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Management Of Morel-Lavallee Lesion Of The Knee: Twenty-Seven Cases In The National Football League, Samir G. Tejwani, Steven B. Cohen, James P. Bradley

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: The Morel-Lavallee lesion is a closed degloving injury most commonly described in the region of the hip joint after blunt trauma. It also occurs in the knee as a result of shearing trauma during football and is a distinct lesion from prepatellar bursitis and quadriceps contusion.

PURPOSE: To review the authors' experience with Morel-Lavallee lesion of the knee in the elite contact athlete to construct a diagnostic and treatment algorithm.

STUDY DESIGN: Case series; Level of evidence, 4.

METHODS: Twenty-seven knees in 24 players were identified from 1 National Football League team's annual injury database as having sustained a …

Fairfax County's Commitment: A Housing And Health Continuum For Seniors, Judith D. Moore, Lisa Sprague

National Health Policy Forum

This one-day site visit focused on the range of services made available to seniors by Fairfax County, Virginia, including senior centers, adult day health care, and assisted living and independent housing. Services to low-income residents were emphasized. Participants were introduced to the different agencies and funding streams involved and were able to observe how county officials have acted on a stated commitment to help seniors who wish to age in place, staying in the county and in their own homes rather than in a nursing home or other institution. The day included tours of two Fairfax County multiservice sites, in …

Medical Education Digest, Vol. 9 No. 2 (March/April 2007), Nova Southeastern University

Medical Education Digest

No abstract provided.

Oocyte Cytoplasmic Maturation: A Key Mediator Of Oocyte And Embryo Developmental Competence., A J Watson

Obstetrics & Gynaecology Publications

Efforts have intensified to successfully mature and inseminate oocytes in vitro and then culture ensuing embryos to transferable stages from a large number of mammalian species. Success varies, but generally even for the most successful species it is only possible to obtain a maximum of a 40 to 50% development of zygotes to the blastocyst stage. Reduced oocyte developmental competence is suggested as a primary reason for the reduced potential of in vitro-produced embryos. The vast majority of in vitro-matured oocytes are meiotically competent; however, many do not attain an optimal oocyte diameter before insemination. Variations in oocyte in vitro …

Predoctoral Directors: Who Are They And What Do They Do In These Trying Times?, John Gazewood, Katherine Margo, Christine Jerpbak, Sandra Burge, Thea Ballinger, Richard Usatine

Department of Family & Community Medicine Faculty Papers

BACKGROUND AND OBJECTIVES: Family medicine faces declining student interest and funding. Predoctoral directors will help lead efforts to overcome these challenges. Academic success will be important for predoctoral directors to be effective leaders in academic health centers. We therefore sought to describe predoctoral directors and factors associated with their academic success.

METHODS: We carried out a cross-sectional survey of all family medicine predoctoral directors at US allopathic medical schools using a Web-based questionnaire. The response rate was 82%. We measured academic success using a variable combining rank and tenure status. We used bivariate analysis and multiple linear regression …

Association Of The Tensin N-Terminal Protein-Tyrosine Phosphatase Domain With The Alpha Isoform Of Protein Phosphatase-1 In Focal Adhesions, Masumi Eto, Jason Kirkbride, Elizabeth Elliott, Su Hao Lo, David L. Brautigan

Department of Molecular Physiology and Biophysics Faculty Papers

Focal adhesions attach cultured cells to the extracellular matrix, and we found endogenous protein phosphatase-1alpha isoform (PP1alpha) localized in adhesions across the entire area of adherent fibroblasts. However, in fibroblasts migrating into a scrape wound or spreading after replating PP1alpha did not appear in adhesions near the leading edge but was recruited into other adhesions coincident in time and space with incorporation of tensin. Endogenous tensin and PP1alpha co-precipitated from cell lysates with isoform-specific PP1 antibodies. Chemical cross-linking of focal adhesion preparations with Lomant's reagent demonstrated molecular proximity of endogenous PP1alpha and tensin, whereas neither focal adhesion kinase nor vinculin …

