Digital Commons Network^™

Safety And Efficacy Of Drug-Eluting Balloons In The Treatment Of Drug-Eluting In-Stent Restenosis: Experience Of A Tertiary Care Hospital, Sajid H. Dhakam, Asif Jafferani, Hafeez Ahmed, Nasir Rahman, Ambreen Gowani

Section of Cardiology

Background: The advent of drug-eluting balloons (DEBs) is a promising development for coronary revascularization procedures, especially for in-stent restenosis (ISR). This study aims to highlight our experience with DEBs in the treatment of drug-eluting ISR at a tertiary care hospital in Pakistan.

Methods: All Patients presenting to our institution from August 2008 to February 2011 with significant drug-eluting in-stent restenosis (DES-ISR) who were eligible to receive treatment via DEB were included in the analysis. Patient baseline characteristics and angiographic data about the lesion characteristics were obtained. Postprocedural and follow-up endpoints, including cardiac death, myocardial infarction, and repeat revascularization, ie, major …

Malignant Peripheral Nerve Sheath Tumor (Mpnst): An Overview With Emphasis On Pathology, Imaging And Management Strategies., Timothy C. Beer

Jefferson Hospital Staff Papers and Presentations

MPNSTs are rare malignancies that are classically associated with pre-existing plexiform neurofibromas in neurofibromatosis type 1 (NF-1) patients, but also occur in association with radiation as well as sporadically in patients with no known risk factors. The typical presentation of sporadic MPNST is a new painless enlarging mass. The typical presentation of MPNST in an NF-1 patient is rapid enlargement or new onset of pain associated with a pre-existing plexiform neurofibroma. Although both MPNST and benign neurofibromas share in common the absence of neurofibromin function due to loss of both NF-1 alleles, malignant transformation to MPNST requires several additional aberrations, …

The Use Of Epoetin-Α In Revision Knee Arthroplasty., Lawrence A Delasotta, Ashwin V Rangavajjula, Michael L Frank, Jamie L Blair, Fabio R Orozco, Alvin C Ong

Department of Surgery Faculty Papers

Introduction. To evaluate the efficacy of epoetin-α prior to revision total knee arthroplasty, we hypothesized that epoetin-α will reduce blood transfusion. Methods. Eighty-one patients were compared in this retrospective review; twenty-eight patients received our dosing regimen. All patients were mildly anemic. Epoetin-α to control (1 : 2) patient matching occurred so that one of two attending surgeons, gender, BMI, complexity of surgery, ASA score, and age were similar between groups. The clinical triggers for blood transfusion during or after the procedure were determined based on peri- and postoperative hemoglobin levels, ASA score, and/or clinical symptoms consistent with anemia. Blood salvage …

Melanotic Neuroectodermal Tumour Of Infancy: A Rare Brain Tumour Of Childhood, Muhammad Babar Khan, Delvene Soares, Muhammad Zubair Tahir, Rajesh Kumar, Khurram Minhas, Muhammad Ehsan Bari

Medical College Documents

Melanotic neuroectodermal tumour of infancy is a rare, mostly benign but locally aggressive tumour of neural crest cell
origin occurring in infants. The most commonly affected anatomic site is the maxilla. Such tumours of the brain and skull are very rare. We present the case of an 8 months old baby girl whose presenting complaint was a swelling in the scalp for 6 months. She was otherwise asymptomatic. CT imaging confirmed the presence of an osteolytic tumour in the anterior parasagittal skull with dural involvement. The tumour was surgically excised enbloc. The patient has been well at 2 years follow-up …

The Relationship Between Cancer-Related Fatigue And Upper Extremity Function In Breast Cancer Survivors, Meryl Marger Picard

Seton Hall University Dissertations and Theses (ETDs)

Background: Cancer-related fatigue (CRF) and arm morbidity constitute the two most common symptom complexes impacting breast cancer survivors (BCS) following surgery and adjuvant treatment, but these multifaceted entities have traditionally been researched as if they were separately occurring events in the survivor’s recovery. Objective: This study examined the relationship between breast cancer survivors’ perceptions of CRF and upper extremity function one to six years post-diagnosis. The study further investigated the impact of multiple adjuvant therapies, node dissection procedures, caring for dependent children, and physical aspects of employment on CRF and upper extremity function. Methods: One hundred fifty-eight BCS responded to …

