Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Spectral Discrimination Of Breast Pathologies In Situ Using Spatial Frequency Domain Imaging, Ashley M. Laughney, Venkataramanan Krishnaswamy, Elizabeth J. Rizzo, Mary C. Schwab, Richard J. Barth, David J. Cuccia, Bruce J. Tromberg, Keith D. Paulsen, Brian W. Pogue, Wendy A. Wells

Dartmouth Scholarship

Introduction: Nationally, 25% to 50% of patients undergoing lumpectomy for local management of breast cancer require a secondary excision because of the persistence of residual tumor. Intraoperative assessment of specimen margins by frozen-section analysis is not widely adopted in breast-conserving surgery. Here, a new approach to wide-field optical imaging of breast pathology in situ was tested to determine whether the system could accurately discriminate cancer from benign tissues before routine pathological processing.

Measurement And Description Of Dynamics Required For In Vivo Surgical Robotics Via Kinematic Methods, Jacob G. Greenburg

Department of Mechanical and Materials Engineering: Dissertations, Theses, and Student Research

With the goal of improved recovery times and reduced trauma to the patient there has been a substantial shift in the medical community’s demand for minimally invasive surgical (MIS) techniques. With the standardization of MIS becoming more commonplace in the medical field there are still many improvements that are desired. Traditional, manual methods of these surgeries require multiple incisions on the abdomen for the tools and instruments to be inserted. The more recent demand has been to localize the incisions into what is being referred to as a Laparoendoscopic Single-Site (LESS) surgery. Furthermore, the manual instruments that are commonly used …

Development Of Hif-1Α/Hif-1Β Heterodimerization Inhibitors Using A Novel Bioluminescence Reporter Assay System For In Vitro High Throughput Screening And In Vivo Imaging, Yun-Chen Chiang

Dissertations and Theses (Open Access)

Tumor growth often outpaces its vascularization, leading to development of a hypoxic tumor microenvironment. In response, an intracellular hypoxia survival pathway is initiated by heterodimerization of hypoxia-inducible factor (HIF)-1α and HIF-1β, which subsequently upregulates the expression of several hypoxia-inducible genes, promotes cell survival and stimulates angiogenesis in the oxygen-deprived environment. Hypoxic tumor regions are often associated with resistance to various classes of radio- or chemotherapeutic agents. Therefore, development of HIF-1α/β heterodimerization inhibitors may provide a novel approach to anti-cancer therapy. To this end, a novel approach for imaging HIF-1α/β heterodimerization in vitro and in vivo was developed in this study …

Airway Management In A Patient With Bullous Pemphigoid, Mohammad Yasir, Fauzia Anis Khan

Department of Anaesthesia

Airway management in patients with pemphigoid lesions has anaesthetic implications. We report a case of a 23 years old female with bullous pemphigoid who presented with laryngeal stenosis and critical airway narrowing. The airway was initially managed with jet ventilation. Anaesthesia was maintained with propofol infusion and ventilation was performed by introducing a size 10 French gauge suction catheter through the stenotic laryngeal orifice. Thirty minutes into anaesthesia, she developed subcutaneous emphysema and decreased air entry on right side of the chest but remained hemodynamically stable. The airway was further managed by tracheostomy. This case report highlights complications that can …

Early Echocardiographic Changes After Percutaneous Implantation Of The Edwards Sapien Transcatheter Heart Valve In The Pulmonary Position., Shahryar M. Chowdhury, Ziyad M. Hijazi, John Rhodes, Saibal Kar, Raj Makkar, Michael Mullen, Qi-Ling Cao, Lydia King, Jodi Akin, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: To evaluate echocardiographic changes after SAPIEN valve implantation in the pulmonary position.

BACKGROUND: The feasibility of the SAPIEN transcatheter pulmonary valve (TPV) has recently been demonstrated. We evaluated changes in pulmonary valve function and the right ventricle after SAPIEN TPV placement.

METHODS: We evaluated echocardiograms at baseline, discharge, 1 and 6 months after TPV placement in 33 patients from 4 centers. Pulmonary insufficiency severity was graded 0-4. TPV peak and mean gradients were measured. Right ventricular (RV) size and function were quantified using routine measures derived from color, spectral, and tissue Doppler indices and two-dimensional echocardiography.

