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Emerging role of cell-free DNA in kidney transplantation

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World Journal of Experimental Medicine 2021年第5期11卷 55-65页

作者： Bhavna Chopra Kalathil K sureshkumar Nephrology and Hypertension Allegheny General HospitalPittsburghPA 15212United States Division of Nephrology Department of MedicineAllegheny General HospitalAllegheny Health NetworkPittsburghPA 15212United State

Monitoring kidney transplants for rejection conventionally includes serum creatinine,immunosuppressive drug levels,proteinuria,and donor-specific antibody(DSA).Serum creatinine is a late marker of allograft injury,and the predictive ability of DSA regarding risk of rejection is *** analysis of an allograft biopsy is the standard method for diagnosing rejection but is invasive,inconvenient,and carries risk of *** has been a long quest to find a perfect biomarker that noninvasively predicts tissue injury caused by rejection at an early stage,so that diagnosis and treatment could be pursued without delay in order to minimize irreversible damage to the *** this review,we discuss relatively novel research on identifying biomarkers of tissue injury,specifically elaborating on donor-derived cell-free DNA,and its clinical utility.

关键词： Biomarker Donor-derived cell-free DNA Kidney allograft outcomes Kidney transplant Allograft biopsy

Recurrent isochromosome 21 and multiple abnormalities in a patient suspected of having acute myeloid leukemia with eosinophilic differentiation—a rare case from South India

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Chinese Journal of Cancer 2012年第1期31卷 45-50页

作者： Sangeetha Vijay Santhi Sarojam sureshkumar Raveendran Vani Syamala Sreeja Leelakumari Geetha Narayanan Sreedharan Hariharan Division of Cancer Research Regional Cancer CentreMedical CollegeThiruvananthapuramKerala 695011India Division of Medical Oncology Regional Cancer CentreMedical CollegeThiruvananthapuramKerala 695011India

Acute myeloid leukemia (AML) is a phenotypically heterogeneous disorder. The M4 subtype of AML is frequently associated with the cytogenetic marker inversion 16 and/or the presence of eosinophilia. Blast crisis is the aggressive phase of the triphasic chronic myeloid leukemia (CML), which is a disease with Philadelphia (Ph) chromosome as the major abnormality. In the present study, we report a 76-year-old patient suspected of having AML with eosinophilic differentiation (AML-M4), which in clinical tests resembles CML blast crisis with multiple chromosomal abnormalities. Isochromosome 21 [i(21)(q10)] was the most recurrent feature noted in metaphases with 46 chromosomes. Ring chromosome, tetraploid endoreduplication, recurrent aneuploid clones with loss of X chromosome, monosomy 17, monosomy 7, and structural variation translocation (9;14) were also observed in this patient. Fluorescent in situ hybridization (FISH) confirmed the absence of Ph chromosome. This report shows how cytogenetic analyses revealed atypical structural aberrations in the M4 subtype of AML.

关键词：慢性粒细胞白血病嗜酸性粒细胞等臂染色体染色体异常髓细胞急性细胞遗传学分析复发

Vaccinations in kidney transplant recipients: Clearing the muddy waters

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World Journal of Transplantation 2019年第1期9卷 1-13页

作者： Swati Arora Gretchen Kipp Nitin Bhanot Kalathil K sureshkumar Divisions of Nephrology and Hypertension Allegheny General HospitalAllegheny Health Network Department of Pharmacy Allegheny General HospitalAllegheny Health Network Infectious Diseases Department of MedicineAllegheny General HospitalAllegheny Health Network

Vaccine preventable diseases account for a significant proportion of morbidity and mortality in transplant recipients and cause adverse outcomes to the patient and allograft. Patients should be screened for vaccination history at the time of pre-transplant evaluation and vaccinated at least four weeks prior to transplantation. For non-immune patients, dead-vaccines can be administered starting at six months post-transplant. Live attenuated vaccines are contraindicated after transplant due to concern for infectious complications from the vaccine and every effort should be made to vaccinate prior to *** transplant recipients are on life-long immunosuppression, these patients may have lower rates of serological conversion, lower mean antibody titers and waning of protective immunity over shorter period as compared to general population. Recommendations regarding booster dose in kidney transplant recipients with sub-optimal serological response are lacking. Travel plans should be part of routine post-transplant assessment and pre-travel vaccines and counseling should be provided. More studies are needed on vaccination schedules, serological response, need for booster doses and safety of live attenuated vaccines in this special population.

