Medicine and Health Sciences Commons^™

Trends In Survival Of Chronic Lymphocytic Leukemia Patients In Germany And The Usa In The First Decade Of The Twenty-First Century., Dianne Pulte, Felipe A Castro, Lina Jansen, Sabine Luttmann, Bernd Holleczek, Alice Nennecke, Meike Ressing, Alexander Katalinic, Hermann Brenner

Cardeza Foundation for Hematologic Research

BACKGROUND: Recent population-based studies in the United States of America (USA) and other countries have shown improvements in survival for patients with chronic lymphocytic leukemia (CLL) diagnosed in the early twenty-first century. Here, we examine the survival for patients diagnosed with CLL in Germany in 1997-2011.

METHODS: Data were extracted from 12 cancer registries in Germany and compared to the data from the USA. Period analysis was used to estimate 5- and 10-year relative survival (RS).

RESULTS: Five- and 10-year RS estimates in 2009-2011 of 80.2 and 59.5%, respectively, in Germany and 82.4 and 64.7%, respectively, in the USA were …

Physical Therapy Capstone Posters In The Jefferson Digital Commons, Daniel G. Kipnis, Msi

Jefferson Digital Commons News

New Department of Physical Therapy capstone posters have been loaded in the Jefferson Digital Commons.

Heart Rhythm Monitoring Strategies For Cryptogenic Stroke: 2015 Diagnostics And Monitoring Stroke Focus Group Report., Gregory W. Albers, Richard A. Bernstein, Johannes Brachmann, John Camm, J. Donald Easton, Peter Fromm, Shinya Goto, Christopher B. Granger, Stefan H. Hohnloser, Elaine Hylek, Amir K. Jaffer, Derk W. Krieger, Rod Passman, Jesse M. Pines, Shelby D. Reed, Peter M. Rothwell, Peter R. Kowey

Department of Medicine Faculty Papers

No abstract provided.

Ectopic Mineralization Of Cartilage And Collagen-Rich Tendons And Ligaments In Enpp1asj-2j Mice., Jieyu Zhang, Nathaniel A Dyment, David W Rowe, Sarah Y Siu, John P Sundberg, Jouni Uitto, Qiaoli Li

Department of Dermatology and Cutaneous Biology Faculty Papers

Generalized arterial calcification of infancy (GACI), an autosomal recessive disorder caused by mutations in the ENPP1 gene, manifests with extensive mineralization of the cardiovascular system. A spontaneous asj-2J mutant mouse has been characterized as a model for GACI. Previous studies focused on phenotypic characterization of skin and vascular tissues. This study further examined the ectopic mineralization phenotype of cartilage, collagen-rich tendons and ligaments in this mouse model. The mice were placed on either control diet or the "acceleration diet" for up to 12 weeks of age. Soft connective tissues, such as ear (elastic cartilage) and trachea (hyaline cartilage), were processed …

Presentation: 125 Years Of Nursing At Jefferson, Daniel G. Kipnis, Msi

Jefferson Digital Commons News

Michael Angelo, University Archivist and Special Collections Librarian, presented a webinar to Jefferson Nursing Alumni as part of the Jefferson College of Nursing’s 125th anniversary celebration. Now you can view his image-rich presentation,“From Probationer to Doctorate: 125 Years of Nursing at Jefferson”, in the Jefferson Digital Commons.

Training Emr In Case-Based Curriculum, Anthony J. Frisby, Phd, Steven Herrine, Md, Deborah Ziring, Md

Department of Medicine Posters

Introduction:

The Sidney Kimmel Medical College (SKMC) at Thomas Jefferson University (TJU) is creating a new medical curriculum (JeffMD), in which more learning will take place in small groups and individual activities.

In their small groups, students will focus on core case studies that will become increasingly complex, each building on the prior phase of the curriculum.

