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Minimal Invasive Decompression For Lumbar Spinal Stenosis., Victor Popov, David G Anderson

Department of Orthopaedic Surgery Faculty Papers

Lumbar spinal stenosis is a common condition in elderly patients and may lead to progressive back and leg pain, muscular weakness, sensory disturbance, and/or problems with ambulation. Multiple studies suggest that surgical decompression is an effective therapy for patients with symptomatic lumbar stenosis. Although traditional lumbar decompression is a time-honored procedure, minimally invasive procedures are now available which can achieve the goals of decompression with less bleeding, smaller incisions, and quicker patient recovery. This paper will review the technique of performing ipsilateral and bilateral decompressions using a tubular retractor system and microscope.

Minimal Invasive Decompression For Lumbar Spinal Stenosis., Victor Popov, David G Anderson

Department of Orthopaedic Surgery Faculty Papers

Lumbar spinal stenosis is a common condition in elderly patients and may lead to progressive back and leg pain, muscular weakness, sensory disturbance, and/or problems with ambulation. Multiple studies suggest that surgical decompression is an effective therapy for patients with symptomatic lumbar stenosis. Although traditional lumbar decompression is a time-honored procedure, minimally invasive procedures are now available which can achieve the goals of decompression with less bleeding, smaller incisions, and quicker patient recovery. This paper will review the technique of performing ipsilateral and bilateral decompressions using a tubular retractor system and microscope.

Genes Adopt Non-Optimal Codon Usage To Generate Cell Cycle-Dependent Oscillations In Protein Levels., Milana Frenkel-Morgenstern, Tamar Danon, Thomas Christian, Takao Igarashi, Lydia Cohen, Ya-Ming Hou, Lars Juhl Jensen

Department of Biochemistry and Molecular Biology Faculty Papers

The cell cycle is a temporal program that regulates DNA synthesis and cell division. When we compared the codon usage of cell cycle-regulated genes with that of other genes, we discovered that there is a significant preference for non-optimal codons. Moreover, genes encoding proteins that cycle at the protein level exhibit non-optimal codon preferences. Remarkably, cell cycle-regulated genes expressed in different phases display different codon preferences. Here, we show empirically that transfer RNA (tRNA) expression is indeed highest in the G2 phase of the cell cycle, consistent with the non-optimal codon usage of genes expressed at this time, and lowest …

Functional Evaluation Of The Urinary Tract By Duplex Doppler Ultrasonography In Patients With Acute Renal Colic., Raza Sayani, Muhammad Ali, Kashif Shazlee, Rana Shoaib Hamid, Kamran Hamid

Department of Radiology

Purpose: To determine the role of duplex Doppler ultrasonography (DDU) in Patients with acute unilateral renal obstruction. Subjects And Methods:A total of 161 Patients with suspected renal colic due to urolithiasis were evaluated by DDU followed by intravenous urography (IVU). The mean intra-arterial resistive index (RI) and the difference of mean resistive index between both kidneys (delta RI) were determined for each person. An RI value of ≥0.70 and a delta RI value of ≥0.06 were taken as the discriminatory threshold for obstruction. IVU results were considered the " reference standard" against which renal DDU findings were compared.

Results: …

Earlier Surgical Intervention In Congenital Heart Disease Results In Better Outcome And Resource Utilization, Roheena Z. Panni, Awais Ashfaq, Muhammad M. Amanullah

Section of Cardiothoracic Surgery

Background:Congenital heart disease (CHD) accounts for a major proportion of disease in the pediatric age group. The objective of the study was to estimate the cost of illness associated with CHD pre, intra and postoperatively, among Patients referred to a tertiary care hospital in Karachi, Pakistan. This is the first study conducted to estimate the cost of managing CHD in Pakistan.

