 Left Ventricular Assist Device Exchange. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Putta T, John R, Simon B, Sathyakumar K, Chandramohan A, Eapen A. Imaging Manifestations of Accessory Cavitated Uterine Mass-A Rare Mullerian Anomaly. Indian J Radiol Imaging 2021; 31:545-550. [PMID: 34790296 PMCID: PMC8590559 DOI: 10.1055/s-0041-1735504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Context
Accessory cavitated uterine mass (ACUM) is an uncommon and under-recognized entity with distinct imaging characteristics and causing significant patient distress. Differentiating it from its other clinical and radiological differentials is therefore extremely important and prevents delay in surgical management which is the treatment of choice.
Aims
The aim of the study is to describe the MRI appearance of the surgically and pathologically proven ACUM cases from our institution in the last 2 years.
Settings and Design
This is a retrospective study in a tertiary care hospital in South India.
Methods and Material
We reviewed the clinical presentations and imaging findings of seven surgically proven cases of ACUM qualifying the proposed diagnostic criteria.
Results
All patients presented with chronic pelvic pain, dysmenorrhea, and prolonged post-menstrual pain. MRI in all seven cases showed an intramural, noncommunicating, and cavitating lesion near the uterine cornua with internal contents similar to that of endometrioma. Although the cavity was lined by endometrium in all the cases (proven in pathology), it was well appreciable on MRI in only five cases. The rest of the uterine myometrium and main endometrial cavity were normal with no features of adenomyosis.
Conclusion
MRI is a reliable diagnostic tool for accurate diagnosis of ACUM, and more importantly, in distinguishing it from other causes of chronic pelvic pain like adenomyosis and endometriosis and other imaging differentials like adenomyoma, noncommunicating uterine horn, and degenerating leiomyoma.
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Affiliation(s)
- Tharani Putta
- Department of Radiology, AIG Hospitals, Hyderabad, Telangana, India
| | - Reetu John
- Department of Radiology, CMC, Vellore, Tamil Nadu, India
| | - Betty Simon
- Department of Radiology, CMC, Vellore, Tamil Nadu, India
| | | | | | - Anu Eapen
- Department of Radiology, CMC, Vellore, Tamil Nadu, India
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John R, Putta T, Simon B, Eapen A, Jebasingh F, Thomas N, Rajaratnam S. Normal adrenal gland thickness on computerized tomography in an Asian Indian adult population. Indian J Radiol Imaging 2021; 28:465-469. [PMID: 30662212 PMCID: PMC6319091 DOI: 10.4103/ijri.ijri_129_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 11/21/2022] Open
Abstract
Context: The size and morphology of the adrenal glands are affected by several physiological and pathological conditions. Radiologists need to be aware of the normal thickness of adrenal gland to accurately assess patients with suspected adrenal pathology. However, there is limited data on the normal size of the adrenal glands. Moreover, this has not been studied in our population. Aims: To study the normal thickness of adrenal gland on computerized tomography (CT) in Indian adult population. Settings and Design: Retrospective study in a tertiary care hospital in Southern India. Subjects and Methods: Our study included 586 adults who underwent a CT abdominal angiogram over 15 months, and excluding patients with clinical or imaging evidence of adrenal disease. The measurements made included: the maximum thickness of the body, medial and lateral limbs, measured perpendicular to the long axis. Results: The median age was 51 (range: 18–85) years. The mean maximum thickness of the adrenal body, medial, and lateral limbs were 7.2 ± 1.8, 4.1 ± 1.1, and 4.3 ± 1.1 mm on the right side and 8.8 ± 1.9, 4.7 ± 1.1, and 4.9 ± 1.3 mm on the left. The cumulative thickness of the body and the limbs were 15.6 ± 3.7 mm and 18.4 ± 3.8 mm on the right and left sides, respectively. There was a statistically significant difference in all the measurements between the right and left adrenal glands (all P values = 0.000) and between men and women, being larger in men (P value <0.05). Among our patients 27% had at least one adrenal gland body measuring ≥10 mm in thickness. Conclusions: Our study has defined the normal range of adrenal gland thickness in an Asian Indian adult population, which may be used as a baseline reference for future research and as a reference for radiological reporting.
