Medical Specialties Commons^™

Nipple Aspirate Cytology And Pathologic Parameters Predict Residual Cancer And Nodal Involvement After Excisional Breast Biopsy., E R Sauter, H Ehya, A Mammen, G Klein

Department of Surgery Faculty Papers

We previously demonstrated that abnormal nipple aspirate fluid (NAF) cytology predicted residual breast cancer (RC) and tumour size after excisional biopsy (EB), although normal NAF cytology did not exclude RC. Tumour size correlates with the risk of lymph node (LN) metastases. LN metastases provide prognostic information allowing medical and radiation oncologists to determine the need for adjuvant therapy. We hypothesized that pathologic factors known after EB, combined with NAF cytology, would predict with a high degree of accuracy the presence of RC and LN spread. NAF cytology and pathologic parameters: tumour distance from biopsy margins, multifocal and multicentric disease, sub-type …

Regulation Of Type-Ii Collagen Gene Expression During Human Chondrocyte De-Differentiation And Recovery Of Chondrocyte-Specific Phenotype In Culture Involves Sry-Type High-Mobility-Group Box (Sox) Transcription Factors, David G. Stokes, Gang Liu, Rita Dharmavaram, David Hawkins, Sonsoles Piera-Velazquez, Sergio A. Jimenez

Selected Works of Sergio Jiménez, MD, MACR

During ex vivo growth as monolayer cultures, chondrocytes proliferate and undergo a process of de-differentiation. This process involves a change in morphology and a change from expression of chondrocyte-specific genes to that of genes that are normally expressed in fibroblasts. Transfer of the monolayer chondrocyte culture to three-dimensional culture systems induces the cells to re-acquire a chondrocyte-specific phenotype and produce a cartilaginous-like tissue in vitro. We investigated mechanisms involved in the control of the de-differentiation and re-differentiation process in vitro. De-differentiated chondrocytes re-acquired their chondrocyte-specific phenotype when cultured on poly-(2-hydroxyethyl methacrylate) (polyHEMA) as assayed by morphology, reverse transcriptase PCR of …

Evaluation Of Cholera Vaccines Formulated With Toxin-Coregulated Pilin Peptide Plus Polymer Adjuvant In Mice, Jia-Yan Wu, William F. Wade, Ronald K. Taylor

Dartmouth Scholarship

Cholera is an acute diarrheal disease that is caused by the gram-negative bacterium Vibrio cholerae. The low efficacy of currently available killed-whole-cell vaccines and the reactinogenicity coupled with potential reversion of live vaccines have thus far precluded widespread vaccination for the control of cholera. Recent studies on the molecular nature of the virulence components that contribute to V. cholerae pathogenesis have provided insights into possible approaches for the development of a defined subunit cholera vaccine. Genetic analysis has demonstrated that the toxin-coregulated pilus (TCP) is the major factor that contributes to colonization of the human intestine by V. cholerae. In …

Immune Response Genes Modulate Serologic Responses To Vibrio Cholerae Tcpa Pilin Peptides, Michael D. Meeks, Terri K. Wade, Ronald K. Taylor, William F. Wade

Dartmouth Scholarship

Cholera is an enteric disease caused by Vibrio cholerae. Toxin-coregulated pilus (TCP), a type 4 pilus expressed by V. cholerae, is a cholera virulence factor that is required for host colonization. The TCP polymer is composed of subunits of TcpA pilin. Antibodies directed against TcpA are protective in animal models of cholera. While natural or recombinant forms of TcpA are difficult to purify to homogeneity, it is anticipated that synthesized TcpA peptides might serve as immunogens in a subunit vaccine. We wanted to assess the potential for effects of the immune response (Ir) gene that could complicate a peptide-based …

Anti-Class Ii Monoclonal Antibody-Targeted Vibrio Cholerae Tcpa Pilin: Modulation Of Serologic Response, Epitope Specificity, And Isotype, Jia-Yan Wu, Ronald K. Taylor, William F. Wade

