Medical Specialties Commons^™

Massive Pulmonary Embolism With Hemodynamic Compromise Successfully Treated With Veno-Arterial Extracorporeal Membrane Oxygenation, B. Akkanti, S. Nathan, E. N. Centeno, K. Akasapu, P. Doshi, R. Hussain, F. Raissi, A. Nascimbene, R. Srinivasan, I. Rajapreyar, M. Patel, J. Patel, M. Akay, P. Loyalka, B. Kar, I. Gregoric

The VAD Journal

Introduction: Cardiogenic shock that results from pulmonary embolus has a high mortality rate. Systemic thrombolysis is frequently used in submassive and massive pulmonary embolus and has been shown to restore circulation. However, in the event of impending or ongoing cardiac arrest, systemic thrombolysis or anticoagulation alone has not been always shown to be effective. Case reports have previously established that extracorporeal membrane oxygenation can effectively be used as an effective rescue strategy in cases of cardiac arrest as a result from massive pulmonary embolus. We report six cases of massive pulmonary embolism (PE), in which veno-arterial extracorporeal membrane oxygenation (VA …

Early Manifestations Of Atrial Tamponade In A Patient Implanted With Syncardia Total Artificial Heart., Manoj Thangam, Bindu Akkanti, Sriram Nathan, Daniel Ocazionez-Trujillo, Indranee Rajapreyar, Manish K. Patel, Jayesh Patel, Pranav Loyolka, Biswajit Kar, Igor Gregoric

The VAD Journal

Implantation rates of the SynCardia Total Artificial Heart (TAH) system is growing owing to the increasing incidence of biventricular heart failure and the limited number of transplantable hearts. Among the complications associated with the device, atrial tamponade is an emergent condition that requires immediate attention. Atrial tamponade occurs when increasing pericardial hemorrhage leads to atrial compression that produces tamponade physiology and compromises cardiac output. Unfortunately to our knowledge, information concerning the early manifestations of tamponade in TAH patients is extremely scarce. Previous reports have focused on decreased cardiac output as an indicator of tamponade. However, other presentations including pulmonary decompensation …

Distal Insertional Footprint Of The Brachialis Muscle: 3d Morphometric Study, Srinath Kamineni, Abdo Bachoura, William Behrens, Ellora Kamineni, Andrew Deane

Orthopaedic Surgery and Sports Medicine Faculty Publications

Objective. The purpose of this study is to describe the three-dimensional morphometry of the brachialis muscle at its distal attachment to the ulna. Methods. Fifty cadaveric elbows were dissected and the brachialis distal insertion was isolated on the ulna bone and probed with a three-dimensional digitizer, to create a three-dimensional model of the footprint. Measurements and analysis of each footprint shape were recorded and compared based on gender and size. Results. There was significant gender difference in the surface length (P = 0.002) and projected length (P = 0.001) of the brachialis footprint. The shapes …

Plant-Derived Sac Domain Of Par-4 (Prostate Apoptosis Response 4) Exhibits Growth Inhibitory Effects In Prostate Cancer Cells, Shayan Sarkar, Sumeet Jain, Vineeta Rai, Dipak K. Sahoo, Sumita Raha, Sujit Suklabaidya, Shantibhusan Senapati, Vivek M. Rangnekar, Indu B. Maiti, Nrisingha Dey

Radiation Medicine Faculty Publications

The gene Par-4 (Prostate Apoptosis Response 4) was originally identified in prostate cancer cells undergoing apoptosis and its product Par-4 showed cancer specific pro-apoptotic activity. Particularly, the SAC domain of Par-4 (SAC-Par-4) selectively kills cancer cells leaving normal cells unaffected. The therapeutic significance of bioactive SAC-Par-4 is enormous in cancer biology; however, its large scale production is still a matter of concern. Here we report the production of SAC-Par-4-GFP fusion protein coupled to translational enhancer sequence (5′ AMV) and apoplast signal peptide (aTP) in transgenic Nicotiana tabacum cv. Samsun NN plants under the control of a unique recombinant promoter M24. …

Women With Disabilities: Reproductive Care And Women’S Health, Stephanie Stockburger, Hatim A. Omar

