Medicine and Health Sciences Commons^™

Porokeratosis Ptychotropica With Scalp Involvement: A Case Report, Kobpat Phadungsaksawasdi, Pravit Asawanonda

Chulalongkorn Medical Journal

Porokeratosis, a spectrum of disorders characterized by abnormal keratinization, includes the rare variant, porokeratosis ptychotropica, typically manifests with hyperkeratotic plaques on the buttocks and genital area. Its clinical mimicry to various skin diseases, coupled with under-recognition of the disorder, results in frequent misdiagnosis. This challenge is compounded by the resistance of porokeratosis ptychotropica to treatment.

We report a 62-year-old Thai male with persistent pruritic hypertrophic plaques affecting the genitogluteal area, extremities, and scalp over five years, unresponsive to diverse topical agents. Histopathological findings revealed acanthotic epidermis with a cornoid lamella, consistent with porokeratosis ptychotropica. He was given oral acitretin at …

A Rare Presentation Of Giant Hepatic Hemangioma Mimicking Fibrolamellar Hepatocellular Carcinoma, Bikash Parida, Sherry Garg, Somadatta Das

Chulalongkorn Medical Journal

Hepatic hemangioma is a frequently occurring benign liver lesion detected on Imaging. It might be challenging to make a definite diagnosis of Hepatic hemangioma since its radiological characteristics can mimic those of hepatic malignancies such as metastatic liver cancer. A 65-year-old female patient complained of a month-long reduction in appetite and distension of abdominal discomfort in the right hypochondriac area. A B-mode ultrasound was suggested for the patient. On USG, there was a large, poorly defined heterogeneous lesion that entirely occupied the right lobe of the liver. It had a hyperechoic periphery, an irregular hypoechoic patch in the center, necrosis, …

Identification And Characterization Of Malaria Box Compounds Possessing Inhibition Effect On The Sars-Cov2 Spike Protein, Chotiyapat Sangvansindhu

Chulalongkorn Medical Journal

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused millions of infections and deaths worldwide since 2019. The repurposing existing drugs is a practical and promising alternative.

Objectives: To evaluate the binding interactions and inhibitory effect of malaria box compounds on the B-cell epitope regions of SARS-CoV-2 spike protein.

Methods: Molecular docking of 400 malaria box compounds against the predicted B-cell epitopes of the spike was performed. The inhibitory effect of the malaria box compounds on the spike RBD were determined using competitive ELISA. The binding affinity between malaria box compounds and non-RBD epitopes were examined by surface …

The Impact Of Covid-19 Booster Vaccination On Reducing Mortality In Patients Hospitalized With Covid-19 At Sisaket Hospital, Nidhikul Tem-Eiam

Chulalongkorn Medical Journal

The COVID-19 vaccine has the potential to decrease hospitalizations and fatalities, even when different vaccine types are administered. Towards the end of 2021, during the ongoing COVID-19 pandemic, there were guidelines suggesting the administration of booster shots following the completion of the primary vaccine series. Consequently, this study aims to investigate the efficacy of COVID-19 booster vaccinations and the timing between booster shots in terms of preventing fatalities among COVID-19-infected patients receiving care at Si Sa Ket Hospital

A retrospective cohort study was conducted on individuals aged 18 and above who were hospitalized with COVID-19 infection at Si Sa Ket …

Endogenous Car T Cell Activation Signal-Based Dual Car Construct, Asmita Khaniya, Koramit Suppipat M.D., Supannikar Tawinwung Ph.D., Nattiya Hirankarn M.D., Ph.D.

Chulalongkorn Medical Journal

Background: Despite the notable success of chimeric receptor (CAR) T-cell therapy in treating hematological malignancies, many challenges limit its therapeutic effectiveness. To overcome antigen loss mediated disease relapses, strategies like dual antigen-targeted CAR constructs have been used. However, this strategyrequires robust promoters, to ensure sufficient CAR expression on the cell surface. Utilization of multiple promoters cause the constitutive and simultaneous expression of CARs which lead to issues with CAR T cell tonic signaling and exhaustion.

Objective: This study aimed to utilize the endogenous CAR T cell activation signals to explore the dual CAR T cell-based platform.