关键词： Immunizations Kidney transplant Vaccines Transplant outcomes Serological response

Effect of Zr^(4+)on piezoelectric,dielectric and ferroelectric properties of barium calcium titanate lead-free ceramics

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Journal of Advanced Dielectrics 2021年第6期11卷 23-31页

作者： Prasanta Kumar Panda Benudhar Sahoo V.sureshkumar Ekaterina Dmitrievna Politova Materials Science Division CSIR-National Aerospace Laboratories KodihalliBengaluru 560017India Semenov Federal Research Centre for Chemical Physics Russian Academy of Sciences Kosygin 4Moscow 119991Russia

Ba_(0.85)Ca_(0.15)(Ti1−xZrx)O_(3)(BCTZ)ceramics with x=0.05,0.10,_(0.15),0.20,0.25,0.30 were prepared by the solid-state reaction *** of the powders was carried out at 1100°C for 4 h and the green pellets were sintered at 1400°C for 2 h.X-ray diffraction patterns of the sintered pellets showed tetragonal splitting up to x=0.10 while the mixture of the rhombohedral/cubic phase appeared at higher ZrO_(2)*** piezoelectric charge constant d33=510 pC/N and strain(S=0.103%)were measured for BCT doped by 0.10 mol ZrO_(2).Dielectric constant,remnant polarization and saturation polarization also found maxima for this *** Curie temperature(TC)of the compositions decreased with increase in ZrO_(2)concentration and reached 98°C,87°C and 36°C at x=0.05,0.10,_(0.15)mol,*** remaining compositions have TC below the room temperature;therefore,they can be used for subzero/cryogenic *** scanning electron microscopy study revealed an increase in grain size with increase in ZrO_(2)concentration and confirmed the complete solubility of ZrO_(2)in the crystal ***,low ZrO_(2)-doped BCT compositions with high d33 could be suitable for low temperature(<80°C)applications.

关键词： ZrO_(2)-doped BCT lead-free piezoelectrics high piezoelectric charge constant Curie temperature

Clinical Efficacy of Inhaled Nitric Oxide in Preventing the Progression of Moderate to Severe COVID-19 and Its Correlation to Viral Clearance:Results of a Pilot Study

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Infectious Microbes & Diseases 2022年第1期4卷 26-33页

作者： Merlin Moni Thushara Madathil Dipu T.Sathyapalan Veena Menon Georg Gutjahr Fabia Edathadathil Deepthi sureshkumar Preetha Prasanna Soumya Jose Roshni Jerome Ajai Krishnan Indulekha C.L.Pillai Geetha Kumar Bipin Nair Victor Nizet Aveek Jayant Department of Medicine Division of Infectious DiseasesAmrita Institute of Medical ScienceAmrita Vishwa VidyapeethamKochiKeralaIndia Department of Cardiac Anaesthesiology Amrita Institute of Medical ScienceAmrita Vishwa VidyapeethamKochiKeralaIndia Clinical Virology Laboratory Amrita Institute of Medical SciencesAmrita Vishwa VidyapeethamKochiKeralaIndia Center for Research in Analytics and Technologies for Education(CREATE) Amrita Vishwa VidyapeethamAmritapuriKollamKeralaIndia Department of Infection Control and Epidemiology Amrita Institute of Medical ScienceAmrita Vishwa VidyapeethamKochiKeralaIndia School of Medicine Amrita Institute of Medical ScienceAmrita Vishwa VidyapeethamKochiKeralaIndia School of Biotechnology Amrita Vishwa VidyapeethamAmritapuriKollamKeralaIndia Skaggs School of Pharmacy and Pharmaceutical Sciences University of CaliforniaSan DiegoLa JollaCaliforniaUSA Department of Pediatrics University of CaliforniaSan DiegoLa JollaCaliforniaUSA

