Medicine and Health Sciences Commons^™

Xpert Mtb/Rif Assay Shows Faster Clearance Of Mycobacterium Tuberculosis Dna With Higher Levels Of Rifapentine Exposure., A Jayakumar, R M Savic, C K Everett, Debra Benator, D Alland, C M Heilig, M Weiner, S O Friedrich, N A Martinson, A Kerrigan, C Zamudio, S V Goldberg, W C Whitworth, J L Davis, P Nahid

Medicine Faculty Publications

The Xpert MTB/RIF assay is both sensitive and specific as a diagnostic test. Xpert also reports quantitative output in cycle threshold (CT) values, which may provide a dynamic measure of sputum bacillary burden when used longitudinally. We evaluated the relationship between Xpert CT trajectory and drug exposure during tuberculosis (TB) treatment to assess the potential utility of Xpert CT for treatment monitoring. We obtained serial sputum samples from patients with smear-positive pulmonary TB who were consecutively enrolled at 10 international clinical trial sites participating in study 29X, a CDC-sponsored Tuberculosis Trials Consortium study evaluating the tolerability, safety, and antimicrobial activity …

Strategies For Enriching Variant Coverage In Candidate Disease Loci On A Multiethnic Genotyping Array, Stephanie Bien, Genevieve L. Wojcik, Niha Zubair, Christopher Gignoux, Alicia R. Martin, Lisa W. Martin, Page Study Investigators

Medicine Faculty Publications

Investigating genetic architecture of complex traits in ancestrally diverse populations is imperative to understand the etiology of disease. However, the current paucity of genetic research in people of African and Latin American ancestry, Hispanic and indigenous peoples in the United States is likely to exacerbate existing health disparities for many common diseases. The Population Architecture using Genomics and Epidemiology, Phase II (PAGE II), Study was initiated in 2013 by the National Human Genome Research Institute to expand our understanding of complex trait loci in ethnically diverse and well characterized study populations. To meet this goal, the Multi-Ethnic Genotyping Array (MEGA) …

Lipid Coated Microbubbles And Low Intensity Pulsed Ultrasound Enhance Chondrogenesis Of Human Mesenchymal Stem Cells In 3d Printed Scaffolds, Mitra Aliabouzar, Lijie Grace Zhang, Kausik Sarkar

Medicine Faculty Publications

Lipid-coated microbubbles are used to enhance ultrasound imaging and drug delivery. Here we apply these microbubbles along with low intensity pulsed ultrasound (LIPUS) for the first time to enhance proliferation and chondrogenic differentiation of human mesenchymal stem cells (hMSCs) in a 3D printed poly-(ethylene glycol)-diacrylate (PEG-DA) hydrogel scaffold. The hMSC proliferation increased up to 40% after 5 days of culture in the presence of 0.5% (v/v) microbubbles and LIPUS in contrast to 18% with LIPUS alone. We systematically varied the acoustic excitation parameters—excitation intensity, frequency and duty cycle—to find 30 mW/cm2, 1.5 MHz and 20% duty cycle to be optimal …

Irisin Lowers Blood Pressure By Improvement Of Endothelial Dysfunction Via Ampk‐Akt‐Enos‐No Pathway In The Spontaneously Hypertensive Rat, Jinjuan Fu, Yu Han, Jialiang Wang, Yukai Liu, Shuo Zeng, Lin Zhou, Pedro A. Jose, Chunyu Zeng

Medicine Faculty Publications

Background Exercise is a major nonpharmacological treatment for hypertension, but its underlying mechanisms are still not completely elucidated. Irisin, a polypeptide containing 112 amino acids, which is secreted mainly by skeletal muscle cells during exercise, exerts a protective role in metabolic diseases, such as diabetes mellitus and obesity. Because of the close relationship between irisin and metabolic diseases, we hypothesized that irisin may play a role in the regulation of blood pressure.