Methods: Using scFv …

Factors Related To Physical Activity Of Patients With Permanent Cardiac Pacemaker, Priyaporn Phruksahiran, Noraluk Ua-Kit

Chulalongkorn Medical Journal

Background: Over 1.3 million patients worldwide have permanent cardiac pacemakers (PPM). Patients with PPM, in the first to third months after implantation, still report problems with physical activity (PA), such as limitations in their lives, jobs, and exercise, inability to perform activities as before, and decreased PA.

Objectives: This study aimed to investigate the PA of patients with PPM and identify factors (age, perceived self-efficacy, perceived benefits, perceived barriers, social support, and health literacy) related to the PA of patients with PPM.

Methods: This descriptive-correlational study included 110 male and female patients with PPM from three tertiary hospitals in …

Trends Of Methicillin-Resistant Staphylococcus Aureus Infections Among Thai Pediatric Patients, Pintip Suchartlikitwong, Nopphon Wuthinantiwong, Watsamon Jantarabenjakul, Noppadol Wacharachaisurapol, Jiratchaya Sophonphan, Tanittha Chatsuwan, Thanyawee Puthanakit

Chulalongkorn Medical Journal

Background While reductions in methicillin-resistant Staphylococcus aureus (MRSA) infections have been reported, vancomycin prescription rates have remained high.

Objectives We aimed to update trends in pediatric prevalence and antibiotic susceptibilities of MRSA infections.

Methods We conducted a retrospective study in patients aged S. aureus infections during 2016-2022 at a Thai tertiary-care hospital. MRSA was defined when resistant to cefoxitin or oxacillin MIC of >4 µg/mL. Patients with MRSA infections and their first isolates were classified into HA-MRSA or CA-MRSA based on surveillance definitions. Antibiotic susceptibilities were tested using the VITEK 2XL automated system and disk diffusion. The annual prevalence of …

Sinonasal Anatomical Analysis In Nonsyndromic Bilateral Coronal Suture Craniosynostosis Using Computerized Tomography, Tunchanok Paprad, Netsiri Dumromgpisutikul, Warunee Napakaew

Chulalongkorn Medical Journal

Background: Craniosynostosis is a deformity of the skull associated with the premature fusion of one or more cranial sutures. In children with syndromic craniosynostosis, anomalies related to the cranial base and midface contribute to midface hypoplasia, affecting the diameter of the axial facial concavity. Nonsyndromic craniosynostosis, especially bilateral coronal suture craniosynostosis, may result in abnormal facial proportions and affect sinonasal anatomy.

Objectives: The aim of our study was to determine and analyze morphometric measurement values in the sinonasal cavity of patients with nonsyndromic bilateral coronal suture craniosynostosis.

Methods: A retrospective study was conducted on 91 children, aged 0 - 10 …

Modeling The Effect Of Human Behavior On Disease Transmission, Katie Yan

Rose-Hulman Undergraduate Mathematics Journal

Many infectious disease models build upon the classic Susceptible-Infected-Recovered (SIR) model, a compartmental system that is used to simulate disease transmission in a population. The SIR model focuses on the transmission of disease but rarely includes behavioral or informational components that explore how disease perception influences transmission. In this paper, we propose a six-compartment behavioral SIR model that further segments the classic SIR system based on knowledge of information about the disease, and we explore how sharing information affects disease transmission. We designate two states as aware and unaware based on whether the relevant information is known by the population. …

Medical School Watercooler Newsletter - July 25, 2024, Lindsay Hughes

Watercooler Newsletter

This is the July 25, 2024 edition of the Frederick P. Whiddon College of Medicine’s newsletter - Watercooler.

