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Searching For Genes That Matter In Acute Kidney Injury: A Systematic Review, Jonathan Lu Oct 2009

Searching For Genes That Matter In Acute Kidney Injury: A Systematic Review, Jonathan Lu

Yale Medicine Thesis Digital Library

Identifying patients who may develop acute kidney injury (AKI) remains challenging as clinical determinants explain only a portion of individual risk. Another factor that likely affects risk is intrinsic genetic variability. Therefore, we performed a systematic review of studies that related the development or prognosis of AKI to genetic variation. We searched MEDLINE, EMBASE, HuGEnet, SCOPUS and Web of Science for articles from 1950 to Dec 2007. Two independent researchers screened articles using predetermined criteria. Studies were assessed for methodological quality via an aggregate scoring system. The 16 included studies were of cohort or case-cohort design, and investigated 35 polymorphisms …

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Tryptophan Depletion By Indoleamine 2,3-Dioxygenase (Ido) Contributes To Medial Immunoprivilege In Graft Arteriosclerosis, Amanda Silverio Oct 2009

Tryptophan Depletion By Indoleamine 2,3-Dioxygenase (Ido) Contributes To Medial Immunoprivilege In Graft Arteriosclerosis, Amanda Silverio

Yale Medicine Thesis Digital Library

TRYPTOPHAN DEPLETION BY INDOLAMINE 2,3-DIOXYGENASE (IDO) CONTRIBUTES TO MEDIAL IMMUNOPRIVILEGE IN GRAFT ARTERIOSCLEROSIS. Amanda M. Silverio, Madison C. Cuffy, and George Tellides. Interdepartmental Program in Vascular Biology and Transplantation and the Departments of Surgery and Immunobiology, Yale University, School of Medicine, New Haven, CT. Introduction: Since blood vessels and their endothelial lining are major stimulators and targets of the graft rejection response, the study of the differential immune properties of vascular cells is needed for the proper application of human vessels in the transplant setting. Experimental models of atherosclerosis and graft arteriosclerosis show leukocytes selectively infiltrating the intima and adventitia …

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Capillary Blood Gas Measurement As A Novel Means Of Assessing Flap Perfusion In Free Tissue Transfer, Aaron Remenschneider Oct 2009

Capillary Blood Gas Measurement As A Novel Means Of Assessing Flap Perfusion In Free Tissue Transfer, Aaron Remenschneider

Yale Medicine Thesis Digital Library

CAPILLARY BLOOD GAS MEASUREMENT AS A NOVEL MEANS OF ASSESSING FLAP PERFUSION IN FREE TISSUE TRANSFER. Aaron K. Remenschneider and Douglas A. Ross (Sponsored by Dr. Clarence Sasaki). Section of Otolaryngology, Department of Surgery, Yale University, School of Medicine, New Haven, CT. To demonstrate that in comparison to implantable O2 microelectrodes, Capillary Blood Gas measurements represent a reliable, accessible and easy method of identifying failing free flaps, and furthermore, to assess post-operative free-flap monitoring techniques nation-wide, determining the openness of surgeons to new surveillance modalities. Groin fasciocutaneous flaps were elevated in 10 rats and following arterial or venous occlusion, oxygen …

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Tubular Carcinoma Of The Breast Versus Invasive Ductal Carcinoma Treated With Breast Conservation Therapy, Gene-Fu Liu Oct 2009

Tubular Carcinoma Of The Breast Versus Invasive Ductal Carcinoma Treated With Breast Conservation Therapy, Gene-Fu Liu

Yale Medicine Thesis Digital Library

Purpose: The purpose of our study is to evaluate our institutional experience of treating Tubular Carcinoma of the Breast (TC) and Invasive Ductal Carcinoma (IDC) with Breast Conservation Therapy (BCT), consisting of conservative surgery (CS) and radiation therapy (RT), and to compare clinical-pathologic features and long-term outcomes. Materials and Methods: A review of our institutions tumor registry from 1975-2007 was performed, followed by a central pathology review of available slides, yielding 71 cases of Stage I/II TC and 2238 cases of Stage I/II IDC treated with BCT. Results: Clinical-pathologic features and outcomes were then analyzed by subtype to detect significant …

