Medicine and Health Sciences Commons^™

Modulation Of Lipid Metabolism By Phytosterol Stearates And Black Raspberry Seed Oils, Mark Mckinley Ash

Department of Nutrition and Health Sciences: Dissertations, Theses, and Student Research

Naturally occurring compounds and lifestyle modifications as combination and mono-therapy are increasingly used for dyslipidemia. Specficially, phytosterols and fatty acids have demonstrated an ability to modulate cholesterol and triglyceride metabolism in different fashions. In two separate studies, the lipid-lowering effects of black raspberry seed oil and three different phytosterol stearates were examined in order to elucidate the effects of these dietary components and the factors influencing their therapeutic actions.

The first study examined high cholesterol diets supplemented with crude and refined black raspberry seed oils, coconut oil or soybean oil. The crude and refined raspberry seed oil (RSO) treatments significantly …

กรณีศึกษาการฟ้องร้องแพทย์กรณี “ดอกรัก”, ณัฐ ตันศรีสวัสด์ิ

Chulalongkorn Medical Journal

No abstract provided.

Treatment Outcome Of Stage Ic Ovarian Clear Cell Carcinoma Compared To Non-Clear Cell Type, Y Thaweekul, R Lertkhachonsuk, N Khemapech, T Manchana, N Sirisabya, P Worasethsin, A Vasuratna, T. Tul Sittisomwong, W Termrungruanglert, D. Tresukosol

Chulalongkorn Medical Journal

Objective : The aim was to evaluate the treatment outcome of stage Ic clear cell carcinoma of the ovary compared to that of non-clear cell carcinoma of the same stage. Methods : Having searched the tumor registry database of the Department of Obstetrics and Gynecology, King Chulalongkorn Memorial Hospital from June 1997- December 2002, we enrolled all patients with stage Ic (according to FIGO staging criteria) clear cell carcinoma who underwent complete surgical staging procedure. Patients with non-clear cell adenocarcinoma of the ovary were enrolled by the same criteria as control group. They all received postoperative adjuvant chemotherapy with single-agent …

Cervical Disc Dimensions Of The Thai Population, U Wandee, P Itiravivong, T Tejapongvorachai, P. Tangpornprasert

Chulalongkorn Medical Journal

Problem : The incidence of complications in cervical disc arthroplasty was 6.2% per treat level. Perioperative kyphosis, heterotopic ossification and migration may occur be due to undersized prosthesis. Measurement of the dimensions of cervical discs of the Thai population was aimed to be a pilot study to know the estimation of the dimensions of cervical discs that could be referred to the size of disc prosthesis devices. Objective : To provide data regarding the diamension of cervical discs dimensions that can be used in Thailand for preoperative planning and design of cervical disc prosthesis in Thailand. Study design : Descriptive …

Comparisons Of Pharmacokinetic Parameters Of Valproic Acid Between Responsive And Resistant Adult Epileptic, D Panomvana, L Boonmark, T Sriboonruang, S. Towanabut

Chulalongkorn Medical Journal

Objectives : To determine whether there are valproic acid (VPA) pharmacokinetic (PK) parameters differences between the VPA-responsive and VPA-resistant patient groups. Methods : Thirty-three subjects (14 patients were in VPA-resistant group and 19 patients in VPA-responsive group) who were epileptic patients were recruited from the Neurology Clinic, Neurology Institute, Bangkok. Their ages were 15 - 65 years old. They were either treated with VPA (Depakine Chrono) monotherapy or polytherapy in which the combined drug did not have the same metabolic pathways as VPA. At steady state condition, two blood samples were collected from the subjects during elimination phase, approximately five …

A Systematic Review Of Autologous Stem Cell Therapy In Female Stress Urinary Incontinence, S Bunyavejchevin, T Manchana, P Supphanimitcharoenporn, P Kanoksil, M Intharapinthuwat, M Rujiwarodom, M Komolvichit, M. Sudsuriya, M Tungnunthawiwat, Y Siripakarn

