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Fulminant Hepatic Failure Bridged To Liver Transplantation With Molecular Adsorbent Recirculating System: A Single Center Experience, Cataldo Doria Md, Lucio Mandala Md, Victor L. Scott Md, Salvatore Gruttadauria Md, Ignazio R. Marino Md

Department of Surgery Faculty Papers

Purpose: We herein describe the clinical course of a consecutive series of fulminant hepatic failure patients treated with molecular adsorbent recirculating system, a cell-free albumin dialysis technique. From November 2000 to September 2002, 7 adult patients age 22-61 (median 41), one male (14.2%), and 6 females (85.7%), affected by fulminant hepatic failure, underwent 7 courses (1 to 5 session each, six hours in duration) of extracorporeal support using the molecular adsorbent recirculating system technique. Pre and post treatment blood glucose, liver function tests, ammonia, arterial lactate, electrolytes, hemodynamic parameters, arterial blood gases, liver histology, Glasgow Coma Scale, and coagulation studies, …

Analysis Of Epstein-Barr Virus Reservoirs In Paired Blood And Breast Cancer Primary Biopsy Specimens By Real Time Pcr., R Serene Perkins, Katherine Sahm, Cindy Marando, Diana Dickson-Witmer, Gregory R Pahnke, Mark Mitchell, Nicholas J Petrelli, Irving M Berkowitz, Patricia Soteropoulos, Virginie M Aris, Stephen P Dunn, Leslie J Krueger

Department of Surgery Faculty Papers

INTRODUCTION: Epstein-Barr virus (EBV) is present in over 90% of the world's population. This infection is considered benign, even though in limited cases EBV is associated with infectious and neoplastic conditions. Over the past decade, the EBV association with breast cancer has been constantly debated. Adding to this clinical and biological uncertainty, different techniques gave contradictory results for the presence of EBV in breast carcinoma specimens. In this study, minor groove binding (MGB)-TaqMan real time PCR was used to detect the presence of EBV DNA in both peripheral blood and tumor samples of selected patients. METHODS: Peripheral blood and breast …

Coping Processes Of Couples Experiencing Infertility, Brennan Peterson, Christopher R. Newton, Karen H. Rosen, Robert S. Shulman

Psychology Faculty Articles and Research

This study explored the coping processes of couples experiencing infertility. Participants included 420 couples referred for advanced reproductive treatments. Couples were divided into groups based on the frequency of their use of eight coping strategies. Findings suggest that coping processes, which are beneficial to individuals, may be problematic for one's partner. Couples where men used high amounts of distancing, while their partner used low amounts of distancing, reported higher levels of distress when compared to couples in the other groups. Conversely, couples with women who used high amounts of self-controlling coping, when paired with men who used low amounts of …

Inhibition Of Collagen Gene Expression In Systemic Sclerosis Dermal Fibroblasts By Mithramycin, Nora Sandorfi, Natalia Louneva, Elena Hitraya, Gyorgy Hajnoczky, Biagio Saitta, Sergio A. Jimenez

Selected Works of Sergio Jiménez, MD, MACR

ABSTRACT

Introduction. The antitumor antibiotic mithramycin has also been shown to be a potent and effective inhibitor of fibrosis following glaucoma surgery. This DNA interacting drug displays high affinity binding to GC rich sequences in DNA, including those present in the promoter of the gene encoding the Α1 chain of type I collagen (COL1A1).

Objective. To evaluate the effects of mithramycin on the production of type I collagen in fibroblast cultures from patients with systemic sclerosis. Methods. Confluent cultures of dermal fibroblasts from patients with recent onset of the diffuse form of systemic sclerosis were treated with varius concentrations of …

Comparison Between Gram Stain And Culture For The Characterization Of Vaginal Microflora: Definition Of A Distinct Grade That Resembles Grade I Microflora And Revised Categorization Of Grade I Microflora, Rita Verhelst, Hans Verstraelen, Geert Claeys, Gerda Verschraegen, Leen Van Simaey, Catharine De Ganck, Ellen De Backer, Marleen Temmerman, Mario Vaneechoutte

Obstetrics and Gynaecology, East Africa

Background: The microbiological diagnosis of bacterial vaginosis is usually made using Nugent's criteria, a useful but rather laborious scoring system based on counting bacterial cell types on Gram stained slides of vaginal smears. Ison and Hay have simplified the score system to three categories and added a fourth category for microflora with a predominance of the Streptococcus cell type. Because in the Nugent system several cell types are not taken into account for a final score, we carried out a detailed assessment of the composition of the vaginal microflora in relation to standard Gram stain in order the improve the …