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Utility Of Repeat Screening For Asymptomatic Bacteriuria In Pregnancy, Sara Whetstone Oct 2009

Utility Of Repeat Screening For Asymptomatic Bacteriuria In Pregnancy, Sara Whetstone

Yale Medicine Thesis Digital Library

UTILITY OF REPEAT SCREENING FOR ASYMPTOMATIC BACTERIURIA IN PREGNANCY Sara Whetstone, Stephen Thung, and Jessica Illuzzi. Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University, School of Medicine, New Haven, CT. Asymptomatic bacteriuria (ASB) during pregnancy is associated with an increased risk of developing pyelonephritis. The objectives of our study were to determine the incidence of ASB throughout the first two trimesters of pregnancy and to compare the cost effectiveness of performing repeat screening with a single screening strategy for ASB to prevent pyelonephritis. In this prospective cohort study, 206 pregnant women at an urban academic obstetric clinic provided urine …

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The Gender And Generational Consequences Of The Demographic Transition And Population Policy: As Assessment Of The Micro And Macro Linkages, T. Paul Schultz Oct 2009

The Gender And Generational Consequences Of The Demographic Transition And Population Policy: As Assessment Of The Micro And Macro Linkages, T. Paul Schultz

Discussion Papers

No abstract provided.

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Yale Medicine : Alumni Bulletin Of The School Of Medicine, Autumn 2009, Yale University. School Of Medicine Oct 2009

Yale Medicine : Alumni Bulletin Of The School Of Medicine, Autumn 2009, Yale University. School Of Medicine

Yale Medicine Magazine - alumni bulletin and magazine

This is the Autumn 2009 issue of Yale Medicine: alumni bulletin of the School of Medicine, v. 44, no. 1. Prepared in cooperation with the alumni and development offices at the School of Medicine. Earlier volumes are called Yale School of Medicine alumni bulletins, dating from v.1 (1953) through v.13 (1965).

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El Farol Revisited: A Note On Emergence, Game Theory And Society, Martin Shubik Oct 2009

El Farol Revisited: A Note On Emergence, Game Theory And Society, Martin Shubik

Cowles Foundation Discussion Papers

The El Farol Bar problem with coordination is reconsidered in terms and extended with consideration of further context.

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Linking Waste And Material Flows On The Island Of Oahu, Hawai’I: The Search For Sustainable Solutions, Matthew Eckelman, Marian Chertow Oct 2009

Linking Waste And Material Flows On The Island Of Oahu, Hawai’I: The Search For Sustainable Solutions, Matthew Eckelman, Marian Chertow

Yale School of the Environment Publications Series

No abstract provided.

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A Role For Rage System Activation In Preterm Birth, Margaret Ann Baumbusch Sep 2009

A Role For Rage System Activation In Preterm Birth, Margaret Ann Baumbusch

Yale Medicine Thesis Digital Library

The receptor for advanced glycation end products (RAGE) is a multiligand pattern recognition receptor involved in transducing endogenous damage associated stimuli into inflammatory responses. Advanced glycation end products (AGEs), HMGB1 (amphoterin) and S100 proteins, such as S100B, are prototype RAGE ligands, while soluble RAGE (sRAGE), a product of RAGE activation, acts as a ligand scavenger and RAGE inhibitor. We propose that RAGE may play important yet distinct pathogenic roles in both inflammation-induced preterm birth and preeclampsia and that, while inflammation-induced preterm birth associates with fetal RAGE activation, preeclampsia induces a maternal state of RAGE activation. We sought to identify the …

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Predictors Of Early Adult Outcome In Pediatric-Onset Obsessive-Compulsive Disorder, Brittany G. Craiglow Sep 2009

Predictors Of Early Adult Outcome In Pediatric-Onset Obsessive-Compulsive Disorder, Brittany G. Craiglow

Yale Medicine Thesis Digital Library

This study was conducted in order to determine childhood clinical predictors of early adult outcome in pediatric-onset obsessive-compulsive disorder (OCD). We specifically hypothesized that OCD symptom dimensions and comorbid tic disorders would be associated with persistence of obsessive-compulsive (OC) symptoms into early adulthood. The study followed a longitudinal cohort design in which 45 of 61 eligible children with OCD were reassessed in early adulthood an average of 9 years following a baseline childhood assessment. Main outcome measures included expert-rated OC symptom severity and time to remission of OC symptoms. Baseline clinical characteristics were evaluated in terms of their impact on …

