Medicine and Health Sciences Commons^™

An Exploration Of The Quality Of Relationship Between Step-Children And Step-Parents Based On Address Term Usage, Sierra R. Payton

Theses and Dissertations

This study aimed to examine address term usage as a communicative component of blended/step-families by examining the address terms that step-children use to address their step-parent and whether address term usage can allude to the quality of relationship reported by step-children within the step-child step-parent relationship. Rowan University undergraduate students (n=67) were recruited to complete questionnaires on address term usage and quality of relationship using the Quality of Relationships Inventory (QRI). Address term usage was the independent variable and was measured using three levels: formal, familiar, and familial. Quality of relationship was the dependent variable and was measured using the …

The Persistence Of The Associate Degree Nursing Student: The Lost Nurse, Stella A. Barber

Theses and Dissertations

There is controversy surrounding the entry-level degree to the profession of nursing. This study had the focus of showing the persistence of the associate degree nursing student as a way of giving evidence to maintaining this pathway as entry to nursing. Narrative inquiry was used to interview 10 students and 3 faculty on the persistence of the nursing student. Callista Roy's Coping Adaptation Processing Scale was taken by 51 students enrolled in the same nursing program. The overarching themes of the student interviews were goals, learning environment, and admission criteria. The overarching theme as a result of the Coping Adaptation …

Older Adults' Health Care Utilization A Year After Experiencing Fear Or Distress From Hurricane Sandy, Laura P Sands, Yimeng Xie, Rachel Pruchno, Allison Heid, Yili Hong

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

OBJECTIVE: To determine whether self-reports of disaster-related psychological distress predict older adults' health care utilization during the year after Hurricane Sandy, which hit New Jersey on October 29, 2012.

METHODS: Respondents were from the ORANJ BOWL Study, a random-digit dialed sample from New Jersey recruited from 2006 to 2008. Medicare hospital, emergency department (ED) and outpatient claims data from 2012 and 2013 were matched to 1607 people age 65 and older in 2012 who responded to follow-up surveys conducted from July 2013 to July 2015 to determine their hurricane-related experiences.

RESULTS: In total, 7% (107) of respondents reported they experienced …

Cysteine Residues Contribute To The Dimerization And Enzymatic Activity Of Human Nuclear Dutp Nucleotidohydrolase (Ndut)., Shawna M Rotoli, Julia L Jones, Salvatore J Caradonna

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

dUTPase is an enzyme found in all organisms that have thymine as a constituent of DNA. Through evolution, humans have two major isoforms of dUTPase: a mitochondrial (mDut) and a nuclear (nDut) isoform. The nuclear isoform of dUTPase is a 164-amino-acids-long protein containing three cysteine residues. nDut's starting methionine is post-translationally cleaved, leaving four unique amino acids on its amino-terminus including one cysteine residue (C3). These are not present in the mitochondrial isoform (mDut). Using mass spectrometry analyses of recombinant dUTPase constructs, we have discovered an intermolecular disulfide bridge between cysteine-3 of each nDut monomer. We have found that these …

Iron-Dependent Cleavage Of Ribosomal Rna During Oxidative Stress In The Yeast Saccharomyces Cerevisiae, Jessica A Zinskie, Arnab Ghosh, Brandon M Trainor, Daniel Shedlovskiy, Dimitri G Pestov, Natalia Shcherbik

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

Stress-induced strand breaks in rRNA have been observed in many organisms, but the mechanisms by which they originate are not well-understood. Here we show that a chemical rather than an enzymatic mechanism initiates rRNA cleavages during oxidative stress in yeast (Saccharomyces cerevisiae). We used cells lacking the mitochondrial glutaredoxin Grx5 to demonstrate that oxidant-induced cleavage formation in 25S rRNA correlates with intracellular iron levels. Sequestering free iron by chemical or genetic means decreased the extent of rRNA degradation and relieved the hypersensitivity of grx5Δ cells to the oxidants. Importantly, subjecting purified ribosomes to an in vitro iron/ascorbate …