Development And Validation Methodology Of The Nuss Procedure Surgical Planner, Krzysztof J. Rechowicz

Computational Modeling & Simulation Engineering Theses & Dissertations

Pectus excavatum (PE) is a congenital chest wall deformity which is characterized, in most cases, by a deep depression of the sternum. A minimally invasive technique for the repair of PE (MIRPE), often referred to as the Nuss procedure, has been proven to be more advantageous than many other PE treatment techniques. The Nuss procedure consists of placement of a metal bar(s) underneath the sternum, thereby forcibly changing the geometry of the ribcage. Because of the prevalence of PE and the popularity of the Nuss procedure, the demand to perform this surgery is greater than ever. Therefore, a Nuss procedure …

Towards Omni-Tomography -- Grand Fusion Of Multiple Modalities For Simultaneous Interior Tomography, Ge Wang, Jie Zhang, Hao Gao, Victor Weir, Hengyong Yu, Wenxiang Cong, Xiaochen Xu, Haiou Shen, James Bennett, Mark Furth, Yue Wang, Michael Vannier

Radiology Faculty Publications

We recently elevated interior tomography from its origin in computed tomography (CT) to a general tomographic principle, and proved its validity for other tomographic modalities including SPECT, MRI, and others. Here we propose "omni-tomography", a novel concept for the grand fusion of multiple tomographic modalities for simultaneous data acquisition in a region of interest (ROI). Omni-tomography can be instrumental when physiological processes under investigation are multi-dimensional, multi-scale, multi-temporal and multi-parametric. Both preclinical and clinical studies now depend on in vivo tomography, often requiring separate evaluations by different imaging modalities. Over the past decade, two approaches have been used for multimodality …

Prevalence Of Streptococci And Increased Polymicrobial Diversity Associated With Cystic Fibrosis Patient Stability, L. M. Filkins, T. H. Hampton, A. H. Gifford, M. J. Gross, D. A. Hogan, M. L. Sogin, H. G. Morrison, B. J. Paster, G. A. O'Toole

Dartmouth Scholarship

Diverse microbial communities chronically colonize the lungs of cystic fibrosis patients. Pyrosequencing of amplicons for hypervariable regions in the 16S rRNA gene generated taxonomic profiles of bacterial communities for sputum genomic DNA samples from 22 patients during a state of clinical stability (outpatients) and 13 patients during acute exacerbation (inpatients). We employed quantitative PCR (qPCR) to confirm the detection of Pseudomonas aeruginosa and Streptococcus by the pyrosequencing data and human oral microbe identification microarray (HOMIM) analysis to determine the species of the streptococci identified by pyrosequencing. We show that outpatient sputum samples have significantly higher bacterial diversity than inpatients, but …

Influence Of A Short-Term, Multicomponent Intervention On Balance And Strength Among The Elderly, Pamela C. Webert

Master's Theses and Doctoral Dissertations

Background: Few studies have combined strength and balance training to assess improvement of activities of daily living among subjects over the age of 65. The purpose of this study was to demonstrate how an eight-week balance and strength training program can lead to improvements in activities of daily living among elderly individuals.

Methods: The subjects consisted of 14 elderly women and 3 elderly men who were all residents of an independent living community. There were 10 subjects in the intervention group and 7 subjects in the control group. The intervention group participated in a supervised balance and strength …

The Relationship Between Self-Reported Cancer Pain And Personality In Black And White Older Adults Receiving Outpatient Cancer Care, Jessica Krok

USF Tampa Graduate Theses and Dissertations

It is well-established that personality not only affects physical health and longevity, but also mental health and coping mechanisms. One area of limited research is the relationship between cancer pain and personality. This study examined how personality traits affect reported cancer pain severity in older patients (N = 150) receiving outpatient treatment at a comprehensive cancer center. Participants were interviewed regarding their pain severity, personality, affect, and self-efficacy for pain management. Symptom data were collected from the Brief Pain Inventory, while personality data were gathered from the Ten Item Personality Inventory and the Positive and Negative Affect Schedule. Self-efficacy for …

A Prospective Characterization Of Postpartum Changes In Uterine Fibroid Volume Among Black African Women, Christine W. Murungi

