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Mirizzi Syndrome Type Ii: Is Laparoscopic Cholecystectomy Justified?, D C Desai, R D Smink

Department of Surgery Faculty Papers

Mirizzi syndrome type II is an uncommon cause of obstructive jaundice caused by an inflammatory response to an impacted gallstone in Hartmann's pouch or the cystic duct with a resultant cholecystocholedochal fistula. Two cases of Mirizzi syndrome type II are presented. Clinically only one patient had jaundice and endoscopic retrograde cholangiopancreatogram (ERCP) established a preoperative diagnosis of Mirizzi syndrome. The other patient's diagnosis of Mirizzi syndrome was made intraoperatively. It is important to properly identify the anatomy at the time of surgery to avoid compromising the common bile duct. Operative treatment of Mirizzi syndrome type II includes laparoscopic or open …

Transcranial Magnetic Stimulation Of The Prefrontal Cortex Delays Contralateral Endogenous Saccades, Tony Ro, Avishai Henik, Liana Machado, Robert D. Rafal

Publications and Research

The contributions of the superior prefrontal cortex (SPFC) and the superior parietal lobule (SPL) in generating voluntary endogenous and reflexive visually guided saccades were investigated using transcranial magnetic stimulation (TMS). Subjects made choice saccades to the left or right visual field in response to a central arrowhead (endogenous go signal) or a peripheral asterisk (exogenous go signal) that were presented along with a single TMS pulse at varying temporal intervals. TMS over the SPFC increased latencies for saccades made in response to an endogenous go signal toward the contralateral hemifield. No effects were observed when the go signal was exogenous …

Fluorescence In Situ Hybridization Analysis Of Human Embryos Derived From In Vitro And In Vivo Matured Oocytes, Constance Descisciolo

Theses and Dissertations in Biomedical Sciences

Despite adequate hormonal stimulation, oocytes collected for the purpose of in vitro fertilization and embryo transfer display several levels of nuclear maturity. Preovulatory or mature oocytes, technically those that are Metaphase I or II, are inseminated shortly after aspiration and assessed for fertilization the following day. Prophase I oocytes, also called germinal vesicle-bearing or immature oocytes, require a 24-36 hour period in culture before being exposed to spermatozoa. During this time, the majority of Prophase I oocytes complete nuclear maturation in vitro, progressing from germinal vesicle breakdown through first polar body extrusion. If inseminated, many in vitro matured oocytes fertilize …

Department Of Radiology-Annual Report-July 1, 1996 To June 30, 1997, David C. Levin

Department of Radiology Administrative Documents and Reports

Department of Radiology Annual Report, July 1, 1996 to June 30, 1997. Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States. 108 pages.

The Effect Of The Hapad Longitudinal Metatarsal Arch Pad On Ground Reaction Forces And Rear Foot Angle, William F. Rocker

Masters Theses

The effectiveness of the Hapad Longitudinal Metatarsal Arch Pad (HLMAP) to correct for pronation was investigated using 30 female volunteer student subjects. The investigation consisted of measuring ground reaction forces measured by a force plate and rear foot angle (RFA) measured by video digitization. The repeated measures design consisted of l grouping variable with 3 levels, supinators, mildpronators, and over pronators, and 2 research variables, 10 trials, and pad/no-pad. The results indicated (a) no significant difference for medial or lateral force, propulsive force, vertic al thrust, negative torque among groups, or between pad/no-pad; (b) a significant difference was found for …

Vital Signs, Spring 1997, Boonshoft School Of Medicine

Vital Signs

A twenty four page newsletter created by the Boonshoft School of Medicine to document the current affairs of the school. This issue includes a variety of feature articles, alumni profiles, class notes, and more.

