Medicine and Health Sciences Commons^™

Detection Of Progression Or Regression Of Breast Cancer By Circulating Tumor Dna (Ctdna), Ujjwal Karki, Bipin Ghimire, Emma Herrman, Siddhartha Yadav, Mohammad Muhsin Chisti

Conference Presentation Abstracts

Circulating tumor DNA (ctDNA) are short DNA sequences shed by tumor cells into the systemic circulation. Studies have shown potential utility of the test to predict relapse or recurrence following treatment in solid tumors, but sensitivity and specificity have varied widely, ranging from 19-100% and 80-100% respectively, in breast cancer specifically. Moreover, literature describing the utility of monitoring dynamic changes in ctDNA trends is limited. We aim to evaluate the correlation between ctDNA test, both single test as well as dynamic trends in value over time, with imaging findings.

Responsive Neurostimulation (Rns) Of The Centromedian Nucleus Of The Thalamus For The Treatment Of Drug Resistant Idiopathic Generalized Epilepsy, Angelique Manasseh, Hannah Guider, Brooklynn Bondy, Ayman Haykal, Nour Baki, Ashleigh Terrell, Michael Staudt, Christopher Parres, Andrew Zillgitt

Conference Presentation Abstracts

Rationale: Idiopathic generalized epilepsy (IGE) accounts for approximately one-third of all epilepsies. The majority of people with IGE achieve seizure-freedom from treatment with anti-seizure medications (ASM). However, up to 25% of people with IGE continue to experience seizures despite adequate ASM trials. In patients with drug resistant IGE, neuromodulation with responsive neurostimulation (RNS) in the bilateral centromedian nucleus (CMN) of the thalamus may be an effective treatment option. Methods: Five patients with drug resistant IGE were evaluated through the Beaumont Adult Comprehensive Epilepsy Center and underwent an epilepsy presurgical evaluation including video-EEG monitoring in the epilepsy monitoring unit, brain MRI, …

Expansion Of The Detrusor Muscular Ring Surrounding The Bladder Neck On Mri: Moving Beyond The Prostate As An Etiology Of Lower Urinary Tract Symptoms Due To Benign Prostatic Hyperplasia, Kiran Nandalur, David Walker, Hong Ye, Sayf A. Al-Katib, Brian Seifman, David Gangwish, Abhay Dhaliwal, Connor Ervin, Kayla Dobies, Channing Sesoko, Sirisha Nandalur, Bernadette Zwaans, Jennifer Nguyen, Jason Hafron

Conference Presentation Abstracts

Purpose: The etiology of lower urinary tract symptoms secondary to benign prostatic hyperplasia (LUTS/BPH) remains uncertain. The purpose of our study was to quantitatively analyze pelvic anatomic characteristics on magnetic resonance imaging (MRI) to assess for independent factors for symptoms.
*Methods and Materials: This retrospective single-institution study evaluated treatment-naïve men who underwent prostate MRI within 3 months of International Prostate Symptom Score (IPSS) from June 2021 to February 2022. Factors measured on MRI included: detrusor muscular ring surrounding the bladder neck measured as area and alternatively diameter, central gland (CG) mean apparent diffusion coefficient (ADC), levator hiatus (LH) volume, intrapelvic …

Improv-Ing The Forensic Interview, Nina E. Ross, Karen B. Rosenbaum, Charles L. Scott, Jeffrey Guina, Kendall Genre

Conference Presentation Abstracts

No abstract provided.

Watch Your Back: The Risk Of Harm To The Forensic Psychiatrist, Kathleen L. Kruse, Nina E. Ross, Jeffrey Guina, Philip Saragoza, Drew Calhoun

Conference Presentation Abstracts

No abstract provided.

Preparing For The Applied Exam: The Orals And Osce, Roy G. Soto

Conference Presentation Abstracts

No abstract provided.

Sars-Cov-2 Immunization/Therapeutics, Matthew Sims

Conference Presentation Abstracts

No abstract provided.

Residency Program Directors Meeting, Sandor Shoichet

Conference Presentation Abstracts

No abstract provided.

Cases In Psychiatric Neurosurgery, Wael Asaad, Michael Staudt, Darin Dougherty, Wayne Goodman, Robert M. Richardson, Sameer Sheth

Conference Presentation Abstracts

In this session, multidisciplinary teams - surgeon plus psychiatrist - will discuss their own cases and approaches to the innovative management of psychiatric disorders.

Self-Reflections On Culture And Medicine: Exploration Of Diversity, Equity, And Inclusion, James Meza, Jianming Lau, Scott Yaekle

Conference Presentation Abstracts

No abstract provided.

