Medical Specialties Commons^™

The Kras/Mapk Pathway And Ligand Independent Activation Of Erα: Implications For The Treatment Of Endometrial Cancer, Kari Ring

Dissertations and Theses (Open Access)

Hormonal therapy remains a first line option for the treatment of recurrent endometrial cancer (EC), however, many tumors demonstrate de novo or acquired resistance. Member kinases of the PI3K/AKT and Ras/MAPK pathways activate estrogen receptor α (ERα) independent of estrogen, however, few studies have evaluated the role of the Ras/MAPK pathway in predicting response to hormonal therapy in EC. The aims of this project were to evaluate the role of ligand independent activation of ERα in EC and to explore therapeutic implications for the treatment of recurrent EC.

A xenograft model for recurrent EC was used to evaluate the effect …

Novel Serum Biomarkers For Lung Cancer Early Diagnosis And Clinical Outcome, Fanmao Zhang

Dissertations and Theses (Open Access)

The five-year survival rate for all stages of lung cancer combined is only 17%, which has changed little over the past 40 years. Despite the tremendous efforts made, serum biomarkers with clinical utility for lung cancer early detection and clinical outcome prediction are still lacking. Metabolic alterations have been recognized as an emerging hallmark of cancer. We aimed to investigate the metabolic changes associated with lung cancer and to identify novel clinically applicable serum biomarkers for lung cancer early diagnosis and clinical outcome.

Serum metabolites are potential biomarkers for lung cancer early detection. We first performed global metabolomic profiling followed …

Gestational Headaches: Characteristics And Influencing Factors In South-Western Nigeria, Philip Adebayo, Aramide Mikhail Tijani, Olukayode Abayom, Adeseye Abiodun Akintunde

Internal Medicine, East Africa

Background: factor s Headache is one of the common neurological diseases in pregnancy but its pattern and influencing are yet to be determined in our environment in Nigeria. The aim of this study was to determine the prevalence and characteristics, as well as the modifying factors for gestational headaches in Ogbomoşo, Nigeria.

Methods: This study was a biinsti pregnant women attending the antetutional crosssectional descriptive study. Three hundred and eight (308) eligible natal care of the Ladoke Akintola University of T local government hospitals in Ogbomoso were recruited consecu 2013. Using an interviewer administered questionnaire, sociodemographic, obstetrics and headache related …

Risk And Impact Of Inter-Ictal Depression On Quality Of Life Of Nigerian Women With Epilepsy Of Childbearing Age, Philip Adebayo, Olukayode Abayomi, Shamsideen Abayomi Ogun

Internal Medicine, East Africa

Background: Depression, the most common psychiatry comorbidity in patients with epilepsy is common among women, especially those of reproductive age. Although it could be said that the female gender is a risk factor for depression, the risk of inter-ictal depression and its impact on the quality of life (QoL) of women with epilepsy (WWE) has not been sufficiently studied among Nigerians.

Materials and Methods: In this cross-sectional case–control study, data were collected from 70 women (29 WWE and 41 women without epilepsy) within the age range ≥18 and ≤55 between July 2010 and March 2011. A questionnaire that includes items-related …

Nontyphoidal Cardiac Salmonellosis: Two Case Reports And A Review Of The Literature, Daniel Ortiz, Eric M Siegal, Christopher Kramer, Bijoy K Khandheria, Ernesto Brauer

The Texas Heart Institute Journal

Nontyphoidal Salmonella, especially Salmonella enterica, is a rare cause of endocarditis and pericarditis that carries a high mortality rate. Proposed predisposing conditions include immunodeficiency states, congenital heart defects, and cardiac valve diseases. We present 2 cases of cardiovascular salmonellosis. The first case is that of a 73-year-old woman with mechanical mitral and bioprosthetic aortic valves who died from sequelae of nontyphoidal Salmonella mitral valve vegetation, aortic valve abscess, and sepsis. The second case is that of a 62-year-old man with a recent systemic lupus erythematosus exacerbation treated with oral steroids, who presented with obstructive features of tamponade and sepsis secondary …

Abdominal Fat Suspension Device For Maintaining Normal Cardiorespiratory Function In Patients Undergoing Conscious Sedation During Surgery: A Feasibility Study, Norman F Truong, Joanna C Nathan, Daeun Yoon, Gabriel Ochoa, Marisa Prevost, Sehyun Yun, Z Maria Oden, Mehdi Razavi

The Texas Heart Institute Journal

Obese patients undergoing conscious-sedation surgery have increased perioperative morbidity because their excess abdominal tissue limits diaphragmatic excursion. We describe a simple device that might help attenuate this risk. We created a noninvasive suction device for abdominal suspension. By lifting the burden of excess weight, this device should decrease respiratory effort. To test the feasibility of excess weight removal in relieving cardiac stress, we tested 22 supine, healthy, normal-weight subjects by measuring their heart rates with and without a 13-kg tissue model on their abdomen to simulate excess weight. There was no significant difference in blood oxygen saturation before and after …

The In-Hospital Consultation Today: Whom Does It Best Serve?, Herbert L Fred

The Texas Heart Institute Journal

No abstract provided.

