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Zucker School of Medicine at Hofstra/Northwell

2015

Surgery

Keyword

Articles 1 - 30 of 55

Full-Text Articles in Medicine and Health Sciences

Hyperplastic Cardiac Sarcoma Recurrence, M. A. Shariff, J. A. Abreu, F. Durrani, E. Daniele, K. C. Bowman, S. Sadel, K. T. Asgarian, J. T. Mcginn Jr., J. P. Nabagiez Jan 2015

Hyperplastic Cardiac Sarcoma Recurrence, M. A. Shariff, J. A. Abreu, F. Durrani, E. Daniele, K. C. Bowman, S. Sadel, K. T. Asgarian, J. T. Mcginn Jr., J. P. Nabagiez

Journal Articles

Primary cardiac sarcomas are rare tumors with a median survival of 6-12 months. Data suggest that an aggressive multidisciplinary approach may improve patient outcome. We present the case of a male who underwent resection of cardiac sarcoma three times from the age of 32 to 34. This report discusses the malignant nature of cardiac sarcoma and the importance of postoperative multidisciplinary care.


Acute Surgical Pulmonary Embolectomy: A 9-Year Retrospective Analysis, A. R. Hartman, F. Manetta, R. Lessen, R. Pekmezaris, A. Kozikowski, L. Jahn, M. Akerman, M. L. Lesser, L. R. Glassman, M. Graver, J. S. Scheinerman, R. Kalimi, R. Palazzo, S. Vatsia, G. Pogo, M. Hall, P. J. Yu, V. Singh Jan 2015

Acute Surgical Pulmonary Embolectomy: A 9-Year Retrospective Analysis, A. R. Hartman, F. Manetta, R. Lessen, R. Pekmezaris, A. Kozikowski, L. Jahn, M. Akerman, M. L. Lesser, L. R. Glassman, M. Graver, J. S. Scheinerman, R. Kalimi, R. Palazzo, S. Vatsia, G. Pogo, M. Hall, P. J. Yu, V. Singh

Journal Articles

Acute pulmonary embolism is a substantial cause of morbidity and death. Although the American College of Chest Physicians Evidence-Based Clinical Practice Guidelines recommend surgical pulmonary embolectomy in patients with acute pulmonary embolism associated with hypotension, there are few reports of 30-day mortality rates. We performed a retrospective review of acute pulmonary embolectomy procedures performed in 96 consecutive patients who had severe, globally hypokinetic right ventricular dysfunction as determined by transthoracic echocardiography. Data on patients who were treated from January 2003 through December 2011 were derived from health system databases of the New York State Cardiac Surgery Reporting System and the …


Right Heart Transvalvular Embolus With High Risk Pulmonary Embolism In A Recently Hospitalized Patient: A Case Report Of A Therapeutic Challenge, G. K. Acharya, A. M. Adedayo, H. Prabhu, D. R. Brinster, P. Mir Jan 2015

Right Heart Transvalvular Embolus With High Risk Pulmonary Embolism In A Recently Hospitalized Patient: A Case Report Of A Therapeutic Challenge, G. K. Acharya, A. M. Adedayo, H. Prabhu, D. R. Brinster, P. Mir

Journal Articles

Thrombus-in-transit is not uncommon in pulmonary embolism but Right Heart Transvalvular Embolus (RHTVE) complicating this is rare. A 54-year-old obese male with recent hospitalization presented with severe dyspnea and collapse. Initial investigations revealed elevated d-dimer and troponin. CTA showed saddle pulmonary embolus and bedside echocardiogram revealed right ventricular (RV) pressure overload and dilatation (RV > 41 mm), McConnell's sign, and mobile echodensity attached to tricuspid valve. Patient was immediately resuscitated and promptly transferred for surgical embolectomy under cardiopulmonary bypass. A long segment of embolus traversing through the tricuspid valve and extensive bilateral pulmonary artery embolus were removed. IVC filter was placed …


Developments In Intervertebral Disc Disease Research: Pathophysiology, Mechanobiology, And Therapeutics, K. T. Weber, T. D. Jacobsen, R. Maidhof, J. Virojanapa, C. Overby, O. Bloom, S. Quraishi, M. Levine, N. O. Chahine Jan 2015

Developments In Intervertebral Disc Disease Research: Pathophysiology, Mechanobiology, And Therapeutics, K. T. Weber, T. D. Jacobsen, R. Maidhof, J. Virojanapa, C. Overby, O. Bloom, S. Quraishi, M. Levine, N. O. Chahine

