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Patients As Subjects For Research: Ethical Dilemmas For The Primary Care Clinician-Investigator, Susan F. Slatkoff, Peter Curtis, Ann L. Coker

CRVAW Faculty Journal Articles

Background: Past studies suggested an association between human papillomavirus (HPV) and cervical intraepithelial neoplasia (CIN). In 1987, University of North Carolina (UNC) Hospitals Family Practice Center clinicians were approached for a control population to study this association. Methods: One hundred fives patients attending the UNC Hospitals Neoplasia Clinic with biopsy-proven CIN 2 or 3 and 268 control patients attending the UNC Family Practice Center for a routine Papanicolaou smear were enrolled in this case-control study. Case and control patients consented to having an additional cervical specimen taken and to being interviewed. The cervical specimens were classified by the Southern blot …

Functional Analysis Of Human Alpha 1(I) Procollagen Gene Promoter. Differential Activity In Collagen-Producing And -Nonproducing Cells And Response To Transforming Growth Factor Beta 1., Sergio A. Jimenez, John A. Varga, Anne Olsen, Liye Li, Arturo Diaz, Janet Herhal, Julie Koch

Department of Medicine Faculty Papers

To gain a further understanding of the regulation of human type I collagen gene expression under physiologic and pathologic conditions, we characterized 5.3 kilobase pairs (kb) of the human alpha 1(I) procollagen gene promoter. A series of deletion constructs containing portions of the alpha 1(I) procollagen 5'-flanking region (with end points from -5.3 kb to -84 base pairs (bp)) ligated to the chloramphenicol acetyltransferase (CAT) reporter gene were transiently transfected into NIH/3T3 cells. Maximal CAT activity was observed with constructs having 5' end points from -804 to -174 bp. A further 5' deletion to -84 bp caused a marked reduction …

Menopausal Hormone Replacement: Not Necessarily Routine, Mary Guinan

School of Public Health Faculty Research

No abstract provided.

Elevated Expression Of Type Vii Collagen In The Skin Of Patients With Systemic Sclerosis. Regulation By Transforming Growth Factor-Beta., Lidia Rudnicka, John Varga, Angela M. Christiano, Renato V. Iozzo, Sergio A. Jimenez, Jouni Uitto

Department of Dermatology and Cutaneous Biology Faculty Papers

A hallmark of systemic sclerosis (SSc) is the development of tissue fibrosis. Excessive production of several connective tissue components normally present in the dermis, including type I, III, V, and VI collagens as well as fibronectin and proteoglycans, is a consistent finding in the skin of SSc patients. Type VII collagen is a major constituent of anchoring fibrils, present in the skin at the dermal-epidermal basement membrane zone. TGF-beta has been shown to upregulate the expression of the type VII collagen gene. In this study, we assessed the expression of type VII collagen and TGF-beta in the skin of patients …

Cryptic Disseminated Tuberculosis: An Often Missed Diagnosis, A Jabbar

Section of Pulmonary & Critical Care

No abstract provided.

Digest Of The Philadelphia College Of Osteopathic Medicine (Spring 1994), Philadelphia College Of Osteopathic Medicine

Digest

The Spring 1994 issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• President's Perspective: The Osteopathic Education Model
• Health Care Reform: PCOM Retools For The Big Picture
• Changing the Face of Medical Education
• Other Views on Health Care Reform
• Doctor’s Visit Minus Fear = Happy Children
• Founders Day Honorees: A'weekend in the Spotlight
• Clinical Learning Lab Gets Rave Reviews
• Faculty Profile
• Rugby Madness
• Just Published
• Class Acts
• Obituaries
• Coming Events

Amoebic Appendicitis--A Rare Entity, Raheem Ahmed, Hizbullah Shaikh, Muhammad Siddiqui, M Ahmed

Department of Pathology and Laboratory Medicine

Appendectomy is the most common surgical procedure performed in routine general surgical practice. However, not all the appendices removed, are submitted for histopathological examination in this part of the world. We reviewed 1400 appendices received by our department from within our hospital and from outside the hospital. Of these 13 cases were reported as amoebic appendicitis. These patients did not have any different clinical presentation from the patients who were reported as acute appendicitis without amoebae. Microscopically these appendices had minimal neutrophil polymorph infiltration accompanied by tissue necrosis and amoebic trophozoites within the appendiceal wall. After histological diagnosis, different tests …

Vital Signs, Spring 1994, 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.