Contents Include

• Mark your calendar for upcoming Watermark Faculty Success workshops
• MCI researchers receive gift from Norma Livingston Foundation to study ovarian cancer
• New chief of adolescent medicine joins pediatrics faculty
• Ramani visits Guatemala as part of international clinical trial
• Finding career paths — and love — in graduate program

Multimodal Data Integration For Oncology In The Era Of Deep Neural Networks: A Review, Asim Waqas, Aakash Tripathi, Ravi P. Ramachandran, Paul A. Stewart, Ghulam Rasool

Henry M. Rowan College of Engineering Departmental Research

Cancer research encompasses data across various scales, modalities, and resolutions, from screening and diagnostic imaging to digitized histopathology slides to various types of molecular data and clinical records. The integration of these diverse data types for personalized cancer care and predictive modeling holds the promise of enhancing the accuracy and reliability of cancer screening, diagnosis, and treatment. Traditional analytical methods, which often focus on isolated or unimodal information, fall short of capturing the complex and heterogeneous nature of cancer data. The advent of deep neural networks has spurred the development of sophisticated multimodal data fusion techniques capable of extracting and …

Antiformer: Graph Enhanced Large Language Model For Binding Affinity Prediction, Qing Wang, Yuzhou Feng, Yanfei Wang, Bo Li, Jianguo Wen, Xiaobo Zhou, Qianqian Song

Faculty, Staff and Student Publications

Antibodies play a pivotal role in immune defense and serve as key therapeutic agents. The process of affinity maturation, wherein antibodies evolve through somatic mutations to achieve heightened specificity and affinity to target antigens, is crucial for effective immune response. Despite their significance, assessing antibody-antigen binding affinity remains challenging due to limitations in conventional wet lab techniques. To address this, we introduce AntiFormer, a graph-based large language model designed to predict antibody binding affinity. AntiFormer incorporates sequence information into a graph-based framework, allowing for precise prediction of binding affinity. Through extensive evaluations, AntiFormer demonstrates superior performance compared with existing methods, …

How To Teach Your Children Not To Bully, Maggie Mckay, Ram Chettiar

Parent-ish Podcast

We all think the best of our kids, but that doesn't mean that at some point, they may exhibit some bullying behaviors. Dr. Ram Chettiar discusses why this happens, how to teach your kids to not be bullies, and how to react if you find out they've bullied a classmate or friend.

Click here to stream the podcast episode.

Setting Up An Ambulatory Gi Endoscopy Suite In The Usa-Anesthesia And Sedation Challenges, Basavana Goudra

Department of Anesthesiology Faculty Papers

Gastrointestinal endoscopy units, both freestanding and associated with ambulatory surgical centers, are on the increase, and the trend is likely to continue. The concept is relatively new, and there are insufficient guidelines and a general dearth of information for prospective planners and physicians. Debate continues in areas such as the selection of patients, appropriateness of procedures, and access to tertiary care. Leaders often scramble to address both critical and non-critical issues, often after the center has opened to the public. They often encounter issues which were not anticipated. In this review, we have provided comprehensive and concise information on the …

The College Campus, A Place Of Learning, And A Place Of Healing, Huma Bashir, Joshua Francis

Human Services Faculty Publications

The COVID-19 pandemic and its aftermath have precipitated a marked increase in mental health needs among college students. Lockdowns, the sudden shift to remote learning, and social distancing mandates have compounded existing challenges, highlighting a trend that has evolved over the past two decades. Despite heightened demand for mental health support, colleges struggle to meet these needs amid the emotional aftermath of COVID-19 effectively. Recognizing the pivotal role of higher education institutions in shaping future leaders and addressing and enhancing the mental well-being of the college community is imperative to foster an environment conducive to learning and healing. This paper …

Remimazolam And Its Place In The Current Landscape Of Procedural Sedation And General Anesthesia, Matthew Brohan, Janette Brohan, Basavana Goudra

Department of Anesthesiology Faculty Papers

Remimazolam was derived from its parent compound by adding an ester linkage into its structure so that the drug becomes a substrate for ester metabolism. As a result, it undergoes organ-independent ester hydrolysis, although the clinical benefits in terms of shorter recovery are not uniformly observed in clinical practice. Remimazolam is mainly tested in procedural sedation. In comparison to propofol, the current gold standard for procedural sedation, its proposed attractiveness is shorter wake-up times and a clear-headed recovery. Its clear advantages over propofol are better hemodynamic stability, lack of pain on injection and availability of a reversal agent in the …

Bayesian Beta-Binomial Mixed Models For Longitudinal, Clustered, And Spatiotemporal Data, Chun-Che Wen

