Medical Specialties Commons^™

Case Report: Tocilizumab For The Treatment Of Sars-Cov-2 Infection In A Patient With Aplastic Anemia, Gina Keiffer, Zach French, Lindsay Wilde, Joanne Filicko-O'Hara, Usama Gergis, Adam Binder

Department of Medicine Faculty Papers

While cytokine storm develops in a minority of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, novel treatment approaches are desperately needed for those in whom it does. Tocilizumab, an interleukin-6 receptor antibody, has been utilized for the treatment of cytokine storm in a number of severe inflammatory conditions, including in patients with severe coronavirus disease 2019 (COVID-19). Here, we present the first published case utilizing this therapy in a patient with underlying immunodeficiency. Our patient with aplastic anemia developed cytokine storm due to COVID-19 manifested by fever, severe hypoxia, pulmonary infiltrates, and elevated inflammatory markers. Following treatment …

Linguistic Analysis Of Empathy In Medical School Admission Essays, Mary Yaden, David Yaden, Anneke Buffone, Johannes Eichstaedt, Patrick Crutchley, Laura Smith, Jonathan Cass, Clara Callahan, Susan Rosenthal, Lyle Ungar, Andrew Schwartz, Mohammadreza Hojat

Department of Psychiatry and Human Behavior Faculty Papers

Objectives: This study aimed to determine whether words used in medical school admissions essays can predict physician empathy.

Methods: A computational form of linguistic analysis was used for the content analysis of medical school admissions essays. Words in medical school admissions essays were computationally grouped into 20 'topics' which were then correlated with scores on the Jefferson Scale of Empathy. The study sample included 1,805 matriculants (between 2008-2015) at a single medical college in the North East of the United States who wrote an admissions essay and completed the Jefferson Scale of Empathy at matriculation.

Results: After correcting for multiple …

Pain In The Prehospital Setting In Rwanda: Results Of A Mixed-Methods Quality Improvement Project., A Rosenberg, E Uwitonze, M Dworkin, J P D Guidry, T Cyuzuzo, D Banerjee, K Mcintyre, K Carlyle, J M Uwitonze, I Kabagema, T Dushime, S Jayaraman

Student Papers, Posters & Projects

Introduction: Pain is a universal human experience tied to an individual's health but difficult to understand. It is especially important in health emergencies. We performed a two-step quality improvement project to assess pain management by the SAMU ambulance service in Kigali, Rwanda, examining how pain is assessed and treated by ambulance staff to facilitate development of standardized guidelines of pain management in the prehospital setting, which did not exist at the time of the study.

Materials and Methods: Deidentified ambulance service records from December 2012 to May 2016 were analyzed descriptively for patient demographics, emergency conditions, pain assessment, and medications …

A Sonographer’S Step-By-Step Approach For Preventing Transmission Of Covid-19, Corinne Wessner, Joann Nelson, Sarah Mott, Maria Francesco, Laurence Needleman

Department of Radiology Faculty Papers

The 2019 novel coronavirus, known as COVID-19, has greatly affected the way sonographers care for their patients. Sonography can be a useful imaging tool for surveillance and diagnosis of various conditions associated with COVID-19 patients or patients under investigation (PUIs). Currently, there are limited resources and protocols for preventing the transmission of COVID-19 from ultrasound equipment. Our institution has created a detailed protocol for scanning COVID-19 patients or PUIs to address this important issue.