Dartmouth Scholarship

Toxin-coregulated pilus (TCP) is a colonization factor required for cholera infection. It is not a strong immunogen when delivered in the context of whole cells, yet pilus subunits or TcpA derivative synthetic peptides induce protective responses. We examined the efficacy of immunizing mice with TCP conjugated to anti-class II monoclonal antibodies (MAb) with or without the addition of cholera toxin (CT) or anti-CD40 MAb to determine if the serologic response to TcpA could be manipulated. Anti-class II MAb-targeted TCP influenced the anti-TCP peptide serologic response with respect to titer and isotype. Responses to TcpA peptide 4 were induced with class …

Evaluation Of A Tetracycline-Inducible Promoter In Staphylococcus Aureus In Vitro And In Vivo And Its Application In Demonstrating The Role Of Sigb In Microcolony Formation, B. T. Bateman, N. P. Donegan, T. M. Jarry, M. Palma

Dartmouth Scholarship

An inducible promoter system provides a powerful tool for studying the genetic basis for virulence. A variety of inducible systems have been used in other organisms, including pXyl-xylR-inducible promoter, the pSpac-lacI system, and the arabinose-inducible P_BAD promoter, but each of these systems has limitations in its application to Staphylococcus aureus. In this study, we demonstrated the efficacy of a tetracycline-inducible promoter system in inducing gene expression in S. aureus in vitro and inside epithelial cells as well as in an animal model of infection. Using the xyl/tetO promoter::gfp_uvr fusion carried on a shuttle …

Parental [Correction Of Perinatal] Consanguinity: A Risk Factor For Developmental Delay In Pakistani Children, S Ibrahim, Z Habib, S Hyder, I S. Azam, R Ahmed

Department of Paediatrics and Child Health

Objective: To investigate the association of parental consanguinity and delayed development in terms of gross motor, fine motor, speech and social aspects in their children.
Methods: One hundred and seventy seven children (age 15 days--72 months) were evaluated for their developmental status utilizing the Denver Developmental Screening Test (DDST). An unmatched case-control study design was used. Case group consisted of 94 children and control group 83 children. Odds ratios were calculated for parental consanguinity and delay in gross and fine motor, speech and social development in their children, for cases and controls, utilizing Binary Multiple Logistic Regression Analysis. Acquired delay …

Medical Education Digest, Vol. 3 No. 5 (November 15, 2001), Nova Southeastern University

Medical Education Digest

No abstract provided.

Sensitivity Of Bovine Blastocyst Gene Expression Patterns To Culture Environments Assessed By Differential Display Rt-Pcr., D R Natale, P A De Sousa, M E Westhusin, A J Watson

Obstetrics & Gynaecology Publications

The use of culture media to support the development of preimplantation embryos to the blastocyst stage is often associated with detrimental effects on normal development. These effects have been uncovered largely by investigating the phenotypic abnormalities displayed by fetuses and newborns derived from cultured preimplantation embryos. Research to understand the impact of culture on the embryonic developmental programme has focused on embryo metabolism, gene expression and genomic imprinting. We have used differential display RT-PCR to examine culture influences on global transcript pools in bovine embryos. Others have examined culture influences on candidate "marker genes" in cultured murine, ovine and bovine …

Role Of Protein Kinase C-Delta In The Regulation Of Collagen Gene Expression In Scleroderma Fibroblasts, Sergio A. Jimenez, Svetlana Gaidarova, Biagio Saitta, Nora Sandorfi, David J. Herrich, Joan C. Rosenbloom, Umberto Kucich, William R. Abrams, Joel Rosenbloom

Selected Works of Sergio Jiménez, MD, MACR

Working with cultured dermal fibroblasts derived from control individuals and patients with systemic sclerosis (SSc), we have examined the effects of protein kinase C-delta (PKC-delta) on type I collagen biosynthesis and steady-state levels of COL1A1 and COL3A1 mRNAs. Rottlerin, a specific inhibitor of PKC-delta, exerted a powerful, dose-dependent inhibition of type I and type III collagen gene expression in normal and SSc cells. Optimal rottlerin concentrations caused a 70-90% inhibition of type I collagen production, a >80% reduction in COL1A1 mRNA, and a >70% reduction in COL3A1 mRNA in both cell types. In vitro nuclear transcription assays and transient transfections …