Chulalongkorn Medical Journal

Background : Stress urinary incontinence (SUI) is uncontrolable leakage of urine, induced by physical activities such as coughing and laughing. The prevalence of SUI is going to increase. In addition, the quality of life in those patients is much lower than that of normal people. Objectives : To determine the effect of autologous stem cell therapy in female SUI. This review assesses clinical outcome of autologous stem cell therapy compared with other techniques. Design : Retrospective study. Materials and Methods : Selection criteria: all randomized controlled trials and clinical controlled-trials that compared effectiveness between injections of autologous stem cells and …

Neonatal Outcomes Associated With Maternal Treatment For Graves' Disease, P Thaithumyanon, S. Punnahitananda

Chulalongkorn Medical Journal

Background : Both the status of maternal Graves' disease and the methods of treatment can cause a variety of impacts on their fetuses and newborn infants. Objective : To determine the clinical outcome and thyroid function test (TFT) of the infants born to the women who have been diagnosed with Graves' disease. Methods : The study was performed on the infants born to mothers with Graves' disease at King Chulalongkorn Memorial Hospital between April 1999 and March 2006. They were examined and tested for serum FT4 or T4 and TSH levels at age > 48 hours (screening tests). Infants suspected of …

Effects Of Polycystic Ovary Syndrome On Female Reproduction, P. Sirayapiwat

Chulalongkorn Medical Journal

สตรีที่มีภาวะ Polycystic ovary syndrome (PCOS) มีลักษณะอาการทางคลินิกที่หลากหลายและเกี่ยวข้องกับการทำงานของอวัยวะหลายระบบ แต่ระบบที่มีความเกี่ยวข้องหลัก คือระบบสืบพันธุ์สตรีและระบบเมตาบอลิสม ซึ่งปัจจุบันเป็นที่ทราบกันว่าพยาธิกำเนิดของ PCOS คือภาวะฮอร์โมนเพศชายในเลือดสูง และภาวะดื้อต่ออินซูลิน ทำให้เกิดอาการทั้งระยะสั้น ได้แก่ ความผิดปกติของรอบระดู ภาวะมีบุตรยาก มีสิว ขนดก ศีรษะล้านแบบเพศชาย และผลระยะยาว ได้แก่ เบาหวานชนิดที่ 2และมะเร็งเยื่อบุโพรงมดลูก นอกจากนี้ยังอาจเพิ่มความเสี่ยงต่อโรคหัวใจและหลอดเลือด ในบทความนี้จะรวบรวมเกี่ยวกับผลของ PCOS ที่มีต่อภาวะเจริญพันธุ์ของสตรีทั้งในระยะสั้นและระยะยาวรวมทั้งการรักษา นอกจากนี้ ยังรวบรวมเกี่ยวกับ PCOS ในสตรีวัยรุ่นที่พบมากขึ้น และมีความสำคัญทั้งในแง่การวินิจฉัย และการรักษา เนื่องจากภาวะนี้จะส่งผลต่อสุขภาพในระยะยาว จึงเพิ่มความเสี่ยงหากเริ่มเป็นตั้งแต่อายุน้อย.

Mental Health And Coping Styles Among Adolescent Offsprings Of Patients With Depressive Disorders, J Prownebon, U. Trangkasombat

