Endovascular interventions for central vein stenosis

( Anil K. Agarwal ) 대한신장학회 2015 Kidney Research and Clinical Practice Vol.34 No.4

Central vein stenosis is common because of the placement of venous access and cardiac intravascular devices and compromises vascular access for dialysis. Endovascular intervention with angioplasty and/or stent placement is the preferred approach, but the results are suboptimal and limited. Primary patency after angioplasty alone is poor, but secondary patency can be maintained with repeated angioplasty. Stent placement is recommended for quick recurrence or elastic recoil of stenosis. Primary patency of stents is also poor, though covered stents have recently shown better patency than bare metal stents. Secondary patency requires repeated intervention. Recanalization of occluded central veins is tedious and not always successful. Placement of hybrid graft-catheter with a combined endovascular surgical approach can maintain patency in many cases. In the presence of debilitating symptoms, palliative approach with endovascular banding or occlusion of the access may be necessary. Prevention of central vein stenosis is the most desirable strategy.

Studies on the Effect of Picolines on the Stereochemistry of Lanthanide(III) Nitrate Coordination Compounds of 4[N-Furfural)amino]antipyrine Semicarbazone and Antibacterial Activities

Agarwal, Ram K.,Agarwal, Himanshu,Prasad, Surendra,Kumar, Anil Korean Chemical Society 2011 대한화학회지 Vol.55 No.4

4[N-(furfural)amino]antipyrine semicarbazone(FFAAPS)와 질산 란탄(III)이 형성하는 배위화합물의 입체화학에 미치는 ${\alpha}$-, ${\beta}$- 및 ${\gamma}$-picolines의 영향을 연구하였다. 이들 배위화합물의 일반적 조성은 [Ln(FFAAPS)$(NO_3)_3$Pic] (Ln=La, Pr, Nd, Sm, Gd, Tb, Dy 또는 Ho 및 Pic=${\alpha}$-, ${\beta}$- or ${\gamma}$-picolines)이다. 모든 배위화합물은 원소분석, 분자량, 몰전기전도도, 자기수자율, 적외선 및 자외선 스펙트럼으로 특성을 조사하였다. 적외선 연구결과 FFAAPS는 N, N, O 주개를 갖는 중성 삼배위 리간드로 행동하는 반면, ${\alpha}$-, ${\beta}$- 또는 ${\gamma}$-picoline는 헤테로 N-원자를 통하여 란탄(III) 이온에 배위된다. 질산 음이온은 이들 화합물에서 이배위로 결합한다. 자외선 스펙트럼 결과로부터 전자구름 퍼짐 효과(${\beta}$), covalence factor($b^{1/2}$), Sinha parameter (${\delta}%$) 및 covalence angular overlap parameter(${\eta}$)를 계산하였다. 이들 착물의 열적성질을 열무게 분석법에 의해 연구하였다. 본 화합물에 있어서 란탄(III)의 배위수는 10으로 조사되었다. 기본 리간드인 FFAAPS와 착물의 항박테리아 선별조사 결과, 이들 착물은 중간 정도의 항박테리아 활성을 보였다. The effect of ${\alpha}$-, ${\beta}$- and ${\gamma}$-picolines on the stereochemistry of the coordination compounds of lanthanide(III) nitrates derived from 4[N-(furfural)amino]antipyrine semicarbazone (FFAAPS) has been studied. The general composition of the present coordination compounds is [Ln(FFAAPS)$(NO_3)_3$Pic] (Ln=La, Pr, Nd, Sm, Gd, Tb, Dy or Ho and Pic=${\alpha}$-, ${\beta}$- or ${\gamma}$-picolines). All these coordination compounds have been characterized by elemental analyses, molecular weight, molar conductance, magnetic susceptibility, infrared and electronic spectra. The infrared studies suggest that the FFAAPS behaves as a neutral tridentate ligand with N, N, O donor while ${\alpha}$-, ${\beta}$- or ${\gamma}$-picoline is coordinated to the lanthanide(III) ions via heterocyclic N-atom. Nitrates are bicovalently bonded in these compounds. From the electronic spectral data, nephelauxetic effect (${\beta}$), covalence factor ($b^{1/2}$), Sinha parameter (${\delta}%$) and the covalence angular overlap parameter (${\eta}$) have been calculated. Thermal stabilities of these complexes have been studied by thermogravimetric analysis. The coordination number of lanthanide(III) ions in the present compound is found to be ten. The antibacterial studies screening of the primary ligand FFAAPS and the complexes showed that the present complexes have moderate antibacterial activities.

