Medical Specialties Commons^™

Adiponectin At Physiologically Relevant Concentrations Enhances The Vasorelaxative Effect Of Acetylcholine Via Cav-1/Adipor-1 Signaling., Yunhui Du, Rui Li, Wayne Bond Lau, Jianli Zhao, Bernard Lopez, Theodore A Christopher, Xin-Liang Ma, Yajing Wang

Department of Emergency Medicine Faculty Papers

Clinical studies have identified hypoadiponectinemia as an independent hypertension risk factor. It is known that adiponectin (APN) can directly cause vasodilation, but the doses required exceed physiologic levels several fold. In the current study, we determine the effect of physiologically relevant APN concentrations upon vascular tone, and investigate the mechanism(s) responsible. Physiologic APN concentrations alone induced no significant vasorelaxation. Interestingly, pretreatment of wild type mouse aortae with physiologic APN levels significantly enhanced acetylcholine (ACh)-induced vasorelaxation (P

Preserving Cognition In Older African Americans With Mild Cognitive Impairment., Barry W. Rovner, Robin J. Casten

Department of Psychiatry and Human Behavior Faculty Papers

No abstract provided.

A Call For The Structured Physicist Report, John M. Boone, Phd, Mahadevappa Mahesh, Ms, Phd, Eric L. Gingold, Phd, J. Anthony Seibert, Phd

Department of Radiology Faculty Papers

Introduction:

The field of diagnostic radiology continues to struggle with the clinical adoption of the structured interpretive report, with many radiologists preferring a semistructured, free-text dictation style to a more rigid, highly structured approach that some professional leaders have promoted [1]. Although structured reporting compliance in the radiologist community has been difficult to achieve, diagnostic radiologists have been thinking about and discussing this important issue for many years; it is also a part of the ACR’s Imaging 3.0_ campaign [2]. In the breast imaging community, the well-established BI-RADS_ recommendations produce a very structured report, with a discussion of interpretive findings …

Randomized Controlled Trial Of Prolonged Second Stage: Extending The Time Limit Vs Usual Guidelines., Alexis C. Gimovsky, Vincenzo Berghella

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: Guidelines for management of the second stage have been proposed since the 1800s and were created largely by expert opinion. Current retrospective data are mixed regarding differences in maternal and neonatal outcomes with a prolonged second stage. There are no randomized controlled trials that have evaluated whether extending the second stage of labor beyond current American College of Obstetricians and Gynecologists recommendations is beneficial.

OBJECTIVE: The purpose of this study was to evaluate whether extending the length of labor in nulliparous women with prolonged second stage affects the incidence of cesarean delivery and maternal and neonatal outcomes.

STUDY DESIGN: …

Predicting Revision Following In Situ Ulnar Nerve Decompression For Patients With Idiopathic Cubital Tunnel Syndrome., Michael P. Gaspar, Patrick M. Kane, Dechporn Putthiwara, Sidney M. Jacoby, A. Lee Osterman

Department of Orthopaedic Surgery Faculty Papers

PURPOSE: To determine the incidence of revision and potential risk factors for needing revision surgery following in situ ulnar nerve decompression for patients with idiopathic cubital tunnel syndrome (CTS).

METHODS: We conducted a retrospective chart review of all patients treated at 1 specialty hand center with an open in situ ulnar nerve decompression for idiopathic CTS from January 2006 through December 2010. Revision incidence was determined by identifying patients who underwent additional surgeries for recurrent or persistent ulnar nerve symptoms. Bivariate analysis was performed to determine which variables had a significant influence on the need for revision surgery.

