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Hanumanthappa N, Kumar A, Ramamurthy S. Initial experience of a single cancer care centre in treating left breast cancer using first Helical Tomotherapy-H in India. Eur J Cancer 2017. [DOI: 10.1016/s0959-8049(17)30166-1] [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: 10/20/2022]
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Hanumanthappa N, Krishnamurthy P, Amalraj J, Anchaneyan P, Kumar A, Ramamurthy S. 95P Radiotherapy (RT) for breast cancer patients- clinical implementation of the first ever Tomotherapy-H in a tertiary cancer centre in India. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw575.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hanumanthappa N, Krishnamurthy P, Amalraj J, Anchaneyan P, Kumar A, Ramamurthy S. 95P Radiotherapy (RT) for breast cancer patients- clinical implementation of the first ever Tomotherapy-H in a tertiary cancer centre in India. Ann Oncol 2016. [DOI: 10.1016/s0923-7534(21)00255-6] [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: 10/22/2022] Open
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Mahtab N, Ramamurthy S, Willis N, Lewis J, Lethbridge E. CN-12 * PINEAL PARENCHYMAL TUMOUR OF INTERMEDIATE DIFFERENTIATION: CASE SERIES FROM A SINGLE INSTITUTE. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou243.12] [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: 11/12/2022] Open
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Ramamurthy S, Sechopoulos I. TU-F-18C-03: X-Ray Scatter Correction in Breast CT: Advances and Patient Testing. Med Phys 2014. [DOI: 10.1118/1.4889348] [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: 11/07/2022] Open
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Dharmalingam SR, Ramamurthy S, Chidambaram K, Nadaraju S. A Simple HPLC Bioanalytical Method for the Determination of Doxorubicin Hydrochloride in Rat Plasma: Application to Pharmacokinetic Studies. TROP J PHARM RES 2014. [DOI: 10.4314/tjpr.v13i3.15] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [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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Ramamurthy S, Chang E, Cao Y, Zhu J, Ronnett GV. AMPK activation regulates neuronal structure in developing hippocampal neurons. Neuroscience 2013; 259:13-24. [PMID: 24295634 DOI: 10.1016/j.neuroscience.2013.11.048] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 11/21/2013] [Accepted: 11/23/2013] [Indexed: 12/25/2022]
Abstract
AMP-activated protein kinase (AMPK) is a serine/threonine kinase that functions as a cellular and whole organism energy sensor to regulate ATP-consuming (anabolic) and ATP-generating (catabolic) pathways. The heterotrimeric AMPK complex consists of a catalytic α-subunit, regulatory β-subunit, and an AMP/ATP-binding γ-subunit. Several alternate isoforms exist for each subunit (α1, α2, β1, β2, γ1, γ2 and γ3). However, little is known of the expression pattern or function of the individual catalytic complexes in regulating neuronal structure. In this study, we examined the role of AMPK subunits in differentiating hippocampal neurons. We found that during development, the expression of AMPK subunits increase and that activation of AMPK by energetic stress inhibits neuronal development at multiple stages, not only during axon outgrowth, but also during dendrite growth and arborization. The presence of a single functional AMPK catalytic complex was sufficient to mediate these inhibitory effects of energetic stress. Activation of AMPK mediates these effects by suppressing both the mTOR and Akt signaling pathways. These findings demonstrate that the energy-sensing AMPK pathway regulates neuronal structure in distinct regions of developing neurons at multiple stages of development.
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Affiliation(s)
- S Ramamurthy
- Department of Neuroscience, Johns Hopkins University School of Medicine, 855 N Wolfe Street, Baltimore, MD 21205, USA; Center for Metabolism and Obesity Research, Johns Hopkins University School of Medicine, 855 N Wolfe Street, Baltimore, MD 21205, USA
| | - E Chang
- Department of Neuroscience, Johns Hopkins University School of Medicine, 855 N Wolfe Street, Baltimore, MD 21205, USA; Center for Metabolism and Obesity Research, Johns Hopkins University School of Medicine, 855 N Wolfe Street, Baltimore, MD 21205, USA
| | - Y Cao
- Department of Neuroscience, Johns Hopkins University School of Medicine, 855 N Wolfe Street, Baltimore, MD 21205, USA; Center for Metabolism and Obesity Research, Johns Hopkins University School of Medicine, 855 N Wolfe Street, Baltimore, MD 21205, USA
| | - J Zhu
- Department of Neuroscience, Johns Hopkins University School of Medicine, 855 N Wolfe Street, Baltimore, MD 21205, USA; Center for Metabolism and Obesity Research, Johns Hopkins University School of Medicine, 855 N Wolfe Street, Baltimore, MD 21205, USA
| | - G V Ronnett
- Department of Neuroscience, Johns Hopkins University School of Medicine, 855 N Wolfe Street, Baltimore, MD 21205, USA; Department of Neurology, Johns Hopkins University School of Medicine, 855 N Wolfe Street, Baltimore, MD 21205, USA; Department of Biological Chemistry, Johns Hopkins University School of Medicine, 855 N Wolfe Street, Baltimore, MD 21205, USA; Center for Metabolism and Obesity Research, Johns Hopkins University School of Medicine, 855 N Wolfe Street, Baltimore, MD 21205, USA; Daegu Gyeongbuk Institute of Science and Technology, Daegu, Republic of Korea.