Romidepsin For The Treatment Of Relapsed/Refractory Peripheral T Cell Lymphoma: Prolonged Stable Disease Provides Clinical Benefits For Patients In The Pivotal Trial., Francine Foss, Steven Horwitz, Barbara Pro, H Miles Prince, Lubomir Sokol, Barbara Balser, Julie Wolfson, Bertrand Coiffier

Kimmel Cancer Center Faculty Papers

BACKGROUND: Achievement of durable responses in patients with relapsed/refractory peripheral T cell lymphoma (PTCL) is challenging with current therapies, and there are few data regarding the potential benefits of continuing treatment in patients with the best response of stable disease (SD). Histone deacetylase inhibitors are a novel class of drugs with activity in T cell malignancies. Romidepsin was approved by the US Food and Drug Administration for the treatment of relapsed/refractory PTCL based on a pivotal trial demonstrating an objective response rate of 25 % (33/130), including 15 % with confirmed/unconfirmed complete response and a median duration of response of …

Consequential Considerations When Mapping Trna Fragments., Aristeidis G Telonis, Phillipe Loher, Yohei Kirino, Phd, Isidore Rigoutsos

Computational Medicine Center Faculty Papers

We examine several of the choices that went into the design of tDRmapper, a recently reported tool for identifying transfer RNA (tRNA) fragments in deep sequencing data, evaluate them in the context of currently available knowledge, and discuss their potential impact on the output that the tool generates.

Micu1 Regulation Of Mitochondrial Ca(2+) Uptake Dictates Survival And Tissue Regeneration., Anil Noronha Antony, Melanie Paillard, Cynthia Moffat, Egle Juskeviciute, Jason Correnti, Brad Bolon, Emanual Rubin, Md, György Csordás, Erin L Seifert, Jan B. Hoek, György Hajnóczky

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Mitochondrial Ca(2+) uptake through the recently discovered Mitochondrial Calcium Uniporter (MCU) is controlled by its gatekeeper Mitochondrial Calcium Uptake 1 (MICU1). However, the physiological and pathological role of MICU1 remains unclear. Here we show that MICU1 is vital for adaptation to postnatal life and for tissue repair after injury. MICU1 knockout is perinatally lethal in mice without causing gross anatomical defects. We used liver regeneration after partial hepatectomy as a physiological stress response model. Upon MICU1 loss, early priming is unaffected, but the pro-inflammatory phase does not resolve and liver regeneration fails, with impaired cell cycle entry and extensive necrosis. …

Overview Of Bladder Heating Technology: Matching Capabilities With Clinical Requirements., Paul R. Stauffer, Gerard C. Van Rhoon

Department of Radiation Oncology Faculty Papers

Moderate temperature hyperthermia (40-45°C for 1 h) is emerging as an effective treatment to enhance best available chemotherapy strategies for bladder cancer. A rapidly increasing number of clinical trials have investigated the feasibility and efficacy of treating bladder cancer with combined intravesical chemotherapy and moderate temperature hyperthermia. To date, most studies have concerned treatment of non-muscle-invasive bladder cancer (NMIBC) limited to the interior wall of the bladder. Following the promising results of initial clinical trials, investigators are now considering protocols for treatment of muscle-invasive bladder cancer (MIBC). This paper provides a brief overview of the devices and techniques used for …

Bonded Cumomer Analysis Of Human Melanoma Metabolism Monitored By 13c Nmr Spectroscopy Of Perfused Tumor Cells., Alexander A Shestov, Anthony Mancuso, Seung-Cheol Lee, Lili Guo, David S Nelson, Jeffrey C Roman, Pierre-Gilles Henry, Dennis B. Leeper, Ian A Blair, Jerry D Glickson

Department of Radiation Oncology Faculty Papers

A network model for the determination of tumor metabolic fluxes from (13)C NMR kinetic isotopomer data has been developed and validated with perfused human DB-1 melanoma cells carrying the BRAF V600E mutation, which promotes oxidative metabolism. The model generated in the bonded cumomer formalism describes key pathways of tumor intermediary metabolism and yields dynamic curves for positional isotopic enrichment and spin-spin multiplets. Cells attached to microcarrier beads were perfused with 26 mm [1,6-(13)C2]glucose under normoxic conditions at 37 °C and monitored by (13)C NMR spectroscopy. Excellent agreement between model-predicted and experimentally measured values of the rates of oxygen and glucose …

Anterior Cruciate Ligament Injuries In National Football League Athletes From 2010 To 2013: A Descriptive Epidemiology Study., Christopher C Dodson, Eric S Secrist, Suneel B Bhat, Daniel P Woods, Peter F Deluca

Rothman Institute Papers

BACKGROUND: There is a high incidence of anterior cruciate ligament (ACL) injuries among National Football League (NFL) athletes; however, the incidence of reinjury in this population is unknown.