A Randomized Clinical Trial To Compare Selective Posterior Rhizotomy Plus Physiotherapy With Physiotherapy Alone In Children With Spastic Diplegic Cerebral Palsy, Paul Steinbok, Ann M. Reiner, Richard Beauchamp, Robert Armstrong, Douglas Cochrane

Paediatrics and Child Health, East Africa

A randomized controlled single-blind trial was performed to compare lumbo-sacral selective posterior rhizotomy (SPR) followed by intensive physiotherapy, with intensive physiotherapy alone in improving motor function in children with spastic diplegic cerebral palsy. Fifteen patients were randomly assigned to each treatment modality. Patients in the SPR group had rhizotomy within 1 month, followed by intensive outpatient physiotherapy for 9 months. Patients assigned to physiotherapy alone had identical intensive physiotherapy. There was a statistically significant and clinically important difference in improvement in motor function in favor of the SPR group, with a mean increase in total Gross Motor Function Measure (GMFM) …

Social And Cultural Factors Affecting Rates Of Regular Retreatment Of Mosquito Nets With Insecticide In Bagamoyo District, Tanzania, P.J. Winch, A.M. Makemba, V.R. Makame, M.S. Mfaume, M.C. Lynch, Zul Premji, J.N. Minjas, C.J. Shiff

Pathology, East Africa

Insecticide-treated mosquito nets have an impact on mortality and morbidity in young children under controlled conditions. When integrated into larger control programs, there is the danger that rates of regular retreatment of the nets with insecticide will drop, greatly limiting their effectiveness as a public health intervention. In Bagamoyo District, Tanzania, rates of retreatment dropped significantly when payment for the insecticide was introduced. A series of neighbourhood (hamlet) meetings were held in all study villages to discuss people's concerns about the insecticide and ways to increase rates of retreatment. Although changes were made in the procedure for retreatment, rates of …

Digest Of The Philadelphia College Of Osteopathic Medicine (Winter 1997), Philadelphia College Of Osteopathic Medicine

Digest

The Winter 1996 issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• The Faces of Founders Day 1997
• PCOM Welcomes Four Alumni Board Members
• PCOM Salutes Army “Top Doc" Gen. Ronald Blanck
• College Board Profile
• Alumni Board Profile
• Campus Update
• Capital Campaign Developments
• New Executive Vice President: Samuel H. Steinberg
• PCOM Gears Up for its 1999 Centennial
• Class Acts
• In Memoriam
• PCOM’s Website
• Just Published
• PCOM in the Media
• Coming Events

Identification, Localization, And Characterization Of Sodium/Hydrogen Exchanger Isoforms 1 And 3 In The Gerbil Cochlea, Brian R. Bond

MUSC Theses and Dissertations

Mongolian gerbils were used in an investigation into the expression of cochlear sodium/hydrogen (NHE) exchanger isoforms 1,2,3 and 4. NHE 1-4 gene products were identified in the gerbil inner ear by reverse-transcription polymerase chain reaction (RT-PCR). The distribution of NHE-1 and 3 subsequently was mapped in the adult gerbil inner ear using isoform-specific polyclonal antibodies generated against rat antigens. Changes in the cellular expression level of NHE-1 protein in response to treatment with dexamethasone or NH4 CI-induced acidification were then assessed by semiquantitative immunohistochemical analysis. Cochlear cDNA was amplified by the polymerase chain reaction (PCR) using NHE isoform-specific primers based …

An Investigation Of A Theoretical Model Of Willingness To Donate Blood, Douglas Adam

Theses: Doctorates and Masters

The Australian Red Cross Blood Transfusion Service (ARCBTS) in Western Australian faces a major problem with periodic shortages of blood components. These shortages are expected to become more frequent and severe as demand continues to increase at a faster rate than supply. Given that only five percent of the population is registered as blood donors, clearly, the challenge for the ARCBTS is to encourage more people to become regular blood donors. The current study was undertaken to assist the ARCBTS in achieving this goal, by identifying and investigating the factors that influence people's willingness to donate blood. Based on the …

The History Of The Present Illness As Treatment: Who's Listening, And Why Does It Matter?, Herbert M. Adler, Md, Phd

Department of Family & Community Medicine Faculty Papers

BACKGROUND: The history of the present illness (HPI) is examined as a narrative communication that has the potential to be therapeutic.

METHODS: The general principles that influence the therapeutic potential of the HPI are induced from participant observation of personal experience and natural observations of conventional social interaction. These principles are corroborated by evidence from cross-cultural healing practices, clinical experience, and experimental psychology.