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Affiliation(s)
- Reetu John
- Department of Radiodiagnosis, Christian Medical College, Vellore, Tamil Nadu, India
| | - Tharani Putta
- Department of Radiodiagnosis, Christian Medical College, Vellore, Tamil Nadu, India
| | - Betty Simon
- Department of Radiodiagnosis, Christian Medical College, Vellore, Tamil Nadu, India
| | - Anu Eapen
- Department of Radiodiagnosis, Christian Medical College, Vellore, Tamil Nadu, India
| | - Felix Jebasingh
- Department of Endocrinology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Nihal Thomas
- Department of Endocrinology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Simon Rajaratnam
- Department of Endocrinology, Christian Medical College, Vellore, Tamil Nadu, India
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Korula DR, Chandramohan A, John R, Eapen A. Barium Defecating Proctography and Dynamic Magnetic Resonance Proctography: Their Role and Patient's Perception. J Clin Imaging Sci 2021; 11:31. [PMID: 34221640 PMCID: PMC8247951 DOI: 10.25259/jcis_56_2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 05/02/2021] [Indexed: 11/30/2022] Open
Abstract
Objectives: The objectives of the study were to compare the imaging findings and patient’s perception of barium defecating proctography and dynamic magnetic resonance (MR) proctography in patients with pelvic floor disorders. Material and Methods: This is a prospective study conducted on patients with pelvic floor disorders who consented to undergo both barium proctography and dynamic MR proctography. Imaging findings of both the procedures were compared. Inter-observer agreement (IOA) for key imaging features was assessed. Patient’s perception of these procedures was assessed using a short questionnaire and a visual analog scale. Results: Forty patients (M: F =19:21) with a mean age of 43.65 years and range of 21–75 years were included for final analysis. Mean patient experience score was significantly better for MR imaging (MRI) (p < 0.001). However, patients perceived significantly higher difficulty in rectal evacuation during MRI studies (p = 0.003). While significantly higher number of rectoceles (p = 0.014) were diagnosed on MRI, a greater number of pelvic floor descent (p = 0.02) and intra-rectal intussusception (p = 0.011) were diagnosed on barium proctography. The IOA for barium proctography was substantial for identifying rectoceles, rectal prolapse and for determining M line, p < 0.001. There was excellent IOA for MRI interpretation of cystoceles, peritoneoceles, and uterine prolapse and substantial to excellent IOA for determining anal canal length and anorectal angle, p < 0.001. The mean study time for the barium and MRI study was 12 minutes and 15 minutes, respectively. Conclusion: Barium proctography was more sensitive than MRI for detecting pelvic floor descent and intrarectal intussusception. Although patients perceived better rectal emptying with barium proctography, the overall patient experience was better for dynamic MRI proctography.