A Case Of Transient Diabetes Insipidus Following Cardiopulmonary Bypass, Omer Ashraf, Hasanat Sharif, Mansoor Shah

Section of Cardiothoracic Surgery

Cardiopulmonary bypass surgery has been linked with a number of postoperative complications. One of the frequently reported physiological alterations is the relative diuresis seen in the immediate post-op period. Rarely reported though is the development of full-blown diabetes insipidus in such patients. The etiology is unknown and has only been hypothesized in the past. We present the clinical course of a 54 year old male who developed transient diabetes insipidus post bypass surgery with subsequent recovery following exogenous vasopressin administration. The physiological alteration leading to the development of diabetes insipidus in a small fraction of bypass patients remains unknown. We …

Ricketts And Steiner Analysis Using Newtom 3g™ Scout Images, James I. Gibson Iii

Loma Linda University Electronic Theses, Dissertations & Projects

NewTom 3G™ scout images have the general appearance of traditional lateral cephalometric radiographs. The purpose of this research was to determine if Ricketts and Steiner analyses could be accomplished on NewTom 3G™ scout images.

This was a retrospective study comparing the use of NewTom 3G™ scans in DICOM (Digital Imaging and Communications in Medicine) format to scout images from 25 consecutive patients of the Loma Linda University School of Dentistry Department of Orthodontics, three of these patients did not meet the inclusion criteria. The DICOM images were used to create controls. The controls and scout images were digitized using QuickCeph™. …

Fixation Of Bilateral Pelvic Osteotomies With External Fixator In Exstrophy Bladder Complex, Salman Riaz, Shahbaz Sarwar, Masood Umer

Department of Surgery Docs

Abstract

OBJECTIVE:

To present the early results of pelvic osteotomies performed for repair of exstrophy bladder.

METHODS:

Five cases of exstrophy bladder were treated with closure following bilateral iliac osteotomies. Three patients underwent closure of pubic symphysis diastasis by use of external fixator, one by screws and cerclage wires, and one by use of K-wires and suture. The patients were followed up by the pediatric urologist and orthopedic surgeon.

RESULTS:

All patients achieved a closure of diastasis and a tension free repair after the index surgery. The average follow-up was 3.6 years with range of 4 months to 6 years. …

Continuous Asl Perfusion Fmri Investigation Of Higher Cognition: Quantification Of Tonic Cbf Changes During Sustained Attention And Working Memory Tasks, Junghoon Kim, John Whyte, Jiongjiong Wang, Hengyi Rao, Kathy Z. Tang, John A. Detre

Department of Rehabilitation Medicine Faculty Papers

Arterial spin labeling (ASL) perfusion fMRI is an emerging method in clinical neuroimaging. Its non-invasiveness, absence of low frequency noise, and ability to quantify the absolute level of cerebral blood flow (CBF) make the method ideal for longitudinal designs or low frequency paradigms. Despite the usefulness in the study of cognitive dysfunctions in clinical populations, perfusion activation studies to date have been conducted for simple sensorimotor paradigms or with single-slice acquisition, mainly due to technical challenges. Using our recently developed amplitude-modulated continuous ASL (CASL) perfusion fMRI protocol, we assessed the feasibility of a higher level cognitive activation study in twelve …

When Red Lights Look Yellow, Joanne M. Wood, David A. Atchison, Alex Chaparro

Publications

Purpose. Red signals are typically used to signify danger. This study was conducted to investigate a situation identified by train drivers in which red signals appear yellow when viewed at long distances (∼900 m) through progressive-addition lenses.

Methods. A laboratory study was conducted to investigate the effects of defocus, target size, ambient illumination, and surround characteristics on the extent of the color misperception of train signals by nine visually normal participants. The data from the laboratory study were validated in a field study by measuring the amounts of defocus and the distances at which the misperception of the color of …

Surgical Emphysema In The Neck As A Result Of A Dental Procedure, Moghira Iqbal, Mubasher Ikram, Farhan Raza, Ninette Banday

Section of Otolaryngology, Head & Neck Surgery

We report the development of subcutaneous emphysema in a middle-aged woman that occurred several hours after she had undergone a dental restoration procedure. The patient presented to the emergency department, and she was admitted for observation and prophylactic antibiotic coverage. She recovered in 3 days without further intervention and was discharged.