RESULTS: To facilitate a therapeutic HPI, the clinician should convey a sense of safety, sensitivity, affective competence, and cognitive competence. Furthermore, the effective clinician joins the patient in coprocessing the illness experience.

CONCLUSIONS: The (HPI) is not …

Paediatric Prescribing In Karachi, S Q. Nizami, I A. Khan, Z A. Bhutta

Department of Paediatrics and Child Health

To assess amount of drug overuse we studied drug prescribing for common childhood problems by 65 general practitioners (GPs) and 29 paediatricians. A total of 2433 encounters between GPs or paediatricians and children under five years of age were observed. The presenting complaints were fever in 18%, cough in 9%, both fever and cough in 21%, vomiting in 20% and diarrhoea in 41% of encounters. Antibacterials were prescribed in 49% of encounters, analgesics and antipyretics in 29%, antiemetics in 8% and injectables in 15%. Antidiarrhoeals were prescribed in 41% encounters with children reported to have diarrhoea. Ampicillin and cotrimoxazole were …

Basement Membrane And Repair Of Injury To Peripheral Nerve: Defining A Potential Role For Macrophages, Matrix Metalloproteinases, And Tissue Inhibitor Of Metalloproteinases-1, Monique La Fleur, Johnnie L. Underwood, Daniel A. Rappolee, Zena Werb

Department of Obstetrics and Gynecology Research Publications

Injury to a peripheral nerve is followed by a remodeling process consisting of axonal degenera- tion and regeneration. It is not known how Schwann cell–derived basement membrane is pre- served after injury or what role matrix metalloproteinases (MMPs) and their inhibitors play in axonal degeneration and regeneration. We showed that the MMPs gelatinase B (MMP-9), stromelysin-1 (MMP-3), and the tissue inhibitor of MMPs (TIMP)-1 were induced in crush and distal segments of mouse sciatic nerve after injury. TIMP-1 inhibitor activity was present in excess of proteinase activity in extracts of injured nerve. TIMP-1 protected basement mem- brane type IV collagen …

Experience With Larangeal Mask Airway In Pakistani Patients, F A. Khan, M A. Afzal, R S. Kamal

Department of Anaesthesia

One hundred and thirty seven adult patients undergoing peripheral surgery were studied regarding ease of larangeal mask airway (LMA) insertion, airway maintenance during surgery and complication encountered during insertion, maintenance and in the postoperative period. In a majority (84%) of patients, the airway was positioned correctly at the first attempt, 3% patients had mild laryngospasm at insertion and in 85% a good airway was obtained. No airway related problems were encountered intraoperatively. Two percent patients had laryngospasm on removal of LMA. Postoperatively, the complaint of sore throat and uvular trauma was seen in 4% cases.

Glanzmann Thrombasthenia. Cooperation Between Sequence Variants In Cis During Splice Site Selection., Ying Jin, Harry C. Dietz, Robert A. Montgomery, William R. Bell, Iain Mcintosh, Barry Coller, Paul F. Bray

Cardeza Foundation for Hematologic Research

Glanzmann thrombasthenia (GT), an autosomal recessive bleeding disorder, results from abnormalities in the platelet fibrinogen receptor, GP(IIb)-IIIa (integrin alpha(IIb)beta3). A patient with GT was identified as homozygous for a G-->A mutation 6 bp upstream of the GP(IIIa) exon 9 splice donor site. Patient platelet GP(IIIa) transcripts lacked exon 9 despite normal DNA sequence in all of the cis-acting sequences known to regulate splice site selection. In vitro analysis of transcripts generated from mini-gene constructs demonstrated that exon skipping occurred only when the G-->A mutation was cis to a polymorphism 116 bp upstream, providing precedence that two sequence variations …

Pregnancy Induced Hypertension--Anaesthetic Considerations, N A. Zubair

Department of Anaesthesia

No abstract provided.

