Medical Specialties Commons^™

Benzyl Isothiocyanate As An Adjuvant Chemotherapy Option For Head And Neck Squamous Cell Carcinoma, Mary Allison Wolf

Theses, Dissertations and Capstones

Isothiocyanates (ITCs) are natural phytochemicals produced by cruciferous vegetables. Recent evidence supports that, in addition to cancer prevention, ITCs can use various mechanisms to target malignant cells. Current therapies for cancer often provoke detrimental side effects, however clinical evidence supports that ITCs have little to no side effects in patients. Consequently, ITCs may be a promising treatment option for cancer patients, especially patients suffering from head and neck squamous cell carcinoma (HNSCC).

Despite recent improvements in cancer treatment, overall survival of advanced HNSCC has not improved in the past three decades. Metastasis and chemoresistance represent two detrimental events that greatly …

Antioxidants Condition Pleiotropic Vascular Responses To Exogenous H2o2: Role Of Modulation Of Vascular Tp Receptors And The Heme Oxygenase System, Nitin Puri, Fan Zhang, Sumit R. Monu, Komal R. Sodhi, Lars Bellner, Brian D. Lamon, Yilun Zhang, Nader G. Abraham, Alberto Nasjletti

Biochemistry and Microbiology

Aims: Hydrogen peroxide (H(2)O(2)), a nonradical oxidant, is employed to ascertain the role of redox mechanisms in regulation of vascular tone. Where both dilation and constriction have been reported, we examined the hypothesis that the ability of H(2)O(2) to effect vasoconstriction or dilation is conditioned by redox mechanisms and may be modulated by antioxidants.

Results: Exogenous H(2)O(2) (0.1-10.0 μM), dose-dependently reduced the internal diameter of rat renal interlobular and 3rd-order mesenteric arteries (p<0.05). This response was obliterated in arteries pretreated with antioxidants, including tempol, pegylated superoxide dismutase (PEG-SOD), butylated hydroxytoluene (BHT), and biliverdin (BV). However, as opposed to tempol or PEG-SOD, BHT & BV, antioxidants targeting radicals downstream of H(2)O(2), also uncovered vasodilation.

Innovations: Redox-dependent vasoconstriction to H(2)O(2) was blocked by inhibitors of cyclooxygenase (COX) (indomethacin-10 μM), thromboxane (TP) synthase (CGS13080-10 μM), and TP receptor antagonist (SQ29548-1 μM). However, H(2)O(2) …

How Could, Should, And Would Physicians Use Facebook With Patients, Joy Peluchette, Katherine Karl, Alberto Coustasse

Management Faculty Research

After reviewing the benefits and risks of social media, we examine online discussion boards to determine the thoughts of physicians and patients regarding the use of Facebook to communicate with one another about health-related issues. Of the 290 comments analyzed, we found 42 percent were opposed to physicians using Facebook. Additionally, most (51.7 were opposed to physicians being Facebook “friends” with patients. Most opponents expressed concerns about privacy and the need to maintain professional boundaries in the physician-patient relationship. We provide suggestions for how healthcare administrators can effectively manage their social media presence and provide assistance to physicians.

Lactobacillus Acidophilus Alleviates Platelet-Activating Factor-Induced Inflammatory Responses In Human Intestinal Epithelial Cells, Alip Borthakur, Sumit Bhattacharyya, Anoop Kumar, Arivarasu Natarajan Anbazhagan, Joanne K. Tobacman, Pradeep K. Dudeja

Clinical & Translational Sciences

Probiotics have been used as alternative prevention and therapy modalities in intestinal inflammatory disorders including inflammatory bowel diseases (IBD) and necrotizing enterocolitis (NEC). Pathophysiology of IBD and NEC includes the production of diverse lipid mediators, including platelet-activating factor (PAF) that mediate inflammatory responses in the disease. PAF is known to activate NF-kB, however, the mechanisms of PAF-induced inflammation are not fully defined. We have recently described a novel PAF-triggered pathway of NF-κB activation and IL-8 production in intestinal epithelial cells (IECs), requiring the pivotal role of the adaptor protein Bcl10 and its interactions with CARMA3 and MALT1. The current studies …

