Medicine and Health Sciences Commons^™

Thoracoscopy In Children: Is A Chest Tube Necessary?, Todd A. Ponsky, Steven S. Rothenberg, Kuojen Tsao, Daniel J. Ostlie, Shawn D. St Peter, G W. Holcomb Iii

Manuscripts, Articles, Book Chapters and Other Papers

PURPOSE: Historically, a chest tube or drain has been left following a thoracic operation to allow drainage of air or fluid in the postoperative period. However, in patients undergoing thoracoscopy, the tube is often the greatest source of postoperative pain. We began excluding chest tubes several years ago and therefore are reviewing our experience to evaluate the safety and efficacy of this approach.

METHODS: A retrospective review of the medical record was performed on patients undergoing thoracoscopy at two centers from 1993 to 2007. Patients who left the operating room without a chest tube were included in this series. Patient …

Laparoscopic Duodenojejunostomy For Superior Mesenteric Artery Syndrome., Jason D. Fraser, Shawn D. St Peter, Jenevieve H. Hughes, James M. Swain

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Superior mesenteric artery (SMA) syndrome, also called Wilkie's syndrome, is a rare clinical phenomenon believed to be caused by compression of the third portion of the duodenum by the overlying superior mesenteric artery. We present the case of a 32-year-old female who presented with epigastric pain, weight loss, and vomiting.

METHODS: Her workup included a normal upper endoscopy as well as an abdominal CT scan and upper GI contrast study that confirmed the diagnosis of superior mesenteric artery syndrome. The patient was taken to the operating room and underwent successful treatment with laparoscopic duodenojejunostomy.

RESULTS: The patient achieved complete …

Universal Screening For Extracardiac Abnormalities In Neonates With Congenital Heart Disease., Javier H. Gonzalez, Girish S. Shirali, Andrew M. Atz, Sarah N. Taylor, Geoffrey A. Forbus, Sinai C. Zyblewski, Anthony M. Hlavacek

Manuscripts, Articles, Book Chapters and Other Papers

Extracardiac or genetic abnormalities (EGA) represent a factor in the morbidity of patients with congenital heart disease. We evaluated the way neonates with CHD are screened at our institution and determined the yield for the screening tests. We reviewed the charts of 223 neonates with structural CHD. Subjects were categorized into 6 groups: univentricular, left-sided obstructive lesions, right-sided obstructive lesions, septal defects, conotruncal defects (CTD), and other. We reviewed which patients underwent cranial ultrasonogram (CUS), abdominal ultrasonogram (AUS), and/or genetic studies (GS) as well as their results. There was a high prevalence of EGA in each group by CUS (32% …

A Contrast Of Bilingual And Monolingual Children In Regards To Semantic And Syntactic Language Acquisition, Jessica Michelle Pfister

Undergraduate Honors Thesis Collection

Multiple language acquisition has only recently become a heavily researched and focused topic. Many questions have been left unanswered and furthermore, experts in the field are coming to contradicting results and conclusions. The presented thesis investigates the culmination of recent research in this newly developed field, as well as provides feedback from bilingual individuals on their experiences of being bilingual. Through analyzing current studies, the conclusion is made that bilingual children will follow a series of stages in their semantic and syntactic acquisition in which there is a bilingual disadvantage, followed by a bilingual advantage, and lastly a continuous stage …

Resolving The Lateral Component Of Blood Flow Velocity Based On Ultrasound Speckle Size Change With Scan Direction And Speed, Tiantian Xu, Greg R. Bashford

Biomedical Imaging and Biosignal Analysis Laboratory

Conventional blood flow velocity measurement using ultrasound is capable of resolving the axial component (i.e., that aligned with the ultrasound propagation direction) of the blood flow velocity vector. However, these Doppler-based methods are incapable of detecting blood flow in the direction normal to the ultrasound beam. In addition, these methods require repeated pulse-echo interrogation at the same spatial location. In this paper, we introduce a method which estimates the lateral component of blood flow within a single image frame using the observation that the speckle pattern corresponding to the blood reflectors (typically red blood cells) stretches (i.e., is “smeared”) if …

Further Progress On Lateral Flow Estimation Using Speckle Size Variation With Scan Direction, Tiantian Xu, Gregory R. Bashford

Biomedical Imaging and Biosignal Analysis Laboratory

Conventional blood flow velocity measurement using ultrasound is capable of resolving the axial component (i.e., that aligned with the ultrasound propagation direction) of the blood flow velocity vector. However, these Doppler-based methods are incapable of detecting blood flow in the direction normal to the ultrasound beam. In addition, these methods require repeated pulse-echo interrogation at the same spatial location. In this paper, we report additional data on a new method recently introduced. This method estimates the lateral component of blood flow within a single image frame using the observation that the speckle pattern corresponding to the blood reflectors (typically red …

