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Jefferson Journal Award

Jefferson Journal of Psychiatry

The Jefferson Journal Award has been established to honor the best paper submitted during each calendar year to the Jefferson Journal of Psychiatry: A Resident Publication. An award of one thousand dollars is given to the chosen author, with an additional one thousand dollars to be given to the residency program or fellowship in which the author is enrolled. The winning submission is selected by the Journal's editorial board from manuscripts submitted on any subject related to psychiatric practice or research.

The editorial board of the Journal is proud to announce the recipient of the 1993 Jefferson Journal Award: Scott …

Letters To The Editor

Jefferson Journal of Psychiatry

Letters to the Editor.

Firesetting In Children, Donna V. Mehregany, Md

Jefferson Journal of Psychiatry

This article reviews the literature regarding the history, etiology, diagnosis, and treatment of firesetting. A critique of the literature reveals the need to generate a clearer definition of firesetting as well as more stringent criteria for diagnosing firesetting. The standard treatments for firesetting are reviewed. Linkage of childhood firesetting to future adolescent and adult crimes is also examined. Finally, avenues for future research are discussed.

Pharmacologic Advances In The Treatment Of Schizophrenia, Scott A. West, Md

Jefferson Journal of Psychiatry

The treatment of schizophrenia was revolutionized with the introduction of chlorpromaeine in 1952. The effectiveness of chlorpromazine in controlling psychotic symptoms lead to the dopamine Hypothesis of schizophrenia, which revolutionized our conceptualization of this illness. Since that time, numerous typical antipsychotic drugs have been developed for the treatment of schizophrenia. However, the introduction of clozapine in 1990 began a new era in the pharmacologic management of schizophrenia. Clozapine, an atypical antipsychotic drug, is effective in controlling the positive Symptoms of schizophrenia in a large number of otherwise treatment-resistant patients, and also improves the negative symptoms of the illness in marry …

Interferon Alpha For Chronic Hepatitis D, Zaigham Abbas, Muhammad Arsalan Khan, Mohammad Salih, Wasim Jafri

Department of Medicine

Background:

Hepatitis D virus is a small defective RNA virus that requires the presence of hepatitis B virus infection to infect a person. Hepatitis D is a difficult-to-treat infection. Several clinical trials have been published on the efficacy of interferon alpha for hepatitis D virus (HDV) infection. However, there are few randomised trials evaluating the effects of interferon alpha, and it is difficult to judge any benefit of this intervention from the individual trials.

Objectives:

To evaluate the beneficial and harmful effects of interferon alpha for Patients with chronic hepatitis D.

Search methods:

We identified relevant for the review randomised …

Disparate Degrees Of Hypervariable Loop Flexibility Control T Cell Receptor Cross-Reactivity, Specificity, And Binding Mechanism, Daniel R. Scott, Oleg Y. Borbulevych, Kurt H. Piepenbrink, Steven A. Corcelli, Brian M. Baker

Food for Health: Publications

αβ T cell receptors recognize multiple antigenic peptides bound and presented by major histocompatibility complex molecules. TCR cross-reactivity has been attributed in part to flexibility of the complementarity-determining region loops, yet there have been limited direct studies of loop dynamics to determine the extent of its role. Here we studied the flexibility of the binding loops of the αβ TCR A6 utilizing crystallographic, spectroscopic, and computational methods. A significant role for flexibility in binding and cross-reactivity was indicated only for the CDR3α and CDR3β hypervariable loops. Examination of the energy landscapes of these two loops indicated that CDR3β possesses a …

Sonographic Fetal Biometry Charts For A Pakistani Cohort., W. Akhtar, A. Ali, M. A. Arain, F. Saeed, S. Siddiqui, A Memon

Department of Radiology

This study aimed to develop growth centiles at different gestational weeks for fetal biparietal diameter, abdominal circumference, femur length and head circumference in a Pakistani cohort. Data were collected at a tertiary referral hospital from pregnant women at gestational ages 13-40 weeks referred for obstetric ultrasound as a part of routine antenatal care. A total of 1599 fetal sonographic biometric measurements were collected after screening for the inclusion criteria. For each measurement, separate regression models were derived to estimate the mean, standard deviation and reference percentiles at each week of gestational age for this cohort. The best fitting model for …