Hypoxic patients with coronavirus disease 2019(COVID-19)are at high risk of adverse *** nitric oxide(iNO)has shown anti-viral and immunomodulatory effects in ***,in vivo evidence of efficacy in hypoxic COVID-19 is *** open label feasibility study was conducted at a single referral center in South India and evaluated the effectiveness of repurposed iNO in improving clinical outcomes in COVID-19 and its correlation with viral *** recruited hypoxemic COVID-19 patients and allocated them into treatment(iNO)and control groups(1:1).Viral clearance on day 5 favored the treatment group(100%vs 72%,P<0.01).The speed of viral clearance as adjudged by normalized longitudinal cycle threshold(Ct)values was positively impacted in the treatment *** proportion of patients who attained clinical improvement,defined as a≥2-point change on the World Health Organization ordinal scale,was higher in the iNO cohort(n=11,79%)as compared to the control group(n=4,36%)(odds ratio 6.42,95%confidence interval 1.09–37.73,P=0.032).The proportion of patients progressing to mechanical ventilation in the control group(4/11)was significantly higher than in the treatment group(0/14).The all-cause 28-day mortality was significantly different among the study arms,with 36%(4/11)of the patients dying in the control group while none died in the treatment *** numbers needed to treat to prevent an additional poor outcome of death was estimated to be *** study demonstrates the putative role of repurposed iNO in hypoxemic COVID-19 patients and calls for extended validation.

关键词： nitric oxide COVID-19 antiviral activity WHO ordinal scale

Effects of clump spacing on nutrient distribution and root activity of Dendrocalamus strictus in the humid region of Kerala,peninsular India

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Journal of Forestry Research 2017年第6期28卷 1133-1144页

作者： B. H. Kittur K. Sudhakara B. Mohan Kumar T. K. Kunhamu P. sureshkumar Department of Silviculture and Agroforestry College of Forestry Kerala Agricultural UniversityVellanikkara Thrissur Kerala 680656 India School of Ecology and Environment Studies Nalanda University Rajgir District Nalanda Bihar 803116 India Department of Soil Science and Agricultural Chemistry Radio-tracer Laboratory College of Horticulture Kerala Agricultural University Vellanikkara ThrissurKerala 680656 India

The humid agroclimatic conditions of Kerala,India permit the cultivation of an array of bamboo species of which Dendrocalamus strictus Roxb.(Nees.) is an important one on account of its high growth rate and multiple uses. Stand density, a potential tool in controlling the productivity of woody ecosystems, its effect on growth and root distribution patterns may provide a better understanding of productivity optimization especially when bamboo-based intercropping options are *** attributes of 7-year-old bamboo(D. strictus) stands managed at variable spacing(4×4 m, 6×6 m, 8×8 m,10×10 m, 12×12 m) were studied. Functional root activity among bamboo clumps were also studied using a radio tracer soil injection method in which the radio isotopeP was applied to soil at varying depths and lateral distances from the clump. Results indicate that spacing exerts a profound influence on growth of bamboo. Widely spaced bamboo exhibited higher clump diameters and crown widths while clump heights were better under closer spacing. Clump height was 30% lower and DBH 52%higher at the widest spacing(12×12 m) compared to the closest spacing(4×4 m). With increasing soil depth and lateral distance, root activity decreased significantly. Root activity near the clump base was highest(809 counts per minute, cpm; 50 cm depth and 50 cm lateral distance) at 4×4 m. Tracer study further showed wider distribution of root activity with increase in clump spacing. It may be concluded that the intensive foraging zone of bamboo is within a 50-cm radius around the clump irrespective of spacing. N, P and K content in the upper 20 cm was 2197,21, and 203 kg/ha respectively for the closely spaced bamboo(4×4 m) which were significantly higher than corresponding nutrient content at wider spacings. About 50% of N, P and K were present within the 0–20 cm soil layer, which decreased drastically beyond the 20 cm *** results suggest that stand management practices through planting density regula