Journal Articles

Low back pain is a leading cause of disability worldwide and the second most common cause of physician visits. There are many causes of back pain, and among them, disc herniation and intervertebral disc degeneration are the most common diagnoses and targets for intervention. Currently, clinical treatment outcomes are not strongly correlated with diagnoses, emphasizing the importance for characterizing more completely the mechanisms of degeneration and their relationships with symptoms. This review covers recent studies elucidating cellular and molecular changes associated with disc mechanobiology, as it relates to degeneration and regeneration. Specifically, we review findings on the biochemical changes in …


Exploratory Study For Identifying Systemic Biomarkers That Correlate With Pain Response In Patients With Intervertebral Disc Disorders, K. T. Weber, S. Satoh, D. O. Alipui, J. Virojanapa, M. Levine, C. Sison, S. Quraishi, O. Bloom, N. O. Chahine Jan 2015

Exploratory Study For Identifying Systemic Biomarkers That Correlate With Pain Response In Patients With Intervertebral Disc Disorders, K. T. Weber, S. Satoh, D. O. Alipui, J. Virojanapa, M. Levine, C. Sison, S. Quraishi, O. Bloom, N. O. Chahine

Journal Articles

Molecular events that drive disc damage and low back pain (LBP) may precede clinical manifestation of disease onset and can cause detrimental long-term effects such as disability. Biomarkers serve as objective molecular indicators of pathological processes. The goal of this study is to identify systemic biochemical factors as predictors of response to treatment of LBP with epidural steroid injection (ESI). Since inflammation plays a pivotal role in LBP, this pilot study investigates the effect of ESI on systemic levels of 48 inflammatory biochemical factors (cytokines, chemokines, and growth factors) and examines the relationship between biochemical factor levels and pain or …


First-In-Human, Phase 1, Randomized, Dose-Escalation Trial With Recombinant Anti-Il-20 Monoclonal Antibody In Patients With Psoriasis, A. B. Gottlieb, J. G. Krueger, M. Sandberg Lundblad, M. Gothberg, B. E. Skolnick Jan 2015

First-In-Human, Phase 1, Randomized, Dose-Escalation Trial With Recombinant Anti-Il-20 Monoclonal Antibody In Patients With Psoriasis, A. B. Gottlieb, J. G. Krueger, M. Sandberg Lundblad, M. Gothberg, B. E. Skolnick

Journal Articles

BACKGROUND: The current trial was a first-in-human clinical trial evaluating the safety, tolerability, pharmacokinetics, pharmacodynamics, and preliminary efficacy of the recombinant monoclonal anti-interleukin-20 (IL-20) antibody, NNC0109-0012, which targets the inflammatory cytokine IL-20. METHODS: In total, 48 patients aged 18 to 75 years with moderate to severe stable chronic plaque psoriasis with affected body surface area >/=15% and physician global assessment score >/=3 were enrolled in this randomized, double-blind, multicenter, placebo-controlled, phase 1 dose-escalation trial. Patients were randomized within each single dose cohort (0.01, 0.05, 0.2, 0.6, 1.5, or 3.0 mg/kg) or multiple dose cohort (0.05, 0.2, 0.5, 1.0, or 2.0 …


Combining Task-Evoked And Spontaneous Activity To Improve Pre-Operative Brain Mapping With Fmri, M. D. Fox, T. Qian, J. R. Madsen, D. Wang, M. Ge, H. C. Zuo, D. M. Groppe, A. D. Mehta, B. Hong, H. Liu, +1 Additional Author Jan 2015

Combining Task-Evoked And Spontaneous Activity To Improve Pre-Operative Brain Mapping With Fmri, M. D. Fox, T. Qian, J. R. Madsen, D. Wang, M. Ge, H. C. Zuo, D. M. Groppe, A. D. Mehta, B. Hong, H. Liu, +1 Additional Author

Journal Articles

Noninvasive localization of brain function is used to understand and treat neurological disease, exemplified by pre-operative fMRI mapping prior to neurosurgical intervention. The principal approach for generating these maps relies on brain responses evoked by a task and, despite known limitations, has dominated clinical practice for over 20years. Recently, pre-operative fMRI mapping based on correlations in spontaneous brain activity has been demonstrated, however this approach has its own limitations and has not seen widespread clinical use. Here we show that spontaneous and task-based mapping can be performed together using the same pre-operative fMRI data, provide complimentary information relevant for functional …


Laminar Profile And Physiology Of The Alpha Rhythm In Primary Visual, Auditory, And Somatosensory Regions Of Neocortex, S. Haegens, A. Barczak, G. Musacchia, M. L. Lipton, A. D. Mehta, P. Lakatos, C. E. Schroeder Jan 2015