Oncolog, Volume 52, Number 03, March 2007, Sunni Hosemann, Karen Stuyck, Elizabeth L. Travis Phd

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• New Approaches for Advanced Melanoma
• Helping Patients Stop Smoking
• House Call: Simple Skin Cancer Prevention
• DiaLog: Toward Gender Equity in Academic Medicine, by Elizabeth Travis, PhD, Associate Vice President, Women Faculty Programs

Collecting Duct Carcinoma: An Incidental Finding In A Non Functional Kidney Secondary To Nephrolithiasis, Asim Qureshi

Department of Pathology and Laboratory Medicine

A nephrectomy specimen was sent to the laboratory for end stage renal disease secondary to nephrolithiasis. Initial sections incidentally revealed a tumor infiltrating the normal renal tissue. Further workup including cytochemical and immuno-histochemical stains confirmed it to be collecting duct carcinoma.

Vital Signs, Spring 2007, Boonshoft School Of Medicine

Vital Signs

A twenty-seven 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, an alumni profile, class notes, and more.

Granular Cell Tumors Of The Urinary Bladder, Farhat Abbas, Amanullah Memon, Tanya Siddiqi, Naila Kayani Naila Kayani, Nazim Ali Ahmad

Department of Surgery Docs

Abstract

BACKGROUND:

Granular cell tumors (GCTs) are extremely rare lesions of the urinary bladder with only nine cases being reported in world literature of which one was malignant. Generally believed to be of neural origin based on histochemical, immunohistochemical, and ultrastructural studies; they mostly follow a clinically benign course but are commonly mistaken for malignant tumors since they are solid looking, ulcerated tumors with ill-defined margins.

MATERIALS AND METHODS:

We herein report two cases of GCTs, one benign and one malignant, presenting with gross hematuria in a 14- and a 47-year-old female, respectively.

RESULTS:

Histopathology revealed characteristic GCTs with positive …

The Association Between Lifestyle Factors And Inflammatory Markers, Kerry Ann Stonebrook

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Cardiovascular disease (CVD) is the leading cause of death for both men and women in the United States. While smoking, high blood pressure, and elevated cholesterol levels are established risk factors for CVD, inflammation is being evaluated as a potential independent risk factor. A key cytokine regulator of the inflammatory response, interleukin-1 (IL-1), has emerged as playing a particularly important role at the genetic level in determining the degree to which the inflammation pathway is turned on. How an individual’s genetic make-up affects inflammation, CVD risk, and response to lifestyle intervention is an area of research that is in …

Rotator Cuff Contusions Of The Shoulder In Professional Football Players: Epidemiology And Magnetic Resonance Imaging Findings, Steven B. Cohen, Jeffrey D. Towers, James P. Bradley

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: No published reports have studied the epidemiology and magnetic resonance imaging findings associated with rotator cuff contusions of the shoulder in professional football players.

PURPOSE: To determine a single professional football team's incidence, treatment, and magnetic resonance imaging appearance of players sustaining rotator cuff contusions of the shoulder.

STUDY DESIGN: Case series; Level of evidence, 4.

METHODS: From 1999 to 2005, a North American professional football team's injury records were retrospectively reviewed for athletes who had sustained a rotator cuff contusion of the shoulder during in-season participation. Those patients who had magnetic resonance imaging of the shoulder with a …

Three-Portal Technique For Anterior Cruciate Ligament Reconstruction: Use Of A Central Medial Portal, Steven B. Cohen, Freddie H. Fu

Department of Orthopaedic Surgery Faculty Papers

Standard endoscopic reconstruction of the anterior cruciate ligament (ACL) is performed with the use of 2 arthroscopic portals. The surgical error most commonly associated with ACL reconstruction is improper positioning of the tunnel. Errors in femoral tunnel position may be related to poor visualization of the lateral wall. When anatomic double-bundle ACL reconstruction is performed, proper visualization of the lateral wall is essential to ensure correct placement of both tunnels. We propose the use of a central portal, in addition to more standard anterolateral and anteromedial portals, to enhance visualization of the lateral wall. In addition, the arthroscope can be …