Ier5, A Dna Damage Response Gene, Is Required For Notch-Mediated Induction Of Squamous Cell Differentiation, Li Pan, Madeleine E Lemieux, Tom Thomas, Julia M Rogers, Colin H Lipper, Winston Lee, Carl Johnson, Lynette M Sholl, Andrew P. South, Jarrod A Marto, Guillaume O Adelmant, Stephen C Blacklow, Jon C Aster

Department of Dermatology and Cutaneous Biology Faculty Papers

Notch signaling regulates squamous cell proliferation and differentiation and is frequently disrupted in squamous cell carcinomas, in which Notch is tumor suppressive. Here, we show that conditional activation of Notch in squamous cells activates a context-specific gene expression program through lineage-specific regulatory elements. Among direct Notch target genes are multiple DNA damage response genes, including IER5, which we show is required for Notch-induced differentiation of squamous carcinoma cells and TERT-immortalized keratinocytes. IER5 is epistatic to PPP2R2A, a gene that encodes the PP2A B55α subunit, which we show interacts with IER5 in cells and in purified systems. Thus, Notch and DNA-damage …

Endogenous Cyclin D1 Promotes The Rate Of Onset And Magnitude Of Mitogenic Signaling Via Akt1 Ser473 Phosphorylation., Ke Chen, Xuanmao Jiao, Agnese Di Rocco, Duanwen Shen, Shaohua Xu, Adam Ertel, Zuoren Yu, Gabriele Di Sante, Min Wang, Zhiping Li, Timothy G Pestell, Mathew C Casimiro, Emmanuel Skordalakes, Samuel Achilefu, Richard G Pestell

Department of Cancer Biology Faculty Papers

Cyclin D1 encodes the regulatory subunit of a holoenzyme that phosphorylates RB and functions as a collaborative nuclear oncogene. The serine threonine kinase Akt plays a pivotal role in the control of cellular metabolism, survival, and mitogenic signaling. Herein, Akt1-mediated phosphorylation of downstream substrates in the mammary gland is reduced by cyclin D1 genetic deletion and is induced by mammary-gland-targeted cyclin D1 overexpression. Cyclin D1 is associated with Akt1 and augments the rate of onset and maximal cellular Akt1 activity induced by mitogens. Cyclin D1 is identified in a cytoplasmic-membrane-associated pool, and cytoplasmic-membrane-localized cyclin D1-but not nuclear-localized cyclin D1-recapitulates Akt1 …

Access-Site Complications In Transfemoral Neuroendovascular Procedures: A Systematic Review Of Incidence Rates And Management Strategies, Mazen Oneissi, Ahmad Sweid, Md, Stavropoula Tjoumakaris, David Hasan, Michael R. Gooch, Md, Robert H. Rosenwasswer Md, Pascal Jabbour

Department of Neurosurgery Faculty Papers

BACKGROUND: The femoral artery is the most common access route for cerebral angiography and neurointerventional procedures. Complications of the transfemoral approach include groin hemorrhages and hematomas, retroperitoneal hematomas, pseudoaneurysms, arteriovenous fistulas, peripheral artery occlusions, femoral nerve injuries, and access-site infections. Incidence rates vary among different randomized and nonrandomized trials, and the literature lacks a comprehensive review of this subject.

OBJECTIVE: To gather data from 16 randomized clinical trials (RCT) and 17 nonrandomized cohort studies regarding femoral access-site complications for a review paper. We also briefly discuss management strategies for these complications based on the most recent literature.

METHODS: A PubMed …

Hepatocellular Carcinoma-The Influence Of Immunoanatomy And The Role Of Immunotherapy, Keyur Patel, Ryan Lamm, Peter Altshuler, Hien Dang, Ashesh P. Shah, Md

Department of Surgery Faculty Papers

Hepatocellular carcinoma (HCC) is a leading cause of cancer-related morbidity and mortality worldwide. Most patients are diagnosed with advanced disease, limiting their options for treatment. While current treatments are adequate for lower staged disease, available systemic treatments are limited, with marginal benefit at best. Chimeric antigen receptor (CAR) T cell therapy, effective in treating liquid tumors such as B-cell lymphoma, presents a potentially promising treatment option for advanced HCC. However, new challenges specific to solid tumors, such as tumor immunoanatomy or the immune cell presence and position anatomically and the tumor microenvironment, need to be defined and overcome. Immunotherapy currently …

