Medicine and Health Sciences Commons^™

A Case Report Of Successful Management Of Clostridium Difficile Colitis With Antegrade Fidaxomicin Through A Mucous Fistula Obviating The Need For Subtotal Colectomy., Suzanne Arnott, Matthew Skancke, Sheena Chen, Bruce Abell

Surgery Faculty Publications

Introduction

Clostridium difficile is the most common cause of healthcare-associated infections and can have devastating morbidity and mortality. Traditional treatment algorithms involve intravenous metronidazole and enteric metronidazole or vancomycin. Fidaxomicin (DificidR) targets “switch regions” within RNA polymerases and effectively kills clostridium difficile bacteria and is typically administered orally primarily or through a naso/oro-gastric conduit.

Presentation of case

55-year-old with a recent elective surgical procedure was hospitalized with multifocal pneumonia and subsequently developed clostridium difficile colitis. This patient failed the standard medical therapy for clostridium difficile colitis, decompensated and required surgical exploration, partial colectomy and mucous fistula creation. Following her surgery, …

Transcriptional Alterations In Hereditary And Sporadic Nonfunctioning Pancreatic Neuroendocrine Tumors According To Genotype., Xavier M Keutgen, Suresh Kumar, Sudheer Gara, Myriem Boufraqech, Sunita Agarwal, Ralph H Hruban, Naris Nilubol, Martha Quezado, Richard Finney, Maggie Cam, Electron Kebebew

Surgery Faculty Publications

BACKGROUND

Nonfunctioning pancreatic neuroendocrine tumors (NFPanNETs) may be sporadic or inherited because of germline mutations associated with von Hippel-Lindau disease (VHL) or multiple endocrine neoplasia type 1 (MEN1). The clinical behavior of NFPanNETs is difficult to predict, even in tumors of the same stage and grade. The authors analyzed genotype-specific patterns of transcriptional messenger RNA (mRNA) levels of NFPanNETs to understand the molecular features that determine PanNET phenotype.

METHODS

Thirty-two samples were included for genome-wide mRNA gene expression analysis (9 VHL-associated, 10 MEN1-associated, and 9 sporadic NFPanNETs and 4 purified normal islet cell [NIC] samples). Validation of genes was performed …

Thyroid Cancer: Is It All In The Genes?, Electron Kebebew

Surgery Faculty Publications

No abstract provided.

The Strong Cell-Based Hydrogen Peroxide Generation Triggered By Cold Atmospheric Plasma., Dayun Yan, Haitao Cui, Wei Zhu, Annie Talbot, Lijie Grace Zhang, Jonathan H Sherman, Michael Keidar

Surgery Faculty Publications

Hydrogen peroxide (H2O2) is an important signaling molecule in cancer cells. However, the significant secretion of H2O2 by cancer cells have been rarely observed. Cold atmospheric plasma (CAP) is a near room temperature ionized gas composed of neutral particles, charged particles, reactive species, and electrons. Here, we first demonstrated that breast cancer cells and pancreatic adenocarcinoma cells generated micromolar level H2O2 during just 1 min of direct CAP treatment on these cells. The cell-based H2O2 generation is affected by the medium volume, the cell confluence, as well as the discharge voltage. The application of cold atmospheric plasma (CAP) in cancer …

The World Database For Pediatric And Congenital Heart Surgery: The Dawn Of A New Era Of Global Communication And Quality Improvement In Congenital Heart Disease., James D St Louis, Hiromi Kurosawa, Richard A Jonas, Nestor Sandoval, Jorge Cervantes, Christo I Tchervenkov, Jeffery P Jacobs, Kisaburo Sakamoto, Giovanni Stellin, James K Kirklin

Surgery Faculty Publications

No abstract provided.

Alcohol, Stem Cells And Cancer., Shoujun Gu, Bao-Ngoc Nguyen, Shuyun Rao, Shulin Li, Kirti Shetty, Asif Rashid, Vivek Shukla, Chu-Xia Deng, Lopa Mishra, Bibhuti Mishra

Surgery Faculty Publications

Dosage, gender, and genetic susceptibility to the effects of alcohol remained only partially elucidated. In this review, we summarize the current knowledge of the mechanisms underlying the role of alcohol in liver and gastrointestinal cancers. In addition, two recent pathways- DNA repair and TGF-β signaling which provide new insights into alcohol in the regulation of cancers and stem cells are also discussed here.