MUSC Theses and Dissertations

Overdispersed binomial data arise in many clinical and public health research studies. Examples include timeline followback data (TLFB), which are used in addiction research to monitor recent substance use. This dissertation proposes novel beta-binomial (BB) mixed models to address the challenges associated with overdispersed binomial data, including zero-inflation, heterogenous effects, and spatiotemporal correlation. Motivated by a 12-week randomized controlled trial evaluating the efficacy of varenicline tartrate for smoking cessation among adolescents, Aim 1 develops a Bayesian zero-inflated beta-binomial (ZIBB) model to analyze longitudinal and bounded TLFB data — namely, the number of abstinent days in the past week. Because treatment …

Csf1r Inhibition Depletes Brain Macrophages And Reduces Brain Virus Burden In Siv-Infected Macaques, Diana G. Bohannon, Laurent D. Zablocki-Thomas, Evan S. Leung, Jinbum K. Dupont, Julian B. Hattler, Jolanta Kowalewska, Miaoyun Zhao, Jiangtao Luo, Marco Salemi, Angela M. Amedee, Qingsheng Li, Marcelo J. Kuroda, Woong-Ki Kim

School of Graduate Studies Faculty Publications

Perivascular macrophages (PVMs) and, to a lesser degree, microglia are targets and reservoirs of HIV and simian immunodeficiency virus (SIV) in the brain. Previously, we demonstrated that colony-stimulating factor 1 receptor (CSF1R) in PVMs was upregulated and activated in chronically SIV-infected rhesus macaques with encephalitis, correlating with SIV infection of PVMs. Herein, we investigated the role of CSF1R in the brain during acute SIV infection using BLZ945, a brain-penetrant CSF1R kinase inhibitor. Apart from three uninfected historic controls, nine Indian rhesus macaques were infected acutely with SIVmac251 and divided into three groups (n = 3 each): an untreated control and …

Geriatric Emergency Medicine Fellowship Journal Club: Strategies For Success In Geriatric Emergency Medicine Research, Priyank Bhatnagar, Lauren Southerland, Ula Hwang, Jacques Lee

Journal of Geriatric Emergency Medicine

n/a

A Correctable Immune Niche For Epithelial Stem Cell Reprogramming And Post-Viral Lung Diseases, Kangyun Wu, Yong Zhang, Huiqing Yin-Declue, Kelly Sun, Dailing Mao, Kuangying Yang, Stephen R. Austin, Erika C. Crouch, Steven L. Brody, Derek E. Byers, Christy M. Hoffmann, Michael E. Hughes, Michael J. Holtzman

2020-Current year OA Pubs

Epithelial barriers are programmed for defense and repair but are also the site of long-term structural remodeling and disease. In general, this paradigm features epithelial stem cells (ESCs) that are called on to regenerate damaged tissues but can also be reprogrammed for detrimental remodeling. Here we identified a Wfdc21-dependent monocyte-derived dendritic cell (moDC) population that functioned as an early sentinel niche for basal ESC reprogramming in mouse models of epithelial injury after respiratory viral infection. Niche function depended on moDC delivery of ligand GPNMB to the basal ESC receptor CD44 so that properly timed antibody blockade of ligand or receptor …

Review Of The Impact And Burden Of Urinary Urgency On Adults With Overactive Bladder, Adrian Wagg, A Lenore Ackerman, H Henry Lai, Diane K. Newman

2020-Current year OA Pubs

No abstract provided.

A Systematic Study Of The Distribution And Expression Of Aquaporin Water Channels In Normal Adult Human Brain, Oyinkansola Mudasiru, Vivian Etugbo, Reginald Adiele

School of Podiatric Medicine - Student Research

Water regulation in the central nervous system (CNS) is very crucial to maintain normal neurophysiological homeostasis, intracranial pressure and play a role in the pathogenesis of edema and brain disorders. Not only because of the rigidity and limited mobility of the brain encasement that offer little room for fluid expansion, but also the need to maintain an appropriate osmotic balance across the various fluid-filled brain compartments which is necessary for normal neurological functions. Aquaporins (AQPs), a family of non-energy dependent, bidirectional water transport protein channels, play a critical role in maintaining water and electrolyte balance in human brain. The distribution …