Functional Genomics Reveals An Essential And Specific Role For Stat1 In Protection Of The Central Nervous System Following Herpes Simplex Virus Corneal Infection, Tracy J. Pasieka, Cristian Cilloniz, Victoria S. Carter, Pamela Rosato, Michael G. Katze, David A. Leib

Dartmouth Scholarship

Innate immune deficiencies result in a spectrum of severe clinical outcomes following infection. In particular, there is a strong association between loss of the signal transducer and activator of transcription (Stat) pathway, breach of the blood-brain barrier (BBB), and virus-induced neuropathology. The gene signatures that characterize resistance, disease, and mortality in the virus-infected nervous system have not been defined. Herpes simplex virus type 1 (HSV-1) is commonly associated with encephalitis in humans, and humans and mice lacking Stat1 display increased susceptibility to HSV central nervous system (CNS) infections. In this study, two HSV-1 strains were used, KOS (wild type [WT]), …

Novel Amino Acid Transporter-Targeted Radiotracers For Breast Cancer Imaging, Fanlin Kong

Dissertations and Theses (Open Access)

Breast cancer is the most common malignancy among women in the world. Its 5-year survival rate ranges from 23.4% in patients with stage IV to 98% in stage I disease, highlighting the importance of early detection and diagnosis. ¹⁸F-2-Fluoro-2-deoxy-glucose (¹⁸F-FDG), using positron emission tomography (PET), is the most common functional imaging tool for breast cancer diagnosis currently. Unfortunately, ¹⁸F-FDG-PET has several limitations such as poorly differentiating tumor tissues from inflammatory and normal brain tissues. Therefore, ¹⁸F-labeled amino acid-based radiotracers have been reported as an alternative, which is based on the fact that tumor cells uptake …

Association Between Childhood Demographics And Blood Lead Screening---Nevada Kindergarten Health Survey 2010, Lina Zhang

UNLV Theses, Dissertations, Professional Papers, and Capstones

Lead, as a toxic substance, invades the human body, and gradually damages the organs. Oftentimes, elevated blood lead levels are not recognized until serious health issues are found. In the United States, approximately 250,000 children aged 1-5 years have elevated blood lead levels greater than 10 micrograms of lead per deciliter of blood (Centers for Disease Control and Prevention, 2004).

However, there is no effective treatment for lead poisoning. Chelation can merely decrease the blood lead levels but cannot reverse the existing damage. To prevent and control childhood lead poisoning, many studies have been conducted to investigate the sources of …

We Can Do It Together: Par1/Par2 Heterodimer Signaling In Vsmcs., Rafal Pawlinski, Michael Holinstat

Department of Medicine Faculty Papers

In this issue, Sevigny and colleagues demonstrate that a protease-activated receptor 1 (PAR1)-PAR2 heterodimer regulates vascular smooth muscle cell (VSMC) hyperplasia following vascular injury ¹. PARs belong to a family of G-protein coupled receptors that are proteolytically activated by a variety of proteases ^{2, 3}. Cleavage of PARs results in intracellular signaling mediated by activation of various G proteins including G_12/13, G_q, and G_i ^{2, 4-6}. The PAR family consists of 4 members, PAR1-PAR4, with PARs 1, 3, and 4 being primarily activated by thrombin, while PAR2 is activated by trypsin and …

Women's Cognitive Appraisals Of Their Birth Experience As Predictive And Maintaining Factors Of Postpartum Posttraumatic Stress Symptom Severity, Lauren Carr Spooner

Dissertations

Empirical support has accumulated for evidence of posttraumatic stress symptoms following approximately 30% of childbirth experiences (Olde, van der Hart, Kleber, & van Son, 2006). Researchers have suggested that there is a complex relationship among predisposing, precipitating, and maintaining factors that impact postpartum PTSD (Slade, 2006). Anxiety, perception of support, and negative cognitions are such factors that have been shown to significantly correlate with PTSD symptoms (Foa & Rothbaum, 1998; Olde et al., 2006; Soet, Brack, & Dilorio, 2003), but have not been studied together in relation to PTSD associated with traumatic birth. The current study controlled for trait anxiety …

Contribution Of Ectodomain Mutations In Epidermal Growth Factor Receptor To Signaling In Glioblastoma Multiforme, Marta L. Rojas

Dissertations and Theses (Open Access)

CONTRIBUTION OF ECTODOMAIN MUTATIONS IN EPIDERMAL GROWTH FACTOR RECEPTOR TO SIGNALING IN GLIOBLASTOMA MULTIFORME

Publication No._________

Marta Rojas, M.S.