RESULTS: At baseline, …

Maximization Of Hydraulic Flow Through Small Flexible Polymer Tubes By The Optimization Of Tubing Stiffness And Wall Thickness, Christopher L. Chipman

Theses and Dissertations

As illness becomes increasingly more common in the United States and across the globe, the need for better and faster medical treatment is greater than ever. The purpose of this work is to evaluate advanced polymers and polymer composites that will provide for increased fluid flow while maintaining outer dimensional, stiffness, and burst resistance characteristics when compared to a currently used material. A polymer configuration consisting of a proprietary formulation that has a durometer approximately 10% higher than the current material with an outer wall thickness of approximately .020" passed a series of tests involving tensile strength, stiffness, flexural fatigue …

Chhs July E-Newsletter, Dr. John Bonaguro, Dean, Vashon S. Wells, Editor, Wku College Of Health & Human Services

College of Health & Human Services Publications

No abstract provided.

Is Laparoscopy A Risk Factor For Bile Duct Injury During Cholecystectomy?, Terrence M. Fullum, Stephanie R. Downing, Gezzer Ortega, David C. Chang, Tolulope A. Oyetunji, Kendra Van Kirk, Daniel D. Tran, Ian Woods, Edward E. Cornwell, Patricia L. Turner

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND AND OBJECTIVES: Previously, risk factors for bile duct injury have been identified as acute cholecystitis, male gender, older age, aberrant biliary anatomy, and laparoscopic cholecystectomy.

METHODS: A retrospective analysis of the Nationwide Inpatient Sample from 1998 to 2006 was performed with an inclusion criterion of cholecystectomy performed on hospital day 0 or 1. Patient- and hospital-level factors potentially associated with bile duct injury were examined by logistic regression.

RESULTS: A total of 377,424 cholecystectomy patients were identified. There were 1124 bile duct injuries (0.30%), with 177 (0.06%) in the laparoscopic cholecystectomy group and 947 (1.46%) in the open cholecystectomy …

Treatment Of Psychiatric Inpatients With Relationship Dysfunction Using A Short Term Cognitive Interpersonal Intervention: A Pilot Study, Tamra Rasberry

Doctoral Dissertations and Projects

Relationship conflict for the psychiatric patient can have significant detrimental effects. There are specific types of interactions that can increase conflict and predict the potential for relapse; these have been identified by research and designated as components of Expressed Emotion (EE). Cognitive Behavioral Therapy (CBT) and Interpersonal Therapy (IPT) have been very effective when targeting specific psychiatric diagnoses, but less effective when addressing relationship conflict. The majority of studies addressing relationship conflict have taken place in an outpatient, long-term setting. There is limited research that utilizes an inpatient short-term intensive therapy with relationship conflict as its sole focus, targeting areas …

Maximizing The Delivery Performance Of Point-Of-Care Cd4+ T-Cell Counting Tests In Resource-Limited Settings - A Policy Brief, Nan Kong, J. Paul Robinson, Fenggang Yang

Purdue Policy Research Institute (PPRI) Policy Briefs

Managing HIV/AIDS presents challenges to public health policymakers, frontline workers, and researchers worldwide. A key strategy in the disease management is early diagnosis and rapid treatment initiation. While the technological field of point‐of‐care HIV/AIDS diagnostics has advanced significantly in the past two decades, several critical issues remain that hinder the deployment of point‐of‐care testing devices in resource‐deprived settings. In this policy brief, we discuss these issues, including technological specifics of point‐of‐care CD4⁺ T‐cell counting approaches and requirements of deploying them. We also discuss cultural and religious concerns on the deployment. At the end of the brief, we propose a …

Automated Channel Assessment For Single Chip Medradio Transceivers, Mark Alexander Hillig

Dissertations and Theses

Modern implantable and body worn medical devices leverage wireless telemetry to improve patient experience and expand therapeutic options. Wireless medical devices are subject to a unique set of regulations in which monitoring of the available frequency spectrum is a requirement. To this end, implants use software protocols to assess the in-band activity to determine which channel should be used. These software protocols take valuable processing time and possibly degrade the operational lifetime of the battery. Implantable medical devices often take advantage of a single chip transceiver as the physical layer for wireless communications. Embedding the channel assessment task in the …

Grip And Pinch Strength Norms For Michigan Workers, Joel M. Phillips, Debra K. Lindstrom-Hazel, Samantha Harrow Swantek, Erin Courtnay Catalano

The Open Journal of Occupational Therapy

The purpose of this study was to create a norm reference of current grip and pinch strength norms for working-age Michigan adults. This normative study included a convenience sample of 179 volunteers who were employees at car plants in South East Michigan or hospital sites in West Michigan. Participants’ ages ranged from between 20 and 62 years of age with a mean age of 49.15 years. There were 78 females (44%) and 101 males (56%). Subjects were classified by gender and in the age categories of ages 20 to 49 years and ages 50-62 years. Grip and pinch strength norms …