RESULTS: Revision …

C-Src/Cav1-Dependent Activation Of The Egfr By Dsg2., Andrew M. Overmiller, Kathleen P. Mcguinn, Brett J. Roberts, Felicia Cooper, Donna M. Brennan-Crispi, Takahiro Deguchi, Sirkku Peltonen, James K. Wahl, Mỹ G. Mahoney

Department of Dermatology and Cutaneous Biology Faculty Papers

The desmosomal cadherin, desmoglein 2 (Dsg2), is deregulated in a variety of human cancers including those of the skin. When ectopically expressed in the epidermis of transgenic mice, Dsg2 activates multiple mitogenic signaling pathways and increases susceptibility to tumorigenesis. However, the molecular mechanism responsible for Dsg2-mediated cellular signaling is poorly understood. Here we show overexpression as well as co-localization of Dsg2 and EGFR in cutaneous SCCs in vivo. Using HaCaT keratinocytes, knockdown of Dsg2 decreases EGFR expression and abrogates the activation of EGFR, c-Src and Stat3, but not Erk1/2 or Akt, in response to EGF ligand stimulation. To determine whether …

Two Separate Colorectal Granular Cell Tumors: A Case Report, Danica N. Giugliano, Md, Danielle Fortuna, Md, Scott D. Goldstein, Md, Benjamin Philllips, Md, Gerald A. Isenberg, Md

Department of Surgery Posters

Introduction, Case Report, Discussion, Conclusion and References.

Acute Rehabilitation Of Spinal Epidural Abscess Following Triple Laminectomy: A Case Report, B. A. Dahlben, Ms, D. Fleischmann, Md

Department of Rehabilitation Medicine Posters

Case Description:

• A 36-year-old man presented with a large epidural collection, shown on MRI to extend from C1-S5 and resulting in spinal canal narrowing (Figures 1-3). The patient was admitted for acute inpatient rehabilitation after neurosurgical treatment and stabilization s/p C7-T1, T7-8, L4-5 laminectomies.
• He presented with impaired mobility and activities of daily living, and reported moderate pain in the back and lower extremities, but without specific distribution, during PT/OT therapies.
• Throughout his 7-day length of stay, the patient was closely monitored for methicillin-susceptible S. aureus bacteremia, and he received IV oxacillin and oral rifampin. Active medical problems …

Conjugate Haemophilus Influenzae Type B Vaccines For Sickle Cell Disease., Slimane Allali, Martin Chalumeau, Odile Launay, Samir K. Ballas, Mariane De Montalembert

Cardeza Foundation for Hematologic Research

BACKGROUND: People affected with sickle cell disease are at high risk of infection from Haemophilus influenzae type b. Before the implementation of Haemophilus influenzae type b conjugate vaccination in high-income countries, this was responsible for a high mortality rate in children under five years of age. In African countries, where coverage of this vaccination is still extremely low, Haemophilus influenzae type b remains one of the most common cause of bacteraemias in children with sickle cell disease. The increased uptake of this conjugate vaccination may substantially improve the survival of children with sickle cell disease.

OBJECTIVES: The primary objective was …

Corticosteroid Implants For Chronic Non-Infectious Uveitis., Christopher J Brady, Andrea C Villanti, Hua Andrew Law, Ehsan Rahimy, Rahul Reddy, Pamela C. Sieving, Sunir J. Garg, Johnny Tang

Wills Eye Hospital Papers

BACKGROUND: Uveitis is a term used to describe a heterogeneous group of intraocular inflammatory diseases of the anterior, intermediate, and posterior uveal tract (iris, ciliary body, choroid). Uveitis is the fifth most common cause of vision loss in high-income countries, accounting for 5% to 20% of legal blindness, with the highest incidence of disease in the working-age population.Corticosteroids are the mainstay of acute treatment for all anatomical subtypes of non-infectious uveitis and can be administered orally, topically with drops or ointments, by periocular (around the eye) or intravitreal (inside the eye) injection, or by surgical implantation.

OBJECTIVES: To determine the …

Plan Quality And Treatment Efficiency For Radiosurgery To Multiple Brain Metastases: Non-Coplanar Rapidarc Vs. Gamma Knife., Haisong Lui Phd, David W. Andrews Md, James J. Evans, Maria Werner-Wasik, Yan Yu, Adam Dicker Md, Phd, Wenyin Shi

Department of Radiation Oncology Faculty Papers

OBJECTIVES: This study compares the dosimetry and efficiency of two modern radiosurgery [stereotactic radiosurgery (SRS)] modalities for multiple brain metastases [Gamma Knife (GK) and LINAC-based RapidArc/volumetric modulated arc therapy], with a special focus on the comparison of low-dose spread.