Postoperative Wound Leak And Anterior Chamber Reaction In Patients Undergoing Phacoemulsification Cataract Surgery With Sutured And Sutureless Corneal Incisions, Tanveer Anjum Chaudhry, Muhammad Shahzad Shamim, Sameer Khan, Khabir Ahmad

Department of Surgery Docs

Purpose: To compare the rates of significant post operative wound leak and anterior chamber (AC) reaction in patients undergoing phacoemulsification cataract surgery with sutured and sutureless corneal incisions. Material and Methods: All eyes scheduled to have phacoemulsification surgery by two surgeons at two centers were selected. The first group of eyes underwent phacoemulsification surgery with 3.25 mm superior and superior-temporal clear corneal incisions. The incision was sutured using a single 10/0 nylon suture. The second group of eyes underwent an identical surgery, but the incision was not sutured. Patients were followed up at 24 hours, and 1 week and evaluated …

Symptom Clusters In Acute Myocardial Infarction: A Secondary Data Analysis, Catherine J. Ryan, Holli A. Devon, Rob Horne, Kathleen B. King, Kerry A. Milner, Debra K. Moser, Jill R. Quinn, Anne Rosenfeld, Seon Young Hwang, Julie J. Zerwic

Nursing Faculty Publications

Background: Early recognition of acute myocardial infarction (AMI) symptoms and reduced time to treatment may reduce morbidity and mortality. People having AMI experience a constellation of symptoms, but the common constellations or clusters of symptoms have yet to be identified.
Objectives: To identify clusters of symptoms that represent AMI.
Methods: This was a secondary data analysis of nine descriptive, cross-sectional studies that included data from 1,073 people having AMI in the United States and England. Data were analyzed using latent class cluster analysis, an atheoretical method that uses only information contained in the data.
Results: Five distinct clusters of symptoms …

Impact Of Morbid Obesity On Outcome Of Laparoscopic Splenectomy., Edward P Dominguez, Yong U Choi, Bradford G Scott, Alan M. Yahanda Md, Facs, Edward A Graviss, John F Sweeney

PCI Publications and Projects

BACKGROUND: Because of the obesity epidemic, surgeons are operating on morbidly obese patients in increasing numbers. The aim of this study was to evaluate the impact of morbid obesity on the outcome of laparoscopic splenectomy.

METHODS: The study group consisted of 120 consecutive patients who underwent laparoscopic splenectomy for benign and malignant disease from March 1996 to May 2005. These patients were retrospectively divided into three groups. Group 1 had a body mass index (BMI) < 30. Group 2 patients had a BMI > or = 30 and < 40 and were considered obese. Group 3 had a BMI > or = 40 and were considered morbidly obese. Data including surgical approach (laparoscopic vs. hand-assisted), operative time, conversion rate, estimated blood …

Endoscopic Management Of Biliary Leaks After Open And Laparoscopic Cholecystectomy, Mohammad Salih, Saeed Hamid, Hasnain Ali Shah, Zaigham Abbas, Wasim Jafri

Section of Gastroenterology

Objective: To evaluate the diagnostic and therapeutic efficacy of ERCP in the management of biliary leaks.Methods: The study recruited 35 out of total 436 ERCP patients with post surgical biliary leaks, who presented to our department between January 1, 2001 and September 30, 2004. Unsuccessful ERCP and/or completely transected CBD injuries were handed over to surgery.Results: ERCP was successful in 33 (94%) patients. Of these 25 (75%) had cystic stump leaks, 3 (9%) had transected CBD, 2 (6%) had leakage from gall bladder (GB) bed, 2 (6%) had persistently draining T-tube with retained CBD stones and one (3%) patient had …