Master of Medicine in Obstetrics and Gynecology

Background: Fibroids are benign smooth muscle tumours of the uterus common in women of reproductive age. The prevalence is thought to be higher amongst women over the age of 35 years and in African women. More women are delaying their child bearing leading to an increase in the number of women dealing with pregnancy in the context of fibroids. The relationship between pregnancy and fibroids is controversial. It is thought that pregnancy exerts a protective effect, an observation made from epidemiological and animal studies. Although the mechanism is not clear, the postpartum period is thought to possibly explain this benefit. …

C1q/Tumor Necrosis Factor-Related Protein-3, A Newly Identified Adipokine, Is A Novel Antiapoptotic, Proangiogenic, And Cardioprotective Molecule In The Ischemic Mouse Heart., Wei Yi, Yang Sun, Yuexing Yuan, Wayne Bond Lau, Qijun Zheng, Xiaoliang Wang, Yajing Wang, Xiying Shang, Erhe Gao, Walter J Koch, Xin-Liang Ma

Department of Emergency Medicine Faculty Papers

BACKGROUND: Obesity and diabetes mellitus adversely affect postischemic heart remodeling via incompletely understood mechanisms. C1q/tumor necrosis factor-related protein-3 (CTRP3) is a newly identified adipokine exerting beneficial metabolic regulation, similar to adiponectin. The aim of the present study was to determine whether CTRP3 may regulate postischemic cardiac remodeling and cardiac dysfunction, and, if so, to elucidate the underlying mechanisms.

METHODS AND RESULTS: Male adult mice were subjected to myocardial infarction (MI) via left anterior descending coronary artery occlusion. Both the effect of MI on endogenous CTRP3 expression/production and the effect of exogenous CTRP3 (adenovirus or recombinant CTRP3) replenishment on MI injury …

The Convergence Of Science And Culture: Developing A Framework For Diabetes Education In Tribal Communities, Michelle Chino Dr, Carolee Dodge Francis, Lemyra Debruyn, Lynn Short, Dawn Satterfield

Journal of Health Disparities Research and Practice

In an unprecedented effort to address the epidemic of diabetes in tribal communities, the Diabetes Education in Tribal Schools project brought together a group of individuals from eight tribal colleges and three federal agencies to develop a diabetes prevention curriculum for American Indian and Alaska Native school children. The curriculum incorporates Western and Native science with culturally responsive teaching techniques. Both the project and its evaluation process have reached beyond conventional bounds to acknowledge fundamental issues of tribal culture, history and health and the integration of science, culture, and community. This article will discuss the challenges and rewards of the …

Two Boundaries Separate Borrelia Burgdorferi Populations In North America, Gabriele Margos, Jean I. Tsao, Santiago Castillo-Ramirez, Yvette A. Girard, Anne G. Hoen

Dartmouth Scholarship

Understanding the spread of infectious diseases is crucial for implementing effective control measures. For this, it is important to obtain information on the contemporary population structure of a disease agent and to infer the evolutionary processes that may have shaped it. Here, we investigate on a continental scale the population structure of Borrelia burgdorferi, the causative agent of Lyme borreliosis (LB), a tick-borne disease, in North America. We test the hypothesis that the observed d population structure is congruent with recent population expansions and that these were preceded by bottlenecks mostly likely caused by the near extirpation in the 1900s …

Transdisciplinary Approaches To Ameliorating Racial Disparities In Prostate Cancer Outcomes, Chanita H. Halbert, Katrina Armstrong, John Holmes, David Fenstermacher, Janet Weiner, Carmen Guerra, J. S. Schwartz, Jerry C. Johnson, Edmund Weisberg, Chantal Montagnet, Benita Weathers, Charnita Zeigler-Johnson, Ernestine Delmoor, Timothy R. Rebbeck

Journal of Health Disparities Research and Practice

Though prostate cancer is the second leading cause of cause cancer deaths among men in the US, it ranks first among African American men in terms of incidence, morbidity, and mortality. To address this and other complex health issues, some researchers advocate transdisciplinary research as a framework for analysis; however, few examples exist that indicate how the framework should be applied. This report uses prostate cancer outcomes as a paradigm to describe how such a framework can be used to identify determinants of racial disparities. By integrating diverse scientific disciplines, methods, and analytic approaches from psychology, sociology, epidemiology and genetics, …

What's New In Spine Surgery., Keith H Bridwell, Paul A Anderson, Scott D Boden, Alexander R Vaccaro, Jeffrey C Wang

Rothman Institute Papers

No abstract provided.

