Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Blood Utilization In Children Managed Non-Operatively For Blunt Solid Organ Injury., Scott J. Keckler, Kuojen Tsao, Susan W. Sharp, G W. Holcomb Iii, Daniel J. Ostlie, Shawn D. St Peter

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Blood product utilization is an important issue in health care, given the frequent shortages in hospitals and the societal burden required to maintain the supply. Therefore, we retrospectively audited our blunt spleen/liver trauma experience to determine the percentage of cross-matched blood that was transfused to see whether more stringent typing criteria should be applied.

METHODS: A retrospective analysis of a recent 7-year experience with nonoperative management in patients with blunt spleen or liver injury was performed. Demographics, packed red blood cells prepared by cross-match, and transfusions were measured. Unmatched, O-type blood given in the trauma bay was excluded. Patients …

Management Of Pediatric Acute Appendicitis In The Computed Tomographic Era., Kuojen Tsao, Shawn D. St Peter, Patricia A. Valusek, Troy L. Spilde, Scott J. Keckler, Abhilash Nair, Daniel J. Ostlie, G W. Holcomb Iii

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND/PURPOSE: The treatment options for complicated appendicitis in children continue to evolve. Optimal management of complicated appendicitis relies on an accurate preoperative diagnosis. We examined the accuracy of our preoperative diagnosis including computed tomography (CT) and the influence on the management of children with perforated and nonperforated appendicitis.

METHODS: Following IRB approval, a 6-year review of all patients that underwent an appendectomy for suspected appendicitis was performed. Treatments included immediate operations and initial nonoperative management (antibiotic therapy +/- percutaneous drainage of abscess). Appendicitis was confirmed by histological examination.

RESULTS: One thousand seventy-eight patients underwent appendectomy for suspected appendicitis. Preoperative CT …

Radiotherapy Optimal Design: An Academic Radiotherapy Treatment Design System, R Acosta, W Brick, A Hanna, Allen Holder, D Lara, G Mcquillen, D Nevin, P Uhlig, B Salter

Mathematical Sciences Technical Reports (MSTR)

Optimally designing radiotherapy and radiosurgery treatments to increase the likelihood of a successful recovery from cancer is an important application of operations research. Researchers have been hindered by the lack of academic software that supports head-to-head comparisons of different techniques, and this article addresses the inherent difficulties of designing and implementing an academic treatment planning system. In particular, this article details the algorithms and the software design of Radiotherapy optimAl Design (RAD).

Clinical Features And Management Of Autoimmune Hepatitis, Edward L. Krawitt

Dartmouth Scholarship

Autoimmune hepatitis (AIH) is a chronic hepatitis of unknown etiology which can progress to cirrhosis. Its clinical manifestations are highly variable and sometimes follow a fluctuating course. Diagnosis is based on characteristic histologic, clinical, biochemical and serological findings. Anti-inflammatory/immunosuppressive treatment frequently induces remission but long-term maintenance therapy is often required. Liver transplantation is generally successful in patients with decompensated cirrhosis unresponsive to or intolerant of medical therapy.

Resource Utilization And Outcomes From Percutaneous Drainage And Interval Appendectomy For Perforated Appendicitis With Abscess., Scott J. Keckler, Kuojen Tsao, Susan W. Sharp, Daniel J. Ostlie, G W. Holcomb Iii, Shawn D. St Peter

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: Given the perceived technical demands of laparoscopic appendectomy and the expected postoperative morbidity in patients with a well-defined abscess, initial percutaneous drainage has become an attractive option in this patient population. This strategy allows for a laparoscopic appendectomy to be performed in an elective manner at the convenience of the surgeon. However, the medical burden on the patient and on the quality of patient outcomes has not been described in the literature. Therefore, we audited our experience with initial percutaneous drainage followed by laparoscopic interval appendectomy to evaluate the need for a prospective trial.