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Yan Y, Irani F, Teo T, Yeow T, Gogna A, Ramamurthy S, Patel A, Chan S, Too C, Lo R, Tan B, Tay K. Intra-arterial CT angiography: the new gold standard for mesenteric embolisation in acute gastrointestinal bleeding. J Vasc Interv Radiol 2013. [DOI: 10.1016/j.jvir.2013.01.259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Liu X, Teo T, Tan B, Irani F, Gogna A, Patel A, Lo R, Ramamurthy S, Too C, Chan S, Tan S, Chua B, Chng S, Pasupathy S, Choong L, Chan C, Tay K. Management of vessel rupture during angioplasty of malfunctioning hemodialysis access. J Vasc Interv Radiol 2013. [DOI: 10.1016/j.jvir.2013.01.329] [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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Ramamurthy S, McDonald F, Macdonald A, McCallum H, Lawrence G. A Study Comparing Clinical Outcomes in Non-small Cell Lung Cancer Patients Treated With Radical Thoracic Radiation Therapy Planned Using Pencil Beam Algorithm and Collapsed Cone Algorithm. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.1548] [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]
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Palmer AM, Degano AL, Park MJ, Ramamurthy S, Ronnett GV. Normal mitral cell dendritic development in the setting of Mecp2 mutation. Neuroscience 2011; 202:108-16. [PMID: 22138506 DOI: 10.1016/j.neuroscience.2011.11.044] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2011] [Revised: 11/17/2011] [Accepted: 11/17/2011] [Indexed: 12/23/2022]
Abstract
Rett syndrome (RTT) is an autism spectrum disorder caused by mutation in the gene encoding methyl CpG binding protein 2 (MECP2). Evidence to date suggests that these disorders display defects in synaptic organization and plasticity. A hallmark of the pathology in RTT has been identified as decreased dendritic arborization, which has been interpreted to represent abnormal dendritic formation and pruning during development. Our previous studies revealed that olfactory axons display defective pathfinding and targeting in the setting of Mecp2 mutation. In the present work, we use Mecp2 mutant mouse models and the olfactory system to investigate dendritic development. Here, we demonstrate that mitral cell dendritic development proceeds normally in mutant mice, resulting in typical dendritic morphology at early postnatal ages. We also failed to detect abnormalities in dendritic inputs at symptomatic stages when glomeruli from mutant mice appear smaller in area than the wild type (WT) (6 weeks postnatally). Collectively, these findings suggest that the initial defects in glomeruli impairment seen with Mecp2 mutation do not result from abnormal dendritic development. Our results using the olfactory system indicate that dendritic abnormalities are not an early feature in the abnormalities incurred by Mecp2 mutation.
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Affiliation(s)
- A M Palmer
- The Center for Metabolism and Obesity Research, the Johns Hopkins University, School of Medicine, Baltimore, MD 21205, USA
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Singh N, Kaleka P, Chandra S, Song D, Suh D, Yan L, Dorsey A, Ramamurthy S. 564 Ethnic differences in patient characteristics, but not implantable cardioverter-defibrillator (ICD) utilization rates for primary prevention of sudden cardiac death (SCD). Can J Cardiol 2011. [DOI: 10.1016/j.cjca.2011.07.468] [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: 10/16/2022] Open
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Ramamurthy S, Willis R, Lee D. Contraception in premenopausal breast cancer patients on tamoxifen: Have you advised? J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e11558] [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: 11/20/2022] Open
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Ramamurthy S, Evans H, Evans A. Misleading presentation of empyema. Arch Dis Child 2010; 95:654. [PMID: 20584845 DOI: 10.1136/adc.2010.185942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- S Ramamurthy
- Department of Radiology, University Hospital of Wales, Heath Park, Cardiff, UK.
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Palaniswamy C, Guleria R, Mohan A, Selvaraj DR, Narang R, Ramamurthy S. AIRWAY HYPERREACTIVITY IN RHEUMATIC MITRAL STENOSIS IMPROVES AFTER BALLOON VALVOTOMY. Chest 2009. [DOI: 10.1378/chest.136.4_meetingabstracts.104s-a] [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: 11/01/2022] Open
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Palaniswamy C, Guleria R, Mohan A, Ramamurthy S, Narang R. RESPIRATORY MUSCLE STRENGTH IN RHEUMATIC MITRAL STENOSIS IMPROVES AFTER BALLOON VALVOTOMY. Chest 2009. [DOI: 10.1378/chest.136.4_meetingabstracts.105s-c] [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: 11/01/2022] Open
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Gulati GS, Ramamurthy S, Sharma S. Utility of multislice computed tomography in the diagnosis of a right coronary artery fistula to the right atrium. J Postgrad Med 2008; 53:191-2. [PMID: 17699997 DOI: 10.4103/0022-3859.33866] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- G S Gulati
- Department of Cardiovascular Radiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi - 110 029, India.
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Ramamurthy S, Anandaraja S, Matthew N. Percutaneous coronary intervention for persistent complete heart block complicating inferior myocardial infarction. J Invasive Cardiol 2007; 19:E372-E374. [PMID: 18180531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Current guidelines recommend implantation of permanent pacemakers for advanced atrioventricular block complicating acute myocardial infarction (MI) when the block is present beyond the usual hospital course. In patients with inferior MI, such blocks are usually transient, but they can also be persistent. However, they are not considered as primary indications for early reperfusion by percutaneous coronary intervention (PCI) in the absence of ongoing ischemia. We describe a patient with inferior MI in whom a successful PCI was effective in reversing persistent complete heart block, thus avoiding implantation of a permanent pacemaker. In selected patients with inferior MI and advanced atrioventricular block, PCI should be considered as a treatment option before recommending permanent pacemaker implantation.