Oncolog, Volume 46, Number 11/12, November-December 2001, Karen Stuyck, Kerry L. Wright

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Multidisciplinary Team Helps Patients with Cancer Overcome Cognitive Problems
• Protocols: Studies Focus on Cognitive Effects of Cancer and Its Treatment
• House Call: Simple Steps Can Put Patients on the Road to Well-Being
• Highly Selective Synthetic Binding Agents Target Different DNA Conformations

Asymmetrical Response Of P38 Kinase Activation To Volume Changes In Primary Rat Astrocytes, Dazhong Xu, Ling Wang, James E. Olson, Luo Lu

Emergency Medicine Faculty Publications

Activation of p38 kinase by osmotic stress has been documented in many cells; however, no report has distinguished the effects of cell volume on p38 activity from the effects of the altered osmotic condition per se. Here we report asymmetrical activation of astrocyte p38 mitogen-activated protein (MAP) kinase in response to volume increases and volume decreases. We separate effects of cell volume changes from the effects of osmotic exposure on p38 activation. Exposure to 400, 500, or 600 mOsm phosphate-buffered saline (PBS) caused cell shrinkage and an osmolality-dependent increase in p38 activity to 175%, 409%, or 518%, respectively, compared with …

Prevalence Of Smokers Among Air-Conditioned Coaches, Pakistan, R Mal, N Rizvi, S Rathi

Section of Otolaryngology, Head & Neck Surgery

Objective: To estimate the proportion of smokers among passengers of air-conditioned (A/C) coaches running between Karachi and Hyderabad. Pakistan.METHOD: A cross-sectional survey was done on passengers and staff members of 20 air-conditioned coaches.Results: Of 847 passengers interviewed, 17.3% were smokers and 11.7% passengers smoked during travel while rest of them remained passive smokers. Out of 147 smokers 91.2% were literate persons. Among staff members 59.3% were smokers. Approximately 56% of smokers among passengers were in the age range of 14-40 years. In 95% of A/C coaches there were no anti-smoking warning signs or written words present.CONCLUSION: In this study majority …

Sex And Race Differences In Electrocardiogram Use (The National Hospital Ambulatory Medical Care Survey), Amy L. Arnold, Kerry A. Milner, Viola Vaccarino

Nursing Faculty Publications

There are sex and race differences in many aspects of health care delivery. For example, blacks and women are less likely to receive aspirin and thrombolytic drugs. Blacks and women presenting with chest pain are less likely to be referred for cardiac catheterization. Blacks and women diagnosed with acute myocardial infarction (AMI) are also less likely to undergo cardiac catheterization. The gender differences in diagnostic evaluation after AMI appear more pronounced among younger women. The American College of Cardiology and the American Heart Association joint electrocardiography guidelines state that all patients presenting to the emergency department (ED) with chest pain …

Com Outlook October 2001, College Of Osteopathic Medicine

COM Outlook

No abstract provided.

Mapping And Ablation Of Complex Cardiac Arrhythmia Guided By A Novel Three Dimensional Non-Contact Endocardial Activation Mapping System, Wing-Hong Fung, Chi-Kin Chan, Kam-Sang Woo, Wilson Wai-Man Chan

Journal of the Hong Kong College of Cardiology

Conventional cardiac activation mapping requires a sequentially-based method of positioning a catheter in contact with the endocardium to generate intracardiac electrograms at single points during sustained arrhythmia. Significant limitation of such point by point mapping may be encountered when applying to complex arrhythmia e.g. non-sustained arrhythmia or haemodynamically unstable arrhythmia. A novel non-contact mapping system (Ensite 3000 system) providing a three-dimensional simultaneous display of arrhythmia activation may offer a solution. The non-contact mapping system consists of a specially designed balloon catheter (Ensite EP catheter) with 64 insulated wires over the surface of the balloon for sensing electrical potentials on the …

Vital Signs, Fall 2001, Boonshoft School Of Medicine

Vital Signs

A twenty three page newsletter created by the Boonshoft School of Medicine to document the current affairs of the school. This issue includes a variety of feature articles, alumni profiles, class notes, and more.

