Medical Specialties Commons^™

Natural History Of Isolated Skull Fractures In Children., S. Hassan, A. Q. Alarhayema, S. M. Cohn, J. C. Wiersch, M. R. Price

Journal Articles

Head injury is the most common cause of neurologic disability and mortality in children. We had hypothesized that in children with isolated skull fractures (SFs) and a normal neurological examination on presentation, the risk of neurosurgical intervention is very low. We retrospectively reviewed the medical records of all children aged six to sixteen years presenting to our Level 1 trauma center with traumatic brain injuries between January 1, 2006 and December 31, 2014. We also analyzed the National Trauma Data Bank (NTDB) research data set for the years 2012-2014 using the same metrics. During this study period, our center admitted …

Wses Worldwide Emergency General Surgery Formation And Evaluation Project, Federico Coccolini, Yoram Kluger, Luca Ansaloni, Ernest E. Moore, Raul Coimbra, Gustavo P. Fraga, Andrew Kirkpatrick, Andrew Peitzman, Ron Maier, Gianluca Baiocchi, Vanni Agnoletti, Emiliano Gamberini, Ari Leppaniemi, Rao Ivatury, Michael Sugrue, Massimo Sartelli, Salomone Di Saverio, Walt Biffl, Fausto Catena

Surgery Publications

Optimal management of emergency surgical patients represents one of the major health challenges worldwide. Emergency general surgery (EGS) was identified as multidisciplinary surgery performed for traumatic and nontraumatic acute conditions during the same admission in the hospital. EGS represents the easiest viable way to provide affordable and high-quality level of care to emergency surgical and trauma patients. It may result from the association of different physicians with other specialties in a cooperative model. The World Society of Emergency Surgery (WSES) has been working on the EGS organization and implementation since its foundation believing in the need of common benchmarks for …

Reduction Of Endothelial Nitric Oxide Increases The Adhesiveness Of Constitutive Endothelial Membrane Icam-1 Through Src-Mediated Phosphorylation, Feng Gao, Brandon P. Lucke-Wold, Xiang Li, Aric F. Logsdon, Li-Chong Xu, Sulei Xu, Kyle B. Lapenna, Huaqi Wang, M.A. Hassan Talukder, Christopher A. Siedlecki, Jason D. Huber, Charles L. Rosen, Pingnian He

Faculty & Staff Scholarship

Nitric oxide (NO) is a known anti-adhesive molecule that prevents platelet aggregation and leukocyte adhesion to endothelial cells (ECs). The mechanism has been attributed to its role in the regulation of adhesion molecules on leukocytes and the adhesive properties of platelets. Our previous study conducted in rat venules found that reduction of EC basal NO synthesis caused EC ICAM-1-mediated firm adhesion of leukocytes within 10–30min. This quick response occurred in the absence of alterations of adhesion molecules on leukocytes and also opposes the classical pattern of ICAM-1-mediated leukocyte adhesion that requires protein synthesis and occurs hours after stimulation. The objective …

The Role Of Tgf-Β/Smad4 Signaling In Cancer, M Zhao, Lopa Mishra, C Deng

Surgery Faculty Publications

Transforming growth factor β (TGF-β) signaling pathway plays important roles in many biological processes, including cell growth, differentiation, apoptosis, migration, as well as cancer initiation and progression. SMAD4, which serves as the central mediator of TGF-β signaling, is specifically inactivated in over half of pancreatic duct adenocarcinoma, and varying degrees in many other types of cancers. In the past two decades, multiple studies have revealed that SMAD4 loss on its own does not initiate tumor formation, but can promote tumor progression initiated by other genes, such as KRAS activation in pancreatic duct adenocarcinoma and APC inactivation in colorectal cancer. In …

Surgical Management Of Symptomatic Intraluminal Duodenal Diverticulum In An Adolescent, Vivian Lam Saavedra, Timothy D. Kane, Stefany Garrity

Surgery Faculty Publications

No abstract provided.

