Medicine and Health Sciences Commons^™

Symptom Clusters In Acute Myocardial Infarction: A Secondary Data Analysis, Catherine J. Ryan, Holli A. Devon, Rob Horne, Kathleen B. King, Kerry A. Milner, Debra K. Moser, Jill R. Quinn, Anne Rosenfeld, Seon Young Hwang, Julie J. Zerwic

Nursing Faculty Publications

Background: Early recognition of acute myocardial infarction (AMI) symptoms and reduced time to treatment may reduce morbidity and mortality. People having AMI experience a constellation of symptoms, but the common constellations or clusters of symptoms have yet to be identified.
Objectives: To identify clusters of symptoms that represent AMI.
Methods: This was a secondary data analysis of nine descriptive, cross-sectional studies that included data from 1,073 people having AMI in the United States and England. Data were analyzed using latent class cluster analysis, an atheoretical method that uses only information contained in the data.
Results: Five distinct clusters of symptoms …

Three-Portal Technique For Anterior Cruciate Ligament Reconstruction: Use Of A Central Medial Portal, Steven B. Cohen, Freddie H. Fu

Department of Orthopaedic Surgery Faculty Papers

Standard endoscopic reconstruction of the anterior cruciate ligament (ACL) is performed with the use of 2 arthroscopic portals. The surgical error most commonly associated with ACL reconstruction is improper positioning of the tunnel. Errors in femoral tunnel position may be related to poor visualization of the lateral wall. When anatomic double-bundle ACL reconstruction is performed, proper visualization of the lateral wall is essential to ensure correct placement of both tunnels. We propose the use of a central portal, in addition to more standard anterolateral and anteromedial portals, to enhance visualization of the lateral wall. In addition, the arthroscope can be …

Perioperative Management Of Pheochromocytoma: Anaesthetic Implications, Aliya Ahmed

Department of Anaesthesia

Pheochromocytoma is a catecholamine producing tumour that can cause severe hypertension and other systemic disturbances. The perioperative management of pheochromocytoma remains a complicated anaesthesia challenge requiring intensive preoperative preparation and vigilant intraoperative and postoperative care. In this article the perioperative management of pheochromocytoma is reviewed by first summarizing its pathophysiology, clinical aspects and diagnosis, then highlighting the preoperative optimization of the patient and finally describing the intraoperative and postoperative anaesthetic management in the light of the current information.

An Ergonomic Assessment Of A Customer Service Organisation, Victor Hrymak

Articles

An ergonomic assessment of a customer services organisation was carried out. The nethodology is described and the results presented together with recommendations

Dogs Spermatozoa Labelling With 99mtc-Hmpao, Kaywalee Chatdarong, Eva Axnér, Bernt Jones, Catharina Linde Forsberg

The Thai Journal of Veterinary Medicine

The study was aimed at finding out whether dog sperm could be labelled using 99mTc-HMPAO and finding the optimum incubation temperature and amount of 99mTc-HMPAO to label spermatozoa from fresh ejaculates and from frozen-thawed semen. A radiopharmaceutical was prepared by reconstituting 0.5 mg of HMPAO with 5 ml pertechnetate solution containing 100 kBq 99mTc. Semen samples were obtained from three dogs, pooled and divided into aliquots containing 100x106 spermatozoa each. Fresh and frozen-thawed semen samples were used. In experiment 1, the fresh and frozen-thawed spermatozoa were incubated with 99mTc-HMPAO at 20oC or 37oC for 20 min. In experiment 2, 0.01, …

Congenital Oesophageal Stenosis In A Puppy, Churee Pramatwinai

The Thai Journal of Veterinary Medicine

An extremely rare case of congenital oesophageal stenosis in a two-month-old, male, miniature pincher dog was reported. The puppy was presented at the Small Animal Teaching Hospital, Faculty of Veterinary Science, Chulalongkorn University, with a history of an acute onset of regurgitation at the time of weaning on to solid food. Contrast radiography of the oesophagus showed that the oesophagus at the cervical and thoracic-inlet portions was moderately dilated. Upon oesophagoscopic examination, the oesophageal lumen adjacent to the heart base showed intraluminal stenosis. The mucosa was normal and the stenotic opening was localized at the center of the lumen. Upon …