Chulalongkorn Medical Journal

วัตถุประสงค์ : เพื่อศึกษาภาวะสุขภาพจิต วิธีจัดการกับปัญหา และปัจจัยที่เกี่ยวข้องในบุตรวัยรุ่นของผู้ป่วยโรคซึมเศร้ากลุ่มตัวอย่าง : บุตรวัยรุ่นของผู้ป่วยโรคซึมเศร้าที่มารับการรักษาที่แผนกผู้ป่วยนอก โรงพยาบาลจุฬาลงกรณ์และโรงพยาบาลศรีธัญญา จำนวน 61 คนระเบียบวิธีการวิจัย : โดยใช้แบบสอบถามข้อมูลทั่วไป แบบสอบถามดัชนีชี้วัดสุขภาพจิต คนไทยฉบับสั้น (TMHI-15 ) และแบบสอบถามวิธีจัดการกับปัญหา วิเคราะห์ข้อมูลโดยใช้โปรแกรมทางสถิติ SPSS ที่ระดับนัยสำคัญ P<.05ผลการศึกษา : 1) ผลการศึกษาพบว่ากลุ่มตัวอย่างส่วนใหญ่มีภาวะสุขภาพจิตอยู่ในระดับดีเท่ากับค่าเฉลี่ยของคนทั่วไป (ร้อยละ 39.3) 2) วิธีจัดการกับปัญหาที่กลุ่มตัวอย่างส่วนใหญ่เลือกใช้บ่อยมากที่สุด ได้แก่ การนอนหลับ (ร้อยละ 80.3)วิธีที่เลือกใช้บ่อยน้อยที่สุด ได้แก่ ไปหาผู้เชี่ยวชาญในการให้คำปรึกษาอื่น ๆเช่น จิตแพทย์ นักจิตวิทยา (ร้อยละ 93.4) 3) ส่วนวิธีจัดการกับปัญหาที่เกี่ยวข้องกับคะแนนสุขภาพจิตอย่างมีนัยสำคัญทางสถิติ เช่น การวาดฝันถึงสิ่งอยากจะให้มี อยากจะให้เป็น และการพยายามใช้เหตุผลและพูดคุยประนีประนอมกับบิดามารดา เป็นต้น 4) ปัจจัยอื่น ๆ ที่เกี่ยวข้องกับคะแนนสุขภาพจิตอย่างมีนัยสำคัญทางสถิติ เช่น คะแนนเฉลี่ยสะสม ระดับการศึกษาของบิดา บุคคลที่ปรึกษาเมื่อมีเรื่องที่ไม่สบายใจ ความสัมพันธ์กับบิดาความสัมพันธ์กับมารดา การทำกิจกรรมร่วมกันในครอบครัว จำนวนเพื่อนสนิทและความสัมพันธ์โดยรวมกับเพื่อน ๆผลสรุป : บุตรวัยรุ่นของผู้ป่วยโรคซึมเศร้าส่วนใหญ่มีมีภาวะสุขภาพจิตเท่ากับค่าเฉลี่ยของคนทั่วไป จึงควรมีการสนับสนุน ปัจจัยและวิธีจัดการกับปัญหาที่เกี่ยวข้องกับการมีสุขภาพจิตดีให้มีประสิทธิภาพมากขึ้น เพื่อช่วยส่งเสริมให้วัยรุ่นที่มีบิดามารดาป่วยเป็นโรคซึมเศร้าประสบความสำเร็จ.

Pattern Of Injury In Child Fatalities Resulting From Child Abuse, วาทิตต์ รุจิราวรรณ

Chulalongkorn Medical Journal

No abstract provided.

Goal Directed Learning: Early Assessment And Individualized Education Plans For Family Medicine Interns, Glenda Stockwell, Beth Anne Fox, Reid Blackwelder

ETSU Faculty Works

• Articulate rationale for early assessment
• Describe process of assessment and feedback sessions
• List benefits of process based on:
  • Objective data
  • Opinion of interns over past 2 years

Workshop Enhances Clinical Faculty Development, Joseph F. Lipscomb, Crna, Ms

College of Nursing Faculty Papers & Presentations

Enhanced clinical faculty teaching strategies and skills. Consistent approaches to clinical education. Increased faculty and student satisfaction. Positive student outcomes. Strengthened alliance with clinical affiliates.

Basal Insulin Requirements On Continuous Subcutaneous Insulin Infusion During The First 12 Months After Diagnosis Of Type 1 Diabetes Mellitus., Neesha Ramchandani, Mary Kristine Ellis, Shobhit Jain, Sonal Bhandari, Henry Anhalt, Noel K. Maclaren, Svetlana Ten

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: While the endogenous first-phase insulin response has disappeared by the time of diagnosis of type 1 diabetes mellitus (T1DM), anecdotal evidence suggests that these patients can continue to have a second-phase insulin response during the first 12 months after diagnosis. We hypothesized that patients who are started on continuous subcutaneous insulin infusion (CSII) at the time of diagnosis of T1DM would have a lower basal insulin requirement than the 40-60% usually expected.