Dural Metastases Presenting As An Extradural Hematoma: A Rare Presentation, Muhammad Shahzad Shamim, Muhammad Ehsan Bari, S. Ather Enam

Department of Surgery Docs

Abstract

We report a case of an elderly man who presented with hemiparesis and plain CT scan findings highly suggestive of an extradural hematoma as the underlying cause. This patient was later found to have dural metastases secondary to bronchogenic carcinoma. Dural metastases are rare, usually presenting as dural mass, but may also present as chronic subdural or extradural hematoma on non contrast CT scan, leading to an erroneous diagnosis in the unsuspecting.

Evaluation Of Stature Development During Childhood And Adolescence In Individuals With Familial Hypophosphatemic Rickets, Mauro M. S. Borghi, Verônica Coates, Hatim A. Omar

Pediatrics Faculty Publications

This review was conducted to study the diagnosis, treatment, and growth progression in infants and adolescents with familial hypophosphatemic rickets. The bibliographic search was carried out utilizing the electronic databases MEDLINE, OVID, and LILACS and by direct research within the last 15 years using the keywords rickets, familial hypophosphatemia, vitamin D deficiency, stature growth, childhood, and adolescence. Article selection was done by comparing the evaluation of the growth in patients with familial hypophosphatemic rickets, including the variables that might affect them, for possible future therapeutic proposals. It is concluded that the most significant fact in the treatment of familial hypophosphatemic …

Evaluation Of African-American And White Racial Classification In A Surveillance, Epidemiology, And End Results Cancer Registry, Diva A. Patel, Alicia Knowles, Ann G. Schwartz, Kendra Schwartz

FMPHS Faculty Publications

Objectives: This study evaluated the validity of registry-reported race for individuals who participated in research studies conducted since 1980 through the Metropolitan Detroit Cancer Surveillance System (MDCSS), a Surveillance, Epidemiology, and End Results (SEER) Program registry.

Methods: 5329 individuals who self-identified as African American or White and were classified in the MDCSS registry as African American or White were included. Self-identified and registry-reported race were compared, and associations between demographics and racial misclassification were examined.

Results: Most self-identified African Americans and Whites were correctly classified (sensitivity= 98.5%, specificity=99.7%). Males were two times more likely to be misclassified than females [odds …

Near-Infrared Characterization Of Breast Tumors In Vivo Using Spectrally-Constrained Reconstruction, Subhadra Srinivasan, Brian W. Pogue, Ben Brooksby, Shudong Jiang, Hamid Dehghani, Christine Kogel, Wendy A. Wells, Steven P. Poplack, Keith D. Paulsen

Dartmouth Scholarship

Multi-wavelength Near-Infrared (NIR) Tomography was utilized in this study to non-invasively quantify physiological parameters of breast tumors using direct spectral reconstruction. Frequency domain NIR measurements were incorporated with a new spectrally constrained direct chromophore and scattering image reconstruction algorithm, which was validated in simulations and experimental phantoms. Images of total hemoglobin, oxygen saturation, water, and scatter parameters were obtained with higher accuracy than previously reported. Using this spectral approach, in vivo NIR images are presented and interpreted through a series of case studies (n=6 subjects) having differing abnormalities. The corresponding mammograms and ultrasound images are also evaluated. Three of six …

Flow Cytometric And Demographic Analysis Of T Cell Acute Lymphoblastic Leukemia In Pakistani Population., M R. Khawaja, S S. Allana, N N. Akbaral, S N. Adil, M. Khurshid, Shahid Pervez

Department of Pathology and Laboratory Medicine

Background: This study was carried out to analyze the proportion of T cell acute lymphoblastic leukemia (TALL) among all acute lymphoblastic leukemia (ALL) in Pakistani population and its correlation with the demographic features. Accuracy of cell surface markers used in flow cytometric analysis of the leukemic cells was also determined.

Methods: Data of 209 consecutive cases of acute lymphoblastic leukemia (ALL) presenting between July 1995 and July 2003 was analyzed. Flow cytometry was performed on all ALL cases using the standard protocols. TALL markers included CD3, CD5 and CD7.

