Digital Commons Network^™

Neuroprotective Action Of Cycloheximide Involves Induction Of Bcl-2 And Antioxidant Pathways, Katsutoshi Furukawa, Steven Estus, Weiming Fu, Robert J. Mark, Mark P. Mattson

Sanders-Brown Center on Aging Faculty Publications

The ability of the protein synthesis inhibitor cycloheximide (CHX) to prevent neuronal death in different paradigms has been interpreted to indicate that the cell death process requires synthesis of “killer” proteins. On the other hand, data indicate that neurotrophic factors protect neurons in the same death paradigms by inducing expression of neuroprotective gene products. We now provide evidence that in embryonic rat hippocampal cell cultures, CHX protects neurons against oxidative insults by a mechanism involving induction of neuroprotective gene products including the antiapoptotic gene bcl-2 and antioxidant enzymes. Neuronal survival after exposure to glutamate, FeSO₄, and amyloid β-peptide …

Special Maneuver For Removal Of An Impacted Bronchial Foreign Body At Thoracotomy, Saima H. Khan, Asad Mian, Qaisar M. Khan, Naeem-Uz-Zafar Khan

Department of Emergency Medicine

Tracheobronchial foreign body aspiration is a common, but often unobserved event in children. A delay in diagnosis can lead to difficulty in removal of the aspirated object. The present case report highlights a special intraoperative maneuver at thoracotomy that was adopted to remove an impacted foreign body that could not be removed at bronchoscopy.

Percutaneous Removal Of Biliary Stone From Anomalous Right Hepatic Duct, T Ul Haq, M Y. Sheikh, C K. Jadun, M N. Ahmad, Y H. Husen

Department of Radiology

No abstract provided.

Profile And Risk Factors For Congenital Heart Disease, I Hassan, A A. Haleem, Z A. Bhutta

Department of Paediatrics and Child Health

Congenital heart disease is an important cause of infant mortality and disability. The frequency, spectrum and contributory risk factors for significant cardiovascular malformations among live-births was retrospectively evaluated at the Aga Khan University Hospital. Of a total of 8331 live births between July, 1987 and December, 1992 34 babies were diagnosed to have congenital heart disease in the neonatal period giving a prevalence of 4 per 1000 live births. Ventricular septal defects was the most common (n = 10, 29%) abnormality. Eight cases had associated chromosomal abnormality, the most common being Trisomy 21. Maternal abortions, still-births, consanguinity and diabetes mellitus …

The Role Of Zinc In Health And Disease: Relevance To Child Health In Developing Countries, Z A. Bhutta

Department of Paediatrics and Child Health

No abstract provided.

Ambulatory Arthroscopic Knee Surgery Results Of Partial Meniscectomy, Muhammad Umar

Section of Orthopaedic Surgery

In an open prospective study the results of arthroscopic partial meniscectomy were reviewed in 188 knees. Group I comprised of 139 (65%) knees with pure meniscus lesions without any ligament laxity, the remaining 49 (35%) knees in group II had anterior cruciate ligament (ACL) deficiency in addition to meniscus lesions. In group I, 93% had excellent to good and 7% had fair results by criteria of Tapper and Hoover. In group II, 75% had excellent to good and 25% had fair results. Arthroscopic knee surgery was a good method of identifying patients in group II who required anterior cruciate reconstruction. …

Late Onset Oesophageal Perforation Due To Gunshot Injury Of Chest: Successful Non-Operative Management In A Young Child, Asad Mian, Saima H. Khan, Naeem-Uz-Zafar Khan

Department of Emergency Medicine

Penetrating firearm injuries of the chest have become commonplace in children living in violent urban areas. Esophageal perforation may present as a late manifestation of peadiatric thoracic trauma due to gunshot injury. Opinion varies as to the surgical or nonsurgical management of such a patient. The authors report a case of a 12-year-old girl who presented with a similar dilemma and her successful conservative management, that they opted for; is discussed.