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Affiliation(s)
- S Ramamurthy
- Department of Cardiology, Ste. 25, All India Institute of Medical Sciences, New Delhi, India.
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Bhargava B, Karthikeyan G, Narag R, Ramamurthy S, Bahl V, Talwar K, Raju PR, Raju BS, Reddy NK, Kapoor SK, Singh C, Duggal J, Krishna D. Clinical Evaluation of an Indigenous Paclitaxel-Eluting Stent in De NovoCoronary Artery Stenosis. Indian Heart J 2006; 58:38-41. [PMID: 18984929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND, Drug-eluting stents have enabled considerable reduction in restenosis in patients subjected to angioplasty. However, in view of high cost of drug-eluting stents, efforts to develop medicated stents at reduced cost using alternative polymers in Indian setting are imperative. Hence a multi-center study was undertaken to evaluate the safety and efficacy of the indigenously developed paclitaxel-eluting RELEASE-T stent. METHODS, The study included 100 patients (male:86, Female:14) who were undergoing angioplasty for various indications at four centres viz. Delhi, Hyderabad, Pune and Warangal. The age range was 29 - 76 years; 37 patients were diabetic. All patients were pre-treated with aspirin 150-325 mg plus clopidogrel 75 mg daily four days before procedure or clopidogrel alone. Aspirin was continued indefinitely. RESULTS, Direct stenting ws done in majority of patients. One patient, in whom stent could not be delivered, received only baloon angioplasty. Sixty-four patients had stenting of left anterior descending artery. The stent diameter ranged from 2.5 to 3.5 mm, and the length, 15 to 20 mm. All patients were followed up at 1,3 and 6 months. There was two deaths: one had subacute thrombosis on both stents, and the other (who was HIV positive) had sudden cardiac death. The 6-month rate of major adverse cardiac events was 4% and target lesion revascularization rate ws 2%. CONCLUSION, This ulti-locational study brings out that the use of indigenously developed paclitaxel-eluting stent is safe and clinically efficacious.
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Affiliation(s)
- B Bhargava
- All India Institute of Medical Sciences, New Delhi
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Kobe BA, Ramamurthy S, Biesinger MC, McIntyre NS, Brennenstühl AM. XPS imaging investigations of pitting corrosion mechanisms in Inconel 600. SURF INTERFACE ANAL 2005. [DOI: 10.1002/sia.2038] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Abstract
BACKGROUND Sulfatides are sulfated glycosphingolipids expressed on the surface of erythrocytes, leukocytes, and platelets. Sulfatides interact with several cell adhesion molecules involved in hemostasis. Beta2-glycoprotein I is an anionic phospholipid-binding plasma protein, and the phospholipid-bound form is the target for most anti-phospholipid antibodies that are associated with recurrent thrombosis, miscarriages, and neurological symptoms. In this study, we examined whether beta2-glycoprotein I forms a complex with sulfatides and thereby becomes a target for anti-phospholipid antibodies. METHODS AND RESULTS Beta2-glycoprotein I binds to surface-bound sulfatides but not to other glycolipids, such as ceramide, cerebrosides, sphingomyelin, or ganglioside. At a sulfatide coating density of 1 microg/well, beta2-glycoprotein I reaches half-maximal binding at 2.5 microg/mL, and the binding is saturated at 10 microg/mL. The binding of beta2-glycoprotein I also depends on the coating density of sulfatides in the well. At a constant beta2-glycoprotein I concentration of 5 microg/mL, maximal binding of beta2-glycoprotein I is observed at a coating density of 1 mug/well. The serum from 14 patients with anti-cardiolipin antibodies, a subset of anti-phospholipid antibodies, bound to sulfatide-bound beta2-glycoprotein I and previous absorption on cardiolipin-coated surfaces decreased the immunoreactivity toward sulfatide-beta2-glycoprotein I complex by >50% in 12 of 14 patients. Furthermore, immunoaffinity-purified anti-cardiolipin antibodies from 4 of 5 patients reacted with sulfatide-bound beta2-glycoprotein I. CONCLUSIONS These results show that not only anionic phospholipids, as commonly known, but also sulfatides are targets for most anti-phospholipid antibodies. We therefore postulate that interactions of these antibodies with sulfatides may contribute to some of the clinical symptoms of the anti-phospholipid antibody syndrome.