A Study Of Potential Risk Factors Of Depression Among Latina Breast Cancer Survivors, Claudia Ximena Aguado Loi

USF Tampa Graduate Theses and Dissertations

Women with breast cancer commonly experience depression. However, this condition often goes unrecognized, undertreated, and understudied, especially in ethnic minorities. If left untreated, co-existing depression in women with cancer can complicate cancer treatment, lead to poor treatment adherence for both conditions, and decrease survival. These negative consequences are considerably higher among Latinas. With the growing number of Latinos and diversity within the Latino community, the literature has identified the need to disaggregate Latinos by region of origin. Unfortunately, few studies account for these differences and no study to date has examined risk factors of depression among Latinas diagnosed with breast …

Trends In Mortality From Septicaemia And Pneumonia With Economic Development: An Age-Period-Cohort Analysis, Irene O.L. Wong, Benjamin J. Cowling, Gabriel M. Leung, Mary Schooling

Publications and Research

Background
Hong Kong population has experienced drastic changes in its economic development in the 1940s. Taking advantage of Hong Kong’s unique demographic and socioeconomic history, characterized by massive, punctuated migration waves from Southern China, and recent, rapid transition from a pre-industrialized society to the first ethnic Chinese community reaching ‘‘first world’’ status over the last 60 years (i.e., in two or three generations), we examined the longitudinal trends in infection related mortality including septicemia compared to trends in non-bacterial pneumonia to generate hypotheses for further testing in other recently transitioned economies and to provide generalized aetiological insights on how economic …

Selective Impact Of Hiv Disease Progression On The Innate Immune System In The Human Female Reproductive Tract, Timothy Lahey, Mimi Ghosh, John V. Fahey, Zheng Shen, Lucy R. Mukura, Yan Song, Susan Cu-Uvin, Kenneth H. Mayer, Peter F. Wright, John C. Kappes, Christina Ochsenbauer, Charles R. Wira

Dartmouth Scholarship

Background: We have previously demonstrated intrinsic anti-HIV activity in cervicovaginal lavage (CVL) from HIV-infected women with high CD4 counts and not on antiretroviral therapy. However, the impact of HIV disease progression on CVL innate immune responses has not been delineated.

Methods: CVL from 57 HIV-infected women not on antiretroviral therapy were collected by washing the cervicovaginal area with 10 ml of sterile normal saline. We characterized subject HIV disease progression by CD4 count strata: >500 cells/µl, 200-500 cells/µl, or <200 cells/µl of blood. To assess CVL anti-HIV activity, we incubated TZM-bl cells with HIV plus or minus CVL. Antimicrobials, cytokines, chemokines and anti-gp160 HIV IgG antibodies were measured by ELISA and Luminex.

Melanoma Induction By Ultraviolet A But Not Ultraviolet B Radiation Requires Melanin Pigment, Frances P. Noonan, M. Raza Zaidi, Agnieszka Wolnicka-Glubisz, Miriam R. Anver, Jesse Bahn, Anastas Popratiloff, +9 Additional Authors

Anatomy and Regenerative Biology Faculty Publications

Malignant melanoma of the skin (CMM) is associated with ultraviolet radiation exposure, but the mechanisms and even the wavelengths responsible are unclear. Here we use a mammalian model to investigate melanoma formed in response to precise spectrally defined ultraviolet wavelengths and biologically relevant doses. We show that melanoma induction by ultraviolet A (320–400 nm) requires the presence of melanin pigment and is associated with oxidative DNA damage within melanocytes. In contrast, ultraviolet B radiation (280–320 nm) initiates melanoma in a pigment-independent manner associated with direct ultraviolet B DNA damage. Thus, we identified two ultraviolet wavelength-dependent pathways for the induction of …

Molecular Genetic Studies And Delineation Of The Oculocutaneous Albinism Phenotype In The Pakistani Population, Thomas J. Jaworek, Tasleem Kausar, Shannon M. Bell, Nabeela Tariq, Muhammad I. Maqsood, Asma Sohail, Muhammad Ali, Furhan Iqbal, Shafqat Rasool, Saima Riazuddin, Rehan S. Shaikh, Zubair M. Ahmed

Obstetrics and Gynecology Faculty Publications

Background: Oculocutaneous albinism (OCA) is caused by a group of genetically heterogeneous inherited defects that result in the loss of pigmentation in the eyes, skin and hair. Mutations in the TYR, OCA2, TYRP1 and SLC45A2 genes have been shown to cause isolated OCA. No comprehensive analysis has been conducted to study the spectrum of OCA alleles prevailing in Pakistani albino populations.