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Affiliation(s)
| | | | - Reetu John
- Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Anu Eapen
- Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India
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Maharaj V, Masotti M, Schultz J, Martin C, John R, Alexy T, Thenappan T, Knoper R, Shaffer A, Cogswell R. Trends in Renal Function Prior to and after LVAD Placement and Association with Post LVAD Mortality. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1181] [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: 11/17/2022] Open
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El Rafei A, Schultz J, Masotti M, Maharaj V, Fraser M, Mutschler M, Martin C, Alexy T, Kamdar F, Knoper R, Shaffer A, John R, Cogswell R. Risk Factors and Clinical Significance of Vasoplegia after LVAD Implantation. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Shaaban A, Schultz J, Leonard J, John R, Martin C, Alexy T, Pritzker M, Thenappan T, Kamdar F, Shaffer A, Cogswell R. Outcomes of Patients Referred for Cardiac Rehabilitation after Left Ventricular Assist Device Implantation. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.532] [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] Open
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Schultz J, Hoeg A, Masotti M, Teigen L, John R, Shaffer A, Martin C, Alexy T, Cogswell R. Trends in Body Mass Index before and after Left Ventricular Assist Device and Association with Pectoralis Muscle Measures: Evidence for Progressive Sarcopenia Prior to LVAD Implantation. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1223] [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] Open
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Cogswell R, Masotti M, Schultz J, Maharaj V, El Rafei A, Fraser M, Mutschler M, Martin C, Thenappan T, Pritzker M, Knoper R, John R, Shaffer A. A New Hemodynamic Profile Signaling Early Death on Left Ventricular Assist Device. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.506] [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] Open
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Botsch L, Raatz N, Pezzagna S, Staacke R, John R, Abel B, Esquinazi PD, Meijer J, Diziain S. Vectorial calibration of superconducting magnets with a quantum magnetic sensor. Rev Sci Instrum 2020; 91:125003. [PMID: 33379962 DOI: 10.1063/5.0023597] [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] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 11/29/2020] [Indexed: 06/12/2023]
Abstract
Cryogenic vector magnet systems make it possible to study the anisotropic magnetic properties of materials without mechanically rotating the sample but by electrically tilting and turning the magnetic field. Vector magnetic fields generated inside superconducting vector magnets are generally measured with three Hall sensors. These three probes must be calibrated over a range of temperatures, and the temperature-dependent calibrations cannot be easily carried out inside an already magnetized superconducting magnet because of remaining magnetic fields. A single magnetometer based on an ensemble of nitrogen vacancy (NV) centers in diamond is proposed to overcome these limitations. The quenching of the photoluminescence intensity emitted by NV centers can determine the field in the remanent state of the solenoids and allows an easy and fast canceling of the residual magnetic field. Once the field is reset to zero, the calibration of this magnetometer can be performed in situ by a single measurement of an optically detected magnetic resonance spectrum. Thereby, these magnetometers do not require any additional temperature-dependent calibrations outside the magnet and offer the possibility to measure vector magnetic fields in three dimensions with a single sensor. Its axial alignment is given by the crystal structure of the diamond host, which increases the accuracy of the field orientation measured with this sensor, compared to the classical arrangement of three Hall sensors. It is foreseeable that the magnetometer described here has the potential to be applied in various fields in the future, such as the characterization of ferromagnetic core solenoids or other magnetic arrangements.
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Affiliation(s)
- L Botsch
- Division of Superconductivity and Magnetism, Felix Bloch Institute for Solid State Physics, University of Leipzig, Linnéstrasse 5, D-04103 Leipzig, Germany
| | - N Raatz
- Division of Applied Quantum Systems, Felix Bloch Institute for Solid State Physics, University of Leipzig, Linnéstrasse 5, D-04103 Leipzig, Germany
| | - S Pezzagna
- Division of Applied Quantum Systems, Felix Bloch Institute for Solid State Physics, University of Leipzig, Linnéstrasse 5, D-04103 Leipzig, Germany
| | - R Staacke
- Division of Applied Quantum Systems, Felix Bloch Institute for Solid State Physics, University of Leipzig, Linnéstrasse 5, D-04103 Leipzig, Germany
| | - R John
- Division of Applied Quantum Systems, Felix Bloch Institute for Solid State Physics, University of Leipzig, Linnéstrasse 5, D-04103 Leipzig, Germany
| | - B Abel
- Leibniz Institute of Surface Engineering (IOM), Permoserstrasse15, D-04318 Leipzig, Germany
| | - P D Esquinazi
- Division of Superconductivity and Magnetism, Felix Bloch Institute for Solid State Physics, University of Leipzig, Linnéstrasse 5, D-04103 Leipzig, Germany
| | - J Meijer
- Division of Applied Quantum Systems, Felix Bloch Institute for Solid State Physics, University of Leipzig, Linnéstrasse 5, D-04103 Leipzig, Germany
| | - S Diziain
- Division of Superconductivity and Magnetism, Felix Bloch Institute for Solid State Physics, University of Leipzig, Linnéstrasse 5, D-04103 Leipzig, Germany
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Chandramohan A, Bhat TA, John R, Simon B. Multimodality imaging review of complex pelvic lesions in female pelvis. Br J Radiol 2020; 93:20200489. [DOI: 10.1259/bjr.20200489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Complex pelvic lesions can originate from various anatomical structures in the pelvis and pose a diagnostic dilemma due to a wide range of possible diagnoses. Accurate characterisation of these lesions would often require an algorithmic approach, which incorporates clinical findings, sequential use of multiple imaging modalities and a multiparametric approach. This approach usually aims at identifying key imaging features, which aid in anatomical localisation, morphology and tissue characterisation. There have been various attempts to standardise the lexicon used for describing adnexal masses in female patients; stratify their risk of cancer and suggest appropriate next steps in the management pathway. Through this review, we extend this approach to complex pelvic masses in female pelvis in general and will focus on optimal use of different imaging modalities to arrive at definitive diagnosis or meaningful differential diagnosis. We will also discuss potential pitfalls of imaging diagnosis and common mimics.