Comparative Evaluation of Several Gene Targets for Designing a Multiplex-PCR for an Early Diagnosis of Extrapulmonary Tuberculosis

Promod K. Mehta,Ankush Raj,Netrapal Singh,Krishna B. Gupta,Dhruva Chaudhary,Aparna Yadav,Anil Chaudhary,Kshitij Agarwal,Mandira Varma-Basil,Rajendra Prasad,Gopal K. Khuller 연세대학교의과대학 2016 Yonsei medical journal Vol.57 No.1

Purpose: Diagnosis of extrapulmonary tuberculosis (EPTB) poses serious challenges. A careful selection of appropriate gene targetsis essential for designing a multiplex-polymerase chain reaction (M-PCR) assay. Materials and Methods: We compared several gene targets of Mycobacterium tuberculosis, including IS6110, devR, and genes encodingMPB-64 (mpb64), 38kDa (pstS1), 65kDa (hsp65), 30kDa (fbpB), ESAT-6 (esat6), and CFP-10 (cfp10) proteins, using PCR assayson 105 EPTB specimens. From these data, we chose the two best gene targets to design an M-PCR. Results: Among all gene targets tested, mpb64 showed the highest sensitivity (84% in confirmed cases and 77.5% in clinically suspectedcases), followed by IS6110, hsp65, 38kDa, 30kDa, esat6, cfp10, and devR. We used mpb64+IS6110 for designing an M-PCR assay. Our M-PCR assay demonstrated a high sensitivity of 96% in confirmed EPTB cases and 88.75% in clinically suspected EPTB cases with a high specificity of 100%, taking clinical diagnosis as the gold standard. Conclusion: These M-PCR results along with the clinical findings may facilitate an early diagnosis of EPTB patients and clinical management of disease.

Depression masquerading as chest pain in a patient with Wolff Parkinson White syndrome

( Rajashree Madabush ),( Anil Agarwal ),( Saipriya Tewar ),( Sujeet K S Gautam ),( Sandeep Khuba ) 대한통증학회 2016 The Korean Journal of Pain Vol.29 No.4

Wolff Parkinson White (WPW) syndrome is a condition in which there is an aberrant conduction pathway between the atria and ventricles, resulting in tachycardia. A 42-year-old patient, who was treated for WPW syndrome previously, presented with chronic somatic pain. With her cardiac condition in mind, she was thoroughly worked up for a recurrence of disease. As part of routine screening of all patients at our pain clinic, she was found to have severe depression as per the Patient Health Questionnaire-9 (PHQ-9) criteria. After ruling out sinister causes, she was treated for depression using oral Duloxetine and counselling. This led to resolution of symptoms, and improved her mood and functional capability. This case highlights the use of psychological screening tools and diligent examination in scenarios as confusing as the one presented here. Addressing the psychological aspects of pain and adopting a holistic approach are as important as treatment of the primary pathology. (Korean J Pain 2016; 29: 262-5)

Interleukin-1B (IL-1B-31 and IL-1B-511) and interleukin-1 receptor antagonist (IL-1Ra) gene polymorphisms in primary immune thrombocytopenia

Deependra Kumar Yadav,Anil Kumar Tripathi,Divya Gupta,Saurabh Shukla,Aloukick Kumar Singh,Ashutosh Kumar,Jyotsna Agarwal,K. N. Prasad 대한혈액학회 2017 Blood Research Vol.51 No.4

Background: Immune thrombocytopenia (ITP) is an immune-mediated disease caused by autoanti-bodies against platelets membrane glycoproteins GPIIb/IIIa and GPIb/IX. The etiology of ITP remains unclear. This study evaluated the association of polymorphisms in interleukin (IL)-1B-31, IL-1B-511, and IL-1Ra with ITP. Methods: Genotyping of IL-1B-31, IL-1B-511, and IL-1Ra was performed in 118 ITP patients and 100 controls by polymerase chain reaction restriction fragment length polymorphism and detection of variable number tandem repeats. Results: Genotype differences in IL-1B-31 and IL-1Ra were significantly associated with ITP. Patients showed a higher frequency of the IL-1B-31 variant allele (T) and a 1.52-fold greater risk of susceptibility to ITP (odds ratio [OR]=1.52, 95% confidence interval [CI]=1.04‒2.22, P=0.034). The frequencies of both homozygous and heterozygous variant geno-types of IL-1B-31 were higher (OR=2.33, 95% CI=1.069‒5.09, P=0.033 and OR=2.044, 95% CI=1.068‒39, P=0.034) among patients and were significantly associated with ITP susceptibility. Both homozygous and heterozygous variant genotypes of IL-1Ra were also more frequent (OR=4.48, 95% CI=1.17‒17.05, P=0.0230 and OR=1.80, 95% CI=1.03‒3.14, P=0.0494) among patients and were associated with ITP risk. IL-1B-31 and IL-1Ra also showed significant association with severe ITP. However, IL-1B-511 was not asso-ciated with ITP. Conclusion: IL-1B-31 and IL-1Ra polymorphisms may significantly impact ITP risk, and they could be associated with disease severity, which may contribute to the pathogenesis of ITP.