Results: Proportion of TALL among known ALL Pakistani patients was 17.22%. …

Chromosomal Localization Of The Islet Neogenesis Associated Protein (Ingap) Gene In Syrian Hamster By Tyramide Signal Amplification-Fluorescence In Situ Hybridization (Tsa-Fish), Sallie A. Smith

Biological Sciences Theses & Dissertations

Diabetes mellitus is a group of conditions characterized by hyperglycemia due to an inability to produce or properly utilize insulin. The majority of cases fall into two categories, Type I and Type 2. Type I results from the autoimmune destruction of pancreatic β-cells of the islets. The beta cells are the exclusive source of insulin and the patient becomes entirely dependent on exogenous insulin to survive. Patients with Type 2 are distinguished by insulin resistance, a condition that develops due to the inability of the body to effectively use the insulin being produced. The β-cells gradually lose their ability to …

Oncolog, Volume 50, Number 09, September 2005, Don Norwood, Razelle Kurzrock Md, Robert S. Benjamin Md

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• A New Source of Stem Cells
• House Call: Complementary and Alternative Medicine: Sorting through the Choices
• DiaLog: Risks and Benefits of Phase I Oncology Trials, by Razelle Kurzrock, MD, Professor, Division of Cancer Medicine Phase I Program, and Robert S. Benjamin, MD, Professor, Department of Sarcoma Medical Oncology

Magnification In Images Produced By Five Popular Digital Lateral Cephalometric Machines, Gretchen Marie Schnepper

Loma Linda University Electronic Theses, Dissertations & Projects

Modern digital lateral cephalometric images are produced by machines that vary in a number of critical features such as: 1) machine geometry, 2) movement (or lack of movement) of the x-ray source, 3) movement (or lack of movement) or x-ray detectors, 4) cephalostat geometry and 5) digital data manipulations by proprietary software. The purpose of this study was to evaluate the magnification characteristics of images produced by five commercial digital lateral cephalometric machines. These digital image magnification characteristics were then compared with images produced by an analog cephalometric machine. The two goals of this study were to: 1) measure the …

Treatment Outcome Of Root Perforations Repaired With Mineral Trioxide Aggregate, Stephen H. Paik

Loma Linda University Electronic Theses, Dissertations & Projects

Root perforations during root canal therapy have a significant negative impact on long-term prognosis of teeth. Proper treatment is critical in managing these accidental procedures. Laboratory and animal studies have demonstrated that Mineral Trioxide Aggregate (MTA) is biocompatible, provides an excellent seal against penetrating bacteria, and promotes hard tissue healing. The purpose of this study was to determine the long term treatment outcome of root perforations repaired with MTA.

Ninety-nine records from the Graduate Endodontic Clinic at Loma Linda University School of Dentistry from 1996 to 2001 were reviewed. Clinical and radiographic evaluations were completed. Three independent examiners evaluated digitized …

The Experience Of American And Canadian Cancer Patients In Deciding To Seek Alternative Care In Mexican Cancer Clinics, Alicia Bright

Dissertations, Masters Theses, Capstones, and Culminating Projects

Background. Each year, despite warnings from the American Cancer Association, many US and Canadian citizens travel to Tijuana, Mexico, for cancer care. The main criticism of these clinics is that they provide treatments that are unproven, potentially unsafe, and expensive. Despite this, about 35 clinics exist in Tijuana that provide alternative care to patients who pay cash for these services.

Objectives. To understand the lived experience of people who have made the choice to receive cancer treatment at alternative cancer clinics in Tijuana, and gain insight into the process by which that decision occurs.

Population. 5 participants were interviewed. Three …

Effects Of Resistance Training Volume And Variety On Dietary Intake And Mood State In Untrained Subject, Suzette K. Smith

Loma Linda University Electronic Theses, Dissertations & Projects

Background: While there is research on the effects of aerobic training on various aspects of mood state and nutrient intake, little is known of the effect of resistance training on these variables.

Purpose: To examine the effects of resistance training (RT) volume and variety on total energy (kcal) and macronutrient intake, and mood states in a healthy, untrained population.

Method:The investigation was part of a prospective experimental study examining the effects of three RT protocols on body composition and strength. An initial 102, healthy, untrained male and female participants, ages 20-40, were recruited, and randomized into one of three …

Prevention Of Deep Vein Thrombosis And Pulmonary Embolism In The Perioperative Period: A Review, Aliya Ahmed

Department of Anaesthesia

No abstract provided.

