Medicine and Health Sciences Commons^™

Organophosphate Retinopathy, Hang Pham, Michelle D. Lingao, Anuradha Ganesh, Jenina E. Capasso, Rosanne Keep, Karthikeyan A. Sadagopan, Alex V. Levin

Wills Eye Hospital Papers

Organophosphates have rarely been reported to cause various ocular sequelae including retinal degeneration. Retinal manifestations have been rarely reported and poorly characterized. We describe a case of a 76-year-old man with vision loss beginning in his 20s due to acute on chronic exposure to dimethoate, an organophosphate. He presented with bilateral geographic macular atrophy and midperipheral pigmentary clumping which we characterized by dilated fundoscopic examination, optical coherence tomography, and fundus autofluorescence.

Modified Appleby Procedure With Arterial Reconstruction For Locally Advanced Pancreatic Adenocarcinoma: A Literature Review And Report Of Three Unusual Cases., Jessica A. Latona, Kathleen M. Lamb, Michael J. Pucci, Warren R. Maley, Charles J. Yeo

Department of Surgery Faculty Papers

BACKGROUND: Pancreatic body and tail ductal adenocarcinomas are often diagnosed with local vascular invasion of the celiac axis (CA) and its various branches. With such involvement, these tumors have traditionally been considered unresectable. The modified Appleby procedure allows for margin negative resection of some such locally advanced tumors. This procedure involves distal pancreatectomy with en bloc splenectomy and CA resection and relies on the presence of collateral arterial circulation via an intact pancreaticoduodenal arcade and the gastroduodenal artery to maintain prograde hepatic arterial perfusion. When the resultant collateral circulation is inadequate to provide sufficient hepatic and gastric arterial inflow, arterial …

Evaluation Of A Pacap Peptide Analogue Labeled With (68)Ga Using Two Different Chelating Agents., Pardeep Kumar, Sushil Kumar Tripathi, Chang-Po Chen, Neil Mehta, Bishnuhari Paudyal, Eric Wickstrom, Mathew L. Thakur

Department of Radiology Faculty Papers

OBJECTIVE: The authors have conjugated chelating agents (DOTA and NODAGA) with a peptide (pituitary adenylate cyclase-activating peptide [PACAP] analogue) that has a high affinity for VPAC1 receptors expressed on cancer cells. To determine a suitable chelating agent for labeling with (68)Ga, they have compared the labeling kinetics and stability of these peptide conjugates.

METHODS: For labeling, (68)GaCl3 was eluted in 0.1 M HCl from a [(68)Ge-(68)Ga] generator. The influences of peptide concentration, pH, and temperature on the radiolabeling efficiency were studied. The stability was evaluated in saline, human serum, DTPA, transferrin, and metallic ions (FeCl3, CaCl2, and ZnCl2). Cell binding …

Grace Spena, Grace Spena, Kelsey Duinkerken

Jefferson Nursing Oral Histories

Grace Spena grew up with an interest in health sciences, first wanting to be a medical laboratory technologist and later a registered nurse after attending an open house on nursing at Saint Agnes Hospital, where she volunteered as a teenager. Upon completing her education in 1971 from the Jefferson Diploma School of Nursing, Ms. Spena began her career as a Staff Nurse in the Surgical ICU at Jefferson Hospital. She then went to Medical College of Pennsylvania, working as a Staff Nurse in the combined Medical/Surgical ICU and later as the Head Nurse of the 3 West Medical/Surgical unit. After …

New Grand Round Presentations In Jdc, Daniel G. Kipnis, Msi

Jefferson Digital Commons News

January 2016 is off to a great start for the Jefferson Digital Commons with a wide variety of Grand Rounds already archived. Be prepared for the next blizzard and enjoy one or more of the following:

Eileen Healy Garrity, Eileen Healy Garrity, Kelsey Duinkerken

Jefferson Nursing Oral Histories

Eileen Garrity’s first draw to the medical field came through her interest in Christiaan Barnard’s work as a cardiac surgeon. After deciding to pursue nursing instead of medicine, Ms. Garrity entered the Jefferson School of Nursing’s Diploma program, graduating in 1976. She began her career as an ER and ICU nurse, working at Atlantic City Medical Center, Pennsylvania Hospital, and Mercy Fitzgerald. She eventually left hospital nursing to work at Blue Cross, ending there as the manager of their risk programs department before moving on to Taylor Hospital as a director of social work case management and later manager of …