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Affiliation(s)
| | | | - Reetu John
- Department of Radiology, Christian Medical College, Vellore, India
| | - Betty Simon
- Department of Radiology, Christian Medical College, Vellore, India
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Barakat A, Siers D, Schaffer A, John R, Kaizer A, Perry T, Lanigan M. Variability in adherence to goal-directed transfusion protocols and inter-physician variability: an odd phenomenon. J Cardiothorac Vasc Anesth 2020. [DOI: 10.1053/j.jvca.2020.09.076] [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: 11/11/2022]
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21
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Siers D, Barakat A, Shaffer A, John R, Kaizer A, Perry T, Lanigan M. Pre-labeled laboratory syringe bundles increase compliance with institutional thromboelastography ordering guidelines. J Cardiothorac Vasc Anesth 2020. [DOI: 10.1053/j.jvca.2020.09.078] [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: 11/11/2022]
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22
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Schultz J, Trachtenberg B, Estep J, Goodwin K, Araujo R, Rafei A, Pritzker M, Kamdar F, John R, Cogswell R. Association of Use of Angiotensin-Converting Enzyme Inhibitors or Angiotensin II Receptor Blockers on LVAD Support and Risk of Gastrointestinal Bleeding: A Multi-Center Analysis. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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23
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Maharaj V, Masotti M, Schultz J, Murray T, Teigen L, Shah H, Shaffer A, Alexy T, John R, Cogswell R. Worsening Creatinine Trend in the Year Prior to LVAD Implantation is Associated with Lower Pectoralis Muscle Measures and Increased Post LVAD Mortality. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.223] [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: 11/29/2022] Open
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Araujo-Gutierrez R, Potter L, Teigen L, Schultz J, Estep J, John R, Martin C, Cogswell R, Trachtenberg B. Pre-Operative Pectoralis Muscle Quantity and Attenuation by Computed Tomography are Predictive of Recurrent Gastrointestinal Bleeding on Left Ventricular Assist Device Support: A Multicenter Analysis. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Schultz J, Trachtenberg B, Estep J, Goodwin K, Araujo R, Rafei AE, Alexy T, Shaffer A, John R, Cogswell R. Association between Angiotensin II Antagonism and Mortality after LVAD Implantation: A Multi-Center, Contemporary Analysis. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Maharaj V, Schultz J, Charpentier V, Duval S, John R, Shaffer A, Pritzker M, Martin C, Thenappan T, Cogswell R, Alexy T. Higher Body Mass Index is Associated with End Stage Renal Failure after Left Ventricular Assist Device Implantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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El Rafei A, Trachetenberg B, John R, Estep J, Schultz J, Goodwin K, Araujo R, Thenappan T, Cogswell R. Association between Digoxin Use and Gastrointestinal Bleeding in Contemporary Continuous Flow Left Ventricular Assist Device Support. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Cogswell R, Rafei A, Cowger J, Joseph S, Schultz J, Estep J, John R, Eckman P. Defining LVAD Success: A Nationwide Survey of LVAD Program Team Members. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Saeed D, Muslem R, Rasheed M, Caliskan K, Kalampokas N, Sipahi F, Lichtenberg A, Jawad K, Borger M, Huhn S, Cogswell R, John R, Schultz J, Shah H, Hsu S, Gilotra N, Tomashitis B, Hajj ME, Lozonschi L, Houston B, Tedford R. Less Invasive Surgical Implant Strategy is Associated with Significant Reduction in INTERMACS Defined Right Heart Failure Following LVAD Implantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Cogswell R, Murray T, Araujo R, Teigen L, Trachtenberg B, Schultz J, John R, Martin C, Estep J. External Validation of the Minnesota Pectoralis Muscle Risk Score to Predict Mortality after Ventricular Assist Device Implantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Eapen A, Chandramohan A, John R, Simon B, Putta T, Joseph AJ. Imaging of an Indeterminate Pancreatic Mass. Journal of Gastrointestinal and Abdominal Radiology 2020. [DOI: 10.1055/s-0040-1701351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