PURPOSE: This retrospective epidemiological study analyzed all publicly disclosed ACL tears occurring in NFL players between 2010 and 2013 to characterize injury trends and determine the incidence of reinjury.

STUDY DESIGN: Descriptive epidemiological study.

METHODS: A comprehensive online search identified any NFL player who had suffered an ACL injury from 2010 to 2013. Position, playing surface, activity, and date were recorded. Each player was researched for any history of previous ACL injury. …

Thyroid Cancer Metabolism: A Review, Kurren Gill, Ba, Patrick Tassone, Md,, James Hamilton, Md, Nikolaus Hjelm, Md, Adam J. Luginbuhl, Md, David Cognetti, Md, Madalina Tuluc, Md, Ubaldo E. Martinez-Outshoorn, Md, Jennifer Johnson, Md, Joseph Curry, Md

Department of Otolaryngology - Head and Neck Surgery Posters

Abstract

Metabolic dysregulation within the tumor microenvironment (TME) is critical to the process of tumorigenesis in various cancer types. Thyrocyte metabolism in papillary and anaplastic thyroid cancer, however, remains poorly characterized, and studies analyzing the role of multicompartment metabolism in thyrocyte oncogenesis are sparse. We present a review of the current knowledge on cellular metabolism in non-cancerous and cancerous thyroid tissues, focusing on the monocarboxylate transporters MCT1 and MCT4, and on a transporter of the outer mitochondrial membrane TOMM20. Understanding the metabolic phenotype of tumor cells and associated stromal cells in thyroid cancer can have profound implications on the use …

Emil Zuckerkandl, M.D. (1849-1910): Bridging Anatomic Study And The Operating Room Table., Leah Winer, Md, Pankhuri Jha, Scott W. Cowan, Md, Charles J. Yeo, Md, Scott D. Goldstein, Md

Department of Surgery Gibbon Society Historical Profiles

In the mid-19th century, the Vienna School of Anatomy was at the epicenter of the rapidly growing field of anatomy. One of the school’s most distinguished professors, Hungarian-born anatomist Emil Zuckerkandl was instrumental in transforming anatomy from a descriptive science to one of practical and clinical value. A prolific researcher interested in nearly all areas of morphology and most famously, the chromaffin system, Zuckerkandl’s discoveries from more than a century ago still provide a foundation for surgeons to this day.

Stabilization Of Microtubule-Unbound Tau Via Tau Phosphorylation At Ser262/356 By Par-1/Mark Contributes To Augmentation Of Ad-Related Phosphorylation And Aβ42-Induced Tau Toxicity., Kanae Iijima-Ando, Akiko Maruko-Otake, Yosuke Ohtake, Motoki Hayashishita, Michiko Sekiya, Koichi M Iijima

Department of Neuroscience Faculty Papers

Abnormal accumulation of the microtubule-interacting protein tau is associated with neurodegenerative diseases including Alzheimer's disease (AD). β-amyloid (Aβ) lies upstream of abnormal tau behavior, including detachment from microtubules, phosphorylation at several disease-specific sites, and self-aggregation into toxic tau species in AD brains. To prevent the cascade of events leading to neurodegeneration in AD, it is essential to elucidate the mechanisms underlying the initial events of tau mismetabolism. Currently, however, these mechanisms remain unclear. In this study, using transgenic Drosophila co-expressing human tau and Aβ, we found that tau phosphorylation at AD-related Ser262/356 stabilized microtubule-unbound tau in the early phase of …

Adiponectin At Physiologically Relevant Concentrations Enhances The Vasorelaxative Effect Of Acetylcholine Via Cav-1/Adipor-1 Signaling., Yunhui Du, Rui Li, Wayne Bond Lau, Jianli Zhao, Bernard Lopez, Theodore A Christopher, Xin-Liang Ma, Yajing Wang