Pediatrics Faculty Publications

Children, adolescents, and women with disabilities experience the same sexual development, pubertal changes, concerns, and desire to reproduce as their typically developing counterparts. However, society has tended to stigmatize women with disabilities as “asexual” and ignore this aspect of their health care. These women are less likely to receive gynecological exams, contraception, and evaluation of sexual dysfunction. Unfortunately, having a disability places women at risk for sexual exploitation and abuse as well as sexually transmitted infections. Therefore, reproductive health care for these women is imperative. A number of barriers to receiving reproductive care exist. However, with proper education and knowledge …

Effects Of Adipocyte Aryl Hydrocarbon Receptor Deficiency On Pcb-Induced Disruption Of Glucose Homeostasis In Lean And Obese Mice, Nicki A. Baker, Robin Shoemaker, Victoria English, Nika Larian, Manjula Sunkara, Andrew J. Morris, Mary Walker, Frederique Yiannikouris, Lisa A. Cassis

Saha Cardiovascular Research Center Faculty Publications

BACKGROUND: Coplanar polychlorinated biphenyls (PCBs) promote adipocyte inflammation and impair glucose homeostasis in lean mice. The diabetes-promoting effects of lipophilic PCBs have been observed only during weight loss in obese mice. The molecular mechanisms linking PCB exposures to impaired glucose metabolism are unclear.

OBJECTIVES: In this study we tested the hypothesis that coplanar PCBs act at adipocyte aryl hydrocarbon receptors (AhRs) to promote adipose inflammation and impair glucose homeostasis in lean mice and in obese mice during weight loss.

METHODS AND RESULTS: PCB-77 administration impaired glucose and insulin tolerance in LF (low fat diet)-fed control (AhR^fl/fl) mice …

Impact Of Environmental Health On Teen Outcomes In Rural Kentucky, Lesley Davidson, Alissa Briggs, Hatim A. Omar

Pediatrics Faculty Publications

Understanding the impact of family dynamics on health has become an environmental health priority in the field of adolescent medicine. Family dynamics are much more complex than they were 60 years ago and so are behavioral outcomes. This transformation in the American family has led towards a large array of adolescent living situations. Rural Kentucky is a prime example of an area with a high rate of non-traditional family composition. Poor family dynamics may be associated with increased rates of high risk behaviors among teenagers. Among these behaviors are drug use, sexual activity, and depression. In this study, we evaluated …

Deubiquitinase Usp47/Ubp64e Regulates Β-Catenin Ubiquitination And Degradation And Plays A Positive Role In Wnt Signaling, Jiandang Shi, Yajuan Liu, Xuehe Xu, Wen Zhang, Tianxin Yu, Jianhang Jia, Chunming Liu

Markey Cancer Center Faculty Publications

Wnt signaling plays important roles in development and tumorigenesis. A central question about the Wnt pathway is the regulation of β-catenin. Phosphorylation of β-catenin by CK1α and GSK3 promotes β-catenin binding to β-TrCP, leading to β-catenin degradation through the proteasome. The phosphorylation and ubiquitination of β-catenin have been well characterized; however, it is unknown whether and how a deubiquitinase is involved. In this study, by screening RNA interference (RNAi) libraries, we identified USP47 as a deubiquitinase that prevents β-catenin ubiquitination. Inactivation of USP47 by RNAi increased β-catenin ubiquitination, attenuated Wnt signaling, and repressed cancer cell growth. Furthermore, USP47 deubiquitinates itself, …

Differential Expression And Tumorigenic Function Of Neurotensin Receptor 1 In Neuroendocrine Tumor Cells, Ji Tae Kim, Jing Li, Jun Song, Eun Y. Lee, Heidi L. Weiss, Courtney M. Townsend, B. Mark Evers