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 …

The Changing Economic Circumstances Of The Elderly: Income, Wealth, And Social Security, James P. Smith

Center for Policy Research

How is the economic status of the elderly changing and what are their prospects for the future? My portrait tells us how well off they are on average, but also about the vast disparities that exist among them. This description includes an often neglected measure of their economic well-being--the amount of wealth they control. Amazingly little is known about how much personal wealth older people have and how and what determines its distribution. But the conventional definition of household wealth ignores two critical components of wealth: the expected income flows from pensions and Social Security. For some elderly households, Social …

Computed Tomography In Staging Of Patients With Melanoma Metastatic To The Regional Nodes., T M Johnson, D J Fader, A E Chang, Alan M. Yahanda Md, Facs, J W Smith, K R Hamlet, V K Sondak

PCI Publications and Projects

BACKGROUND: This study addresses the yield and clinical impact of computed tomography (CT) imaging in otherwise asymptomatic patients with stage III melanoma metastatic to the regional nodes.

METHODS: The database from the University of Michigan Mutlidisciplinary Melanoma Clinic was reviewed and identified 127 asymptomatic patients with stage III melanoma (regional nodal disease) who received CT scans of the head, chest, abdomen, and/or pelvis. Scans were confirmed as true positive, false positive, and normal.

RESULTS: Four hundred twenty-six head and body CT scans were performed at the time of presentation of stage III disease. Twenty patients had a true-positive CT scan …

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 …

Interleukin-2 Fusion Protein: An Investigational Therapy For Interleukin-2 Receptor Expressing Malignancies, Jean Nichols, Foss Francine, Kuzel Timothy, Lemaistre Charles Fred, Platanias Leonidas, Ratain Mark, Rook Alain, Mansoor Saleh, Schwartz Gary

Haematology and Oncology, East Africa

DAB3s91L-2 is an interleukin-2 receptor (IL-2R) specific fusion protein with a molecular weight of 58 kD containing the enzymatic and translocation domains of diphtheria toxin (DT) and human IL-2. This fusion protein is able to direct the cytocidal action of the DT enzymatic region only to cells which bear the IL-2R. The human IL-2R exists in three forms: low, intermediate and high affinity. The high-affinity form is believed to be the biologically relevant form on mature, activated T-lymphocytes, B-lymphocytes and monocytes. DAB3sgIL-2 is able to bind selectively to the high-affinity IL-2R in a concentration-dependent manner, and once bound is internalised …

Vital Signs, Winter 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.

Lactose Intolerance In Persistent Diarrhoea During Childhood: The Role Of A Traditional Rice-Lentil (Khitchri) And Yogurt Diet In Nutritional Management, Z A. Bhutta, S Q. Nizami, Z Isani

Department of Paediatrics and Child Health

Lactose intolerance is frequently encountered in children with persistent diarrhoea (PD). Selection of an appropriate milk-based formulation is a major management problem in the developing world. In a consecutive series of studies, we evaluated the role of feeding a traditional rice-lentil (khitchri) diet alone (KY) or in combination with either soy formula (KY-Soy) a dilute buffalo milk (KY-B), in children (age 6 months-3 years) with PD. Serial observations of stool output, caloric intake and weight gain of these children over a 14 day period indicated satisfactory tolerance of the KY diet with adequate weight gain. The weight gain and stool …

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 …

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.

Parotid Gland Lipoma: A Rare Entity, S Muzaffar, N Kayani, S H. Hasan

Department of Pathology and Laboratory Medicine

No abstract provided.

Enteric Absorption Of Ciprofloxacin During Tube Feeding In The Critically Ill, Stephen M. Cohn, Mark D. Sawyer, Gerard A. Burns, Concertina Tolomeo, Kerry A. Milner

Nursing Faculty Publications

To determine the pharmacokinetic properties of ciprofloxacin in the critically ill, we studied seven mechanically ventilated patients with pneumonia during entcral feedings. Subjects received ciprofloxacin 750 mg every 12 h via nasogastric tube and serial serum drug concentrations were measured after the first and fourth dose. After the initial dose, the maximum serum concentration ranged from 1.24–3.06 mg/L, and the area under the time curve from 0–12 h ranged from 3.2–19.65 mg.h/L. Similar levels were noted after dose four. Gastrointestinal absorption of ciprofloxacin in tube fed critically ill patients was decreased, but well above MIC values for many pathogenic bacteria.