Endoscopic Management Of Biliary Leaks After Open And Laparoscopic Cholecystectomy, Mohammad Salih, Saeed Hamid, Hasnain Ali Shah, Zaigham Abbas, Wasim Jafri

Section of Gastroenterology

Objective: To evaluate the diagnostic and therapeutic efficacy of ERCP in the management of biliary leaks.Methods: The study recruited 35 out of total 436 ERCP patients with post surgical biliary leaks, who presented to our department between January 1, 2001 and September 30, 2004. Unsuccessful ERCP and/or completely transected CBD injuries were handed over to surgery.Results: ERCP was successful in 33 (94%) patients. Of these 25 (75%) had cystic stump leaks, 3 (9%) had transected CBD, 2 (6%) had leakage from gall bladder (GB) bed, 2 (6%) had persistently draining T-tube with retained CBD stones and one (3%) patient had …

Expression Of The Neural Stem Cell Markers Ng2 And L1 In Human Angiomyolipoma: Are Angiomyolipomas Neoplasms Of Stem Cells?, So Dug Lim, William Stallcup, Benjamin Lefkove, Baskaran Govindarajan, Kit Sing Au, Hope Northrup, Deborah Lang, David E Fisher, Avani Patel, Mahul B Amin, Jack L Arbiser

Faculty, Staff and Student Publications

Angiomyolipomas are benign tumors of the kidney which express phenotypes of smooth muscle, fat, and melanocytes. These tumors appear with increased frequency in the autosomal dominant disorder tuberous sclerosis and are the leading cause of morbidity in adults with tuberous sclerosis. While benign, these tumors are capable of provoking life threatening hemorrhage and replacement of the kidney parenchyma, resulting in renal failure. The histogenesis of these tumors is currently unclear, although currently, we believe these tumors arise from "perivascular epithelioid cells" of which no normal counterpart has been convincingly demonstrated. Recently, stem cell precursors have been recognized that can give …

Aldosterone-Induced Sgk1 Relieves Dot1a-Af9-Mediated Transcriptional Repression Of Epithelial Na+ Channel Alpha, Wenzheng Zhang, Xuefeng Xia, Mary Rose Reisenauer, Timo Rieg, Florian Lang, Dietmar Kuhl, Volker Vallon, Bruce C Kone

Faculty, Staff and Student Publications

Aldosterone plays a major role in the regulation of salt balance and the pathophysiology of cardiovascular and renal diseases. Many aldosterone-regulated genes--including that encoding the epithelial Na+ channel (ENaC), a key arbiter of Na+ transport in the kidney and other epithelia--have been identified, but the mechanisms by which the hormone modifies chromatin structure and thus transcription remain unknown. We previously described the basal repression of ENaCalpha by a complex containing the histone H3 Lys79 methyltransferase disruptor of telomeric silencing alternative splice variant a (Dot1a) and the putative transcription factor ALL1-fused gene from chromosome 9 (Af9) as well as the release …

Severe Aortic And Arterial Aneurysms Associated With A Tgfbr2 Mutation, Scott A Lemaire, Hariyadarshi Pannu, Van Tran-Fadulu, Stacey A Carter, Joseph S Coselli, Dianna M Milewicz

Faculty, Staff and Student Publications

BACKGROUND: A 24-year-old man presented with previously diagnosed Marfan's syndrome. Since the age of 9 years, he had undergone eight cardiovascular procedures to treat rapidly progressive aneurysms, dissection and tortuous vascular disease involving the aortic root and arch, the thoracoabdominal aorta, and brachiocephalic, vertebral, internal thoracic and superior mesenteric arteries. Throughout this extensive series of cardiovascular surgical repairs, he recovered without stroke, paraplegia or renal impairment.

INVESTIGATIONS: CT scans, arteriogram, genetic mutation screening of transforming growth factor beta receptors 1 and 2.

