Medicine and Health Sciences Commons^™

Rac-1 And Iqgap Are Potential Regulators Of E-Cadherin-Catenin Interactions During Murine Preimplantation Development., David R Natale, Andrew J Watson

Obstetrics & Gynaecology Publications

Adherens junction formation is fundamental for compaction and trophectoderm differentiation during mammalian preimplantation development. We recently isolated an IQGAP-2 cDNA from a differential display-polymerase chain reaction screen of bovine preimplantation developmental stages. IQGAP-1 and -2 proteins mediate E-cadherin-based cell-to-cell adhesion through interactions with beta-catenin and the Rho GTPases, rac1 and cdc42. Our study demonstrates IQGAP-1,-2, rac-1 and cdc42 mRNAs are present throughout murine preimplantation development. IQGAP-1 and rac-1 protein distribution changes from predominantly plasma membrane associated to predominantly cytoplasmic as the embryo progresses through cleavage divisions and compaction to the blastocyst stage.

Post-Chemotherapy Residual Mass In Stage Iic Seminomatous Testicular Tumor, N A. Ahmad, S R. Biyabani, Farhat Abbas

Section of Urology

Introduction

The management of patients with residual masses following chemotherapy for advanced seminoma remains a difficult problem with no clear guidelines. While most patients with advanced seminoma achieve a complete or partial response with cisplatin based chemotherapy¹, a significant number will reveal a residual mass on follow up CT scan or MR imaging^2,3. Management options for post chemotherapy residual mass in a case of seminoma include close observation, radiation therapy and excisional surgery. While 80 to 85% of residual masses represent either fibrosis or necrotic tissue needing no further therapy, 10 to 15% may contain viable …

District Hospital Based Injury Data-Are They An Option In A Developing Country?, Junaid Abdul Razzak, David Marsh, S. Stansfield

Department of Emergency Medicine

No abstract provided.

Symptomatic Granulomatous Prostatitis Following Bacillus Calmette-Guerin Immunotherapy For Bladder Cancer, M A. Noor, S R. Biyabani, I A. Burney, J Talatia

Section of Urology

No abstract provided.

Implementation Of Gy-Eq For Deterministic Effects Limitation In Shield Design, John W. Wilson, Myung-Hee Y. Kim, Giovanni De Angelis, Francis A. Cucinotta, Nobuaki Yoshizawa, Francis F. Badavi

Mathematics & Statistics Faculty Publications

The NCRP has recently defined RBE values and a new quantity (Gy-Eq) for use in estimation of deterministic effects in space shielding and operations. The NCRP's RBE for neutrons is left ambiguous and not fully defined. In the present report we will suggest a complete definition of neutron RBE consistent with the NCRP recommendations and evaluate attenuation properties of deterministic effects (Gy-Eq) in comparison with other dosimetric quantities.

View Box Case--12 Osteomyelitis, I Masroor, R Hashmi

Department of Radiology

No abstract provided.

L’Observation Du Comportement Du Nouveau-Ne: Une Source Pertinente D’Informations Medicales, N. Ratynski, G. Cioni, L. Franck, Yvette Blanchard, J. Sizun

All PTHMS Faculty Publications

L’observation du comportement du nouveau-né est une source importante d’informations d’ordre médical. Trois domaines bénéficient des données de l’observation : 1) l’analyse du développement grâce à l’utilisation de l’Assessment of Preterm Infant Behavior (évaluation du comportement de l’enfant prématuré) ; 2) l’évaluation de la douleur dominée par l’analyse de l’expression faciale grâce à des échelles validées, telle que le Neonatal Facial Coding System (système néonatal de codage facial) ; 3) la recherche de lésions cérébrales par le Quality Assessment of General Movements (évaluation de la qualité des mouvements généraux). L’observation comportementale fondée sur des outils validés par la recherche …

Cancer Patterns In Quetta (1998-1999), Yasmin Bhurgri, Hadi Bhurgri, A. Ajam, Shahid Pervez, S. H. Hasan, A. Usman, J. A. Khan, Q. Kasi, I. Kasi, A. G. Rasool, A. Bhurgri, N. Faridi, J. Malik

Department of Pathology and Laboratory Medicine

Introduction: Quetta, the capital of Baluchistan, is located at latitude 30,25; longitude 67.00. It has a population of 759,245; 425,474 males (56%) and 333,771 females (44%); Census 1998. The majority of residents are Persian or Baluchi speaking Baluchs.