A Primer On The Acute Management Of Intravenous Extravasation Injuries For The Plastic Surgeon, Connor Maly, Kenneth Fan, Gary F. Rogers, Benjamin Mitchell, June Amling, Kara Johnson, Laura Welch, Albert K. Oh, Jerry Chao

Surgery Faculty Publications

Intravenous therapy is a common practice among many specialties. Intravenous therapy extravasation is a potential complication to such therapy. Hospitals without a dedicated wound care team trained in these interventions will often default to plastic surgical consultation, making an understanding of available interventions essential to the initial evaluation and management of these injuries. The goal of this article was to provide plastic surgeons and health care providers with a general overview of the acute management of intravenous infiltration and extravasation injuries. Though the decision for surgical versus nonsurgical management is often a clear one for plastic surgeons, local interventions, and …

Same Day Discharge For Non-Perforated Appendicitis In Children: An Updated Institutional Protocol, Tolulope A. Oyetunji Md Mph

Presentations

No abstract provided.

Relationship Of Transmural Variations In Myofiber Contractility To Left Ventricular Ejection Fraction: Implications For Modeling Heart Failure Phenotype With Preserved Ejection Fraction, Yanghoub Dabiri, Kevin L. Sack, Semion Shaul, Partho P. Sengupta, Julius M. Guccione

Faculty & Staff Scholarship

The pathophysiological mechanisms underlying preserved left ventricular (LV) ejection fraction (EF) in patients with heart failure and preserved ejection fraction (HFpEF) remain incompletely understood. We hypothesized that transmural variations in myofiber contractility with existence of subendocardial dysfunction and compensatory increased subepicardial contractility may underlie preservation of LVEF in patients with HFpEF. We quantified alterations in myocardial function in a mathematical model of the human LV that is based on the finite element method. The fiber-reinforced material formulation of the myocardium included passive and active properties. The passive material properties were determined such that the diastolic pressure-volume behavior of the LV …

Quantum Confined Peptide Assemblies With Tunable Visible To Near-Infrared Spectral Range, Kai Tao, Zhen Fan, Leming Sun, Pandeeswar Makam, Zhen Tian, Mark Ruegsegger, Shira Shaham-Niv, Derek Hansford, Ruth Aizen, Zui Pan, Scott Galster, Jianjie Ma, Fan Yuan, Mingsu Si, Songnan Qu, Mingjun Zhang, Ehud Gazit, Junbai Li

Faculty & Staff Scholarship

Quantum confined materials have been extensively studied for photoluminescent applica- tions. Due to intrinsic limitations of low biocompatibility and challenging modulation, the utilization of conventional inorganic quantum confined photoluminescent materials in bio- imaging and bio-machine interface faces critical restrictions. Here, we present aromatic cyclo-dipeptides that dimerize into quantum dots, which serve as building blocks to further self-assemble into quantum confined supramolecular structures with diverse morphologies and photoluminescence properties. Especially, the emission can be tuned from the visible region to the near-infrared region (420 nm to 820 nm) by modulating the self-assembly process. Moreover, no obvious cytotoxic effect is observed for …

Mucinous Adenocarcinoma Of The Scalp: Primary Cutaneous Neoplasm Versus Underlying Metastatic Disease, Ciara A. Brown, Michael C. Lynch, Cristiane M. Ueno

Faculty & Staff Scholarship

Primary cutaneous mucinous carcinoma (PCMC) is a rare mucin-pro- ducing malignancy derived from epithelial glandular structures. The literature re- garding this topic is mostly in the form of case reports and case series. PCMC tends to present in the elderly with predilection for the head and neck and on initial assessment it can be easily mistaken for a simple inclusion cyst. Although PCMC is often indolent in nature, in rare instances it can metastasize and should remain a differential diagnosis in a selected population. The significance in identifying PCMC is reliably differentiating it from metastatic mucinous adenocarcinoma. We present a …

Isolated Inferior Rectus Muscle Entrapment Following Endoscopic Sinus Surgery, Scott Shapiro, Jamie L. Schaefer, Sumeet Gupta, John Nguyen, Brian Kellerymeyer