Preterm Birth And The Controversy Over Universal Cervical Length Screenings, Elizabeth Mearns, Laura Pizzi Pharmd, Mph, Jason K. Baxter Md, Mscp, Vincenzo Berghella Md

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Fluorescence Characterization Of Quantum Dots For Use As Biomarkers, Logan M. Grimes

Materials Engineering

Fluorescence profiles of quantum dots (QDs) were characterized to select the ideal QDs for encapsulation in phospholipids for use as biomarkers to selectively adhere to cancer cells. QDs were synthesized and extracted 0, 30, 60, and 90 seconds after precursor compounds were mixed. These extractions were isolated by extraction time. Portions from each vial were coated in a zinc sulfide shelling procedure, leaving at least half of the QD solution unshelled. These samples were characterized over four days to monitor fluctuations in fluorescence. This was done utilizing an Ocean Optics spectrometer in conjunction with Spectra Suite software. The central wavelength, …

Myofascial Pain Syndrome: A Treatment Review, Mehul J. Desai, Vikramjeet Saini, Shawnjeet Saini

Anesthesiology and Critical Care Medicine Faculty Publications

Myofascial pain syndrome (MPS) is defined as pain that originates from myofascial trigger points in skeletal muscle. It is prevalent in regional musculoskeletal pain syndromes, either alone or in combination with other pain generators. The appropriate evaluation and management of myofascial pain is an important part of musculoskeletal rehabilitation, and regional axial and limb pain syndromes. This article reviews the current hypotheses regarding the treatment modalities for myofascial trigger points and muscle pain. Through a critical evidence-based review of the pharmacologic and nonpharmacologic treatments, the authors aim to provide clinicians with a more comprehensive knowledge of the interventions for myofascial …

Experimental Assessment Of The Impact Of Asymptomatic Gas Emboli On The Vessel Wall, Linxia Gu, Eric L. Cutler

Department of Mechanical and Materials Engineering: Faculty Publications

Quantitative evaluation of shear stress in the vessel wall due to the presence of asymptomatic gas emboli is lacking. The goal of this work was to assess the impact of chronic asymptomatic gas emboli on the risk of atherosclerosis through a custom-built cardiovascular flow simulator. Gas bubbles were created by forced air from a syringe pump. The influences of embolism injection rate, pulse rate, and time-averaged flow rate on the wall mean shear stress were investigated at resting and elevated heart rate conditions. The recorded pressure and volumetric flow rate from 24 experimental settings with four repetitions each were used …

Beach Wheelchair Project, Rory Aronson, Joshua Marcum, Samuel Coyne, Alex Hayes, Alexa Colburn, Max Hessel, Benedikt Strauss, Marvin Rimmele, Marco Pietsch

Mechanical Engineering

The Beach Wheelchair, Sandcrawler, is a machine intended to help give people with disabilities the full beach experience. The non-profit organization Bridge II Sports sponsored this project, and tasked us with developing the design and fabricating a prototype. This chair has several features including a linkage mechanism that raises and lowers a chair relative to an external frame, hand crank drive with Gates Carbondrive belt and sprockets, buoyant Wheeleez balloon tires, and much more.

Evaluation Of The Anterior Talofibular And Calcaneofibular Ligament In Relation To Supination Ankle Sprains, Peter Tran

Biomedical Engineering

Ankle injuries have always posed an issue to a number of athletes. Sports that involve running and jumping accumulate about 25% of injuries correlating to ankle sprains. In most ankle sprains the inversion (supination) of the ankle cause damage to lateral ligaments. The two most common lateral ligaments to experience damage are the anterior talofibular (ATFL) and calcaneofibular (CFL) ligaments. The methods of taping and ankle braces have allowed athletes to prevent recurring sprains from occurring. However, sprains can still occur even when one or both methods are applied. The purpose of each method is to restrict the range of …

Raman Spectroscopic Analysis Of Human Skin Tissue Sections Ex-Vivo: Evaluation Of The Effects Of Tissue Processing And Dewaxing, Syed Mehmood Ali, Franck Bonnier, Ali Tfayli, Helen Lambkin, Kathleen Flynn, Vincent Mcdonagh, Claragh Healy, Thomas Lee, Fiona Lyng, Hugh Byrne

Articles

Raman spectroscopy coupled with K-means clustering analysis (KMCA) is employed to elucidate the biochemical structure of human skin tissue sections, and the effects of tissue processing. Both hand and thigh sections of human cadavers were analysed in their unprocessed and formalin fixed paraffin processed (FFPP) and subsequently dewaxed forms. In unprocessed sections, KMCA reveals clear differentiation of the stratum corneum, intermediate underlying epithelium and dermal layers for sections from both anatomical sites. The stratum corneum is seen to be relatively rich in lipidic content; the spectrum of the subjacent layers is strongly influenced by the presence of melanin, while that …