METHODS: We analyzed 38 patients with T1DM, age 9.9 +/- 6.4 years, 71% male, who were started on CSII within the first month of diagnosis.

RESULTS: Average …

Inspired Gas-Induced Vascular Change In Tumors With Magnetic-Resonance-Guided Near-Infrared Imaging: Human Breast Pilot Study, Colin M. Carpenter, Rebecca Rakow-Penner, Shudong Jiang, Bruce L. Daniel, Brian W. Pogue, Gary H. Glover, Keith D. Paulsen

Dartmouth Scholarship

This study investigates differences in the response of breast tumor tissue versus healthy fibroglandular tissue to inspired gases. Cycles of carbogen and oxygen gas are administered while measuring the changes with magnetic-resonance-guided near-infrared imaging in a pilot study of breast cancers. For two patients, analyses are performed with cross-correlation techniques, which measure the strength of hemodynamic modulation. The results show that the overall vasoresponse, indicated by total hemoglobin, of healthy tissue has approximately a 72% and 41% greater correlation to the gas stimulus than the tumor region, in two patients respectively, when background physiological changes are controlled. These data support …

Evaluation Of Medication Effects On Academic Performance, Sleep, And Core Adhd Symptoms In Children, Tina K. Head

Dissertations

Idiosyncratic effects of Vyvanse™ (lisdexamfetamine dimesylate) and placebo were evaluated in a double-blind alternating treatments experimental design in this 4-week study. Direct, objective measures were combined with traditional behavior ratings to provide data sets to assess whether or not the prescribed stimulant medication showed detectable therapeutic effects for a child whose positive response to medication was not obvious via traditional subjective methods. Effects of medication on core ADHD symptoms, academic performance, and sleep in four children ages 10-12 with attention deficit/ hyperactivity disorder. Potential side effects were also measured. Daily measures included parent rating scales, side effects checklist, sleep journal …

Weight Discrimination: Why Current Perceptions Need To Change, Kelsey Rae Eller

Undergraduate Honors Capstone Projects

Discrimination based on weight has been labeled the last form of socially acceptable prejudice. Weight discrimination is becoming more and more prevalent in schools, the workplace, social settings, the media, and even in healthcare. Overweight and obese individuals are often stereotyped as lazy, addicted to food, and lacking self-discipline and initiative, and as a result may struggle with decreased employment opportunities, fear and shame in public, attempting dangerous weight loss methods, or even eating disorders.

This project seeks to identify and examine research that has been done on this subject in order to increase awareness of weight bias and to …

Female Condom Knowledge, Attributes And Behavior: Barriers To Use And Potential For Acceptance Among Sexually Active Undergraduate Students, Paige Nuzzolillo 6368479

Honors Scholar Theses

Minimal research has been conducted on the acceptability of the female condom among college populations despite its existence in the world market since 1992. The FC2, an improved version of FC1, has recently been released in the United States, thus prompting the need for further acceptability studies. Due to increasingly high rates of STDs among those aged 15-24, every method of protection against STDs/HIV and pregnancy must be utilized. This study involved a campus-wide survey which examined University of Connecticut (Uconn) main campus (Storrs) undergraduate students’ knowledge of the female condom, perceptions of and attitudes towards the female condom as …

Knowledge Transfer In Public School Food Service: Post-Implementation Of The Process Approach To Haccp Food Safety System, Lydia Rebecca Frass

Dissertations

Based on Havelock's (Havelock & University of Michigan. Center for Research on Utilization of Scientific Knowledge, 1969) Knowledge Transfer Model and using Kirkpatrick's Training Evaluation Model (1996a, 1996b) levels of Reaction, Behavior, and Learning, this study analyzed knowledge transfer between public school district managers, cafeteria managers, and line workers. These employees were trained through cascade training methods during the federally mandated implementation of the Process Approach to HACCP food safety system beginning in the 2005-2006 school year.