Faculty & Staff Scholarship

Orbital complications are known risks of endoscopic sinus surgery (ESS). The lamina papyracea and medial rectus muscle are the most commonly injured structures during ESS. Inferior rectus injury is more rare, with only one reported case of isolated inferior rectus injury in the literature. Guidelines for managing ESS-induced inferior rectus injury do not exist, and delayed intervention and management of adjacent sinuses may affect long-term outcomes such as persistent diplopia and disfigurement. In this report, we present a case of a 67-year-old man with diplopia due to isolated left inferior rectus muscle entrapment and injury from violation of the orbital …

Pseudomonas Aeruginosa Algr Phosphorylation Status Differentially Regulates Pyocyanin And Pyoverdine Production, Alexander S. Little, Yuta Okkotsu, Alexandria A. Reinhart, Heath Damron, Mariette Barbier, Brandon Barrett, Amanda G. Ogledby-Sherrouse, Joanna B. Goldberg, William L. Cody, Michael J. Schurr, Michael L. Vasil

Faculty & Staff Scholarship

Pseudomonas aeruginosa employs numerous, complex regulatory ele- ments to control expression of its many virulence systems. The P. aeruginosa AlgZR two-component regulatory system controls the expression of several crucial viru- lence phenotypes. We recently determined, through transcriptomic profiling of a PAO1 ΔalgR mutant strain compared to wild-type PAO1, that algZR and hemCD are cotranscribed and show differential iron-dependent gene expression. Previous ex- pression profiling was performed in strains without algR and revealed that AlgR acts as either an activator or repressor, depending on the gene. Thus, examination of P. aeruginosa gene expression from cells locked into different AlgR phosphorylation states …

Tracheocutaneous Sinus Following Tracheocutaneous Fistula Repair: Management Strategies In A Pediatric Patient, Adam Bender-Heine, Habib G. Zalzal, Nainika Nanda, Hassan Ramadan

Faculty & Staff Scholarship

Objective. To present a rare case of a pediatric tracheocutaneous sinus years after repair of a tracheocutaneous fistula and to review management strategies. Background. A tracheocutaneous fistula is a common sequela of pediatric tracheostomy and can occur in as many as one in three pediatric patients. There is debate in the literature regarding optimal surgical management. Case Presentation. An 8-year-old girl presented to the emergency department with swelling and erythema over the anterior neck. Clinical exam and diagnostic imaging revealed an underlying tracheocutaneous sinus. Discussion. Complications following pediatric tracheostomy are common and range in complexity from stomal granulation to tracheocutaneous …

Hyperspectral Imaging And K-Means Classification For Histologic Evaluation Of Ductal Carcinoma In Situ, Yasser Khouj, Jeremy Dawson, James Coad, Linda Vona-Davis

Faculty & Staff Scholarship

Hyperspectral imaging (HSI) is a non-invasive optical imaging modality that shows the potential to aid pathologists in breast cancer diagnoses cases. In this study, breast cancer tissues from different patients were imaged by a hyperspectral system to detect spectral differences between normal and breast cancer tissues. Tissue samples mounted on slides were identified from 10 different patients. Samples from each patient included both normal and ductal carcinoma tissue, both stained with hematoxylin and eosin stain and unstained. Slides were imaged using a snapshot HSI system, and the spec- tral reflectance differences were evaluated. Analysis of the spectral reflectance values indicated …

Macrophage Sensing Of Single- Walled Carbon Nanotubes Via Toll- Like Receptors, Sourav P. Mukherjee, Olesja Bondarenko, Pekka Kohonen, Fernando T. Andon, Tana Brzicova, Isabel Gessner, Sanjay Mathur, Massimo Bottini, Paolo Calligari, Lorenzo Stella, Elena Kisin, Anna Shvedova, Reija Autio, Heli Salminen-Mankonen, Ritta Lahesmaa, Bengt Fadeel