Single Molecule Diffusion Coefficient Estimation By Image Analysis Of Simulated Ccd Images To Aid High-Throughput Screening, Pengfei Song, Lloyd M. Davis, Greg Bashford

Biomedical Imaging and Biosignal Analysis Laboratory

Extension of one-dimensional signal analysis to two-dimensional image analysis could accelerate conventional methods of high-throughput screening in the discovery of new pharmaceutical agents. This work describes a first step taken towards this goal – the evaluation of image-analysis based estimation strategies of the diffusion coefficient of a single molecule transported within a microfabricated flowcell. A computer simulation of single-molecule imaging by a charge-coupled device (CCD) camera is used to determine if it is possible to distinguish three different types of molecules with different diffusion coefficients. The Gaussian fitting algorithm finds the variance of the transverse trajectory, which increases linearly with …

Optimal Thresholds Of Feature Tracking For Blood Velocity And Tissue Motion Estimation, Tiantian Xu, Gregory R. Bashford

Biomedical Imaging and Biosignal Analysis Laboratory

Feature tracking is an algorithm for estimating blood flow velocity and tissue motion using pulse-echo ultrasound. In contrast to cross-correlation speckle-tracking techniques, feature tracking identifies features at discrete locations and corresponds them from frame to frame. Prior studies have demonstrated that feature-tracking estimates exhibit lower variance than those obtained by the conventional autocorrelation method and require less computational complexity than either speckle tracking or autocorrelation. To date, not much attention has been paid to the process by which trackable features (normally local maxima) are selected from the set of all available features. In the selection process, it is desired to …

Chronic Elbow Dislocation Treated With Open Reduction And Lateral Ulnar Collateral Ligament Reconstruction, Louis Joseph Rubino, Michael A. Herbenick, Ryan P. Finnan, Philip A. Anloague

Physical Therapy Faculty Publications

In the United States, chronic unreduced elbow dislocations are rare injuries. We report the successful short-term outcome of a chronic elbow dislocation treated with open reduction and lateral ulnar collateral ligament reconstruction using a split semitendinosus allograft in a figure-of-8 technique without use of hinged external fixation. The authors have obtained the patient’s written informed consent for print and electronic publication of the case report.

Contribution Of A Portable Air Plasma Torch To Rapid Blood Coagulation As A Method Of Preventing Bleeding, Kuo S. P., O. Tarasenko, J. Chang, S. Popović, C. Y. Chen, H. W. Fan, A. Scott, M. Lahiani, P. Alusta, J. D. Drake, Milka Nikolic

Physics and Astronomy

The effectiveness and mechanism of a low temperature air plasma torch in clotting blood are explored. Both blood droplets and smeared blood samples were used in the tests. The treated droplet samples reveal how blood clotting depends on the distance at which the torch operated, and for how long the droplets have been exposed to the torch. Microscopy and cell count of smeared blood samples shed light on dependencies of erythrocyte and platelet counts on torch distance and exposure time. With an increase of torch distance, the platelet count of treated blood samples increases but is less than that of …

Singlet Oxygen Delivery Through The Porous Cap Of A Hollow-Core Fiber Optic Device, Matibur Zamadar, David Aebisher, Alexander Greer

Faculty Publications

The development of the first photosensitizer/fiber optic device is reported. An oxygen-flowing, fiber-capped configuration is used for the application of heterogeneous, spatially confined singlet oxygen delivery in aqueous media. This is a unique device, unlike other heterogeneous photosensitizers, in which local concentrations of singlet oxygen can be delivered via introduction and withdrawal of the fiber tip.

Ua10/1 Cec: Clinical Exchange Corner, Mary Lloyd Moore, Laura Reynolds, Wku Suzanne Vitale Clinical Education Complex

CEC Publications

No abstract provided.

Impairments In Attention In Occasionally Snoring Children: An Event-Related Potential Study, Maria E. Barnes, Elizabeth A. Huss, Krista N. Garrod, Eric Van Raay, Ehab Dayyat, Dennis L. Molfese

Center for Brain, Biology, and Behavior: Faculty Publications

Objective—To determine whether minimal snoring is benign in children.

Procedure—22 rarely snoring children (mean age=6.9 years, 11 females) and age- and sexmatched controls participated in an auditory oddball task wearing 128-electrode nets. Parents completed Conner’s Parent Rating Scales-Revised Long (CPRS-R:L).