Supervisory Professor: Oliver Bögler, Ph.D.

The Cancer Genome Atlas (TCGA) has conducted a comprehensive analysis of a large tumor cohort and has cataloged genetic alterations involving primary sequence variations and copy number aberrations of genes involved in key signaling pathways in glioblastoma (GBM). This dataset revealed missense ectodomain point mutations in epidermal growth factor receptor (EGFR), but the biological and clinical significance of these mutations is not well defined in the context of gliomas.

In our study, we focused on understanding …

Adaptive Intensity Modulated Radiation Therapy Planning Optimization With Changing Tumor Geometry And Biology Enforcing Both Cumulative And Fraction Size Dose Constraints, Behlul Saka

Graduate Theses and Dissertations

Intensity Modulated Radiation Therapy (IMRT) is a modern technique of delivering radiation treatments to cancer patients. In IMRT technology, intensities must be chosen for the many small unit grids into which the beams are divided to produce a desired distribution of dose at points throughout the body with the goal of maximizing dose delivered to the tumor while sparing healthy tissues from excessive radiation and keeping dose homogeneous across the tumor. Although IMRT plans are optimized as a single overall treatment plan, they are delivered over 30-50 treatment sessions (fractions) and both cumulative and per-fraction dose constraints apply. The extended …

Proliferating Tricholemmal Tumour: Clinicopathological Aspects Of A Case., Adeel Khoja, Yan B, Lee Sj, Cheong E. C, Tan K B

Department of Medicine

We report the case of a 49-year-old man who presented with an enlarging mass over his occipital scalp. The clinical impression was either a squamous cell carcinoma or an unusual adnexal tumour. A wide excision was performed with skin grafting. Gross examination revealed a large exophytic tumour mass measuring 10 cm. Histopathological examination showed a circumscribed, well-differentiated squamoproliferative lesion with a lobulated architecture. Clear cell features, pilar-type keratinisation, microcalcifications and the presence of mucinous degeneration were noted. A diagnosis of proliferating tricholemmal tumour was made. This entity incorporates a spectrum of lesions, ranging from the mostly benign proliferating tricholemmal cyst …

Magnesium, A Drug Of Diverse Use, Mohammad Irfan Akhtar, Hameed Ullah, Mohammad Hamid

Department of Anaesthesia

Magnesium has evolved as a drug with diverse clinical applications. Mg++ is an important caution and its homeostasis is very important for normal body functioning. The physiological role of Mg is due to its calcium channel blocking properties at smooth muscle, skeletal muscle and conduction system levels. The analgesic properties are due to NMDA receptor blocking action. Mg++ is beneficial in acute Myocardial Infarction, protection during open heart surgery and treatment and prevention of heart rhythm disturbances. Mg has an established role in the management of preeclampsia and eclampsia. Magnesium prevents or controls convulsions by blocking neuromuscular transmission and decreasing …

Switches, Excitable Responses And Oscillations In The Ring1b/Bmi1 Ubiquitination System., Lan K Nguyen, Javier Muñoz-García, Helene Maccario, Aaron Ciechanover, Walter Kolch, Boris N Kholodenko

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

In an active, self-ubiquitinated state, the Ring1B ligase monoubiquitinates histone H2A playing a critical role in Polycomb-mediated gene silencing. Following ubiquitination by external ligases, Ring1B is targeted for proteosomal degradation. Using biochemical data and computational modeling, we show that the Ring1B ligase can exhibit abrupt switches, overshoot transitions and self-perpetuating oscillations between its distinct ubiquitination and activity states. These different Ring1B states display canonical or multiply branched, atypical polyubiquitin chains and involve association with the Polycomb-group protein Bmi1. Bistable switches and oscillations may lead to all-or-none histone H2A monoubiquitination rates and result in discrete periods of gene (in)activity. Switches, overshoots …