Intravitreal Triamcinolone Acetonide Injection For Macular Edema Due To Central Retinal Vein Occlusion Persisting Despite Multiple Intravitreal Bevacizumab Injections., Rayan A Alshareef, Sunir Garg, Jason Hsu, James Vander, Carl Park, Marc J Spirn

Wills Eye Hospital Papers

PURPOSE: To evaluate the response to intravitreal triamcinolone acetonide for macular edema persisting or recurring despite multiple intravitreal bevacizumab (IVB) treatments for central retinal vein occlusion (CRVO).

METHODS: Retrospective interventional case series of 21 eyes with CRVO from 21 patients who were diagnosed with persistent or recurrent macular edema secondary to CRVO and treated with 0.1mL (4mg) intravitreal triamcinolone acetonide (IVTA) after initial treatment with 3 or more IVB injections. Anatomic and visual responses were the study primary outcomes.

RESULTS: Mean logarithm of the minimum angle of resolution visual acuity was 1.19 (20/316) immediately before IVTA injection, and improved to …

Sleep Environment Risks For Younger And Older Infants., Jeffrey D. Colvin, Vicki Collie-Akers, Christy Schunn, Rachel Y. Moon

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: Sudden infant death syndrome and other sleep-related causes of infant mortality have several known risk factors. Less is known about the association of those risk factors at different times during infancy. Our objective was to determine any associations between risk factors for sleep-related deaths at different ages.

METHODS: A cross-sectional study of sleep-related infant deaths from 24 states during 2004-2012 contained in the National Center for the Review and Prevention of Child Deaths Case Reporting System, a database of death reports from state child death review teams. The main exposure was age, divided into younger (0-3 months) and older …

Parp-2 And Parp-3 Are Selectively Activated By 5' Phosphorylated Dna Breaks Through An Allosteric Regulatory Mechanism Shared With Parp-1., Marie-France Langelier, Amanda A Riccio, John M Pascal

Department of Biochemistry and Molecular Biology Faculty Papers

PARP-1, PARP-2 and PARP-3 are DNA-dependent PARPs that localize to DNA damage, synthesize poly(ADP-ribose) (PAR) covalently attached to target proteins including themselves, and thereby recruit repair factors to DNA breaks to increase repair efficiency. PARP-1, PARP-2 and PARP-3 have in common two C-terminal domains-Trp-Gly-Arg (WGR) and catalytic (CAT). In contrast, the N-terminal region (NTR) of PARP-1 is over 500 residues and includes four regulatory domains, whereas PARP-2 and PARP-3 have smaller NTRs (70 and 40 residues, respectively) of unknown structural composition and function. Here, we show that PARP-2 and PARP-3 are preferentially activated by DNA breaks harboring a 5' phosphate …

Hypertensive Crisis, Burden, Management, And Outcome At A Tertiary Care Center In Karachi, Aysha Almas, Ayaz Ghouse, Ahmed Raza Iftikhar, Munawar Khursheed

Department of Medicine

Objectives:. Hypertension, if uncontrolled, can lead to hypertensive crisis. We aim to determine the prevalence of hypertensive crisis, its management, and outcome in patients presenting to a tertiary care center in Karachi.
Methods: This was a cross-sectional study conducted at the Aga Khan University, Karachi, Pakistan. Adult inpatients (>18 yrs) presenting to the ER who were known hypertensive and had uncontrolled hypertension were included.
Results. Out of 1336 patients, 28.6% (387) had uncontrolled hypertension. The prevalence of hypertensive crisis among uncontrolled hypertensive was 56.3% (218). Per oral calcium channel blocker; 35.4% (137) and intravenous nitrate; 22.7% (88) …

Clinical, Lifestyle, Socioeconomic Determinants And Rate Of Asymptomatic Intracranial Atherosclerosis In Stroke Free Pakistanis., Ayeesha Kamran Kamal, Farzin Majeed, Omrana Pasha, Hasan Rehman, Muhammad Islam, Iqbal Azam Syed, Muhammad Saleem Ilyas, Munawar Hussain, Kamran Masood, Bilal Ahmed, Sumaira Nazir, Zafar Sajjad, Scott E. Kasner

Department of Medicine

Background: Intracranial Atherosclerotic Disease (ICAD) is the most frequent etiology of stroke with high prevalence among Asians. Despite this, early determinants of ICAD have not been described from this region.

Methods: The study is an analytical prospective cross-sectional study of 200 adults from Radiology Departments of two diagnostic centers in Karachi. Eligible participants confirmed the absence of stroke symptoms via the Questionnaire for Verifying Stroke Free Status (QVSFS) and underwent an interview covering medical, socio demographic, lifestyle and anthropometric evaluation using locally validated and standardized definitions. