Medical Specialties Commons^™

The Effect Of Spinal Cord Injury On Vagal Afferents., April N. Herrity

Electronic Theses and Dissertations

Spinal cord injury (SCI) is a significant public health concern that leaves patients with a multitude of life-long disabilities. Major complications of SCI apart from paralysis, include deficits in bladder and bowel function. Lower urinary tract dysfunction continues to remain a top priority issue affecting quality of life for this population. The majority of visceral organs receive a dual sensory innervation from both spinal nerves as well as the vagus nerve. Following SCI, the vagus nerve is a potential pathway through which information from regions below the level of a spinal injury can travel directly to the brainstem, bypassing the …

Pupillometry: A Non-Invasive Technique For Pain Assessment In Paediatric Patients., Mark A. Connelly, Jacob T. Brown, Gregory L. Kearns, Rawni A. Anderson, Shawn D. St Peter, Kathleen A. Neville

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: Pupillometry has been used to assess pain intensity and response to analgesic medications in adults. The aim of this observational study was to explore proof of concept for the use of this technique in paediatric patients. Changes in pupil parameters before and after opioid exposure also were evaluated.

DESIGN AND SETTING: This was a single-centre, prospective study conducted at an academic paediatric medical centre.

PATIENTS: Children 9-17 years of age undergoing elective surgical correction of pectus excavatum were enrolled into a protocol approved by the human ethical committee (institutional review board).

INTERVENTIONS: Pupil size and reactivity were measured using …

Simplified Post Processing Of Cine Dense Cardiovascular Magnetic Resonance For Quantification Of Cardiac Mechanics, Jonathan D. Suever, Gregory J. Wehner, Christopher M. Haggerty, Linyuan Jing, Sean M. Hamlet, Cassi M. Binkley, Sage P. Kramer, Andrea C. Mattingly, David K. Powell, Kenneth C. Bilchick, Frederick H. Epstein, Brandon K. Fornwalt

Saha Cardiovascular Research Center Faculty Publications

BACKGROUND: Cardiovascular magnetic resonance using displacement encoding with stimulated echoes (DENSE) is capable of assessing advanced measures of cardiac mechanics such as strain and torsion. A potential hurdle to widespread clinical adoption of DENSE is the time required to manually segment the myocardium during post-processing of the images. To overcome this hurdle, we proposed a radical approach in which only three contours per image slice are required for post-processing (instead of the typical 30-40 contours per image slice). We hypothesized that peak left ventricular circumferential, longitudinal and radial strains and torsion could be accurately quantified using this simplified analysis.

METHODS …

Surface Attachment Induces Pseudomonas Aeruginosa Virulence, Albert Siryaporn, Sherry L. Kuchma, George A. Ou2019toole, Zemer Gitai

Dartmouth Scholarship

Pseudomonas aeruginosa infects every type of host that has been examined by deploying multiple virulence factors. Previous studies of virulence regulation have largely focused on chemical cues, but P. aeruginosa may also respond to mechanical cues. Using a rapid imaging-based virulence assay, we demonstrate that P. aeruginosa activates virulence in response to attachment to a range of chemically distinct surfaces, suggesting that this bacterial species responds to mechanical properties of its substrates. Surface-activated virulence requires quorum sensing, but activating quorum sensing does not induce virulence without surface attachment. The activation of virulence by surfaces also requires the surface-exposed protein PilY1, …

Plasticity In The Contribution Of T Cell Receptor Variable Region Residues To Binding Of Peptide-Hla-A2 Complexes, Sheena N. Smith, Daniel Sommermeyer, Kurt H. Piepenbrink, Sydney J. Blevins, Helga Bernhard, Wolfgang Uckert, Brian M. Baker, David M. Kranz

Food for Health: Publications

One hypothesis to account for MHC-restriction by T cell receptors (TCRs) holds that there are several evolutionary-conserved residues in TCR variable regions that contact MHC. While this ‘germline-codon’ hypothesis is supported by various lines of evidence, it has been difficult to test. The difficulty stems in part from the fact that TCRs exhibit low affinities for pep/MHC, thus limiting the range of binding energies that can be assigned to these key interactions using mutational analyses. To measure the magnitude of binding energies involved, here we used high affinity TCRs engineered by mutagenesis of CDR3. The TCRs included a high-affinity, MART-1/ …

Severe Tubulointerstitial Nephritis From Acute Epstein-Barr Virus Infection, Craig A. Mackaness Do

Department of Medicine

No abstract provided.