METHODS: Six patients with three or four small brain metastases were used in this study. The size of targets varied from 0.1 to 10.5 cc. SRS doses were prescribed according to the size of lesions. SRS plans were made using both Gamma Knife(®) Perfexion and a single-isocenter, multiple non-coplanar RapidArc(®). Dosimetric parameters analyzed included RTOG conformity index (CI), gradient index (GI), …

Mesial Temporal Lobe Epilepsy With Childhood Febrile Seizure., Ali Akbar Asadi-Pooya, Maromi Nei, Cyrus Rostami, Michael R. Sperling

Department of Neurology Faculty Papers

OBJECTIVES: To evaluate the demographic and clinical manifestations of patients with mesial temporal sclerosis and temporal lobe epilepsy (MTS-TLE) with childhood febrile seizure (FS) and establishing the potential differences as compared to those without FS. We also investigated the surgery outcome in these two groups of patients.

MATERIALS AND METHODS: In this retrospective study, all patients with a clinical diagnosis of drug-resistant TLE due to mesial temporal sclerosis, who underwent epilepsy surgery at Jefferson Comprehensive Epilepsy Center, were recruited. Patients were prospectively registered in a database from 1986 through 2014. Postsurgical outcome was classified into two groups; seizure-free or relapsed. …

Dual Kidney Allocation Score: A Novel Algorithm Utilizing Expanded Donor Criteria For The Allocation Of Dual Kidneys In Adults, Adam P. Johnson, Md, Mph, Thea P. Price, Md, Benjamin E Leiby, Phd, Cataldo Doria, Md, Phd, Facs

Department of Surgery Posters

Background:

Dual kidney transplantation (DKT) of expanded criteria donors is a cost intensive procedure to help increase the pool of available deceased organ donors. In studies to day, expanded criteria single kidney (eSKT) or dual kidney transplantation (DKT) have demonstrated equivalence, but a more rigorous allocation system is needed to optimize limited resources for improved operative outcomes.

Consecutive Bilateral Decompression Retinopathy After Mitomycin C Trabeculectomy: A Case Report., Ana Raquel Marcos Figueiredo, Isabel Coutinho Sampaio, Maria João Fernandes Dos Santos Menéres, George L. Spaeth

Wills Eye Hospital Papers

BACKGROUND: After a successful trabeculectomy, a sudden intraocular pressure decrease may alter the intracranial to intraocular pressure ratio and cause decompression retinopathy. Frequent Valsalva maneuvers may also play a role in its pathogenesis. This condition may manifest as multiple retinal hemorrhages, edema of the optic disc, macular edema, or a sudden decrease in visual acuity postoperatively. Outcomes for patients are usually good, with spontaneous resolution occurring within a matter of weeks. It has been rarely reported in the literature as a bilateral condition.

CASE PRESENTATION: We present a case of consecutive bilateral decompression retinopathy in a 54-year-old severely obese Caucasian …

Lambda Red-Mediated Recombineering In The Attaching And Effacing Pathogen Escherichia Albertii., Marisa Egan, Jasmine Ramirez, Christian Xander, Chirag Upreti, Shantanu Bhatt

Department of Medicine Faculty Papers

BACKGROUND: The ability to introduce site-specific mutations in bacterial pathogens is essential towards understanding their molecular mechanisms of pathogenicity. This has been greatly facilitated by the genetic engineering technique of recombineering. In recombineering, linear double- or single-stranded DNA molecules with two terminal homology arms are electroporated into hyperrecombinogenic bacteria that express a phage-encoded recombinase. The recombinase catalyzes the replacement of the endogenous allele with the exogenous allele to generate selectable or screenable recombinants. In particular, lambda red recombinase has been instrumental in engineering mutations to characterize the virulence arsenal of the attaching and effacing (A/E) pathogens enteropathogenic Escherichia coli (EPEC), …

Spatially Selective 2d Rf Inner Field Of View (Ifov) Diffusion Kurtosis Imaging (Dki) Of The Pediatric Spinal Cord, Chris J. Conklin, Devon M. Middleton, Mehdi Alizadeh, Jürgen Finsterbusch, David L. Raunig, Scott H. Faro, Pallav N. Shah, Laura Krisa, Rebecca Sinko, Ms, Otr/L, Joan Z. Delalic, M. J. Mulcahey, Feroze B. Mohamed

Department of Physical Therapy Faculty Papers

No abstract provided.