Prevalence Of Allergic Fungal Sinusitis In Nonspecific Allergic Sinusitis, P L. Zhang, H D. Kanaan

Conference Presentation Abstracts

Background: Increased eosinophils in sinus contents are regarded as nonspecific allergic sinusitis. However there are only a few studies addressing the rate of fungal infection associated allergic fungal sinusitis in non-specific allergic sinusitis. This study was to identify the prevalence of allergic fungal sinusitis in the sinus content specimens with increased eosinophils. Methods: A computer search for allergic sinusitis was done over a 4 year period of time. And allergic fungal sinusitis was individually identified within listed allergic sinusitis cases. Each individual case of allergic fungal sinusitis was reviewed in correlation with sinus culture findings and the prevalence of allergic …

Increased Eosinophils In The Muscularis Propria Of Appendix May Indicate Early Symptomatic Appendicitis, Ping L. Zhang, Zhenhong Qu

Conference Presentation Abstracts

Background: The presence of neutrophils in muscularis propria is known to best correlate with clinical symptoms of acute appendicitis. Eosinophils present in the muscularis propria were noted in cases of acute appendicitis in 2000 (Carr, NJ. Annal of Diagnostic Pathology 2000;4:46–58), but the significance of their presence there has been unclear. The goal of this study was to investigate whether increased eosinophils in muscularis propria could be correlated with early symptoms of patients with clinical diagnosis of symptomatic appendicitis.

Methods: Seventeen patients with clinical diagnosis of acute appendicitis were identified as having acute symptomatology, but the resection specimens displayed a …

Paneth Cell-Like Granules In Clear Cell Renal Cell Carcinomas Are Cd68 And Lysozyme Positive Lysosomes, P L. Zhang

Conference Presentation Abstracts

Background:Paneth cells with features ofneuroendocrine differentiation can be seen inmultiple organs and various tumours. Paneth cell-likegranules in clear cell renal cell carcinomas (RCC)have previously been reported, but are found noexpression of neuroendocrine markers. Given thatclear cell RCC are rich in phagocytic factors, wehypothesized that the Paneth cell-like granules inclear cell RCC were associated with lysosomes.Methods:In this study, 72 different renal tumoursincluded 42 clear cell RCC, 16 papillary RCC, 5 clearcell papillary RCC, 6 chromophobe RCC, 2 urothelialcarcinomas and one unclassified RCC. All tumourswere evaluated for the Paneth cell-like granules onhaematoxylin & eosin stained sections. In addition,PAS-D staining, immunohistochemical stains andelectron …

Deletion Of Chemokine Receptor 6 Augments Ductular Reaction And Fibrosis In A Mouse Model Of Cholestatic Liver Injury, Nazli Begum Ozturk, Kaiyel Cutshaw, Anuradha Krishnan, Gregory J. Gores

Conference Presentation Abstracts

Background: The chemokine CCL20 is expressed by activated cholangiocytes implicating its’ receptor, CC-chemokine receptor 6 (CCR6) in immune cell trafficking to the liver during cholestatic liver injury. In particular, the innate immune cells macrophages and neutrophils have been identified in cholestatic liver injury. Therefore, our aim was to investigate the effect of CCR6 deletion on a mouse model of 3,5-diethoxycarbonyl-1,4-dihydrocollidine (DDC) diet-induced cholestatic liver injury. Methods: Age and gender matched WT and Ccr6-/- mice were placed on an DDC or a control diet for 21 days. Serum biochemistry, liver injury and the ductular reaction (DR) were examined by standard …

Bet Protein Complexes With Ets1 And Mediates The Senescence-Associated Secretory And Apoptotic Resistant Phenotypes Of Senescent Cholangiocytes, Jeong-Han Kang, Patrick Splinter, Christy Trussoni, Nicholas E. Pirius, Maria Eugenia Guicciardi, Anuradha Krishnan, Nazli Begum Ozturk, Gregory J. Gores, Nicholas F. Larusso, Steven P. O'Hara

Conference Presentation Abstracts

Background: We reported that cholangiocyte senescence is a pathogenic feature of Primary Sclerosing Cholangitis (PSC) and is regulated by the transcription factor, ETS1. We also showed that Histone 3 Lysine 27 is acetylated at senescence-associated loci. The bromodomain and extra-terminal domain (BET) proteins are epigenetic readers that bind acetylated histones, recruit transcription factors, and drive gene expression. Thus, we tested the hypothesis that BET proteins interact with ETS1 to drive gene expression and promote cholangiocyte senescence. Methods: We performed immunofluorescence to assess cholangiocyte expression of two BET proteins, BRD2 and BRD4, in tissue from PSC patients and PSC mouse models …

The Diagnostic Role Of Cytokeratin 8/18 Immunohistochemical Marker For Lean Non-Alcoholic Fatty Liver Disease, P Telli, M Buyuk, Nazli Begum Ozturk, Z Istemihan, K Nuriyev, A Atasoy, B Cavus, A Cifcibasi Ormeci, U Akyuz, K Demir

Conference Presentation Abstracts

Introduction

Non-alcoholic fatty liver disease (NAFLD) is one of the leading causes of chronic liver diseases. NAFLD spectrum begins from simple steatosis to non-alcoholic steatohepatitis (NASH), progressive fibrosis, cirrhosis, and even hepatocellular carcinoma. Although most NAFLD patients are overweight and obese, 30% are lean. We analyzed lean and non-lean NAFLD patients’ liver biopsies for cytokeratin 8/18 immunohistochemical staining differences.