Faculty & Staff Scholarship

Carbon-based nanomaterials including carbon nanotubes (CNTs) have been shown to trigger

inflammation. However, how these materials are ‘sensed’ by immune cells is not known. Here we compared the effects of two carbon-based nanomaterials, single-walled CNTs (SWCNTs) and graphene oxide (GO), on primary human monocyte-derived macrophages. Genome-wide transcriptomics assessment was performed at sub-cytotoxic doses. Pathway analysis of the microarray data revealed pronounced effects on chemokine-encoding genes in macrophages exposed to SWCNTs, but not in response to GO, and these results were validated by multiplex array-based cytokine and chemokine profiling. Conditioned medium from SWCNT-exposed cells acted as a chemoattractant for dendritic cells. …

Thoracic Stent Graft Placement For Repair Of Iatrogenic Aortic Injury Secondary To Sheath Placement During Pacemaker Insertion, Jared T. Feyko, Kelsey Musgrove, Cara Lyle, Alexandre D'Audiffret

Faculty & Staff Scholarship

We describe the inadvertent cannulation of the proximal descending thoracic aortic stent with a five French sheath during attempted pacemaker placement in an 88- year-old male. The injury was managed successfully by the percutaneous placement of a thoracic aortic stent graft with good outcome. Our case highlights the feasibility of managing this uncommon injury with this technique.

Palatine Tonsil Stenting Of The Airway As Determined By Drug-Induced Sleep Endoscopy, Habib G. Zalzal, Steven Coutras

Faculty & Staff Scholarship

Objective. To demonstrate lateral pharyngeal wall collapse and increased apnea-hypopnea index in a child posttonsillectomy. Background. Some children have worsening of their sleep symptoms after tonsillectomy for obstructive sleep apnea. This case report demonstrates an open airway on drug-induced sleep endoscopy (DISE) in a child with tonsillar hypertrophy followed by more pronounced airway obstruction related to lateral pharyngeal wall collapse after tonsillectomy. Case Presentation. A 7-year- old boy presented with obstructive sleep apnea and underwent workup with DISE. Following adenotonsillectomy and subsequent lingual tonsillectomy with epiglottopexy, the patient’s sleep apnea symptoms and polysomnogram results worsened. Subsequent DISE showed a more …

Determinants And Outcomes Of Vasoplegia Following Left Ventricular Assist Device Implantation, K. M. Tecson, B. Lima, A. Y. Lee, F. S. Raza, G. Ching, C. Lee, J. Felius, R. D. Baxter, S. Still, S. M. Joseph, +2 Additional Authors

Journal Articles

No abstract provided.

High-Frequency Percussive Ventilation Facilitates Weaning From Extracorporeal Membrane Oxygenation In Adults, I. Gulkarov, J. Schiffenhaus, I. Wong, A. Afzal, F. Khusid, B. Worku

Journal Articles

© 2018 American Society of Extra-Corporeal Technology. All Rights Reserved. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is an invaluable rescue therapy for patients suffering from cardiopulmonary arrest, but it is not without its drawbacks. There are cases where patients recover their cardiac function, yet they fail to wean to mechanical conventional ventilation (MCV). The use of high-frequency percussive ventilation (HFPV) has been described in patients with acute respiratory failure (RF) who fail MCV. We describe our experience with five patients who underwent VA-ECMO for cardiopulmonary arrest who were successfully weaned from VA-ECMO with HFPV after failure to wean with MCV. Weaning …

Sternotomy Closure Using Rigid Plate Fixation: A Paradigm Shift From Wire Cerclage, K. B. Allen, K. J. Icke, V. H. Thourani, Y. Naka, K. J. Grubb, J. Grehan, N. Patel, T. S. Guy, K. Landolfo, M. Bonnell, +1 Additional Author

Journal Articles

No abstract provided.

Identification Of Ethyl Pyruvate As A Nlrp3 Inflammasome Inhibitor That Preserves Mitochondrial Integrity, S. Li, F. Liang, K. Kwan, Y. Tang, X. Wang, H. Yang, S. S. Chavan, H. Wang, K. J. Tracey, +3 Additional Authors

Journal Articles

No abstract provided.

