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Skeletal Abnormalities In Mice Lacking Extracellular Matrix Proteins, Thrombospondin-1, Thrombospondin-3, Thrombospondin-5, And Type Ix Collagen, Karen L Posey, Kurt Hankenson, Alka C Veerisetty, Paul Bornstein, Jack Lawler, Jacqueline T Hecht

Faculty, Staff and Student Publications

Thrombospondin-5 (TSP5) is a large extracellular matrix glycoprotein found in musculoskeletal tissues. TSP5 mutations cause two skeletal dysplasias, pseudoachondroplasia and multiple epiphyseal dysplasia; both show a characteristic growth plate phenotype with retention of TSP5, type IX collagen (Col9), and matrillin-3 in the rough endoplasmic reticulum. Whereas most studies focus on defining the disease process, few functional studies have been performed. TSP5 knockout mice have no obvious skeletal abnormalities, suggesting that TSP5 is not essential in the growth plate and/or that other TSPs may compensate. In contrast, Col9 knockout mice have diminished matrillin-3 levels in the extracellular matrix and early-onset osteoarthritis. …

The Impact Of Telemonitoring On Self-Efficacy, Emotional Well-Being, And Clinical Outcomes In Patients With Chronic Obstructive Pulmonary Disease Or Heart Failure, Jaclyn West-Frasier

Dissertations

Telemonitoring is the remote monitoring of patients' health status using telecommunications and information processing technologies. This pilot study analyzed data collected through a parent study that randomized 46 home health patients to either standard care (SC) or standard care with the addition of telemonitoring (TM). The telemonitoring device used in this study provided daily transmission of physiologic data and patients responses to questions about their disease and symptom management. Data analysis was completed to address the question whether telemonitoring, as part of standard home care for patients with chronic obstructive pulmonary disease (COPD) and patients with heart failure (HF), has …

A Randomised Comparative Clinical Trial Of Prokinetic Agents And Proton Pump Inhibitors In H. Pylori Negative Non-Ulcer Dyspepsia, Mzee Ngunga

Master of Medicine in Internal Medicine

Aim: To compare the efficacy of prokinetic agents and proton pump inhibitors in symptom relief of patients with non-ulcer dyspepsia. Design: Comparative prospective single blind clinical trial. Patients and setting: Fifty four cases of non-ulcer dyspepsia in whom H. pylori has been eradicated were seen in the specialist gastroenterology clinic of a tertiary care hospital. Methodology: Patients with dyspepsia and negative endoscopy for peptic ulcer disease, gastro-oesophageal reflux disease, hiatus hernia and upper gastrointestinal malignancy in whom H pylori has been eradicated but still had dyspepsia were assessed and scored using the modified Glasgow dyspepsia severity score (GDSS) at baseline. …

Triple Test Assessment And A Scoring System To Predict The Presence Of Breast Cancer At Aga Khan University Hospital, Nairobi, Aideed A. Kahie

Master of Medicine in General Surgery

Background: Breast cancer is an emerging health concern in Africa. It is the most common female cancer in Kenya. The accuracy of the diagnostic modalities in our institution has not been previously assessed, especially in cases where components of the Triple Test (TT) are non-concordant. Objectives: To retrospectively evaluate the accuracy of TT, its components and its modification; the Triple Test Score when the components are nonconcordant at Aga Khan University Hospital, Nairobi. Methods: Using ICD9 611.72 we identified patients with breast lump or mass in the period between January 2000 and July 2007. One hundred and thirty nine patients …

Resource Utilization And Outcomes From Percutaneous Drainage And Interval Appendectomy For Perforated Appendicitis With Abscess., Scott J. Keckler, Kuojen Tsao, Susan W. Sharp, Daniel J. Ostlie, G W. Holcomb Iii, Shawn D. St Peter

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: Given the perceived technical demands of laparoscopic appendectomy and the expected postoperative morbidity in patients with a well-defined abscess, initial percutaneous drainage has become an attractive option in this patient population. This strategy allows for a laparoscopic appendectomy to be performed in an elective manner at the convenience of the surgeon. However, the medical burden on the patient and on the quality of patient outcomes has not been described in the literature. Therefore, we audited our experience with initial percutaneous drainage followed by laparoscopic interval appendectomy to evaluate the need for a prospective trial.