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 …

Efficacy Of Octreotide In Diarrhoea Due To Vibrio Cholerae: A Randomized, Controlled Trial, Z Abbas, I Moid, A H. Khan, S M. Jafri, S H. Shah, S Abid, S Hamid

Section of Gastroenterology

Although octreotide, a long-acting analogue of somatostatin, is currently used in the treatment of chronic secretory diarrhoea due to various causes, its role in the management of acute secretory diarrhoea is not well established. In the present study, therefore, the therapeutic value of octreotide in the management of cholera, a classical example of acute secretory diarrhoea, was investigated. During an outbreak of cholera, patients admitted with acute secretory diarrhoea of < or = 24 h duration and a purging rate > 100 ml/h were enrolled on the study and randomly assigned to octreotide (N = 17) and control (N = 16) groups. All 33 patients received intravenous fluid replacement and antibiotic …

Hereditary Ovarian Cancer Syndromes In Three Pakistani Families, A B. Aziz, M Sabih, I A. Malik

Department of Obstetrics & Gynaecology

No abstract provided.

Complications Of Endotracheal Intubation In Mechanically Ventilated Patients In A General Intensive Care Unit, Fazal Hameed Khan, Fauzia A. Khan, Robyna Irshad Khan, Rehana S Kamal

Department of Anaesthesia

During a period of one year, 126 patients were prospectively audited to analyse complications of endotra­cheal intubation in a general intensive care unit setting. A total of 62 complications were observed in 48 patients. The most frequent complications during intubation were hypotension and bradycardia. The blockage of endotracheal tubes significantly increased with the duration of intubation. Sore throat was the commonest (22%) complication following extubation. Other complications like stridor and ulceration of mouth and lips which followed extubation were not related to the duration of intubation.

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

Department of Anaesthesia

No abstract provided.

Resistance Of Blastocystis Hominis Cysts To Chlorine, M Zaki, V Zaman, N A. Sheikh

Department of Pathology and Laboratory Medicine

No abstract provided.

Pneumococcal Sepsis In The Newborn--An Emerging Problem?, Z A. Bhutta

Department of Paediatrics and Child Health

No abstract provided.

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.

Digest Of The Philadelphia College Of Osteopathic Medicine (Summer 1996), Philadelphia College Of Osteopathic Medicine

Digest

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

• Commencement ‘96
• Campus Update
• Alumni Board of Directors
• College Board Profile
• Alumni Board Profile
• Capital Campaign Developments
• The Archivist’s Digs
• PCOM in the Media
• PCOM Survivors Celebrate 50th Anniversary
• Just Published
• Class Acts
• Coming Events
• Sports Banquet Honors Athletes

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 …

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

Department of Pathology and Laboratory Medicine

No abstract provided.

Needle Localization Of Non-Palpable Breast Lesions, S Khan, N Mitha, F Kazi, M Siddiqui

Department of Surgery Docs

Screening mammography identifies suspicious, non palpable mammary lesions. Mammographic needle localization (MNL) is currently being used to facilitate excision biopsy of these lesions. Thirty-two patients underwent biopsies of the breast after MNL for non-palpable lesions. Mammographic indications for biopsy consisted of microcalcifications (48%), mass or abnormal density (21%) or mass+abnormal density (24%). The carcinoma was identified in four cases (12%). Two of these were in situ, one was microinvasive and one was frankly invasive. Three were treated with a modified radical mastectomy. One of these non palpable lesion demonstrated nodal metastasis but none showed distant metastasis. All radiologically detected abnormalities …