Methods and Results Blood pressures of male Wistar‐Kyoto (WKY) rats and spontaneously hypertensive rats (SHRs) were monitored through the carotid artery. Our study found that acute intravenous injection …

Beer Potomania: A Challenging Case Of Hyponatremia, Hind Rafei, Raza Yunus, Parvinder S. Khurana

Medicine Faculty Publications

Beer potomania is a syndrome of hyponatremia associated with excessive beer drinking. Little or no salt content of beer results in marked reduction in the solute load to the kidney. This leads to impaired water clearance and dilutional hyponatremia. A 66-year-old man with history of alcoholism and alcoholic cardiomyopathy presented to the emergency room with tremors of his upper and lower extremities. He had a significant history of alcohol consumption, usually drinking 4 - 5 cans of beer per night for the past 34 years. In addition, he had consumed a fifth of a vodka bottle the day before presentation. …

Beta Protein 1 Homeoprotein Induces Cell Growth And Estrogen-Independent Tumorigenesis By Binding To The Estrogen Receptor In Breast Cancer., Sidney W Fu, Saurabh P Kirolikar, Erika Ginsburg, Xiaohui Tan, Arnold Schwartz, Samuel J Simmens, Yan-Gao Man, Joseph J Pinzone

Medicine Faculty Publications

Expression of Beta Protein 1 (BP1), a homeotic transcription factor, increases during breast cancer progression and may be associated with tumor aggressiveness. In our present work, we investigate the influence of BP1 on breast tumor formation and size in vitro and in vivo. Cells overexpressing BP1 showed higher viability when grown in the absence of serum (p < 0.05), greater invasive potential (p < 0.05) and formed larger colonies (p < 0.004) compared with the controls. To determine the influence of BP1 overexpression on tumor characteristics, MCF-7 cells transfected with either empty vector (V1) or overexpressor plasmids (O2 and O4) were injected into the fat pads of athymic nude mice. Tumors grew larger in mice receiving O2 or O4 cells than in mice receiving V1 cells. Moreover, BP1 mRNA expression levels were positively correlated with tumor size in patients (p = 0.01). Interestingly, 20% of mice injected with O2 or O4 cells developed tumors in the absence of estrogen, while no mice receiving V1 cells developed tumors. Several mechanisms of estrogen independent tumor formation related to BP1 were established. These data are consistent with the fact that expression of breast cancer anti-estrogen resistance 1 (BCAR1) was increased in O2 compared to V1 cells (p < 0.01). Importantly, O2 cells exhibited increased proliferation when treated with tamoxifen, while V1 cells showed growth inhibition. Overall, BP1 overexpresssion in MCF-7 breast cancer cells leads to increased cell growth, estrogen-independent tumor formation, and increased proliferation. These findings suggest that BP1 may be an important biomarker and therapeutic target in ER positive breast cancer.

G Protein-Coupled Receptor Kinases: Crucial Regulators Of Blood Pressure, J. Yang, V. Villar, Ines Armando, Pedro A. Jose, C. Zeng

Medicine Faculty Publications

No abstract provided.

The Respiratory Protection Effectiveness Clinical Trial (Respect): A Cluster-Randomized Comparison Of Respirator And Medical Mask Effectiveness Against Respiratory Infections In Healthcare Personnel., Lewis J Radonovich, Mary T Bessesen, Derek A Cummings, Aaron Eagan, Charlotte Gaydos, Cynthia Gibert, Geoffrey J Gorse, Ann-Christine Nyquist, Nicholas G Reich, Maria Rodrigues-Barradas, Connie Savor-Price, Ronald E Shaffer, Michael S Simberkoff, Trish M Perl

Medicine Faculty Publications

BACKGROUND: Although N95 filtering facepiece respirators and medical masks are commonly used for protection against respiratory infections in healthcare settings, more clinical evidence is needed to understand the optimal settings and exposure circumstances for healthcare personnel to use these devices. A lack of clinically germane research has led to equivocal, and occasionally conflicting, healthcare respiratory protection recommendations from public health organizations, professional societies, and experts.