METHODS: After institutional review board …

Single Daily Dosing Ceftriaxone And Metronidazole Vs Standard Triple Antibiotic Regimen For Perforated Appendicitis In Children: A Prospective Randomized Trial., Shawn D. St Peter, Kuojen Tsao, Troy L. Spilde, G W. Holcomb Iii, Susan W. Sharp, J Patrick Murphy, Charles L. Snyder, Ronald J. Sharp, Walter S. Andrews, Daniel J. Ostlie

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: Appendicitis is the most common emergency condition in children. Historically, a 3-drug regimen consisting of ampicillin, gentamicin, and clindamycin (AGC) has been used postoperatively for perforated appendicitis. A retrospective review at our institution has found single day dosing of ceftriaxone and metronidazole (CM) to be a more simple and cost-effective antibiotic strategy. Therefore, we performed a prospective, randomized trial to compare efficacy and cost-effectiveness of these 2 regimens.

METHODS: After internal review board approval (IRB no. 04 12-149), children found to have perforated appendicitis at appendectomy were randomized to either once daily dosing of CM (2 total doses per …

Response Of Endothelial Cells To Stressors: The Impact Of Aging And Diabetes, Katie Mclellan

Loma Linda University Electronic Theses, Dissertations & Projects

Preliminary research indicates there is some impairment of the endothelial cells to respond to single stressors such as local heat, shear stress, and global heat in older people and people who have diabetes. The response of the skin blood flow to local heat is an indicator of the endothelial cells ability to cope with stress. In addition, factors such as thicker subcutaneous fat and skin moisture may impair the skin’s ability to dissipate heat. For older people and people with diabetes, this endothelial dysfunction may cause an even more diminished response to multiple stressors. However, no studies have examined the …

Immediate Provionalization Of Single Threaded Oxidized Implants On Maxillary Premolars Healed Sites: One-Year Study, Kiyotaka Umezu

Loma Linda University Electronic Theses, Dissertations & Projects

Osseointegrated endosseous implants have been widely used and become a predictable treatment option for completely and partially edentulous patients. The viability and predictability of this treatment modality have been supported with the high success rates in numerous studies. Clinical guideline requires a healing period of 3 to 6 months without functional loading to achieve osseointegration with machine surface implants. Therefore, numerous studies on immediately loaded implants have been conducted in an attempt to minimize or eliminate this healing period. The purpose of this study was to evaluate the success rate of the immediately provisionalized oxidized-surface implants in healed sites supporting …

Predicting Long-Term Memory In Adult Brain Injury Patients Using Mr Spectroscopy, Herminia De La Rosa-Trujillo

Loma Linda University Electronic Theses, Dissertations & Projects

Accurate outcome prediction has proven to be somewhat elusive for patients with traumatic brain injury (TBI). The difficulty is due to the sometimes inaccurate methods of prediction currently available. Despite the advances seen in radiological technology, the traditional methods of x-rays, CT scans and MRIs are not always accurately able to predict patient functional outcome. These radiological methods are adequate in determining gross structural anatomical disturbances, however, they unable to detect more diffuse cellular damage believed to be responsible for the functional impairments evidenced in patients sustaining TBI. Magnetic Resonance Spectroscopy (MRS) is an imaging technique which measures brain metabolites …

Factors That Affect Performance On Executive Functioning After Coronary Artery Bypass Grafting, Sapna Mahesh Patel

Loma Linda University Electronic Theses, Dissertations & Projects

Research suggests that individuals who undergo coronary artery bypass grafting (CABG) experience declines in neuropsychological functioning post-operatively. This decline has been observed in up to 80% of patients early after surgery, and in up to 30% of patients after six months. Many studies have examined the potential effects of CABG on neuropsychological functioning in general, and numerous studies have found that executive functions are impaired in particular. However, none have examined what factors contribute to observed executive dysfunction after CABG. This study investigated the role of memory functions on executive functions in a selected sample of patients undergoing CABG. This …