Cells From Discarded Dressings Differentiate Chronic From Acute Wounds In Patients With Epidermolysis Bullosa, Ignacia Fuentes, Christina Guttmann-Gruber, Birgit Tockner, Anja Diem, Alfred Klausegger, Glenda Cofré-Araneda, Olga Figuera, Yessia Hidalgo, Pilar Morandé, Francis Palisson, Boris Rebolledo-Jaramillo, María Joao Yubero, Raymond J Cho, Heather I Rishel, M Peter Marinkovich, Joyce M C Teng, Timothy G. Webster, Marco Prisco, Luis H. Eraso, Josefina Piñon Hofbauer, Andrew P. South

Department of Dermatology and Cutaneous Biology Faculty Papers

Impaired wound healing complicates a wide range of diseases and represents a major cost to healthcare systems. Here we describe the use of discarded wound dressings as a novel, cost effective, accessible, and non-invasive method of isolating viable human cells present at the site of skin wounds. By analyzing 133 discarded wound dressings from 51 patients with the inherited skin-blistering disease epidermolysis bullosa (EB), we show that large numbers of cells, often in excess of 100 million per day, continually infiltrate wound dressings. We show, that the method is able to differentiate chronic from acute wounds, identifying significant increases in …

Fad Diets, Simon Newsom, Pgy-3

Department of Family & Community Medicine Presentations and Grand Rounds

Overview

• Brief history of dieting

• Overview of different types of fad diets

• Conditions affected by specific dieting

• Physicians role in dieting

Factors Affecting The Decision To Initiate Anticoagulation After Spine Surgery: Findings From The Aospine Anticoagulation Global Initiative, Sapan D Gandhi, Krishn Khanna, Garrett Harada, Philip Louie, James Harrop, Thomas Mroz, Khalid Al-Saleh, Giovanni Barbanti Brodano, Jens Chapman, Michael G Fehlings, Serena S Hu, Yoshiharu Kawaguchi, Michael Mayer, Venugopal Menon, Jong-Beom Park, Shanmuganathan Rajasekaran, Marcelo Valacco, Luiz Vialle, Jeffrey C Wang, Karsten Wiechert, K Daniel Riew, Dino Samartzis

Department of Neurosurgery Faculty Papers

STUDY DESIGN: Cross-sectional, international survey.

OBJECTIVES: To identify factors influencing pharmacologic anticoagulation initiation after spine surgery based on the AOSpine Anticoagulation Global Survey.

METHODS: This survey was distributed to the international membership of AOSpine (n = 3805). A Likert-type scale described grade practice-specific factors on a scale from low (1) to high (5) importance, and patient-specific factors a scale from low (0) to high (3) importance. Analysis was performed to determine which factors were significant in the decision making surrounding the initiation of pharmacologic anticoagulation.

RESULTS: A total of 316 spine surgeons from 64 countries completed the survey. In terms …

Translocase Of The Outer Mitochondrial Membrane Complex Subunit 20 (Tomm20) Facilitates Cancer Aggressiveness And Therapeutic Resistance In Chondrosarcoma., Megan E Roche, Zhao Lin, Diana Whitaker-Menezes, Tingting Zhan, Karoly Szuhai, Judith V M G Bovee, John A Abraham, Wei Jiang, Ubaldo Martinez-Outschoorn, Atrayee Basu-Mallick

Department of Medical Oncology Faculty Papers

Chondrosarcoma is the second most common primary bone malignancy, representing one fourth of all primary bone sarcomas. It is typically resistant to radiation and chemotherapy treatments. However, the molecular mechanisms that contribute to cancer aggressiveness in chondrosarcomas remain poorly characterized. Here, we studied the role of mitochondrial transporters in chondrosarcoma aggressiveness including chemotherapy resistance. Histological grade along with stage are the most important prognostic biomarkers in chondrosarcoma. We found that high-grade human chondrosarcoma tumors have higher expression of the mitochondrial protein, translocase of the outer mitochondrial membrane complex subunit 20 (TOMM20), compared to low-grade tumors. TOMM20 overexpression in human chondrosarcoma …