Antimetabolite Ttl-315 Selectively Kills Glucose-Deprived Cancer Cells And Enhances Responses To Cytotoxic Chemotherapy In Preclinical Models Of Cancer., James Duhadaway, George C Prendergast

Kimmel Cancer Center Faculty Papers

Maintaining thiol homeostasis is an imperative for cancer cell survival in the nutrient-deprived microenvironment of solid tumors. Despite this metabolic vulnerability, a selective approach has yet to be developed to disrupt thiol homeostasis in solid tumors for therapeutic purposes. In this study, we report the identification of 2-mercaptopropionyl glycine disulfide (TTL-315) as a novel antimetabolite that blocks cell survival in a manner conditional on glucose deprivation. In the presence of glucose, TTL-315 lacks cytotoxic effects in normal cells where it is detoxified by reduction to 2-mercaptopropionyl glycine, a compound with known clinical pharmacologic and safety profiles. In several rodent models …

Breanne Ward, Breanne Ward, Kelsey Duinkerken

Jefferson Nursing Oral Histories

Though she originally decided to become an accountant during college, Breanne Ward soon realized she would rather be in a field where she could work more closely with people. She chose nursing because she wanted the opportunity to physically care for others. Ms. Ward was accepted as a nursing student in Jefferson’s Full-time Accelerated Coursework Track (FACT) program, during which time she discovered an interest in community health through both her non-hospital clinical experiences and volunteering with Jeff HEALTH (Helping East Africa Link To Health). After working in the Thomas Jefferson University Hospital and completing her Master’s in Community Systems …

Pat Owens, Pat Owens, Kelsey Duinkerken

Jefferson Nursing Oral Histories

From a young age Pat Owens had a strong interest in nursing, and as a high school student she was even the President of her school’s Future Nurses Club. However, she also really liked home economics so when she went to college she decided to pursue home economics rather than nursing. After working as at the Dairy Council as a nutrition consultant and later at Campbell’s Soup in their test kitchen, Ms. Owens decided that she wanted to instead pursue a career in nursing. After looking into different programs in the Philadelphia area, she chose Jefferson, entering in 1990 and …

Biodistribution And Pharmacokinetics Study Of Sirna-Loaded Anti-Ntsr1-Mab-Functionalized Novel Hybrid Nanoparticles In A Metastatic Orthotopic Murine Lung Cancer Model., Maryna Perepelyuk, Chellappagounder Thangavel, Yi Liu, Robert B. Den, Bo Lu, Adam E. Snook, Sunday A. Shoyele

Department of Radiation Oncology Faculty Papers

Small interfering RNA (siRNA) is effective in silencing critical molecular pathways in cancer. The use of this tool as a treatment modality is limited by lack of an intelligent carrier system to enhance the preferential delivery of this molecule to specific targets in vivo. In the present study, the in vivo behavior of novel anti-NTSR1-mAb-functionalized antimutant K-ras siRNA-loaded hybrid nanoparticles, delivered by i.p. injection to non-small-cell lung cancer in mice models, was investigated and compared to that of a naked siRNA formulation. The siRNA in anti-NTSR1-mAb-functionalized hybrid nanoparticles was preferentially accumulated in tumor-bearing lungs and metastasized tumor for at least …

Neural Substrate Expansion For The Restoration Of Brain Function., H Isaac Chen, Dennis Jgamadze, Mijail Serruya, D Kacy Cullen, John A Wolf, Douglas H Smith

Department of Neurology Faculty Papers

Restoring neurological and cognitive function in individuals who have suffered brain damage is one of the principal objectives of modern translational neuroscience. Electrical stimulation approaches, such as deep-brain stimulation, have achieved the most clinical success, but they ultimately may be limited by the computational capacity of the residual cerebral circuitry. An alternative strategy is brain substrate expansion, in which the computational capacity of the brain is augmented through the addition of new processing units and the reconstitution of network connectivity. This latter approach has been explored to some degree using both biological and electronic means but thus far has not …

Reducing Gastrointestinal Anastomotic Leak Rates: Review Of Challenges And Solutions, Benjamin Philllips

Department of Surgery Faculty Papers

Various techniques and interventions have been developed in an effort to obviate gastrointestinal anastomotic leaks. This review is intended to delineate potential modifications that can be made to reduce the risk of anastomotic leaks following gastrointestinal surgery. It may also serve to aid in identifying patients who are at increased risk of anastomotic leak. Modifiable risk factors for leak discussed include malnutrition, smoking, steroid use, bowel preparation, chemotherapy, duration of surgery, use of pressors, intravenous fluid administration, blood transfusion, and surgical anastomotic technique. Based upon literature review, operative techniques should include minimizing operative time, reducing ischemia, and utilizing stapled anastomoses. …