Laminar Profile And Physiology Of The Alpha Rhythm In Primary Visual, Auditory, And Somatosensory Regions Of Neocortex, S. Haegens, A. Barczak, G. Musacchia, M. L. Lipton, A. D. Mehta, P. Lakatos, C. E. Schroeder

Journal Articles

The functional significance of the alpha rhythm is widely debated. It has been proposed that alpha reflects sensory inhibition and/or a temporal sampling or "parsing" mechanism. There is also continuing disagreement over the more fundamental questions of which cortical layers generate alpha rhythms and whether the generation of alpha is equivalent across sensory systems. To address these latter questions, we analyzed laminar profiles of local field potentials (LFPs) and concomitant multiunit activity (MUA) from macaque V1, S1, and A1 during both spontaneous activity and sensory stimulation. Current source density (CSD) analysis of laminar LFP profiles revealed alpha current generators in …


Galantamine Attenuates Type 1 Diabetes And Inhibits Anti-Insulin Antibodies In Non-Obese Diabetic Mice, W. M. Hanes, P. S. Olofsson, K. Kwan, L. K. Hudson, S. S. Chavan, V. A. Pavlov, K. J. Tracey Jan 2015

Galantamine Attenuates Type 1 Diabetes And Inhibits Anti-Insulin Antibodies In Non-Obese Diabetic Mice, W. M. Hanes, P. S. Olofsson, K. Kwan, L. K. Hudson, S. S. Chavan, V. A. Pavlov, K. J. Tracey

Journal Articles

Type 1 diabetes in mice is characterized by autoimmune destruction of insulin-producing pancreatic beta cells. Disease pathogenesis involves invasion of pancreatic islets by immune cells, including macrophages and T cells, and production of antibodies to self-antigens, including insulin. Activation of the inflammatory reflex, the neural circuit that inhibits inflammation, culminates on cholinergic receptor signals on immune cells to attenuate cytokine release and inhibit B cell antibody production. Here, we show that galantamine, a centrally acting acetylcholinesterase inhibitor and an activator of the inflammatory reflex, attenuates murine experimental type 1 diabetes. Administration of galantamine to animals immunized with keyhole limpet hemocyanin …


A Unifying Principle Underlying The Extracellular Field Potential Spectral Responses In The Human Cortex, E. Podvalny, N. Noy, M. Harel, S. Bickel, G. Chechik, C. E. Schroeder, A. D. Mehta, M. Tsodyks, R. Malach Jan 2015

A Unifying Principle Underlying The Extracellular Field Potential Spectral Responses In The Human Cortex, E. Podvalny, N. Noy, M. Harel, S. Bickel, G. Chechik, C. E. Schroeder, A. D. Mehta, M. Tsodyks, R. Malach

Journal Articles

Electrophysiological mass potentials show complex spectral changes upon neuronal activation. However, it is unknown to what extent these complex band-limited changes are interrelated or, alternatively, reflect separate neuronal processes. To address this question, intracranial electrocorticograms (ECoG) responses were recorded in patients engaged in visuomotor tasks. We found that in the 10- to 100-Hz frequency range there was a significant reduction in the exponent chi of the 1/f(chi) component of the spectrum associated with neuronal activation. In a minority of electrodes showing particularly high activations the exponent reduction was associated with specific band-limited power modulations: emergence of a high gamma (80-100 …


Damp Signaling Is A Key Pathway Inducing Immune Modulation After Brain Injury, A. Liesz, A. Dalpke, E. Mracsko, D. J. Antoine, S. Roth, W. Zhou, H. Yang, P. P. Nawroth, K. J. Tracey, R. Veltkamp, +4 Additional Authors Jan 2015

Damp Signaling Is A Key Pathway Inducing Immune Modulation After Brain Injury, A. Liesz, A. Dalpke, E. Mracsko, D. J. Antoine, S. Roth, W. Zhou, H. Yang, P. P. Nawroth, K. J. Tracey, R. Veltkamp, +4 Additional Authors

Journal Articles

Acute brain lesions induce profound alterations of the peripheral immune response comprising the opposing phenomena of early immune activation and subsequent immunosuppression. The mechanisms underlying this brain-immune signaling are largely unknown. We used animal models for experimental brain ischemia as a paradigm of acute brain lesions and additionally investigated a large cohort of stroke patients. We analyzed release of HMGB1 isoforms by mass spectrometry and investigated its inflammatory potency and signaling pathways by immunological in vivo and in vitro techniques. Features of the complex behavioral sickness behavior syndrome were characterized by homecage behavior analysis. HMGB1 downstream signaling, particularly with RAGE, …