METHODS: After institutional review board …

Single Daily Dosing Ceftriaxone And Metronidazole Vs Standard Triple Antibiotic Regimen For Perforated Appendicitis In Children: A Prospective Randomized Trial., Shawn D. St Peter, Kuojen Tsao, Troy L. Spilde, G W. Holcomb Iii, Susan W. Sharp, J Patrick Murphy, Charles L. Snyder, Ronald J. Sharp, Walter S. Andrews, Daniel J. Ostlie

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: Appendicitis is the most common emergency condition in children. Historically, a 3-drug regimen consisting of ampicillin, gentamicin, and clindamycin (AGC) has been used postoperatively for perforated appendicitis. A retrospective review at our institution has found single day dosing of ceftriaxone and metronidazole (CM) to be a more simple and cost-effective antibiotic strategy. Therefore, we performed a prospective, randomized trial to compare efficacy and cost-effectiveness of these 2 regimens.

METHODS: After internal review board approval (IRB no. 04 12-149), children found to have perforated appendicitis at appendectomy were randomized to either once daily dosing of CM (2 total doses per …

Comparison Of Microleakage In Three Sealant Placement Protocols Vs. The Enamel Loc System, Audrey T. Sheu

Loma Linda University Electronic Theses, Dissertations & Projects

PURPOSE: To evaluate sealant microleakage using four different application techniques.

METHODS: The four application techniques evaluated were acid etch only, Adper L-Pop bonding, Optibond bonding, and Enamel Loc One-Step Sealant. Sixty-four extracted third molar teeth were assigned on one of four application techniques (n=16) and Clinpro sealants applied according to the manufacturer's instructions. The teeth were thermocycled for 500 cycles, dyed, and embedded in resin. The samples were then sectioned and evaluated for microleakage on the buccal and lingual surfaces. Statistical methods employed to analyze the data were the Kruskal-Willis rank test and the Mann-Whitney U test.

RESULTS: No significant …

Immediate Provionalization Of Single Threaded Oxidized Implants On Maxillary Premolars Healed Sites: One-Year Study, Kiyotaka Umezu

Loma Linda University Electronic Theses, Dissertations & Projects

Osseointegrated endosseous implants have been widely used and become a predictable treatment option for completely and partially edentulous patients. The viability and predictability of this treatment modality have been supported with the high success rates in numerous studies. Clinical guideline requires a healing period of 3 to 6 months without functional loading to achieve osseointegration with machine surface implants. Therefore, numerous studies on immediately loaded implants have been conducted in an attempt to minimize or eliminate this healing period. The purpose of this study was to evaluate the success rate of the immediately provisionalized oxidized-surface implants in healed sites supporting …

Predicting Long-Term Memory In Adult Brain Injury Patients Using Mr Spectroscopy, Herminia De La Rosa-Trujillo

Loma Linda University Electronic Theses, Dissertations & Projects

Accurate outcome prediction has proven to be somewhat elusive for patients with traumatic brain injury (TBI). The difficulty is due to the sometimes inaccurate methods of prediction currently available. Despite the advances seen in radiological technology, the traditional methods of x-rays, CT scans and MRIs are not always accurately able to predict patient functional outcome. These radiological methods are adequate in determining gross structural anatomical disturbances, however, they unable to detect more diffuse cellular damage believed to be responsible for the functional impairments evidenced in patients sustaining TBI. Magnetic Resonance Spectroscopy (MRS) is an imaging technique which measures brain metabolites …

Tendinopathy Discrimination By Use Of Spatial Frequency Parameters In Ultrasound B-Mode Images, Gregory R. Bashford, Nicholas Tomsen, Shruti Arya, Judith M. Burnfield, Kornelia Kulig

Biomedical Imaging and Biosignal Analysis Laboratory

The structural characteristics of a healthy tendon are related to the anisotropic speckle patterns observed in ultrasonic images. This speckle orientation is disrupted upon damage to the tendon structure as observed in patients with tendinopathy. Quantification of the structural appearance of tendon shows promise in creating a tool for diagnosing, prognosing, or measuring changes in tendon organization over time. The current work describes a first step taken towards this goal—classification of Achilles tendon images into tendinopathy and control categories. Eight spatial frequency parameters were extracted from regions of interest on tendon images, filtered and classified using linear discriminant analysis. Resulting …

Discipline, Facial Affect Recognition And Self-Efficacy, Julie Harris

Graduate Theses

The present study explored facial affect recognition, discipline and self-efficacy correlates, predicted using the Social Cognitive Theory framework. A sample of undergraduate students (N—114) from The University of Texas of the Permian Basin, were surveyed on parental style, discipline, self-efficacy, and then tested for facial affect recognition. The results indicated that participants reporting more corporal punishment scored lower on facial affect than those reporting less corporal punishment (p < .05). No significance was found for corporal punishment and self-efficacy (p > .05). The parental style of the father emerged as a significant predictor for the relationship between corporal punishment and facial affect recognition (p < .05). Results appear to support the idea that the social environment parents, especially fathers, create via discipline may hinder ability to interpret emotion. One important implication of this study is that paternal influence may be more vital to emotional detection development than previously considered.