Department of Emergency Medicine Faculty Papers

Clinical studies have identified hypoadiponectinemia as an independent hypertension risk factor. It is known that adiponectin (APN) can directly cause vasodilation, but the doses required exceed physiologic levels several fold. In the current study, we determine the effect of physiologically relevant APN concentrations upon vascular tone, and investigate the mechanism(s) responsible. Physiologic APN concentrations alone induced no significant vasorelaxation. Interestingly, pretreatment of wild type mouse aortae with physiologic APN levels significantly enhanced acetylcholine (ACh)-induced vasorelaxation (P

Effect Of The Time Of Day And Queue Position In The Endoscopic Schedule On The Performance Characteristics Of Endoscopic Ultrasound-Guided Fine-Needle Aspiration For Diagnosing Pancreatic Malignancies., Jason Korenblit, Danielle M Tholey, Joanna Tolin, David Loren, Thomas Kowalski, Douglas G. Adler, Julie Davolos, Ali A. Siddiqui

Division of Gastroenterology and Hepatology Faculty Papers

BACKGROUND AND OBJECTIVES: Recent reports have indicated that the time of day may impact the detection rate of abnormal cytology on gynecologic cytology samples. The aim of this study was to determine if procedure time or queue position affected the performance characteristics of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for diagnosing solid pancreatic malignancies.

PATIENTS AND METHODS: We conducted a retrospective study evaluating patients with solid pancreatic lesions in whom EUS-FNA was performed. Three timing variables were evaluated as surrogate markers for endoscopist fatigue: Procedure start times, morning versus afternoon procedures, and endoscopy queue position. Statistical analyses were performed to determine …

Big Data Transforms Discovery-Utilization Therapeutics Continuum., Scott A. Waldman, Andre Terzic

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Enabling omic technologies adopt a holistic view to produce unprecedented insights into the molecular underpinnings of health and disease, in part, by generating massive high-dimensional biological data. Leveraging these systems-level insights as an engine driving the healthcare evolution is maximized through integration with medical, demographic, and environmental datasets from individuals to populations. Big data analytics has accordingly emerged to add value to the technical aspects of storage, transfer, and analysis required for merging vast arrays of omic-, clinical-, and eco-datasets. In turn, this new field at the interface of biology, medicine, and information science is systematically transforming modern therapeutics across …

Acute Myocardial Infarction Complicated By Cardiogenic Shock: An Algorithm Based Ecmo Program Can Improve Clinical Outcomes., Shinya Unai, Md, Daizo Tanaka, Md, Nicholas Ruggiero, Md, Hitoshi Hirose, Md, Nicholas C. Cavarocchi, Md

Department of Surgery Faculty Papers

Objective: Extracorporeal membrane oxygenation (ECMO) in our institution resulted in near total mortality prior to the establishment of an algorithm-based program in July 2010. We hypothesized that an algorithm based ECMO program improves the outcome of patients with acute myocardial infarction complicated with cardiogenic shock.

Methods: Between March 2003 and July 2013, 29 patients underwent emergent catheterization for acute myocardial infarction due to left main or proximal left anterior descending artery occlusion complicated with cardiogenic shock (defined as systolic blood pressure < 90mmHg despite multiple inotropes, +- balloon pump, lactic acidosis). Of 29 patients, 15 patients were before July 2010 (Group 1, old program), 14 patients were after July 2010 (Group 2, new program).

Results: There were no significant differences in the baseline characteristics, including age, sex, coronary risk factors …

Predicting Revision Following In Situ Ulnar Nerve Decompression For Patients With Idiopathic Cubital Tunnel Syndrome., Michael P. Gaspar, Patrick M. Kane, Dechporn Putthiwara, Sidney M. Jacoby, A. Lee Osterman

Department of Orthopaedic Surgery Faculty Papers

PURPOSE: To determine the incidence of revision and potential risk factors for needing revision surgery following in situ ulnar nerve decompression for patients with idiopathic cubital tunnel syndrome (CTS).

METHODS: We conducted a retrospective chart review of all patients treated at 1 specialty hand center with an open in situ ulnar nerve decompression for idiopathic CTS from January 2006 through December 2010. Revision incidence was determined by identifying patients who underwent additional surgeries for recurrent or persistent ulnar nerve symptoms. Bivariate analysis was performed to determine which variables had a significant influence on the need for revision surgery.