Expression Of The Neural Stem Cell Markers Ng2 And L1 In Human Angiomyolipoma: Are Angiomyolipomas Neoplasms Of Stem Cells?, So Dug Lim, William Stallcup, Benjamin Lefkove, Baskaran Govindarajan, Kit Sing Au, Hope Northrup, Deborah Lang, David E Fisher, Avani Patel, Mahul B Amin, Jack L Arbiser

Faculty, Staff and Student Publications

Angiomyolipomas are benign tumors of the kidney which express phenotypes of smooth muscle, fat, and melanocytes. These tumors appear with increased frequency in the autosomal dominant disorder tuberous sclerosis and are the leading cause of morbidity in adults with tuberous sclerosis. While benign, these tumors are capable of provoking life threatening hemorrhage and replacement of the kidney parenchyma, resulting in renal failure. The histogenesis of these tumors is currently unclear, although currently, we believe these tumors arise from "perivascular epithelioid cells" of which no normal counterpart has been convincingly demonstrated. Recently, stem cell precursors have been recognized that can give …

Aldosterone-Induced Sgk1 Relieves Dot1a-Af9-Mediated Transcriptional Repression Of Epithelial Na+ Channel Alpha, Wenzheng Zhang, Xuefeng Xia, Mary Rose Reisenauer, Timo Rieg, Florian Lang, Dietmar Kuhl, Volker Vallon, Bruce C Kone

Faculty, Staff and Student Publications

Aldosterone plays a major role in the regulation of salt balance and the pathophysiology of cardiovascular and renal diseases. Many aldosterone-regulated genes--including that encoding the epithelial Na+ channel (ENaC), a key arbiter of Na+ transport in the kidney and other epithelia--have been identified, but the mechanisms by which the hormone modifies chromatin structure and thus transcription remain unknown. We previously described the basal repression of ENaCalpha by a complex containing the histone H3 Lys79 methyltransferase disruptor of telomeric silencing alternative splice variant a (Dot1a) and the putative transcription factor ALL1-fused gene from chromosome 9 (Af9) as well as the release …

Severe Aortic And Arterial Aneurysms Associated With A Tgfbr2 Mutation, Scott A Lemaire, Hariyadarshi Pannu, Van Tran-Fadulu, Stacey A Carter, Joseph S Coselli, Dianna M Milewicz

Faculty, Staff and Student Publications

BACKGROUND: A 24-year-old man presented with previously diagnosed Marfan's syndrome. Since the age of 9 years, he had undergone eight cardiovascular procedures to treat rapidly progressive aneurysms, dissection and tortuous vascular disease involving the aortic root and arch, the thoracoabdominal aorta, and brachiocephalic, vertebral, internal thoracic and superior mesenteric arteries. Throughout this extensive series of cardiovascular surgical repairs, he recovered without stroke, paraplegia or renal impairment.

INVESTIGATIONS: CT scans, arteriogram, genetic mutation screening of transforming growth factor beta receptors 1 and 2.

DIAGNOSIS: Diffuse and rapidly progressing vascular disease in a patient who met the diagnostic criteria for Marfan's syndrome, …

Functional Taxonomy Of Bacterial Hyperstructures, Vic Norris, Tanneke Den Blaauwen, Armelle Cabin-Flaman, Roy H Doi, Rasika Harshey, Laurent Janniere, Alfonso Jimenez-Sanchez, Ding Jun Jin, Petra Anne Levin, Eugenia Mileykovskaya, Abraham Minsky, Milton Saier, Kirsten Skarstad

Faculty, Staff and Student Publications

The levels of organization that exist in bacteria extend from macromolecules to populations. Evidence that there is also a level of organization intermediate between the macromolecule and the bacterial cell is accumulating. This is the level of hyperstructures. Here, we review a variety of spatially extended structures, complexes, and assemblies that might be termed hyperstructures. These include ribosomal or "nucleolar" hyperstructures; transertion hyperstructures; putative phosphotransferase system and glycolytic hyperstructures; chemosignaling and flagellar hyperstructures; DNA repair hyperstructures; cytoskeletal hyperstructures based on EF-Tu, FtsZ, and MreB; and cell cycle hyperstructures responsible for DNA replication, sequestration of newly replicated origins, segregation, compaction, and …