Use Of Monoclonal ∆-9-Tetrahydrocannabinol Antibodies Chemically Bound To A Polystyrene Surface Using Glutaraldehyde For The Purpose Of Extracting ∆-9-Tetrahydrocannabinol And ∆-9-Tetrahydrocannabinol Carboxylic Acid From Postmortem Whole Blood Samples For Analysis By Gas Chromatography Mass Spectrometry, Thomas Sidney Pittman

Dissertations

Quantitations of drugs and their respective metabolites in postmortem blood samples using gas chromatographic instrumentation is a primary analytical practice used to determine if drugs played a role in or were the cause of a victim's death. Postmortem blood samples often prove difficult to work with due to interfering substances formed during the putrefaction process. Attempts to eliminate interfering substances with present day extraction methods can be time-consuming, costly and often ineffective when dealing with drugs that exhibit toxicity or impairment at very low concentrations. This study was conducted using monoclonal antibodies chemically bound to a polystyrene surface to extract …

Current Significance Of Meconium Plug Syndrome., Scott J. Keckler, Shawn D. St Peter, Troy L. Spilde, Kuojen Tsao, Daniel J. Ostlie, G W. Holcomb Iii, Charles L. Snyder

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The significance of meconium plug syndrome is dependent on the underlying diagnosis. The incidence of pathologic finding, particularly Hirschsprung's disease, contributing to the presence of these plugs, has been debated. However, there are little recent data in the literature. Therefore, we reviewed our experience with meconium plugs as a cause of abdominal distension to evaluate the associated conditions and incidence of Hirschsprung's disease.

METHODS: We reviewed the records of newborns with meconium plugs found in the distal colon on contrast enema from 1994 to 2007. Demographics, radiologic findings, histologic findings, operative findings, and clinical courses were reviewed.

RESULTS: During …

Cost Saving By Reloading The Multiband Ligator In Endoscopic Esophageal Variceal Ligation: A Proposal For Developing Countries, Zaigham Abbas, Lubna Rizvi, Umair Syed Ahmed, Khalid Mumtaz, Wasim Jafri

Department of Medicine

Aim: To assess the cost savings of reloading the multiband ligator in endoscopic esophageal variceal ligation (EVL) used on the same patient for subsequent sessions.

Methods: This single centre retrospective descriptive study analysed patients undergoing variceal ligation at a tertiary care centre between 1st January, 2003 and 30th June, 2006. The multiband ligator was reloaded with six hemorrhoidal bands using hemorrhoidal ligator for the second and subsequent sessions. Analysis of cost saving was done for the number of follow-up sessions for the variceal eradication.

Results: A total of 261 patients underwent at least one session of endoscopic esophageal variceal ligation …

Treg Depletion Inhibits Efficacy Of Cancer Immunotherapy: Implications For Clinical Trials., James Curtin, Marianela Candolfi, Tamer Fakhouri, Chunyan Liu, Anderson Alden, Matthew Edwards, Pedro Lowenstein, Maria Castro

Articles

BACKGROUND: Regulatory T lymphocytes (Treg) infiltrate human glioblastoma (GBM); are involved in tumor progression and correlate with tumor grade. Transient elimination of Tregs using CD25 depleting antibodies (PC61) has been found to mediate GBM regression in preclinical models of brain tumors. Clinical trials that combine Treg depletion with tumor vaccination are underway to determine whether transient Treg depletion can enhance anti-tumor immune responses and improve long term survival in cancer patients. FINDINGS: Using a syngeneic intracrabial glioblastoma (GBM) mouse model we show that systemic depletion of Tregs 15 days after tumor implantation using PC61 resulted in a decrease in Tregs …