Cannibalism, Kuru, And Mad Cows: Prion Disease As A "Choose-Your-Own-Experiment" Case Study To Simulate Scientific Inquiry In Large Lectures., Antonio Serrano, Jeffrey Liebner, Justin K Hines

Department of Medicine Faculty Papers

Despite significant efforts to reform undergraduate science education, students often perform worse on assessments of perceptions of science after introductory courses, demonstrating a need for new educational interventions to reverse this trend. To address this need, we created An Inexplicable Disease, an engaging, active-learning case study that is unusual because it aims to simulate scientific inquiry by allowing students to iteratively investigate the Kuru epidemic of 1957 in a choose-your-own-experiment format in large lectures. The case emphasizes the importance of specialization and communication in science and is broadly applicable to courses of any size and sub-discipline of the life sciences.

Cloning And Transcriptional Activity Of The Mouse Omi/Htra2 Gene Promoter., Dan Liu, Xin Liu, Ye Wu, Wen Wang, Xin-Liang Ma, Huirong Liu

Department of Medicine Faculty Papers

HtrA serine peptidase 2 (HtrA2), also named Omi, is a pro-apoptotic protein that exhibits dramatic changes in expression levels in a variety of disorders, including ischemia/reperfusion injury, cancer, and neurodegeneration. In our study, Omi/HtrA2 protein levels were high in the heart, brain, kidney and liver, with elevated heart/brain expression in aging mice. A similar expression pattern was observed at the mRNA level, which suggests that the regulation of Omi/HtrA2 is predominately transcriptional. Promoter binding by transcription factors is the main influencing factor of transcription, and to identify specific promoter elements that contribute to the differential expression of mouse Omi/HtrA2, we …

Obesity-Induced Colorectal Cancer Is Driven By Caloric Silencing Of The Guanylin-Gucy2c Paracrine Signaling Axis., Jieru E. Lin, Francheska Colon-Gonzalez, Erik S. Blomain, Gilbert W. Kim, Amanda Aing, Brian Stoecker, Justin Rock, Adam E. Snook, Tingting Zhan, Terry M. Hyslop, Michal Tomczak, Richard S. Blumberg, Scott A. Waldman

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Obesity is a well-known risk factor for colorectal cancer but precisely how it influences risks of malignancy remains unclear. During colon cancer development in humans or animals, attenuation of the colonic cell surface receptor guanylyl cyclase C (GUCY2C) that occurs due to loss of its paracrine hormone ligand guanylin contributes universally to malignant progression. In this study, we explored a link between obesity and GUCY2C silencing in colorectal cancer. Using genetically engineered mice on different diets, we found that diet-induced obesity caused a loss of guanylin expression in the colon with subsequent GUCY2C silencing, epithelial dysfunction, and tumorigenesis. Mechanistic investigations …

Mary Greenwood Schaal, Mary Greenwood Schaal, Kelsey Duinkerken

Jefferson Nursing Oral Histories

Dr. Schaal graduated from Jefferson’s Nursing Diploma Program in 1963 and received her BSN from Jefferson in 1981. Though she started her career as an operating room nurse she soon discovered an interest in public health. After coming back to Jefferson for her Bachelor’s degree and then going on to the University of Pennsylvania for her Master’s degree and Rutgers for her Doctorate, she began teaching Community Health to nursing students at Rutgers in Camden. Dr. Schaal then went on to teach in MCP Hahnemann’s graduate program, which is now Drexel, before coming back to Thomas Jefferson University and ending …

Epigenetic Repression Of Pdz-Lim Domain-Containing Protein 2 Promotes Ovarian Cancer Via Nos2-Derived Nitric Oxide Signaling., Linjie Zhao, Chuan Yu, Shengtao Zhou, Wayne Bond Lau, Bonnie Lau, Zhongyue Luo, Qiao Lin, Huiliang Yang, Yu Xuan, Tao Yi, Xia Zhao, Yuquan Wei

Department of Emergency Medicine Faculty Papers

Ovarian cancer constitutes one of the most lethal gynaecological malignancies worldwide and currently no satisfactory therapeutic approaches have been established. Therefore, elucidation of molecular mechanisms to develop targeted therapy of ovarian cancer is crucial. PDLIM2 is critical to promote ubiquitination of nuclear p65 and thus its role in inflammation has been highlighted recently. We demonstrate that PDLIM2 is decreased in both ovarian high-grade serous carcinoma and in various human ovarian cancer cell lines compared with normal ovary tissues and human ovarian surface epithelial cells (HOSE). Further functional analysis revealed that PDLIM2 is epigenetically repressed in ovarian cancer development and inhibition …