AbstractSeveral conditions ranging from neoplasm to inflammatory disorders can present as a pancreatic mass on imaging. While classic imaging features help us make an accurate diagnosis, we are often confronted by indeterminate pancreatic masses that pose diagnostic dilemma. In this review, we describe the typical imaging features of common mass forming conditions of pancreas followed by description of atypical imaging appearances, which make a pancreatic mass indeterminate. We also emphasize on imaging features useful in differentiating one from the other.
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Affiliation(s)
- Anu Eapen
- Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Reetu John
- Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Betty Simon
- Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Tharani Putta
- Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - A. J. Joseph
- Department of Gastroenterology, Christian Medical College, Vellore, Tamil Nadu, India
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Abstract
AbstractDisorders of sex development (DSD) refer to congenital conditions with a typical development of chromosomal, gonadal, or anatomic sex. In the revised classification of DSD, there are three categories based on karyotype: 46,XX DSD; 46,XY DSD; and sex chromosome DSD. Imaging, as part of a multidisciplinary approach to management of DSD, has a key role in gender assignment. The main role of imaging is to help in identifying the gonads and the Müllerian structures. Ultrasound is useful, especially in the neonate with ambiguous genitalia. Magnetic resonance imaging is a useful modality to locate and characterize the gonads in young girls with primary amenorrhea and also to identify streak gonads, which have a risk of malignancy.
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Affiliation(s)
- Anu Eapen
- Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Betty Simon
- Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Tharani Putta
- Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Reetu John
- Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Aruna Kekre
- Department of Obstetrics and Gynaecology, Christian Medical College, Vellore, Tamil Nadu, India
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Gomez N, Porther R, John R, Evans P, Shaw P, Button M, Williams S, Williamson I, Ionescu A. Mesothelioma: diagnosis, treatment and survival in a large teaching hospital. Lung Cancer 2020. [DOI: 10.1016/s0169-5002(20)30192-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Reynolds T, John R. Comparison of Assay Kits for Unconjugated Estriol Shows that Expressing Results as Multiples of the Median Causes Unacceptable Variation in Calculated Risk Factors for Down Syndrome. Clin Chem 2019. [DOI: 10.1093/clinchem/38.9.1888] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
We compared the performance of two methods for assaying unconjugated estriol in serum: the modified Amerlex third-trimester RIA kit, as used in seminal papers on unconjugated estriol in Down syndrome screening, and the new optimized Amerlex-M second-trimester kit. The significant difference between the results of each assay could cause unacceptable changes in the detection rate and false-positive rate of Down syndrome screening programs, especially if previously published values for estriol are used in the risk calculation. It is not possible to define new calculation parameters for every assay kit because new parameters will need to be defined every time kit changes occur, which would require a large collection of samples from Down syndrome pregnancies for standardization. Possible solutions to this problem are discussed.