Primary Solitary Retro-Clival Amyloidoma., J. R. Schneider, K. Kwan, K. O. Kulason, L. J. Faltings, S. Colantonio, S. Safir, J. Y. Li, K. S. Black, B. T. Schaeffer, M. B. Eisenberg, +1 Additional Author

Journal Articles

Amyloidosis encompasses a group of disorders sharing the common feature of intercellular deposition of amyloid protein by several different pathogenetic mechanisms. Primary solitary amyloidosis, or amyloidoma, is a rare subset of amyloidosis in which amyloid deposition is focal and not secondary to a systemic process or plasma cell dyscrasia.This 84-year-old female presented with history of multiple syncopal episodes, dysphagia, and ataxia. Motor strength was 3+/5 in the right upper extremity. Rheumatoid factor, cyclic citrullinated peptide (CCP), and anti-nuclear antibody (ANA) were normal. Serum and urine immune-electrophoresis detected no abnormal bands. Computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated a …

Induction And Quantification Of Excitability Changes In Human Cortical Networks, C. J. Keller, Y. Huang, J. L. Herrero, M. E. Fini, V. Du, F. A. Lado, C. J. Honey, A. D. Mehta

Journal Articles

No abstract provided.

Correction To: First Results On Survival From A Large Phase 3 Clinical Trial Of An Autologous Dendritic Cell Vaccine In Newly Diagnosed Glioblastoma, L. M. Liau, K. Ashkan, D. D. Tran, J. L. Campian, J. E. Trusheim, C. S. Cobbs, J. A. Heth, M. Salacz, M. Schulder, M. L. Bosch, +59 Additional Authors

Journal Articles

© 2018 The Author(s). Following publication of the original article [1], the authors reported an error in the spelling of one of the author names. In this Correction the incorrect and correct author names are indicated and the author name has been updated in the original publication. The authors also reported an error in the Methods section of the original article. In this Correction the incorrect and correct versions of the affected sentence are indicated. The original article has not been updated with regards to the error in the Methods section.

Spontaneous Intracranial Hypotension Complicated By Refractory Subdural Hematomas In A Patient With Coagulation Factor Xiii Deficiency, R. Gilad, S. L. Motivala, S. Khan, E. Chang, D. L. Klein, M. J. Raden

Journal Articles

© 2018 The Authors Spontaneous intracranial hypotension (SIH) is often secondary to an occult cerebrospinal fluid (CSF) leak in the neuroaxis. It is sometimes associated with chronic subdural hematomas (SDH). The authors present the case of a 61 year-old male who presented with SIH from an occult CSF leak and complicated by refractory SDH. The patient underwent treatment for SIH with multiple epidural blood patches, hydration and bed rest. In addition, he underwent evacuation of his SDH twice, once via burr hole drainage and the second via craniotomy. Once the diagnosis of coagulation factor XIII (CFXIII) deficiency was made, the …

Cold-Inducible Rna-Binding Protein Activates Splenic T Cells During Sepsis In A Tlr4-Dependent Manner, A. C. Bolognese, A. Sharma, W. Yang, J. Nicastro, G. F. Coppa, P. Wang

Journal Articles

No abstract provided.

A Cold-Inducible Rna-Binding Protein (Cirp)-Derived Peptide Attenuates Inflammation And Organ Injury In Septic Mice, F. Zhang, M. Brenner, W. Yang, P. Wang

Journal Articles

No abstract provided.

Bleeding Risk And Thromboprophylaxis In Neurosurgical Patients After Emergency Procedures, J. Cagliani, G. Ritter, C. Nelson, D. Knobel, K. Hopkins, E. P. Molmenti, J. Nicastro, G. Coppa, R. Barrera

Journal Articles

No abstract provided.

Cirp Increases Icam-1(+) Phenotype Of Neutrophils Exhibiting Elevated Inos And Nets In Sepsis, Y. Ode, M. Aziz, P. Wang

Journal Articles

No abstract provided.

Activation Of Invariant Natural Killer T Cells Redirects The Inflammatory Response In Neonatal Sepsis, A. C. Bolognese, W. Yang, L. W. Hansen, A. Sharma, J. M. Nicastro, G. F. Coppa, P. Wang

Journal Articles

No abstract provided.