Escherichia Coli Itat Is A Type Ii Toxin That Inhibits Translation By Acetylating Isoleucyl-Trnaile, Brendan Wilcox, Ilya Osterman, Marina Serebryakova, Dmitry Lukyanov, Ekaterina Komarova, Bridget Gollan, Natalia Morozova, Yuri I Wolf, Kira S Makarova, Sophie Helaine, Petr Sergiev, Svetlana Dubiley, Sergei Borukhov, Konstantin Severinov

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

Prokaryotic toxin-antitoxin (TA) modules are highly abundant and are involved in stress response and drug tolerance. The most common type II TA modules consist of two interacting proteins. The type II toxins are diverse enzymes targeting various essential intracellular targets. The antitoxin binds to cognate toxin and inhibits its function. Recently, TA modules whose toxins are GNAT-family acetyltransferases were described. For two such systems, the target of acetylation was shown to be aminoacyl-tRNA: the TacT toxin targets aminoacylated elongator tRNAs, while AtaT targets the amino acid moiety of initiating tRNAMet. We show that the itaRT gene pair from Escherichia coli …

N-Terminal Domain Of Human Uracil Dna Glycosylase (Hung2) Promotes Targeting To Uracil Sites Adjacent To Ssdna-Dsdna Junctions, Brian P Weiser, Gaddiel Rodriguez, Philip A Cole, James T Stivers

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

The N-terminal domain (NTD) of nuclear human uracil DNA glycosylase (hUNG2) assists in targeting hUNG2 to replication forks through specific interactions with replication protein A (RPA). Here, we explored hUNG2 activity in the presence and absence of RPA using substrates with ssDNA-dsDNA junctions that mimic structural features of the replication fork and transcriptional R-loops. We find that when RPA is tightly bound to the ssDNA overhang of junction DNA substrates, base excision by hUNG2 is strongly biased toward uracils located 21 bp or less from the ssDNA-dsDNA junction. In the absence of RPA, hUNG2 still showed an 8-fold excision bias …

The Role Of Developmental Timing Regulators In Progenitor Proliferation And Cell Fate Specification During Mammalian Neurogenesis, Jennifer S. Romer-Seibert

Graduate School of Biomedical Sciences Theses and Dissertations

Developmental timing is a key aspect of tissue and organ formation in which distinct cell types are generated through a series of steps from common progenitors. These progenitors undergo specific changes in gene expression that signifies both a distinct progenitor type and developmental time point that thereby specifies a particular cell fate at that stage of development. The nervous system is an important setting for understanding developmental timing because different cell types are produced in a certain order and the switch from stem cells to progenitors requires precise timing and regulation. Notable examples of such regulatory molecules include the RNA-binding …

Inhibition Of Ribosome Biogenesis Through Genetic And Chemical Approaches, Leonid Anikin

Graduate School of Biomedical Sciences Theses and Dissertations

In order to maintain the ability to generate proteins, proliferating cells must continuously generate ribosomes, designating up to 80% of their energy to ribosome biogenesis (RBG). RBG involves transcription of rDNA by RNA polymerases I (Pol I) and III (Pol III), expression of approximately 80 ribosomal proteins, and assembly of these components in a process referred to as ribosome maturation. During maturation, the Pol I transcribed 47S pre-rRNA undergoes a number of processing events, while simultaneously interacting with processing factors and ribosomal proteins that drive pre-ribosome assembly. Inhibition of RBG has become one of the pursued targets for cancer therapy …

Insight Into Translational Activation In Yeast Mitochondria, Julia Lynn Jones

Graduate School of Biomedical Sciences Theses and Dissertations

Mitochondrial function depends on over a thousand proteins, of which the majority are nuclear DNA-encoded and approximately one percent are mitochondrial DNA-encoded. The mitochondrial DNA of Saccharomyces cerevisiae contains eight protein-encoding genes, seven of which are required for proper function of the respiratory complexes and one encodes a ribosomal protein. The bigenomic nature of the oxidative phosphorylation complexes requires coordinated expression and regulation from both the nuclear and the mitochondrial genomes. It is currently unclear how this regulatory network operates. However, it is thought that nuclear genome-encoded messengers localized to the mitochondria aid in this coordination.