Dynamic Dual-Tracer Mri-Guided Fluorescence Tomography To Quantify Receptor Density In Vivo, Scott C. Davis, Kimberley S. Samkoe, Kenneth M. Tichauer, Kristian J. Sexton, Jason R. Gunn, Sophie J. Deharvengt, Tayyaba Hasan, Brian W. Pogue

Dartmouth Scholarship

The up-regulation of cell surface receptors has become a central focus in personalized cancer treatment; however, because of the complex nature of contrast agent pharmacokinetics in tumor tissue, methods to quantify receptor binding in vivo remain elusive. Here, we present a dual-tracer optical technique for noninvasive estimation of specific receptor binding in cancer. A multispectral MRI-coupled fluorescence molecular tomography system was used to image the uptake kinetics of two fluorescent tracers injected simultaneously, one tracer targeted to the receptor of interest and the other tracer a nontargeted reference. These dynamic tracer data were then fit to a dual-tracer compartmental model …

Necrotizing Sarcoid Granulomatosis With Hemoptysis: A Case Report And Literature Review, Haidong Huang, Chen Li, Chong Bai, Qiang Li, Weiqiang Zheng, Zhi Zhu, Paul Zarogoulidis, Konstantinos Zarogoulidis, Andreas Gschwendtner, Wolfgang Hohenforst-Schmidt, Michael Simoff

Internal Medicine Faculty Publications

We present a case of 39-year-old male with the symptoms of fever, cough, chest pain and bloody phlegm, whose chest CT showed multiple subpleural nodules and inflammatory infiltration. Video-Assisted Thoracic Surgery ( VATS ) for right subplural nodule was performed and confirmed the diagnosis of necrotizing sarcoid granulomatosis. Prednisolone was administered and the symptoms were under control untill the occurrence of intermittent hemoptysis after 10 months. Chest CT and bronchoscope revealed the right lower lobe nodule with intraluminal necrotic tissue in the right lower lobe posterior basal segment respectively. Fatal hemoptysis happened during endobronchial biopsy by flexible bronchoscope forcep. Based …

Biomedical Photoacoustic Imaging Using Gas-Coupled Laser Acoustic Detection, Jami Johnson

Student Research Initiative

Several detection methods have been explored for photoacoustic and ultrasound imaging of biological tissues. Piezoelectric transducers are commonly used, which require contact with the sample to be imaged and have limiting bandwidth characteristics. Interferometry detection exhibits improved bandwidth characteristics and resolution, yet generally require complicated optics and the incorporation of a contacting reflective medium. In this paper, we report the use of a noncontact photoacoustic imaging system that does not require the use of a reflective layer. A simple, robust technique known as gas-coupled laser acoustic detection is used, which has previously been applied to evaluation of composite materials. This …

Using Optimal Control Theory To Optimize The Use Of Oxygen Therapy In Chronic Wound Healing, Donna Lynn Daulton

Masters Theses & Specialist Projects

Approximately 2 to 3 million people in the United States suffer from chronic wounds, which are defined as wounds that do not heal in 30 days time; an estimated $25 billion per year is spent on their treatment in the United States. In our work, we focused on treating chronic wounds with bacterial infections using hyperbaric and topical oxygen therapies.

We used a mathematical model describing the interaction between bacteria, neutrophils and oxygen. Optimal control theory was then employed to study oxygen treatment strategies with the mathematical model. Existence of a solution was shown for both therapies. Uniqueness was also …

A Knowledge-Based Clinical Toxicology Consultant For Diagnosing Multiple Exposures, Joel D. Schipper, Douglas D. Dankel Ii, A. Antonio Arroyo, Jay L. Schauben

Publications

Objective: This paper presents continued research toward the development of a knowledge-based system for the diagnosis of human toxic exposures. In particular, this research focuses on the challenging task of diagnosing exposures to multiple toxins. Although only 10% of toxic exposures in the United States involve multiple toxins, multiple exposures account for more than half of all toxin-related fatalities. Using simple medical mathematics, we seek to produce a practical decision support system capable of supplying useful information to aid in the diagnosis of complex cases involving multiple unknown substances.

