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Determination Of Thermal Dose Model Parameters Using Magnetic Resonance Imaging, Christopher James Maclellan

Dissertations and Theses (Open Access)

Magnetic Resonance Temperature Imaging (MRTI) is a powerful technique for noninvasively monitoring temperature during minimally invasive thermal therapy procedures. When coupled with thermal dose models, MRTI feedback provides the clinician with a real-time estimate of tissue damage by functioning as a surrogate for post-treatment verification imaging. This aids in maximizing the safety and efficacy of treatment by facilitating adaptive control of the damaged volume during therapy. The underlying thermal dose parameters are derived from laboratory experiments that do not necessarily reflect the surrogate imaging endpoints used for treatment verification. Thus, there is interest and opportunity in deriving model parameters from …

Targeting Pd-1/Pdl-1 Signaling In The Treatment Of Osteosarcoma Lung Metastasis, Pooja Dhupkar 3012359

Dissertations and Theses (Open Access)

Osteosarcoma (OS) manifests itself as pulmonary metastasis, which is a major cause of death in OS patients. Novel treatments like immunotherapy hold promise for the treatment of OS pulmonary metastasis. However, immunosuppressive mechanisms such as binding of immune inhibitory receptor, PD-1 with PDL-1, which is upregulated in cancer cells, may cause disease relapse.

The effect of PD-1 blockade on NK cells and macrophages has not been investigated till date. The aim of this study was to determine if PD-1 blockade leads to of OS lung metastasis regression and study the role of NK cells and/or macrophages in the anti-PD-1 responses. …

Organ Specific Vascular Response To Fibrosis Affects Breast Cancer Metastatic Organotropism, Eliot S. Fletcher, Eliot S. Fletcher

Dissertations and Theses (Open Access)

The solid tumor microenvironment, pre-metastatic niche, and fibrotic environment are known to have significant biochemical and biomechanical similarities to the fibrotic environment. All have significantly increased levels of factors such as TGFβ, HIF1α, TNFα, PDGF, VEGF, FGF, interleukins and other growth factors that are known to be pro-tumorigenic. Clinical and basic science research has shown that fibrosis presents an environment that favors tumor growth, such as hepatocellular carcinoma being commonly preceded by liver cirrhosis, or bleomycin induced lung fibrosis enhancing pulmonary metastasis in mouse models of breast cancer. In addition to the evidence indicating that fibrosis enhances primary tumor growth …

Long-Term Survival In Metastatic Melanoma Patients With Leptomeningeal Disease Treated With Intrathecal Interleukin-2, Isabella C. Glitza Oliva

Dissertations and Theses (Open Access)

BACKGROUND: Metastatic melanoma patients with leptomeningeal disease (LMD) have an extremely poor prognosis and a paucity of effective treatment options. We assessed the safety and efficacy of intrathecal interleukin-2 (IT IL-2) in metastatic melanoma patients with LMD.

METHODS: We reviewed the outcomes of 43 consecutive metastatic melanoma patients with LMD who were treated with IT IL-2 from 2006 to 2014 in a Compassionate Investigational New Drug Study. All patients had evidence of LMD based on cerebrospinal fluid (CSF) cytology, radiology, and/or surgical pathology. IL-2 at a dose of 1.2 mIU was administered intrathecally via Ommaya reservoir up to 5 times …

Nucleotide Excision Repair, Crosslink Repair And Transcriptional Function Of Xpa In Human Cells, Mandira Mananadhar

Dissertations and Theses (Open Access)

Nucleotide excision repair (NER) in mammalian cells includes xeroderma pigmentosum group A protein (XPA) as a core factor. XPA and other NER proteins have been detected previously at some active promoters, and NER deficiency is reported to decrease activated transcription of selected genes. To determine the global extent of XPA influence on transcription, we analyzed the human transcriptome by RNA sequencing. We first confirmed that XPA is confined to the cell nucleus even in the absence of external DNA damage, in contrast to previous reports that XPA is normally resident in the cytoplasm and is imported following DNA damage. We …

Microenvironment-Induced Pten Loss By Exosomal Microrna Primes Brain Metastasis Outgrowth, Lin Zhang

Dissertations and Theses (Open Access)

Development of life-threatening cancer metastases at distant organs requires disseminated tumor cells’ adaptation to and co-evolution with the drastically different microenvironments of metastatic sites. Cancer cells of common origin manifest distinct gene expression patterns after metastasizing to different organs. Clearly, the dynamic interplay between metastatic tumor cells and extrinsic signals at individual metastatic organ sites critically impacts the subsequent metastatic outgrowth. Yet, it is unclear when and how disseminated tumor cells acquire the essential traits from the microenvironment of metastatic organs that prime their subsequent outgrowth. Here we show that primary tumor cells with normal expression of PTEN, an important …