DIAGNOSIS: Diffuse and rapidly progressing vascular disease in a patient who met the diagnostic criteria for Marfan's syndrome, …

Functional Taxonomy Of Bacterial Hyperstructures, Vic Norris, Tanneke Den Blaauwen, Armelle Cabin-Flaman, Roy H Doi, Rasika Harshey, Laurent Janniere, Alfonso Jimenez-Sanchez, Ding Jun Jin, Petra Anne Levin, Eugenia Mileykovskaya, Abraham Minsky, Milton Saier, Kirsten Skarstad

Faculty, Staff and Student Publications

The levels of organization that exist in bacteria extend from macromolecules to populations. Evidence that there is also a level of organization intermediate between the macromolecule and the bacterial cell is accumulating. This is the level of hyperstructures. Here, we review a variety of spatially extended structures, complexes, and assemblies that might be termed hyperstructures. These include ribosomal or "nucleolar" hyperstructures; transertion hyperstructures; putative phosphotransferase system and glycolytic hyperstructures; chemosignaling and flagellar hyperstructures; DNA repair hyperstructures; cytoskeletal hyperstructures based on EF-Tu, FtsZ, and MreB; and cell cycle hyperstructures responsible for DNA replication, sequestration of newly replicated origins, segregation, compaction, and …

Impact Of Morbid Obesity On Outcome Of Laparoscopic Splenectomy., Edward P Dominguez, Yong U Choi, Bradford G Scott, Alan M. Yahanda Md, Facs, Edward A Graviss, John F Sweeney

PCI Publications and Projects

BACKGROUND: Because of the obesity epidemic, surgeons are operating on morbidly obese patients in increasing numbers. The aim of this study was to evaluate the impact of morbid obesity on the outcome of laparoscopic splenectomy.

METHODS: The study group consisted of 120 consecutive patients who underwent laparoscopic splenectomy for benign and malignant disease from March 1996 to May 2005. These patients were retrospectively divided into three groups. Group 1 had a body mass index (BMI) < 30. Group 2 patients had a BMI > or = 30 and < 40 and were considered obese. Group 3 had a BMI > or = 40 and were considered morbidly obese. Data including surgical approach (laparoscopic vs. hand-assisted), operative time, conversion rate, estimated blood …

Strategies For The Control Of Respiratory Disease, Stanley Done

The Thai Journal of Veterinary Medicine

This is a paper about common sense and respiratory disease using information that has been known for some time i.e. historical, and which is not accessed when a literary search is supplied by a computer. Respiratory disease in pigs has its most serious effects in the finishing stages, when the sequelae to progressive atrophic rhinitis, enzootic pneumonia and Actinobacillosis are most severe. Nowadays this relatively simple position is even more complicated by the worldwide occurrence of porcine reproductive and respiratory syndrome (PRRS) and porcine circovirus type 2 (PCV-2)-associated diseases principally PMWS where no vaccination is practised. Up to 80% of …

The Molecular Identification Of Mycoplasma Haemofelis And Mycoplasma Haemominutum In Cats Suffering From Haemoplasmosis In Thailand, Sudchit Chungpivat, Meena Sarikaputi, Supparin Jirasukprasert, Siriluk Jenchangkol, Nareerat Viseshakul

The Thai Journal of Veterinary Medicine

Haemotrophic Mycoplasma is the obligatory bacteria formerly classified to the genus Haemobartonella. This blood mycoplasma is responsible for the cause of a cat disease, haemoplasmosis or feline infectious anemia (FIA). The housed cats evidenced by cachexia, high fever and a certain degree of anemic condition have been reported with FIA worldwide. However, this disease is only a presumptive case in Thailand where the disease is presumably endemic. We examined two cats suffering from FIA tested with the standard microscopic examination. With the destruction of erythrocytes, one cat had only a mild clinical condition while the other was severe. The parasitized …

Pathological Study Of Helicobacter Spp. Infection In Pig Stomachs, Nopadon Pirarat, Veerasak Sada, Supradit Wangnaitham, Boonmee Sunyasootcharee