A family of proteins …

Association Between Bone-Specific Physical Activity Scores And Pqct-Derived Measures Of Bone Strength And Geometry In Healthy Young And Middle-Aged Premenopausal Women., Sojung Kim, Breanne S Baker, Pragya Sharma-Ghimire, Debra A Bemben, Michael G Bemben

Faculty Scholarship for the College of Science & Mathematics

The aim of this study was to determine if bone-specific physical activity questionnaire (BPAQ) scores were positively related to bone health in healthy young and middle-aged premenopausal women. The total BPAQ was a stronger predictor of bone strength and bone mineral density of hip in young women as compared to middle-aged premenopausal women.

PURPOSE: The purpose of this study was to determine whether the BPAQ scores were predictive indices of volumetric BMD (vBMD), bone strength, and bone geometry in young and middle-aged premenopausal women.

METHODS: Healthy young (n = 60) and middle-aged premenopausal women (n = 54) between the ages …

Loss Of Marv1 Promotes Chop Signaling In Mouse Liver, Shad Anthony Mitchell

Graduate School of Biomedical Sciences Theses and Dissertations

Metabolic syndrome (MetS) is a term used to define a set of metabolic diseases: obesity, type 2 diabetes (T2D), hyperlipidemia, hypertension, nonalcoholic fatty liver disease (NAFLD), and nonalcoholic hepatosteatosis (NASH). Those with MetS have a higher incidence of cardiovascular disease and stroke. Current drug treatments for MetS treat the individual pathologies associated with the diseases, rather than directly targeting MetS as a whole. We hypothesize that the inhibition of a ubiquitous lipid transporter known as ARV1 can improve pathologies associated with MetS. To test this hypothesis, we utilized liver tissue from mARV1 knockout mice fed a high-fat diet and examined …

Supervision In Community Mental Health: Understanding Intensity Of Ebt Focus., Leah Lucid, Rosemary Meza, Michael D Pullmann, Nathaniel Jungbluth, Esther Deblinger, Shannon Dorsey

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

The goal of the present study was to examine clinician, supervisor, and organizational factors that are associated with the intensity of evidence-based treatment (EBT) focus in workplace-based clinical supervision of a specific EBT, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). Supervisors (n = 56) and clinicians (n = 207) from mental health organizations across Washington State completed online self-report questionnaires. Multilevel modeling (MLM) analyses were used to examine the relative influence of nested clinician and supervisor factors on the intensity of EBT focus in supervision. We found that 33% of the variance in clinician report of EBT supervision intensity clustered at the …

Snf1 Cooperates With The Cwi Mapk Pathway To Mediate The Degradation Of Med13 Following Oxidative Stress, Stephen D Willis, David C Stieg, Kai Li Ong, Ravina Shah, Alexandra K. Strich, Julianne H Grose, Katrina F Cooper

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

Eukaryotic cells, when faced with unfavorable environmental conditions, mount either pro-survival or pro-death programs. The conserved cyclin C-Cdk8 kinase plays a key role in this decision. Both are members of the Cdk8 kinase module that, along with Med12 and Med13, associate with the core Mediator complex of RNA polymerase II. In Saccharomyces cerevisiae, oxidative stress triggers Med13 destruction, which releases cyclin C into the cytoplasm to promote mitochondrial fission and programmed cell death. The SCFGrr1 ubiquitin ligase mediates Med13 degradation dependent on the cell wall integrity pathway, MAPK Slt2. Here we show that the AMP kinase Snf1 activates a second …

Multinational Comparative Cross-Sectional Survey Of Views Of Medical Students About Acceptable Terminology And Subgroups In Schizophrenia, Shanaya Rathod, Muhammad Irfan, Rachna Bhargava, Narsimha Pinninti, Joseph Scott, Haifa Mohammad Algahtani, Zhihua Guo, Rishab Gupta, Pallavi Nadkarni, Farooq Naeem, Fleur Howells, Katherine Sorsdahi, Kerensa Thorne, Victoria Osman-Hicks, Sasee Pallikadavath, Peter Phiri, Hannah Carr, Lizi Graves, David Kingdon

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

AIM: The aim of this study was to inform thinking around the terminology for 'schizophrenia' in different countries.

OBJECTIVES: The objective of this study was to investigate: (1) whether medical students view alternative terminology (psychosis subgroups), derived from vulnerability-stress models of schizophrenia, as acceptable and less stigmatising than the term schizophrenia; (2) if there are differences in attitudes to the different terminology across countries with different cultures and (3) whether clinical training has an impact in reducing stigma.