Accuracy Of The Abc/2 Score For Intracerebral Hemorrhage: Systematic Review And Analysis Of Mistie, Clear-Ivh, And Clear Iii, A. J. Webb, N. L. Ullman, T. C. Morgan, J. Muschelli, J. Kornbluth, I. A. Awad, S. Mayo, M. Rosenblum, R. Narayan, D. F. Hanley, +14 Additional Authors Jan 2015

Accuracy Of The Abc/2 Score For Intracerebral Hemorrhage: Systematic Review And Analysis Of Mistie, Clear-Ivh, And Clear Iii, A. J. Webb, N. L. Ullman, T. C. Morgan, J. Muschelli, J. Kornbluth, I. A. Awad, S. Mayo, M. Rosenblum, R. Narayan, D. F. Hanley, +14 Additional Authors

Journal Articles

BACKGROUND AND PURPOSE: The ABC/2 score estimates intracerebral hemorrhage (ICH) volume, yet validations have been limited by small samples and inappropriate outcome measures. We determined accuracy of the ABC/2 score calculated at a specialized reading center (RC-ABC) or local site (site-ABC) versus the reference-standard computed tomography-based planimetry (CTP). METHODS: In Minimally Invasive Surgery Plus Recombinant Tissue-Type Plasminogen Activator for Intracerebral Hemorrhage Evacuation-II (MISTIE-II), Clot Lysis Evaluation of Accelerated Resolution of Intraventricular Hemorrhage (CLEAR-IVH) and CLEAR-III trials. ICH volume was prospectively calculated by CTP, RC-ABC, and site-ABC. Agreement between CTP and ABC/2 was defined as an absolute difference up to 5 …


Interest In Bariatric Surgery Among Obese Patients With Obstructive Sleep Apnea, K. A. Dudley, A. Tavakkoli, R. A. Andrews, A. N. Seiger, J. P. Bakker, S. R. Patel Jan 2015

Interest In Bariatric Surgery Among Obese Patients With Obstructive Sleep Apnea, K. A. Dudley, A. Tavakkoli, R. A. Andrews, A. N. Seiger, J. P. Bakker, S. R. Patel

Journal Articles

BACKGROUND: Standard obstructive sleep apnea (OSA) therapies are poorly tolerated. Bariatric surgery is a potential alternative but the level of interest in this intervention among OSA patients is unknown. OBJECTIVES: Determine the proportion of OSA patients who would be interested in bariatric surgery. SETTING: Sleep clinics, United States. METHODS: Consecutive adult patients with untreated severe OSA and a body mass index of 35-45 kg/m2 were approached. Patients at low perioperative risk and no urgent indication for OSA treatment were invited to a separate informational visit about bariatric surgery as primary treatment for OSA. RESULTS: Of 767 eligible patients, 230 (30.0%) …


Competence Acquisition For Single-Incision Laparoscopic Cholecystectomy, G. B. Deutsch, S. A. Sathyanarayana, M. Giangola, M. Akerman, G., 3rd Denoto, J. D. Klein, H. Zemon, E. Rubach Jan 2015

Competence Acquisition For Single-Incision Laparoscopic Cholecystectomy, G. B. Deutsch, S. A. Sathyanarayana, M. Giangola, M. Akerman, G., 3rd Denoto, J. D. Klein, H. Zemon, E. Rubach

Journal Articles

BACKGROUND AND OBJECTIVES: Within the past few years, there has been a push for an even more minimally invasive approach to biliary disease with the adoption of single-incision laparoscopic cholecystectomy. We sought to compare 4 individual surgeon experiences to define whether there exists a learning curve for performing single-incision laparoscopic cholecystectomy. METHODS: We performed a retrospective review 290 single-incision laparoscopic cholecystectomies performed by a group of general surgeons, with varying levels of experience and training, at 3 institutions between May 2008 and September 2010. The procedure times were recorded for each single-incision laparoscopic cholecystectomy, ordered chronologically for each surgeon, and …


Survival Outcomes In Liver Transplant Recipients With Model For End-Stage Liver Disease Scores Of 40 Or Higher: A Decade-Long Experience, H. J. Panchal, J. B. Durinka, J. Patterson, F. Karipineni, S. Ashburn, E. Siskind, J. Ortiz Jan 2015

Survival Outcomes In Liver Transplant Recipients With Model For End-Stage Liver Disease Scores Of 40 Or Higher: A Decade-Long Experience, H. J. Panchal, J. B. Durinka, J. Patterson, F. Karipineni, S. Ashburn, E. Siskind, J. Ortiz

Journal Articles

BACKGROUND: The Model for End-stage Liver Disease (MELD) has been used as a prognostic tool since 2002 to predict pre-transplant mortality. Increasing proportions of transplant candidates with higher MELD scores, combined with improvements in transplant outcomes, mandate the need to study surgical outcomes in patients with MELD scores of >/=40. METHODS: A retrospective longitudinal analysis of United Network for Organ Sharing (UNOS) data on all liver transplantations performed between February 2002 and June 2011 (n = 33 398) stratified by MELD score (/=40) was conducted. The primary outcomes of interest were short- and longterm graft and patient survival. A Kaplan-Meier …