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Affiliation(s)
- M Merten
- Departments of Pathology and Medicine, Baylor College of Medicine, Houston, Tex, USA
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Reithmann C, Dorwarth U, Dugas M, Hahnefeld A, Ramamurthy S, Remp T, Steinbeck G, Hoffmann E. Risk factors for recurrence of atrial fibrillation in patients undergoing hybrid therapy for antiarrhythmic drug-induced atrial flutter. Eur Heart J 2003; 24:1264-72. [PMID: 12831821 DOI: 10.1016/s0195-668x(03)00233-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
AIMS Catheter ablation of the inferior vena cava-tricuspid annulus isthmus and continuation of antiarrhythmic drug therapy have been shown to be an effective hybrid therapy for atrial flutter which results from antiarrhythmic drug treatment of atrial fibrillation. The aim of this study was to determine the risk factors for recurrence of atrial fibrillation in patients undergoing hybrid therapy for antiarrhythmic drug-induced atrial flutter. METHODS AND RESULTS 90 patients with paroxysmal (n=46) or persistent atrial fibrillation (n=44) developed atrial flutter due to the administration of amiodarone (n=48), flecainide (n=22), propafenone (n=14) or sotalol (n=6). Recurrence of atrial fibrillation after ablation was assessed during follow-up on continued antiarrhythmic drug therapy and during long-term follow-up, irrespective of the initial antiarrhythmic medication. During the follow-up on continued antiarrhythmic drug therapy (16+/-13 months), recurrence of atrial fibrillation was documented in 24 of 90 patients (27%). The presence of accompanying pre-ablation episodes of atrial fibrillation on antiarrhythmic treatment (Odds ratio 7.1, 95% confidence interval 2.3 to 25, p=0.001) and decreased left ventricular ejection fraction (Odds ratio 3.7, 95% confidence interval 1.01 to 12.5, p=0.048) were significant and independent predictors of post-ablation atrial fibrillation. Antiarrhythmic medication was discontinued during long-term follow-up due to adverse drug effects (amiodarone, n=12; flecainide, n=1) in 13 patients (14%). During the long-term follow-up, irrespective of the initial antiarrhythmic medication (21+/-15 months), stable sinus rhythm was maintained in 60 of 90 patients (67%). CONCLUSION Hybrid therapy can be considered as the first line therapy for patients with antiarrhythmic drug-induced atrial flutter but patients should be carefully evaluated for accompanying pre-ablation episodes of atrial fibrillation and possible adverse drug effects before initiation of hybrid therapy.
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Affiliation(s)
- C Reithmann
- Medizinische Klinik I, Klinikum Grosshadern, Universität München, Munich, Germany.
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Ramamurthy S, Talwar KK, Sharma S. Extensive dissection requiring multiple stents following balloon angioplasty for non-specific aorto-arteritis. J Invasive Cardiol 2003; 15:49-51. [PMID: 12499531] [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: 02/28/2023]
Abstract
Discrete stenoses of the thoraco-abdominal aorta in non-specific aorto-arteritis are considered favorable lesions for balloon angioplasty characterized by good results without major complications. Herein, we describe one such case manifesting with severe hypertension, left ventricular dysfunction and congestive heart failure treated by angioplasty. Balloon dilatation, however, resulted in extensive dissection requiring implantation of two Wallstents. Over a follow-up of one year, hypertension remained under good control with fewer drugs and symptom relief was maintained. Left ventricular ejection fraction improved from 35% to 61%.
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Affiliation(s)
- S Ramamurthy
- Visiting Professor, Med. Klinik I, Klinikum Grosshadern, University of Munich, Marchioninistrasse 15, D 81377 Munich, Germany
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Francis JT, Brennenstühl AM, Ramamurthy S, McIntyre NS. Use of ToF-SIMS in the study of corrosion processes: Monel 400 steam generator tubing under CANDU start-up conditions. SURF INTERFACE ANAL 2002. [DOI: 10.1002/sia.1280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Francis JT, McIntyre NS, Davidson RD, Ramamurthy S, Brennenstühl AM, McBride A, Roberts A. Mechanisms for pitting corrosion in alloy N04400 as revealed by imaging XPS, ToF-SIMS and low-voltage SEM. SURF INTERFACE ANAL 2002. [DOI: 10.1002/sia.1157] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Ramamurthy S, Bahl VK, Manchanda SC. Successful inoue balloon valvotomy in a difficult case of mitral stenosis using multiple modifications of technique: alternative method for loop formation of the Inoue balloon catheter. J Invasive Cardiol 2001; 13:755-7. [PMID: 11689721] [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: 02/22/2023]
Abstract
Transseptal puncture was accomplished with difficulty at an unfavorable site in a case of severe mitral stenosis with distorted atrial and septal anatomy. Septal balloon entrapment could not be avoided during attempts to cross the mitral valve using the standard technique. This problem was circumvented by resorting to the loop method and the left ventricle was entered first with a guidewire, which then supported the balloon catheter. Successful mitral valve dilatation could thus be performed. A simple alternative method that was used to form the Inoue balloon catheter into a loop is also described.
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Affiliation(s)
- S Ramamurthy
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
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Bhatla N, Lal S, Behera G, Kriplani A, Agarwal N, Takkar D, Mittal S, Ramamurthy S, Talwar K, Kumar A. Cardiac disease in pregnancy—A.I.I.M.S. experience. J Mol Cell Cardiol 2001. [DOI: 10.1016/s0022-2828(01)90045-8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Mishra S, Narang R, Sharma M, Chopra A, Seth S, Ramamurthy S, Prabhakaran D, Goswami KC, Talwar KK, Manchanda SC, Bahl VK. Percutaneous transseptal mitral commissurotomy in pregnant women with critical mitral stenosis. Indian Heart J 2001; 53:192-6. [PMID: 11428476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
Abstract
BACKGROUND Percutaneous transseptal mitral commissurotomy has been successfully performed in selected pregnant patients with severe symptomatic mitral stenosis. Its safety and efficacy needs to be evaluated in a large number of cases. METHODS AND RESULTS Percutaneous transseptal mitral commissurotomy was performed in 85 severely symptomatic (New York Heart Association functional class III or IV) pregnant women aged 22.7+/-4.1 years (range 18-39 years) with critical mitral stenosis at 24.8+/-4.7 weeks (range 20-34 weeks) of gestation. Percutaneous valvotomy was performed using a flow-guided Inoue balloon in all the patients. The procedure was considered successful in 80 (94%) patients. The hemodynamic mean end-diastolic gradient decreased from 26.7+/-6.8 mm Hg (range 16-35 mmHg) to 4.5+/-3.8 mmHg (range 0-14 mmHg) (p<0.001). The mean diastolic gradient decreased from 29.1+/-9.1 mmHg (range 18-38 mmHg) to 7.2+/-4.1 mmHg (range 4.1-18 mmHg) (p<0.001). The mean mitral valve area assessed by echocardiography increased from 0.75+/-0.5 cm2 (range 0.4-1.0 cm2) to 2.0+/-0.5 (range 1.0-2.7 cm2) (p<0.001). The mean fluoroscopy time was 3.6+/-3.2 minutes. The results of the mitral valvotomy were considered suboptimal in 4 patients. Mitral regurgitation increased by 1 grade in 16 patients and more than 2 grades in 2 patients. One patient developed pericardial tamponade during the procedure and was managed by catheter drainage. Percutaneous mitral valve dilatation was then successfully performed in this patient. No fetal abortion occurred after the procedure. CONCLUSIONS The results of this study indicate that percutaneous transseptal mitral commissurotomy is a safe and effective procedure for severe symptomatic mitral stenosis in pregnancy.