Differential Combination Of Cytokine And Interferon- Gamma +874 T/A Polymorphisms Determines Disease Severity In Pulmonary Tuberculosis., Ambreen Ansari, Zahra Hasan, Ghaffar Dawood, Rabia Hussain

Department of Pathology and Laboratory Medicine

Background:Mycobacterium tuberculosis infects nearly 1/3 of the world population and this reservoir forms the largest pool from which new cases arise. Among the cytokines, IFN-gamma is a key determinant in protection against tuberculosis. Single nucleotide polymorphisms (SNPs) in IFN-gamma gene (+874 T/A) which determine TT high ((hi)), AA low ((lo)) and TA intermediate ((int)) responder phenotypes have shown variable associations with tuberculosis disease outcome in different ethnic populations. The objective of the current study was to analyze IFN-gamma gene combinations with other IFN-gamma regulating cytokine genes (IL-10, TNF -alpha, IL-6) to see the effect of gene- combinations on disease …

Hiv-1 Tat Protein Promotes Neuronal Dysfunction Through Disruption Of Micrornas, J Robert Chang, Ruma Mukerjee, Asen Bagashev, Luis Del Valle, Tinatin Chabrashvili, Brian J. Hawkins, Johnny J. He, Bassel E. Sawaya

School of Medicine Faculty Publications

Over the last decade, small noncoding RNA molecules such as microRNAs (miRNAs) have emerged as critical regulators in the expression and function of eukaryotic genomes. It has been suggested that viral infections and neurological disease outcome may also be shaped by the influence of small RNAs. This has prompted us to suggest that HIV infection alters the endogenous miRNA expression patterns, thereby contributing to neuronal deregulation and AIDS dementia. Therefore, using primary cultures and neuronal cell lines, we examined the impact of a viral protein (HIV-1 Tat) on the expression of miRNAs due to its characteristic features such as release …

A Brief Overview Of Adolescent Developmental Problems In Hong Kong, Daniel T. L. Shek, Hing Keung Ma, Rachel C. F. Sun

Pediatrics Faculty Publications

Several adolescent developmental problems in Hong Kong are briefly reviewed in this paper. First, rising adolescent substance abuse trends are described. Second, Internet use problems and Internet addiction among young people are examined. Third, worrying trends in adolescent sexuality are identified. Fourth, phenomena on bullying among young people are reviewed. Finally, phenomena related to adolescent materialistic orientation are focused upon. With reference to these adolescent developmental problems, possible solutions are briefly discussed particularly with reference to the ecological perspective. It is argued that the related scientific literature provides useful pointers for designing the curriculum in the extension phase of the …

Clozapine-Induced Seizures And Eeg Changes: A Case Report And Discussion Of Clinical Management, Jeffrey Daly, M.D., Stephen Salloway, M.D., M.S.

Jefferson Journal of Psychiatry

Clorapine is an atypical antipsychotic agent associated with a higher frequency of seizures than standard neuroleptics. In addition, clozapine causes epileptiform abnormalities in the EEG in up to 72% of patients. A patient who developed a generalized seizure shortly after beginning clozapine treatment and the patient's EEG findings are presented. The neuropharmacology of dozapine and the management of clozapine-induced seizures and EEG abnormalities are discussed.

Oxidative Stress And Heme Oxygenase-1 Regulated Human Mesenchymal Stem Cells Differentiation, Luca Vanella, Christopher Sanford Jr., Dong Hyun Kim, Nader G. Abraham, Nabil Ebraheim

Biochemistry and Microbiology

This paper describes the effect of increased expression of HO-1 protein and increased levels of HO activity on differentiation of bone-marrow-derived human MSCs. MSCs are multipotent cells that proliferate and differentiate into many different cell types including adipocytes and osteoblasts. HO, the rate-limiting enzyme in heme catabolism, plays an important role during MSCs differentiation. HO catalyzes the stereospecific degradation of heme to biliverdin, with the concurrent release of iron and carbon monoxide. Upregulation of HO-1 expression and increased HO activity are essential for MSC growth and differentiation to the osteoblast lineage consistent with the role of HO-1 in hematopoietic stem …