Results—Snorers scored significantly higher on 4 CPRS-R:L subscales. Stepwise regression indicated that two ERP variables from a region of the ERP that peaked at 844 ms post-stimulus onset predicted CPRS-R:L ADHD Index scores.

Conclusions—Occasional snorers according to parental report do exhibit ADHD-like behaviors. Basic sensory processing is longer than in controls, suggesting that delayed frontal activation requires more effort in …

Thoracoscopic Decortication Vs Tube Thoracostomy With Fibrinolysis For Empyema In Children: A Prospective, Randomized Trial., Shawn D. St Peter, Kuojen Tsao, Troy L. Spilde, Scott J. Keckler, Christopher J. Harrison, Mary Anne Jackson, Susan W. Sharp, Walter S. Andrews, Douglas C. Rivard, Frank P. Morello, G W. Holcomb Iii, Daniel J. Ostlie

Manuscripts, Articles, Book Chapters and Other Papers

PURPOSE: Management of empyema has been debated in the literature for decades. Although both primary video-assisted thoracoscopic surgery (VATS) and tube thoracostomy with pleural instillation of fibrinolytics have been shown to result in early resolution when compared to tube thoracostomy alone, there is a lack of comparative data between these modes of management. Therefore, we conducted a prospective, randomized trial comparing VATS to fibrinolytic therapy in children with empyema.

METHODS: After Institutional Review Board approval, children defined as having empyema by either loculation on imaging or more than 10,000 white blood cells/microL were treated with VATS or fibrinolysis. Based on …

Mathematical Aids Epidemic Model: Preferential Anti-Retroviral Therapy Distribution In Resource Constrained Countries, Nadia Abuelezam

HMC Senior Theses

HIV/AIDS is one of the largest health problems the world is currently facing. Even with anti-retroviral therapies (ART), many resource-constrained countries are unable to meet the treatment needs of their infected populations. ART-distribution methods need to be created that prevent the largest number of future HIV infections. We have developed a compartment model that tracks the spread of HIV in multiple two-sex populations over time in the presence of limited treatment. The model has been fit to represent the HIV epidemic in rural and urban areas in Uganda. With the model we examine the spread of HIV among urban and …

Demographic Profile Of Clinical Research Volunteers: Improving The Effectiveness Of Promotional Recruitment, Amanda M. Mcallister

Master's Theses and Doctoral Dissertations

Background: Successfully recruiting participants for clinical trials is a challenge that crosses all medical disciplines. Slow enrollment to clinical trials delays the completion of clinical research studies.

Objectives: This study collected demographic data of current and past clinical trial volunteers. Furthermore, it examined similarities and differences between clinical trial volunteers, which provides deeper understandings of who volunteers are and which may allow for improved education and recruitment of subjects.

Methods: 87 adults who had participated in at least one clinical research study were surveyed.

Findings:

*Healthcare represented the most common career at 27.6%.

*93.1% received education beyond high school.

*0% …

Hmgb1 Mediates Endogenous Tlr2 Activation And Brain Tumor Regression, James Curtin, Naiyou Liu, Marianela Candolfi, Weidong Xiong, Hikmat Assi, Kader Yagiz, Matthew Edwards, Kathrin Michelsen, Kurt Kroeger, Chunyan Liu, Akm Ghulam Muhammad, Mary Clark, Moshe Arditi, Begonya Comin-Anduix, Antoni Ribas, Pedro Lowenstein, Maria Castro

Articles

BACKGROUND: Glioblastoma multiforme (GBM) is the most aggressive primary brain tumor that carries a 5-y survival rate of 5%. Attempts at eliciting a clinically relevant anti-GBM immune response in brain tumor patients have met with limited success, which is due to brain immune privilege, tumor immune evasion, and a paucity of dendritic cells (DCs) within the central nervous system. Herein we uncovered a novel pathway for the activation of an effective anti-GBM immune response mediated by high-mobility-group box 1 (HMGB1), an alarmin protein released from dying tumor cells, which acts as an endogenous ligand for Toll-like receptor 2 (TLR2) signaling …

Cultural Determinants Affect Implementation Of Good Clinical Practice (Gcp) In Human Research Studies In Malawi, Africa, Joann Jeanne Schmidt

Master's Theses and Doctoral Dissertations

Clinical research conduct and Good Clinical Practice (GCP) implementation are influenced by local culture. This study examines the experiences of 26 clinical research personnel in Malawi, Africa, in order to define relevant issues, identify solutions, and give voice to local investigators. Qualitative, semi-structured interviews were conducted, audio-recorded, transcribed, and analyzed. Six themes, related to cultural determinants, emerged: 1) communitybased decision-making, 2) illiteracy, 3) patient identifiers, 4) local myths and misconceptions, 5) poverty and disease, and 6) barriers to teamwork. Findings revealed that: 1) Malawians are best at identifying local solutions, 2) operations research is needed 3) greater networking and communication …

Parameter Optimization For Image Denoising Based On Block Matching And 3d Collaborative Filtering, Ramu Pedada, Emin Kugu, Jiang Li, Zhanfeng Yue, Yuzhong Shen, Josien P.W. Pluim (Ed.), Benoit M. Dawant (Ed.)