Markey Cancer Center Faculty Publications

Neurotensin (NTS), localized predominantly to the small bowel, stimulates the growth of a variety of cancers, including neuroendocrine tumors (NETs), mainly through its interaction with the high-affinity NTS receptor 1 (NTSR1). Here, we observed increased expression of NTSR1 in almost all tested clinical NET samples, but not in normal tissues. Through RT-PCR analysis, we found that the expression of NTSR1 and NTSR2 was either variable (NTSR1) or absent (NTSR2) in human NET cell lines. In contrast, NTSR3 and NTS were expressed in all NET cells. Treatment with 5-aza-2'-deoxycytidine, a demethylating agent, increased levels of NTSR1 and NTSR2 suggesting that DNA …

Lipin1 Regulates Skeletal Muscle Differentiation Through Extracellular Signal-Regulated Kinase (Erk) Activation And Cyclin D Complex-Regulated Cell Cycle Withdrawal, Weihua Jiang, Jing Zhu, Xun Zhuang, Xiping Zhang, Tao Luo, Karyn Esser, Hongmei Ren

Saha Cardiovascular Research Center Faculty Publications

Lipin1, an intracellular protein, plays critical roles in controlling lipid synthesis and energy metabolism through its enzymatic activity and nuclear transcriptional functions. Several mouse models of skeletal muscle wasting are associated with lipin1 mutation or altered expression. Recent human studies have suggested that children with homozygous null mutations in the LPIN1 gene suffer from rhabdomyolysis. However, the underlying pathophysiologic mechanism is still poorly understood. In the present study we examined whether lipin1 contributes to regulating muscle regeneration. We characterized the time course of skeletal muscle regeneration in lipin1-deficient fld mice after injury. We found that fld mice exhibited smaller regenerated …

Mir-29/Hsp47 In Ecm Network, Ren Xu

Markey Cancer Center Faculty Publications

No abstract provided.

Phase Iii Study Of Pasireotide Long-Acting Release In Patients With Metastatic Neuroendocrine Tumors And Carcinoid Symptoms Refractory To Available Somatostatin Analogues, Edward M. Wolin, Barbara Jarzab, Barbro Eriksson, Thomas Walter, Christos Toumpanakis, Michael A. Morse, Paola Tomassetti, Matthias M. Weber, David R. Fogelman, John Ramage, Donald Poon, Brian Gadbaw, Jiang Li, Janice L. Pasieka, Abakar Mahamat, Fredrik Swahn, John Newell-Price, Wasat Mansoor, Kjell Öberg

Markey Cancer Center Faculty Publications

In a randomized, double-blind, Phase III study, we compared pasireotide long-acting release (pasireotide LAR) with octreotide long-acting repeatable (octreotide LAR) in managing carcinoid symptoms refractory to first-generation somatostatin analogues. Adults with carcinoid tumors of the digestive tract were randomly assigned (1:1) to receive pasireotide LAR (60 mg) or octreotide LAR (40 mg) every 28 days. Primary outcome was symptom control based on frequency of bowel movements and flushing episodes. Objective tumor response was a secondary outcome. Progression-free survival (PFS) was calculated in a post hoc analysis. Adverse events were recorded. At the time of a planned interim analysis, the data …

Time-Dependent Effects Of Cx3cr1 In A Mouse Model Of Mild Traumatic Brain Injury, Heidi Y. Febinger, Hannah E. Thomasy, Maria N. Pavlova, Kristyn M. Ringgold, Paulien R. Barf, Amrita M. George, Jenna N. Grillo, Adam D. Bachstetter, Jenny A. Garcia, Astrid E. Cardona, Mark R. Opp, Carmelina Gemma

Sanders-Brown Center on Aging Faculty Publications

BACKGROUND: Neuroinflammation is an important secondary mechanism that is a key mediator of the long-term consequences of neuronal injury that occur in traumatic brain injury (TBI). Microglia are highly plastic cells with dual roles in neuronal injury and recovery. Recent studies suggest that the chemokine fractalkine (CX3CL1, FKN) mediates neural/microglial interactions via its sole receptor CX3CR1. CX3CL1/CX3CR1 signaling modulates microglia activation, and depending upon the type and time of injury, either protects or exacerbates neurological diseases.