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The Impact Of A School Garden On Nutrition Knowledge, Attitudes And Behaviors Of Urban Youth, Erica Rose Mintzer Sep 2009

The Impact Of A School Garden On Nutrition Knowledge, Attitudes And Behaviors Of Urban Youth, Erica Rose Mintzer

Yale Medicine Thesis Digital Library

Hypothesis: A garden-based high school curriculum and school lunch program positively impact the nutrition knowledge, attitudes, behaviors and health outcomes of participating urban youth. Specific aims: 1. To characterize the objectives and implementation of the Common Ground High Schools garden-based curriculum and school lunch program 2. To evaluate the effectiveness of the program in promoting healthy nutrition knowledge, attitudes, behaviors and health outcomes among Common Ground students Methods: Mixed quantitative and qualitative methods were used to conduct the program evaluation. The Common Ground curriculum was characterized through in-depth staff interviews and review of relevant policies and procedures. Surveys on nutrition …

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The Regulation Of Dcdc2, A Candidate Gene For Dyslexia, Christopher J. Gibson Sep 2009

The Regulation Of Dcdc2, A Candidate Gene For Dyslexia, Christopher J. Gibson

Yale Medicine Thesis Digital Library

Within the human genome, genetic mapping studies have identified ten regions of different chromosomes, known as DYX loci, in genetic linkage with dyslexia. The gene DCDC2, located within the DYX2 region on chromosome 6p22, has been shown to have genetic association with dyslexia in several independent studies. Functional assays of DCDC2 indicate that it may help guide the migration of neurons during early brain development. DCDC2 polymorphisms that display the strongest association with dyslexia are located in a highly GC-rich region in intron 2 known as BV677278. These polymorphisms contain several transcription factor binding sites, including the canonical 8-base recognition …

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Blue Cohosh: History, Science, Safety, And Midwife Prescribing Of A Potentially Fetotoxic Herb, Aviva Romm Sep 2009

Blue Cohosh: History, Science, Safety, And Midwife Prescribing Of A Potentially Fetotoxic Herb, Aviva Romm

Yale Medicine Thesis Digital Library

Abstract: Blue Cohosh: Science, Safety, And Patterns of Midwife Prescribing Of A Potentially Fetotoxic Herb Aviva Jill Romm (Sponsored by Errol Norwitz) Department of Obstetrics and Gynecology, Yale University School of Medicine Background: Blue cohosh (Caulopyhyllum thalictroides) has been used traditionally and historically as an obstetric aid for labor induction, to assure a prompt delivery, to relieve childbirth pain, and to induce abortion. Officially listed in the United States Pharmacopoeia from 1882-1905 and in the National Formulary from 1916-1950 for labor induction, its use remains popular. Maternal ingestion has been implicated in acute nicotinic toxicity, neonatal heart failure, perinatal stroke, …

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Inventing New Cars: Analysis Of Chimeric Antigen Receptor Gene-Targeted T Cells Modified To Overcome Regulatory T Cell Suppression In The Tumor Microenvironment, James Lee Aug 2009

Inventing New Cars: Analysis Of Chimeric Antigen Receptor Gene-Targeted T Cells Modified To Overcome Regulatory T Cell Suppression In The Tumor Microenvironment, James Lee

Yale Medicine Thesis Digital Library

Human T cells may be genetically modified to express targeted chimeric antigen receptors (CARs). We have previously demonstrated that T cells modified to express a CAR specific to the B cell tumor antigen CD19, termed 19-28z, successfully eradicate systemic human CD19+ tumors in SCID-Beige mice. While these results are encouraging, this xenogeneic tumor model fails to address potential limitations of this therapeutic approach in the clinical setting wherein these modified T cells encounter a hostile tumor microenvironment. Specifically, these models fail to address potential effector T cell inhibition mediated by endogenous regulatory T cells (Tregs). To investigate the role of …