Physical Education In West Virginia Schools: Are We Doing Enough To Generate Peak Bone Mass And Promote Skeletal Health?, Franklin D. Shuler Md, Phd, Dana Lycans, Thomas Gill Md, Ali Oliashirazi Md

Orthopaedics

Peak bone mass (PBM) is attained at 25-35 years of age, followed by a lifelong decline in bone strength. The most rapid increase in bone mass occurs between the ages of 12-17. Daily school physical education (PE) programs have been shown to produce measurable increases in PBM, but are not federally mandated. Increases in PBM can decrease the lifelong risk of osteoporosis and fractures; critical for West Virginia prevention programs. Nationally only 1 in 6 schools require PE three days per week, with 4% of elementary schools, 8% of middle schools and 2% of high schools providing daily PE. In …

A Case Of Congenital Unilateral Absence Of The Vas Deferens, Bi Mo, Vishnu Garla, Lawrence M. Wyner M.D.

Surgery

Background

Congenital unilateral absence of the vas deferens occurs in 0.5%–1.0% of males. It has been associated with various genitourinary abnormalities, including renal agenesis. We report a case of congenital unilateral absence of the vas deferens found incidentally during vasectomy in a patient with known unilateral renal agenesis.

Case presentation

A 24-year-old male presented to our urology clinic requesting vasectomy. His past history was significant for left renal agenesis. Following successful right vasectomy, several attempts to locate the left vas deferens were unsuccessful. We diagnosed congenital unilateral absence of the vas deferens. Follow-up semen analysis showed azoospermia.

Conclusion

As vasectomies …

Intraoperative Hyperglycemia In Adult Patients Undergoing An Emergency Craniotomy Following A Traumatic Brain Injury As A Predictor Of Postoperative Outcomes And Mortality, Sara Lynn Hoover

Theses, Dissertations and Capstones

Abstract: The purpose of this study was to determine if there was an association between intraoperative blood glucose ≥150 mg/dl in patients undergoing an emergency craniotomy and Intensive Care Unit (ICU) Length of Stay (LOS), hospital LOS and mortality.

Introduction: Traumatic Brain Injuries (TBI)’s are associated with increased morbidity and mortality. The stress response by the body may cause an increase in blood glucose levels which can cause secondary brain injury. When a patient undergoes an emergency craniotomy following a TBI the increased stress on the body can cause an even higher blood glucose. There is no consensus in …

Antibiotic-Like Actions Of Vitamin D, Franklin D. Shuler Md, Phd, Josh Hendrix, Adam Short, Sammy Hodroge

Orthopaedics

Vitamin D is a secosteroid hormone that has expanding importance for a healthy lifestyle and disease prevention. A multitude of studies have highlighted that vitamin D acts not only in bone and calcium homeostasis but is critically important for human immunity. The discovery that the storage form of vitamin D (25-hydroxyvitamin D3) can be locally converted to the active form (1,25-hydroxyvitamin D3) in immune cells, epithelial cells and numerous other non-renal tissues highlights the importance of maintaining sufficient stores. When responding to a specific external stimulus, like bacterial invasion, intracrine synthesis of active vitamin D has the ability to regulate …

An Update On Braf Inhibitors And Other New Molecular Targets For The Treatment Of Malignant Melanoma Of The Skin, M. O. Faruk Khan, Carroll L. Ramos

Pharmaceutical Science and Research

Malignant melanoma of the skin originates from mutations in melanocytes and can be lethal if unrecognized or untreated in its earlier stages. Deaths from melanoma are increasing in the United States and around the world every year. The available treatments produce low rates of response with modest survival impact. Among potential molecular targets under investigation, which are mostly in the tyrosine kinase pathway, the BRAF (V-raf murine sarcoma viral oncogene homolog B1) gene is the best studied and most frequently reported mutation in melanoma. The molecular targets for melanoma treatment, promising drugs for future melanoma treatment as well as the …

Screening Diabetic And Hypertensive Patients For Ocular Pathology Using Telemedicine Technology In Rural West Virginia: A Retrospective Chart Review, Rezwan Ahmed Md, Stephen M. Petrany, Russell Fry Ii, Michael Krasnow Do, Phd

Internal Medicine

Abstract: Purpose: There is a disparity between the number of people who need healthcare and availability of medical services in rural areas. This paper describes the experience of using telemedicine technologies for ophthalmologic evaluation in diabetic and hypertensive patients presenting to a community health center in rural West Virginia.