METHODS: The Respiratory Protection Effectiveness Clinical Trial (ResPECT) is a prospective comparison of respiratory protective equipment to be conducted at multiple U.S. study sites. Healthcare personnel who work in outpatient settings will be cluster-randomized to …

Interdisciplinary Workshop To Increase Collaboration Between Medical Students And Standardized Patient Instructors In Teaching Physical Diagnosis To Novices, Tanakorn Kittisarapong, Benjamin Blatt, Karen Lewis, Jennifer Owens, Larrie Greenberg

Medicine Faculty Publications

Traditionally, full-time faculty members have assumed major responsibility for teaching physical examination skills to first- and second-year medical students. Problems with faculty recruitment and adhering to a standardized way of teaching have challenged educators to seek alternatives to teaching the physical examination to novices. To address these problems, we created and implemented a novel curriculum that has standardized the teaching of physical examination skills to novice students by using standardized patient instructors and fourth-year medical students working as an interdisciplinary team (known as a dyad). Feedback after the first iteration of this course revealed confusion about roles, goals, and responsibilities …

Hypertonicity: Pathophysiologic Concept And Experimental Studies, Christos Argyropoulos, Helbert Rondon-Berrios, Dominic S. Raj, Deepak Malhotra, Emmanuel I. Agaba, +5 Additional Authors

Medicine Faculty Publications

Disturbances in tonicity (effective osmolarity) are the major clinical disorders affecting cell volume. Cell shrinking secondary to hypertonicity causes severe clinical manifestations and even death. Quantitative management of hypertonic disorders is based on formulas computing the volume of hypotonic fluids required to correct a given level of hypertonicity. These formulas have limitations. The major limitation of the predictive formulas is that they represent closed system calculations and have been tested in anuric animals. Consequently, the formulas do not account for ongoing fluid losses during development or treatment of the hypertonic disorders. In addition, early comparisons of serum osmolality changes predicted …

Genetic Association Of Deleted In Colorectal Carcinoma Variants With Breast Cancer Risk: A Case-Control Study., Xinghan Liu, Xijing Wang, Sidney W. Fu, Zhijun Dai, + 9 More

Medicine Faculty Publications

Deleted in colorectal carcinoma (DCC), a netrin-1 dependence receptor, is correlated with cell progression, migration, and adhesion. Evidence indicated that DCC was frequently down-regulated in many cancers. However, the association of DCC with breast cancer remains uncertain. We conducted a case-control study to investigate the impact of three DCC gene variants (rs2229080, rs7504990, and rs4078288) on breast cancer susceptibility in Chinese women. This study included 560 breast cancer patients and 583 age-matched healthy controls from Northwest China. The three gene variants were genotyped via Sequenom MassARRAY. Odds ratios (ORs) and 95% confidence intervals (CIs) were utilized to evaluate …

Low Radiation Dose Calcium Scoring: Evidence And Techniques, Kaitlin B. Baron, Andrew D. Choi, Marcus Y. Chen

Medicine Faculty Publications

Coronary computed tomography (CT) allows for the acquisition of thin slices of the heart and coronary arteries, which can be used to detect and quantify coronary artery calcium (CAC), a marker of atherosclerotic cardiovascular disease. Despite the proven clinical value in cardiac risk prognostication, there remain concerns regarding radiation exposure from CAC CT scans. There have been several recent technical advancements that allow for significant radiation dose reduction in CAC scoring. This paper reviews the clinical utility and recent literature in low radiation dose CAC scoring.

Cerebral Malaria: An Unusual Case Of Central Diabetes Insipidus, Resmi Premji, Nira Roopnarinesingh, Joshua Cohen, Sabyasachi Sen

Medicine Faculty Publications

Central diabetes insipidus is an uncommon feature of malaria. A previously healthy 72-year-old man presented with fever, rigors, and altered mental status after a recent trip to Liberia, a country known for endemic falciparum malaria. Investigations confirmed plasmodium falciparum parasitemia. Within one week after admission, the serum sodium rose to 166 mEq/L and the urine output increased to 7 liters/day. Other labs were notable for a high serum osmolality, low urine osmolality, and low urine specific gravity. The hypernatremia did not respond to hypotonic fluids. Diabetes insipidus was suspected and parenteral desmopressin was started with a prompt decrease in urinary …