On Reporting The Onset Of The Intention To Move, Uri Maoz, Liad Mudrik, Ram Rivlin, Ian Ross, Adam Mamelak, Gideon Yaffe

Psychology Faculty Books and Book Chapters

"In 1965, Hans Kornhuber and Luder Deecke made a discovery that greatly influenced the study of voluntary action. Using electroencephalography (EEG), they showed that when aligning some tens of trials to movement onset and averaging, a slowly decreasing electrical potential emerges over central regions of the brain. It starts 1 second ( s) or so before the onset of the voluntary action1 and continues until shortly after the action begins. They termed this the Bereitschaftspotential, or readiness potential (RP; Kornhuber & Deecke, 1965).2 This became the first well-established neural marker of voluntary action. In that, the RP allowed for more …

Autoantibodies To The Ny-Eso-1 Tumor Antigen In Metastatic Melanoma: Sialylation Of The Fc Region Of Immunoglobulin G Induces Differential Expression Signatures Of Inflammatory Molecules During Dendritic Cell Differentiation And Maturation, Martin Oaks, Nathaniel Rein, John O. Richards, James Shaffer

Journal of Patient-Centered Research and Reviews

Purpose: We tested the hypothesis that different glycoforms of antibodies from patients with metastatic melanoma have different functional effects on human dendritic cell differentiation and maturation.

Methods: Antibodies to the cancer antigen NY-ESO-1 were affinity-purified from patients with melanoma and further fractionated into different glycoforms by lectin chromatography. Sialic acid-rich and sialic acid-poor fractions of these immunoglobulin G antibodies (IgG) were added to dendritic cell cultures during both differentiation and maturation, and the resulting cellular messenger RNA (mRNA) and culture supernatants were tested by microarray and enzyme-linked immunoassay for molecules related to inflammatory pathways.

Results: We identified unique mRNA and …

Management Of Severe Hyponatremia: Infusion Of Hypertonic Saline And Desmopressin Or Infusion Of Vasopressin Inhibitors?, Antonios H. Tzamaloukas Md, Joseph I. Shapiro Md, Dominic S. Raj Md, Glen H. Murata Md, Robert H. Glew Phd, Deepak Malhotra Md, Phd

Pharmaceutical Science and Research

Rapid correction of severe hyponatremia carries the risk of osmotic demyelination. Two recently introduced methods of correction of hyponatremia have diametrically opposite effects on aquaresis. Inhibitors of vasopressin V2 receptor (vaptans) lead to the production of dilute urine, whereas infusion of desmopressin causes urinary concentration. Identification of the category of hyponatremia that will benefit from one or the other treatment is critical. In general, vaptans are effective in hyponatremias presenting with concentrated urine and, with the exception of hypovolemic hyponatremia, can be used as their primary treatment. Desmopressin is effective in hyponatremias presenting with dilute urine or developing urinary dilution …

Adult Neurogenesis In The Four-Striped Mice (Rhabdomys Pumilio), Olatunbosun O. Olaleye, Amadi O. Ihunwo

Brain and Mind Institute

In this study, we investigated non-captive four-striped mice (Rhabdomys pumilio) for evidence that adult neurogenesis occurs in the adult brain of animal models in natural environment. Ki-67 (a marker for cell proliferation) and doublecortin (a marker for immature neurons) immunostaining confirmed that adult neurogenesis occurs in the active sites of subventricular zone of the lateral ventricle with the migratory stream to the olfactory bulb, and the subgranular zone of the dentate gyrus of the hippocampus. No Ki-67 proliferating cells were observed in the striatum substantia nigra, amygdala, cerebral cortex or dorsal vagal complex. Doublecortin-immunoreactive cells were observed in …

Acidosis Potentiates The Host Proinflammatory Interleukin-1Β Response To Pseudomonas Aeruginosa Infection, I. M. Torres, Y. R. Patankar, Tamer B. Shabaneh, E. Dolben, Deborah Hogan, David Leib, Brent L. Berwin