Caring For Aging Patients With Idd/Asd/Spmi, E. Adel Herge, Otd, Otr/L, Faota, Rachelle Rene, Phd, Mary M. Stephens, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Outline and Objectives:

• What are we talking about?
• Prevalence and associated co-morbidities
• Healthy aging pearls for special populations
• A case: Dr. Herge. . . . From the OT perspective
• Best practices for referral and resources
• A case: Dr. Rene. . . .From the behavioral health perspective
• Best practices for referral and resources

Hiv/Hcv/Sti Cases, Marshal Miller, Md, Aahivs

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives:

• Discuss approach to Syphilis testing and management in persons infected with HIV and HIV negative patients
• Review strategies to improve ART adherence
• Review ART options and considerations for initiating and modifying ART and clinically relevant Rx-Rx interactions
• Assess patients for HCV treatment and review simplified treatment strategies for patients with chronic HCV infection

Does Preoperative Dipyridamole-Thallium Scanning Reduce 90-Day Cardiac Complications And 1-Year Mortality In Patients With Femoral Neck Fractures Undergoing Hemiarthroplasty?, Chin-Yi Liao, Timothy L. Tan, Yu-Der Lu, Cheng-Ta Wu, Mel S Lee, Feng-Chih Kuo

Rothman Institute Papers

BACKGROUND: This study aimed to evaluate the effect of dipyridamole-thallium scanning (DTS) on the rates of 90-day cardiac complications and 1-year mortality in patients with a femoral neck fracture treated with hemiarthroplasty.

METHODS: Between 2008 and 2015, 844 consecutive patients who underwent cemented or cementless hemiarthroplasty were identified from the database of a single level-one medical center. One-hundred and thirteen patients (13%) underwent DTS prior to surgery, and 731 patients (87%) did not. Patient characteristics, comorbidities, surgical variables, and length of the delay until surgery were recorded. A propensity score-matched cohort was utilized to reduce recruitment bias in a 1:3 …

The Awareness Of Negative Pressure Pulmonary Edema In The Medical Intensive Care Unit., Qian Zhang, Jonathan Vayalumkal, John Ricely, Sarah Elrod, Ahmad Raza

Abington Jefferson Health Papers

Negative pressure pulmonary edema (NPPE) is a noncardiogenic-related rapid onset of bilateral pulmonary edema secondary to various etiologies that lead to upper airway obstruction. Despite the fact that it is more commonly seen in the emergency department (ED), pediatric intensive care unit (PICU), and the postanesthesia care unit (PACU), there is a lower disease prevalence in the medical intensive care unit (MICU) as it sometimes could be overlooked upon. Prompt treatment often leads to favorable clinical outcomes. We detail a 55-year-old lady with a past medical history of nephrolithiasis, obesity, and obstructive sleep apnea presented with right flank pain due …

Urinary Acrylonitrile Metabolite Concentrations Before And After Smoked, Vaporized, And Oral Cannabis In Frequent And Occasional Cannabis Users., David L Ashley, Víctor R De Jesús, Osama A Abulseoud, Marilyn A. Huestis, Daniel F Milan, Benjamin C Blount

Institute of Emerging Health Professions Faculty Papers

Cannabis use through smoking, vaping, or ingestion is increasing, but only limited studies have investigated the resulting exposure to harmful chemicals. N-acetyl-S-(2-cyanoethyl)-L-cysteine (2CYEMA), a urinary metabolite of acrylonitrile, a possible carcinogen, is elevated in the urine of past-30-day cannabis users compared to non-cannabis users. Five frequent and five occasional cannabis users smoked and vaped cannabis on separate days; one also consumed cannabis orally. Urine samples were collected before and up to 72 h post dose and urinary 2CYEMA was quantified. We compared 2CYEMA pre-exposure levels, maximum concentration, time at maximum concentration for occasional versus frequent users following different exposure routes, …