Electrical & Computer Engineering Faculty Publications

Clinical MRI images are generally corrupted by random noise during acquisition with blurred subtle structure features. Many denoising methods have been proposed to remove noise from corrupted images at the expense of distorted structure features. Therefore, there is always compromise between removing noise and preserving structure information for denoising methods. For a specific denoising method, it is crucial to tune it so that the best tradeoff can be obtained. In this paper, we define several cost functions to assess the quality of noise removal and that of structure information preserved in the denoised image. Strength Pareto Evolutionary Algorithm 2 (SPEA2) …

Automatic Diagnosis For Prostate Cancer Using Run-Length Matrix Method, Xiaoyan Sun, Shao-Hui Chuang, Jiang Li, Frederic Mckenzie, Nico Karssemeijer (Ed.), Maryellen L. Giger (Ed.)

Electrical & Computer Engineering Faculty Publications

Prostate cancer is the most common type of cancer and the second leading cause of cancer death among men in US¹. Quantitative assessment of prostate histology provides potential automatic classification of prostate lesions and prediction of response to therapy. Traditionally, prostate cancer diagnosis is made by the analysis of prostate-specific antigen (PSA) levels and histopathological images of biopsy samples under microscopes. In this application, we utilize a texture analysis method based on the run-length matrix for identifying tissue abnormalities in prostate histology. A tissue sample was collected from a radical prostatectomy, H&E fixed, and assessed by a pathologist …

Isoniazid Completion Rates For Latent Tuberculosis Infection Among College Students Managed By A Community Pharmacist, Karl M. Hess, Jeffery A. Goad, Joanne Wu, Kathleen Johnson

Pharmacy Faculty Articles and Research

Objective: The authors' objective was to document 9-month and previously recommended 6-month treatment completion rates for latent tuberculosis infection (LTBI) in a pharmacist-managed LTBI clinic in a community pharmacy oil a college Campus. and to describe patient characteristics. Participants: Participants were university Students diagnosed with LTBI. Methods: The authors conducted a retrospective review, of pharmacy records from 2000 to 2006. Main outcome measures included 6-month and 9-month LTBI treatment completion rates, total isoniazid (INH) tablets taken. characteristics of completers versus noncompleters. average time to treatment completion, and reported adverse drug events. Results: The 9-month completion rate was 59%, and the …

Kinematic Demands Of Nucleus Arthroplasty Technology, Elizabeth J. Sander

Theses and Dissertations (ETD)

Recent advancements in biomaterial technologies have fostered growth in alternative surgical procedures to fusion surgery for treatment of early stages of degenerative disc disease. One application of immediate interest is that of nucleus arthroplasty (NA). Novel materials are being developed to better match the nonlinear biomechanical properties of the native tissue. The effects of changing the motion segment unit (MSU) properties via surgery (nucleotomy) or placement of a nucleus arthroplasty material, changes the effort or work required to move the altered spine condition through a prescribed kinematic path relative to the intact spine condition. The closer the loading mechanics of …

Use Of Compliant Interbody Force Sensing Grafts To Compare Load Sharing Properties Of Unidirectional And Bidirectional Multilevel Dynamic Translational Anterior Cervical Plates, Jason Roscoe Roberson

Theses and Dissertations (ETD)

INTRODUCTION: Pseudoarthrosis is a relatively rare complication following anterior cervical arthrodesis, and is felt to be related to stress shielding. To address this, dynamic anterior cervical plates have emerged to maintain load sharing as an arthodesis matures. Dynamic plates can translate bidirectionally (allow translation in compressive and tensile loads), or unidirectionally (allow translation in compression, but maintain its position under tensile loads). The objective of this study was to compare the graft load mechanics between three plated conditions during settling using compliant interbody load cells: A static (fixed, non-moving) plate, a unidirectional multi-level translational plate design, and a bidirectional two-level …

A Kinematics-Based Testing Protocol To Study The Mechanics Of The Human Lumbar Spine, Nephi A. Zufelt