Implications Of Observation-Fact Modifiers To I2b2 Ontologies, Jack W. London, Devjani Chatterjee

Kimmel Cancer Center Faculty Papers

Biomedical translational research can be facilitated by integrating clinical and research data. In particular, study cohort identification and hypothesis generation is enabled by the mining of integrated clinical observations and research resources. The "informatics for integrating biology and the bedside, " or i2b2, framework is widely used for this biomedical data mining. The i2b2 "star schema" data model using entity-attribute-value (EA V) formatted concepts is a very efficient strategy for querying large amounts of data. However, until the most recent i2b2 release, the utility of the platform was somewhat constrained by the limitations on being able to express "facts about …

Psychoanalytic Approach To Child Development, Jeanette M.S. Zaimes, M.D.

Jefferson Journal of Psychiatry

THE COURSE OF LIFE VOL III

MIDDLE AND LATE CHILDHOOD

Editors: Stanley I. Greenspan, M.D. and George H. Pollock, M.D., Ph.D.,

International Universities Press, Inc.

1991, revised edition

562 pages $65.00

Reversal Of Catatonia With Midazolam, Larry V. Mcdonald, M.D., Barry I. Liskow, M.D.

Jefferson Journal of Psychiatry

We report a case of dramatic reversal of catatonic symptoms with a single dose of midazolam, an ultra short acting parenteral benzodiazepine commonly used for procedure sedation.

The Risk Of Hospitalizing Suicidal Patients: A Personal Retrospective, Leora Bar-Levav, M.D.

Jefferson Journal of Psychiatry

Many statistically significant risk factors for suicide have been identified. Unfortunately, no study can identify the patient who will, in fact, kill himself. Maintaining a low threshold for hospitalization of potentially suicidal patients generally lowers their short-term risk. Hospitalization, however, like every medical intervention, carries attendant side effects. The dynamic implications of hospitalization for suicidal patients are considered in this paper along with recommendations to lessen the deleterious effects of such an intervention.

An Overview Of The Separation Phenomenon And The Experience Of Hospitalization For Children, Tara Pressley, M.D.

Jefferson Journal of Psychiatry

When children are psychologically bonded to a caretaking adult they experience a characteristic spectrum of emotions and behaviors upon being separated from that attachment figure. This paper reviews the literature pertaining to the separation phenomenon and the emotional experience of hospitalisation for children in an attempt to integrate this knowledge into the diagnosis and treatment of children hospitalized medically and psychiatrically.

Neuroleptic Malignant Syndrome: Diagnostic Dilemma In The Medically Ill, Mahmoud A. Parsa, M.D., Andrew J. Picken,, Robert Keating, M.D.

Jefferson Journal of Psychiatry

Neuroleptic malignant syndrome is a potentially fatal complication of neuroleptic treatment. It is characterized by a variery of signs and symptoms associated with autonomic instability, and hypothalamic and extrapyramidal dysfunction. Since other medical disorders may mimic its clinical presentation, the accurate recognition of this syndrome in the medical setting is often a diagnostic dilemma. Three medically ill patients with a clinical presentation suggestive of neuroleptic malignant syndrome are presented here. The authors discuss the complexity of making the diagnosis, and offer a brief review of the literature.

Demystifying The Psychiatric Case Formulation, Len Sperry, M.D., Ph.D.

Jefferson Journal of Psychiatry

Until recently case formulation was an ethereal art, in that there was 110 standard, agreed-upon format for conceptualizing and writing formulations. However, the increasing emphasis on accountability in psychiatric care, the trend toward theoretical integration, and the difficulty trainees experience in mastering formulation skills highlight the need for a standard format. The descriptive, etiological and treatment-prognostic components of a formulation are discussed as a standard format for conceptualizing and writing case formulations. Four written formulations are described in terms of content, structure and process to illustrate this format.

Perspectives On The Mind, S. Nassir Ghaemi, M.D.

Jefferson Journal of Psychiatry

PHILOSOPHY, PSYCHIATRY, AND NEUROSCIENCE: THREE APPROACHES TO THE MIND

Edward M. Hundert

Clarendon Press: Oxford, 1989

$19.95

313 pages