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A gist of gastrointestinal stromal tumors: A review

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World Journal of Gastrointestinal Oncology 2013年第6期5卷 102-112页

作者： ashwin rammohan Jeswanth Sathyanesan Kamalakannan Rajendran Anbalagan Pitchaimuthu Senthil-Kumar Perumal UP Srinivasan Ravi Ramasamy Ravichandran Palaniappan Manoharan Govindan The Institute of Surgical Gastroenterology and Liver Transplantation Centre for GI Bleed Division of HPB Diseases Stanley Medical College Hospital

Gastrointestinal stromal tumors (GISTs) have been recognized as a biologically distinctive tumor type, different from smooth muscle and neural tumors of the gastrointestinal tract (GIT). They constitute the majority of gastrointestinal mesenchymal tumors of the GIT and are known to be refractory to conventional chemotherapy or radiation. They are defined and diagnosed by the expression of a proto-oncogene protein detected by immunohistochemistry which serves as a crucial diagnostic and therapeutic target. The identification of these mutations has resulted in a better understanding of their oncogenic mechanisms. The remarkable antitumor effects of the molecular inhibitor imatinib have necessitated accurate diagnosis of GIST and their distinction from other gastrointestinal mes-enchymal tumors. Both traditional and minimally invasive surgery are used to remove these tumors with minimal morbidity and excellent perioperative outcomes. The revolutionary use of specific, molecularlytargeted therapies, such as imatinib mesylate, reduces the frequency of disease recurrence when used as an adjuvant following complete resection. Neoadjuvant treatment with these agents appears to stabilize disease in the majority of patients and may reduce the extent of surgical resection required for subsequent complete tumor removal. The important interplay between the molecular genetics of GIST and responses to targeted therapeutics serves as a model for the study of targeted therapies in other solid tumors. This review summarizes our current knowledge and recent advances regarding the histogenesis, pathology, molecular biology, the basis for the novel targeted cancer therapy and current evidence based management of these unique tumors.

关键词： Gastrointestinal stromal tumors c-KIT Imatinib mesylate Surgery Review

Role of plasmapheresis in early allograft dysfunction following deceased donor liver transplantation

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World Journal of Hematology 2017年第1期6卷 24-27页

作者： ashwin rammohan Deepti Sachan Satish Logidasan Jeswanth Sathyanesan Ravichandran Palaniappan Mohamed Rela Institute of Liver Disease and Transplantation Global Hospitals and Health City Institute of Surgical Gastroenterology and Liver Transplantation Govt Stanley Medical College Hospital Institute of Liver Studies King’s College Hospital

The role of plasmapheresis in liver failure and hepatic encephalopathy is undefined and its use as a strategy to salvage patients with severe allograft dysfunction after liver transplantation remains investigational. We present a case of early allograft dysfunction following deceased donor liver transplantation(DDLT) where plasmapheresis was effective as a bridge to recovery and possibly avoiding a retransplantation. A 16 years old boy, known to have decompensated Wilson's disease underwent DDLT at our Public Sector Hospital. He received a healthy liver from a brain-dead donor, whose liver was considered too large for the boy. The graft was reduced in situ to a left lobe graft. Surgery was uneventful and the recipient was well for the initial 96 h. On Doppler and further computed tomography scan, a partial portal vein thrombus was noted. He was reexplored and a Fogarty endothombecteomy was performed. Following the second surgery, he developed severe allograft dysfunction with a peak bilirubin of 40 mg/d L. He underwent imaging to rule out technical causes for the dysfunction, followed by a liver biopsy, which revealed acute cellular rejection. Multiple cycles of plasmapheresis were initiated. Over the next two weeks, the graft demonstrated a gradual recovery. He was discharged on the 30 th postoperative day, with a serum bilirubin of 5.5 mg/d L. He remains well on follow-up, with the liver function tests improving further. Our report demonstrates the beneficial effect of plasmapheresis, which appears to be an effective treatment option for early allograft dysfunction following liver transplantation and may obviate the need for retransplantation.

关键词： Liver transplantation Allograft dysfunction Plasmapheresis

Embolization of liver tumors:Past,present and future

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World Journal of Radiology 2012年第9期4卷 405-412页

作者： ashwin rammohan Jeswanth Sathyanesan Sukumar Ramaswami Anand Lakshmanan Perumal Senthil-Kumar Ulagendra Perumal Srinivasan Ravi Ramasamy Palaniappan Ravichandran The Institute of Surgical Gastroenterology and Liver Transplantation Centre for GI BleedDivision of HPB DiseasesStanley Medical College Hospital Interventional RadiologistInstitute of Surgical Gastroenterology and Liver TransplantationCentre for GI BleedDivision of HPB DiseasesStanley Medical College Hospital

Curative therapies for hepatocellular carcinoma(HCC),such as resection and liver transplantation,can only be applied in selected patients with early *** advanced stages require local or systemic *** of HCC offers the only hope for *** in patients undergoing resection,recurrences are ***,a technique combining intraarterial chemotherapy with selective tumor ischemia,has been shown by randomized controlled trials to be efficacious in the palliative *** is now renewed interest in transarterial embolization/transarterial chemoembolization(TACE) with regards to its use as a palliative tool in a combined modality approach,as a neoadjuvant therapy,in bridging therapy before transplantation,for symptomatic indications,and even as an alternative to *** have also been rapid advances in the agents being embolized trans-arterially(genes,biological response modifiers,etc.).The current review provides an evidence-based overview of the past,present and future trends of TACE in patients with HCC.