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Affiliation(s)
- T Reynolds
- Medical Biochemistry Department, University Hospital of Wales, Heath Park, Cardiff, UK
| | - R John
- Medical Biochemistry Department, University Hospital of Wales, Heath Park, Cardiff, UK
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Storm Van's Gravesande K, Calabrese P, Blaschek A, Rostásy K, Huppke P, Rothe L, Mall V, Kessler J, Kalbe E, Dornfeld E, Elpers C, Lohmann H, Weddige A, Hagspiel S, Kirschner J, Brehm M, Blank C, Schubert J, Schimmel M, Pacheè S, Mohrbach M, Karenfort M, Kamp G, Lücke T, Neumann H, Lutz S, Gierse A, Sievers S, Schiffmann H, de Soye I, Trollmann R, Candova A, Rosner M, Neu A, Romer G, Seidel U, John R, Hofmann C, Schulz, Kinder S, Bertolatus A, Scheidtmann K, Lasogga R, Leiz S, Alber M, Kranz J, Bajer-Kornek B, Seidl R, Novak A. The Multiple Sclerosis Inventory of Cognition for Adolescents (MUSICADO): A brief screening instrument to assess cognitive dysfunction, fatigue and loss of health-related quality of life in pediatric-onset multiple sclerosis. Eur J Paediatr Neurol 2019; 23:792-800. [PMID: 31551133 DOI: 10.1016/j.ejpn.2019.08.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 07/23/2019] [Accepted: 08/22/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Screening for cognitive impairment (CI), fatigue and also Health-related quality of life (HRQoL) in patients with pediatric-onset multiple sclerosis (POMS) is of utmost importance in clinical practice. The aim of this study was to establish a new and validated pediatric screening tool "MUSICADO" that is easy to use and time economical. METHODS 106 patients with POMS aged 12-18 years and 210 healthy controls (HCs) stratified for age and education underwent neuropsychological testing including a screening test "Multiple Sclerosis Inventory of Cognition" for adults and 8 standardized cognitive tests and established scales to assess fatigue and HRQoL. RESULTS The phonemic verbal fluency task (RWT "s-words"), the Trail Making Test A (TMT-A), and the Digit Span Forward discriminated significantly between patients and HCs (p = 0.000, respectively) and showed the highest proportion of test failure in patients (24.5%, 17.9%; 15.1%, respectively). Therefore, they were put together to form the cognitive part of the "MUSICADO". After applying a scoring algorithm with balanced weighting of the subtests and age and education correction and a cut-off score for impairment, 35.8% of patients were categorized to be cognitively impaired (specificity: 88.6%). Fatigue was detected in 37.1% of the patients (specificity: 94.0%) and loss of HRQoL in 41.8% (specificity 95.7%) with the screening version, respectively. CONCLUSION The MUSICADO is a newly designed brief and easy to use screening test to help to early identify CI, fatigue, and loss of HRQoL in patients with POMS as cut scores are provided for all three items. Further studies will have to show its usability in independent samples of patients with POMS.
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Affiliation(s)
- K Storm Van's Gravesande
- Department of Pediatrics, Child and Adolescent Psychosomatics, Technische Universität München, Munich, Heigelhofstr. 63, 81377 München, Germany.