The Thai Journal of Veterinary Medicine

pathological study of Helicobacter spp. infection in pigs was performed to determine the incidence of Helicobacter spp. infection, and to define the relationship between Helicobacter spp. infection and the histopathological changes of gastric mucosa in pigs, using Warthin Starry stain and immunohistochemistry. A total of 115 biopsies of the cardia, fundus, body and pyloric antrum of swine (mean weight 150 kg) obtained from slaughterhouses in Nakornpathom province (Thailand) were investigated. Histopathological results of the cardia region showed thickening of mucosa 54.78% (63/115), vacuolated degeneration of the epithelium 83.47% (96/115), lymphoid aggregation 74.78% (86/115), inflammatory cells infiltration 38.26% (44/115) and neovascularized …

Ecg Quiz, Chollada Buranakarl, Kris Angkanaporn

The Thai Journal of Veterinary Medicine

No abstract provided.

Ophthalmology Snapshot, Nalinee Tuntivanich

The Thai Journal of Veterinary Medicine

No abstract provided.

Ultrasound Diagnosis, Phiwipha Kamonrat

The Thai Journal of Veterinary Medicine

No abstract provided.

Editor’S Note, Roongroje Thanawongnuwech

The Thai Journal of Veterinary Medicine

No abstract provided.

What Is Your Diagnosis?, Pranee Tuntivanich, Suwicha Chuthatep

The Thai Journal of Veterinary Medicine

No abstract provided.

Proceedings Of The 6th Chulalongkorn University Veterinary Annual Conference 26-27 April 2007, Roongroje Thanawongnuwech

The Thai Journal of Veterinary Medicine

No abstract provided.

A Day In The Life Of Pubmed: Analysis Of A Typical Day's Query Log, Jorge R Herskovic, Len Y Tanaka, William Hersh, Elmer V Bernstam

Faculty, Staff and Student Publications

OBJECTIVE: To characterize PubMed usage over a typical day and compare it to previous studies of user behavior on Web search engines. DESIGN: We performed a lexical and semantic analysis of 2,689,166 queries issued on PubMed over 24 consecutive hours on a typical day. MEASUREMENTS: We measured the number of queries, number of distinct users, queries per user, terms per query, common terms, Boolean operator use, common phrases, result set size, MeSH categories, used semantic measurements to group queries into sessions, and studied the addition and removal of terms from consecutive queries to gauge search strategies. RESULTS: The size of …

K1 Protein Of Human Herpesvirus 8 Suppresses Lymphoma Cell Fas-Mediated Apoptosis, Suizhao Wang, Shu Wang, Hoyoung Maeng, Daniel P Young, Om Prakash, Luis E Fayad, Anas Younes, Felipe Samaniego

Faculty, Staff and Student Publications

Expression of the K1 gene of human herpesvirus 8 activates nuclear factor-kappaB and induces lymph node hyperplasia and lymphomas in transgenic mice. To further delineate its role in cell survival, we determined whether K1 altered apoptosis of lymphoma cells. K1 protein is expressed in Kaposi sarcoma and primary effusion lymphoma. We retrovirally transfected BJAB lymphoma, THP-1, U937, and Kaposi sarcoma SLK cells to express K1 and a K1 mutant with the deleted immunoreceptor tyrosine-based activation motif (K1m). We challenged cells with an agonistic anti-Fas antibody, Fas ligand, irradiation, and tumor necrosis factor-related apoptosis-inducing ligand. K1 transfectants but not K1m transfectants …

Imaging Of Pulmonary Embolism And T-Pa Therapy Effects Using Mdct And Liposomal Iohexol Blood Pool Agent: Preliminary Results In A Rabbit Model, Stephen J Burke, Ananth Annapragada, Eric A Hoffman, Emmanuel Chen, Ketan B Ghaghada, Jered Sieren, Edwin J R Van Beek