Possible Roles Of Insulin And Insulin-Like Growth Factors In Rat Preimplantation Development: Investigation Of Gene Expression By Reverse Transcription-Polymerase Chain Reaction., X Zhang, G M Kidder, A J Watson, G A Schultz, D T Armstrong

Obstetrics & Gynaecology Publications

The sensitive mRNA phenotyping technique of reverse transcription-polymerase chain reaction was used to demonstrate that insulin receptor mRNA is present in rat embryos during the preimplantation period. In addition, mRNA encoding insulin-like growth factor (IGF) type I and type II receptors have also been detected in rat preimplantation embryos. IGF-I mRNA was not detected in preimplantation embryos but was found in oviducts and uteri of prepubertal and early pregnant rats. IGF-II mRNA was present in both embryos and in oviducts and uteri during the preimplantation period. These findings suggest that insulin and IGF-I could influence early embryo development in endocrine …

Conjoined Twins - A Review Of Literature With Two Case Studies, Naaeem Uz-Zafar Khan, Nadeem Ullah Khan, Khalid Matin, Adnan Zaidi

Department of Emergency Medicine

Two cases of conjoined twins have been reported. A review of literature is given.

Malakoplakia Of The Uterus, H Shaikh, P E. Khan, N Faridi

Department of Pathology and Laboratory Medicine

No abstract provided.

Endobronchial Tuberculosis Simulating Bronchial Asthma, J A. Khan, N Islam, J Akhter, S F. Hussain

Section of Pulmonary & Critical Care

No abstract provided.

Laparoscopic Appraisal Of Infertility And Pelvic Pain In Pakistani Women: A 5 Years Audit, R Hamid, K S. Khan, T Mubeen, J A. Razzak

Department of Obstetrics & Gynaecology

Five hundred and nine Laparoscopic examinations performed between 1987-91, (147 procedures for evaluation of gynaecologic pelvic pain and 313 for infertility) revealed ectopic pregnancy (27%), twisted ovarian cyst (18%) and acute pelvic inflammatory disease (14%) in cases of acute gynaecologic pain, and endometriosis (17%) and chronic pelvic inflammatory disease (16%) in chronic pelvic pain. Adhesions (20%), tubal block (15%), endometriosis (9%) and polycystic ovary (7%) were common findings in cases of infertility. These data support the usefulness of this minimally invasive procedure in accurate diagnosis of gynaecological disorders and provides insight into the spectra of diseases seen in Pakistani women …

Ai : Artificial Insemination Of Sheep, David Windsor

Journal of the Department of Agriculture, Western Australia, Series 4

Artificial insemination (Al) is used widely in the dairy and beef industries and often performed by farmers themselves. By contrast, sheep breeders generally require assistance from vets when frozen semen is to be used. However, recent experiments with frozen semen are indicating that do-it-yourself Al may soon become a reality.

Penetration Of Piperacillin/Tazobactam Into Gynecologic Tissues Following A Single Loading Dose Prior To Hysterectomy, William F. O'Brien, Shelley George

Obstetrics & Gynecology Faculty Publications

Objective: This study was undertaken to determine plasma and pelvic tissue concentrations of piperacillin/tazobactam following a single intravenous administration.Methods: Plasma and tissue samples were obtained following administration of 3 g of piperacillin and 0.375 g of tazobactam. Concentrations of these agents were determined by chromatography.Results: Plasma concentrations (mean ±SD) for piperacillin/tazobactam were 208 ± 87/27 ± 8 and 95 ± 53/14 ± 2, respectively, at 30 and 60 min after the start of the infusion. The 8:1 ratio between piperacillin and tazobactam in plasma remained constant for up to 96 min. Tissue concentrations yielded a broader range, but …

Digest Of The Philadelphia College Of Osteopathic Medicine (Winter 1994), Philadelphia College Of Osteopathic Medicine

Digest

The Winter 1994 issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• President's Perspective: Our Commitment to Primary Care
• The Consummate Educator and Physician: Fairman Denlinger, DO, ‘53
• Richard S. Koch, DO, ‘38
• Connie McKenzie: Bookkeeping with a Personal Touch
• Cardiology Teaching Facility Opens
• AOA and ACOS Conventions: The Place to be for PCOM Alumni
• Alumni Profile: Kathryn Campanella, DO, '88
• Elders Addresses PCOM
• Class Acts
• Obituaries
• In Memoriam
• Coming Events

Social Security Reform: A Budget Neutral Approach To Reducing Older Women's Disproportional Risk Of Poverty, Richard V. Burkhauser, Timothy M. Smeeding

Center for Policy Research

Perhaps the single greatest achievement of social policy in the United States over the last three decades has been reducing poverty in old age. The transition from work to retirement is no longer economically perilous for the vast majority of older American workers. For most married couples, the risk of falling into poverty even several years after retirement is small. But when one partner of the marriage dies, the survivor faces another much more risky economic transition. The single greatest risk of falling into poverty in old age now comes after the death of a spouse, as the survivor faces …

Integrative Theories Of Medicine: A (W)Holistic Vision, Kathryn B. Forestal

Master's Theses

No abstract provided.