Oncolog, Volume 46, Number 10, October 2001, Dawn Chalaire, Kerry L. Wright, Mary K. Hughes Ms, Rn

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Surgical Techniques, New Agents Target Breast Disease with Increasing Accuracy
• Undiagnosed Breast Clinic Provides Answers for Concerned Patients
• House Call: Tips for Coping with the Cosmetic Effects of Breast Cancer
• DiaLog: Breast Cancer and Body Image, by Mary K. Hughes, MS, RN, Department of Psychiatry
• New Screening and Diagnostic Techniques Are Changing the Practice of Breast Imaging

Mysterious Rectal Bleeding In A Female Adolescent, Hatim A. Omar

Pediatrics Faculty Publications

A 15-year-old female referred to our adolescent clinic for further evaluation of rectal bleeding was seen a week earlier in the acute care clinic with a two-day history of bright red rectal bleeding. The physical examination at that time was reportedly normal, including the rectal exam. The blood count with differential, liver function tests, ESR, and barium enema were all within normal limits. The patient, however, continued to complain of rectal bleeding and this led to the referral. She was known in the adolescent clinic as having a history of learning disability and mild mental retardation. She was started on …

Labial Adhesion As A Complication Of Primary Genital Herpes In Young Women, Hatim A. Omar

Pediatrics Faculty Publications

Genital herpes is a common sexually transmitted disease in adolescents. It may be associated with significant morbidity if not diagnosed on time or not properly treated. The objective of this study was to determine the incidence of labial adhesion secondary to primary herpes in young women and the possible predisposing factors for this complication. The method was analysis of clinical data regarding primary genital herpes in young women seen in an adolescent outpatient clinic at a university hospital. Cases of primary genital herpes seen between December 1^st 1998 and November 30^th 1999 were included. A total of 34 …

Morphological Pattern Of Salivary Gland Tumours, M. S. Gill, S. Muzaffar, I. N. Soomro, Naila Kayani, A. S. Hussainy, Shahid Pervez, S. H. Hasan

Department of Pathology and Laboratory Medicine

Objective: To delineate the spectrum of salivary gland tumors in our setup.

Setting: The Aga Khan University Medical Centre, Karachi.

Method: Tumors were analysed considering histological type, age and sex of the patients and anatomic location. The diagnosis of individual tumours was based on the 1991 World Health Organisation Classification.

Results: During the span of eight years (1991-1998), 379 cases of salivary gland tumours were diagnosed. Of these, 205 (65.7%) were male and 174 (34.3%) were female. The median age at the time of diagnosis was 35 years. The median age for patients with malignant lesions (44 years) was 12 …

The Use Of Wallstent And Smart Stents Incarotid Stent-Supported Angioplasty, Steven Siu-Lung Li

Journal of the Hong Kong College of Cardiology

In the endovascular approach of carotid stenosis treatment, stent-supported angioplasty is current state-of-the-art technique. Self-expandable stents are preferable to balloon-expandable stents due to the potential risk of deformation of the latter by external pressure. Wallstents and SMART stents are the more commonly used self-expandable stents. They appear to be of similar efficacy and safety but due to their different characteristics, their applications may be different according to different lesion characteristics.

Presentation And Symptom Predictors Of Coronary Heart Disease In Patients With And Without Diabetes, Marjorie Funk, Janice B. Naum, Kerry A. Milner, Deborah Chyun

Nursing Faculty Publications

The aims of this prospective, observational study were to compare: (1) symptom presentation of coronary heart disease (CHD) between patients with and without diabetes and (2) symptom predictors of CHD in patients with and without diabetes. We directly observed 528 patients with symptoms suggestive of CHD as they presented to the ED of a 900-bed cardiac referral center in the northeastern United States. There were no significant differences in symptom presentation of CHD between patients with and without diabetes, although patients with diabetes were slightly more likely to present with shortness of breath (P =.056). Patients with diabetes reported …

Medical Education Digest, Vol. 3 No. 4 (September 15, 2001), Nova Southeastern University

Medical Education Digest

No abstract provided.