Methods: A registered nurse at a community health center in McDowell County, WV was trained to use a retinal camera to capture high-resolution digital images of the retina. Patients with diabetes or hypertension were screened during their routine primary care visits. Retinal photos were transmitted to an ophthalmologist for review and …

Cost-Savings Analysis Of Telemedicine Use For Ophthalmic Screening In A Rural Appalachian Health Clinic, D. Russell Richardson, Russell Fry Ii, Michael Krasnow Do, Phd

Ophthalmology

Life in mountainous, rural areas poses unique obstacles for ophthalmic care--notably, a lack of access to ophthalmologists and cost of care. Using telemedicine as a screening tool addresses both issues for diabetic retinopathy (DR) screening, as fundus photography has been determined to be sensitive and specific when screening for DR.^1,2 The American Diabetes Association places a Grade E recommendation on fundus photography as a screening tool.³ We analyze the financial impact of ophthalmic telemedicine in a mountainous, rural health clinic in West Virginia over a seven year period from 2003-2009. At-risk patients are screened with a fundus camera …

Gender Differences In The Development Of Uremic Cardiomyopathy Following Partial Nephrectomy: Role Of Progesterone, Christopher A. Drummond, George Buddny, Steven T. Haller, Jiang Liu, Yanling Yan, Zijian Xie, Deepak Malhotra, Joseph I. Shapiro Md, Jiang Tian

Biochemistry and Microbiology

Gender difference has been suggested as a risk factor for developing cardiovascular and renal diseases in humans and experimental animals. As a major sex hormone, progesterone was reported to compete with cardiotonic steroid binding to Na/K-ATPase. Our previous publication demonstrated that cardiotonic steroids (e.g., marinobufagenin) play an important role in the development of experimental uremic cardiomyopathy. We also observed that the putative mineralocorticoid antagonists, spironolactone and its major metabolite canrenone, antagonize binding of cardiotonic steroids to Na/K-ATPase in a competitive manner and also ameliorate experimental uremic cardiomyopathy induced by partial nephrectomy. In the following studies, we noted that progesterone displayed …

Predicting Risk For Adverse Outcomes Following Distal Radius Fracture, Saurabh Mehta Phd

Physical Therapy Faculty Research

Some individuals remain at risk for adverse outcomes such as chronic wrist/hand pain, falls, and fall-related osteoporotic fractures after distal radius fracture (DRF) remain. This thesis includes five studies that were conducted to establish prediction rules or assessing the risk of these adverse outcomes following DRF.

The first manuscript outlines a theoretical framework (RACE - Reducing pain, Activating, Cognitive reshaping, Empowering) for managing the risk of adverse outcomes, mainly chronic pain, in individuals with DRF. The RACE is one of the first frameworks to suggest a risk-based management approach for individuals with DRF.

The Patient-Rated Wrist Evaluation (PRWE) is a …

Is Chest Tube Insertion With Ultrasound Guidance Safe In Patients Using Clopidogrel?, Wissam Abouzgheib, Yousef R. Shweihat, Nikhil Meena, Thaddeus Barrter

Internal Medicine

Background and objective: Drainage of the pleural space is a common procedure.The safety of chest tube insertion in patients using clopidogrel has not been investigated.

Methods: Ultrasound-guided chest tube insertions performed on 24 patients who were being actively treated with clopidogrel were retrospectively reviewed.

Results: No excessive bleeding occurred in any of these patients.

Conclusions: Given the known effects of clopidogrel on platelet function, these results were interpreted as indicating that clopidogrel therapy is a relative but not an absolute contraindication to chest tube insertion, if an experienced operator places a small-bore tube under ultrasound guidance.