Hiv Risk Among Nursing Students In Rwanda : Self-Efficacy, Knowledge And Attitudes, Jacqueline Wosinski

Loma Linda University Electronic Theses, Dissertations & Projects

Acquired immune deficiency syndrome (AIDS) is the leading cause of death in sub-Saharan Africa. With a prevalence rate of 3.1% in 2006, Rwanda is one of the hardest hit countries. Nurses are often the leading health professionals in rural communities and at the forefront of the fight against the HIV pandemic. Little has been written on how nurses are prepared to intervene successfully along the continuum of HIV prevention and care. A mixed-methods sequential exploratory approach was used to explore this question.

In the first phase, cognitive, socio-psychological, and environmental factors of nursing education in Rwanda in regard to HIV …

Partner Communication And Factors Associated With The Decision To Obtain An Hiv Test Among Chinese/Chinese American Community College Students In Northern California, Sang Leng Trieu

Loma Linda University Electronic Theses, Dissertations & Projects

HIV testing and counseling is considered the cornerstone of a comprehensive approach to HIV prevention and education. Little is known, however, about HIV prevention, including HIV testing rates for Asian Pacific Islander (API) women, because data for this ethnic group is aggregated, thus limiting specific data for Chinese/Chinese American population or other API subgroups. This dissertation research examined factors associated with the decision to obtain an HIV test among Chinese/Chinese American community college women and explored the association among relationship status, partnership communication, and discussions of HIV testing.

Using constructs of the health belief model, an online and paper-pencil, crosssectional …

Neuronal Connections From The Cervix To The Spinal Cord Before Parturition, Mary Medina Groves

Loma Linda University Electronic Theses, Dissertations & Projects

By the day before birth, the density of nerve fibers in the cervix has increased compared to earlier in pregnancy or in nonpregnant mice. Similar findings are reported in parturient women. To test the hypothesis that connections between the cervix and spinal cord are enhanced by term, the cervix of nonpregnant and time-dated pregnant mice (day 15 or 18 post-breeding) was injected with pseudorabies virus (PRV), a trans-synaptic retrograde neural tract tracer. Mice were euthanized and perfused 5 days later. The spinal cord and cervix were removed and postfixed overnight, immersed in sucrose, and cryostat sections through the thoracic to …

Mechanisms Of T Helper Cell Modulation In A Simulated Space Radiation Environment, Asma Rizvi

Loma Linda University Electronic Theses, Dissertations & Projects

Exposure to solar particle events (SPEs) poses the most serious threat to astronaut health. Due to this radiation environment, exploration of the solar system beyond Earth’s orbit entails many risks for the crew on these deep space missions. Depression or dysfunction of the immune system is a major concern due to its high radio-sensitivity; potential consequences include overwhelming infection, development of cancer, fibrosis, and poor wound healing. Astronauts are also exposed to low dose/low dose rate (LDR) radiation. A three month stay at the international space station exposes them to ~ 0.05 Gy of radiation.

C57BL/6 mice received LDR gamma-radiation …

Case Report: Signal Drop On Mra Imaging Of The Internal Carotid Artery After Neuroform Stent Placement, Aditya S. Pandey Md, Meryl A. Severson Iii Md, Robert H. Rosenwasser Md

JHN Journal

Magnetic resonance angiography (MRA) is an important tool in evaluating the patency of vessels which have previously been stented. Neuroform stents (Boston Scientific, Natick, MA, U.S.A.) are utilized to provide a scaffold across the neck of an aneurysm. These stents are synthesized from Nitinol (nickel and titanium) and thus cause minimal distortion upon imaging with MRA. Patients who have undergone Neuroform stent assisted coiling of aneurysms are routinely followed with MRA to delineate stenosis of the stented segment of vessel as well as recurrence of the aneurysms. While numerous reports show that Neuroform stents do not lead to MRA imaging …