Basic Fibroblast Growth Factor And Fibroblast Growth Factor Receptor I Are Implicated In The Growth Of Human Astrocytomas., R S Morrison, F Yamaguchi, H Saya, J M Bruner, Alan M. Yahanda Md, Facs, L A Donehower, M Berger

PCI Publications and Projects

Malignant astrocytomas are highly invasive, vascular neoplasms that comprise the majority of nervous system tumors in humans. A strong association has previously been made between malignancy in human astrocytic tumors and increased expression of certain fibroblast growth factor (FGF) family members, including basic and acidic FGF. The influence of endogenous basic FGF on glioblastoma cell growth in vitro was evaluated using basic FGF-specific antisense oligonucleotides. These studies indicated that human glioblastoma cell growth in vitro, can be inhibited by suppressing basic FGF expression. Human astrocytomas also exhibited changes in FGF receptor (FGFR) expression during the course of their progression from …

Complexity Of Fetal Movement Detection Using A Single Doppler Ultrasound Transducer, William A. Russell Jr., Curtis L. Lowery, Patrick J. Baggot, James D. Wilson, Robert Walls, Roger M. Hawk, Pam Murphy

Journal of the Arkansas Academy of Science

The objective of this paper is to discuss the complexity of fetal movement detection encountered during development and implementation of an automated single Doppler ultrasonic transducer based instrument. The single transducer instrument was intended to better quantify the duration, velocity, and magnitude of fetal movements. A Corometrics Model 116 fetal heart rate monitor was modified, and a fetal movement detection algorithm (Russell Algorithm) was developed to detect fetal movements on one and two (data fusion) transducers. A Hewlett-Packard (HP) M-1350-A fetal monitor and the Russell Algorithm were used to detect and record fetal movements concurrently on sixty patients between the …

Bacteriuria And Pregnancy Outcome: A Prospective Hospital-Based Study In Pakistani Women, Rahat Qureshi, Khalid S. Khan, Omar Darr, Nasir Khattak, Javaid H. Rizvi, Bader J. Farooqui

Department of Obstetrics & Gynaecology

The prevalence of bacteriuria in Pakistani women and its association with complications of pregnancy was studied. Out of 1579 women, 77 had bacteriuria (4.8%). There was no association of age, gravidity, parity, haemoglobin, pre-eclampsia, mode of delivery, gestational age at delivery, preterm delivery and low birth-weight with presence of bacteriuria. With detection and treatment the pregnancy outcome of women with bacteriuria in pregnancy was the same as that of those without

Pattern Of Dyslipoproteinemia In Selected Population Of Karachi, Erum Khan, Ayesha Molla, Naila Kayani, Mohammad Khurshid

Department of Pathology and Laboratory Medicine

Pattern of dyslipoproteinemia was studied ,over a period of 3-1/2 years in 487(394 males, 93 females) cases aged 4 to above 70 years. Type IV hyperlipoproteinemia was most prevalent (36%) followed by type V (15%)

A View Of Hiv--Infection In Karachi, Naila Kayani, Aamir Sheikh, Asif Khan, Chhotoobhai Mithani, Mohammad Khurshid

Department of Pathology and Laboratory Medicine

A prospective study on the prevalence of HIV-l infection in Karachi, Pakistan was conducted over a period of six years (1986-1992). Over 15,000 individualsamples and more than 32,000 donor units of individuals residing in Karachi at the time of sample co llection were tested for HIV-I infection by our screening test EIA which revealed a positivity rate of 0.23% and 0.003% in individual and donor units respectively by Western Blot. We divided patients into four groups A,B,C and D based on the most plausible cause of transmission. The largest number of positive patients belonged to group B, who were of …

Bacteriuria And Pregnancy Outcome: A Prospective Hospital-Based Study In Pakistani Women, Rahat N. Qureshi, Khalid S. Khan, Omar Darr, Nasir Khattak, Bader J. Farooqui, Javed H. Rizvi

Department of Obstetrics & Gynaecology

The prevalence of bacteriuria in Pakistani women and its association with complications of pregnancy was studied. Out of 1579 women, 77 had bacteriuria (4.8%). There was no association of age, gravidity, parity, haemoglobin, pre-eclampsia, mode of delivery, gestational age at delivery, preterm delivery and low birth-weight with presence of bacteriuria. With detection and treatment the pregnancy outcome of women with bacteriuria in pregnancy was the same as that of those without.