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The Relationship Between Economic Deprivation And Emerging Inhibitory Control In Young Children, Rachel Weston Aug 2009

The Relationship Between Economic Deprivation And Emerging Inhibitory Control In Young Children, Rachel Weston

Yale Medicine Thesis Digital Library

THE RELATIONSHIP BETWEEN ECONOMIC DEPRIVATION AND EMERGING INHIBITORY CONTROL IN YOUNG CHILDREN. Rachel S. Weston, David J. Bridgett, Linda C. Mayes. Yale Child Study Center, Yale University School of Medicine, New Haven, CT. An extensive body of research has documented detrimental effects of growing up in poverty on children's global cognitive development, particularly when economic deprivation occurs in early childhood. However, little is known about the impact of poverty on children's component neurocognitive capacities. The prefrontal cortex is one brain region, responsible for the executive control functions, that has a prolonged period of postnatal development and therefore may be especially …

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Prevalence Of Overweight Resident Physicians And Year Of Training, Maya Roberts Aug 2009

Prevalence Of Overweight Resident Physicians And Year Of Training, Maya Roberts

Yale Medicine Thesis Digital Library

PREVALENCE OF OVERWEIGHT RESIDENT PHYSICIANS AND YEAR OF TRAINING Maya Roberts, Mark R. Zonfrillo, Division of Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, James Dziura and Sunkyung Yu, Yale Center for Clinical Investigation, New Haven, CT, and David Spiro, Department of Emergency Medicine and Pediatrics, Oregon Health & Sciences University, Portland, OR. (Sponsored by Howard Pearson, Department of Pediatrics, Yale University School of Medicine). Post-graduate clinical training has numerous implications for the health of resident physicians. The primary goal of this study is to monitor the health of resident physicians by year of training through measurement of body mass …

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Social Determinants Of Mixed Feeding Behavior Among Hiv-Infected Mothers In Jos, Nigeria, Sheela Maru Aug 2009

Social Determinants Of Mixed Feeding Behavior Among Hiv-Infected Mothers In Jos, Nigeria, Sheela Maru

Yale Medicine Thesis Digital Library

Mixed feeding confers excess risk of mother-to-child transmission (MTCT) of Human Immunodeficiency Virus (HIV) compared with exclusive breastfeeding (EBF) and exclusive formula feeding (EFF). We undertook a quantitative and qualitative cross-sectional survey to identify the social determinants of mixed feeding among a subset of HIV-infected women enrolled in a MTCT prevention program in Jos, Nigeria. Of the 91 participants, 68(75%) exclusively formula fed, 7(8%) exclusively breastfed, and 16(18%) practiced mixed feeding. Of the mixed feeding women, 7 primarily formula fed and 9 primarily breastfed. Women who primarily formula fed described family pressure as the reason for mixed feeding, whereas women …

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Temporal Evolution In The Histopathologic Diagnosis Of Borderline Melanocytic Lesions, Jason Elihu Frangos Aug 2009

Temporal Evolution In The Histopathologic Diagnosis Of Borderline Melanocytic Lesions, Jason Elihu Frangos

Yale Medicine Thesis Digital Library

TEMPORAL EVOLUTION IN THE HISTOPATHOLOGIC DIAGNOSIS OF BORDERLINE MELANOCYTIC LESIONS. Jason E. Frangos, Lyn Duncan and Alexa B. Kimball. Departments of Dermatology and Dermatopathology, Massachusetts General Hospital, Harvard Medical School, Boston MA. (Sponsored by Dr. Robert Tigelaar, Department of Dermatology, Yale University School of Medicine). While the incidence of cutaneous malignant melanoma has risen steeply over the past half century, increases in the mortality rate have been relatively modest. In an effort to understand this discrepancy, we sought to determine whether a shift toward more malignant diagnoses may have been made by dermatopathologists (DPs) diagnosing severely dysplastic nevi over a …

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Evaluation Of A Social Support Measure That May Indicate Risk Of Depression During Pregnancy, Lori Spoozak Jul 2009

Evaluation Of A Social Support Measure That May Indicate Risk Of Depression During Pregnancy, Lori Spoozak