Methods:

A prevalence based cost of illness Study Design was used to estimate the cost of cardiac surgery (corrective & palliative) for congenital heart defects in children Results:The mean age at the time of surgery in group …

Research Brief: "Secondary Trauma And Military Veteran Caregivers", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about the stress that occurs for caregivers of veterans due to secondary trauma. In policy and practice, caregivers can continuously monitor themselves for symptoms of secondary trauma, maintain a balance between professional life and personal life, and promote a supportive culture within the caregiver community; policies should acknowledge that secondary trauma stressors do exist for caregivers and should look for ways to reduce the negative effects of secondary trauma stressors. Suggestions for future research include using econometric models to detect relevant factors for risk of developing secondary trauma stressors.

A Critical Analysis Of The Current State Of Neurosurgery Training In Pakistan, Muhammad Shahzad Shamim, Muhammad Zubair Tahir, Saniya Siraj Godil, Rajesh Kumar, Arshad Ali Siddiqui

Section of Neurosurgery

Objective: To observe interdepartmental variation in the availability of resources and academic activities within the various neurosurgery programs of Pakistan.
Methods: This was a proforma-based survey of neurosurgery trainees and young neurosurgeons of Pakistan, looking at the academic infrastructure and output of their programs. The proforma was filled by 36 respondents from 11 neurosurgery centers of the country. All these centers were accredited for neurosurgery training in Pakistan.
Results: Out of the 36 respondents, 30 were completing a Fellowship training (FCPS) and six were enrolled for a Master in Surgery (MS) program. About 80% of the participants used the Youman's …

Outbreak Of Beriberi Among African Union Troops In Mogadishu, Somalia, John T. Watson, Hassan El Bushra, Emmaculate J. Lebo, Godfrey Bwire, James Kiyengo, Gideon Emukule, Victor Omballa, John Tole, Muvunyi Zuberi, Robert F. Breiman, Mark A. Katz

Internal Medicine, East Africa

Context and Objectives: In July 2009, WHO and partners were notified of a large outbreak of unknown illness, including deaths, among African Union (AU) soldiers in Mogadishu. Illnesses were characterized by peripheral edema, dyspnea, palpitations, and fever. Our objectives were to determine the cause of the outbreak, and to design and recommend control strategies.

Design, Setting, and Participants: The illness was defined as acute onset of lower limb edema, with dyspnea, chest pain, palpitations, nausea, vomiting, abdominal pain, or headache. Investigations in Nairobi and Mogadishu included clinical, epidemiologic, environmental, and laboratory studies. A case-control study was performed to identify risk …

Factors Influencing The Opinion Of Individuals In Determining Tumour Spread After Biopsy, Tayyaba Z. Ansari, Adnan A. Zaidi, Asra Parekh, Owais Iqbal, Nehal Masood, Ahmed Mateen, Tehseen Fatima

Section of General Surgery

Background: People often have concerns regarding tumour spread after biopsy which leads to a delay in seeking expert medical advice. The data regarding this perception is scanty. Therefore, we conducted this cross sectional study to explore the beliefs and perceptions of individuals regarding tumour spread after biopsy and the basis of those beliefs.
Methods: The survey was conducted in outPatient areas of two different tertiary care hospitals of Karachi namely Aga Khan University Hospital Karachi (AKUH) and Karachi Institute of Radiotherapy and Nuclear Medicine (KIRAN). We interviewed 600 individuals and documented their responses on a questionnaire. There were 400 responders …

Microglial P38Α Mapk Is Critical For Lps-Induced Neuron Degeneration, Through A Mechanism Involving Tnfα, Bin Xing, Adam D. Bachstetter, Linda J. Van Eldik

Sanders-Brown Center on Aging Faculty Publications

BACKGROUND: The p38α MAPK isoform is a well-established therapeutic target in peripheral inflammatory diseases, but the importance of this kinase in pathological microglial activation and detrimental inflammation in CNS disorders is less well understood. To test the role of the p38α MAPK isoform in microglia-dependent neuron damage, we used primary microglia from wild-type (WT) or p38α MAPK conditional knockout (KO) mice in co-culture with WT cortical neurons, and measured neuron damage after LPS insult.