Faculty, Staff and Student Publications

RATIONALE AND OBJECTIVES: Polyethylene glycol-coated liposomal blood pool contrast agents maintain contrast enhancement over several hours. This study aimed to evaluate (long-term) imaging of pulmonary arteries, comparing conventional iodinated contrast with a liposomal blood pool contrast agent. Also, visualization of the (real-time) therapeutic effects of tissue plasminogen activator (t-PA) on pulmonary embolism (PE) was attempted. MATERIALS AND METHODS: Six rabbits (weight approximately 4 kg) had autologous blood clots injected through the superior vena cava. Imaging was performed using conventional contrast (iohexol, 350 mg I/ml; GE HealthCare, Princeton, NJ) at a dose of 1400 mg I per animal, and after wash-out, …

Untangling The Signalling Wires, Boris N. Kholodenko Phd, Dsci

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Mitogen-activated protein kinase (MAPK) cascades process myriads of stimuli, generating receptor-specific cellular outcomes. New work exploits emergent mathematics of network inference to reveal distinct feedback designs of the RAF/MEK/ERK cascade induced by two different growth factors. It shows that response specificity can arise from differential signal-induced wiring of overlapping protein networks.

Rotator Cuff Contusions Of The Shoulder In Professional Football Players: Epidemiology And Magnetic Resonance Imaging Findings, Steven B. Cohen, Jeffrey D. Towers, James P. Bradley

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: No published reports have studied the epidemiology and magnetic resonance imaging findings associated with rotator cuff contusions of the shoulder in professional football players.

PURPOSE: To determine a single professional football team's incidence, treatment, and magnetic resonance imaging appearance of players sustaining rotator cuff contusions of the shoulder.

STUDY DESIGN: Case series; Level of evidence, 4.

METHODS: From 1999 to 2005, a North American professional football team's injury records were retrospectively reviewed for athletes who had sustained a rotator cuff contusion of the shoulder during in-season participation. Those patients who had magnetic resonance imaging of the shoulder with a …

Releasing Individually Identifiable Microdata With Privacy Protection Against Stochastic Threat: An Application To Health Information, Robert Garfinkel, Ram Gopal, Steven M. Thompson

Management Faculty Publications

The ability to collect and disseminate individually identifiable microdata is becoming increasingly important in a number of arenas. This is especially true in health care and national security, where this data is considered vital for a number of public health and safety initiatives. In some cases legislation has been used to establish some standards for limiting the collection of and access to such data. However, all such legislative efforts contain many provisions that allow for access to individually identifiable microdata without the consent of the data subject. Furthermore, although legislation is useful in that penalties are levied for violating the …

Assessing The Unreliability Of The Medical Literature: A Response To "Why Most Published Research Findings Are False", Steven Goodman, Sander Greenland

Johns Hopkins University, Dept. of Biostatistics Working Papers

A recent article in this journal (Ioannidis JP (2005) Why most published research findings are false. PLoS Med 2: e124) argued that more than half of published research findings in the medical literature are false. In this commentary, we examine the structure of that argument, and show that it has three basic components:

1)An assumption that the prior probability of most hypotheses explored in medical research is below 50%.

2)Dichotomization of P-values at the 0.05 level and introduction of a “bias” factor (produced by significance-seeking), the combination of which severely weakens the evidence provided by every design.

3)Use of Bayes …

Commentary: The Daubert Decision, Robert L. Brent

The Selected Works of Robert Brent

No abstract provided.

Adaptation Of Lean Methodologies For Healthcare Applications, Heather (Woodward) Hagg, Deanna Suskovich, Jamie Workman-Germann, Susan Scachitti, Brian Hudson, Joseph Swartz, Chris Vanni

RCHE Publications

Lean and Six Sigma quality concepts and terminology have been applied in the manufacturing arena since the late 1980’s and early 1990’s. It has only been in recent years that healthcare administrators have identified these methods as being adaptable to their organizations so that they may realize organizational improvements for continuing success and delighting customers. Unfortunately, this is not an application that is widely taught in typical Industrial Engineering curriculum and therefore there are few educated professionals coming right out of college that are able to apply these principles to healthcare. There are however, many experienced professionals knowledgeable in the …