Case Report: Hemorrhage Into An Occult Spinal Ependymoma After Epidural Anesthesia, Peter G. Campbell Md, Ashwini D. Sharan Md, James S. Harrop Md, Alex R. Vaccaro Md, John K. Ratliff Md

JHN Journal

Epidural anesthesia is a procedure which is well tolerated and has a low incidence of adverse events. In performing caesarean sections, regional anesthesia (spinal or epidural) is the preferred modality for anesthetic delivery. Although rare with continuous epidural anesthesia, epidural hematomas have been reported to occur with an incidence between 1:150,000 and 1:190,00010. An underlying bleeding diathesis has been implicated as a causative factor. We present the sixth reported case of hemorrhage into an occult intradural neoplasm after spinal or epidural anesthesia. Similar lesions have not been reported in the recent spine literature.

Endovascular Cure Of A "Locked-In" Patient, Meryl A. Severson Iii Md, Aditya S. Pandey Md, Erol Veznedaroglu Md

JHN Journal

We report the case of a 60 year-old right-handed gentleman who became acutely “Locked-In” several days after a lower extremity orthopedic procedure. He underwent emergent endovascular treatment and had complete resolution of his neurologic findings except for mild dysarthria and dysphagia. Endovascular intervention for posterior circulation thrombosis is highly effective when patients are treated within 24 hours.

Primary Stroke Centers: Their Role And Impact On Acute Stroke Management, Carissa C. Pineda Md, Jeanne Birch Rn, Bsn

JHN Journal

The management of acute ischemic stroke has been recognized as a significant medical problem. Stroke remains to be the third leading cause of death and the leading cause of long-term disability; 80% of all strokes are ischemic (a blood clot disrupts blood flow), and the rest are hemorrhagic (a blood vessel ruptures in the brain). Nearly 1 in 15 deaths in 2003 were the result of a stroke.1 Approximately 750,000 new strokes occur annually, of which 250,000 result in the deaths in the United States alone. The latest estimates for stroke costs total to about $30 billion in direct costs, …

Understanding Neurosurgery Through Experimental And Computer Models, Ciro Randazzo Md, Aditya S. Pandey Md, Erol Veznedaroglu Md

JHN Journal

Endovascular neurosurgery is an evolving field, with the goal of treating neurological disease with minimal invasion of the body. The current approach is to deliver focused therapies via catheters traveling through the vascular tree. Refinement and advancement of these techniques requires not just new ideas, but new ideas that hold up when tested through the scientific method.

Before clinical trials can begin, ethics and law demand that the ideas are tested first under experimental models. One benefit of these pre-clinical tests is the early identification of side effects. Another is the opportunity to practice and polish surgical technique in advance …

Jhn Journal (Download The Full Pdf Of This Issue), Robert H. Rosenwasser Md

JHN Journal

Complete JHN Journal Issue, Vol. 4, Issue 1, June 2008.

Effectiveness Of Improving Performance With The Bigger Faster Stronger In-Season Training Program, Alicia D. Crelinsten

Masters Theses

This study investigated the effectiveness of improving performance of adolescents with the in-season Bigger Faster Stronger (BFS) program. Thirty seven high school athletes were divided into three groups; BFS (n=l4 ), traditional weight training (n= l0), and control (n= 13 ). Each participant went through a battery of seven performance pre-tests and post-tests ( estimated 1 ORM incline bench, broad jump, one minute sit-up test, t-test, line drill, 40 yard sprint, 1.5 mile run). Following the pre-testing, the control group continued to participate in their sport. The BFS group participated in the in-season BFS program (30 minute supervised session consisting …

Usefulness Of Baseline Lipids And C-Reactive Protein In Women Receiving Menopausal Hormone Therapy As Predictors Of Treatment-Related Coronary Events., Paul Bray, Joseph C Larson, Andrea Z Lacroix, Joann Manson, Marian C Limacher, Jacques E Rossouw, Norman L Lasser, William E Lawson, Marcia L Stefanick, Robert D Langer, Karen L Margolis