Efficient Vasoactive Intestinal Polypeptide Hydrolyzing Autoantibody Light Chains Selected By Phage Display, Sonia Tyutyulkova, Qing-Sheng Gao, Austin Thompson, Stephen I. Rennard, Sudhir Paul

Journal Articles: Pulmonary & Critical Care Med

An immunoglobulin light chain (L chain) library derived from the peripheral blood lymphocytes of a patient with asthma was cloned into a phagemid vector. Phage particles displaying L chains capable of binding vasoactive intestinal polypeptide (VIP) were isolated by affinity chromatography. Two VIP binding L chains were expressed in Escherichia coli in soluble form and purified to electrophoretic homogeneity by metal chelating and protein L affinity chromatography. Both L chains catalyzed the hydrolysis of [tyr10-125I]VIP substrate. The catalytic activity eluted at the molecular mass of the monomer form of the L chain (28 kDa) from a gel filtration column. The …

Effects Of Exercise And Psychosocial Stress On Blood Glucose In Non-Insulin Dependent Diabetics, Lisa Renae Clemensen

Dissertations

Non-insulin dependent diabetes often has serious consequences for individuals if blood glucose is not maintained within relatively normal ranges. Exercise and stress have been enumerated as important variables for the control of blood glucose in non-insulin dependent diabetics.

This study compared blood glucose and stress for eight exercise and eight matched control non-exercise adult noninsulin dependent participants. A prospective home monitoring design was used to monitor daily blood glucose, stress, and physical activity via multiple measures for six days.

Results indicated that control participants had significantly higher average blood glucose readings and higher blood glucose variability. Daily stress measures did …

Method Of Tendon Repair, Bradley B. Hill

Surgery Faculty Patents

A method for repairing a transected or torn flexor or extensor tendon of a finger that has retracted proximally within its protective sheath includes the steps of: (a) visually locating a distal end of the tendon within the sheath; (b) engaging the distal end of the tendon, (c) pulling the tendon distally through the sheath to a tendon mending position; and (d) repairing the tendon.

Subcutaneous Phaeohyphomycosis: Infection With Pigmented Fungi, I N. Soomro, A Kennedy

Department of Pathology and Laboratory Medicine

No abstract provided.

Fulminant Hepatic Failure In Pregnant Women: Acute Fatty Liver Or Acute Viral Hepatitis?, S S. Hamid, S M. Jafri, H Khan, H Shah, Z Abbas, H Fields

Section of Gastroenterology

Background: Hepatitis E virus, which is endemic in our region, can cause severe liver dysfunction in pregnant women and this can be clinically confused with acute fatty liver of pregnancy.

Methods: We studied the clinical and laboratory data as well as the maternal and fetal outcomes of 12 pregnant women presenting with fulminant hepatic failure in order to determine the etiology of the disease. The clinical diagnoses were subsequently correlated with serologic assays for acute HEV infection. All patients were severely ill with deep jaundice, grade 3-4 encephalopathy and abnormal prothrombin times.

Results: A clinical diagnosis of acute viral …

Department Of Radiology-Annual Report-July 1, 1995 To June 30, 1996, David C. Levin

Department of Radiology Administrative Documents and Reports

Department of Radiology Annual Report, July 1, 1995 to June 30, 1996. Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States. 110 pages.

Apparatus And Method For Restoring Eyelid Function, Robert S. Baker, Brian J. Willoughby, Robert R. Marshall

Ophthalmology and Visual Science Faculty Patents

An apparatus is provided to restore eyelid function in a patient unable to voluntarily raise an eyelid. The apparatus includes a spiral torsion spring and pulley arrangement mounted in a housing that is implanted in the superior portion of the orbit of the eye. A wire connects the pulley to the eyelid. A spiral torsion spring provides the necessary spring force in tension to overcome the weight of the eyelid and draw the eyelid open. The natural muscles of eye closure are, however, sufficiently strong to overcome the spring tension thereby paying out wire from the pulley and closing the …

The Effects Of Lowering Cholesterol On Vasodilation, Maria Christi Hardt

Loma Linda University Electronic Theses, Dissertations & Projects

Endothelial dysfunction has been found prior to any signs of atherosclerotic plaque formation in patients with a variety of risk factors for atherosclerosis. Elevated serum cholesterol has repeatedly been associated with endothelial dysfunction as demonstrated by impaired vasoreactivity to vasodilating stimuli.