Aims & Methods

Thirty biopsy-proven NAFLD patients (15 patients with BMI ≤ 25 kg/m2, 15 patients with BMI > 25 kg/m2) were included in the study. Demographic, biochemical, and histologic features of the patients were recorded. Biopsy specimens from our archive were …

Intraorbital Transvenous Embolization Of A Direct Arteriovenous Fistula, Olivia Cheng, Stella Chung, Jeffrey Wilseck, Alon Kahana

Conference Presentation Abstracts

No abstract provided.

Irreversible Electroporation For Recurrent Pelvic Metastases: Case Series And Literature Review., Duncan A. Stevens, Jeffrey H. Savin, Brett J. Friedman, Michael A. Savin

Conference Presentation Abstracts

Purpose: Irreversible electroporation (IRE) is a nonthermal ablative technique that has potential safety advantages over thermal ablation in the treatment of tumors near critical structures. It creates an electrical field which forms permanent nanopores in the membranes of cells and triggers apoptosis. This case series reviews three patients with pelvic metastases from colorectal cancer treated with IRE.

Material and Methods: Two patients had rectal cancer and one sigmoid colon cancer. The mean age was 55 years and there were two males and one female. Thermal ablation was contraindicated due to proximity to ureter, bladder, bowel, and/or sciatic or lumbosacral nerves. …

Obstetric Complications And Wellbeing Among Us Surgical Residents, Ruojia Li, Joshua Eng, Darci C. Foote, Christine Wu, Julie Johnson, Sarah Easter, Karl Bilimoria, Yue-Yung Hu, Erika Rangel

Conference Presentation Abstracts

No abstract provided.

An Epi-Metabolomics Approach For Studying Epigenetic And Metabolic Changes In Alzheimer’S Disease Brain, Nadia Ashrafi, Sangeetha Vishweswaraiah, Ali Yilmaz, Sumeyya Akyol, Juozas Gordevicius, Stewart Graham

Conference Presentation Abstracts

No abstract provided.

Mild And Severe Traumatic Brain Injury Longitudinally Profiled Using High-Resolution Metabolomics, Ali Yilmaz, Sigal Liraz Zaltsman, Esther Shohami, Juozas Gordevicius, Jack E. Sherman, Ray Bahado-Singh, Stewart F. Graham

Conference Presentation Abstracts

No abstract provided.

Protecting Wellness And Boundaries While Navigating Leaves Of Absences: Case Studies For Approaching From An Ethical And Behavioral Health Lens, Jennifer Kowalkowski, Sawsan Edriss, Stephen Warnick

Website/Multimedia Contributions

The new ACGME guidelines for paid 6-week family and medical leave are a big step forward in helping our residents maintain their health and well-being. Previously noted for having one of the strictest leave allowances among medical specialties, family medicine programs may see future increases in leave requests due to policy changes extending allowable leave times and increased stress from both the Covid-19 pandemic and current mental health crisis facing our nation. Leaves that involve physical or mental health crises are certainly very difficult for the resident on leave but can significantly impact co-residents and program faculty as well. Our …

Roundtable Discussion: 68-Year-Old Man With Mhspc, Jason M. Hafron

Articles

No abstract provided.

Igg4-Related Interstitial Nephritis Ranges From Kidney Mass To Acute Kidney Injury, Mai Elzieny, Wei Li, Hassan D. Kanaan, Ping Zhang

Conference Presentation Abstracts

Context: IgG4-related interstitial nephritis (IRIN) can present as either a renal mass or with acute kidney injury (AKI). The goal of this study was to present our 4 IRIN cases with different clinical scenarios.

Design: Over the past 5 years, we identified 4 cases of IRIN. Each case was evaluated.