Caring For Aml Patients During The Covid-19 Crisis: An American And Italian Experience., Lindsay Wilde, Md, Alessandro Isidori, Gina Keiffer, Md, Neil D. Palmisiano, Md, Margaret Kasner

Department of Medical Oncology Faculty Papers

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the subsequent pandemic have impacted every aspect of oncology care worldwide. Healthcare systems have been forced to rapidly change practices in order to maximize the safety of patients and healthcare providers and preserve scare resources. Patients with acute myeloid leukemia are at increased risk of complications from SARS-CoV-2 not only due to immune compromise related to the malignancy but also due to the acuity of the disease and intensity of treatment. These issues have created unique challenges during this difficult time. In this article, we present the approaches taken …

Nsaids For Analgesia In The Era Of Covid-19, Daniel L Herzberg, Harry P Sukumaran, Eugene R. Viscusi

Department of Anesthesiology Faculty Papers

Globally, non-steroidal anti-inflammatory drugs (NSAIDs) are highly used to treat pain. With the rise of the COVID-19 pandemic, the safety of NSAIDs use has been called into question. These concerns are worthy of review. At present, there is no compelling data showing that NSAIDs worsen the severity of COVID-19 symptoms or increase one's likelihood of contracting the illness. For patients in pain and without symptoms that could potentially be attributed to COVID-19 (cough, fevers/chills, lethargy, myalgias, anosmia and so on), NSAIDs should continue to remain a viable option to provide analgesia to patients in need.

A Multi-Institutional Analysis Of Sternoclavicular Joint Coverage Following Osteomyelitis, Sammy Othman, Omar Elfanagely, Saïd C Azoury, Geoffrey M Kozak, Jessica Cunning, Arturo J Rios-Diaz, Prashanth Palvannan, Patrick J. Greaney, Matthew Jenkins, Doraid Jarrar, Stephen J Kovach, John P Fischer

Department of Surgery Faculty Papers

BACKGROUND: Sternoclavicular joint (SCJ) osteomyelitis is a rare pathology requiring urgent intervention. Several operative approaches have been described with conflicting reports. Here, we present a multi-institutional study utilizing multiple surgical pathways for SCJ reconstruction.

METHODS: A multi-institutional retrospective cohort study was conducted to identify patients who underwent surgical repair for sternoclavicular osteomyelitis between 2008 and 2019. Patients were stratified according to reconstruction approach: single-stage reconstruction with advancement flap and delayed-reconstruction with flap following initial debridement. Demographics, operative approach, type of reconstruction, and postoperative outcomes were analyzed.

RESULTS: Thirty-two patients were identified. Mean patient age was 56.2±13.8 years and 68.8% were …

The Effects Of Direct Brain Stimulation In Humans Depend On Frequency, Amplitude, And White-Matter Proximity, Uma R Mohan, Andrew J Watrous, Jonathan F Miller, Bradley C Lega, Michael R Sperling, Gregory A Worrell, Robert E Gross, Kareem A Zaghloul, Barbara C Jobst, Kathryn A Davis, Sameer A Sheth, Joel M Stein, Sandhitsu R Das, Richard Gorniak, Md, Paul A Wanda, Daniel S Rizzuto, Michael J Kahana, Joshua Jacobs

Department of Neurology Faculty Papers

BACKGROUND: Researchers have used direct electrical brain stimulation to treat a range of neurological and psychiatric disorders. However, for brain stimulation to be maximally effective, clinicians and researchers should optimize stimulation parameters according to desired outcomes.

OBJECTIVE: The goal of our large-scale study was to comprehensively evaluate the effects of stimulation at different parameters and locations on neuronal activity across the human brain.