METHODS: In this study, mice deficient in CX3CR1 were subjected to mild controlled cortical impact injury (CCI), a model of TBI. We evaluated …

Behavioral And Morphological Parameters Of Neurons Predict The Inhibitory Potential Of Cspg Motifs: A Novel Technique, Edward Matin Kobraei

Kaleidoscope

Our lab aims to systematically identify the structural elements of chondroitin sulfate proteoglycans (CSPGs) that inhibit regeneration following spinal cord injury (SCI). CSPGs are extracellular matrix molecules produced by astrocytes of glial scar tissue following SCI. Central to this project is the use of CSPGs referred to as “Designer PGs,” which contain engineered modifications in the GAG chains and/ or the protein core of the neural CSPG aggrecan. Using established bioassays in vitro, we qualitatively and quantitatively measure growth cone behaviors and morphology as they interact with Designer PG molecules. These measurements are then translated into a composite inhibitory quotient …

Nurturing University Students To Be Social Entrepreneurs: Relevance Of Service Leadership Education, Daniel T. L. Shek, Li Lin

Pediatrics Faculty Publications

When the concept of social entrepreneurship becomes more popular, many universities explicitly claim that they wish to nurture social entrepreneurs. In this paper, the concept of social entrepreneurship and the successful attributes of social entrepreneurs are outlined. With reference to the question of how university students can be nurtured to be social entrepreneurs, it is suggested that the service leadership model proposed by the Hong Kong Institute of Service Leadership and Management is a good framework to be considered. In the framework, it is asserted that there are three attributes of a successful service leader – leadership competence, moral character, …

Clinical Significance Of The Integrin Α6Β4 In Human Malignancies, Rachel L Stewart, Kathleen L O'Connor

Pathology and Laboratory Medicine Faculty Publications

Integrin α6β4 is a cellular adhesion molecule that binds to laminins in the extracellular matrix and nucleates the formation of hemidesmosomes. During carcinoma progression, integrin α6β4 is released from hemidesmosomes, where it can then signal to facilitate multiple aspects of tumor progression including sustaining proliferative signaling, tumor invasion and metastasis, evasion of apoptosis, and stimulation of angiogenesis. The integrin achieves these ends by cooperating with growth factor receptors including EGFR, ErbB-2, and c-Met to amplify downstream pathways such as PI3K, AKT, MAPK, and the Rho family small GTPases. Furthermore, it dramatically alters the transcriptome …

Intrapersonal Competencies And Service Leadership, Daniel T. L. Shek, Li Lin

Pediatrics Faculty Publications

Intrapersonal competencies form the foundation of one’s development, and they are fundamental qualities of leadership competences. Four types of intelligence are highlighted in the literature of positive psychology: intelligence quotient (IQ), emotional intelligence quotient (EQ), adversity quotient (AQ) and spiritual intelligence quotient (SQ). It is argued that these competences are important in a service leader. Through this lecture, it is expected that students will understand the basic concepts and the importance of different intrapersonal competencies (IQ, EQ, AQ and SQ). We also discuss the relationship between these intrapersonal competencies and effective service leadership. Finally, ways to promote different intrapersonal competencies …

Muscle Weakness During Aging: A Deficiency State Involving Declining Angiogenesis, Charles T. Ambrose

Microbiology, Immunology, and Molecular Genetics Faculty Publications

This essay begins by proposing that muscle weakness of old age from sarcopenia is due in large part to reduced capillary density in the muscles, as documented in 9 reports of aged persons and animals. Capillary density (CD) is determined by local levels of various angiogenic factors, which also decline in muscles with aging, as reported in 7 studies of old persons and animals. There are also numerous reports of reduced CD in the aged brain and other studies showing reduced CD in the kidney and heart of aged animals. Thus a waning angiogenesis throughout the body may be …

Albumin Administration In Acute Ischemic Stroke: Safety Analysis Of The Alias Part 2 Multicenter Trial, Michael D. Hill, Renee H. Martin, Yuko Y. Palesch, Claudias S. Moy, Diego Tamariz, Karla J. Ryckborst, Elizabeth B. Jones, David Weisman, L. Creed Pettigrew, Myron D. Ginsberg

Sanders-Brown Center on Aging Faculty Publications

BACKGROUND: Albumin treatment of ischemic stroke was associated with cardiopulmonary adverse events in previous studies and a low incidence of intracranial hemorrhage. We sought to describe the neurological and cardiopulmonary adverse events in the ALIAS Part 2 Multicenter Trial.