Yale Medicine Thesis Digital Library

The objective of this study was to evaluate the psychometric properties of the Kendler Social Support Interview modified for administration to pregnant women and to assess the relationship between social support and depression in the first trimester of pregnancy. Subjects were administered the Modified Kendler Social Support Interview (MKSSI) and the Composite International Diagnostic Index to diagnose depression. Principal components analysis was employed to construct the MKSSI score. Cronbachs coefficient alpha and principal factor analysis were run for items included in the MKSSI score. The relationship between a depressive diagnosis and the MKSSI score and subscales was assessed by logistic …

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Monitoring, Identification, And Intervention For Metabolic Disorders In Veterans With Psychotic Disorders, Michael Swtye Jul 2009

Monitoring, Identification, And Intervention For Metabolic Disorders In Veterans With Psychotic Disorders, Michael Swtye

Yale Medicine Thesis Digital Library

In light of growing evidence that certain antipsychotics may cause potentially life-threatening metabolic side-effects, the purpose of this study was to determine how regularly mental health clinicians (MHCs) currently monitor and manage metabolic abnormalities in overweight and obese patients with psychotic disorders. We hypothesized that MHCs monitor, identify and intervene for metabolic abnormalities in their patients at significantly lower rates than primary care physicians (PCCs), and that such rates may jeopardize patient health. We performed a one-year cross-sectional medical record review of primary care and mental health routine outpatient visit notes from the West Haven Campus of the Veteran Affairs …

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Role Of Biomarkers In Monitoring Gaucher Disease And Potential Of Biomarkers To Illuminate Pathophysiologic Pathways, Hanna Yu Jul 2009

Role Of Biomarkers In Monitoring Gaucher Disease And Potential Of Biomarkers To Illuminate Pathophysiologic Pathways, Hanna Yu

Yale Medicine Thesis Digital Library

Objectives: 1.) Assess utility of biomarkers as a surrogate endpoint and a reflection of total body burden of Gaucher cells by examining correlations between biomarkers and liver volume and characterizing biomarker response to enzyme replacement therapy (ERT), and 2.) to gain insight into pathophysiologic pathways of GD. Study Design: This is an observational study Subjects and Methods: 114 patients with both pretreatment and post-treatment data were identified. These patients were further subdivided into intact spleen and asplenic patients. Differences in means among the subgroups of patients were determined, then regression analyses were run to investigate correlations between biomarkers and liver …

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Ccm2 Molecular Signaling Pathway, Arianne J. Boylan Jul 2009

Ccm2 Molecular Signaling Pathway, Arianne J. Boylan

Yale Medicine Thesis Digital Library

Cerebral cavernous malformations (CCM) are a central nervous system vascular malformation often responsible for hemorrhagic strokes. Molecular genetic studies have identified three genes (CCMl KRITI, CCM2 Malcavernin, and CCM3 PDCDIO) and four possible loci responsible for the pathogenesis of these lesions. CCMl functions through integrin signaling and regulation of RACl activity and may be involved in the MAPK and JNK signaling cascades. We hypothesized that CCM2 likely functioned through the same pathways and that CCM3 expression is regulated by these stress-induced signaling cascades. We showed that CCM2 likely functions through the MAPK pathway as the mouse homolog, osmosensing scaffold protein …

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Intussusception Of The Appendix: New Trends And Comprehensive Analysis Of 140 Case Reports, Barbara Wexelman Jul 2009

Intussusception Of The Appendix: New Trends And Comprehensive Analysis Of 140 Case Reports, Barbara Wexelman

Yale Medicine Thesis Digital Library

INTUSSUSCEPTION OF THE APPENDIX: NEW TRENDS AND COMPREHENSIVE ANALYSIS OF 140 PUBLISHED CASE REPORTS. Barbara A. Wexelman, Cassius Ochoa Chaar, and Walter Longo. Section of Colorectal Surgery, Department of Surgery, Yale University, School of Medicine, New Haven, CT. Statement of Purpose: This paper uses 139 published case reports to understand the demographic, diagnostic, and treatment trends of intussusception of the appendix. Methods: Using the PubMed literature search engine to find all English references of intussusception and appendix, and reviewing those that contained actual case reports of intussusception of the appendix, we analyzed the demographics, presentation, diagnostic methods, surgical treatment, and …