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Affiliation(s)
- S Mishra
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi
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Narang R, Kothari SS, Sharma S, Ramamurthy S, Talwar KK, Manchanda SC. Aortic dissection into the interatrial septum. Indian Heart J 2001; 53:110-1. [PMID: 11456136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
Affiliation(s)
- R Narang
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi
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Morrison SF, Ramamurthy S, Young JB. Reduced rearing temperature augments responses in sympathetic outflow to brown adipose tissue. J Neurosci 2000; 20:9264-71. [PMID: 11125004 PMCID: PMC6773001] [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] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
Sympathetic outflow to brown adipose tissue (BAT) contributes to both thermoregulation and energy expenditure in rats through regulation of BAT thermogenesis. Acute cold exposure in mature animals augments BAT thermogenesis; however, the enhanced BAT thermogenic response returns to normal shortly after cessation of the cold exposure. In this study, we sought to determine whether cold exposure in early neonatal life could induce enhanced responses in the sympathetic outflow to BAT and whether this altered sympathetic regulation would be sustained after the cold stimulus was removed. BAT sympathetic nerve activity (SNA) was recorded in urethane-chloralose-anesthetized, artificially ventilated rats that were raised from birth in either 18 or 30 degrees C environments and then, at 8 weeks of age, were maintained in 23 degrees C for at least 4 weeks. An acute hypothermic stimulus, disinhibition of a brainstem thermogenic network in the raphe pallidus, or electrical stimulation in this raphe site produced increases in BAT SNA that were twice as great in rats reared at 18 degrees C as in those reared at 30 degrees C. The norepinephrine content of the interscapular BAT (IBAT) and the number of sympathetic ganglion cells projecting to interscapular BAT were 70% greater in the 18 degrees C-reared rats. We conclude that neonatal exposure to a cold environment induces a permanent developmental alteration in the capacity for sympathetic stimulation of BAT thermogenesis that may be mediated, in part, by a greater number of sympathetic ganglion cells innervating BAT in cold-reared animals.
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Affiliation(s)
- S F Morrison
- Department of Physiology, Northwestern University Medical School, Chicago, Illinois 60611, USA.
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Schneider JM, Herberstein ME, De Crespigny FC, Ramamurthy S, Elgar MA. Sperm competition and small size advantage for males of the golden orb-web spider Nephila edulis. J Evol Biol 2000. [DOI: 10.1046/j.1420-9101.2000.00238.x] [Citation(s) in RCA: 126] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Basu A, Garg P, Datta S, Chakraborty S, Bhattacharya T, Khan A, Ramamurthy S, Bhattacharya SK, Yamasaki S, Takeda Y, Nair GB. Vibrio cholerae O139 in Calcutta, 1992-1998: incidence, antibiograms, and genotypes. Emerg Infect Dis 2000; 6:139-47. [PMID: 10756147 PMCID: PMC2640858 DOI: 10.3201/eid0602.000206] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We report results of surveillance for cholera caused by Vibrio cholerae O139 from September 1992, when it was first identified, to December 1998. V. cholerae O139 dominated as the causative agent of cholera in Calcutta during 1992-93 and 1996- 97, while the O1 strains dominated during the rest of the period. Dramatic shifts in patterns of resistance to cotrimoxazole, neomycin, and streptomycin were observed. Molecular epidemiologic studies showed clonal diversity among the O139 strains and continuous emergence of new epidemic clones, reflected by changes in the structure, organization, and location of the CTX prophages in the V. cholerae O139
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Affiliation(s)
- A Basu
- National Institute of Cholera and Enteric Diseases, Calcutta, India
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Sharma S, Mahapatra M, Bhargava S, Bhargava B, Ramamurthy S, Rajani M. Utility of coaxial technique for renal angioplasty in patients with a difficult-to-cross stenosis. Eur Radiol 1999; 9:1586-9. [PMID: 10525870 DOI: 10.1007/s003300050889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The aim of this study was to evaluate the feasibility of coaxial approach in difficult-to-cross lesions in patients with failed percutaneous transluminal renal angioplasty by conventional over-the-wire exchange technique. Twelve stenoses in 10 patients (six women and four men; age range 19 +/- 7 years) with uncontrolled hypertension were treated by this method. The stenosis was caused by nonspecific aortoarteritis in 8 patients and fibromuscular dysplasia in 2 patients. It was ostial in seven and post-ostial in five vessels. Conventional exchange technique was unsuccessful in all of them. All procedures were done by femoral route. Technical success was seen in 11 (92%), without complication. The stenosis improved from 90 +/- 2.1% (range 80-100%) to 6 +/- 7% (range 0-20%), blood pressure decreased from 198 +/- 12.3 mm Hg (range 180-220 mm Hg)/130 +/- 6.7 mm Hg (range 120-140 mm Hg) to 119 +/- 5.7 mm Hg (range 110-130 mm Hg)/83 +/- 3.9 mm Hg (range 80-90 mm Hg), and number of drug treatments for hypertension fell from 3.6 +/- 0.52 (range 3-4) to 1 +/- 0.94 (range 0-3; p < 0.01). Percutaneous transluminal renal angioplasty resulted in "cure" in 3 patients and "improvement" in 7 patients. Follow-up period was 3-21 months (mean 6.4 months). No restenosis was detected. Coaxial approach is safe and effective in treating difficult-to-cross lesions in which renal angioplasty by conventional exchange technique is unsuccessful.