Optimal Unified Combination Rule In Application Of Dempster-Shafer Theory To Lung Cancer Radiotherapy Dose Response Outcome Analysis, Yanyan He, M. Yousuff Hussaini, Yutao U T Gong, Ying Xiao

Department of Radiation Oncology Faculty Papers

No abstract provided.

Evaluation Of A Pacap Peptide Analogue Labeled With (68)Ga Using Two Different Chelating Agents., Pardeep Kumar, Sushil Kumar Tripathi, Chang-Po Chen, Neil Mehta, Bishnuhari Paudyal, Eric Wickstrom, Mathew L. Thakur

Department of Radiology Faculty Papers

OBJECTIVE: The authors have conjugated chelating agents (DOTA and NODAGA) with a peptide (pituitary adenylate cyclase-activating peptide [PACAP] analogue) that has a high affinity for VPAC1 receptors expressed on cancer cells. To determine a suitable chelating agent for labeling with (68)Ga, they have compared the labeling kinetics and stability of these peptide conjugates.

METHODS: For labeling, (68)GaCl3 was eluted in 0.1 M HCl from a [(68)Ge-(68)Ga] generator. The influences of peptide concentration, pH, and temperature on the radiolabeling efficiency were studied. The stability was evaluated in saline, human serum, DTPA, transferrin, and metallic ions (FeCl3, CaCl2, and ZnCl2). Cell binding …

Safety And Efficacy Of Blood Exchange Transfusion For Priapism Complicating Sickle Cell Disease., Samir K. Ballas, David Lyon

Cardeza Foundation for Hematologic Research

BACKGROUND: Priapism is unwanted painful penile erection that affects about 36% of boys and men with sickle cell disease (SCD) most of whom have sickle cell anemia. Clinically, priapism could be stuttering, minor, or major. The first two types are mild, last < 4 h, are usually treated at home, have good prognosis with normal sexual function. The major type of priapism lasts >4 h, associated with severe pain, requires hospitalization; often does not respond to medical treatment and may require shunt surgery. Untreated major priapism and surgical intervention often cause impotence. In this study, we report our 15-year experience in treating adult patients with SCD and major priapism with blood exchange transfusion after being refractory to other medical therapies.

METHODS: …

Organophosphate Retinopathy, Hang Pham, Michelle D. Lingao, Anuradha Ganesh, Jenina E. Capasso, Rosanne Keep, Karthikeyan A. Sadagopan, Alex V. Levin

Wills Eye Hospital Papers

Organophosphates have rarely been reported to cause various ocular sequelae including retinal degeneration. Retinal manifestations have been rarely reported and poorly characterized. We describe a case of a 76-year-old man with vision loss beginning in his 20s due to acute on chronic exposure to dimethoate, an organophosphate. He presented with bilateral geographic macular atrophy and midperipheral pigmentary clumping which we characterized by dilated fundoscopic examination, optical coherence tomography, and fundus autofluorescence.

Modified Appleby Procedure With Arterial Reconstruction For Locally Advanced Pancreatic Adenocarcinoma: A Literature Review And Report Of Three Unusual Cases., Jessica A. Latona, Kathleen M. Lamb, Michael J. Pucci, Warren R. Maley, Charles J. Yeo

Department of Surgery Faculty Papers

BACKGROUND: Pancreatic body and tail ductal adenocarcinomas are often diagnosed with local vascular invasion of the celiac axis (CA) and its various branches. With such involvement, these tumors have traditionally been considered unresectable. The modified Appleby procedure allows for margin negative resection of some such locally advanced tumors. This procedure involves distal pancreatectomy with en bloc splenectomy and CA resection and relies on the presence of collateral arterial circulation via an intact pancreaticoduodenal arcade and the gastroduodenal artery to maintain prograde hepatic arterial perfusion. When the resultant collateral circulation is inadequate to provide sufficient hepatic and gastric arterial inflow, arterial …

Variables Prognostic For Delayed Union And Nonunion Following Ulnar Shortening Fixed With A Dedicated Osteotomy Plate., Michael P. Gaspar, Patrick M. Kane, Ralph C Zohn, Taylor Buckley, Sidney M. Jacoby, Eon K. Shin

Department of Orthopaedic Surgery Faculty Papers

PURPOSE: To examine potential risk factors for the development of delayed or nonunion following elective ulnar shortening osteotomy using a dedicated osteotomy plating system.