Methods: We enrolled 40 large Pakistani families and screened them for OCA genes and a candidate gene, SLC24A5. Protein function effects were evaluated using in silico prediction algorithms and ex vivo studies in human melanocytes. The effects of splice-site …

Foodborne Illness Outbreak Response: A Snapshot Of Ohio, Calen Wherry

Master of Public Health Program Student Publications

Biosurveillance is one of the primary roles of local Public health offices. As the all-hazards (biological, chemical, and radiation emergencies) approach adds to the responsibilities already performed in foodborne illness outbreak response, it is crucial to assess the capabilities and robustness of the local public health Foodborne Illness (FBI) response. By surveying the most populated counties in Ohio with a checklist based on the 2009 Council for Improvement of Foodborne Outbreak Response (CIFOR) guidelines, it was possible to obtain a snapshot of the current outbreak response capabilities. Though only one county reported 100% compliance with the checklist, the overall average …

A Prospective Observational Study Of Mycophenolate Mofetil Treatment In Progressive Diffuse Cutaneous Systemic Sclerosis Of Recent Onset., Fabian A. Mendoza, Md, Sarah J. Nagle, Jason B. Lee, Md, Sergio A. Jimenez

Jefferson Institute of Molecular Medicine Papers and Presentations

OBJECTIVE: A prospective observational study of mycophenolate mofetil (MMF) treatment in patients with diffuse progressive cutaneous systemic sclerosis (SSc) of recent onset.

METHODS: Twenty-five previously untreated consecutive patients with recent-onset (< 24 mo) diffuse progressive cutaneous SSc received MMF as the only disease-modifying therapy. Modified Rodnan skin score (mRSS) and affected body surface area (BSA) were compared from initiation of MMF to study end. Pulmonary function tests performed at the same institution before therapy and at study end were available in 15 patients. Histopathology and real-time PCR assessment of fibrosis-related gene expression were performed before and after treatment in skin biopsies from 3 patients.

RESULTS: At 18.2 ± 8.73 months of MMF therapy (median 2000 mg/day) the mRSS decreased from 24.56 ± 8.62 to 14.52 ± 10.9 (p = 0.0004) and the affected BSA from 36% ± 16% to 14% ± 13.3% (p = 0.00001). Pulmonary function tests remained stable from initiation of MMF to the end of the study. Skin histopathology showed a remarkable reduction in accumulation of fibrotic tissue. Real-time PCR …

Threshold Primary Tumour Sizes For Nodal And Distant Metastases In Papillary And Follicular Thyroid Cancers., Maseeh Uz Zaman, Nosheen Fatima, Zafar Sajjad, Jaweed Akhter, Najmul Islam, Qamar Masood, Asma Ahmed

Department of Radiology

Abstract

BACKGROUND:

In papillary and follicular thyroid cancers (PTC, FTC), nodal and distant metastasis are generally considered important determinants of recurrence and survival, respectively. However, there is no consensus about the threshold primarytumour size (PTS) for these determinants. The aim of this study was to assess size relationships for developing nodal, pulmonary, bone and overall distant metastases.

METHODS:

This prospective study covered 139 (93 females and 46 males) consecutive biopsy proven patients with PTC (114/139, mean age 41.0 ± 15.7 years, M: F, 35%:65%) and FTC (25/139, mean age 39.2 ± 14.3 years, M: F: 24%:76%).