Perioperative Management Of Pheochromocytoma: Anaesthetic Implications, Aliya Ahmed

Department of Anaesthesia

Pheochromocytoma is a catecholamine producing tumour that can cause severe hypertension and other systemic disturbances. The perioperative management of pheochromocytoma remains a complicated anaesthesia challenge requiring intensive preoperative preparation and vigilant intraoperative and postoperative care. In this article the perioperative management of pheochromocytoma is reviewed by first summarizing its pathophysiology, clinical aspects and diagnosis, then highlighting the preoperative optimization of the patient and finally describing the intraoperative and postoperative anaesthetic management in the light of the current information.

Colon Carcinoma Cells Harboring Pik3ca Mutations Display Resistance To Growth Factor Deprivation Induced Apoptosis., J. Wang, Karen Kuropatwinski, Jennie Hauser, Michael R. Rossi, Yunfei Zhou, Alexis Conway, Julie L.C. Kan, Neil W. Gibson, James K.V. Willson, John K. Cowell, Michael G. Brattain

Journal Articles: Eppley Institute

PIK3CA, encoding the p110alpha catalytic subunit of phosphatidylinositol 3-kinase (PI3K), is mutated in a variety of human cancers. We screened the colon cancer cell lines previously established in our laboratory for PIK3CA mutations and found that four of them harbored gain of function mutations. We have now compared a panel of mutant and wild-type cell lines for cell proliferation and survival in response to stress. There was little difference in PI3K activity between mutant PIK3CA-bearing cells (mutant cells) and wild-type PIK3CA-bearing cells (wild-type cells) under optimal growth conditions. However, the mutant cells showed constitutive PI3K activity during growth factor deprivation …

Hepatitis C Risk Assessment, Testing And Referral For Treatment In Urban Primary Care: Role Of Race And Ethnicity., Stacey B. Trooskin, Victor J. Navarro, Robert J. Winn, David J. Axelrod, A. Scott Mcneal, Maricruz Velez, Steven K. Herrine, Simona Rossi

Division of Gastroenterology and Hepatology Faculty Papers

AIM: To determine rates of hepatitis C (HCV) risk factor ascertainment, testing, and referral in urban primary care practices, with particular attention to the effect of race and ethnicity.

METHODS: Retrospective chart review from four primary care sites in Philadelphia; two academic primary care practices and two community clinics was performed. Demographics, HCV risk factors, and other risk exposure information were collected.

RESULTS: Four thousand four hundred and seven charts were reviewed. Providers documented histories of injection drug use (IDU) and transfusion for less than 20% and 5% of patients, respectively. Only 55% of patients who admitted IDU were tested …

Development Of A Reliable And Construct Valid Measure Of Nutritional Literacy In Adults, James J. Diamond

Department of Family & Community Medicine Faculty Papers

NOTE: The Nutritional Literacy Scale can be found here: http://jdc.jefferson.edu/nls/1/

Background: Research into the relation of literacy to health status has not included measures of nutritional literacy. This may be a critical area in the study of chronic conditions such as hypertension and diabetes, which can both relate to obesity and nutrition. This paper details the development and psychometric characteristics of the Nutritional Literacy Scale (NLS), offered as a measure of adults' ability to comprehend nutritional information.

Methods: In order to assess the internal consistency and construct validity of the NLS, demographic data, readability statistics, NLS scores and …

Genome-Wide Analysis Of Neuroblastomas Using High-Density Single Nucleotide Polymorphism Arrays., Rani E George, Edward F Attiyeh, Shuli Li, Lisa A Moreau, Donna Neuberg, Cheng Li, Edward A Fox, Matthew Meyerson, Lisa Diller, Paolo Fortina, A Thomas Look, John M Maris

Cardeza Foundation for Hematologic Research

BACKGROUND: Neuroblastomas are characterized by chromosomal alterations with biological and clinical significance. We analyzed paired blood and primary tumor samples from 22 children with high-risk neuroblastoma for loss of heterozygosity (LOH) and DNA copy number change using the Affymetrix 10K single nucleotide polymorphism (SNP) array.