RESULTS: Revision …

Randomized Controlled Trial Of Prolonged Second Stage: Extending The Time Limit Vs Usual Guidelines., Alexis C. Gimovsky, Vincenzo Berghella

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: Guidelines for management of the second stage have been proposed since the 1800s and were created largely by expert opinion. Current retrospective data are mixed regarding differences in maternal and neonatal outcomes with a prolonged second stage. There are no randomized controlled trials that have evaluated whether extending the second stage of labor beyond current American College of Obstetricians and Gynecologists recommendations is beneficial.

OBJECTIVE: The purpose of this study was to evaluate whether extending the length of labor in nulliparous women with prolonged second stage affects the incidence of cesarean delivery and maternal and neonatal outcomes.

STUDY DESIGN: …

Analysis Of Tumor Template From Multiple Compartments In A Blood Sample Provides Complementary Access To Peripheral Tumor Biomarkers., William M Strauss, Chris Carter, Jill Simmons, Erich Klem, Nathan Goodman, Behrad Vahidi, Juan Romero, Michael Masterman-Smith, Ruth O'Regan, Keerthi Gogineni, Lee Schwartzberg, Laura Austin, Paul W Dempsey, Massimo Cristofanilli

Kimmel Cancer Center Faculty Papers

Targeted cancer therapeutics are promised to have a major impact on cancer treatment and survival. Successful application of these novel treatments requires a molecular definition of a patient's disease typically achieved through the use of tissue biopsies. Alternatively, allowing longitudinal monitoring, biomarkers derived from blood, isolated either from circulating tumor cell derived DNA (ctcDNA) or circulating cell-free tumor DNA (ccfDNA) may be evaluated. In order to use blood derived templates for mutational profiling in clinical decisions, it is essential to understand the different template qualities and how they compare to biopsy derived template DNA as both blood-based templates are rare …

Preserving Cognition In Older African Americans With Mild Cognitive Impairment., Barry W. Rovner, Robin J. Casten

Department of Psychiatry and Human Behavior Faculty Papers

No abstract provided.

Pressure To Publish For Residency Applicants In Dermatology, Jordan V. Wang, Matthew S. Keller

Department of Dermatology and Cutaneous Biology Faculty Papers

As it grows increasingly difficult to match into a dermatology residency program each year, there is a widening gap in research accomplishments between those who have and have not matched successfully. Applicants should be aware of the current trends in order to maximize their chances of matching. Such research inequality may subsequently lead to increases in the pressure to publish and the incidence of academic misrepresentation. Academic dermatology programs should be aware of these issues in order to help their students successfully match and exercise caution when reviewing the curricula vitae of applicants. We believe that student mentors in dermatology …

A Call For The Structured Physicist Report, John M. Boone, Phd, Mahadevappa Mahesh, Ms, Phd, Eric L. Gingold, Phd, J. Anthony Seibert, Phd

Department of Radiology Faculty Papers

Introduction:

The field of diagnostic radiology continues to struggle with the clinical adoption of the structured interpretive report, with many radiologists preferring a semistructured, free-text dictation style to a more rigid, highly structured approach that some professional leaders have promoted [1]. Although structured reporting compliance in the radiologist community has been difficult to achieve, diagnostic radiologists have been thinking about and discussing this important issue for many years; it is also a part of the ACR’s Imaging 3.0_ campaign [2]. In the breast imaging community, the well-established BI-RADS_ recommendations produce a very structured report, with a discussion of interpretive findings …

Parp-2 Domain Requirements For Dna Damage-Dependent Activation And Localization To Sites Of Dna Damage., Amanda A Riccio, Gino Cingolani, John M Pascal