Add-On Laba In A Separate Inhaler As Asthma Step-Up Therapy Versus Increased Dose Of Ics Or Ics/Laba Combination Inhaler., David B Price, Gene Colice, Elliot Israel, Nicolas Roche, Dirkje S Postma, Theresa W Guilbert, Willem M C Van Aalderen, Jonathan Grigg, Elizabeth V Hillyer, Victoria Thomas, Richard J Martin

Medicine Faculty Publications

Asthma management guidelines recommend adding a long-acting β2-agonist (LABA) or increasing the dose of inhaled corticosteroid (ICS) as step-up therapy for patients with uncontrolled asthma on ICS monotherapy. However, it is uncertain which option works best, which ICS particle size is most effective, and whether LABA should be administered by separate or combination inhalers. This historical, matched cohort study compared asthma-related outcomes for patients (aged 12-80 years) prescribed step-up therapy as a ≥50% extrafine ICS dose increase or add-on LABA, via either a separate inhaler or a fine-particle ICS/LABA fixed-dose combination (FDC) inhaler. Risk-domain asthma control was the primary end-point …

Single-Nucleotide Polymorphisms In Psca And The Risk Of Breast Cancer In A Chinese Population., Meng Wang, Xijing Wang, Sidney W. Fu, Zhijun Dai, Tianbo Jin, + 10 Additional Authors

Medicine Faculty Publications

This study explored the associations between common PSCA single-nucleotide polymorphisms (rs2294008, rs2978974, and rs2976392) and breast cancer among 560 breast cancer cases and 583 controls (Chinese Han women). We found rs2294008 was significantly associated with a high risk of breast cancer (homozygote model, odds ratio [OR]: 1.67, 95% confidence interval [CI]: 1.06–2.59; recessive, OR: 1.64, 95% CI: 1.06–2.53). And stratification by menopausal status revealed an association of the minor allele of rs2294008 with breast cancer risk among premenopausal (homozygote model, OR: 2.41, 95% CI: 1.03–5.66; recessive, OR: 2.80, 95 % CI: 1.21–6.47) and postmenopausal women (allele model, OR: 1.29, 95% …

Targeting Ho-1 By Epigallocatechin-3-Gallate Reduces Contrast-Induced Renal Injury Via Anti-Oxidative Stress And Anti-Inflammation Pathways., Zhao Gao, Yu Han, Yunhui Hu, Xiaoyan Wu, Yongbin Wang, Xiaoqun Zhang, Jinjuan Fu, Xue Zou, Jun Zhang, Xiongwen Chen, Pedro A. Jose, Xi Lu, Chunyu Zeng

Medicine Faculty Publications

Both oxidative stress and inflammation are involved in the pathogenesis of contrast-induced nephropathy (CIN). Epigallocatechin-3-gallate (EGCG), a purified catechin from green tea, has antioxidant and anti-inflammatory effects. However, it is unknown whether or not EGCG is effective in treating CIN. Our present study found that intravenous administration of EGCG, either before or just after the establishment of CIN, had a protective effect, determined by normalization of serum creatinine and blood urea nitrogen levels, improvement in renal histopathological scoring and alleviation of apoptosis, accompanied by decreased oxidative stress and inflammation. Because EGCG is a potent inducer of the antioxidant heme oxygenase-1 …

Relation Of Statin Use With Non-Melanoma Skin Cancer: Prospective Results From The Women's Health Initiative., Ange Wang, Marcia L Stefanick, Kristopher Kapphahn, Haley Hedlin, Manisha Desai, Jo Ann E Manson, Howard Strickler, Lisa W. Martin, Jean Wactawski-Wende, Michael Simon, Jean Y Tang

Medicine Faculty Publications

BACKGROUND: The relationship between statin use and non-melanoma skin cancer (NMSC) is unclear with conflicting findings in literature. Data from the Women's Health Initiative (WHI) Observational Study and WHI Clinical Trial were used to investigate the prospective relationship between statin use and NMSC in non-Hispanic white (NHW) postmenopausal women.