Multiplatform Molecular Profiling Identifies Potentially Targetable Biomarkers In Malignant Phyllodes Tumors Of The Breast., Zoran Gatalica, Semir Vranic, Anatole Ghazalpour, Joanne Xiu, Idris Tolgay Ocal, John Mcgill, Ryan P Bender, Erin Discianno, Aaron Schlum, Souzan Sanati, Juan P. Palazzo, Sandeep Reddy, Barbara Pockaj

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Malignant phyllodes tumor is a rare breast malignancy with sarcomatous overgrowth and with limited effective treatment options for recurrent and metastatic cases. Recent clinical trials indicated a potential for anti-angiogenic, anti-EGFR and immunotherapeutic approaches for patients with sarcomas, which led us to investigate these and other targetable pathways in malignant phyllodes tumor of the breast. Thirty-six malignant phyllodes tumors (including 8 metastatic tumors with two cases having matched primary and metastatic tumors) were profiled using gene sequencing, gene copy number analysis, whole genome expression, and protein expression. Whole genome expression analysis demonstrated consistent over-expression of genes involved in angiogenesis including …

Reduction Of Ctrp9, A Novel Anti-Platelet Adipokine, Contributes To Abnormal Platelet Activity In Diabetic Animals., Wenqing Wang, Wayne Bond Lau, Yajing Wang, Xin-Liang Ma, Rong Li

Department of Medicine Faculty Papers

Platelet hyper-reactivity is a crucial cause of accelerated atherosclerosis increasing risk of thrombotic vascular events in diabetic patients. The mechanisms leading to abnormal platelet activity during diabetes are complex and not fully defined. The current study attempted to clarify the role of CTRP9, a novel adiponectin paralog, in enhanced platelet activity and determined whether CTRP9 may inhibit platelet activity. Adult male C57BL/6 J mice were randomized to receive high-fat diet (HFD) or normal diet (ND). 8 weeks after HFD, animals were sacrificed, and both plasma CTRP9 and platelet aggregation were determined. HFD-fed animals increased weight gain significantly, and became hyperglycemic …

Factors Contributing To Nonadherence To Follow-Up Appointments In A Resident Glaucoma Clinic Versus Primary Eye Care Clinic., Scott J Fudemberg, Brian Lee, Michael Waisbourd, Rachel A Murphy, Yang Dai, Benjamin E Leiby, Lisa A Hark

Wills Eye Hospital Papers

PURPOSE: To determine the rate of adherence to follow-up appointment recommendations in a resident glaucoma clinic with no mechanism for reminders, compared to a resident cataract and primary eye care (CPEC) clinic in which telephone reminders were used, and to identify factors that contribute to adherence in each patient group.

METHODS: This retrospective cohort study included subjects in the CPEC clinic who received telephone reminders and those in the glaucoma clinic who did not. Each sample was selected to have a similar proportion of follow-up recommendations for 1, 3, and 6 months. Subjects were considered adherent if they returned within …

In-Silico Identification Of Prognostically Inversely Correlated Mirnas And Mrnas (Pic’S) In Multiple Cancers, Chirayu Pankaj Goswami, Zi-Xuan Wang

Department of Pathology, Anatomy, and Cell Biology Posters

Despite numerous methods available to identify potential mRNA targets for miRNAs, prognostic relationship of these molecules in diseases like cancers where deregulation of gene expression is a major pathogenic factor, has not yet been emphasized. We performed in-silico identification of prognostically inversely correlated miRNA - mRNA pairs (PIC’s) in multiple cancers using expression data from The Cancer Genome Atlas. Partners in a PIC show inverse correlation of expression and opposite hazard implication. Using a three step approach, we identified a total of 1,253,443 PIC’s from 23 cancer types, several of which have previously been shown to have a predicted or …

Effectiveness Of A New Method For Endotracheal Tube Pilot Balloon Repair, Amir C. Dayan, Md, Richard H. Epstein, Md

Department of Anesthesiology Posters

Introduction:

• An intact pilot balloon is crucial to proper function of a cuffed endotracheal tube (ETT).
• Failure of the pilot balloon or disruption of the inflation tubing results in cuff deflation which may lead to inadequate ventilation and aspiration of oropharyngeal secretions.
• We describe a method that we employed using readily available components to repair a pilot balloon and inflation tubing, and report on the effectiveness of the repair method, as tested in vitro.