Stem Cell Transplantation Increases Antioxidant Effects In Diabetic Mice, Ming Li, Luca Vanella, Yuming Zhang, Ming Shi, Takashi Takaki, Joseph I. Shapiro M.D., Susuma Ikehera

Biochemistry and Microbiology

Intra bone marrow-bone marrow transplantation (IBM- BMT) + thymus transplantation (TT) has been shown to reduce the incidence of graft versus host disease (GVHD) and restore donor-derived T cell function. In addition, an increase in insulin sensitivity occurred in db/db mice after IBM-BMT+TT treatment. Heme oxygenase (HO)-1 is a stress inducible enzyme which exert antioxidant, antiapoptotic, and immune-modulating properties. We examined whether IBM-BMT+TT could modulate the expression of HO-1 in the kidneys of db/db mice. Six-week-old db/db mice with blood glucose levels higher than 250 mg/dl were treated with IBM-BMT+TT. Six weeks later, the db/db mice showed decreased body weight, …

Screening Mammograms In Alzheimer’S Disease Patients, George M. Yousef, Piyush Sovani, Sirisha Devabhaktuni, Lynne J. Goebel

Internal Medicine

Very little guidance exists to help clinicians and families decide whether mammograms are useful in elderly women with Alzheimer’s Disease (AD). We present a case of a patient with moderate AD who had a positive mammogram and discuss the dilemma faced by the family and clinician in deciding what was best to do for the patient. In this case, the family opted for breast conserving surgery (BCS) followed by palliative care which brought up the question of whether screening was appropriate with this treatment goal in mind. We reviewed the literature on AD and breast cancer screening and summarize these …

Replacement Gastrostomy Tube Causing Acute Pancreatitis: Case Series With Review Of Literature, Anish M. Shah, Nihar Shah Md, Joseph R. Depasquale

Gastroenterology

Context Percutaneous endoscopic gastrostomy (PEG) feedings are generally considered safe with few serious complications. Acute pancreatitis is a rare complication associated with replacement percutaneous endoscopic gastrostomy tubes.

Case report We report two cases of acute pancreatitis induced by migrated replacement percutaneous endoscopic gastrostomy tubes.

Conclusions Migration of a balloon into the duodenum can result in external manipulation of the ampulla of Vater thereby disturbing the flow of pancreatic secretions leading to acute pancreatitis. Recognition of this complication is important and should be included as potential etiology of acute pancreatitis in patients receiving percutaneous endoscopic gastrostomy feedings. Periodic examination and documentation …

The Role Of Ptip In Breast Cancer, Lina Niu

Theses, Dissertations and Capstones

In the U.S., breast cancer comprises about 30% of all cancer cases (excluding skin cancer) in women. Such a high incidence makes breast cancer a significant health concern, but our understanding of the molecular and cellular mechanisms of this disease is still limited. Growing evidence suggests that the development of human breast cancer may involve epigenetics, which attributes changes in phenotype to mechanisms other than changes in the DNA sequence itself. Histones as the chief proteins of chromatin work on gene expression, and methylation of histone 3 lysine 4 (H3K4) results in transcriptional activation. Lately, Paired box (Pax) trans-activation domain-interacting …

Factors That Motivate Certified Registered Nurse Anesthetists To Practice Independently In The Appalachian Region, Michael Lee Frame Jr.

Theses, Dissertations and Capstones

Introduction: Independent Certified Registered Nurse Anesthetists (CRNAs) provide anesthesia services without the supervision or medical direction of anesthesiologists in healthcare facilities throughout the United States. The present literature is limited concerning the factors that motivate CRNAs to choose employment in rural independent practice.

Research Hypothesis: In a sample of CRNAs who practice independently in one of the 13 states of the Appalachian region there will be no differences between the CRNAs from Appalachian and Non-Appalachian counties in their responses to the motivation factors of achievement, recognition, responsibility, advancement, work itself, salary, working conditions, company and administrative policies, supervision, and …

Risk Factors For Ventilator-Associated Pneumonia In The Adult Trauma Patient: A Retrospective Case-Control Study From A Level I Trauma Center, Summer L. Chapman

Theses, Dissertations and Capstones

Introduction: Ventilator-Associated Pneumonia (VAP) continues to be a common complication among the adult trauma population. Little advancements have been made to decrease the incidence, suggesting further research is needed to establish modifiable risk factors. The purpose of this study was to test for an associated link between prehospital intubation and the development of VAP in the adult trauma patient.