The aim of this research was to determine whether short term lowering of serum cholesterol levels by life style changes or by cholesterol lowering medication could reverse or reduce the endothelial dysfunction. The brachial artery diameter was measured by high-resolution ultrasound at rest and during reactive hyperemia pre and postintervention. Fifty-three subjects with cholesterol levels above 240 mg/dl were …

Treatment Effects Of The Edgewise Bioprogressive Herbst Appliance, Bernard C. Chang

Loma Linda University Electronic Theses, Dissertations & Projects

The effect of the Edgewise Bioprogressive Herbst appliance, as described by Dr. Terry Dischinger, was investigated on 24 Class II, Division 1 malocclusions. Mean pretreatment age of this sample was 11.2 months. All patients were treated by Dischinger with a Bioprogressive Herbst appliance. Lateral cephalographs taken before, after Herbst appliance therapy, and after edgewise treatment were traced, then digitized into Quick Ceph™. Measurements were computed by the computer software. The following results were found: 1) Average treatment time was 9 months. 2) An overcorrected Class I relationship was achieved. 3) Class II malocclusion was corrected by 4.5 mm skeletal alteration …

The Accuracy Of Computer Video Imaging Prediction : Just Prior To Surgical Mandibular Advancement/Genioplasty Orthognathic Cases, Jason T. Chiakowsky

Loma Linda University Electronic Theses, Dissertations & Projects

The accuracy of the computer video imaging treatment prediction was investigated using Quick Ceph Image.™ Thirty one surgical mandibular advancement/genioplasty orthognathic cases were examined to determine if the soft tissue profile prediction was representative of the actual result. All patients were over the age of 18. Lateral cephalographs and slides were taken immediately pre-surgically, and six months post-surgically. The slides were duplicated into 4X6 photographs. The cephalographs were digitized and the photographs captured by video on the Quick Ceph Image software program. A line drawing and computer video image treatment prediction were generated using the actual surgical change that had …

A Validation Of Target Heartrate Formulas Used In Swimming, Tasha Kay Litwinski

Masters Theses

The purpose of this study was to explore whether procedures used to establish target heart rates (THRs) for running are applicable to front crawl swimming. Eight male and 22 female fitness swimmers from Western Michigan University participated in this study. Their exercise durations under three experimental conditions were compared. The conditions were: (a) Condition 1, a treadmill run at an intensity equal to a THR of 85% of heart rate reserve (HRR); (b) Condition 2, a front crawl swim at an intensity equal to 85% of HRR; and (c) Condition 3, a front crawl swim at an intensity equal to …

Perturbations Of Periosteel Bone During Healing: Effect Of Non-Weight Bearing, Helen E. Gruber, Mary E. Kirchen, John R. Sweeney, William E. Anderson, G. June Marshall

Cells and Materials

Weight bearing (WB) is an important factor influencing bone remodelling. The present study evaluates the effects of weight bearing and non-weight bearing (S) (achieved by tail suspension and hindlimb elevation) on the healing of a fibular osteotomy in adult male rats. After 9, 18 or 36 days under WB or S conditions, periosteum near the callus formed at the osteotomy site was compared to periosteum of the contralateral fibula (which did not receive an osteotomy) or to periosteum of fibula of control animals which did not receive an osteotomy. Data show that periosteal bone healing is sensitive to alterations in …

Validation Of Energy Dispersive X-Ray Spectrometry As A Method To Standardize Backscattered Electron Images Of Bone, E. G. Vajda, R. D. Bloebaum, J. G. Skedros

Cells and Materials

The use of backscattered electron (BSE) imaging as a tool for the qualitative measurement of mineral content in bone has been well documented. The challenge still remains to develop BSE imaging as a tool for quantitative mineral content analysis in bone. The limiting factor has been the ability to standardize the BSE signal within and between laboratories. Energy dispersive x-ray spectrometry (EDX) has been proposed as a method to standardize the BSE operating environment. The goal of this study is to investigate the relationship between EDX-determined wt.% Ca measurements and BSE graylevels. A comparison with traditional ash content measurements will …