The Prevalence Of Behavioural Risk Factors Associated With Sudden Infant Death Syndrome, Ann M. Callaghan

Theses : Honours

Sudden Infant Death syndrome (SIDS) is a major cause of death in the first year of life. In Western Australia (WA), two infants in every thousand live births die from SIDS each year. The aim of this study was to ascertain the prevalence in WA of three risk factors which have been associated with SIDS, namely prone lying, maternal smoking and lack of breast feeding. In addition the study sought to determine the significant influences that encourage change in infant care practices by parents. The study obtained information from child health nurses and midwives regarding the advice they provide on …

Cardiovascular Risk Factors In School Children From Low Middle Income Families In Karachi, Pakistan, Salma H. Badruddin, A. Molla, Mohammad Khurshid, S. Vaz, S. Hassanali

Section of Haematology/Oncology

Serum levels of total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and trigly cerides (TG) were determined on 239 school children aged 5-19 years belonging to lower middle class families. The mean TC, LDL-C, HDL-C and TG ranged from 3.70-4.37 mmol/L, 2.17- 2.70 mmol/L, 0.94-1.14 mmol/L, 1.07-1.26 mmol/L respectively. In general, girls had higher TC, LDL-C and HDL-C levels. There was no significant difference in the TG levels between boys and girls. Thirty-three percent of the girls and 22% of the boys had TC level _4.4 mmol/L, the level at which dietary intervention is recommended …

Anaemia In Pregnancy - Its Cause In The Underprivileged Class Of Karachi, Saadiya Aziz Karim, Mohammad Khurshid, A.M. Memon, Sadiqua N. Jafarey

Section of Haematology/Oncology

A prospective study of the frequency and type of anaemia amongst poor urban parturients of Karachi was done. It was performed at 2 large teaching hospitals over the time span January to September, 1990. Out of 318 women studied, 104(32.7%) were anaemic (Hb levels <10gm/dl). The type of anaemia was assessed. Iron deficiency predominated and was seen amongst 63.5% of the anaemic population. There was an even distribution of other kinds of anaemia amongst the remainder of the population

A Comparison Of Four Muscle Relaxant Techniques And Their Incidence Of Postoperative Myalgia In Ambulatory Patients, William James Garske Jr.

Community & Environmental Health Theses & Dissertations

Postoperative myalgia was measured 24 and 72 hours following the administration of four different anesthetic regimens to 36 patients undergoing outpatient or 23-hour admission procedures. Each patient, ASA class I or II, was to undergo procedures of limited duration, 30 to 90 minutes, and surgical stimulation, including procedures such as knee arthroscopy, hernia repair, and breast biopsy. Anesthesia was induced with propofol 1.5 mg/kg, fentanyl 50 mcg, and maintained with O₂ , N₂O, and isoflurane. Group I (n=20), the control, received no muscle relaxant and was maintained with mask ventilation. Group II (n=5) received succinylcholine 1.5 mg/kg …

Interaoperative Frozen Section Consultation: An Analysis Of Accuracy In A Teaching Hospital., Farrukh Aijaz, Suhail Muzaffar, Akbar Shah Hussainy, Shahid Pervez, Sheema H. Hasan, Hizbullah Sheikh

Department of Pathology and Laboratory Medicine

This Is a retrospective quality assurance study of all frozen sections done at The Aga Khan University Hospital during a six year period (1986 to 1991). There were 1,031 frozen sections out of a cumulative total of 42,985 surgical specimens (2.39%). Nine hundred and seventy-six (94.66%) were concordant. In 92(8.9%) fresh specimens were brought from other hospitals of Karachi, in 37 cases (3.58%) the diagnosis was deferred till the evaluation of permanent paraffin sections and 18 (1,74%) were discordant with 7 (0.67%) false positive and 11(1,06%) false negative. Among the discordant cases, 9 were attributed to misinterpretation, 7 due to …

A Clustering Of Childhood Meningococcal Disease: A Challenge For Physicians, Press And Community., Michael S. Dreyer, Stephen C. Eppes, Joel D. Klein

Department of Pediatrics Faculty Papers

The Delaware Division of Public Health reported only two cases of documented meningococcal infection in the pediatric population in 1992. As of March 1, 1993, the Morbidity and Mortality Weekly Report indicated only one case of meningococcal disease in the state of Delaware for 1993. However, from the end of February to early April 1993, approximately six weeks, there were seven cases of documented meningococcal infection in the pediatric population that either presented or were transferred to one of the pediatric care facilities in the Wilmington, Delaware area. Notification of these cases to the Delaware Division of Public Health prompted …