Dartmouth Scholarship

Infection by Pseudomonas aeruginosa, and bacteria in general, frequently promotes acidification of the local microenvironment, and this is reinforced by pulmonary exertion and exacerbation. However, the consequence of an acidic environment on the host inflammatory response to P. aeruginosa infection is poorly understood. Here we report that the pivotal cellular and host proinflammatory interleukin-1β (IL-1β) response, which enables host clearance of the infection but can produce collateral inflammatory damage, is increased in response to P. aeruginosa infection within an acidic environment. Synergistic mechanisms that promote increased IL-1β release in response to P. aeruginosa infection in an acidic environment are …

Central And Peripheral Nervous System Demyelination Following Mycoplasma Pneumonia Infection With Review Of Literature, Brian Miller Do, Andres Zirlinger Md

Department of Medicine

No abstract provided.

Isolated Gastroduodenal Crohn’S Disease, Matthew Sullivan Do, Patrick Hickey Do, Saba Ahmad Md, Jeffrey Brodsky Md, Hiral N. Shah Md, Ronald Bross Md

Department of Medicine

No abstract provided.

Improving Outcomes In Diabetic Patients, Daniel Tseytlin Do, Cheryl A. Bloomfield Md, Ranjit R. Nair Md, Carolyn Casey, Vlad Vlatsis Do, Maura Bucciarelli Do, Chris Kern Do, Stephen Awuor Md, Arsha Shreedhar Md, Ron Julia Jr. Md

Department of Medicine

No abstract provided.

Atypical Presentation Of Actinomyces, Brian Friel Do, Sarah Park Do, Stacey Smith Md, Facp

Department of Medicine

No abstract provided.

Ectopic Cushing Syndrome And Pancreatic Cancer: A Case Report, Mira Mitry Md, Nicole M. Agostino Do, Stacey Smith Md, Facp, Vasudev G. Magaji Md, Ms

Department of Medicine

No abstract provided.

Unchain My Heart: Constrictive Pericarditis In The Setting Of Chronic Kidney Disease And Monoclonal Gammopathy Of Undetermined Significance, Neiman Ramjattan Do, Justin L. Guthier Do, Stacey Smith Md, Facp

Department of Medicine

No abstract provided.

Rare Presentation Of A Massive Intermittent Upper Gastrointestinal Bleed, Bonnie Patek Do, Matthew Sullivan Do, Shashin Shah Md

Department of Medicine

No abstract provided.

Markedly Elevated Ca 19-9 In A Case Of Mirizzi’S Syndrome: An Atypical Presentation, Saba Ahmad Md, Hiral N. Shah Md, Patrick Hickey Do, Matthew Sullivan Do

Department of Medicine

No abstract provided.

Role Of A Genetic Variant On The 15q25.1 Lung Cancer Susceptibility Locus In Smoking-Associated Nasopharyngeal Carcinoma, Xuemei Ji, Weidong Zhang, Jiang Gui, Xia Fan, Weiwei Zhang, Yafang Li, Guangyu An, Dakai Zhu, Qiang Hu

Dartmouth Scholarship

Background: The 15q25.1 lung cancer susceptibility locus, containing CHRNA5, could modify lung cancer susceptibility and multiple smoking related phenotypes. However, no studies have investigated the association between CHRNA5 rs3841324, which has been proven to have the highest association with CHRNA5 mRNA expression, and the risk of other smoking-associated cancers, except lung cancer. In the current study we examined the association between rs3841324 and susceptibility to smoking-associated nasopharyngeal carcinoma (NPC).

Methods: In this case-control study we genotyped the CHRNA5 rs3841324 polymorphism with 400 NPC cases and 491 healthy controls who were Han Chinese and frequency-matched by age (±5 years), gender, and …

Progressive Ataxia In An Aids Patient On Antiretroviral Therapy, Misbahuddin Syed Md

Department of Medicine

No abstract provided.

Microscopic Polyangiitis Presenting With A Pure Sensory Peripheral Symmetric Polyneuropathy, Matthew Sullivan Do, Craig A. Mackaness Do, James Ross Md, Facp

Department of Medicine

No abstract provided.