Measuring Behavior, an Observation Checklist (based on HACCP's 7 steps and 10 FDA food borne illness risk factors and interventions) was used to …

Evolution Of The Sensory Integration Frame Of Reference., Roseann C. Schaaf, Patricia L. Davies

Department of Occupational Therapy Faculty Papers

No abstract provided.

Tamoxifen: Mechanisms Of Resistance, Cyrus Mccoy Adams

Theses and Dissertations (ETD)

The role of estrogen in breast cancer has been recognized for decades. The selective estrogen receptor modulator tamoxifen was the first targeted therapy for the treatment of breast cancer. It was also the first drug approved by the FDA for the reduction of breast cancer risk. While tamoxifen has extended the lives of countless patients with breast cancer, resistance to tamoxifen remains a significant clinical problem. Work over the last two decades has greatly enhanced our understanding of the molecular mechanisms by which breast cancer cells may become resistant to tamoxifen treatment. Here I review our current understanding of the …

Systems Biology Approach To Identifying Host Interactive Pathways Modulating The Severity Of Streptococcal Sepsis, Nourtan Fatthy Abdeltawab

Theses and Dissertations (ETD)

Clinical outcomes of infectious diseases are controlled by complex interactions between the host and the pathogen. Epidemiological, genetic and molecular studies in my mentor’s laboratory provided evidence that in invasive Group A streptococcal (GAS) infections, genetic variations in both bacteria and patients influenced the severity of GAS sepsis. Allelic variations in class II human leukocyte antigens (HLA) contributed significantly to differences in the severity of group A streptococcal sepsis caused by the same virulent strain of the bacteria. HLA class II molecules present streptococcal superantigens (SAgs) to T cells, and variations in HLA class II molecules can strongly influence SAg …

A Survey Of Treatment Characteristics In A University-Based Graduate Orthodontic Program, A. Brian Anderson

Theses and Dissertations (ETD)

While there are a few national surveys on malocclusion in the U.S., few reports characterize actual orthodontic patients and their treatments. The purpose of this study was to describe the patients and their treatment at a university based orthodontic department, namely the University of Tennessee Health Science Center, Memphis. The goals of this study are: (1) to research patient demographics, dental and skeletal relationships and treatment variables; (2) to test for temporal trends in these patients and their treatment across a 26 year interval from 1980 to 2005; and (3) to assess the correlations among patient demographics, dental and skeletal …

The Design And Synthesis Of Novel Antimicrobial Agents For Use In The Battle Against Bacterial Resistance, Joshua Randal Brown

Theses and Dissertations (ETD)

There is an ever increasing need to develop new antimicrobial agents with novel mechanisms of action. These new agents will help to combat the steady rise of antibiotic-resistant bacteria which are becoming more and more difficult to treat due to the dwindling number of antibiotics available to treat such organisms. This body of work brings to light the many ways in which medicinal chemistry plays a vital role in the discovery of novel antimicrobial agents. Chapter 1 is an introduction into antimicrobial agents. It provides a brief history of the discovery of antimicrobial agents, and delves into reasons why new …

Transcriptional Regulation Of Azole Antifungal Resistance And Tolerance In Candida Glabrata, Kelly E. Caudle

Theses and Dissertations (ETD)

Azole antifungal resistance has emerged as a significant problem in the management of infections caused by fungi including Candida species. In recent years, Candida glabrata has become the second most common cause of mucosal and invasive fungal infections in humans second to Candida albicans. Not only are systemic C. glabrata infections characterized by high mortality rates, treatment failures to the azole class of antifungals, the most widely used antifungal for treatment of Candida infections, have been reported. Contributing to this problem, C. glabrata exhibits intrinsic reduced susceptibility to the azole antifungals, and the development of high-level azole resistance …

Tetrahydroisoquinoline Neurotoxins In Parkinson Disease, Michael G. Decuypere

Theses and Dissertations (ETD)