关键词： Bamboo Clump spacing Functional root activity Radio tracer 32P Soil nutrients

Kidney transplantation in older recipients:Preemptive high KDPI kidney vs lower KDPI kidney after varying dialysis vintage

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World Journal of Transplantation 2018年第4期8卷 102-109页

作者： Bhavna Chopra Kalathil K sureshkumar Division of Nephrology and Hypertension Department of Medicine Allegheny General Hospital Allegheny Health Network

AIM To evaluate the outcomes of transplanting marginal kidneys preemptively compared to better-quality kidneys after varying dialysis vintage in older *** Using OPTN/United Network for Organ Sharing database from 2001-2015, we identified deceased donor kidney(DDK) transplant recipients > 60 years of age who either underwent preemptive transplantation of kidneys with kidney donor profile index(KDPI) ≥ 85%(marginal kidneys) or received kidneys with KDPI of 35%-84%(better quality kidneys that older wait-listed patients would likely receive if waited longer) after being on dialysis for either 1-4 or 4-8 years. Using a multivariate Cox model adjusting for donor, recipient and transplant related factors-overall and death-censored graft failure risks along with patient death risk of preemptive transplant recipients were compared to transplant recipients in the 1-4 and 4-8 year dialysis vintage *** The median follow up for the whole group was 37 mo(interquartile range of 57 mo). A total of 6110 DDK transplant recipients above the age of 60 years identified during the study period were found to be eligible to be included in the analysis. Among these patients350 received preemptive transplantation of kidneys with KDPI ≥ 85. The remaining patients underwent transplantation of better quality kidneys with KDPI 35-84% after being on maintenance dialysis for either 1-4 years(n = 3300) or 4-8 years(n = 2460). Adjusted overall graft failure risk and death-censored graft failure risk in preemptive high KDPI kidney recipients were similar when compared to group that received lower KDPI kidney after being on maintenance dialysis for either 1-4 years(HR 1.01, 95%CI: 0.90-1.14, P = 0.84 and HR 0.96, 95%CI: 0.79-1.16, P = 0.66 respectively) or 4-8 years(HR 0.82, 95%CI: 0.63-1.07, P = 0.15 and HR 0.81, 95%CI: 0.52-1.25, P = 0.33 respectively). Adjusted patient death risk in preemptive high KDPI kidney recipients were similar when compared to groups that received l

关键词： Preemptive kidney transplantation Kidney donor profile index Dialysis vintage Kidney transplant outcomes Older recipients Waiting list

Changing organ allocation policy for kidney transplantation in the United States

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World Journal of Transplantation 2015年第2期5卷 38-43页

作者： Bhavna Chopra Kalathil K sureshkumar Division of Nephro-logy and Hypertension Department of Medicine Allegheny General Hospital

The new kidney allocation scheme(KAS) in effect since December 4th 2014 was designed to overcome the shortcomings of previous system. A key feature of the new KAS is preferential allocation of best quality organs to wait-list candidates with the longest predictivesurvival in a concept called longevity matching. Highly sensitized recipients would get extra points and enjoy widespread sharing of organs in order to increase accessibility to transplant. Wait-list candidates with blood group B will be offered organs from donors with A2 and A2 B blood type in order to shorten their wait-list time. Time on the wait list will start from day of listing or date of initiation of dialysis whichever comes first which should benefit candidates with limited resources who might be late to get on the transplant list. Pay back system has been eliminated in the new KAS. These changes in organ allocation policy may lead to increase in median half-life of the allograft and increase the number of transplants; thus resulting in better utilization of a scarce resource. There could be unintended negative consequences which may become evident over time.

关键词： New kidney allocation scheme Longevity matching Highly sensitized Kidney donor profile index Expected post-transplant survival

Dynamics and rheology of micellar fluids from molecular dynamics simulations

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Dynamics and rheology of micellar fluids from molecular dyna...