Theses and Dissertations (ETD)

The objective of this work was to develop a new kinematics-based testing protocol to quantify the axial and shear force components and rotational moment properties of the human cadaveric lumbar motion segment unit (MSU) in response to specific kinematic inputs. Modern, non-fusion spinal devices claim to treat degenerative disc disease better than traditional fusion surgery. Though there have been many biomechanical studies completed on these devices, there is still a debate over their efficacy. Conventional testing methods provide insight into the rotational properties of the MSU but lack the sensitivity or capacity to quantify lumbar MSU’s mechanical properties including shear …

Buccal Bone Changes Following Rapid Maxillary Expansion (Rmf), Long-Term Results, Elena S. Iacob

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to use Cone Beam Computed Tomography (CBCT) images to quantitatively evaluate buccal bone changes of maxillary first premolar (P1), second premolar (P2) and first molar (M1) shortly after Rapid Maxillary Expansion (RME) and at the end of orthodontic treatment, as well as to evaluate the variables that may be associated with the short-term and long-term changes. Forty-seven consecutive patients (25 males and 22 females) with a mean age of 14.5years and who required RME as part of their orthodontic treatment and had pre-RME (T1) and post-RME (T2) CBCT images available were used for the …

Predictors Of Emesis And Time To Goal Intake After Pyloromyotomy: Analysis From A Prospective Trial., Shawn D. St Peter, Kuojen Tsao, Susan W. Sharp, G W. Holcomb Iii, Daniel J. Ostlie

Manuscripts, Articles, Book Chapters and Other Papers

Background: Emesis after pyloromyotomy for pyloric stenosis is a common clinical phenomenon and the limiting factor in time to goal feeds. The amount of emesis that can be expected after myotomy is unknown. No data have been published that equip caregivers with the ability to understand which patients are more likely to have emesis and take longer to advance to goal feeds after pyloromyotomy. Therefore, we performed analysis of prospective data obtained from a randomized trial to determine if outcome can be predicted from preoperative or intraoperative variables.

Methods: The dataset was prospectively collected from a randomized trial comparing open …

Methodology Development For Three-Dimensional Mr-Guided Near Infrared Spectroscopy Of Breast Tumors, Colin M. Carpenter, Subhadra Srinivasan, Brian W. Pogue, Keith D. Paulsen

Dartmouth Scholarship

Combined Magnetic Resonance (MR) and Near Infrared Spectroscopy (NIRS) has been proposed as a unique method to quantify hemodynamics, water content, and cellular size and packing density of breast tumors, as these tissue constituents can be quantified with increased resolution and overlaid on the structural features identified by the MR. However, the choices in how to reconstruct and visualize this information can have a dramatic impact on the feasibility of implementing this modality in the clinic. This is especially true in 3 dimensions, as there is often limited optical sampling of the breast tissue, and methods need to accurately reflect …

Acquisition De Modèles Pour L’Étude De L’Absorption Percutanée Des Substances Chimiques : Cellules De Diffusion À Flux Continu, Claude Viau, Suzanne Leroux, Ross Thuot, Sophie Lim

Rapports de recherche scientifique

Dans les milieux de travail où des substances chimiques sont utilisées, celles-ci peuvent se retrouver dans l’air. Les employés peuvent donc y être exposés par le fait de la respiration. C’est d’ailleurs pour ça que le règlement sur la santé et la sécurité du travail donne des valeurs limites d’exposition dans l’air pour près de 700 substances chimiques. Mais il est aussi possible d’être exposé par le contact des substances avec la peau. Quand on veut savoir à quel point un travailleur peut absorber des substances dans son organisme de cette manière, on doit savoir trois choses principales :

• la …

Gender Differences In Motivation To Resolve Eating And Body Image Concerns In College Students, Harold L. Merriman, C. Jayne Brahler, Laura Dinan, Lauren Finzer

Physical Therapy Faculty Publications

The objective of this study was to identify similarities and differences between college women and men with respect to their eating and body image concerns, weight fluctuation and level of motivation to resolve these concerns. 101 University of Dayton students participated in this study. Students completed an eating and body concern survey online.

Body image concerns were significantly greater for females compared to males (p=0.007) and significantly greater as motivation level to resolve the concerns increased (p=0.019). Eating concerns followed the same trends but did not reach statistical significance. Weight fluctuation in both genders increased significantly as motivation level increased …

Ua10/1 Cec: Clinical Exchange Corner, Mary Lloyd Moore, Laura Reynolds, Wku Suzanne Vitale Clinical Education Complex

CEC Publications

No abstract provided.