RESULTS: We found that neurons in co-culture with p38α-deficient microglia were protected against LPS-induced synaptic loss, neurite degeneration, and neuronal death. The involvement of the proinflammatory …

Cerebrospinal Fluid Rhinorrhea: An Institutional Perspective From Pakistan, Muhammad Zubair Tahir, Muhammad Babar Khan, Muhammad Umair Bashir, Shabbir Akhtar, Muhammad Ehsan Bari

Section of Neurosurgery

Background:The management of cerebrospinal fluid (CSF) rhinorrhea has evolved over the last two decades. We present here a review of our 11-year data on CSF rhinorrhea and its management at a tertiary care hospital in a developing country, with particular reference to the diagnosis, surgical management and outcome of the disease.
Methods: The medical charts of all Patients with a diagnosis of CSF rhinorrhea over an 11-year period were reviewed. The etiology of CSF rhinorrhea was classified into three categories: spontaneous, iatrogenic and traumatic. All the Patients were divided into three categories based on the type of management as …

A Meta-Analysis Of Array-Cgh Studies Implicates Antiviral Immunity Pathways In The Development Of Hepatocellular Carcinoma., Xu Guo, Yanna Ba, Xi Ma, Jiaze An, Yukui Shang, Qichao Huang, Hushan Yang, Zhinan Chen, Jinliang Xing

Kimmel Cancer Center Faculty Papers

BACKGROUND: The development and progression of hepatocellular carcinoma (HCC) is significantly correlated to the accumulation of genomic alterations. Array-based comparative genomic hybridization (array CGH) has been applied to a wide range of tumors including HCCs for the genome-wide high resolution screening of DNA copy number changes. However, the relevant chromosomal variations that play a central role in the development of HCC still are not fully elucidated.

METHODS: In present study, in order to further characterize the copy number alterations (CNAs) important to HCC development, we conducted a meta-analysis of four published independent array-CGH datasets including total 159 samples.

RESULTS: Eighty …

Project P.A.T.H.S. In Hong Kong: New Curriculum In Response To Adolescent Developmental Issues, Hing Keung Ma, Daniel T. L. Shek, Joav Merrick

Pediatrics Faculty Publications

No abstract.

De Novo Design Of Antiviral And Antibacterial Peptides With Varying Loop Structures, Guangshun Wang, Karen W. Buckheit, Biswajit Mishra, Tamara Lushnikova, Robert W. Buckheit Jr.

Journal Articles: Pathology and Microbiology

No abstract provided.

Race/Ethnicity, Gender, Weight Status, And Colorectal Cancer Screening., Heather Bittner Fagan, Ronald E Myers, Constantine Daskalakis, Randa Sifri, Arch G Mainous, Richard Wender

Department of Medical Oncology Faculty Papers

Background. The literature on colorectal cancer (CRC) screening is contradictory regarding the impact of weight status on CRC screening. This study was intended to determine if CRC screening rates among 2005 National Health Interview Survey (NHIS) respondent racial/ethnic and gender subgroups were influenced by weight status. Methods. Univariable and multivariable logistic regression analyses were performed to determine if CRC screening use differed significantly among obese, overweight, and normal-weight individuals in race/ethnic and gender subgroups. Results. Multivariable analyses showed that CRC screening rates did not differ significantly for individuals within these subgroups who were obese or overweight as compared to their …

Risk Factors Of Gallbladder Cancer In Karachi-A Case-Control Study, A. Rehman Alvi, Nadeem Ahmed Siddiqui, Hasnain Zafar

Department of Surgery Docs

Background:Gallbladder carcinoma (GC) is a relatively rare malignancy worldwide but is the second commonest gastrointestinal cancer in Pakistani women. Gallstones have a positive association with GC but other factors also influence in causation.