Investigation Of Radiation Injury In The Esophagus From Definitive Chemoradiation Therapy Using Novel Imaging Biomarkers, Joshua S. Niedzielski

Dissertations and Theses (Open Access)

Radiation injury in the esophagus occurs with high frequency from the treatment of non-small cell lung cancer (NSCLC). Radiation esophagitis is an acute normal tissue toxicity that negatively affects treatment efficacy by limiting dose and potentially interrupting radiation therapy. Clinical quantification of this toxicity is typically achieved by utilizing physician grading scales, assigning complication severity on an ordinal scale of symptom presentation and/or physician chosen interventions. These criteria are subjective in nature, both from the physician assigning the grade and the patient reporting the symptom. Furthermore, radiation therapy planning guidelines for the esophagus are derived from toxicity prediction models utilizing …

Cellular And Genetic Bases Of Cold Nociception And Nociceptive Sensitization In Drosophila Larvae, Heather N. Turner

Dissertations and Theses (Open Access)

Organisms from flies to mammals utilize thermoreceptors to detect and respond to noxious thermal stimuli. Although much is understood about noxious heat avoidance, our understanding of the basic biology of noxious cold perception is gravely minimal. Numerous clinical conditions disrupt the sensory machinery, such as in patients suffering from tissue damage (from wound or sunburn), or injury to the peripheral nerves, as in patients with diabetes or undergoing chemotherapy. Our goal is to determine the genetic basis for noxious cold perception and injury-induced nociceptive sensitization using the genetically tractable Drosophila model. Using a novel "cold probe" tool and assay we …

Novel Simulation To Avoid Bias In Measurement Of Hyperpolarized Pyruvate: Demonstrated In Phantom And In Vivo, Christopher M. Walker

Dissertations and Theses (Open Access)

Dynamic nuclear polarization creates a transient hyperpolarized nuclear state that can dramatically increase the signal detected by magnetic resonance imaging. This signal increase allows real-time spectroscopic imaging of specific metabolites in vivo by magnetic resonance. Real-time imaging of both the spatial and chemical fate of hyperpolarized metabolites is showing great promise to meaningfully benefit clinical care of cancer patients. Imaging of hyperpolarized agents will have a larger clinical impact if it can function as a quantitative modality upon which clinical decisions can be made. However, quantitative measurement of hyperpolarized agents is currently difficult due to the restrictions imposed by the …

Assessing The Potential Clinical Impact Of Variable Biological Effectiveness In Proton Radiotherapy, Christopher R. Peeler Ph.D.

Dissertations and Theses (Open Access)

It has long been known that proton radiotherapy has an increased biological effectiveness compared to traditional x-ray radiotherapy. This arises from the clustered nature of DNA damage produced by the energy deposition of protons along their tracks in medium. This effect is currently quantified in clinical settings by assigning protons a relative biological effectiveness (RBE) value of 1.1 corresponding to 10% increased effectiveness compared to photon radiation. Numerous studies have shown, however, that the RBE value of protons is variable and can deviate substantially from 1.1, but experimental data on RBE and clinical evidence of its variability remains limited.

The …

Neurogenic Megacolon In Spinal Cord Injury, Rukma R Govindu, Michelle Kelley

Faculty, Staff and Student Publications

No abstract provided.

Sickle Cell Disease With Cyanotic Congenital Heart Disease: Long-Term Outcomes In 5 Children, Glen J Iannucci, Olufolake A Adisa, Matthew E Oster, Michael Mcconnell, William T Mahle

The Texas Heart Institute Journal

Sickle cell disease is a risk factor for cerebrovascular accidents in the pediatric population. This risk is compounded by hypoxemia. Cyanotic congenital heart disease can expose patients to prolonged hypoxemia. To our knowledge, the long-term outcome of patients who have combined sickle cell and cyanotic congenital heart disease has not been reported. We retrospectively reviewed patient records at our institution and identified 5 patients (3 girls and 2 boys) who had both conditions. Their outcomes were uniformly poor: 4 died (age range, 12 mo-17 yr); 3 had documented cerebrovascular accidents; and 3 developed ventricular dysfunction. The surviving patient had developmental …

"Eyeing" The Cause Of Heart Failure: Visible Telltale Clues, Herbert L Fred, Manoj Thangam

The Texas Heart Institute Journal

No abstract provided.