Total Knee Arthroplasty Using Computer-Assisted Navigation In Patients With Deformities Of The Femur And Tibia: A Report Of 5 Cases, Gregg R. Klein Md, Matthew S. Austin Md, Eric B. Smith Md, William J. Hozack Md

Department of Orthopaedic Surgery Faculty Papers

Anatomic aberrations of the femur and tibia secondary to trauma, congenital defects, and prior surgery present challenges for the reconstructive knee surgeon because of an altered mechanical axis and distorted anatomic landmarks. Five patients with arthritis of the knee and extra-articular femoral and/or tibial deformity, retained hardware, or intramedullary (IM) implants underwent total knee arthroplasty using a computer navigation system. The navigation system obviated the need for an IM guide, and the normal mechanical axis of the patients was restored. Extensive dissection for hardware removal or osteotomy was not necessary in these patients. In these 5 cases, a navigation system …

Pulmonary Embolism In Pemphigus Vulgaris, The Need For Judicious Immunotherapy, Omer Ashraf, Hasanat Sharif

Section of Cardiothoracic Surgery

Pemphigus vulgaris is a serious chronic mucocutaneous ailment. In recent decades advances in diagnostic and therapeutic measures have led to a significant decline in morbidity and mortality. However, with the advent of active and prolonged immunotherapy involving corticosteroids, there has been a rise in steroid-associated complications. This has led to significant concern globally over the sensible use of treatment regimen in pemphigus patients. We present a patient who underwent a massive pulmonary embolism following over usage of corticosteroid therapy for pemphigus vulgaris. Whilst the patient survived owing to timely assessment and aggressive surgical intervention, the need for cautious and judicious …

Recollections Of My Research In Developing The Heart-Lung Machine At Jefferson Medical College, Bernard J. Miller

Jefferson Biographies

A personal memoir written by Dr. Bernard J. Miller about his introduction to and interest in medical research as well as his experiences working on the heart-lung machine. He focuses specifically on his working relationship with John H. Gibbon, Jr., the development of a viable oxygenator and ventilator, and early testing of the machine on animals

Ponderal Index, Jabeen Fayyaz

Department of Emergency Medicine

No abstract provided.

Predictors Of Intention To Use Contraception, Given Alcohol Consumption, Among Women In Southeast Alaska, Donna Louise Hebbeler

Loma Linda University Electronic Theses, Dissertations & Projects

Fetal alcohol exposure is a serious public health problem and is 100% preventable. Traditionally, FASD prevention programs and research recommendations have targeted peri-conceptual or pregnant women. Another approach to the prevention of FASD involves preventing pregnancy in women who use alcohol. The purpose of this cross sectional study was to identify factors that predicted women’s intention to use contraception using the theory of planned behavior (TPB), to determine if predictors of the theoretical constructs varied in women depending on alcohol use, and to examine interactions between alcohol use and TPB constructs. Qualitative data was gathered to triangulate with the quantitative …

The Application Of The Transtheoretical Model Of Change To Self-Care Behaviors In Type 2 Diabetics, Heather N. Mercer

Loma Linda University Electronic Theses, Dissertations & Projects

Background. The Transtheoretical Model of Change (TTM) has been investigated as a model of health behavior change; however, it has only begun to gain recognition in the diabetic population, and has not yet been investigated as it relates to the full-spectrum of diabetes self-care behaviors.

Purpose. The purpose of this study was to compare the pattern of stages of change across four self-care behaviors between intervention and control groups, and examine psychosocial and health outcome variables.

Method. In a cross-sectional design, a sample of 132 adult subjects with type 2 diabetes completed surveys. The survey assessed stages of change among …

Perioperative Anaesthetic Management Of A Patient With Relapsed Aplastic Anaemia, Aliya Ahmed, Abdul Monem

Department of Anaesthesia

Aplastic anaemia occurs due to failure of blood cell production by bone marrow. All blood cell counts are low. Untreated patients may die within one year mainly due to uncontrolled infection due to neutropenia. Anaemia and thrombocytopenia cause troublesome symptoms and necessitate frequent red cell and platelets transfusions. Surgery poses a very high risk for these patients because of the several complications that can occur in the perioperative period. In this paper we report on a patient with relapsed aplastic anaemia who was optimized preoperatively and underwent a total abdominal hysterectomy under general anaesthesia.