Prostate Segmentation On Pelvic Ct Images Using A Genetic Algorithm, Payel Ghosh, Melanie Mitchell

Computer Science Faculty Publications and Presentations

A genetic algorithm (GA) for automating the segmentation of the prostate on pelvic computed tomography (CT) images is presented here. The images consist of slices from three-dimensional CT scans. Segmentation is typically performed manually on these images for treatment planning by an expert physician, who uses the “learned” knowledge of organ shapes, textures and locations to draw a contour around the prostate. Using a GA brings the flexibility to incorporate new “learned” information into the segmentation process without modifying the fitness function that is used to train the GA. Currently the GA uses prior knowledge in the form of texture …

The Mind-Body Connection: The Association Between Adolescent Locus Of Control And Indicators Of Physical Health, C. Jayne Brahler, James Cropper

Physical Therapy Faculty Publications

Locus of control (LOC) describes an individual’s generalized beliefs or expectancies that their reinforcements are under internal versus external control (1). An individual exhibits either an internal or external LOC. This study examines the link between LOC and selected health risk factors in adolescents. A convenience sample of 167 high school physical education students completed a 13-item LOC questionnaire based on Rotter’s 1966 instrument.

Various anthropometric measurements, blood pressure, body mass index (BMI), and body fat were recorded on all subjects. A subsample of 61 female students received blood chemistry analysis that included a lipid profile, hemoglobin A1c (HbA1c), Apo …

Current Application Of Thoracoscopy In Children., Kuojen Tsao, Shawn D. St Peter, Susan W. Sharp, Abhilash Nair, Walter S. Andrews, Ronald J. Sharp, Charles L. Snyder, Daniel J. Ostlie, G W. Holcomb Iii

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The safety and efficacy of thoracoscopy for thoracic lesions and conditions in children is evolving. Our experience with thoracoscopy has expanded in recent years. Therefore, we reviewed our most recent 7-year experience to examine the current applications for thoracoscopy in children.

METHODS: A retrospective review of all patients undergoing a thoracoscopic operation at Children's Mercy Hospital (Kansas City, MO) between January 1, 2000, and June 18, 2007, was performed. Data points reviewed included patient demographics, type of operation, final diagnosis, complications, and recovery.

RESULTS: During the study period, 230 children underwent 231 thoracoscopic procedures. The mean age was 9.6 …

Manual For The Motivational Interviewing Skill Code (Misc), Paul Amrhein, William R. Miller, Theresa Moyers, Denise Ernst

Department of Psychology Faculty Scholarship and Creative Works

Over years of using MISC 1 we have learned much about which categories were redundant or unreliable, and also about which processes are most important to the effectiveness of MI. The MISC has also helped us to clarify the points at which skill acquisition in MI is more challenging.

Based on this experience, we have developed Version 2.0, which is intended to improve on the original MISC in reliability, efficiency, and relevance to training and clinical practice. A disadvantage of revising an instrument, of course, is that one must start over in demonstrating its reliability and validity. Although many strong …

Antidepressant Medications, Amir A. Afkhami

Psychiatry and Behavioral Sciences Faculty Publications

No abstract provided.

Ua10/1 Cec: Clinical Exchange Corner, Mary Lloyd Moore, Laura Reynolds, Wku Suzanne Vitale Clinical Education Complex

CEC Publications

No abstract provided.

Electroconvulsive Therapy : A Brief Overview, Adam A. Sauceda

Graduate Research Papers

Electroconvulsive therapy (ECT) has been increasing in popularity for treating various types of mental health disorders. Although a notably controversial medical procedure, ECT continues to be an option when intense therapy and psychopharmacology fails. This research project will review the recent literature on ECT and provide useful information specific to mental health professionals. A definition, administration procedures, effectiveness, side effects, and specific disorders that have been targeted and most and least receptive for ECT treatment will be the focus of attention

Adaptive Technology Catalog, Cisr

CISR Studies and Reports

By design, the purpose of this Adaptive Technology Catalog is to provide a resource for governments, survivor-assistance and other agencies to help victims of landmines and other explosive remnants of war (ERW) and other disabled workers get back to self-sufficiency and paid work.

Landmine and ERW injuries have a devastating impact on the economic security of individuals, families and communities. Most often, these circumstances exist in countries that lack the basic social welfare infrastructure that might otherwise keep this at-risk population from poverty.