Department of Biochemistry and Molecular Biology Faculty Papers

Poly(ADP-ribose) polymerase-2 (PARP-2) is one of three human PARP enzymes that are potently activated during the cellular DNA damage response (DDR). DDR-PARPs detect DNA strand breaks, leading to a dramatic increase in their catalytic production of the posttranslational modification poly(ADP-ribose) (PAR) to facilitate repair. There are limited biochemical and structural insights into the functional domains of PARP-2, which has restricted our understanding of how PARP-2 is specialized toward specific repair pathways. PARP-2 has a modular architecture composed of a C-terminal catalytic domain (CAT), a central Trp-Gly-Arg (WGR) domain and an N-terminal region (NTR). Although the NTR is generally considered the …

Microcystic, Elongated, And Fragmented (Melf) Pattern Invasion In Ovarian Endometrioid Carcinoma: Immunohistochemical Profile And Prognostic Implications, Allison F. Goldberg, Md, Lauren Cooper, Md, D. De Cotiis, Norman G. Rosenblum, Md, Phd, Joanna Chan, Md

Department of Pathology, Anatomy, and Cell Biology Resident's Posters

BACKGROUND

•Microcystic, Elongated and Fragmented (MELF) is a well-recognized pattern of uterine endometrioid carcinoma (UEC) associated with lymphovascular space invasion and occult lymph node metastasis

•MELF in UEC may be seen with Lynch Syndrome

•MELF in UEC is hypothesized to be histologic evidence of an epithelial mesenchymal transition

•MELF pattern invasion in ovarian endometrioid carcinoma (OEC) was first described at USCAP 2015 •

Current study evaluates MELF in OEC for

•Prognostic implications

•Immunohistochemical (IHC) profile related to

•Lynch Syndrome

•Epithelial mesenchymal transition

DESIGN

•42 consecutive cases of OEC without concurrent UEC (1996-2014) evaluated by 2 pathologists

•MELF defined as at …

Methemoglobinemia In Acetaminophen Overdose And Glucose-6-Phosphate Dehydrogenase Deficiency, Maelen Ignacio, Pharmd, Colin Craft, Md, Fern M. Martin, Md, Cara Mcdaniel, Pharmd, Bcps

College of Pharmacy Posters

Background:

• Methemoglobin (MetHb) is formed when the iron moiety of hemoglobin (Hgb) is oxidized from ferrous (Fe²⁺) to ferric (Fe³⁺) state à impaired O₂ delivery to tissues
• Acetaminophen Metabolism:

~90% is metabolized in liver via sulfation and glucuronidation

remainder is metabolized via CYP450 to a toxic oxidizing agent, N-acetyl-p-benzoquinone imine (NAPQI), which is detoxified via glutathione¹

• Acute Acetaminophen Overdose:

saturates sulfation and glucuronidation pathways

depletes glutathione stores

leads to excess NAPQI à oxidative stress à methemoglobinemia¹

• MetHb Reduction Pathway:

cytochrome b5 reductase removes 95% to 99% of endogenous MetHb

nicotinamide adenine dinucleotide phosphate …

C-Src/Cav1-Dependent Activation Of The Egfr By Dsg2., Andrew M. Overmiller, Kathleen P. Mcguinn, Brett J. Roberts, Felicia Cooper, Donna M. Brennan-Crispi, Takahiro Deguchi, Sirkku Peltonen, James K. Wahl, Mỹ G. Mahoney

Department of Dermatology and Cutaneous Biology Faculty Papers

The desmosomal cadherin, desmoglein 2 (Dsg2), is deregulated in a variety of human cancers including those of the skin. When ectopically expressed in the epidermis of transgenic mice, Dsg2 activates multiple mitogenic signaling pathways and increases susceptibility to tumorigenesis. However, the molecular mechanism responsible for Dsg2-mediated cellular signaling is poorly understood. Here we show overexpression as well as co-localization of Dsg2 and EGFR in cutaneous SCCs in vivo. Using HaCaT keratinocytes, knockdown of Dsg2 decreases EGFR expression and abrogates the activation of EGFR, c-Src and Stat3, but not Erk1/2 or Akt, in response to EGF ligand stimulation. To determine whether …

Two Separate Colorectal Granular Cell Tumors: A Case Report, Danica N. Giugliano, Md, Danielle Fortuna, Md, Scott D. Goldstein, Md, Benjamin Philllips, Md, Gerald A. Isenberg, Md

Department of Surgery Posters

Introduction, Case Report, Discussion, Conclusion and References.