Prothrombin Time And Activated Partial Thromboplastin Time Testing: A Comparative Effectiveness Study In A Million-Patient Sample, M. N. Capoor, J. L. Stonemetz, J. C. Baird, F. S. Ahmed, A. Awan, C. Birkenmaier, M. A. Inchiosa, S. K. Magid, K. Mcgoldrick, E. Molmenti, S. Naqvi, S. D. Parker, S. M. Pothula, A. Shander, R. G. Steen, M. K. Urban, J. Wall, V. A. Fischetti Jan 2015

Prothrombin Time And Activated Partial Thromboplastin Time Testing: A Comparative Effectiveness Study In A Million-Patient Sample, M. N. Capoor, J. L. Stonemetz, J. C. Baird, F. S. Ahmed, A. Awan, C. Birkenmaier, M. A. Inchiosa, S. K. Magid, K. Mcgoldrick, E. Molmenti, S. Naqvi, S. D. Parker, S. M. Pothula, A. Shander, R. G. Steen, M. K. Urban, J. Wall, V. A. Fischetti

Journal Articles

Background A substantial fraction of all American healthcare expenditures are potentially wasted, and practices that are not evidence-based could contribute to such waste. We sought to characterize whether Prothrombin Time (PT) and activated Partial Thromboplastin Time (aPTT) tests of preoperative patients are used in a way unsupported by evidence and potentially wasteful. Methods and Findings We evaluated prospectively-collected patient data from 19 major teaching hospitals and 8 hospital-affiliated surgical centers in 7 states (Delaware, Florida, Maryland, Massachusetts, New Jersey, New York, Pennsylvania) and the District of Columbia. A total of 1,053,472 consecutive patients represented every patient admitted for elective surgery …


Weight Trends In United States Living Kidney Donors: Analysis Of The Unos Database, M. Sachdeva, L. M. Rosen, J. Varghese, S. Fishbane, E. P. Molmenti Jan 2015

Weight Trends In United States Living Kidney Donors: Analysis Of The Unos Database, M. Sachdeva, L. M. Rosen, J. Varghese, S. Fishbane, E. P. Molmenti

Journal Articles

AIM: To analyze the national trends associated with body mass index (BMI) and living kidney donation. METHODS: Forty-seven thousand seven hundred and five adult living kidney donors as reported to the Organ Procurement and Transplantation Network from 1999 to 2011 were analyzed using their pre-donation BMI. Predictor variables of interest included age, gender, ethnicity, relationship, education status, and transplant region. RESULTS: Sixteen thousand nine hundred and seventy-one of the living kidney donors were normal weight (35.6%); 19337 were overweight (40.5%); 9007 were mildly obese (18.9%); 1992 were moderate to morbidly obese (4.2%). Overweight and mildly obese kidney donors have increased …


Growth Arrest-Specific Protein 6 Protects Against Renal Ischemia-Reperfusion Injury, M. D. Giangola, W. L. Yang, S. R. Rajayer, M. Kuncewitch, E. Molmenti, J. Nicastro, G. F. Coppa, P. Wang Jan 2015

Growth Arrest-Specific Protein 6 Protects Against Renal Ischemia-Reperfusion Injury, M. D. Giangola, W. L. Yang, S. R. Rajayer, M. Kuncewitch, E. Molmenti, J. Nicastro, G. F. Coppa, P. Wang

Journal Articles

BACKGROUND: Renal injury caused by ischemia-reperfusion (I/R) often occurs after shock or transplantation. Growth arrest-specific protein 6 (Gas6) is a secreted protein that binds to the TAM-Tyro3, Axl, Mer-family tyrosine kinase receptors, which modulate the inflammatory response and activate cell survival pathways. We hypothesized that Gas6 could have a protective role in attenuating the severity of renal injury after I/R. MATERIALS AND METHODS: Adult mice were subjected to 45 min of bilateral renal ischemia. Recombinant mouse Gas6 (rmGas6, 5 mug per mouse) or normal saline (vehicle) was administered intraperitoneally 1 h before ischemia and all subjects were sacrificed at 23 …


Adenocarcinoma Arising At Ileostomy Sites: Two Cases And A Review Of The Literature, L. Procaccino, S. Rehman, A. Abdurakhmanov, P. Mcwhorter, N. La Gamma, M. C. Bhaskaran, J. Maurer, G. M. Grimaldi, H. Rilo, J. Nicastro, G. Coppa, E. P. Molmenti, J. Procaccino Jan 2015