Methodology: A retrospective, case-control study design was utilized. The sample included 494 adult trauma patients who required endotracheal intubation and mechanical ventilation for a minimum of 24 hours. All patients presented as a priority one or two trauma to the Charleston …

Redox Regulation Of Differentiation In Neuroblastoma, Anne Marie Silvis

Theses, Dissertations and Capstones

Neuroblastoma is the most common extracranial solid tumor in childhood, ranking third in prevalence among infant cancers. Despite intensive therapy with surgery, radiation and chemotherapy, there is a high chance of tumor recurrence. These children are therefore given retinoids in the maintenance phase to differentiate the tumor cells and to avoid/lessen this incidence. Although 13-cis retinoic acid (13-cis RA) is currently used to treat neuroblastoma, there is much evidence supporting the prevalence of its metabolite, all-trans retinoic acid (ATRA), to be the main signaling retinoid in vivo.

The SK-N-SH neuroblastoma cell line, which is composed of three sub-types: sympatheoadrenal neuroblasts …

Down-Regulation Of The Transcription Factor Snail In The Placentas Of Patients With Preeclampsia And In A Rat Model Of Preeclampsia, Larissa Federova, Cara Gatto-Weis, Sleiman Smaili, Nauman Khurshid, Joseph I. Shapiro M.D., Deepak Malhorta, Terrence Horrigan

Biochemistry and Microbiology

Background: Placental malfunction in preeclampsia is believed to be a consequence of aberrant differentiation of trophoblast lineages and changes in utero-placental oxygenation. The transcription factor Snail, a master regulator molecule of epithelial-mesenchymal transition in embryonic development and in cancer, is shown to be involved in trophoblast differentiation as well. Moreover, Snail can be controlled by oxidative stress and hypoxia. Therefore, we examined the expression of Snail and its downstream target, e-cadherin, in human normal term, preterm and preeclamptic placentas, and in pregnant rats that developed preeclampsia-like symptoms in the response to a 20- fold increase in sodium intake.

Methods: Western …

Controlled Biomineralization Of Electrospun Poly(Ε-Caprolactone) Fibers For Enhancing Their Mechanical Properties, Jingwei Xie, Shaoping Zhong, Bing Ma, Franklin D. Shuler, Chwee Teck Lim

MIIR Faculty Research

Electrospun polymeric fibers have been investigated as scaffolding materials for bone tissue engineering. However, their mechanical properties, and in particular stiffness and ultimate tensile strength, cannot match those of natural bones. The objective of the study was to develop novel composite nanofiber scaffolds by attaching minerals to polymeric fibers using an adhesive material-the mussel-inspired protein polydopamine-as a "superglue". Herein, we report for the first time the use of dopamine to regulate mineralization of electrospun poly(ε-caprolactone) (PCL) fibers to enhance their mechanical properties. We examined the mineralization of the PCL fibers by adjusting the concentration of HCO3 - and dopamine in …

Extraskeletal Effects Of Vitamin D: Potential Impact On Wv Disease Morbidity And Mortality, Franklin D. Shuler, Dana Lycans, Elias Salloum

Orthopaedics

Vitamin D is an essential nutrient and a secosteroid hormone that regulates many physiologic processes beyond calcium and bone homeostasis. These "extraskeletal" effects are impacted by the circulating levels of the storage form of vitamin D, 25-hydroxyvitamin D3. Levels of vitamin D can be detected after completing a simple 25(OH)D blood test. Vitamin D deficiency (< 30 ng/mL) is associated with a higher risk of many chronic diseases including, but not limited to, fourteen types of cancers, type 1 and 2 diabetes mellitus, obesity, cardiovascular disease, hypertension, stroke, and asthma. This article explores the association between vitamin D deficiency and the burden of chronic diseases in West Virginia.

Consumption Of High Ω-3 Fatty Acid Diet Suppressed Prostate Tumorigenesis In C3(1) Tag Mice, Juliana A. Akinsete, Gabriela Ion, Theodore R. Witte, W. Elaine Hardman

Biochemistry and Microbiology

Prostate cancer incidence and mortality are high in the Western world and high ω-6/ω-3 PUFA in the Western diet may be a contributing factor. We investigated whether changing from a diet that approximates ω-6 fat content of the Western diet to a high ω-3 fat diet at adulthood might reduce prostate cancer risk. Female SV 129 mice that had consumed a high ω-6 diet containing corn oil for 2 weeks were bred with homozygous C3(1)Tag transgenic male mice. All male offspring were weaned to the corn oil diet (CO) until postpuberty when half of the male offspring were transferred to …

The Fit-Hansa Demonstrates Reliability And Convergent Validity Of Functional Performance In Patients With Shoulder Disorders, Prajyot Kumta, Joy C. Macdermid, Saurabh Mehta, Paul W. Stratford

Physical Therapy Faculty Research

Study

DesignPsychometric study design.