Health Care Providers Advice Not To Smoke And Quit Attempts Among Mid-Adolescent Smokers, Russell K. Mcintire, Phd, Mph

College of Population Health Posters

Background

• Nearly 1 out of 7 U.S. adolescents is a current cigarette smoker by the time they leave high school. ¹
• Although almost one third of adolescents who saw a healthcare provider in the past month were advised to quit or avoid tobacco,² research on the influence of provider advice on quit attempts among adolescent smokers has shown mixed results. ³
• These results may be due to selection bias—adolescent smokers who get advice may be different from those who do not on a range of factors including age of initiation, smoking frequency, attitudes toward smoking, exposure to other anti-tobacco …

Jefferson Digital Commons Quarterly Report: October-December 2015, Daniel G. Kipnis, Msi, Kelsey Duinkerken, Msi, James Copeland, Libt

Jefferson Digital Commons Reports

This quarterly report includes:

• What People are Saying Link & Bepress Blog post

• JDC Inventory by Year Link

• New Podcast from Radiation Oncology

• Top 5 most downloaded assets added in 2015

• Assorted assets added this quarter

Feedback: Helping Learners Grow, Nina Mingioni, Md, Tasha Kouvatsos, Md

Medical Education Teaching Tools

Learning Objectives

1. Understand the role of feedback in medical education
2. Learn several models for delivering feedback
3. Develop list of go-to activities that would prompt feedback delivery
4. Practice feedback delivery skills

Historical Marker Commemorating Founding Of Medical Library Association In Philadelphia Unveiled!, Daniel G. Kipnis, Msi

Academic Commons and Scott Memorial Library Staff Papers and Presentations

On Wednesday, November 4, 2015, the Pennsylvania Historical and Museum Commission, MLA and the Philadelphia Regional Chapter of MLA unveiled a historical marker commemorating MLA's founding in 1898.

Exercise Beliefs During Pregnancy In A Predominantly Low-Income, Urban Minority Population, Lindsay S. Mcalpine, Msiii, Christine A. Marschilok, Pgy-3, Amber S. Maratas, Md, Jeremy D. Close, Md

CwiC Posters

In 2002, and reaffirmed in 2009, The American College of Obstetricians and Gynecologists recommended that healthy pregnant women exercise for at least thirty minutes most days of the week. Exercise during a healthy pregnancy is safe and has many maternal and fetal benefits. Identified benefits include management of weight gain, improvement in mood, and preparation for labor. Previous research has evaluated women’s beliefs and practices of exercise in pregnancy, but it has focused on affluent, ethnic majority populations. This survey study was performed to assess beliefs about exercise in pregnancy in a predominantly low-income, urban minority population.

Turn-Around-Time Improvements For Positive Blood Cultures From Incorporation Of Workflow Modifications, Brent Bobik, Allison F. Goldberg, Md, P. Prior, Amity L. Roberts, Phd, D(Abmm)

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

Background:

Emergence of direct from positive blood culture bottle identification (ID) methods reveal opportunities for improving bacterial ID and select resistance marker detection turn-around-times. Each system has various advantages and disadvantages; each institution must select the method/s that best fit the laboratory and patient needs. Here we elucidate improvements in 24 hour workflow through incorporating multiple rapid technologies for positive blood culture ID into a 24 hour algorithm.

Methods:

MALDI-TOF (Bruker) analysis with sepsityper extraction (aerobic Gram-positive and anaerobic bacteria); MALDI-TOF analysis with serum separator tube concentration (Gram-negative bacteria); and a FilmArray Blood Culture Panel (Biofire) were utilized. MALDI was …

Recurrence Of Ganglion Cysts Following Re-Excision, Lindsay S. Mcalpine, Msiii, Juana Medina, Md, Nayoung Kim, Bs, Michael Rivlin, Md

CwiC Posters

Previous studies have examined the recurrence of ganglion cysts after surgical excision at a rate of 4 to 40%. However, recurrence after revision surgical excision is unknown. The purpose of this study was to define the incidence of recurrent ganglion cysts in patients who underwent a 2nd excisional procedure.

Preparation And Biological Activity Of The Monoclonal Antibody Against The Second Extracellular Loop Of The Angiotensin Ii Type 1 Receptor, Mingming Wei, Chengrui Zhao, Suli Zhang, Li Wang, Huirong Liu, Xin-Liang Ma

Department of Medicine Faculty Papers

No abstract provided.