Endovascular Treatment Of Superior Vena Cava Syndrome Via Balloon-In-Balloon Catheter Technique With A Palmaz Stent, Wassim Shatila, Abdelkader Almanfi, Mehran Massumi, Kathryn G Dougherty, Dhaval R Parekh, Neil E Strickman

The Texas Heart Institute Journal

Superior vena cava syndrome is a well-known disease entity that carries substantial rates of morbidity and mortality. Although most cases of superior vena cava syndrome are secondary to a malignant process, additional causes (such as mediastinal fibrosis, pacemaker lead implantation, or central venous catheter placement) have been reported. Multiple treatment options include percutaneous transluminal angioplasty, stent implantation, thrombolysis, mechanical thrombectomy, and venous grafting. We present a case of superior vena cava syndrome in a symptomatic 30-year-old woman who obtained complete relief of obstruction and marked symptomatic improvement through venoplasty and stenting, aided by our use of a balloon-in-balloon catheter system.

Comparative Efficacy Of Nebivolol And Metoprolol To Prevent Tachycardia-Induced Cardiomyopathy In A Porcine Model, Alireza Nazeri, Macarthur A Elayda, Ana Maria Segura, Raymond F Stainback, Joanna Nathan, Vei-Vei Lee, Christina Bove, Luiz Sampaio, Brian Grace, Ali Massumi, Mehdi Razavi

The Texas Heart Institute Journal

Chronic tachycardia is a well-known cause of nonischemic cardiomyopathy. We hypothesized that nebivolol, a β-blocker with nitric oxide activity, would be superior to a pure β-blocker in preventing tachycardia-induced cardiomyopathy in a porcine model.

Fifteen healthy Yucatan pigs were randomly assigned to receive nebivolol, metoprolol, or placebo once a day. All pigs underwent dual-chamber pacemaker implantation. The medication was started the day after the pacemaker implantation. On day 7 after implantation, each pacemaker was set at atrioventricular pace (rate, 170 beats/min), and the pigs were observed for another 7 weeks. Transthoracic echocardiograms, serum catecholamine levels, and blood chemistry data were …

Aspirin Resistance Predicts Adverse Cardiovascular Events In Patients With Symptomatic Peripheral Artery Disease, Tilak Pasala, Jennifer Soo Hoo, Mary Kate Lockhart, Rehan Waheed, Prasanna Sengodan, Jeffrey Alexander, Sanjay Gandhi

The Texas Heart Institute Journal

Antiplatelet therapy reduces the risk of myocardial infarction, stroke, and vascular death in patients who have symptomatic peripheral artery disease. However, a subset of patients who take aspirin continues to have recurrent cardiovascular events. There are few data on cardiovascular outcomes in patients with peripheral artery disease who manifest aspirin resistance.

Patients with peripheral artery disease on long-term aspirin therapy (≥4 wk) were tested for aspirin responsiveness by means of the VerifyNow Aspirin Assay. The mean follow-up duration was 22.6 ± 8.3 months. The primary endpoint was a composite of death, myocardial infarction, or ischemic stroke. Secondary endpoints were the …

Consensus Paper: Cerebellar Development, K Leto, M Arancillo, Ebe Becker, A Chiang, Et Al.

Faculty, Staff and Students Publications

The development of the mammalian cerebellum is orchestrated by both cell-autonomous programs and inductive environmental influences. Here, we describe the main processes of cerebellar ontogenesis, highlighting the neurogenic strategies used by developing progenitors, the genetic programs involved in cell fate specification, the progressive changes of structural organization, and some of the better-known abnormalities associated with developmental disorders of the cerebellum.

Ms 025 Guide To Samuel Bloom, Phd Papers (1935-2000), Samuel Bloom (1921-2006)

Manuscript Finding Aids

The Samuel Bloom, Ph.D., collection consists of materials related to his career as Assistant Professor of Sociology, Department of Psychiatry, Baylor College of Medicine. See more at MS 025.

Extended Hours For Herbert Fred Study Hall, Beatriz Varman

TMC Library Newsletter (2015-)

The Herbert L. Fred MD, MACP Student Study Hall in the TMC Library will have extended hours during final exams. If you haven't visited the library/study hall recently, please note that your institutional ID badge needs to be registered with Circulation so that you will be able to access the study hall while the library is closed.

Contribution Of Tactile Dysfunction To Manual Motor Dysfunction In Type Ii Diabetes, Nereyda Ochoa, Gloria R Gogola, Stacey L Gorniak

Faculty, Staff and Student Publications

Introduction:

Changes in sensory and motor functions of the hand in Type II Diabetes (T2D) patients have been reported; there is speculation that these changes are driven by tactile dysfunction. The purpose of this study was to evaluate the effects of tactile feedback on manual function in T2D patients.

Methods:

T2D patients and healthy controls underwent median nerve blocks at the wrist and elbow. All participants underwent traditional timed motor evaluations, force dynamometry, laboratory-based kinetic evaluations, and sensory evaluation.