关键词： Liver tumors Embolization Chemoembolization Review

Correlates of first dose of measles vaccination delivery and uptake in Indonesia

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Asian Pacific Journal of Tropical Medicine 2011年第2期4卷 140-145页

作者： Renae Fernandez Anu rammohan Niyi Awofeso School of Population Health University of Western AustraliaAustralia School of Business Discipline of EconomicsUniversity of Western AustraliaAustralia School of Public Health and Community Medicine University of New South WalesAustralia

Objective:To determine health systems-related,familial,and cultural factors which influence the delivery and uptake of measles vaccination in ***:Logistic regression analysis of data collected during the 2007 Indonesian Demographic and Health Survey was undertaken by the authors to investigate these *** 2007 Indonesian Demographic and Health Survey dataset is a nationally representative,randomly sampled survey containing 15 065 children aged between 9 and 59 ***:72.8%of children had received the measles *** coverage was similar for males and females;however,coverage was higher amongst urban children,80.1%,compared to 68.5%in rural *** key findings of the regression analysis were congruent with the results of previous research targeting vaccination *** controlling for all other factors,maternal age,maternal education,wealth, the use of a skilled birth attendant,and postnatal check-ups were positively and significantly (P< 0.01) correlated with measles *** number of children per household was negatively correlated(P<0.01).Conclusions:In order to enhance measles vaccination coverage in Indonesia,delivery to,and uptake by,rural and low socio-economic populations require substantial *** health education and health systems improvements are also required.

关键词： Measles Indonesia Vaccination Rural-urban differences Maternal education

NEAR-INFRARED MONITORING OF THE LUMBAR ERECTOR SPINAE MUSCLE IN HEALTHY MEN AND WOMEN DURING STATIC AND DYNAMIC ENDURANCE WORK

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Journal of Innovative Optical Health Sciences 2011年第2期4卷 173-182页

作者： rammohan V.MAIKALA YAGESH N.BHAMBHANIy Liberty Mutual Research Institute for Safety 71 Frankland Road HopkintonMA 01748USA Faculty of Rehabilitation Medicine University of Alberta Edmonton Alberta T6G 2G4Canada

Understanding muscle hemodynamics using near-infrared spectroscopy is increasingly evident in the recent spinal disorders-related ***,none of these human studies addressed the issue of physiological limits for the lumbar muscle within the same participants during various exercise *** purpose of this study is to evaluate physiological limits for the lumbar muscle during dynamic and static endurance *** three separate days,22 healthy men and women performed three endurance protocols(static prone trunk extension,arm cranking,and pushingpulling)until volitional *** each protocol,minimum and maximum oxygenation and blood volume responses from the right lumbar erector spinae were obtained using a continuous dual wavelength near-infrared spectroscopy(Micro-Runman,NIM Inc.,PA,USA).Statistical analysis showed that greatest reduction in oxygenation(minimum)were obtained during dynamic exercises:pushingpulling(2.1 times)and arm cranking(2.03 times)versus static test (P<0:05).Physiological change(calculated as the difference between maximum during recovery and minimum at the point of volitional exhaustion)during static test was lower[(66-75%for oxygenation)and(34-46%for blood volume)]than dynamic exercises (P<0:05).Contrary to the theory that sufficient occlusion of bloodflow to the lumbar muscle is possible with static trunk extension,it was concluded that a dynamic protocol until volitional exhaustion might be a good alternative in establishing near-infrared spectroscopy-derived physiological limits to the lumbar *** research is essential to identify an optimal calibration procedure for establishing true hypoxic values for the human lumbar muscle.

关键词： Arm cranking back muscle endurance gender differences oxygenation and blood volume pushingpulling Sorensen test

Diversity of fungal isolates from fungus-growing termite Macrotermes barneyi and characterization of bioactive compound from Xylaria escharoidea

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Insect Science 2021年第2期28卷 392-402页

作者： Venkateswarulu Nagam rammohan Aluru Muhammad Shoaib Guang-Rui Dong Zhi Li Veera Bramhachari Pallaval Jin-Feng Ni State Key Laboratory of Microbial Technology Microbial technology instituteShandong University72 Binhai RoadQingdaoShandongChina Department of Organic and Biomolecular Chemistry Ural Federal University19 MiraYekaterinburgRussian Federation Department of Biotechnology Krishna UniversityMachilipatnamAndhra PradeshIndia

Owing to their potential applications,as well as their structural diversity,the discovery of novel secondary metabolites from insect-associated fungi has been of interest to researchers in recent *** aim of this study was therefore to estimate the diversity of fungi associated with fungus-growing termites and bioprospecting these for potential secondary *** total,18 fungal species were isolated and described from the gut and comb of Macrotermes barneyi based on 18S ribosomal DNA gene sequence *** activity assays were carried out on all the known fungi,and nine isolates were recorded as active against pathogenic *** escharoidea,the best performing isolate,was grown at laboratory scale and 4,8-dihydroxy-3,4-dihydronaphthalen-l(2H)was isolated and *** minimum inhibitory concentration of this isolated compound against tested pathogenic organisms was found to be 6.25 *** addition,molecular docking studies have revealed that 4,8-dihydroxy-3,4-dihydronaphthalen-l(2H)is a prominent antibacterial agent with a marked interaction with key residues on protein A(agrAc)that regulates the accessory *** findings of this study support the drug discovery of antimicrobial properties in insect-associated fungi,which may lead to novel secondary metabolites.