Designing, developing and identifying simple and inexpensive tools and programs that assist with survivor work reintegration is …

A Surface Inspection Machine Vision System That Includes Fractal Texture Analysis, Jonathan Blackledge, Dmitry Dubovitskiy

Articles

The detection, recognition and classification of features in a digital image is an important component of quality control systems in production and process engineering and industrial systems monitoring, in general. In this paper, a new pattern recognition system is presented that has been designed for the specific task of monitoring the quality of sheet-steel production in a rolling mill. The system is based on using both the Euclidean and Fractal geometric properties of an imaged object to develop training data that is used in conjunction with a supervised learning procedure based on the application of a fuzzy inference engine. Thus, …

Urine Protein Electrophoresis: Comparison Of Agarose Gel And Capillary Zone Electrophoretic Techniques., Anne-Marie Curtin

Theses

Proteinuria is the excess excretion of protein in the urine and is found in a variety of conditions including renal diseases and neoplastic conditions such as multiple myeloma (MM). The investigation of proteinuria type through the use of electrophoresis is a useful and widely used non-invasive diagnostic tool. The aim of this study was to compare various agarose gel and capillary zone electrophoresis techniques in order to establish a method choice for the separation of protein in routine laboratories. Comparisons were made based on urine monoclonal peak quantification and protein fractions detected. An examination of a capillary zone electrophoresis (CZE) …

Barriers To Breast Cancer Prevention, Detection And Treatment Among Middle Eastern Women, Senida Husic

Mahurin Honors College Capstone Experience/Thesis Projects

Many have heard of breast cancer and how it has become one of the top caused of death in the United States. but how many know of the impact it has on other parts of the world, the developed and developing countries? Accourding to the World Health Organization (WHO), 13% of all deaths in the world are due to cancer and it is predicted to increase in the upcoming decades. In the Arab World, particularly in the Eastern Mediterranean Region, 70% of women who discovered in late stages in the Unted States. The reseach focused on identifying whether the barriers …

Three Dimensional Echocardiography In Congenital Heart Defects., Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

Three dimensional echocardiography (3DE) is a new, rapidly evolving modality for cardiac imaging. Important technological advances have heralded an era where practical 3DE scanning is becoming a mainstream modality. We review the modes of 3DE that can be used. The literature has been reviewed for articles that examine the applicability of 3DE to congenital heart defects to visualize anatomy in a spectrum of defects ranging from atrioventricular septal defects to mitral valve abnormalities and Ebstein's anomaly. The use of 3DE color flow to obtain echocardiographic angiograms is illustrated. The state of the science in quantitating right and left ventricular volumetrics …

The Integrated Implementation Of Surgical Simulations Through Modeling By Means Of Imaging, Comprehension, Visualization, Deformation, And Collision Detection In Virtual Environments, Sinan Kockara

Theses and Dissertations

Advances in information technology based applications in medicine and biology help to improve the conventional methods of delivering health services by enhancing and complementing traditional approaches of medical education, diagnostic techniques, intra-operative assistance, and pre/post operative services etc. Individualized medical training by virtual simulations and the use of advanced visualization techniques in cell biology will impact the way medicine is practiced and biological processes are understood. Although enhancing visualization and presenting the unreality in a form of blended virtuality is exceedingly accepted in medicine and biology, it brings many challenging but intriguing and intertwined multi disciplinary problems that are required …

Virtual Environments And Their Applications In Surgical Training, Tansel Halic

Theses and Dissertations

The advances in the application of Virtual Environments (VE) in medicine help to improve the conventional methods of delivering health services by enhancing and complementing traditional approaches of medical education, diagnostic techniques, intraoperative assistance, pre-post operative services etc. Virtual Reality (VR) and Augmented Reality (AR) are two forms of VEs that revolutionize medical training and fill the deficiencies in the traditional teaching/learning methods in medicine. Although presenting the unreality in a form of blended virtuality is exceedingly accepted in medicine, it brings many challenging but intriguing and intertwined multi disciplinary problems that are required to be addressed. This thesis proposal …

The Effects Of Yoga And Humor On Stress, Denise Rizzolo

Seton Hall University Dissertations and Theses (ETDs)

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