Methods:

This is a retrospective case control study over a period of 19 years. The cases (Group A) were Patients with histopathological proven carcinoma gallbladder (N = 60) and controls were Patients with cholelithiasis but no carcinoma gallbladder on histopathology (N = 120). Multivariate regression analysis was done to calculate the odds ratio, 95% confidence interval and P-Value. A positive relationship was found between size of …

Wnt Signaling Exerts An Antiproliferative Effect On Adult Cardiac Progenitor Cells Through Igfbp3., Angelos Oikonomopoulos, Konstantina-Ioanna Sereti, Frank Conyers, Michael Bauer, Annette Liao, Jian Guan, Dylan Crapps, Jung-Kyu Han, Hanhua Dong, Ahmad F Bayomy, Gabriel C Fine, Karen Westerman, Travis L Biechele, Randall T Moon, Thomas Force, Ronglih Liao

Center for Translational Medicine Faculty Papers

RATIONALE: Recent work in animal models and humans has demonstrated the presence of organ-specific progenitor cells required for the regenerative capacity of the adult heart. In response to tissue injury, progenitor cells differentiate into specialized cells, while their numbers are maintained through mechanisms of self-renewal. The molecular cues that dictate the self-renewal of adult progenitor cells in the heart, however, remain unclear.

OBJECTIVE: We investigate the role of canonical Wnt signaling on adult cardiac side population (CSP) cells under physiological and disease conditions.

METHODS AND RESULTS: CSP cells isolated from C57BL/6J mice were used to study the effects of canonical …

Treatment Of Chronic Mental Illness, Anu A. Matorin, Md

Jefferson Journal of Psychiatry

RESIDENT'S GUIDE TO TREATMENT OF PEOPLE WITH CHRONIC MENTAL ILLNESS

(GAP Report 136; 1993)

Formulated by the Committee on Psychiatry and the Community, Group for the Advancement of Psychiatry American Psychiatric Press, Inc., 1993, 230 pages, $30.00

A Mesmerizing Book, Daniel A. Monti, Md

Jefferson Journal of Psychiatry

HYPNOSIS IN THE RELIEF OF PAIN

Ernest R. Hilgard and Josephine R. Hilgard

Brunner/Maze!, Inc., New York 1994, paperback, $28 .95, 294 pgs.

Prediction Of Treatment Response And Diagnosis In Psychiatry, Eduardo Dunayevich, Md

Jefferson Journal of Psychiatry

The lack of diagnostic gold standards and the multiplicity of vantage points used to conceptualize mental illness renders psychiatric diagnostic and therapeutic approaches susceptible to individual and cultural biases. Developments in therapeutic approaches have often provided vantage points from which to conceptualize psychopathology. The identification of predictors of treatment response may be a useful element for clinicians to select between multiple treatment tools in an expanding therapeutic armamentarium while fostering refinements in current diagnostic systems.

The Forgotten Evaluation: Taking Competence Seriously, Seth E. Tabb, Md, Scott A. West, Md

Jefferson Journal of Psychiatry

The medical literature devotes little attention to the application of competency to the general medical patient. Commonly, the only cases recognized as necessitating a competency evaluation are overtly psychotic patients, patients requiring written informed consent, and those patients who refuse treatments strongly recommended by their physician. Clarifying terminology and redefining competency provides a practical screening method for assessing competency in all patients. When physicians neglect the evaluation of competency, patient autonomy is compromised. Not only are all physicians capable of performing a competency evaluation, they are ethically and professionally required to do so.

Transition To Psychiatric Residency: Unique Stresses; Unique Rewards, Catherine A. Belitsky, Md, Frcp(C), Sidney H. Kennedy, Md, Frcp(C)

Jefferson Journal of Psychiatry

An individual's decision to pursue a psychiatric residency following medical school training is shaped by many factors. Beginning residents are often ill prepared for the relative impact that the shift from medical doctor to psychiatric resident entails. This paper reviews the literature regarding demographic and psychological factors relating to recruitment, dynamic and practical issues confronting the beginning resident, and various coping styles adopted. These factors are considered in the context of an inpatient setting where the majority of residents begin their training. Much of the resident response is seen as adaptive and a number of strategies for coping are suggested.