Cardeza Foundation for Hematologic Research

Blood lipids and high-sensitivity C-reactive protein (hs-CRP) are altered by hormone therapy. The goal of the present study was to determine whether lipids and hs-CRP have predictive value for hormone therapy benefit or risk for coronary heart disease events in postmenopausal women without previous cardiovascular disease. A nested case-control study was performed in the Women's Health Initiative hormone trials. Baseline lipids and hs-CRP were obtained from 271 incident patients with coronary heart disease (cases) and 707 controls. In a combined trial analysis, favorable lipid status at baseline tended to predict better coronary heart disease outcomes when using conjugated equine estrogen …

Rtr1 Is The Saccharomyces Cerevisiae Homolog Of A Novel Family Of Rna Polymerase Ii-Binding Proteins, Patrick A Gibney, Thomas Fries, Susanne M Bailer, Kevin A Morano

Faculty, Staff and Student Publications

Cells must rapidly sense and respond to a wide variety of potentially cytotoxic external stressors to survive in a constantly changing environment. In a search for novel genes required for stress tolerance in Saccharomyces cerevisiae, we identified the uncharacterized open reading frame YER139C as a gene required for growth at 37 degrees C in the presence of the heat shock mimetic formamide. YER139C encodes the closest yeast homolog of the human RPAP2 protein, recently identified as a novel RNA polymerase II (RNAPII)-associated factor. Multiple lines of evidence support a role for this gene family in transcription, prompting us to rename …

Radioactive Seed Immobilization Techniques For Interstitial Brachytherapy, K. Yan, T. Podder, I. Buzurovic, Y. Hu, E. Messing, D. Rubens, A. Dicker, R. Valicenti, N. Sarkar, W. Ng, Y. Yu

Department of Radiation Oncology Faculty Papers

Purpose In prostate brachytherapy, seeds can detach from their deposited sites and move locally in the pelvis or migrate to distant sites including the pulmonary and cardiac regions. Undesirable consequences of seed migration include inadequate dose coverage of the prostate and tissue irradiation effects at the site of migration. Thus, it is clinically important to develop seed immobilization techniques.

Methods We first analyze the possible causes for seed movement, and propose three potential techniques for seed immobilization: (1) surgical glue, (2) laser coagulation and (3) diathermy coagulation. The feasibility of each method is explored. Experiments were carried out using fresh …

Enzymatic Synthesis Of Structure-Free Dna With Pseudo-Complementary Properties., Georges Lahoud, Victor Timoshchuk, Alexandre Lebedev, Miguel De Vega, Margarita Salas, Khalil Arar, Ya-Ming Hou, Howard Gamper

Department of Biochemistry and Molecular Biology Faculty Papers

Long single-stranded DNAs and RNAs possess considerable secondary structure under conditions that support stable hybrid formation with oligonucleotides. Consequently, different oligomeric probes can hybridize to the same target with efficiencies that vary by several orders of magnitude. The ability to enzymatically generate structure-free single-stranded copies of any nucleic acid without impairing Watson-Crick base pairing to short probes would eliminate this problem and significantly improve the performance of many oligonucleotide-based applications. Synthetic nucleic acids that exhibit these properties are defined as pseudo-complementary. Previously, we described a pseudo-complementary A-T couple consisting of 2-aminoadenine (nA) and 2-thiothymine (sT) bases. The nA-sT couple is …

A New Model For Hemoglobin Ingestion And Transport By The Human Malaria Parasite Plasmodium Falciparum., Michelle D Lazarus, Timothy G Schneider, Theodore F Taraschi