Stratasys Printed 3-D Mandibular Molar With Tooth Anatomy And Texture, M. Austin White, Charles E. Taylor, Edwin Kee, Albert F. Mcmullen

School of Dentistry Faculty Publications

Introduction: We used CBCT scans of a human mandibular molar in concert with the Stratasys 3-D printer to fabricate said teeth with similar texture and hardness to enamel, dentin, and cementum. The printed tooth should also have the same crown and root anatomy, as well as root canal anatomy of the scanned tooth. Methods: One mandibular first molar was scanned (Carestream Dental CS 9600 CBCT) and printed (Stratasys 3D multi-material printer). A (Micromet 5104) hardness tester was used to test the hardness of the printed tooth. Nine combinations of two different materials (Stratasys’ Vero Pure White and Agilus 30 Clear …

Annular Rupture During Transcatheter Aortic Valve Replacement Without A Surgical Option–The Double-Edged Sword Of Mechanical Circulatory Support, Aishah Matar, Corey Adams, Anna Bizios, Rosaleen Chun, Jillian Colbert, Daniel Holloway, Ayaaz K. Sachedina

Journal of Shock and Hemodynamics

Transcatheter aortic valve replacement (TAVR) has become a well-established treatment option for patients with severe aortic stenosis. With advances in the field and positive outcomes in clinical trials, TAVR use has expanded from being limited to older patients with prohibitive surgical risk to younger patients with intermediate and low surgical risk. As operators’ experiences have grown and technology has evolved, there are fewer TAVR complications. However, when complications do occur, they remain associated with significant morbidity and mortality. Aortic annulus rupture is a catastrophic complication of TAVR. Risk factors for annulus rupture include valve oversizing, female gender, a large calcification …

Genome-Wide Methylation Patterns In Primary Uveal Melanoma: Development Of Methylsig-Um, An Epigenomic Prognostic Signature To Improve Patient Stratification, Emilie Lalonde, Dong Li, Kathryn Ewens, Carol L. Shields, Arupa Ganguly

Wills Eye Hospital Papers

Despite studies highlighting the prognostic utility of DNA methylation in primary uveal melanoma (pUM), it has not been translated into a clinically useful tool. We sought to define a methylation signature to identify newly diagnosed individuals at high risk for developing metastasis. Methylation profiling was performed on 41 patients with pUM with stage T2-T4 and at least three years of follow-up using the Illumina Infinium HumanMethylation450K BeadChip (N = 24) and the EPIC BeadChip (N = 17). Findings were validated in the TCGA cohort with known metastatic outcome (N = 69). Differentially methylated probes were identified in patients who developed …

Randomized, Double-Blind, Placebo-Controlled Study Of Anti-Mycobacterial Therapy (Rhb-104) In Active Crohn's Disease, David Y Graham, Saleh A Naser, Thomas Borody, Zbigniew Hebzda, Harry Sarles, Scott Levenson, Robert Hardi, Tomasz Arłukowicz, Petar Svorcan, Reza Fathi, Aida Bibliowicz, Patricia Anderson, Patrick Mclean, Clara Fehrmann, M Scott Harris, Shuhong Zhao, Ira N Kalfus

Faculty, Staff and Students Publications

This study, conducted between 4 October 2013, and 30 November 2018, tested the hypothesis that triple antimicrobial therapy, targeting Mycobacterium avium subspecies paratuberculosis (MAP), long considered a putative cause, would favorably affect Crohn’s disease. A double-blind multicenter study of adults with active Crohn’s disease, (i.e., Crohn’s Disease Activity Index [CDAI] 220–450 plus C-reactive protein ≥ 1.0 mg/dL, fecal calprotectin (FCP) >162.9 µg/g stool, or recent endoscopic or radiographic confirmation of active disease) receiving concomitant standard-of-care Crohn’s disease treatment (Clinicaltrials.gov: NCT01951326) were stratified by anti-tumor necrosis factor use and randomized (1:1) to anti-MAP RHB-104 (clarithromycin 95 mg, rifabutin 45 mg, …