METHODS: Ischemic stroke patients, aged 18-83 and a baseline NIHSS ≥ 6, were randomized to treatment with ALB or saline control within 5 hours of stroke onset. Neurological adverse events included symptomatic intracranial hemorrhage, hemicraniectomy, neurological deterioration and neurological death. Cardiopulmonary adverse events included pulmonary edema/congestive heart failure, acute coronary syndromes, atrial fibrillation, pneumonia and pulmonary thromboembolism.

RESULTS: …

Novel Human Abcc9/Sur2 Brain-Expressed Transcripts And An Eqtl Relevant To Hippocampal Sclerosis Of Aging, Peter T. Nelson, Wang-Xia Wang, Bernard R. Wilfred, Angela Wei, James Dimayuga, Qingwei Huang, Eseosa T. Ighodaro, Sergey C. Artiushin, David W. Fardo

Sanders-Brown Center on Aging Faculty Publications

ABCC9 genetic polymorphisms are associated with increased risk for various human diseases including hippocampal sclerosis of aging. The main goals of this study were 1 > to detect the ABCC9 variants and define the specific 3′ untranslated region (3′UTR) for each variant in human brain, and 2 > to determine whether a polymorphism (rs704180) associated with risk for hippocampal sclerosis of aging pathology is also associated with variation in ABCC9 transcript expression and/or splicing. Rapid amplification of ABCC9 cDNA ends (3′RACE) provided evidence of novel 3′ UTR portions of ABCC9 in human brain. In silico and experimental studies were performed focusing on …

Factors Leading To The Creation, Development, And Maintenance Of Positive Social Relationship, Daniel T. L. Shek, Jocelyn L. Lin

Pediatrics Faculty Publications

In contrast to the manufacturing economy where the focus is primarily placed on the man-machine interface, social relationships are important building blocks in the service economy. Hence, identifyig the factors leading to creation, development, and maintenance of positive social relationships within the context of leadership is an important consideration. In this paper, a lecture covers the nature of social relationships and the related determinants (including trust, care, and respect) are outlined. Through this lecture, students can develop the ability to identify the characteristics and determinants of positive social relationships, appreciate the importance of positive relationships to service leaders, and evaluate …

Adolescent Developmental Assets And Service Leadership, Daniel T. L. Shek, Cecilia M. S. Ma, Ting Ting Liu

Pediatrics Faculty Publications

In the field of positive youth development, it is generally asserted that developmental assets or positive youth development qualities contribute to positive adolescent developmental outcomes. In the context of training for service leadership, it is argued that the promotion of developmental assets would help university students develop the foundational competence of service leaders. In this paper, the lesson plan of Lecture Eleven in a course entitled “Service Leadership” run in The Hong Kong Polytechnic University is discussed. In the lecture, four developmental assets related to positive identity (self-esteem, self-efficacy, purpose in life and optimism about the future) proposed by Peter …

Evolution And Realms Of Service Leadership And Leadership Models, Daniel T. L. Shek, Rachel C. F. Sun, Ting Ting Liu

Pediatrics Faculty Publications

This paper presents a lesson plan in a course entitled “Service Leadership” at The Hong Kong Polytechnic University. In that lecture, three basic aspects of the service leadership model are presented. First, the origin of service leadership from an evolutionary anthropology perspective is outlined. Second, three realms of service leadership with reference to self, others and systems are presented. Third, two leadership models (i.e. top-down and bottom-up models) are introduced, and their strengths and weaknesses are examined. Students are also invited to reflect on their assumptions of men with reference to leadership. Several class activities including role-play, self-reflection exercises and …

Core Beliefs In The Service Leadership Model Proposed By The Hong Kong Institute Of Service Leadership And Management, Daniel T. L. Shek, Li Lin

Pediatrics Faculty Publications

The service leadership model and related curriculum were developed by the Hong Kong Institute of Service Leadership and Management. To nurture service leadership qualities in university students, a 2-credit service leadership subject was developed at The Hong Kong Polytechnic University. This paper presents the core beliefs and key components of the service leadership model and outlines the content of one of the lectures in the subject. The lecture attempts to help students recognize the importance of leadership competencies, moral character and caring disposition in successful leadership, and to explore ways to develop service leadership qualities. In addition to the lecture, …