Adenocarcinoma Arising At Ileostomy Sites: Two Cases And A Review Of The Literature, L. Procaccino, S. Rehman, A. Abdurakhmanov, P. Mcwhorter, N. La Gamma, M. C. Bhaskaran, J. Maurer, G. M. Grimaldi, H. Rilo, J. Nicastro, G. Coppa, E. P. Molmenti, J. Procaccino

Journal Articles

Total colectomy with ileostomy placement is a treatment for patients with inflammatory bowel disease or familial adenomatous polyposis (FAP). A rare and late complication of this treatment is carcinoma arising at the ileostomy site. We describe two such cases: a 78-year-old male 30 years after subtotal colectomy and ileostomy for FAP, and an 85-year-old male 50 years after colectomy and ileostomy for ulcerative colitis. The long latency period between creation of the ileostomies and development of carcinoma suggests a chronic metaplasia due to an irritating/inflammatory causative factor. Surgical excision of the mass and relocation of the stoma is the mainstay …


Surgeon Motivations Behind The Timing Of Breast Reconstruction In Patients Requiring Postmastectomy Radiation Therapy, M. Lee, E. Reinertsen, E. Mcclure, S. Liu, L. Kruper, N. Tanna, J. Brian Boyd, J. W. Granzow Jan 2015

Surgeon Motivations Behind The Timing Of Breast Reconstruction In Patients Requiring Postmastectomy Radiation Therapy, M. Lee, E. Reinertsen, E. Mcclure, S. Liu, L. Kruper, N. Tanna, J. Brian Boyd, J. W. Granzow

Journal Articles

OBJECTIVES: Although postmastectomy radiation therapy (PMRT) has been shown to reduce breast cancer burden and improve survival, PMRT may negatively influence outcomes after reconstruction. The goal of this study was to compare current opinions of plastic and reconstructive surgeons (PRS) and surgical oncologists (SO) regarding the optimal timing of breast reconstruction for patients requiring PMRT. METHODS: Members of the American Society of Plastic Surgeons (ASPS), the American Society of Breast Surgeons (ASBS), and the Society of Surgical Oncology (SSO) were asked to participate in an anonymous web-based survey. Responses were solicited in accordance to the Dillman method, and they were …


Kikuchi-Fujimoto Disease Masquerading As Metastatic Papillary Carcinoma Of The Thyroid, S. Garg, M. Villa, J. R. Asirvatham, T. Mathew, L. J. Auguste Jan 2015

Kikuchi-Fujimoto Disease Masquerading As Metastatic Papillary Carcinoma Of The Thyroid, S. Garg, M. Villa, J. R. Asirvatham, T. Mathew, L. J. Auguste

Journal Articles

Kikuchi-Fujimoto disease also known as histiocytic necrotizing lymphadenitis is a rare cervical inflammatory lymphadenitis that is most commonly seen in young Asian women. It is mainly characterized by lymphadenopathy, hepatosplenomegaly, fever, nocturnal sweats, myalgia, weight loss, and arthralgia, and commonly follows a self-limited course. The differential diagnosis is challenging as many other conditions such as malignant lymphoma, metastatic disease, tuberculosis and infectious lymphadenopathies can present in a similar way. We present an unusual case of Kikuchi-Fujimoto disease masquerading as metastatic papillary carcinoma of the thyroid. A 30-year-old young female presented, 2 months post-partum, with complaints of neck pain and fever. …


A Rare Case Of A Primary Squamous Cell Carcinoma Of The Stomach Presenting As A Submucosal Mass, W. Von Waagner, Z. Wang, A. I. Picon Jan 2015

A Rare Case Of A Primary Squamous Cell Carcinoma Of The Stomach Presenting As A Submucosal Mass, W. Von Waagner, Z. Wang, A. I. Picon

Journal Articles

We report a case of a 70-year-old man, with a status after aortic valve replacement, who presented with melena and hypotension. On physical examination, he was hypotensive, but he responded to resuscitation. Esophagogastroduodenoscopy revealed a submucosal mass in the gastric fundus. Imaging of the chest, abdomen, and pelvis showed no evidence of local or distant metastasis. He underwent a partial diaphragmatic resection, gastrectomy, lymphadenectomy, and Roux-en-Y esophagojejunostomy. Pathology showed a gastric squamous cell carcinoma (SCC) invading the diaphragm, with negative margins of resection, and one positive perigastric lymph node. He received chemoradiation, but the patient expired 27 months after surgery.