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Palmitic Acid Increases Enac Expression And Contributes To Insulin Resistance In Renal Distal Tubule, Timmy Sullivan Jul 2009

Palmitic Acid Increases Enac Expression And Contributes To Insulin Resistance In Renal Distal Tubule, Timmy Sullivan

Yale Medicine Thesis Digital Library

Insulin resistance and obesity are two conditions associated with hypertension. Although the causes of hypertension are likely to be multifactorial, dysregulation of renal distal tubule sodium reabsorption may play a role. It has been shown that insulin increases sodium reabsorption in the distal tubule through the increased expression of epithelial sodium channels (ENaC); and obesity has been shown to cause insulin resistance in various tissues. Thiazolidinediones (TZDs) are insulin-sensitizing drugs whose use can be limited by a side effect of fluid-retention leading to edema and congestive heart failure. We set out to determine if the expression of ENaC in distal …

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The Effect Of Aging On The Innate Immune Response Of Vascular Smooth Muscle, Christopher Winterbottom Jul 2009

The Effect Of Aging On The Innate Immune Response Of Vascular Smooth Muscle, Christopher Winterbottom

Yale Medicine Thesis Digital Library

As our understanding of atherosclerosis has become more sophisticated, a picture of the disease has emerged which emphasizes the role of inflammation in the pathogenesis of the disease, including signaling cascades mediated by toll-like receptors (TLRs). Data has also emerged suggesting that the process of aging plays an important role in atherogenesis, through pathways at least partially mediated by changes in the function of vascular smooth muscle cells. The purpose of this study was to elucidate the role that aging might play in the TLR-dependent innate immune response of vascular smooth muscle. Ex vivo cell and tissue culture models were …

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Population And Health Policies, T. Paul Schultz Jul 2009

Population And Health Policies, T. Paul Schultz

Discussion Papers

No abstract provided.

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Influence Of A Serotonin Transporter Promoter Polymorphism (5-Httlpr) On Corticolimbic Abnormalities In Bipolar Disorder An Integrated Genetics And Functional Mri Study, Maulik Shah Jun 2009

Influence Of A Serotonin Transporter Promoter Polymorphism (5-Httlpr) On Corticolimbic Abnormalities In Bipolar Disorder An Integrated Genetics And Functional Mri Study, Maulik Shah

Yale Medicine Thesis Digital Library

Bipolar disorder (BD) is associated with abnormalities of the subgenual anterior cingulate cortex (sgACC) and the amygdala, components of a corticolimbic neural system that subserves emotional regulation. The short s allele - as opposed to the long l allele - of a serotonin transporter promoter (5-HTTLPR) polymorphism is associated with more severe course features of BD and impaired functional connectivity between the sgACC and amygdala in healthy control (HC) individuals. This study tests the hypothesis that the s allele influences the dysfunction in the sgACC-amygdala neural system in BD. Twenty-six euthymic BD participants (17 s carriers, 9 ll) and 43 …

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Lectures On China’S Environment, Xuhui Lee Jun 2009

Lectures On China’S Environment, Xuhui Lee

Yale School of the Environment Publications Series

No abstract provided.

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The Use Of Traditional Chinese Medicine And Its Possible Relationship With Adherence To Highly-Active Anti-Retroviral Therapy In Patients With Hiv/Aids In Hong Kong, Kurtland Ma May 2009

The Use Of Traditional Chinese Medicine And Its Possible Relationship With Adherence To Highly-Active Anti-Retroviral Therapy In Patients With Hiv/Aids In Hong Kong, Kurtland Ma

Yale Medicine Thesis Digital Library

The aim of this project was to examine the usage of traditional Chinese medicine (TCM) and its possible relation to adherence to HAART by HIV-infected Chinese male patients by answering the following questions: 1. How prevalent is TCM use among HIV-infected Chinese patients? 2. What types of TCM are used by this population? 3. What are the predictors of TCM use in this population? 4. Is there a relationship between TCM use and adherence to HAART? A total of 81 self-administered questionnaires were completed by ethnic Chinese patients who had been on HAART for at least one year at Integrated …

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