Results:

Tactile sensation in the T2D group at baseline was found to be equivalent to tactile function of the control group …

Ms 013 Guide To Laura C. Bickel, Md Papers (1938-1967), Laura C. Bickel (1912-1977)

Manuscript Finding Aids

The Laura C. Bickel, MD papers contain article reprints, correspondance, case studies, photographs, and xrays related to her research into the Rubella virus and congenital defects and her career in pediatrics. See more at MS 013.

Ms 018 Guide To Saul Kit, Phd Papers (1958-1974), Saul Kit (1920-2008)

Manuscript Finding Aids

The Saul Kit, PhD papers contain research journals, reprints, copies, and an undated manuscript documenting his career in biochemistry. This collection focuses on his research published from 1958-1974. The collection consists of one box, equaling .25 cubic feet. The materials are in good condition. See more at MS 018.

Protocol To Increase Administration Of Herpes Zoster Vaccine In A Long-Term Care Facility, Stephen Mbola Dnp, Rn, Anp-Bc

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Although the herpes zoster (HZ) vaccine to decrease the incidence of Shingles was licensed for use in 2008, little coverage for HZ vaccination has occurred and stands nationally at 16%. At a targeted nursing home and assisted living facility, a protocol for including HZ along with state-mandated vaccinations was devised and used in screening incoming residents. Baseline data from chart reviews (n=122) showed that despite treatments given for the infection in the preceding 12 months, no vaccinations had occurred. During a 6-month implementation period, all new residents meeting eligibility criteria were offered the HZ vaccination. In this period, four residents …

Long-Term Follow-Up Study Of Temporary Tricuspid Valve Detachment As Approach To Vsd Repair Without Consequent Tricuspid Dysfunction, Gianluca Lucchese, Lucia Rossetti, Giuseppe Faggian, Giovanni B Luciani

The Texas Heart Institute Journal

Temporary tricuspid valve detachment improves the operative view of certain congenital ventricular septal defects (VSDs), but its long-term effects on tricuspid valve function are still debated.

From 2002 through 2012, we performed a prospective study of 68 children (mean age, 1.28 ± 1.01 yr) who underwent transatrial closure of VSDs following temporary tricuspid valve detachment. Sixty patients had conoventricular and 8 had mid-muscular VSDs. All were in sinus rhythm. Seventeen patients had systemic pulmonary artery pressures. Preoperative echocardiograms showed trivial-to-mild tricuspid regurgitation in 62 patients and tricuspid dysplasia with severe regurgitation in 6 patients. Patients were clinically and echocardiographically monitored …

Thirty-Three Years Of Dizzy Medical Writing And Editing: A Meta-Analysis And The Hall Of Shame, Herbert L Fred, Mark S Scheid

The Texas Heart Institute Journal

No abstract provided.

Pacemaker Troubleshooting: Common Clinical Scenarios, Payam Safavi-Naeini, Mohammad Saeed

The Texas Heart Institute Journal

No abstract provided.

Catheter Ablation Of Ventricular Tachycardia: Moving Beyond Palliation, Nilesh Mathuria

The Texas Heart Institute Journal

No abstract provided.

Venous Myocardial Infarction In An Infant With Obstructed Totally Anomalous Pulmonary Venous Drainage And Coronary Sinus Ostial Atresia, Deepa Prasad, James P Strainic, Khyati Pandya, Peter C Kouretas, Ravi C Ashwath

The Texas Heart Institute Journal

We report a rare causal association between obstructed supracardiac totally anomalous pulmonary venous drainage and coronary sinus ostial atresia. Our 12-week-old patient developed venous myocardial infarction secondary to coronary venous hypertension because her sole route of coronary venous drainage was obstructed. She recovered after the obstruction was relieved by balloon dilation. Surgical repair then included anastomosis of the pulmonary venous confluence to the left atrium, ligation of the vertical vein, and unroofing of the coronary sinus. Coronary sinus ostial atresia is rarely diagnosed before autopsy.

Latino Civic And Social Engagement, Bernardo E. Pohl Jr, Viola Garcia, Traqina Emeka

Journal of Family Strengths

Special issue editors Bernardo Pohl, Viola Garcia and Traqina Emeka introduce the special edition of the Journal of Family Strengths.

Brown Beauty: Body Image, Latinas, And The Media, D. Milton Stokes, Christopher F. Clemens, Diana I. Rios

Journal of Family Strengths

This paper examines the understudied Latina population and the effects of media on their body image. To date, research has ignored this population or aggregated all Latin-American sub-cultures into one general category, missing the nuances of each culture. A review of current literature utilizing cultivation theory and social comparison theory is offered. Important findings suggest that social support and ethnic identity may offer a buffering effect between media exposure and body dissatisfaction, but more research needs to clarify this process. The effects of media and the internalization of the ‘thin ideal’ become stronger the longer Latina women live in the …