DESIGN: This is a cross-sectional survey that examined the attitudes of medical students towards schizophrenia and the alternative subgroups.

SETTING: The study …

The Zinc Transporter Zipt-7.1 Regulates Sperm Activation In Nematodes, Yanmei Zhao, Chieh-Hsiang Tan, Amber Krauchunas, Andrea Scharf, Nicholas Dietrich, Kurt Warnhoff, Zhiheng Yuan, Marina Druzhinina, Sam Guoping Gu, Long Miao, Andrew Singson, Ronald E Ellis, Kerry Kornfeld

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

Sperm activation is a fascinating example of cell differentiation, in which immotile spermatids undergo a rapid and dramatic transition to become mature, motile sperm. Because the sperm nucleus is transcriptionally silent, this transition does not involve transcriptional changes. Although Caenorhabditis elegans is a leading model for studies of sperm activation, the mechanisms by which signaling pathways induce this transformation remain poorly characterized. Here we show that a conserved transmembrane zinc transporter, ZIPT-7.1, regulates the induction of sperm activation in Caenorhabditis nematodes. The zipt-7.1 mutant hermaphrodites cannot self-fertilize, and males reproduce poorly, because mutant spermatids are defective in responding to activating …

Acetic Acid Induces Sch9p-Dependent Translocation Of Isc1p From The Endoplasmic Reticulum Into Mitochondria, António Rego, Katrina F Cooper, Justin Snider, Yusuf A Hannun, Vítor Costa, Manuela Côrte-Real, Susana R Chaves

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

Changes in sphingolipid metabolism have been linked to modulation of cell fate in both yeast and mammalian cells. We previously assessed the role of sphingolipids in cell death regulation using a well characterized yeast model of acetic acid-induced regulated cell death, finding that Isc1p, inositol phosphosphingolipid phospholipase C, plays a pro-death role in this process. Indeed, isc1∆ mutants exhibited a higher resistance to acetic acid associated with reduced mitochondrial alterations. Here, we show that Isc1p is regulated by Sch9p under acetic acid stress, since both single and double mutants lacking Isc1p or/and Sch9p have the same resistant phenotype, and SCH9 …

Agreement Between Clinician-Rated Versus Patient-Reported Outcomes In Huntington Disease, Noelle E Carlozzi, Nicholas R Boileau, Joel S Perlmutter, Kelvin L Chou, Julie C Stout, Jane S Paulsen, Michael K Mccormack, David Cella, Martha A Nance, Jin-Shei Lai, Praveen Dayalu

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

BACKGROUND: Clinician-rated measures of functioning are often used as primary endpoints in clinical trials and other behavioral research in Huntington disease. As study costs for clinician-rated assessments are not always feasible, there is a question of whether patient self-report of commonly used clinician-rated measures may serve as acceptable alternatives in low risk behavioral trials.

AIM: The purpose of this paper was to determine the level of agreement between self-report and clinician-ratings of commonly used functional assessment measures in Huntington disease.

DESIGN: 486 participants with premanifest or manifest Huntington disease were examined. Total Functional Capacity, Functional Assessment, and Independence Scale assessments …

Till Death Do Us Part: The Marriage Of Autophagy And Apoptosis., Katrina F Cooper

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

Autophagy is a widely conserved catabolic process that is necessary for maintaining cellular homeostasis under normal physiological conditions and driving the cell to switch back to this status quo under times of starvation, hypoxia, and oxidative stress. The potential similarities and differences between basal autophagy and stimulus-induced autophagy are still largely unknown. Both act by clearing aberrant or unnecessary cytoplasmic material, such as misfolded proteins, supernumerary and defective organelles. The relationship between reactive oxygen species (ROS) and autophagy is complex. Cellular ROS is predominantly derived from mitochondria. Autophagy is triggered by this event, and by clearing the defective organelles effectively, …

Dimerization Of The Voltage-Sensing Phosphatase Controls Its Voltage-Sensing And Catalytic Activity., Vamseedhar Rayaprolu, Perrine Royal, Karen Stengel, Guillaume Sandoz, Susy C Kohout

