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Familial Eosinophilia with Cardiac Involvement: A Distinct Subset?

Open Journal of Immunology 2023年第3期13卷 86-97页

作者： puthalath koroth raghuprasad Sudhir Amaram Department of Internal Medicine Medical Center Hospital Odessa Texas USA

In this paper we present a five-generation kindred with familial eosinophilia, associated with valvular heart disease in one of seven members of the second generation, four of sixteen members of the third generation, four of thirty-one members of the fourth generation, and two of twenty members of the fifth generation;the clinical features of the two members of the first generation are unavailable. Of a total of 48 members, 26 had eosinophilia, with counts ranging from 1761 to 6045 cells/mm3, with apparent autosomal dominant propagation;this confirms the experience of the authors of previous studies on this condition. Genetic analysis on eight members, which we reported in an earlier paper [1], revealed a pericentric inversion of chromosome 10 in two members. The entity of Familial Eosinophilia has been generally considered benign. However, the clinical presentation of this kindred was unusual in that valvular and endocardial damage, was frequent findings, without apparent involvement of the other organs and tissues. Mitral valve damage leading to both stenosis and regurgitation and requiring mitral valve replacement was noted in the index patient. This unique presentation may suggest that in patients with mitral valve disease, if blood eosinophilia is noted, it could point to a non-rheumatic etiology, thus a possible opportunity for treatment to prevent further damage to the heart. This recommendation may be even more timely, as many effective treatments are now available to treat even high-grade hypereosinophilia.

关键词： Familial Eosinophilia Autosomal Dominant Propagation High-Grade Hypereosinophilia

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Improved Resuscitation Method for Choking Victims

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Open Journal of Emergency Medicine 2021年第4期9卷 143-149页

作者： puthalath koroth raghuprasad Independent Researcher Odessa USA

Abdominal thrust, popularized by Henry Heimlich in 1975 is the standard resuscitation method for victims of choking. When properly applied, this procedure can and has saved many lives over the years, but the process itself is somewhat difficult to perform. The main reason for this difficulty is the need to reach around the trunk of the victim and then apply sufficient force to generate enough pressure upwards to the diaphragm, to be able to dislodge the food bolus (or foreign body) out of the larynx. This is compounded by the size of the average American, especially when they are overweight or obese, thus the ability to reach the front of the abdomen and then the prospect of actually trying to lift the victim up through brute force is a challenge for most people. Some difficulties are inherent in the emotionally charged and panicky situations in which such resuscitation measures take place. Some scientists have advocated the use of mechanical devices to apply thrust to the abdomen. However, the lack of availability of such assisting devices at home and even in restaurants is a distinct issue. Damage to the xiphisternum or internal organs by excessive force is also an issue, so much so, most authorities recommend a post-resuscitation check up of all victims at a hospital or clinic. The procedure(s) described in this report is much simpler in execution, while being almost effortless, and applicable to victims of any size. It also exploits the objects that are likely to be present where such choking accidents occur, the restaurants and dining rooms, while also taking advantage of the earth’s gravity to dislodge the offending food bolus. If such objects are not available, an alternate method using the rescuer’s free forearm to support the victim’s weight, while keeping him/her folded over is also described.

关键词： Abdominal Thrust Choking Food Bolus Heimlich Maneuver Resuscitation

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Pivotal Role of Spin in Celestial Body Motion Mechanics: Prelude to a Spinning Universe

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Journal of High Energy Physics, Gravitation and Cosmology 2021年第1期7卷 98-122页

作者： puthalath koroth raghuprasad Independent Researcher Odessa TX USA

This is the final article in our series dealing with the interplay of spin and gravity that leads to the generation, and continuation of celestial body motions in the universe. In our prior studies we focused on such interactions in the elementary particles, and in the celestial bodies in the solar system. Foremost among the findings was that, along with gravity, matter at all levels exhibits axial spin. We further noted that all freestanding bodies outside our solar system, including the largest such units, the stars and galaxies also spin on their axes. Also, the axial rotation speed of planets in our solar system has a linear positive relationship to their masses, thus hinting at its fundamental and autonomous nature. We have reported that this relationship between the size of the body and its axial rotation speed extends to the stars and even the galaxies. Next, all congregations of matter spin on their axes in the counterclockwise direction;all satellites orbit their mother bodies also in the counterclockwise direction, i.e.: in our solar system, with only rare exceptions, the satellite bodies follow the mother bodies’ axial rotation. This relationship exists also in the case of the rings of planets, the asteroids and the Kuiper belt bodies, as well as the stars and their galaxies. We also noted the intricate involvements between spin and gravity in the exquisite phenomena of synchronous and negative rotations of planets and some satellites;we have explained in detail how these two phenomena occur. The closest large moons of the gas and ice giants and the earth’s moon exhibit synchronous rotation. In this paper we present evidence that these synchronously rotating satellite bodies’ axial rotation speed is closely related to the size and the axial rotation speeds of their respective mother bodies. In the satellites that follow a non-synchronous rotation (most of the planets and their satellites) the satellites’ own rotation speed usually dominates.

关键词： Axial Rotation Centrifugal Force Counterclockwise Gravity Neutron Stars Proto-Planetary Disk Spin

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Metachronous bladder metastasis from papillary renal cell carcinoma

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Journal of Cancer Metastasis and Treatment 2016年第1期2卷 130-132页

作者： Arun Ramdas Menon Nivedita Suresh Prajwal Ravinder Rajeev Thekke puthalath Department of Urology K S Hegde Medical AcademyMangalore 575018KarnatakaIndia Department of Pathology K S Hegde Medical AcademyMangalore 575018KarnatakaIndia

Renal cell carcinoma(RCC)is well known for its metastatic potential and predilection for unusual sites of *** to the bladder is rare and has been reported predominantly from clear cell *** report a case of a 72-year-old male presenting with a bladder tumor which on histopathological evaluation was found to be a metastasis from papillary RCC,7 years after radical *** case highlights the need to maintain a high index of suspicion to diagnose bladder metastasis in a patient with a history of RCC presenting with a bladder lesion.

关键词： Bladder metastasis metachronous metastasis renal cell carcinoma

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