Somatic Vhl Mutation In A Patient With Men1-Associated Metastatic Pancreatic Neuroendocrine Tumor Responding To Sunitinib Treatment: A Case Report., Jasmine Shell, Dhaval Patel, Astin Powers, Martha Quezado, Keith Killian, Paul Meltzer, Jack Zhu, Apostolos Gaitanidis, Fatima Karzai, Vladimir Neychev, Patience Green, Electron Kebebew

Surgery Faculty Publications

Multiple endocrine neoplasia type 1 (MEN1) and von Hippel-Lindau (VHL) are autosomal-dominant diseases caused by germline mutations in tumor-suppressor genes. A patient with a germline MEN1 mutation and a somatic VHL mutation in the tumor has not been reported. Herein, we report on a patient with MEN1 and a metastatic nonfunctioning pancreatic neuroendocrine tumor (PNET) with a somatic VHL mutation. This patient underwent a pancreaticoduodenectomy for a grade 2 PNET obstructing her pancreatic duct. The patient developed liver and regional lymph node metastases as well as growth of a PNET in the remnant pancreas. As part of a clinical trial …

Microstructural Alterations And Oligodendrocyte Dysmaturation In White Matter After Cardiopulmonary Bypass In A Juvenile Porcine Model., Gary R Stinnett, Stephen Lin, Alexandru V Korotcov, Ludmila Korotcova, Paul D Morton, Shruti D Ramachandra, Angeline Pham, Sonali Kumar, Kota Agematsu, David Zurakowski, Paul C Wang, Richard A Jonas, Nobuyuki Ishibashi

Surgery Faculty Publications

BACKGROUND: Newly developed white matter (WM) injury is common after cardiopulmonary bypass (CPB) in severe/complex congenital heart disease. Fractional anisotropy (FA) allows measurement of macroscopic organization of WM pathology but has rarely been applied after CPB. The aims of our animal study were to define CPB-induced FA alterations and to determine correlations between these changes and cellular events after congenital heart disease surgery.

METHODS AND RESULTS: Normal porcine WM development was first assessed between 3 and 7 weeks of age: 3-week-old piglets were randomly assigned to 1 of 3 CPB-induced insults. FA was analyzed in 31 WM structures. WM oligodendrocytes, …

Transforming Growth Factor-Β In Liver Cancer Stem Cells And Regeneration, Shuyun Rao, Jaideep Banerjee, Sobia Zaidi, Wilma Jogunoori, Raul Sebastian, Bao-Ngoc Nguyen, Richard L. Amdur, +Several Additional Authors

Surgery Faculty Publications

Cancer stem cells have established mechanisms that contribute to tumor heterogeneity as well as resistance to therapy. Over 40% of hepatocellular carcinomas (HCCs) are considered to be clonal and arise from a stem-like/cancer stem cell. Moreover, HCC is the second leading cause of cancer death worldwide, and an improved understanding of cancer stem cells and targeting these in this cancer are urgently needed. Multiple studies have revealed etiological patterns and multiple genes/pathways signifying initiation and progression of HCC; however, unlike the transforming growth factor β (TGF-β) pathway, loss of p53 and/or activation of β-catenin do not spontaneously drive HCC in …

Hic1 (Hypermethylated In Cancer 1) Sumoylation Is Dispensable For Dna Repair But Is Essential For The Apoptotic Dna Damage Response (Ddr) To Irreparable Dna Double-Strand Breaks (Dsbs)., Sonia Paget, Marion Dubuissez, Vanessa Dehennaut, Joe Nassour, Brennan T Harmon, Nathalie Spruyt, Ingrid Loison, Corinne Abbadie, Brian R Rood, Dominique Leprince

Surgery Faculty Publications

The tumor suppressor gene HIC1 (Hypermethylated In Cancer 1) encodes a transcriptional repressor mediating the p53-dependent apoptotic response to irreparable DNA double-strand breaks (DSBs) through direct transcriptional repression of SIRT1. HIC1 is also essential for DSB repair as silencing of endogenous HIC1 in BJ-hTERT fibroblasts significantly delays DNA repair in functional Comet assays. HIC1 SUMOylation favours its interaction with MTA1, a component of NuRD complexes. In contrast with irreparable DSBs induced by 16-hours of etoposide treatment, we show that repairable DSBs induced by 1 h etoposide treatment do not increase HIC1 SUMOylation or its interaction with MTA1. Furthermore, HIC1 SUMOylation …