RESULTS:

Average primary tumor …

Oncolog, Volume 57, Number 06, June 2012, Sarah Bronson, Stephanie Deming

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

• Minimally Invasive Component Separation Reduces Wound-Healing Complications from Abdominal Surgery: Component separation, a major advance in abdominal wall reconstruction, can prevent hernia recurrence in many patients
• Bevacizumab for Glioblastoma: Symptom Relief Proven, Overall Survival Benefit Being Studied-The antiangiogenic agent bevacizumab has been shown to prolong progression-free survival and ameliorate symptoms in patients with recurrent glioblastoma. However, it remains unknown whether bevacizumab should be used to treat newly diagnosed glioblastoma and whether bevacizumab prolongs the overall survival of patients with glioblastoma
• HOUSE CALL: Hospice Care- Patients and families have choices for care and comfort
• INBRIEF: Panobinostat Elicits Durable Response in Hodgkin …

The Clinical, Endoscopic And Histological Spectrum Of The Solitary Rectal Ulcer Syndrome: A Single-Center Experience Of 116 Cases, Shahab Abid, Ali Khawaja, Salima Ahmed Bhimani, Zubair Ahmad, Saeed Hamid, Wasim Jafri

Section of Gastroenterology

Background

Solitary rectal ulcer syndrome (SRUS) is an uncommon although benign defecation disorder. The aim of this study was to evaluate the variable endoscopic manifestations of SRUS and its association with other diseases.

Methods

All the patients diagnosed with SRUS histologically from January 1990 to February 2011 at The Aga Khan University, Karachi were included in the study. The medical records were reviewed retrospectively to evaluate the clinical spectrum of the patients along with the endoscopic and histological findings.

Results

A total of 116 patients were evaluated. The mean age was 37.4 ± 16.6 (range: 13–80) years, 61 (53%) of …

Radiation Oncology At Thomas Jefferson University: A Specialty Emerges As A Department Evolves, Eric Gressen Md, Ben W. Corn Md, Adam P Dicker

Department of Radiation Oncology Faculty Papers

Jefferson Radiation Oncology has maintained over fifty years of excellence led by only four chairmen. Dr Kramer after receiving his medical training inLondonled the department into the modern megavoltage era while creating the first independent academic radiation oncology department in the country. He was well-respected nationally as a leader and advocate for the specialty and he mastered the execution of progressive ideas that have raised the standard for the profession. The creation of the Radiation Therapy Oncology Group (RTOG) was critical in developing trials to expand the management and treatment of malignancy. The Patterns of Care Study (PCS) educated the …

Effect Of Oxidative Stress On Protein Tyrosine Phosphatase 1b In Scleroderma Dermal Fibroblasts., Pei-Suen Tsou, Nadine N. Talia, Adam J. Pinney, Ann Kendzicky, Sonsoles Piera-Velazquez, Sergio A. Jimenez, James R. Seibold, Kristine Phillips, Alisa E Koch

Department of Dermatology and Cutaneous Biology Faculty Papers

OBJECTIVE: Platelet-derived growth factor (PDGF) and its receptor, PDGFR, promote fibrosis in systemic sclerosis (SSc; scleroderma) dermal fibroblasts, and such cells in scleroderma skin lesions produce excessive reactive oxygen species (ROS). PDGFR is phosphorylated upon PDGF stimulation, and is dephosphorylated by protein tyrosine phosphatases (PTPs), including PTP1B. This study was undertaken to determine whether the thiol-sensitive PTP1B is affected by ROS in SSc dermal fibroblasts, thereby enhancing the phosphorylation of PDGFR and synthesis of type I collagen. This study also sought to investigate the effect of a thiol antioxidant, N-acetylcysteine (NAC), in SSc.

METHODS: Fibroblasts were isolated from the skin …

Sinonasal Teratocarcinosarcoma, Zainul Abedeen Sobani, Shabbir Akhtar, Montasir Junaid, Iftikhar Salahuddin

Section of Otolaryngology, Head & Neck Surgery

Teratocarcinosarcoma is a rare, morphologically heterogeneous and highly malignant neoplasm. It is characterized by the presence of benign and malignant epithelial, mesenchymal and neural components. The carcinoma may be either squamous or adenocarcinoma and the mesenchymal component may manifest spindle, smooth, skeletal muscle, cartilage and bone features. Because of their infrequency, these lesions are often misdiagnosed, leading to management difficulties. In this case report we have shared our experience with sinonasal teratocarcinosarcoma in a 23 year old female and performed a brief review of literature.

Perspectives On: Sgp Symposium On Mitochondrial Physiology And Medicine: Mitochondria Take Center Stage., Shey-Shing Sheu, Robert T Dirksen, Edward N Pugh

Center for Translational Medicine Faculty Papers

No abstract provided.