Interleukin-1B (IL-1B-31 and IL-1B-511) and interleukin-1 receptor antagonist (IL-1Ra) gene polymorphisms in primary immune thrombocytopenia

Deependra Kumar Yadav,Anil Kumar Tripathi,Divya Gupta,Saurabh Shukla,Aloukick Kumar Singh,Ashutosh Kumar,Jyotsna Agarwal,K. N. Prasad 대한혈액학회 2017 Blood Research Vol.52 No.4

Background: Immune thrombocytopenia (ITP) is an immune-mediated disease caused by autoanti-bodies against platelets membrane glycoproteins GPIIb/IIIa and GPIb/IX. The etiology of ITP remains unclear. This study evaluated the association of polymorphisms in interleukin (IL)-1B-31, IL-1B-511, and IL-1Ra with ITP. Methods: Genotyping of IL-1B-31, IL-1B-511, and IL-1Ra was performed in 118 ITP patients and 100 controls by polymerase chain reaction restriction fragment length polymorphism and detection of variable number tandem repeats. Results: Genotype differences in IL-1B-31 and IL-1Ra were significantly associated with ITP. Patients showed a higher frequency of the IL-1B-31 variant allele (T) and a 1.52-fold greater risk of susceptibility to ITP (odds ratio [OR]=1.52, 95% confidence interval [CI]=1.04‒2.22, P=0.034). The frequencies of both homozygous and heterozygous variant geno-types of IL-1B-31 were higher (OR=2.33, 95% CI=1.069‒5.09, P=0.033 and OR=2.044, 95% CI=1.068‒39, P=0.034) among patients and were significantly associated with ITP susceptibility. Both homozygous and heterozygous variant genotypes of IL-1Ra were also more frequent (OR=4.48, 95% CI=1.17‒17.05, P=0.0230 and OR=1.80, 95% CI=1.03‒3.14, P=0.0494) among patients and were associated with ITP risk. IL-1B-31 and IL-1Ra also showed significant association with severe ITP. However, IL-1B-511 was not asso-ciated with ITP. Conclusion: IL-1B-31 and IL-1Ra polymorphisms may significantly impact ITP risk, and they could be associated with disease severity, which may contribute to the pathogenesis of ITP.

Reappraisal of the Role of Ascitic Fluid Adenosine Deaminase for the Diagnosis of Peritoneal Tuberculosis in Cirrhosis

( Amol Sonyabapu Dahale ),( Amarender Singh Puri ),( Sanjeev Sachdeva ),( Anil K Agarwal ),( Ajay Kumar ),( Ashok Dalal ),( Pritul D Saxena ) 대한소화기학회 2021 대한소화기학회지 Vol.78 No.3

Background/Aims: Although peritoneal tuberculosis (TB) is one of the important differential diagnoses among cirrhotic patients with ascites, a peritoneal biopsy is not always available. High ascitic fluid adenosine deaminase (ADA) has been indicative of peritoneal TB. On the other hand, studies to assess its diagnostic utility based on the confirmation of peritoneal biopsy in cirrhotic patients are scarce. Methods: Patients with new-onset ascites were enrolled prospectively from a tertiary hospital. Peritoneal biopsy was applied according to clinical judgment when required. Based on pathology diagnosis of the peritoneum, the diagnostic efficacy of ascitic fluid ADA for peritoneal TB was evaluated in total and cirrhotic patients, respectively. Results: Among 286 patients enrolled, 78 were diagnosed with peritoneal TB. One hundred and thirty-two patients had cirrhosis, and 30 of those were diagnosed with peritoneal TB. The mean ADA was 72.2 U/L and 22.7 U/L in the peritoneal and non-peritoneal TB group, respectively, among the total study population, and 64.0 U/L and 19.1 U/L in the peritoneal and non-peritoneal TB group, respectively, among the subgroup with cirrhosis. The area under the curve for ADA to diagnose peritoneal TB was 0.96 in the total study population with a cutoff value of 41.1 U/L, and 0.93 in cirrhotic patients with a cutoff value of 39.9 U/L. Conclusions: The ascitic fluid ADA measurements showed high diagnostic performance for peritoneal tuberculosis in patients with ascites regardless of cirrhosis at a similar cutoff value. (Korean J Gastroenterol 2021;78:168-176)