| | - P Calabrese
- Neuropsychology and Behavioral Neurology Unit, Division of Molecular and Cognitive Neuroscience, Department of Psychology, University of Basel, Birmannsgasse 8, 4055 Basel, Switzerland
| | - A Blaschek
- Department of Pediatric Neurology and Developmental Medicine, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University, Lindwurmstrasse 4, 80337 Munich, Germany
| | - K Rostásy
- Pediatric Neurology, Witten/Herdecke University, Children's Hospital Datteln, Dr. Friedrich Steiner Str. 5, 5711 Datteln, Germany
| | - P Huppke
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric Neurology, University Medical Center Göttingen, Robert-Koch Strasse 40, 37075 Göttingen, Germany
| | - L Rothe
- Department of Neurology, University Hospital Cologne, Kerpenerstr. 62, 50937 Cologne, Germany
| | - V Mall
- Department of Pediatrics, Child and Adolescent Psychosomatics, Technische Universität München, Munich, Heigelhofstr. 63, 81377 München, Germany
| | - J Kessler
- Department of Neurology, University Hospital Cologne, Kerpenerstr. 62, 50937 Cologne, Germany
| | - E Kalbe
- Department of Medical Psychology ǀ, Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), University Hospital Cologne, Kerpenerstr. 62, 50937 Cologne, Germany
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Cogswell R, Teigen L, Allen T, Estep J, Araujo R, Schultz J, John R, Martin C, Trachtenberg B. Measurement of Pectoralis Muscle Quantity and Attenuation by Computed Tomography Using Routinely Available Software is Feasible and Predicts Mortality after LVAD Implantation. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.1134] [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: 11/29/2022] Open
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Shah H, Murray T, El Rafei A, Schultz J, Thenappan T, Alexy T, John R, Martin C, Pritzker M, Cogswell R. External Assessment of EUROMACS Right-Sided Heart Failure Risk Score. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Maharaj V, Cogswell R, Schultz J, John R, Martin C, Thenappan T, Alexy T. Poor Left Ventricular Unloading is Associated with Increased Mortality after Continuous Flow Left Ventricular Assist Device Implantation. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.179] [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: 11/29/2022] Open
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40
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Cogswell R, Estep J, Araujo R, Teigen L, Schultz J, John R, Martin C, Trachtenberg B. Heart Failure Severity Stratification beyond INTERMACS Profiles: A Step towards Identification of Optimal LVAD Implantation Timing. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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41
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Shah H, Cogswell R, Misialek J, Schultz J, Nitzkowski A, John R, Martin C, Pritzker M, Shaffer A. Concentrated Factor Administration and Subsequent Pump Thrombosis on HeartMate II LVAD Support. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Gorey A, Jacob PM, Abraham DT, John R, Manipadam MT, Ansari MS, Chen GCK, Vasudevan S. Differentiation of malignant from benign thyroid nodules using photoacoustic spectral response: a preclinical study. Biomed Phys Eng Express 2019. [DOI: 10.1088/2057-1976/ab101c] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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43
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Kho JPY, Ng BHK, John R. Recurrent occipital dermatofibrosarcoma protuberans tackled with wide local excision: A case report and current management. Med J Malaysia 2019; 74:82-84. [PMID: 30846668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Dermatofibrosarcoma protuberans (DFSP) is a slowgrowing, locally invasive tumour of the dermis. It commonly presents in the trunks and proximal extremities but is seen to a lesser extent in the head and neck regions. We present a case report of a recurrent DFSP in a 48-year-old Iban woman at the occipital region. The patient underwent wide local excision and removal of outer table of cranium, dressing followed by split thickness skin graft. Histopathological examination confirmed dermatofibrosarcoma protuberans with clear lateral surgical margins and a deep margin of 0.5mm. She is currently undergoing radiotherapy and is planned for 50Grey 25cycles.
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Affiliation(s)
- J P Y Kho
- Sarawak General Hospital, Department of Otorhinolaryngology, Sarawak, Malaysia.