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

The current model for hemoglobin ingestion and transport by intraerythrocytic Plasmodium falciparum malaria parasites shares similarities with endocytosis. However, the model is largely hypothetical, and the mechanisms responsible for the ingestion and transport of host cell hemoglobin to the lysosome-like food vacuole (FV) of the parasite are poorly understood. Because actin dynamics play key roles in vesicle formation and transport in endocytosis, we used the actin-perturbing agents jasplakinolide and cytochalasin D to investigate the role of parasite actin in hemoglobin ingestion and transport to the FV. In addition, we tested the current hemoglobin trafficking model through extensive analysis of serial …

Feedback From Horizontal Cells To Rod Photoreceptors In Vertebrate Retina., Wallace B. Thoreson, Norbert Babai, Theodore M M. Bartoletti

Journal Articles: Ophthalmology

Retinal horizontal cells (HCs) provide negative feedback to cones, but, largely because annular illumination fails to evoke a depolarizing response in rods, it is widely believed that there is no feedback from HCs to rods. However, feedback from HCs to cones involves small changes in the calcium current (I(Ca)) that do not always generate detectable depolarizing responses. We therefore recorded I(Ca) directly from rods to test whether they were modulated by feedback from HCs. To circumvent problems presented by overlapping receptive fields of HCs and rods, we manipulated the membrane potential of voltage-clamped HCs while simultaneously recording from rods in …

Connexin Expression And Gap Junctional Coupling In Human Cumulus Cells: Contribution To Embryo Quality, Hong-Xing Wang, Dan Tong, Faraj El-Gehani, Francis R. Tekpetey, Gerald M. Kidder

Physiology and Pharmacology Publications

Gap junctional coupling among cumulus cells is important for oogenesis since its deficiency in mice leads to impaired folliculogenesis. Multiple connexins (Cx), the subunits of gap junction channels, have been found within ovarian follicles in several species but little is known about the connexins in human follicles. The aim of this study was to determine which connexins contribute to gap junctions in human cumulus cells and to explore the possible relationship between connexin expression and pregnancy outcome from in vitro fertilization (IVF). Cumulus cells were obtained from IVF patients undergoing intracytoplasmic sperm injection (ICSI). Connexin expression was examined by RT-PCR …

Increasing Tumor Volume Is Predictive Of Poor Overall And Progression-Free Survival: Secondary Analysis Of The Radiation Therapy Oncology Group 93-11 Phase I-Ii Radiation Dose-Escalation Study In Patients With Inoperable Non-Small-Cell Lung Cancer, Maria Werner-Wasik, R. Suzanne Swann, Jeffrey Bradley, Mary Graham, Bahman Emami, James Purdy, William Sause

Department of Radiation Oncology Faculty Papers

PURPOSE: Patients with non-small-cell lung cancer (NSCLC) in the Radiation Therapy Oncology Group (RTOG) 93-11 trial received radiation doses of 70.9, 77.4, 83.8, or 90.3 Gy. The locoregional control and survival rates were similar among the various dose levels. We investigated the effect of the gross tumor volume (GTV) on the outcome.

METHODS AND MATERIALS: The GTV was defined as the sum of the volumes of the primary tumor and involved lymph nodes. The tumor response, median survival time (MST), and progression-free survival (PFS) were analyzed separately for smaller (< or =45 cm(3)) vs. larger (>45 cm(3)) tumors.

RESULTS: The distribution of …

388 A Structure Of Cytoplasmic Polyhedrosis Virus By Cryo-Electron Microscopy, Xuekui Yu, Lei Jin, Z Hong Zhou

Faculty, Staff and Student Publications

Cytoplasmic polyhedrosis virus (CPV) is unique within the Reoviridae family in having a turreted single-layer capsid contained within polyhedrin inclusion bodies, yet being fully capable of cell entry and endogenous RNA transcription. Biochemical data have shown that the amino-terminal 79 residues of the CPV turret protein (TP) is sufficient to bring CPV or engineered proteins into the polyhedrin matrix for micro-encapsulation. Here we report the three-dimensional structure of CPV at 3.88 A resolution using single-particle cryo-electron microscopy. Our map clearly shows the turns and deep grooves of alpha-helices, the strand separation in beta-sheets, and densities for loops and many bulky …