Results: Case 1 involved a 60-year-old man with a 3-cm kidney mass. The core biopsy revealed storiform fibrosis and increased IgG4-positive plasma cells (>30 per high-power field), thus diagnosed as IRIN. Case 2 involved a 69-year-old man with medical history of polymyalgia rheumatica and low complements who developed AKI …

Acute Pericarditis And Acute Pleuritis/Empyema Following Submandibular Infection In A Covid-19-Postive Patient: An Autopsy Revealing The Danger Space Of The Neck, Jessica Anderson, Seyedalireza Fatemi, Joseph Fullmer, Ping Zhang

Conference Presentation Abstracts

Acute pericarditis and empyema are life-threatening complications of severe odontogenic infections; reports of these findings from an autopsy perspective are rare. We report an autopsy case demonstrating infection from the mandibular molars to the pericardium and pleura in a patient following COVID-19 infection. A 53-year-old woman with history of COVID-19 (and on repeat testing at admission) presented with submandibular abscess that grew Streptococcus anginosus. Despite incision and drainage of the neck abscess and medical treatment, her condition deteriorated, with sudden death a week after admission. An autopsy with histologic analysis was performed. Externally, a surgical incision containing purulent drainage …

Spectrum Of C3 Glomerulopathies: A Single-Center Experience, Mustafa Deebajah, Wei Li, Hassan D. Kanaan, Ping Zhang

Conference Presentation Abstracts

Context: C3GNs represent a rare type of glomerulopathy due to the activation of alternative complement pathway, including C3-dominant glomerulonephritis (C3D-GN) and dense deposit disease (DDD). The goal of this study was to demonstrate a spectrum of C3GNs.

Design: The study searched 3165 renal biopsies to identify C3GNs and their clinical indices over an 8-year period.

Conclusions: Our data indicate that C3GN cases had a consistent finding of dominant C3 staining, and low serum C3 in most, but exhibited a wide range of clinical and pathologic changes in pediatric to elderly patients. The findings support the previously reported characteristics of C3GN. …

Association Of Isolated Colitis With Nonsteroidal Anti-Inflammatory Drug Usage, Ashbita Pokharel, Wei Li

Conference Presentation Abstracts

Context: Nonsteroidal anti-inflammatory drugs (NSAIDs) have been known to produce various clinical gastrointestinal side effects and histopathologic changes. It has been reported that NSAID usage is associated with isolated colitis in the periappendiceal orifice region. This study aimed to further evaluate the clinicopathologic features of 16 patients with isolated colitis limited to the cecum or periappendiceal orifice region.

Design: A retrospective review was performed on biopsy specimens from 16 patients with histologically proven colitis (focal active colitis with no chronicity) limited to the cecum or periappendiceal orifice. No significant pathologic changes in the terminal ileum or other parts of the …

A Cost-Conscious Whole Slide Imaging System For Teaching And Teleconsultation In Pathology, Christopher Thorburn, Mustafa Deebajah, Keran Zhao, Zhenhong Qu

Conference Presentation Abstracts

Context: Whole slide imaging (WSI) systems can provide multiple users with concurrent access to slides without the need to be physically present at the same location. However, the cost of an all-in-one WSI system can be prohibitive for programs that do not already use WSI systems at a clinical scale. Here, we delineate a simple, inexpensive WSI system that is easy to implement and meets the need of a resident teaching environment.

Design: A digital camera (Basler acA2500, Mannheim, Germany) is mounted to a brightfield microscope with a 0.63× C-mount and connected to a computer with the manual WSI program …

Lysozyme-Induced Nephropathy Secondary To Chronic Myelomonocytic Leukemia, Vasudevan Mahalingam, Jamal Abukhaled, Ping Zhang

Conference Presentation Abstracts

Lysozyme-induced nephropathy is a rare cause of acute kidney injury (AKI) in patients with chronic myelomonocytic leukemia (CMML). We report the case of an 85-year-old man with type II diabetes and hypertension who was being evaluated for an elevated serum creatinine of 2.27 mg/dL. Additional studies showed proteinuria (1 g), predominantly nonalbumin, along with an IgA λ monoclonal protein found on serum electrophoresis. His serum κ:λ ratio, however, was elevated and urinalysis showed free κ monoclonal protein. Further hematopathologic workup revealed CMML, and he also had progression of his AKI, for which a renal biopsy was performed. Light microscopy showed …

Varieties Of Renal Diseases Identified In Renal Biopsies Of Patients Infected By Covid-19, Jessica Anderson, Wei Li, Hassan D. Kanaan, Ping Zhang

Conference Presentation Abstracts

Context: COVID-19 has been shown to cause renal pathology by multiple proposed mechanisms. However, studies evaluating renal biopsies for the effects of COVID-19 remain limited. We report our experience in our health system in a variety of renal pathologic diagnoses caused by COVID-19 infection.

Design: We performed detailed analysis of 5 renal biopsies related to COVID-19 infection, of 812 renal biopsies over the previous 22 months (0.6% of all cases).

Results: The first 3 patients were 2 African American men, 34 and 45 years old, and 1 48-year-old white male transplant recipient who developed acute kidney injury and nephrotic range …