METHODS: We performed a retrospective review of all patients who underwent elective ulnar shortening using the TriMed single osteotomy dynamic compression plating system by 1 of 2 fellowship-trained hand surgeons over a 5-year period. Demographic data and medical, surgical, and social histories were reviewed. Time to bony union was determined radiographically by a blinded reviewer. Bivariate statistical analysis was performed to examine the effect of explanatory variables on the time to union and the incidence of …

Antimetabolite Ttl-315 Selectively Kills Glucose-Deprived Cancer Cells And Enhances Responses To Cytotoxic Chemotherapy In Preclinical Models Of Cancer., James Duhadaway, George C Prendergast

Kimmel Cancer Center Faculty Papers

Maintaining thiol homeostasis is an imperative for cancer cell survival in the nutrient-deprived microenvironment of solid tumors. Despite this metabolic vulnerability, a selective approach has yet to be developed to disrupt thiol homeostasis in solid tumors for therapeutic purposes. In this study, we report the identification of 2-mercaptopropionyl glycine disulfide (TTL-315) as a novel antimetabolite that blocks cell survival in a manner conditional on glucose deprivation. In the presence of glucose, TTL-315 lacks cytotoxic effects in normal cells where it is detoxified by reduction to 2-mercaptopropionyl glycine, a compound with known clinical pharmacologic and safety profiles. In several rodent models …

Biodistribution And Pharmacokinetics Study Of Sirna-Loaded Anti-Ntsr1-Mab-Functionalized Novel Hybrid Nanoparticles In A Metastatic Orthotopic Murine Lung Cancer Model., Maryna Perepelyuk, Chellappagounder Thangavel, Yi Liu, Robert B. Den, Bo Lu, Adam E. Snook, Sunday A. Shoyele

Department of Radiation Oncology Faculty Papers

Small interfering RNA (siRNA) is effective in silencing critical molecular pathways in cancer. The use of this tool as a treatment modality is limited by lack of an intelligent carrier system to enhance the preferential delivery of this molecule to specific targets in vivo. In the present study, the in vivo behavior of novel anti-NTSR1-mAb-functionalized antimutant K-ras siRNA-loaded hybrid nanoparticles, delivered by i.p. injection to non-small-cell lung cancer in mice models, was investigated and compared to that of a naked siRNA formulation. The siRNA in anti-NTSR1-mAb-functionalized hybrid nanoparticles was preferentially accumulated in tumor-bearing lungs and metastasized tumor for at least …

Neural Substrate Expansion For The Restoration Of Brain Function., H Isaac Chen, Dennis Jgamadze, Mijail Serruya, D Kacy Cullen, John A Wolf, Douglas H Smith

Department of Neurology Faculty Papers

Restoring neurological and cognitive function in individuals who have suffered brain damage is one of the principal objectives of modern translational neuroscience. Electrical stimulation approaches, such as deep-brain stimulation, have achieved the most clinical success, but they ultimately may be limited by the computational capacity of the residual cerebral circuitry. An alternative strategy is brain substrate expansion, in which the computational capacity of the brain is augmented through the addition of new processing units and the reconstitution of network connectivity. This latter approach has been explored to some degree using both biological and electronic means but thus far has not …

Reducing Gastrointestinal Anastomotic Leak Rates: Review Of Challenges And Solutions, Benjamin Philllips

Department of Surgery Faculty Papers

Various techniques and interventions have been developed in an effort to obviate gastrointestinal anastomotic leaks. This review is intended to delineate potential modifications that can be made to reduce the risk of anastomotic leaks following gastrointestinal surgery. It may also serve to aid in identifying patients who are at increased risk of anastomotic leak. Modifiable risk factors for leak discussed include malnutrition, smoking, steroid use, bowel preparation, chemotherapy, duration of surgery, use of pressors, intravenous fluid administration, blood transfusion, and surgical anastomotic technique. Based upon literature review, operative techniques should include minimizing operative time, reducing ischemia, and utilizing stapled anastomoses. …