Methodology: The cancer cases from Quetta reported to the Karachi Cancer Registry were reviewed. The data included cases from the Aga Khan University Hospital (AKUH), Pathology Department (Quetta collection point) and health care facilities in Karachi. The residents of Baluchistan were ascertained and cancer cases residents of Quetta identified with the help of recorded addresses and retraceable telephone numbers.

Results: During a …

Leiomyosarcoma Presenting As A Spontaneously Ruptured Renal Tumor-Case Report, Mohammad Moazzam, M Hammad Ather, Akber S. Hussainy

Department of Pathology and Laboratory Medicine

Background:
Ruptured renal neoplasms can be a catastrophic clinical presentation. Angiomyolipoma is the commonest renal tumor which presents in this fashion. Renal sarcomas are rare renal neoplasms. Renal leiomyosarcomas are the most common histological subtype of renal sarcomas, accounting for approximately 50-60% of the reported cases. These tumors are usually peripherally located and appear to arise from either the renal capsule or smooth muscle tissue in the renal pelvic wall.
Case presentation:
A 70 years old male, with hypertension and ischemic disease, developed acute left flank pain. The general physician evaluated this using ultrasound, which showed a solid left renal …

Comparisons Of American, Israeli, Italian And Mexican Physicians And Nurses On The Total And Factor Scores Of The Jefferson Scale Of Attitudes Toward Physician-Nurse Collaborative Relationships, Mohammadreza Hojat, Joseph S. Gonnella, Thomas J. Nasca, Sylvia K. Fields, Americo Cicchetti, Alessandra Lo Scalzo, Francesco Taroni, Anna Maria Vincenza Amicosante, Manuela Macinati, Massimo Tangucci, Carlo Liva, Gualtiero Ricciardi, Schmuel Eidelman, Hanna Admi, Hana Geva, Tanya Mashiach, Gideon Alroy, Adelina Alcorta-Gonzalez, David Ibarra, Antonio Torres-Ruiz

CRMEHC Faculty Papers

This cross-cultural study was designed to compare the attitudes of physicians and nurses toward physician–nurse collaboration in the United States, Israel, Italy and Mexico. Total participants were 2522 physicians and nurses who completed the Jefferson Scale of Attitudes Toward Physician–Nurse Collaboration (15 Likert-type items, (Hojat et al., Evaluation and the Health Professions 22 (1999a) 208; Nursing Research 50 (2001) 123). They were compared on the total scores and four factors of the Jefferson Scale (shared education and team work, caring as opposed to curing, nurses, autonomy, physicians’ dominance). Results showed inter- and intra-cultural similarities and differences among the study groups …

Toxoplasma Gondii Induces Granulocyte Colony-Stimulating Factor And Granulocyte-Macrophage Colony-Stimulating Factor Secretion By Human Fibroblasts: Implications For Neutrophil Apoptosis, Jacqueline Y. Channon, Kristin A. Miselis, Laurie A. Minns, Chaitali Dutta, Lloyd H. Kasper

Dartmouth Scholarship

Human neutrophils are rescued from apoptosis following incubation with once-washed, fibroblast-derived Toxoplasma gondii tachyzoites. Both infected and uninfected neutrophils are rescued, implicating a soluble mediator. In this study we investigated the origin and identity of this soluble mediator. Neutrophils were incubated either with purified tachyzoites or with conditioned medium derived from T. gondii-infected human fibroblasts. Conditioned medium was found to be a potent stimulus that delayed neutrophil apoptosis up to 72 h, whereas purified and extensively washed tachyzoites had no effect. Delayed apoptosis correlated with up-regulation of the neutrophil antiapoptotic protein, Mcl-1, and the neutrophil interleukin 3 receptor alpha subunit …

A Survey Of Health Services And Identification Of Needs For Asian American Elderly Women In The Greater Boston Area, Connie S. Chan, Lin Zhan

Institute for Asian American Studies Publications

Over one hundred Asian American and mainstream health care providers in the greater Boston area were surveyed for this study. The authors have identified critical gaps in services for elderly Asian American women.