Methods: The system is automatically trained using data mining …

The Relationship Between Vitamin D Status Of Adult Women And Diet, Sun Exposure, Skin Reflectance, Body Composition, And Insulin Sensitivity, Marisa M. Mcadler

Master's Theses

As the prevalence of vitamin D deficiency continues to grow, mounting evidence supporting its link with chronic disease strengthens suggesting vitamin D’s candidacy in the prevention and treatment of multiple disease states and their complications. Dietary guidelines, however, do not take sun exposure into account. The present study sought to explore the impact of sun exposure on vitamin D status (serum 25(OH)D), and identify other significant determinants of serum levels which may have the greatest effects on overall health. Participants (n = 34) were pre-menopausal women aged 18 to 50 years (mean age 39 ± 6 years), who had their …

Sources Of Intravascular Atp During Exercise In Humans: Critical Role For Skeletal Muscle Perfusion, Brett S. Kirby, Anne R. Crecelius, Jennifer C. Richards, Frank A. Dinenno

Health and Sport Science Faculty Publications

Exercise hyperemia is regulated by several factors and one factor known to increase with exercise that evokes powerful vasomotor action is extracellular ATP. The origination of ATP detectable in plasma from exercising muscle of humans is, however, a matter of debate and ATP has been suggested to arise from sympathetic nerves, blood sources (e.g. erythrocytes), endothelial cells, and skeletal myocytes, among others. Therefore, we tested the hypothesis that acute augmentation of sympathetic nervous system activity (SNA) results in elevated plasma ATP draining skeletal muscle, and that SNA superimposition during exercise further increases ATP vs exercise alone. We show that increased …

State-By-State Variation In Emergency Versus Elective Colon Resections: Room For Improvement., Augustine C. Obirieze, Mehreen Kisat, Caitlin W. Hicks, Tolulope A. Oyetunji, Eric B. Schneider, Darrell J. Gaskin, Elliott R. Haut, David T. Efron, Edward E. Cornwell, Adil H. Haider

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Compared with elective surgical procedures, emergency procedures are associated with higher cost, morbidity, and mortality. This study seeks to investigate potential state-by-state variations in the incidence of emergent versus elective colon resections.

METHODS: A retrospective analysis of all adult patients (aged ≥18 years) included in the Nationwide Inpatient Sample from 2005 to 2009 who underwent hemicolectomy (right or left) or sigmoidectomy was conducted. Discharge-level weights were applied, and generalized linear models were used to assess the odds of a patient undergoing emergent versus elective colon surgery nationally and for each state after adjusting for patient and hospital factors. Odds …

Bone Properties Of Recombinant Inbred Line - Bxd Mouse, Yueying Angela Zhang

Theses and Dissertations (ETD)

Osteoporosis is identified by reduced bone mass, decreased bone quality and altered bone micro-architecture. These traits are quantitative and also highly regulated by genetic and environmental factors. As a powerful tool for collaborative analysis of quantitative traits and gene function, BXD recombinant inbred (RI) lines mice have been used to identify genetic effects for bone density.

For the first time, we investigated the bone properties of BXD RI mice by analyzing femur and tibia and compared their phenotypes of different compartments. In this study, microcomputed tomography (µCT) provided an accurate measurement on characterizing bone quality and bone architecture ex-vivo; three-point …

Oxidative Stress Based Strategies For Enhancing The Efficacy Of Histone Deacetylase Inhibitors (Hdaci), Nilsa Rivera-Del Valle

Dissertations and Theses (Open Access)

Histone deacetylase inhibitors (HDACi) are anti-cancer drugs that primarily act upon acetylation of histones, however they also increase levels of intracellular reactive oxygen species (ROS). We hypothesized that agents that cause oxidative stress might enhance the efficacy of HDACi. To test this hypothesis, we treated acute lymphocytic leukemia cells (ALL) with HDACi and adaphostin (ROS generating agent). The combination of two different HDACi (vorinostat or entinostat) with adaphostin synergistically induced apoptosis in ALL. This synergistic effect was blocked when cells were pre-treated with the caspase-9 inhibitor, LEHD. In addition, we showed that loss of the mitochondrial membrane potential is the …

Design, Synthesis And Development Of Transporter Targeting Agents For Image-Guided Therapy And Drug Delivery, Ning Tsao

Dissertations and Theses (Open Access)

The purpose of this study was to design, synthesize and develop novel transporter targeting agents for image-guided therapy and drug delivery. Two novel agents, N4-guanine (N4amG) and glycopeptide (GP) were synthesized for tumor cell proliferation assessment and cancer theranostic platform, respectively. N4amG and GP were synthesized and radiolabeled with ^99mTc and ⁶⁸Ga. The chemical and radiochemical purities as well as radiochemical stabilities of radiolabeled N4amG and GP were tested. In vitro stability assessment showed both ^99mTc-N4amG and ^99mTc-GP were stable up to 6 hours, whereas ⁶⁸Ga-GP was stable up to 2 hours. Cell culture studies …