FINDINGS: Multiple areas of LOH and copy number gain were seen. The most commonly observed area of LOH was on chromosome arm 11q (15/22 samples; 68%). Chromosome 11q LOH was highly associated with occurrence of chromosome 3p LOH: 9 of the 15 samples with 11q LOH had concomitant 3p LOH (P = 0.016). Chromosome 1p …

Teenage Pregnancy: Impact Of The Integral Attention Given To The Pregnant Teenager And Adolescent Mother As A Protective Factor For Repeat Pregnancy, Maria José Carvalho Sant'anna, Kepler Alencar Mendes Carvalho, Amanda Melhado, Verônica Coates, Hatim A. Omar

Pediatrics Faculty Publications

The purpose of this study was to evaluate the impact of the integral attention to the health of pregnant adolescents and adolescent mothers, having follow-up from the Integral Support Program for the Pregnant Teen (ISPPT), with the intention to determine quality of life and prevent repeat pregnancy. A prospective study comprised 85 adolescents attended by the ISPPT between January 2002 and June 2006 who participated in meetings during pregnancy with a multidisciplinary team that provided orientation concerning family planning, self-esteem, pregnancy prevention, motivation to continue education and/or work, and evaluate the postpartum mother-child relationship. The following were analyzed: education level, …

Traumatic Brain Injury Stimulates Hippocampal Catechol-O-Methyl Transferase Expression In Microglia, John B Redell, Pramod K Dash

Faculty, Staff and Student Publications

Outcome following traumatic brain injury (TBI) is in large part determined by the combined action of multiple processes. In order to better understand the response of the central nervous system to injury, we utilized an antibody array to simultaneously screen 507 proteins for altered expression in the injured hippocampus, a structure critical for memory formation. Array analysis indicated 41 candidate proteins have altered expression levels 24h after TBI. Of particular interest was catechol-O-methyl transferase (COMT), an enzyme involved in metabolizing catecholamines released following neuronal activity. Altered catecholamine signaling has been observed after brain injury, and may contribute to the cognitive …

Emotional Expression During Attention-Deficit/Hyperactivity Disorders Treatment: Initial Assessment Of Treatment Effects., Christopher J. Kratochvil, D. Faries, Brigette S. Vaughan, A. Perwien, J. Busner, K. Saylor, S. Kaplan, C. Buermeyer, R. Swindle

Journal Articles: Psychiatry

OBJECTIVE: The purpose of this research was to provide an initial examination of the effects of atomoxetine and stimulants on emotional expression using a newly developed scale for assessing emotional expression in children with attention-deficit/hyperactivity disorder (ADHD).

METHOD: The parent-rated Expression and Emotion Scale for Children (EESC) was collected during two studies. During a cross-sectional validation study, the EESC was completed to assess the child's current treatment and retrospectively for previous medication. In a randomized, placebo-controlled trial of atomoxetine, the EESC was collected at baseline and endpoint.

RESULTS: In the validation study, no statistically significant differences in EESC scores were …

High Dietary Fat Intake Is Not Associated With High Levels Of Circulating Lipoproteins Or Total Cholesterol, C. Jayne Brahler, C. Wilson, Janine Baer

Physical Therapy Faculty Publications

The objective of this study was to determine the association between dietary intake of fats, waist to hip ratio (WHR), body mass index (BMI), and blood lipoproteins and total cholesterol (TC) using food frequency data in one group of apparently healthy, urban African American women and their daughters (n = 110). Subjects were fasted when blood was drawn, waist and hip circumferences and body weight and height were measured, and WHR and BMI were calculated.

Average daily total fat intakes were 91.46 g and 77.83 g for mothers and daughters, respectively, but average LDL levels of 104.4 g/L and 103.1 …