View Box Case-11 Synovial Osteochondromatosis With Osteoarthrosis, I Masroor, R Hashmi

Department of Radiology

No abstract provided.

Radiologic Features Of Hallervorden Spatz Disease, K B. Asumal, M Wasay, S N. Ali

Section of Neurology

Hallervorden Spatz Disease is a rare familial neurodegenerative disorder, which primarily affects children but also can occur in adults1 . Major clinical features are abnormal involuntary movements and cognitive impairment2 . Diagnosis is based on clinical and radiological features. The radiological features are hypointense signals in globus pallidus and substantia niagra on MR! of brain3 . Occasionally the pallidal hypointense signals surround hyperintense signals, this is known as “tigereye-sign”4 and is postulated to be specific for Hallervorden Spatz Disease. We report two brothers with such MRI findings.

Electrically Mediated Delivery Of Vector Plasmid Dna Elicits An Antitumor Effect, L. Heller, D. Coppola

Bioelectrics Publications

In vivo electroporation is an efficient means of increasing plasmid DNA delivery to normal tissues, such as skin and muscle, as well as directly to tumors. In the experiments described here, plasmid DNA was delivered by in vivo electroporation to B16 mouse melanomas using two very different pulsing protocols. Reporter expression increased 21- or 42-fold, respectively with electroporation over injection alone. The growth of experimental melanomas with an approximate diameter of 4 mm on the day of treatment was monitored after electroporation delivery of reporter plasmid DNA. Remarkably, short-term complete regressions using one of these pulsing protocols occurred in up …

Clinical And Demographic Characteristics Of Psychiatric Inpatients Admitted Via Emergency And Non-Emergency Routes At A University Hospital In Pakistan, E U. Syed, S Mehmud, R Atiq

Department of Psychiatry

Objective: To examine the differences in the demographic and clinical characteristics of patients admitted through emergency versus non-emergency routes and see if these two groups of patients were significantly different from each other with respect to criteria mentioned in the title.Methods: Retrospective data was analysed in all 2576 patient records were reviewed and these patients were divided in two groups with respect to their mode of admission (emergency vs non emergency). These groups were then compared with respect to sex, age, length of stay, discharge status and diagnostic categories. Statistical package for social sciences version 8.0 (SPSS 8.0) was used …

Comparison Of Fentanyl And Nalbuphine In Total Intravenous Anaesthesia (Tiva), F A. Khan, Hameedullah

Department of Anaesthesia

Objective: To compare Nalbuphine and fentanyl as total intravenous anaesthesia with propofol infusion in laproscopic cholecystectomy cases.STUDY Design: Double blind randomised.Methods: Changes in haemodynamic variables greater than twenty percent above or below the baseline and recovery profile were observed.Results: Blood pressure remained within 20% of baseline in either group. Nine patients in fentanyl and fifteen in nalbuphine group required an additional bolus of propofol intraoperatively. Heart rate response after tracheal intubation was significantly higher in the nalbuphine group (25%). No difference was observed in the incidence of nausea and vomiting in the recovery room. Twenty-seven percent patients in the nalbuphine …

Low Birthweight Babies: Socio-Demographic And Obstetric Characteristics Of Adolescent Mothers At Kenyatta National Hospital, Nairobi, A. Wasunna, K. Mohammed

Paediatrics and Child Health, East Africa

Objective: To compare some socio-demographic and obstetric factors between adolescent mothers (aged below 20 years) and older mothers of low birthweight (birthweight <2000gm) babies.

Design: Cross sectional descriptive study.

Setting: The Newborn Unit of the Kenyatta National Hospital.