Cooper Medical School of Rowan University Faculty Scholarship

Multimerization is a key characteristic of most voltage-sensing proteins. The main exception was thought to be the Ciona intestinalis voltage-sensing phosphatase (Ci-VSP). In this study, we show that multimerization is also critical for Ci-VSP function. Using coimmunoprecipitation and single-molecule pull-down, we find that Ci-VSP stoichiometry is flexible. It exists as both monomers and dimers, with dimers favored at higher concentrations. We show strong dimerization via the voltage-sensing domain (VSD) and weak dimerization via the phosphatase domain. Using voltage-clamp fluorometry, we also find that VSDs cooperate to lower the voltage dependence of activation, thus favoring the activation of Ci-VSP. Finally, using …

The Influence Of Therapist-Patient Religious/Spiritual Congruence On Satisfaction With Therapy: A Review Of Research, Tammy E. Henderson

Theses and Dissertations

The goal of this review was to examine the relationship between mental health and religion and/or spirituality. Specifically, it was believed that religion and spiritual congruence had a positive influence on satisfaction with therapy. Indeed, the literature reviewed suggests that therapists should be more open to addressing a patient's religious and/or spiritual beliefs as it could lead to more attuned therapeutic sessions. The importance of congruence between patient and therapist is a factor that can impact the therapeutic alliance, based on the literature, this concept appears to hold true for those that are or are not religiously and/or spiritually inclined.

A Rare But Life Threatening Case Of Labile Blood Pressures In Pregnancy, Kelsey Carrio Md, Aarti Aggarwal Md, Susan Mcgroarty Phd

Rowan-Virtua Research Day

Pheochromocytoma is a rare but life threatening adrenal secreting tumor. The infrequency with which it is encountered makes pheochromocytoma, especially in pregnancy, a formidable diagnostic challenge.

Although a pheochromocytoma is rare, it is good to keep it in differential diagnosis as a possible cause of labile BP with headaches and significant orthostatic BP. It is critical to recognize this condition to institute an appropriate therapy & surgical intervention to prevent mortality.

Wearable Fitness Tracking Improves Self-Efficacy For Exercise, Adam Sturts Oms-Ii, Adarsh Gupta Do

Rowan-Virtua Research Day

The present study was designed to determine the impact of wearable fitness tracking technology use on physical activity and self-efficacy for exercise among wearable fitness device users. This was a cross sectional study. A single questionnaire was administered to participants, providing patient data pertaining to wearable fitness tracking device use, exercise habits and intrinsic self-efficacy for exercise. Wearable fitness tracking device users were found to have higher levels of self-efficacy for exercise than non-users across all participating ages, genders and ethnicities. In addition, wearable fitness device users reported increased engagement in physical activity with the concomitant use of their devices. …

Effects Of Vitamin D Supplementation, Keith R. Anacker Oms-Ii, Adarsh K. Gupta Do

Rowan-Virtua Research Day

Vitamin D (1,25-dihydroxycholecalciferol) is known to be a fat soluble vitamin. We hypothesized that losing weight would thus cause an increase in serum vitamin D levels. To investigate this, a retrospective chart review was performed in which data including sex, age, race, serum Vitamin D levels, body weight and more, of 200 Rowan SOM Family Medicine patients for up to 6 doctor’s office visits each were collected. These data were then analyzed using Microsoft Excel and IBM SPSS. We found while there was a significant positive correlation between weight loss and serum Vitamin D levels, there was not a significant …

Maps-Snma Shad.O.W D.O. Day Rowan Som Pipeline Program: A Pilot Study, Taiwo Ajumobi, K. Millar, Hina Mujadad, Yessica Manzo, Tashawni Channer, Cassandra Ramirez, Nkechiyere Eboka, Paula Watkins Mas, Linda Boyd Do

Rowan-Virtua Research Day

Prior to being a medical student, a majority of pre-medical students have not encountered the course load intensity, academic rigor, and time management required by a medical school curriculum. Diversifying the workforce has been shown to have benefits, especially at the micro or patient level, since having racial or ethnic concordance between providers and patients has been associated with increased levels of satisfaction and improvements in certain clinical outcomes. The number of MDs increased to 841,321 or 91.8% versus 72,961 DOs or 8.0% creating the need for minorities to be knowledgeable of both MD and DO paths to becoming a …