METHODS: The WHI study enrolled women aged 50-79 years at 40 US centres. Among 133 541 NHW participants, 118 357 with no cancer history at baseline and complete medication/covariate data comprised the analytic cohort. The association of statin use (baseline, overall as a time-varying variable, duration, type, potency, lipophilicity) and NMSC …

Mir-671-5p Inhibits Epithelial-To-Mesenchymal Transition By Downregulating Foxm1 Expression In Breast Cancer., Xiaohui Tan, Yebo Fu, Liang Chen, Woojin Lee, Yinglei Lai, M. Katayoon Rezaei, Sana Tabbara, Patricia Latham, Christine B Teal, Yan-Gao Man, Robert S. Siegel, Rachel F. Brem, Sidney W. Fu

Medicine Faculty Publications

MicroRNA (miRNA) dysfunction is associated with a variety of human diseases, including cancer. Our previous study showed that miR-671-5p was deregulated throughout breast cancer progression. Here, we report for the first time that miR-671-5p is a tumor-suppressor miRNA in breast tumorigenesis. We found that expression of miR-671-5p was decreased significantly in invasive ductal carcinoma (IDC) compared to normal in microdissected formalin-fixed, paraffin-embedded (FFPE) tissues. Forkhead Box M1 (FOXM1), an oncogenic transcription factor, was predicted as one of the direct targets of miR-671-5p, which was subsequently confirmed by luciferase assays. Forced expression of miR-671-5p in breast cancer cell lines downregulated FOXM1 …

Pleural Fluid Procalcitonin To Distinguish Infectious From Noninfectious Etiologies Of Pleural Effusions, Rahul Khosla, Shikha Khosla, Kenneth L. Becker, Eric S. Nylen

Medicine Faculty Publications

In this study we investigate the diagnostic value of pleural fluid procalcitonin (PCT) in distinguishing infectious and noninfectious etiologies of pleural effusion. We reviewed the medical records of 75 hospitalized patients who underwent thoracentesis between 2011 and 2012. Data on pleural fluid lactate dehydrogenase (LDH), protein, albumin, cell count and differential, pH, Gram stain and culture, cytology, triglyceride, cholesterol, amylase, and PCT were collected. Data on serum LDH, protein, albumin, prothrombin time, normalized, and blood culture were also collected. Pleural effusions were classified into 2 groups, infectious and noninfectious. There were 18 infectious pleural effusions (IPE) and 57 noninfectious pleural …

Mirnas As Potential Biomarkers In Early Breast Cancer Detection Following Mammography, Sidney W. Fu, Woojin Lee, Caitrin M. Coffey, Alexa Lea, Xiaoling Wu, Xiaohui Tan, Yan-Gao Man, Rachel F. Brem

Medicine Faculty Publications

Breast cancer is the most common cancer among American women, except for skin cancers. About 12 % women in the United States will develop invasive breast cancer during their lifetime. Currently one of the most accepted model/theories is that ductal breast cancer (most common type of breast cancer) follows a linear progression: from normal breast epithelial cells to ductal hyperplasia to atypical ductal hyperplasia (ADH) to ductal carcinoma in situ (DCIS), and finally to invasive ductal carcinoma (IDC). Distinguishing pure ADH diagnosis from DCIS and/or IDC on mammography, and even combined with follow-up core needle biopsy (CNB) is still a …

Cost-Effectiveness Of Asthma Step-Up Therapy As An Increased Dose Of Extrafine-Particle Inhaled Corticosteroid Or Add-On Long-Acting Beta2-Agonist, Nicolas Roche, Gene L. Colice, Elliot Israel, Richard J. Martin, Paul M. Dorinsky, Dirkje S. Postma, +9 Additional Authors

Medicine Faculty Publications

Introduction

Data from different healthcare systems on relative cost-effectiveness of asthma step-up therapy strategies are required to inform decision-makers and clinicians. Our objective was to compare cost-effectiveness from the United Kingdom National Health Service perspective of three step-up strategies for patients with asthma uncontrolled by inhaled corticosteroid (ICS) monotherapy.