Objectives

To assess the test-retest reliability and convergent validity of the Functional Impairment Test-Hand and Neck/Shoulder/Arm (FIT-HaNSA) in patients with shoulder disorders.

Background

Performance tests that assess functional ability of patients with shoulder disorders can provide useful information for making clinical or return-to-activity decisions. No performance-based shoulder test has yet demonstrated sufficient relevance or clinical measurement properties. The FIT-HaNSA examines upper extremity performance during repetitive tasks that emphasize shoulder reaching and static postures and, therefore, has greater relevance for assessing performance.

Methods

Thirty-six patients with shoulder disorders and 65 healthy controls were recruited for the study. …

0789: George J. Hill Collection, 1889-2011, Marshall University Special Collections

Guides to Manuscript Collections

This collection includes research materials used by Dr. Hill, pertaining to his research interests in medical, military, and New Jersey history, in addition to cancer and leprosy, Dr. Hill's medical specialties. It also includes copies of articles, reports, and abstracts written about Dr. Hill. Additionally, the collection has an assortment of historical pamphlets about leprosy.

Oxidative Stress And Heme Oxygenase-1 Regulated Human Mesenchymal Stem Cells Differentiation, Luca Vanella, Christopher Sanford Jr., Dong Hyun Kim, Nader G. Abraham, Nabil Ebraheim

Biochemistry and Microbiology

This paper describes the effect of increased expression of HO-1 protein and increased levels of HO activity on differentiation of bone-marrow-derived human MSCs. MSCs are multipotent cells that proliferate and differentiate into many different cell types including adipocytes and osteoblasts. HO, the rate-limiting enzyme in heme catabolism, plays an important role during MSCs differentiation. HO catalyzes the stereospecific degradation of heme to biliverdin, with the concurrent release of iron and carbon monoxide. Upregulation of HO-1 expression and increased HO activity are essential for MSC growth and differentiation to the osteoblast lineage consistent with the role of HO-1 in hematopoietic stem …

Reciprocal Effects Of Oxidative Stress On Heme Oxygenase Expression And Activity Contributes To Reno-Vascular Abnormalities In Ec-Sod Knockout Mice, Tomoko Kawakami, Nitin Puri, Komal Sodhi, Lars Bellner, Toru Takahashi, Kiyoshi Morita, Rita Rezzani, Tim D. Oury, Nader G. Abraham

Biochemistry and Microbiology

Heme oxygenase (HO) system is one of the key regulators of cellular redox homeostasis which responds to oxidative stress (ROS) via HO-1 induction. However, recent reports have suggested an inhibitory effect of ROS on HO activity. In light of these conflicting reports, this study was designed to evaluate effects of chronic oxidative stress on HO system and its role in contributing towards patho-physiological abnormalities observed in extracellular superoxide dismutase (EC-SOD, SOD3) KO animals. Experiments were performed in WT and EC-SOD^(−/−) mice treated with and without HO inducer, cobalt protoporphyrin (CoPP). EC-SOD^(−/−) mice exhibited oxidative stress, renal histopathological abnormalities, …

Defining Bone Health And Fracture Risk In West Virginia: The World Health Organization Frax® Assessment Tool, Franklin D. Shuler Md, Jacob Conjeski Md

Orthopaedics

This article highlights the expanding burden of osteoporosis in West Virginia. WV ranks second nationally in the percentage of its population that is ≥ 65 years of age. Our older population increases the risk of osteoporosis and fracture; the most recent data indicates that 77% of our women age 50 and older have osteoporosis or low bone mass. The lifetime risk of osteoporotic related fracture is alarming and occurs in 50% of females and 25% of males age 50 and older. The risk of osteoporosis related hip fracture in women is equal to the combined risk of breast, uterine or …