Results: Sixty nine adolescent mothers and 73 older mothers were studied. Adolescent mothers were more likely to be unmarried (p 0.0001) have less formal education (p

Morbidity And Outcome Of Low Birthweight Babies Of Adolescent Mothers At Kenyatta National Hospital, Nairobi, A. Wasunna, K. Mohammed

Paediatrics and Child Health, East Africa

Objective: To compare the morbidity and outcome of low birthweight babies (birthweight < 2000gm) of adolescent (age < 20 years) and older mothers.

Design: Cross sectional descriptive study.

Setting: The newborn Unit of the Kenyatta National Hospital. Main outcome measures: All babies weighing less than 2000gm at birth whose mothers consented to the study had their gestational age verified using the Dubowitz scoring system. They were then followed up by daily clinical assessment untill discharge, death or up to one month in the ward. The babies were divided into two groups according to their mother's age and then compared with respect to episodes of illness, duration of hospital stay, and overall …

Electric Field Enhanced Plasmid Delivery To Liver Hepatocellular Carcinomas, Richard Gilbert, Mark J. Jaroszeski, Loree Heller, Richard Heller

Bioelectrics Publications

Electric field enhanced molecular delivery for cancer research and treatment is a new technology that has demonstrated its effectiveness in clinical trials using bleomycin or cisplatin (Heller, R., Gilbert, R., Jaroszeski, M. J. Clinical applications of electrochemotherapy, Advanced Drug Delivery Reviews 35,119-129, 1999), as chemotherapeutic agents. The technology is being investigated in research applications for applicability as a method to enhance gene expression in a target tumor. Success is predicated on an appropriate effective electric field mediated delivery protocol that triggers significant appropriate gene expression duration and levels. An electric field mediated delivery protocol includes a set of conditions …

Respiratory Arrest In A Child After Flushing Of Pancuronium From The Dead Space Of Intravenous Cannula, Robyna Irshad Khan, Fazal Hameed Khan, Hamid Iqil Naqvi

Department of Anaesthesia

It is common practice for patients admitted to Intensive Care Units to have indwelling intravenous cannulae. Sometimes these cannulae are used only for the administration of drugs and are closed otherwise. Residual drugs in the deadspace of these intravenous cannulae as well as connected stoppers or 3-way stopcocks can later be flushed unknowingly. We would like to report a case in which inadvertent flushing of residual pancuronium caused complete muscle paralysis and respiratory arrest in a young child.

Supervised Treatment Interruption (Sti) In An Urban Hiv Clinical Practice: A Prospective Analysis, Joseph L. Yozviak Do, Facp, Peter Kouvatos Do, R Eric Doerfler Np, Cch, William C. Woodward Do

Department of Medicine

Background: In acute HIV-1 infection, STI may induce immunologic control of HIV-1 replication. Several prospective trials of STI in chronic HIV-1 infection have been less encouraging. A previously presented retrospective analysis of our patients showed that in those with a significant CD4 increase (>200 cells) on antiretroviral therapy (ART), 2 or more interruptions may significantly lower viral set point. This prospective study describes STI in a cohort of patients.

Methods: 10 patients with either a positive response to therapy interruption retrospectively or those expressing interest in the strategy who met inclusion criteria (VL BLQ on ART, good adherence, robust …

Depression In The Elderly: Primary Care Practice Fact Sheet #2, Eastern Agency On Aging, University Of Maine Center On Aging, Aroostook Area Agency On Aging, Senior Spectrum, Rosscare, Norumbega Medical, Horizons Health Services, Indian Township Tribal Health Center, Bucksport Regional Health Center

Maine Center on Aging Service and Consultation

Depression is the most common psychiatric disorder that is seen in individuals over the age of 65. The National Institute of Health Consensus Statement concluded that only ten percent of older individuals needing psychiatric treatment actually receive this service. Suicide is common in these individuals, and when recognized and treated, clinical depression can be manages in over 80 percent of cases. The primary care practitioner should ensure that the family caregivers regularly see and speak to their older relatives in order to check in on well-being and recognize possible symptoms of depression.