Cannibalism, Kuru, And Mad Cows: Prion Disease As A "Choose-Your-Own-Experiment" Case Study To Simulate Scientific Inquiry In Large Lectures., Antonio Serrano, Jeffrey Liebner, Justin K Hines

Department of Medicine Faculty Papers

Despite significant efforts to reform undergraduate science education, students often perform worse on assessments of perceptions of science after introductory courses, demonstrating a need for new educational interventions to reverse this trend. To address this need, we created An Inexplicable Disease, an engaging, active-learning case study that is unusual because it aims to simulate scientific inquiry by allowing students to iteratively investigate the Kuru epidemic of 1957 in a choose-your-own-experiment format in large lectures. The case emphasizes the importance of specialization and communication in science and is broadly applicable to courses of any size and sub-discipline of the life sciences.

Cloning And Transcriptional Activity Of The Mouse Omi/Htra2 Gene Promoter., Dan Liu, Xin Liu, Ye Wu, Wen Wang, Xin-Liang Ma, Huirong Liu

Department of Medicine Faculty Papers

HtrA serine peptidase 2 (HtrA2), also named Omi, is a pro-apoptotic protein that exhibits dramatic changes in expression levels in a variety of disorders, including ischemia/reperfusion injury, cancer, and neurodegeneration. In our study, Omi/HtrA2 protein levels were high in the heart, brain, kidney and liver, with elevated heart/brain expression in aging mice. A similar expression pattern was observed at the mRNA level, which suggests that the regulation of Omi/HtrA2 is predominately transcriptional. Promoter binding by transcription factors is the main influencing factor of transcription, and to identify specific promoter elements that contribute to the differential expression of mouse Omi/HtrA2, we …

Obesity-Induced Colorectal Cancer Is Driven By Caloric Silencing Of The Guanylin-Gucy2c Paracrine Signaling Axis., Jieru E. Lin, Francheska Colon-Gonzalez, Erik S. Blomain, Gilbert W. Kim, Amanda Aing, Brian Stoecker, Justin Rock, Adam E. Snook, Tingting Zhan, Terry M. Hyslop, Michal Tomczak, Richard S. Blumberg, Scott A. Waldman

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Obesity is a well-known risk factor for colorectal cancer but precisely how it influences risks of malignancy remains unclear. During colon cancer development in humans or animals, attenuation of the colonic cell surface receptor guanylyl cyclase C (GUCY2C) that occurs due to loss of its paracrine hormone ligand guanylin contributes universally to malignant progression. In this study, we explored a link between obesity and GUCY2C silencing in colorectal cancer. Using genetically engineered mice on different diets, we found that diet-induced obesity caused a loss of guanylin expression in the colon with subsequent GUCY2C silencing, epithelial dysfunction, and tumorigenesis. Mechanistic investigations …

Epigenetic Repression Of Pdz-Lim Domain-Containing Protein 2 Promotes Ovarian Cancer Via Nos2-Derived Nitric Oxide Signaling., Linjie Zhao, Chuan Yu, Shengtao Zhou, Wayne Bond Lau, Bonnie Lau, Zhongyue Luo, Qiao Lin, Huiliang Yang, Yu Xuan, Tao Yi, Xia Zhao, Yuquan Wei

Department of Emergency Medicine Faculty Papers

Ovarian cancer constitutes one of the most lethal gynaecological malignancies worldwide and currently no satisfactory therapeutic approaches have been established. Therefore, elucidation of molecular mechanisms to develop targeted therapy of ovarian cancer is crucial. PDLIM2 is critical to promote ubiquitination of nuclear p65 and thus its role in inflammation has been highlighted recently. We demonstrate that PDLIM2 is decreased in both ovarian high-grade serous carcinoma and in various human ovarian cancer cell lines compared with normal ovary tissues and human ovarian surface epithelial cells (HOSE). Further functional analysis revealed that PDLIM2 is epigenetically repressed in ovarian cancer development and inhibition …