The goal of this dissertation work was to (1) determine the distribution of several tetrahydroisoquinoline (TIQ) derivatives in rodent, normal human and Parkinson disease (PD) brain, (2) quantify the levels of these TIQ derivatives in common food sources in an effort to link specific food intake patterns with the development of PD and (3) examine the neurotoxicity of select TIQ derivatives in human dopaminergic cell culture. The TIQs are a family of monoamine alkaloids that share structural homology with 1-methyl-4-phenyl-1,2,3,6-tetrahyrdropyridine (MPTP), can be formed from dopamine or its oxidized metabolites and may be involved in the pathogenesis of monoaminergic cell …

Evaluating The Impact Of The Guatemalan Nursing Program On Staff, Organizational, And Clinical Outcomes, Sara Williamson Day

Theses and Dissertations (ETD)

There is great disparity between the outcome of childhood cancer in developed and developing countries. Nurses, who comprise the largest group of health care professionals globally, are essential to successful treatment. Pediatric oncology education is generally unavailable for nurses in developing countries. This lack of education is likely to contribute to the disparity in survival rates, as undereducated nurses are unable to meet the demands of pediatric cancer care. A second critical problem in developing countries is the workload of the nurse, with a patient nurse ratio reported as high as 30 patients per one nurse.

In 2006, the quality …

Population Pharmacokinetics Of Therapeutic Monoclonal Antibodies: Examples And Estimation Method Performance Differences, Nathanael Le Dirks

Theses and Dissertations (ETD)

Over the past two decades, there has been an increase in the research and development and therapeutic application of monoclonal antibodies (mAbs). An application of pharmacokinetic (PK) and pharmacodynamic concepts that has likely contributed to the success of the pre-clinical and clinical drug development of therapeutic mAbs is population PK, which attempts to quantify the typical disposition characteristics and sources of PK variability (such as between-subject, within-subject, and inter-occasion variability) within study populations. Population PK also attempts to identify and quantify the impact of covariates on systemic drug exposure and assess their potential implications for clinical dosing. The general theme …

Long-Term Changes In The Dental Occlusion Of Subjects Treated Orthodontically, Kenneth Cooper Dyer Iv

Theses and Dissertations (ETD)

A major challenge in orthodontics is to provide a treatment result that remains stable after appliances are removed. Orthodontic treatment can move teeth from their neutral positions, which increases potential for future relapse. The literature from the University of Washington, Seattle, shows that relapse is pervasive and of considerable magnitude (Little RM. Stability and relapse of mandibular anterior alignment: University of Washington studies. Semin Orthod 1999;5:191-204). The intent of this study was to quantify the posttreatment dental changes that occurred over approximately a quarter-century in a cohort of women who had received comprehensive orthodontic treatment as teenagers. Dental casts of …

Synthesis Of Novel Cannabinoid Ligands And Their Use As Anti-Glioma And Anti-Inflammatory Agents, Steven Neal Gurley

Theses and Dissertations (ETD)

Following the discovery of the cannabinoid receptors, research in the field of cannabinoids has grown exponentially over the last two decades. Cannabinoids have been shown to have tremendous therapeutic potential in the treatment of several pathological conditions ranging from inflammation to asthma, multiple sclerosis, Parkinson’s disease, epilepsy, glaucoma, septic shock, hemorrhagic shock, and cancer. Our research has focused on two major conditions for which cannabinoids hold great promise for drug development, namely, cancer and inflammation.

Our focus in the field of cancer has been on the devastatingly lethal brain tumor glioblastoma multiforme. Due to the high expression of the CB2 …

Neural Crest Contributions To Dental Pulp Stem/Progenitor Cells And Craniofacial Structures: Alveolar Processes, Tongue And Temporomandibular Joint, Vinay Jain

Theses and Dissertations (ETD)

Background: The cranial neural crest, a transient embryonic structure in vertebrates, is crucial to craniofacial and dental development. Populations of multipotent stem cells have been identified in various dental tissues including dental pulp. Hence, identification of multipotent cells of neural crest lineage within dental pulp and delineation of neural crest contributions to various craniofacial tissues may be a step towards utilizing the potential of neural crest progenitor cells for therapeutic applications.

Objective: The overall purpose of the study was to identify a population of dental pulp stem/progenitor cells of neural crest lineage and demonstrate their neural differential potential and to …