Chasing The Dragon: A Case Of Inhaled Heroin Overdose Resulting In Stunned Myocardium, Neiman Ramjattan Do

Department of Medicine

No abstract provided.

Recurrent Biliary Obstruction Overcome With Metal Biliary Stent Placement In The Surgically Altered Down Syndrome Patient For Congenital Duodenal Atresia, Patrick Hickey Do, Matthew Sullivan Do, Saba Ahmad Md, Hiral Shah Md

Department of Medicine

No abstract provided.

Adenomyomatous Hyperplasia Of The Ampulla Of Vater Masquerading As Malignancy: A Case Series, Patrick Hickey Do, Saba Ahmad Md, Matthew Sullivan Do, Miriam L. Enriquez Md, Jeffrey Brodsky Md, Hiral Shah Md

Department of Medicine

No abstract provided.

Temporal And Stochastic Control Of Staphylococcus Aureus Biofilm Development., Derek E. Moormeier, Jeffrey L. Bose, Alexander R. Horswill, Kenneth W. Bayles

Journal Articles: Pathology and Microbiology

Biofilm communities contain distinct microniches that result in metabolic heterogeneity and variability in gene expression. Previously, these niches were visualized within Staphylococcus aureus biofilms by observing differential expression of the cid and lrg operons during tower formation. In the present study, we examined early biofilm development and identified two new stages (designated "multiplication" and "exodus") that were associated with changes in matrix composition and a distinct reorganization of the cells as the biofilm matured. The initial attachment and multiplication stages were shown to be protease sensitive but independent of most cell surface-associated proteins. Interestingly, after 6 h of growth, an …

Analysis Of Differential Mrna And Mirna Expression In An Alzheimer’S Disease Mouse Model, Amanda Hazy, Matthew Dalton

Other Undergraduate Scholarship

Research has shown that changes in gene expression play a critical role in the development of Alzheimer’s Disease (AD). Our project will evaluate genome-wide RNA expression patterns from brain and blood in an AD mouse model. This analysis will provide insight regarding the mechanisms of AD pathology as well as determine a possible diagnostic tool utilizing RNA expression patterns found in the blood as biomarkers for AD.

Malignant Hyperthermia, Chase Contri

Nursing Student Class Projects (Formerly MSN)

Although very rare, occurring one out of every 100,000 anesthesia cases, malignant hyperthermia is a hypermetabolic disorder that anesthesia providers screen and interrogate patients prior to every case they are administering anesthesia. Many research studies about anesthesia induced malignant hyperthermia have explored new methods of testing for the genetic susceptibility for malignant hyperthermia and into hospital based protocols when a patient starts to show the signs and symptoms of the metabolic disorder. This new knowledge and understanding has decreased patient mortality of anesthesia induced malignant hyperthermia from eighty percent to five percent over the past three decades (Rosenberg et al, …

Malignant Hyperthermia, Devin Poncsak

Nursing Student Class Projects (Formerly MSN)

A crisis of malignant hyperthermia is a medical emergency, and must be treated immediately with a coordinated, multidisciplinary team response in order to give the patient the highest chance for a successful recovery (Dirksen, Van Wicklin, Mashman, Neiderer, & Merritt, 2013). Malignant hyperthermia is defined by Bandschapp & Girard (2012), as “a disturbance of the skeletal muscle calcium homeostasis, triggered by volatile anaesthetics and depolarizing muscle relaxants.” Once a vulnerable patient is exposed to one of these triggering agents, a pathologic hypermetabolic response ensues, and the patient has a rapid increase in oxygen consumption and expired carbon dioxide, hyperthermia, acidosis, …

The Pathophysiology Of Tumor Lysis Syndrome In Oncology Patients, Jessica Richardson

Nursing Student Class Projects (Formerly MSN)

Patients with oncological conditions are at an increased risk of developing a wide variety of complications from chemotherapy that they would not otherwise be exposed too. One such life threatening complication is tumor lysis syndrome, which is an oncology emergency that frequently lands patients in the intensive care unit. Tumor lysis syndrome (TLS) occurs most frequently after the initiation of chemotherapy or other chemotoxic drugs during the patients’ treatment course [8]. It causes faster than normal tumor cell breakdown and release of intracellular contents into the general circulation. [8]. This leads to a very predictable development of electrolyte imbalances to …