关键词： fungal isolates Macrotermes barneyi secondary metabolites Xylaria escharoidea

New Greener Alternative for Biocondensation of Aldehydes and Indoles Using Lemon Juice: Formation of Bis-, Tris-, and Tetraindoles

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International Journal of Organic Chemistry 2013年第2期3卷 136-142页

作者： rammohan Pal Department of Chemistry Acharya Jagadish Chandra Bose College Kolkata India

This work presents a new greener alternative for biocondensation of aldehydes and indoles for the synthesis of bis- and tris(indolyl)methanes catalyzed by lemon juice (Citrus limon) in good yields under ultrasound irradiation in aqueous ethanol. Various substituted aldehydes with indoles under this reaction condition are elucidated. Also, tetraindolyl compounds were prepared using terephthaldialdehyde by following the same protocol. This method is an environmentally benign, efficient reaction, which requires shorter reaction time and simple experimental and work-up procedures.

关键词： Citrus limon Juice Biocondensation Aldehydes Indoles Aqueous Ethanol Sonication Bis- Tris- Tetraindoles

Clinical-radiological-pathological correlation of cavernous sinus hemangioma: Incremental value of diffusion-weighted imaging

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World Journal of Radiology 2017年第8期9卷 330-338页

作者： Abhishek Mahajan Vedula Rajni Kanth Rao Gudipati Anantaram ashwin M Polnaya Sandeep Desai Paresh Desai rammohan Vadapalli Manas Panigrahi Department of Radio- diagnosis Tata Memorial Centre Department of Radiology Krishna Institute of Medical Sciences Department of Radiodiagnosis Clumax Imaging Department of Radiology Apollo Victor Hospital Department of Radiology Vijaya Diagnostics Department of Neurosurgery Krishna Institute of Medical Sciences

AIMTo elucidate the clinical, magnetic resonance imaging (MRI), pathological features of these lesions and asses the incremental value of diffusion-weighted imaging (DWI) in diagnosing them. METHODSFifteen consecutive patients (11 females and 4 males; mean age 40.93 years; age range 13-63 years) with cavernous sinus hemangiomas (CSH) who underwent examination between November 2008 and May 2016 were included for the analysis. MRI, clinical and surgical findings of each patient was retrospectively reviewed. DWI were also analysed and mean-apparent diffusion coefficient (ADC) value was calculated. Eleven patients underwent surgical removal of the lesion and 2 patients had biopsy only. Diagnosis of CSH was confirmed histologically in 13 patients. RESULTSEleven patients (73%) presented with headaches and 10 (66%) had cranial nerve involvement. Extra cavernous sinus extension was noted in 14 (94%). Surgery was performed in 13 (87%) and post-operative radiation was given to 4 (28%) patients. Thirteen patients remained asymptomatic on follow up. Three conspicuous imaging features were highly suggestive of the diagnosis: Lack of diffusion restriction (100%), homogeneous hyperintensity on T2 weighted image sequences (93.3%) and intense post-contrast enhancement (100%). The mean ADC was 1.82 × 10-3 ± 0.2186 cm2/s. CONCLUSIONT1-weighted hypointensity with homogeneous hyperintensity on T2-weighted sequences, intense enhancement and absence of hemosiderin within the lesion on GRE sequence favour the diagnosis. Facilitated diffusion on DWI differentiates CSH from other solid cavernous sinus lesions and significantly improves the diagnostic accuracy, a critical factor for planning surgery.

关键词： Cavernous sinus hemangioma Cavernous sinus Magnetic resonance imaging Diffusion weighted imaging

Visible Light Induced Knoevenagel Condensation Catalyzed by Starfruit Juice of <i>Averrhoa carambola</i>

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International Journal of Organic Chemistry 2014年第2期4卷 106-115页

作者： rammohan Pal Taradas Sarkar Department of Chemistry Acharya Jagadish Chandra Bose College Kolkata India

Aqueous starfruit juice catalyzed a simple and efficient Knoevenagel condensation of aromatic aldehydes with malononitrile has been developed under visible light. Products were obtained in yields up to 98% after short reaction times and they were isolated by simple filtration in pure crystallization states. The method is green and economically viable. A plausible mechanism for photochemical Knoevenagel condensation reaction catalyzed by starfruit juice was also predicted.

关键词： Knoevenagel Condensation Aqueous Starfruit Juice Aldehydes Malononitrile Visible Light