Comorbid Profile Rather Than Age Determines Hip Fracture Mortality In A Nonagenarian Population, A. Graver, S. Merwin, L. Collins, N. Kohn, A. Goldman Jan 2015

Comorbid Profile Rather Than Age Determines Hip Fracture Mortality In A Nonagenarian Population, A. Graver, S. Merwin, L. Collins, N. Kohn, A. Goldman

Journal Articles

BACKGROUND: In light of poor outcomes with nonoperative management of hip fractures, orthopedic surgeons are faced with difficult decisions about which patients are too ill or too old for surgical treatment. QUESTIONS/PURPOSES: This study sought to investigate if patients over 90 years had different preoperative laboratory, clinical, and injury characteristics than younger patients with the same injury. We compared our cohort with previously published data. We wished to identify if there were pre-injury risk factors associated with 30-day mortality, which could be modified to enhance postoperative outcomes. METHODS: This is a retrospective review of 198 operatively managed hip fractures in …


An Interesting Cause Of Mechanical Small Bowel Obstruction, S. A. Sathyanarayana, G. B. Deutsch, B. Friedman Jan 2015

An Interesting Cause Of Mechanical Small Bowel Obstruction, S. A. Sathyanarayana, G. B. Deutsch, B. Friedman

Journal Articles

Foreign body ingestion is a known cause of abdominal pain in pediatric population occurring between 6 months and 3 years of age (Wyllie Curr Opin Pediatr 18:563, 2006, Uyemura Am Fam Physician 72:287, 2005, Banerjee Indian J Pediatr 72:173, 2005). Most of the ingested foreign bodies pass spontaneously with 10-20 % requiring endoscopic retrieval, and < 1 % of cases require a surgical intervention (Wyllie Curr Opin Pediatr 18:563, 2006, Uyemura Am Fam Physician 72:287, 2005, Shivakumar Indian J Pediatr 71:689, 2004). Presence of intestinal obstruction necessitates surgical intervention to extract the ingested foreign body. Initial abdominal plain radiograph should be obtained when foreign body ingestion is suspected, which differentiates a radiopaque from radiolucent foreign bodies. A computed tomography with 3D reconstruction (3D-CT) is recommended with radiolucent foreign bodies (Uyemura Am Fam Physician 72:287, 2005, Kazam Am J Emerg Med 23:897, 2005). After 24 h of expectant management, failure of spontaneous passage requires further intervention. Timely intervention to relieve the obstruction is pivotal to prevent undue complications. We present an interesting case of a boy who ingested a radiolucent foreign body diagnosed on 3D-CT, successfully treated with surgical extraction.


Neutralization Of Osteopontin Attenuates Neutrophil Migration In Sepsis-Induced Acute Lung Injury, Y. Hirano, M. Aziz, W.L. Yang, Z. Wang, M. Zhou, M. Ochani, A. Khader, P. Wang Jan 2015

Neutralization Of Osteopontin Attenuates Neutrophil Migration In Sepsis-Induced Acute Lung Injury, Y. Hirano, M. Aziz, W.L. Yang, Z. Wang, M. Zhou, M. Ochani, A. Khader, P. Wang

Journal Articles

INTRODUCTION: Sepsis refers to severe systemic inflammation leading to acute lung injury (ALI) and death. Introducing novel therapies can reduce the mortality in ALI. Osteopontin (OPN), a secretory glycoprotein produced by immune reactive cells, plays a deleterious role in various inflammatory diseases. However, its role in ALI caused by sepsis remains unexplored. We hypothesize that treatment with an OPN-neutralizing antibody (anti-OPN Ab) protects mice against ALI during sepsis. METHODS: Sepsis was induced in 8-week-old male C57BL/6 mice by cecal ligation and puncture (CLP). Anti-OPN Ab or non-immunized IgG as control, at a dose of 50 mug/mouse, was intravenously injected at …


Stimulation Of Wnt/Beta-Catenin Signaling Pathway With Wnt Agonist Reduces Organ Injury After Hemorrhagic Shock, M. Kuncewitch, W.L. Yang, A. Jacob, A. Khader, M. Giangola, Jeffrey Nicastro, G. Coppa, P. Wang Jan 2015

Stimulation Of Wnt/Beta-Catenin Signaling Pathway With Wnt Agonist Reduces Organ Injury After Hemorrhagic Shock, M. Kuncewitch, W.L. Yang, A. Jacob, A. Khader, M. Giangola, Jeffrey Nicastro, G. Coppa, P. Wang