| | - B H K Ng
- University Malaysia Sarawak, Faculty of Medicine and Health Sciences, Department of Otorhinolaryngology, Sarawak, Malaysia
| | - R John
- Sarawak General Hospital, Department of Plastic and Reconstructive Surgery, Sarawak, Malaysia
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Prabhakar S, John R, Dhillon M, Anand A, Sharma K, Bammidi S. Are COL1A1 gene polymorphisms associated with anterior cruciate ligament tear in the Indian population? Results of a preliminary case-control study. Muscles Ligaments Tendons J 2019. [DOI: 10.32098/mltj.01.2018.03] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- S. Prabhakar
- Department of Orthopaedics, Post Graduate Institute od Medical Education and Research (PGIMER), Sector 12, Chandigarth
| | - R. John
- Department of Orthopaedics, Post Graduate Institute od Medical Education and Research (PGIMER), Sector 12, Chandigarth
| | - M.S. Dhillon
- Department of Orthopaedics, Post Graduate Institute od Medical Education and Research (PGIMER), Sector 12, Chandigarth
| | - A. Anand
- Centre for Systems Biology and Bioinformatics, Banjab University, Sector-25, Chandigarh
| | - K. Sharma
- Centre for Systems Biology and Bioinformatics, Banjab University, Sector-25, Chandigarh
| | - S. Bammidi
- Centre for Systems Biology and Bioinformatics, Banjab University, Sector-25, Chandigarh
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45
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Hooda A, Dhillon M, Prabhakar S, Prakash M, John R, Kanwat H. MRI evaluation of anterolateral ligament tears in knee injury with anterior cruciate ligament rupture. Muscles Ligaments Tendons J 2019. [DOI: 10.32098/mltj.01.2018.04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- A. Hooda
- Department of Orthopaedics, Post Graduate Institute od Medical Education and Research (PGIMER), Sector 12, Chandigarth, India 160012
| | - M.S. Dhillon
- Department of Orthopaedics, Post Graduate Institute od Medical Education and Research (PGIMER), Sector 12, Chandigarth, India 160012
| | - S. Prabhakar
- Department of Orthopaedics, Post Graduate Institute od Medical Education and Research (PGIMER), Sector 12, Chandigarth, India 160012
| | - M. Prakash
- Department of Radiology, Post Graduate Institute od Medical Education and Research (PGIMER), Sector 12
| | - R. John
- Department of Orthopaedics, Post Graduate Institute od Medical Education and Research (PGIMER), Sector 12, Chandigarth, India 160012
| | - H. Kanwat
- Department of Orthopaedics, Post Graduate Institute od Medical Education and Research (PGIMER), Sector 12, Chandigarth, India 160012
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46
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John R, Prabhakar S, Singh Dhillon M, Anand A, Minhas G. Association of ACL tears and single nucleotide polymorphisms in the collagen 12 A1 gene in the Indian population - a preliminary case-control study. Muscles Ligaments Tendons J 2019. [DOI: 10.32098/mltj.02.2016.14] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- R. John
- Department of Orthopaedics, PGIMER, Chandigarh, India
| | - S. Prabhakar
- Department of Orthopaedics, PGIMER, Chandigarh, India
| | | | - A. Anand
- Neuroscience Research Lab, Department of Neurology, PGIMER, Chandigarh, India
| | - G. Minhas
- Neuroscience Research Lab, Department of Neurology, PGIMER, Chandigarh, India
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47
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Weber P, John R, Konrad K, v. Livonius B, Lorenz B, Ruple B, Stock-Mühlnickel S, Karch D, Schroeder A. Erratum zu: Visuelle Wahrnehmungsstörungen. Monatsschr Kinderheilkd 2018. [DOI: 10.1007/s00112-018-0529-8] [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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48
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Schultz J, Cogswell R, Prtizker M, Missov E, Liao K, Misialek J, John R. Increased Pump Speed is Associated with Reduced Rates of Stroke on HeartMate II LVAD Support. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.126] [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: 11/15/2022] Open
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49
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Schultz J, Goodwin K, John R, Alexy T, Kamdar F, Martin C, Cogswell R. Association Between Angiotensin II Receptor Blockade and Recurrent Gastrointestinal Bleeding on Left Ventricular Assist Device Support. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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50
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Cogswell R, Teigen L, Schultz J, Thenappan T, Lin L, Kealhofer J, Martin C, John R. Pre-Operative Pectoralis Muscle Measures by Computed Tomography Predict Early Right Heart Failure Deaths After Left Ventricular Assist Device. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.1215] [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: 11/28/2022] Open
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