Patients Who Request A Female Psychotherapist, Timothy C. Smith, Md, Melinda Fudge, Md, Salman Akhtar, Md, Steven Samuel, Phd

Jefferson Journal of Psychiatry

Upon arriving at an outpatient clinic, many patients request to see a female psychotherapist. Yet little has been written on this topic. The aim of this study was to explore the demographic and clinical characteristics of such patients. We compared patients who voiced a preference for a female therapist with controls on the demographic variables of age, sex, race, marital and financial status and the clinical characteristics of diagnosis, history of sexual abuse, sexual preference, overt presence of sexual or social difficulties, history of prior treatment, gender of the previous therapist, and treatment drop out rate. A chi square analysis …

Non-Neuroleptic Pharmacotherapy Of Schizophrenia, Sajiv John, Md, Atul Mahableshwarkar, Md

Jefferson Journal of Psychiatry

Patients with schizophrenia are typically treated with a neuroleptic and some form of psychosocial intervention. In spite of optimum treatment, up to one-third of patients continue to remain severely disabled due to persistent positive or negative symptoms. A variety of drugs have been tried as alternatives or additions to traditional neuroleptics in these patients. This paper is a review of these nonneuroleptic treatment alternatives and an attempt to establish some guidelines for their use.

A Case Study Of Obsessive-Compulsive Disorder: Some Diagnostic Considerations, Jeanette M. Stumbo Zaimes, Md

Jefferson Journal of Psychiatry

Obsessive-Compulsive Disorder (OCD) was considered a rare disorder prior to 1984 when the initial results from the Epidemiologic Catchment Area survey demonstrated a substantial prevalence of the disorder (1). Thus there may be many patients today who entered treatment prior to 1984 with undiagnosed OCD. This paper gives the history of one such patient and reviews the current literature on OCD as it pertains to the diagnostic evidence in this case.

Concepts And Models Of Empathy: Past, Present, And Future, Elizabeth Ann Baxter, Md

Jefferson Journal of Psychiatry

The subject of empathy has been increasing in popularity and importance; correspondingly, the theoretical aspects of empathy are in need of further development. This paper outlines key concepts and processes related to empathy, particularly the mechanisms of identification and regression as they are discussed in the models of empathy articulated by Fleiss, Greenson, and Jordan. Similarities and differences of the models are examined, in addition to each model's description of the roles of identification and regression. Although each model has made significant contributions towards a theoretical perspective of empathy, none of them have distinguished pathological from non-pathological uses of identification. …

Case Report: Sometimes A Cigar Is Just A Cigar, Zafar Y. Ibrahim, Md, Ellen F. Brooks, Md

Jefferson Journal of Psychiatry

This unusual case underscores the need for psychiatrists to consider treatable and curable causes of acute behavior changes even when historical data are not easily available. This case presentation invites physicians of mind (and body) to utilize simple and common-sense approaches while evaluating their patients.

Editor's Column, Mary E. Donovan, Md

Jefferson Journal of Psychiatry

"Sometimes a cigar is just a cigar. " Others had learned, "My son, sometimes a cigar is just a good smoke." Like many of our colleagues, we believed that these were Freud's words during a question and answer session after a lecture he gave at Clark University. The words were comforting in a way, giving us a chance to chalk at least some things up to pure coincidence, thus releasing us from relentless unconscious agendas and hidden sexual interpretations.

Editorial Staff

Jefferson Journal of Psychiatry

Editorial staff for Volume 12, Number 2, 1995 Jefferson Journal of Psychiatry.

Current Concepts-Past Contributions, Cynthia L. Theiss, Md

Jefferson Journal of Psychiatry

WOMEN BEYOND FREUD: NEW CONCEPTS OF FEMININE PSYCHOLOGY

Edited by Milton M. Berger, M.D., with chapters by Marianne Horney Eckardt, Carol Gilligan , Douglas H. Ingram, Helen Singer Kaplan, Harold I. Lief, Jean Baker Miller, Silvia W. Olarte, Susan Quinn, and Mario Rendon

Brunner/Mazel, Inc., New York , 1994, 162 pages, $26.95