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Affiliation(s)
- S Sharma
- Department of Cardiovascular Radiology, Cardiothoracic Centre, All India Institute of Medical Sciences, IND-110029 New Delhi, India
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Mohanty SR, Choudhary SK, Ramamurthy S, Kumar AS. Isolated congenital anterior mitral leaflet cleft: a rare cause of mitral insufficiency. J Heart Valve Dis 1999; 8:67-70. [PMID: 10096485] [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: 02/11/2023]
Abstract
BACKGROUND AND AIM OF THE STUDY Isolated cleft of the anterior mitral leaflet is a rare cause of mitral insufficiency. Although an established entity, due to its rarity the exact anatomic diagnosis is difficult to establish unless sought specifically. METHODS Four patients (age range: 16 to 26 years) with isolated cleft of the anterior mitral leaflet were treated at the authors' institute. Clinical symptoms were typical of mitral insufficiency; the exact anatomic diagnosis was not established preoperatively in any patient. The cleft was directly sutured in all four patients and additional annuloplasty was performed in three. RESULTS Postoperative echocardiography confirmed satisfactory results. After a mean follow up of 46.7 months (range: 3 to 84 months), one patient had mild mitral insufficiency and the remaining patients had no mitral regurgitation. CONCLUSION In severe mitral insufficiency with no obvious mitral valve pathology and an intact atrial septum, a cleft of the anterior mitral leaflet should be sought. Repair of the cleft can restore normal mitral valve function.
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Affiliation(s)
- S R Mohanty
- Cardiothoracic Sciences Center, All India Institute of Medical Sciences, New Delhi
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Agarwal R, Bhargava B, Sapra R, Bahl VK, Talwar KK, Ramamurthy S, Manchanda SC. Extrasupport guidewire as primary wire for percutaneous transluminal coronary angioplasty. Cathet Cardiovasc Diagn 1998; 43:365. [PMID: 9535386 DOI: 10.1002/(sici)1097-0304(199803)43:3<365::aid-ccd31>3.0.co;2-i] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Sayson SC, Ramamurthy S, Hoffman J. Incidence of genitofemoral nerve block during lumbar sympathetic block: comparison of two lumbar injection sites. Reg Anesth 1997; 22:569-74. [PMID: 9425975] [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: 02/05/2023]
Abstract
BACKGROUND AND OBJECTIVES Genitofemoral nerve (GFN) block is a known side effect of a lumbar sympathetic block (LSB), although the incidence has not been well documented. Furthermore, genitofemoral neuralgia can occur following neurolytic LSB. Because the level at which the GFN exits the psoas sheath varies, this study was designed to identify differences in the incidence of GFN block following LSB at the level of the second versus the fourth lumbar vertebrae. METHODS Patients requiring LSB to evaluate chronic lower extremity pain were prospectively studied. Patients were injected at the second lumbar (L2 group) or fourth lumbar (L4 group) vertebral body depending on the location of the pain syndrome in the lower extremity. Lumbar sympathetic blocks were performed using 10 mL of a 0.5% bupivacaine solution with radiocontrast; spread of injectate was verified using fluoroscopy. An observer evaluating for presence of GFN block was blinded to the lumbar level of injection. RESULTS Thirty patients were enrolled (L2 group, n = 15; L4 group, n = 15). Spread of local anesthetic/radiocontrast solution was limited to approximately one vertebral body above and one below the target level. There was no difference in the ability to achieve a LSB; success rates were 66% and 73% using L2 and L4, respectively. The incidence of GFN block was 0% (0/15) in the L2 group versus 40% (6/15) in the L4 group; this was statistically significant (P = .017, Fisher's exact test). CONCLUSIONS The GFN is less likely to be blocked when the LSB is performed near the second lumbar vertebra as compared with the fourth lumbar vertebra.