Interpersonal Competence And Service Leadership, Daniel T. L. Shek, Lu Yu, Andrew M. H. Siu

Pediatrics Faculty Publications

According to the Hong Kong Institute of Service Leadership and Management, interpersonal competence is an important component of an effective service leader. The present paper introduces a lecture embedded in a service leadership subject that focuses on promoting students’ interpersonal competence. Several topics are covered in this lecture. First, concepts and theories about interpersonal competence are introduced. Second, the relevance of interpersonal competence to service leadership is outlined. Third, methods of developing interpersonal competence are presented, particularly different conflict management strategies and assertiveness skills. Finally, conclusions and reflections on students’ own interpersonal competence and its relevance to the service leadership …

Manufacturing Economy Vs. Service Economy: Implications For Service Leadership, Daniel T. L. Shek, Po P.Y. Chung, Hildie Leung

Pediatrics Faculty Publications

In the past few decades, there has been a shift from manufacturing to service economy in many places throughout the world. In Hong Kong, 95% of its GDP is made up by the service industries. Conceptually, these two economies are associated with different production characteristics, organizational structures, and desired attributes of workers and leaders. The differences between these two economies in terms of the production modes are discussed in this paper. In particular, the implications of the economy on effective leadership requirements are outlined. With specific reference to the Service Leadership model proposed by the Hong Kong Institute of Service …

How Unique Is The Service Leadership Model? A Comparison With Contemporary Leadership Approaches, Daniel T. L. Shek, Po P.Y. Chung, Hildie Leung

Pediatrics Faculty Publications

The growth of the service economy in the contemporary world has resulted in a different set of requirements for effective leadership as compared with the industrial era, which focused primarily on manufacturing industries. To nurture “service leaders” in the service economy, the Hong Kong Institute of Service Leadership and Management proposed the service leadership model. The key characteristics of the service leadership model are outlined in this paper. A systematic comparison was also conducted to identify the common and unique features of the service leadership model with reference to the existing leadership theories, including the trait, servant, spiritual, authentic, ethical, …

Commentary On "Systemic Candidiasis And Cytomegalovirus Infection In The Setting Of Artificial Cardiac Device Deployment", Moises A. Huaman

The VAD Journal

No abstract provided.

Systemic Candidiasis And Cytomegalovirus Infection In The Setting Of Artificial Cardiac Device Deployment., Manoj Thangam, Bindu Akkanti, Maan Malahafio, Sriram Nathan, Indranee Rajapreyar, Pranav Loyalka, Biswajit Kar, Igor Gregoric

The VAD Journal

Heart failure is a serious cause of morbidity and mortality worldwide. The advent of implantable cardiac assist devices has generated a new arsenal for treating severe heart failure. However, the potential ramifications of ventricular assist device (VAD) usage are not fully understood. Immune modulation resulting from VAD implantation is an area of growing research. Although we do not fully understand the mechanisms contributing to host immune alteration, changes in cytokine concentrations, deceased lymphocyte activity, and the local effects of device materials have been shown to down regulate immune function. ^7,8 Infection is a serious complication that affects prognosis in this …

Use Of Social Media As A Virtual Community And Support Group By Left Ventricular Assist Device (Lvad) Patients, Bryan Boling, Amanda Hart, Chizimuzo T.C. Okoli, Tamra Halcomb, Peggy El-Mallakh

The VAD Journal

Abstract

Background

Left ventricular assist device (LVAD) patients may benefit from participating in a social support group; however, several factors may limit the availability of these communities. Alternatively, online social support communities may be more accessible for LVAD patients. No studies have examined patterns and reasons for health-related social media use among people with LVADs

Methods

An online survey of patients actively participating in LVAD social media groups was conducted using both multiple choice and open-ended questions.

Results

Thirty-nine participants (65% male) completed the survey. Participants’ reasons for weekly engagement in online communities were to seek (69.2%) and offer (66.7%) …