METHODS: To examine how different kinds of stimulation affect human brain activity, we compared the changes in neuronal activity that resulted from stimulation at a range of frequencies, amplitudes, and locations with direct human brain recordings. We …

Dramatic Outcomes In Epilepsy: Depression, Suicide, Injuries, And Mortality, Boulenouar Mesraoua, Dirk Deleu, Al Hail Hassan, Melykian Gayane, Alsheikh Lubna, Musab Abdalhalim Ali, Torbjorn Tomson, Bassel Abou Khalil, J Helen Cross, Ali A Asadi-Pooya

Department of Neurology Faculty Papers

In this narrative review, we will discuss some of the significant risks and dramatic consequences that are associated with epilepsy: depression, suicide, seizure-related injuries, and mortality, both in adults and in children. Considering the high prevalence of depression among people with epilepsy (PWE), routine and periodic screening of all PWE for early detection and appropriate management of depression is recommended. PWE should be screened for suicidal ideation regularly and when needed, patients should be referred for a psychiatric evaluation and treatment. When starting an antiepileptic drug (AED) or switching from one to another AED, patients should be advised to report …

Reliability And Validity Of The English Version Of The Aospine Prost (Patient Reported Outcome Spine Trauma), Said Sadiqi, Marcel F Dvorak, Alex R. Vaccaro, Gregory D. Schroeder, Marcel W Post, Lorin M Benneker, Frank Kandziora, S Rajasekaran, Klaus J Schnake, Emiliano N Vialle, F Cumhur Oner

Department of Orthopaedic Surgery Faculty Papers

STUDY DESIGN: Multicenter validation study.

OBJECTIVE: The aim of this study was to translate and adapt the AOSpine PROST (Patient Reported Outcome Spine Trauma) into English, and test its psychometric properties among North-American spine trauma patients.

SUMMARY OF BACKGROUND DATA: In the absence of an outcome instrument specifically designed and validated for traumatic spinal column injury patients, it is difficult to measure the effect size of various treatment options. The AOSpine Knowledge Forum Trauma initiated a project and developed the AOSpine PROST consisting of 19 items.

METHODS: Patients were recruited from two level-1 North-American trauma centers. For concurrent validity, next …

Splicing Of The Cake Can Affect The Severity Of Epidermolysis Bullosa, D Murrell, Jouni Uitto

Department of Dermatology and Cutaneous Biology Faculty Papers

No abstract provided.

The Vaso-Occlusive Pain Crisis In Sickle Cell Disease: Definition, Pathophysiology, And Management., Deepika S. Darbari, Vivien A. Sheehan, Samir K. Ballas

Cardeza Foundation for Hematologic Research

Early diagnosis, treatment, and prevention of a vaso-occlusive crisis (VOC) are critical to the management of patients with sickle cell disease. It is essential to differentiate between VOC-associated pain and chronic pain, hyperalgesia, neuropathy, and neuropathic pain. The pathophysiology of VOCs includes polymerization of abnormal sickle hemoglobin, inflammation, and adhesion. Hydroxyurea, L-glutamine, crizanlizumab, and voxelotor have been approved by the US Food and Drug Administration for reducing the frequency of VOCs; the European Medicines Agency has approved only hydroxyurea. Other novel treatments are in late-stage clinical development in both the United States and the European Union. The development of agents …

Ultrasonographic Risk Stratification Of Indeterminate Thyroid Nodules; A Comparison Of An Artificial Intelligence Algorithm With Radiologist Performance, Aylin Tahmasebi, Shuo Wang, Kelly Daniels, Elizabeth Cottrill, Ji-Bin Liu, Jiajun Xu, Andrej Lyshchik, John R. Eisenbrey

Department of Radiology Faculty Papers

Background, Motivation and Objective: Thyroid nodules with indeterminate or suspicious cytology are commonly encountered in clinical practice and their clinical management is controversial. Recently, genetical analysis of thyroid fine needle aspiration (FNAs) was implemented at some institutions to differentiate thyroid nodules as high and low risk based on the presence of certain oncogenes commonly associated with aggressive tumor behavior and poor patient outcomes. Our group recently detailed the performance of a machine-learning model based on ultrasonography images of thyroid nodules for the prediction of high and low risk mutations. This study evaluated the performance of a second-generation machine-learning algorithm incorporating …