Therapeutic Electromagnetic Field Effects On Angiogenesis And Tumor Growth, C. Douglas Williams, Marko S. Markov, W. Elaine Hardman, Ivan L. Cameron

Biochemistry and Microbiology

Background: A new approach to cancer therapy based on the application of therapeutic electromagnetic fields (TEMF) has been developed by EMF Therapeutics, Inc., Chattanooga, TN, USA. This study was designed to assess the effect of TEMF on tumor vascularization and growth of murine 16/C mammmary adenocarcinoma cells in C3H/HeJ mice.

Materials and Methods: Implanted tumors were allowed to grow for seven days until the tumor volume reached 100 mm3 before treatment was started. Mice (20 per control, 10 per EMF exposed group) received treatment (10 minutes per day with 0, 10 mT, 15 mT or 20 mT) with a 120 …

Bilateral Cervical Radiculopathy As A Presentation Of Spinal Tuberculosis: Report Of Two Cases, G R. Sharma, Rashid Jooma

Section of Neurosurgery

No abstract provided.

Percutaneous Transhepatic Biliary Stenting, T U. Haq, M Sanaullah, H Mohsin, M Y. Sheikh, B Ahmed

Department of Radiology

Objective: Bilary stenting with endoprosthesis is a palliative procedure to relieve malignant biliary obstruction. Percutaneous transhepatic technique has been employed whenever endoscopic technique was not possible or had failed.SETTING: Angiography/intervention suite, department of radiology, Aga Khan University hospital, Karachi.Methods: We present retrospective analysis of 17 patients with malignant jaundice who were treated with percutaneous techniques after the endoscopic route had failed.Results: The success rate was 94% with placement of single plastic stent in 14 patients, double stents in 3 patients and self-expandable stent in one patient. The overall complication rate was 41% including sepsis, liver abscess, biloma formation, biliary leakage …

Oncolog, Volume 46, Number 09, September 2001, Beth Notzon, Kerry L. Wright, Renato Lenzi Md

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Completing the Job: Multidisciplinary Effort Restores Form and Function, Improves Patients' Quality of Life
• House Call: Denial and Cancer
• Protocols: Studies Examine Treatments for Glioma
• DiaLog: Addressing the Problem of Patients' Denial, by Renato Lenzi, MD, Associate Professor, Department of Gastrointestinal Medical Oncology
• New Replication-Competent Adenovirus Shows Promise against Gliomas in Preclinical Studies

Continuous Quality Assessment; Development Of A Simple Computer Based Model For Audit, N K. Waheed, F S. Awan, A Ahad, A Rahman, K M. Pal

Department of Surgery Docs

Objective: Accurate assessment of quality of care is a fundamental first step in the process of quality improvement. The vast amount of data generated in a hospital mandates some form of computerization for management of information. We describe a locally developed simple computer based program to access relevant information from a hospital patient management network. The objective was to reduce the amount of manual work involved for busy clinicians attempting to audit quality of care.Methods: A single surgical procedure, Laparoscopic Cholecystectomy was chosen. Quality indicators were identified by literature review as conversion rate from laparoscopic to open cholecystectomy and length …

Communication About End Of Life For Patients Living With Amyotrophic Lateral Sclerosis: A Scoping Review Of The Empirical Evidence, Shelagh K. Genuis, Westerly Luth, Sandra Campbell, Tania M. Bubela, Wendy S. Johnston

Office of the Provost

Background: Communication about end of life, including advance care planning, life-sustaining therapies, palliative care, and end-of-life options, is critical for the clinical management of amyotrophic lateral sclerosis patients. The empirical evidence base for this communication has not been systematically examined.
Objective: To support evidence-based communication guidance by (1) analyzing the scope and nature of research on health communication about end of life for amyotrophic lateral sclerosis; and (2) summarizing resultant recommendations.
Methods: A scoping review of empirical literature was conducted following recommended practices. Fifteen health-related and three legal databases were searched; 296 articles were screened for inclusion/exclusion criteria; and quantitative …