Methods

This was a historical matched cohort cost-effectiveness analysis of anonymized medical records for patients with asthma of age 12–80 years. We conducted two-way comparisons of step-up therapy using increased dose (≥50%) of extrafine-particle ICS or add-on long-acting β2-agonist (LABA) via fixed-dose combination (FDC) ICS/LABA inhaler or via separate inhaler. The …

Knowledge, Attitudes, And Practices Of Florida Physicians Regarding Dengue Before And After An Educational Intervention., Susanne Doblecki-Lewis, Aileen Chang, Renee Jiddou-Yaldoo, Kay M Tomashek, Danielle Stanek, Leena Anil, Paola Lichtenberger

Medicine Faculty Publications

BACKGROUND: Failure to recognize and appropriately manage dengue early in the clinical course may result in late initiation of supportive treatment for severe disease. In Florida, travel-related and autochthonous dengue occur and are likely under-recognized. The objective of this study was to evaluate physician knowledge of dengue and its management before and after an educational intervention in Florida.

METHODS: From 2012-13 we conducted 14 grand-rounds style lectures on dengue clinical management attended by 413 physicians, and analyzed data from the pre- and post-tests.

RESULTS: Of those attending, 231 and 220 completed the pre-and post-tests, respectively. Overall, the mean pre-test score …

The Respiratory Protection Effectiveness Clinical Trial (Respect): A Cluster-Randomized Comparison Of Respirator And Medical Mask Effectiveness Against Respiratory Infections In Healthcare Personnel., Lewis J. Radonovich, Mary T. Bessesen, Derek A.T. Cummings, Aaron Eagan, Charlotte A. Gaydos, Cynthia Gibert, Geoffrey J. Gorse, +8 Additional Authors

Medicine Faculty Publications

BACKGROUND: Although N95 filtering facepiece respirators and medical masks are commonly used for protection against respiratory infections in healthcare settings, more clinical evidence is needed to understand the optimal settings and exposure circumstances for healthcare personnel to use these devices. A lack of clinically germane research has led to equivocal, and occasionally conflicting, healthcare respiratory protection recommendations from public health organizations, professional societies, and experts.

METHODS: The Respiratory Protection Effectiveness Clinical Trial (ResPECT) is a prospective comparison of respiratory protective equipment to be conducted at multiple U.S. study sites. Healthcare personnel who work in outpatient settings will be cluster-randomized to …

Knowledge, Attitudes, And Practices Of Florida Physicians Regarding Dengue Before And After An Educational Intervention., Susanne Doblecki-Lewis, Aileen Chang, Renee Jiddou-Yaldoo, Kay M Tomashek, Danielle Stanek, Leena Anil, Paola Lichtenberger

Medicine Faculty Publications

BACKGROUND: Failure to recognize and appropriately manage dengue early in the clinical course may result in late initiation of supportive treatment for severe disease. In Florida, travel-related and autochthonous dengue occur and are likely under-recognized. The objective of this study was to evaluate physician knowledge of dengue and its management before and after an educational intervention in Florida.

METHODS: From 2012-13 we conducted 14 grand-rounds style lectures on dengue clinical management attended by 413 physicians, and analyzed data from the pre- and post-tests.