Vaccine Value Profile For Hookworm, Karl Philipp Puchner, Maria Elena Bottazzi, Victoria Periago, Martin Grobusch, Rick Maizels, James Mccarthy, Bruce Lee, Erika Gaspari, David Diemert, Peter Hotez

Faculty, Staff and Students Publications

Hookworm, a parasitic infection, retains a considerable burden of disease, affecting the most underprivileged segments of the general population in endemic countries and remains one of the leading causes of mild to severe anemia in Low and Middle Income Countries (LMICs), particularly in pregnancy and children under 5. Despite repeated large scale Preventive Chemotherapy (PC) interventions since more than 3 decades, there is broad consensus among scholars that elimination targets set in the newly launched NTD roadmap will require additional tools and interventions. Development of a vaccine could constitute a promising expansion of the existing arsenal against hookworm. Therefore, we …

Tert Activation Targets Dna Methylation And Multiple Aging Hallmarks, Hong Seok Shim, Jonathan Iaconelli, Xiaoying Shang, Jiexi Li, Zheng D Lan, Shan Jiang, Kayla Nutsch, Brittney A Beyer, Luke L Lairson, Adam T Boutin, Michael J Bollong, Peter G Schultz, Ronald A Depinho

Faculty, Staff and Student Publications

Insufficient telomerase activity, stemming from low telomerase reverse transcriptase (TERT) gene transcription, contributes to telomere dysfunction and aging pathologies. Besides its traditional function in telomere synthesis, TERT acts as a transcriptional co-regulator of genes pivotal in aging and age-associated diseases. Here, we report the identification of a TERT activator compound (TAC) that upregulates TERT transcription via the MEK/ERK/AP-1 cascade. In primary human cells and naturally aged mice, TAC-induced elevation of TERT levels promotes telomere synthesis, blunts tissue aging hallmarks with reduced cellular senescence and inflammatory cytokines, and silences p16INK4a expression via upregulation of DNMT3B-mediated promoter hypermethylation. In the brain, …

The Interplay Between Gender And Duration Of Hospitalization Modulates Psychiatric Symptom Severity In Subjects With Long Covid-19, Alessio Simonetti, Antonio Restaino, Claudia Calderoni, Emanuela De Chiara, Antonio Maria D'Onofrio, Salvatore Lioniello, Giovanni Camardese, Delfina Janiri, Matteo Tosato, Francesco Landi, Gabriele Sani

Faculty, Staff and Students Publications

Long COVID-19 is characterized by ongoing symptoms or prolonged or long-term complications of SARS-CoV-2 contraction which persist beyond 4 weeks from the initial onset of symptoms. Gender and duration of hospitalization (DH) are key risk factors for developing long COVID-19 syndrome, but their impact and interplay need further study. This research involved 996 long COVID-19 patients, and we compared the levels of general psychopathology, depression, agitated depression, anxiety, and medication use between hospitalized and non-hospitalized males and females. In the hospitalized patients, multivariate regressions assessed the impact of gender, DH, and the interaction of these variables. The females had higher …

Comparing The Clinical Features Of Lateral And Medial Approaches Of Costoclavicular Technique Versus Traditional Lateral Sagittal Technique As Infraclavicular Brachial Plexus Block Methods: A Randomized Controlled Trial, Emre Sertaç Bingül, Mert Canbaz, Mehmet Güzel, Emine Aysu Şalvız, Bora Edim Akalın, Ömer Berköz, Ebru Emre Demirel, Zerrin Sungur, Meltem Savran Karadeniz

2020-Current year OA Pubs

BACKGROUND: It is aimed to compare the block onset times and performance features of costoclavicular techniques (medial and lateral approach) versus lateral sagittal technique.

METHODS: Patients were randomized into three groups. For costoclavicular techniques, ultrasound probe was placed parallel to clavicle obtaining nerve cords, axillary artery and axillary vein visual from lateral-to-medial, respectively. The block needle was advanced from lateral (Group CLB) or medial (Group CMB) to perform costoclavicular block. For lateral sagittal technique (Group LSB), ultrasound probe was placed sagittal and perpendicular below the coracoid process to obtain sagittal artery image with the cords around. Total 20 ml of …