Journal Articles

BACKGROUND: Hemorrhagic shock is a leading cause of morbidity and mortality in surgery and trauma patients. Despite a large number of preclinical trials conducted to develop therapeutic strategies against hemorrhagic shock, there is still an unmet need for effective therapy for hemorrhage patients. Wnt/beta-catenin signaling controls developmental processes and cellular regeneration owing to its central role in cell survival and proliferation. We therefore hypothesized that the activation of Wnt signaling reduces systemic injury caused by hemorrhagic shock. METHODS: Adult male Sprague-Dawley rats underwent hemorrhagic shock by controlled bleeding of the femoral artery to maintain a mean arterial pressure of 30 …


Endoplasmic Reticulum Stress In Sepsis, M. M. Khan, W.L. Yang, P. Wang Jan 2015

Endoplasmic Reticulum Stress In Sepsis, M. M. Khan, W.L. Yang, P. Wang

Journal Articles

Sepsis is an enormous public health issue and the leading cause of death in critically ill patients in intensive care units. Overwhelming inflammation, characterized by cytokine storm, oxidative threats, and neutrophil sequestration, is an underlying component of sepsis-associated organ failure. Despite recent advances in sepsis research, there is still no effective treatment available beyond the standard of care and supportive therapy. To reduce sepsis-related mortality, a better understanding of the biological mechanism associated with sepsis is essential. Endoplasmic reticulum (ER), a subcellular organelle, is responsible for the facilitation of protein folding and assembly and involved in several other physiological activities. …


Blocking Cold-Inducible Rna-Binding Protein Protects Liver From Ischemia-Reperfusion Injury, A. Godwin, W. L. Yang, A. Sharma, A. Khader, Z. Wang, F. Zhang, J. Nicastro, G.F. Coppa, P. Wang Jan 2015

Blocking Cold-Inducible Rna-Binding Protein Protects Liver From Ischemia-Reperfusion Injury, A. Godwin, W. L. Yang, A. Sharma, A. Khader, Z. Wang, F. Zhang, J. Nicastro, G.F. Coppa, P. Wang

Journal Articles

Cold-inducible RNA-binding protein (CIRP) is a nuclear protein that has been recently identified as a novel inflammatory mediator in hemorrhagic shock and sepsis. We hypothesized that CIRP acts as a potent inflammatory mediator in hepatic ischemia-reperfusion (I/R), and thus blocking CIRP protects against I/R-induced liver injury. Male C57BL/6 mice were subjected to 70% hepatic ischemia by microvascular clamping of the hilum of the left and median liver lobes for 60 min, followed by reperfusion. Anti-CIRP antibody (1 mg/kg body weight) or vehicle (normal saline) in 0.2 mL was injected via the internal jugular vein at the beginning of the reperfusion. …


Differential Alterations Of Tissue T-Cell Subsets After Sepsis, A. Sharma, W.L. Yang, S. Matsuo, P. Wang Jan 2015

Differential Alterations Of Tissue T-Cell Subsets After Sepsis, A. Sharma, W.L. Yang, S. Matsuo, P. Wang

Journal Articles

Among immune cells in responding to sepsis, macrophages and neutrophils have been extensively studied, while the contribution of T lymphocytes and natural killer T (NKT) cells is less well characterized. Here we monitored tissue specific changes of T cell subsets in male C57BL/6 mice subjected to sham operation or cecal ligation and puncture (CLP) to induce polymicrobial sepsis. Thymus, spleen, liver, lungs and blood were processed and analyzed 20h later. Total lymphocyte count showed a significant reduction in septic thymus, spleen and blood but not in lungs and liver. The septic thymi were hypocellular with severe reduction in cell numbers …


Combination Of Adrenomedullin With Its Binding Protein Accelerates Cutaneous Wound Healing, J. P. Idrovo, W. L. Yang, A. Jacob, M. A. Ajakaiye, C. Cheyuo, Z. M. Wang, J. M. Prince, J. Nicastro, G.F. Coppa, P. Wang Jan 2015

Combination Of Adrenomedullin With Its Binding Protein Accelerates Cutaneous Wound Healing, J. P. Idrovo, W. L. Yang, A. Jacob, M. A. Ajakaiye, C. Cheyuo, Z. M. Wang, J. M. Prince, J. Nicastro, G.F. Coppa, P. Wang

Journal Articles

Cutaneous wound continues to cause significant morbidity and mortality in the setting of diseases such as diabetes and cardiovascular diseases. Despite advances in wound care management, there is still an unmet medical need exists for efficient therapy for cutaneous wound. Combined treatment of adrenomedullin (AM) and its binding protein-1 (AMBP-1) is protective in various disease conditions. To examine the effect of the combination treatment of AM and AMBP-1 on cutaneous wound healing, full-thickness 2.0-cm diameter circular excision wounds were surgically created on the dorsum of rats, saline (vehicle) or AM/AMBP1 (96/320 mu g kg BW) was topically applied to the …