RESULTS: Of those attending, 231 and 220 completed the pre-and post-tests, respectively. Overall, the mean pre-test score …

A Point Mutation In Dna Polymerase Β (Polb) Gene Is Associated With Increased Progesterone Receptor (Pr) Expression And Intraperitoneal Metastasis In Gastric Cancer, Xiaohui Tan, Xiaoling Wu, Shuyang Ren, Hongyi Wang, Weaam Alshenawy, Wenmei Li, Jiantao Cui, Guangbin Luo, Robert S. Siegel, Sidney W. Fu, Youyong Lu

Medicine Faculty Publications

Increased expression of progesterone receptor (PR) has been reported in gastric cancer (GC). We have previously identified a functional T889C point mutation in DNA polymerase beta (POLB), a DNA repair gene in GC. To provide a detailed analysis of molecular changes associated with the mutation, human cDNA microarrays focusing on 18 signal transduction pathways were used to analyze differential gene expression profiles between GC tissues with T889C mutant in POLB gene and those with wild type. Among the differentially expressed genes, notably, PR was one of the significantly up-regulated genes in T889C mutant POLB tissues, which were subsequently confirmed in …

Bedside Teaching: An Underutilized Tool In Medical Education, Mohammed Garout, Abudelah Nuqali, Ahmad Alhazmi, Hani Almoallim

Medicine Faculty Publications

No abstract provided.

An Individual With Human Immunodeficiency Virus, Dementia, And Central Nervous System Amyloid Deposition, Raymond Scott Turner, Melanie Chadwick, Wesley A Horton, Gary L. Simon, Xiong Jiang, Giuseppe Esposito

Medicine Faculty Publications

Human immunodeficiency virus (HIV)-associated neurocognitive disorder (HAND) is found in 30%-50% of individuals with HIV infection. To date, no HIV+ individual has been reported to have a positive amyloid PET scan. We report a 71-year-old HIV+ individual with HAND. Clinical and neuropsychologic evaluations confirmed a progressive mild dementia. A routine brain MRI was normal for age. [18F]Fluorodeoxyglucose-PET revealed mild hypermetabolism in bilateral basal ganglia and hypometabolism of bilateral parietal cortex including the posterior cingulate/precuneus. Resting state functional MRI revealed altered connectivity as found with individuals with mild AD. CSF examination revealed a low Aβ42/tau index but a low phospho-tau. An …

Vertebral Metastasis As The Initial Manifestation Of Colon Cancer, Tushina Jain, Renee Williams, Benjamin Liechty, Lea Ann Chen

Medicine Faculty Publications

Oncology guidelines currently recommend against performing colonoscopies in the workup of adenocarcinoma of unknown primary unless colonic malignancy is otherwise suggested by clinical signs or symptoms. We present 2 cases of metastatic colonic adenocarcinoma that presented only with neurologic symptoms from vertebral metastasis. Although bony metastases are a rare presentation of colon cancer and colonoscopy is not warranted in the initial workup of adenocarcinoma of unknown primary, we describe these cases as a reminder that bony metastases do not rule out a colon cancer diagnosis.

Recurrence Of Acute Page Kidney In A Renal Transplant Allograft., Rajan Kapoor, Carlos Zayas, Laura Mulloy, Muralidharan Jagadeesan

Medicine Faculty Publications

Acute Page Kidney (APK) phenomenon is a rare cause of secondary hypertension, mediated by activation of renin-angiotensin-aldosterone system (RAAS). Timely intervention is of great importance to prevent any end organ damage from hypertension. We present a unique case of three episodes of APK in the same renal transplant allograft.

The Synergistic Roles Of Cholecystokinin B And Dopamine D5 Receptors On The Regulation Of Renal Sodium Excretion., Xiaoliang Jiang, Wei Chen, Xing Liu, Zihao Wang, Yunpeng Liu, Robin A Felder, John J Gildea, Pedro A. Jose, Chuan Qin, Zhiwei Yang

Medicine Faculty Publications

Renal dopamine D1-like receptors (D1R and D5R) and the gastrin receptor (CCKBR) are involved in the maintenance of sodium homeostasis. The D1R has been found to interact synergistically with CCKBR in renal proximal tubule (RPT) cells to promote natriuresis and diuresis. D5R, which has a higher affinity for dopamine than D1R, has some constitutive activity. Hence, we sought to investigate the interaction between D5R and CCKBR in the regulation of renal sodium excretion. In present study, we found D5R and CCKBR increase each other's expression in a concentration- and time-dependent manner in the HK-2 cell, the specificity of which was …