Letter: Thrombotic Neurovascular Disease In Covid-19 Patients., Ahmad Sweid, Batoul Hammoud, Joshua H. Weinberg, Mazen Oneissi, Eytan Raz, Maksim Shapiro, Maureen Deprince, Stavropoula Tjoumakaris, Michael R. Gooch, Nabeel A. Herial, Hekmat Zarzour, Victor Romo, Robert Rosenwasswer, Pascal Jabbour

Department of Neurosurgery Faculty Papers

Although the respiratory system is the primary target of the coronavirus, studies have demonstrated a strong tropism to the central nervous system (CNS).^1,2 The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects cells by binding to the angiotensin-converting enzyme 2 (ACE2) receptor. This receptor is also found in the CNS and plays a crucial role in autoregulating cerebral perfusion pressure.^3,4 Additionally, epidemiological data demonstrated increased mortality due to cardiovascular and cerebrovascular diseases during flu pandemics due to a hypercoagulable state.^5,6 The triad of neuroinvasion of SARS-CoV-2, induction of hypercoagulable state,^{5-9 …}

How I Treat Acute And Persistent Sickle Cell Pain., Samir K. Ballas

Cardeza Foundation for Hematologic Research

Sickle pain is the hallmark of sickle cell disease (SCD). It could be acute, persistent/relapsing, chronic, or neuropathic. Although there is a general consensus that pain is a major manifestation of SCD, there is a controversy as to the types of pain and their interrelationship between acute, chronic, relapsing, persistent, etc. This report first reviews the general approach to the management of acute vaso-occlusive crisis (VOC) pain, including education, counseling, pharmacotherapy, non-pharmacotherapy, and fluid therapy. This is followed by the presentation of five patients that represent typical issues that are commonly encountered in the management of patients with SCD. These …

Blood-Brain Barrier: Mechanisms Governing Permeability And Interaction With Peripherally Acting Μ-Opioid Receptor Antagonists., Eugene R. Viscusi, Andrew R Viscusi

Department of Anesthesiology Faculty Papers

The blood-brain barrier (BBB) describes the unique properties of endothelial cells (ECs) that line the central nervous system (CNS) microvasculature. The BBB supports CNS homeostasis via EC-associated transport of ions, nutrients, proteins and waste products between the brain and blood. These transport mechanisms also serve as physiological barriers to pathogens, toxins and xenobiotics to prevent them from contacting neural tissue. The mechanisms that govern BBB permeability pose a challenge to drug design for CNS disorders, including pain, but can be exploited to limit the effects of a drug to the periphery, as in the design of the peripherally acting μ-opioid …

Regulation Of Microrna-497-Targeting Akt2 Influences Tumor Growth And Chemoresistance To Cisplatin In Lung Cancer., Lin Wang, Xiang-Bo Ji, Li-Hong Wang, Jian-Ge Qiu, Feng-Mei Zhou, Wen-Jing Liu, Di-Di Wan, Marie Chai-Mi Lin, Ling-Zhi Liu, Jian-Ying Zhang, Bing-Hua Jiang

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Background: MicroRNA-497 (miR-497) has been implicated in several cancers. Increasing studies demonstrate the role of AKT2 in cancers as an oncogene which is closely associated with tumor aggressiveness by enhancing cancer cell survival, migration and invasion However, miR-497/AKT2 axis in non-small cell lung cancer (NSCLC) remains unclear.

Methods: Quantitative real-time PCR (qRT-PCR) was used to quantify the expression of miR-497 and its target gene. The function of miR-497 in lung cancer was investigated through in vitro and in vivo assays (cell proliferation assay, cell migration assay, colony formation assay, flow cytometry assay, immunoblotting and tumorigenesis assay). Luciferase reporter assay was …