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Affiliation(s)
- S C Sayson
- Department of Surgery, Brooke Army Medical Center, Fort Sam Houston, San Antonio, Texas 78234-6200, USA
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Ramamurthy S, Mehan V, Kaufmann U, Verin V, Lüscher TF, Meier B. Effect of pre-treatment with transdermal glyceryl trinitrate on myocardial ischaemia during coronary angioplasty. Heart 1996; 76:471-6. [PMID: 9014793 PMCID: PMC484596 DOI: 10.1136/hrt.76.6.471] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE In the light of the reported inconsistent anti-ischaemic and antianginal effects of transdermal glyceryl trinitrate, its efficacy and influence on the effects of intracoronary glyceryl trinitrate were examined during coronary angioplasty, which provides a model of controlled, reversible ischaemia. DESIGN Double blind, randomised study of the effect of transdermal and intracoronary glyceryl trinitrate on ischaemia during coronary angioplasty. PATIENTS 40 patients with isolated severe stenosis of the left anterior descending coronary artery. INTERVENTIONS Patients were randomised (double blind) to transdermal glyceryl trinitrate (10 mg per day) and placebo, starting four to six hours before angioplasty. After 4 one-minute balloon inflations intracoronary glyceryl trinitrate was injected (0.2 mg) and then 4 further one-minute inflations were performed. MAIN OUTCOME MEASURES The time to angina and the time to > 0.2 mV ST shift on surface electrocardiogram (ECG) or intracoronary ECG during the individual inflations. RESULTS These times did not significantly differ during initial inflations between transdermal glyceryl trinitrate (27 (11), 25 (9), and 19 (9) s, respectively) and placebo (34 (11), 30 (8), and 21 (7) s. After intracoronary glyceryl trinitrate, they were significantly prolonged compared with the initial values, without differences between patients with transdermal glyceryl trinitrate (37 (10), 30 (8), and 23 (8) s, respectively) or placebo (39 (15), 36 (11), and 28 (12) s). Ischaemic preconditioning was not seen. CONCLUSIONS Transdermal glyceryl trinitrate (10 mg per day), unlike intracoronary glyceryl trinitrate, did not alleviate the myocardial ischaemia produced by balloon inflation during coronary angioplasty.
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Affiliation(s)
- S Ramamurthy
- Department of Medicine, University Hospital, Bern, Switzerland
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Vainer J, Fleisch M, Gunnes P, Ramamurthy S, Garachemani A, Kaufmann UP, Meyer BJ, Lüscher TF, Meier B. Low-dose heparin for routine coronary angioplasty and stenting. Am J Cardiol 1996; 78:964-6. [PMID: 8888679 DOI: 10.1016/s0002-9149(96)00480-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- J Vainer
- Department of Cardiology, University Hospital, Bern, Switzerland
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Popli S, Leehey DJ, Giacciano JL, Ramamurthy S, Soundararajan R, Ing TS. Obstruction to venous outflow from the left lower extremity after renal transplantation. Clin Nephrol 1996; 45:236-40. [PMID: 8861798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Three patients with acute massive swelling of the left lower extremity occurring soon after placement of a renal allograft in the left iliac fossa are described. In each patient, obstruction to venous outflow from the left lower limb was documented by venography. We surmise that venous obstruction resulted principally from a combination of extrinsic compression of the left iliac vein by the right common iliac artery or by the allograft, and enhanced venous return from the allograft.
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Affiliation(s)
- S Popli
- Department of Medicine, Loyola University Chicago Stritch School of Medicine, Hines, Illinois, USA
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Duggal B, Khilnani GC, Ramamurthy S, Misra A, Gupta SD, Pande JN. Unusual presentation of two rare cases of systemic amyloidosis-- a case report. J Assoc Physicians India 1996; 44:65-6. [PMID: 8773102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- B Duggal
- Dept of Medicine, All India Institute of Medical Sciences, New Delhi
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Ramamurthy S, Hoffman J. Intravenous regional guanethidine in the treatment of reflex sympathetic dystrophy/causalgia: a randomized, double-blind study. Guanethidine Study Group. Anesth Analg 1995; 81:718-23. [PMID: 7574000 DOI: 10.1097/00000539-199510000-00011] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
This double-blind, randomized, multicenter study was designed to determine the short-term and long-term efficacy of intravenous regional block with guanethidine in patients with reflex sympathetic dystrophy (RSD)/causalgia. Sixty patients were enrolled to receive four intravenous regional blocks at 4-day intervals with either guanethidine or placebo in 0.5% lidocaine. Each patient was randomized to receive either one, two, or four blocks with guanethidine. Follow-up visits were scheduled for 4 days, 1 mo, 3 mo, and 6 mo after their final block. At 4 days after the initial block, the group treated with placebo experienced a greater decrease in pain scores than those treated with guanethidine, although this difference was not statistically significant. On long-term followup there was no difference in pain scores between groups receiving one, two, or four guanethidine blocks. Overall, only 35% of patients experienced clinically significant relief on long-term followup even though all were treated early in the evolution of RSD.
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Affiliation(s)
- S Ramamurthy
- Department of Anesthesiology, University of Texas Health Science Center at San Antonio 78284-7838, USA
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Abstract
Previous studies have indicated that physicians have inadequate knowledge of drug costs. This study was designed to determine actual pharmacy prices of 12 nonsteroidal anti-inflammatory drugs (NSAIDs) and physicians' knowledge of these prices. Pharmacists (N = 67) in a large urban area were surveyed to determine the lowest retail price of commonly prescribed medications. Pain clinic and orthopedic physicians (N = 95) were surveyed to determine their knowledge of prices for 12 NSAIDs. There was wide variation between pharmacies in the cost of medications. Eighty-one percent of physicians agreed that cost is an important factor to consider. Only 25% of physicians estimated at least one-half of the medications between the highest and lowest pharmacy price. The results of this study indicate that physicians need more information about prices of medications they prescribe.