Development Of Novel Dual Inhibitor Of Chemokine Receptor 4 And Mcl-1 Against Multiple Myeloma, Kuntal Bhowmick, Kristy K. Patel, Suman Pathi, Subash Jonnalagadda, Tulin Budak-Alpdogan, Manoj K. Pandey

Rowan-Virtua Research Day

Multiple myeloma (MM) is a neoplastic plasma-cell disorder. This is characterized by clonal proliferation of malignant plasma cells in the bone-marrow (BM) microenvironment, monoclonal protein in blood or urine, and associated organ dysfunction. The treatment options approved by FDA are immune-modulatory agents, proteasome inhibitors, and autologous stem cell transplantation (ASCT). Unfortunately, MM remains uniformly fatal owing to intrinsic or acquired drug resistance and the median survival time is 3 to 5 years. Thus, there is a great need for novel strategies to combat MM.

The intimate relationship of myeloma cells to BM microenvironment is “hallmark of myeloma”. The homing of …

Dexmedetomidine (Precedex) Induced Fever, Patrick Dealmeida Do, Michael Matrale Do

Rowan-Virtua Research Day

Precedex is an intravenous, α-2 receptor agonist broadly used for analgesia, maintenance of sedation, and alcohol withdrawal treatment in the intensive care unit (ICU).

The most commonly reported adverse effects associated with precedex are hypotension and bradycardia1.

Fever has been reported with a 5-7% incidence rate. Our case shows a very impressive pyrexia in a 49 year old patient most likely associated to Precedex. When compared to the previously three reported cases his fever reached the largest value (T= 107ºF).

As its use becomes more and more common in the ICU, clinicians should be aware of this adverse effect especially …

The Unity Project: Camden Community Health Center Building Authentic & Impactful Relationships Through The Ask-First Model, Christian Diliberto Oms-Ii, Ruchi Shah Oms-Ii, Patrick J. Tempera Oms-Ii

Rowan-Virtua Research Day

Last spring, the Camden Community Health Center (CCHC) launched the Unity Project, an initiative aimed at fostering relationships with various Camden, New Jersey organizations to not only educate community members about our services, but also to collaborate with them on improving Camden’s health. Although the CCHC has been in Camden for over 15 years, local organizations were unaware of our existence. There was also a similar disconnect among these organizations themselves. The goal of the Unity Project is to work towards affecting long-term change by forming authentic and impactful relationships with organizations that are already doing meaningful work.

Our ‘Ask …

Fatal Case Of Ttp In Patient With Underlying Pulmonary Aspergillosis, Shimool A. Rabbani Do, Ankit Shah Do, Joan Wiley Do, Jay Kirkham Do

Rowan-Virtua Research Day

A 70-year- old Caucasian male with history of renal transplant on tacrolimus presented with 5-days of fevers, productive cough, and confusion. Patient was initially diagnosed with pneumonia, presumed bacterial, but soon noted to have worsening neurologic status, renal failure, and respiratory failure requiring mechanical ventilation. He further developed thrombotic microangiopathy (TMA); TMA along with the other clinical findings led to diagnosis of Thrombotic Thrombocytopenic Purpura (TTP). Despite aggressive treatment of TTP with plasmapheresis, patient expired on day five of his hospitalization. Fungal cultures from a bronchoscope performed on day three of hospitalization that resulted postmortem grew many aspergillus flavus and …

Myeloid Sarcoma: A Rare Cause Of Small Bowel Obstruction, Jonathan Sedeyn Do, Phd, Karlbuto Alexandre, Alan J. Sheinbaum Do, Adeshola Fakulujo Md, Facs

Rowan-Virtua Research Day

Myeloid sarcoma is a rare and aggressive tumor of myelogenous origin that uncommonly presents in the small bowel. Here we describe the case of a 29 year old male with a two week history of worsening abdominal pain associated with nausea and bilious vomiting. The patient displayed tenderness in the epigastric and periumbilical region with grossly normal lab values. On CT he was found to have a small bowel obstruction with a transition point in the pelvis. Exploration revealed a small bowel mass located approximately 12 cm from the ileocecal valve. Pathological analysis showed large malignant cells with a high …