Physician Empathy: Definition, Components, Measurement, And Relationship To Gender And Specialty, Mohammadreza Hojat, Joseph S. Gonnella, Thomas J. Nasca, Salvatore Mangione Md, Michael Vergare, Michael Magee

CRMEHC Faculty Papers

OBJECTIVE: There is a dearth of empirical research on physician empathy despite its mediating role in patient-physician relationships and clinical outcomes. This study was designed to investigate the components of physician empathy, its measurement properties, and group differences in empathy scores.

METHOD: A revised version of the Jefferson Scale of Physician Empathy (with 20 Likert-type items) was mailed to 1,007 physicians affiliated with the Jefferson Health System in the greater Philadelphia region; 704 (70%) responded. Construct validity, reliability of the empathy scale, and the differences on mean empathy scores by physicians’ gender and specialty were examined.

RESULTS: Three meaningful factors …

Clinical And Epidemiological Correlates Of Genotypes Within The Mycobacterium Avium Complex Defined By Restriction And Sequence Analysis Of Hsp65, Sandra C. Smole, Fionnuala Mcaleese, Jutamas Ngampasutadol, C. Fordham Von Reyn, Robert D. Arbeit

Dartmouth Scholarship

Species identification of isolates of the Mycobacterium avium complex (MAC) remains a difficult task. Although M. avium and Mycobacterium intracellulare can be identified with expensive, commercially available probes, many MAC isolates remain unresolved, including those representing Mycobacterium lentiflavum as well as other potentially undefined species. PCR restriction analysis (PRA) of the hsp65 gene has been proposed as a rapid and inexpensive approach. We applied PRA to 278 MAC isolates, including 126 from blood of human immunodeficiency virus (HIV)-infected patients, 59 from sputum of HIV-negative patients with chronic obstructive pulmonary disease, 88 from environmental sources, and 5 pulmonary isolates from …

Role Of Imaging In The Evaluation Of Renal Trauma, M H. Ather, M A. Noor

Section of Urology

No abstract provided.

The Gamma-Subunit Of The Na-K-Atpase As A Potential Regulator Of Apical And Basolateral Na+-Pump Isozymes During Development Of Bovine Pre-Attachment Embryos., L C Barcroft, S E Gill, A J Watson

Obstetrics & Gynaecology Publications

Expression and activity of the Na-K-ATPase within the basolateral membrane domains of the trophectoderm epithelium provide the driving force for accumulation of Na(+) and Cl(-) across the nascent epithelium, mediating fluid movement into the forming blastocoel. Within the trophectoderm of the bovine blastocyst, multiple isozymes of the Na-K-ATPase are expressed. Immunolocalization has demonstrated that the alpha1-isozyme localizes within the basolateral membrane, whereas the alpha 3-isozyme localizes to the apical cell margins. Gene-specific RT-PCR and wholemount indirect immunofluorescence confocal laser scanning microscopy were used to examine expression of the Na-K-ATPase gamma-subunit (a regulatory subunit of the Na-K-ATPase) throughout development of bovine …

View Box Case--9 Bronchiectasis, I Masroor, R Hashmi

Department of Radiology

No abstract provided.

Histiocytosis X Of The Vulva, R M. Rizvi, C Nasreen, N Jafri

Department of Obstetrics & Gynaecology

No abstract provided.

Comparative Study--Efficacy, Safety And Compliance Of Intravenous Iron Sucrose And Intramuscular Iron Sorbitol In Iron Deficiency Anemia Of Pregnancy, A Wali, A Mushtaq, Nilofer

Department of Obstetrics & Gynaecology

Objective: (1) To determine an alternative iron supplementation with better efficacy, compliance & safety in treatment of iron deficiency anemia during pregnancy, (2) to reduce blood transfusion during pregnancy, labor and puerperium.
Material and Method: A prospective comparative study. A total number of 60 pregnant women with the gestational age of 12 - 34 weeks were included in the study who were suffering from iron deficiency anemia. They were divided in 3 groups (A, B and C). Group A (n15) received intravenous iron sucrose according to recommended dose containing 500 mg of iron sucrose for storage, in group B (n=20) …