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Affiliation(s)
- J Hoffman
- Department of Anesthesiology, University of Texas Health Science Center at San Antonio 78284-7838, USA
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Ramamurthy S, Sharma S, Kumar RK, Rajani M, Wasir HS. Collateral arteries in the presence of obstructive coronary disease. Natl Med J India 1994; 7:260-2. [PMID: 7841875] [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: 01/27/2023]
Abstract
BACKGROUND The clinical importance of coronary collaterals in the presence of obstructive coronary artery disease is not clearly defined. METHODS We retrospectively analysed the clinical and angiographic features of 100 patients with > or = 90% luminal diameter stenosis involving at least one major coronary artery. Coronary collaterals were graded 0 to 4 (Nitzberg's classification) and studied to determine their influence on clinical parameters. RESULTS Thirty patients had no collaterals (group I) and 70 showed collaterals (group II). There were no significant differences between groups I and II in age and sex distribution, prevalence of risk factors of coronary artery disease (hypertension, diabetes, smoking, hypercholesterolaemia), duration of symptoms of coronary artery disease and prior myocardial infarction. Groups I and II had similar types (left anterior descending 73% v. 71%; left circumflex 50% v. 50% and right coronary 37% v. 56%) and numbers of arteries involved (one 47% v. 41%; two 47% v. 40%; three 7% v. 19%). Group II had a significantly lower prevalence of rest angina (14% v. 47%, p = 0.002). This difference was also evident when the patients were re-classified according to the extent of flow through the collaterals. Those with good collateralization (Nitzberg grades 3 and 4) had a lower prevalence of rest angina (13%) compared to those with poor collateralization (Nitzberg grades 0 to 2; 35%, p = 0.02). CONCLUSION Coronary artery collaterals may reduce the incidence of rest angina in patients with obstructive coronary artery disease.
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Affiliation(s)
- S Ramamurthy
- Cardiothoracic Sciences Centre, All India Institute of Medical Sciences, Ansari Nagar, New Delhi
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Affiliation(s)
- S Ramamurthy
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi
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Hickey R, Hoffman J, Tingle LJ, Rogers JN, Ramamurthy S. Comparison of the clinical efficacy of three perivascular techniques for axillary brachial plexus block. Reg Anesth 1993; 18:335-8. [PMID: 8117627] [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: 01/28/2023]
Abstract
BACKGROUND AND OBJECTIVES This study compared the efficacy of three perivascular techniques of axillary block. METHODS In group 1, all of the local anesthetic was injected after advancing the needle through the axillary artery (back of artery, n = 20); in group 2, after withdrawing slightly from the artery (front of artery, n = 20); and in group 3, half of the anesthetic was injected after advancing through and half after withdrawing from the axillary artery (half and half, n = 20). The local anesthetic used for the axillary block was 50 ml of 1.5% mepivacaine with epinephrine 1:200,000. RESULTS The groups did not differ significantly in the incidence of analgesia or anesthesia expected in the median nerve distribution, where there was a significantly lower incidence of anesthesia in the back of the artery group. This group also had a slower onset of anesthesia for the median and the medial antebrachial cutaneous nerves. CONCLUSIONS There was no significant difference in the number of patients requiring supplementation, with five patients in the back group (25%), three patients in the front group (15%), and one patient in the half and half group (5%) requiring supplementation for the surgical procedure.
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Affiliation(s)
- R Hickey
- Department of Anesthesiology, University of Texas Health Science Center, San Antonio 78284
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Abstract
We studied 20 patients in detail (age: 27 months to 45 years, mean 22 years; 15 males, 5 females) of idiopathic myocarditis histologically confirmed by endomyocardial biopsy. None of these patients had evidence of active or previous rheumatic fever. The commonest mode of presentation was congestive heart failure (16 patients) followed by arrhythmias (seven patients--five of whom had associated congestive heart failure) and chest pain resembling myocardial infarction (two patients). Ten patients had a history of preceding upper respiratory infection. Only one of these patients had a significant rising serum titre for Coxsackie B3 virus. Throat and rectal swabs for virus culture were negative in all patients. The electrocardiogram was abnormal in all patients, with a prolonged corrected QT-interval being the commonest abnormality (14 patients). Serial electrocardiographic patterns of evolving myocardial infarction occurred in three patients. Echocardiographic left ventricular end diastolic dimension (4.15 +/- 1.01 cm/m2) and end systolic dimension (3.37 +/- 1.03 cm/m2) were increased in 15 of the 18 patients studied. Pericardial involvement occurred in only one patient. Radionuclide ventriculography showed a reduced left ventricular ejection fraction (< 50%) in 17 patients, global hypokinesia in 12 patients and regional wall motion abnormalities in five patients. Left ventricular and right ventricular end diastolic pressures were elevated in 15 and 11 patients, respectively.
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Affiliation(s)
- S Ramamurthy
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi
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Abstract
The triple-phase bone scan is frequently used in the diagnosis of reflex sympathetic dystrophy although the etiology of the abnormal findings is not well established. This study evaluated the effect of increased blood flow secondary to sympathetic block on the triple-phase bone scan. In 15 reflex sympathetic dystrophy patients, all of whom had significant relief with sympathetic block, baseline and postsympathetic block bone scans were analyzed. There was a significant linear relationship between change in counts from baseline to postsympathetic block on the blood pool image and bone uptake image. As the blood pool and bone uptake counts increased, the likelihood of typical reflex sympathetic dystrophy findings on visual inspection also increased. These results strongly support the concept of increased vascular flow as the cause of increased periarticular uptake.
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Affiliation(s)
- J Hoffman
- Department of Anesthesiology, University of Texas Health Science at San Antonio 78284-7838
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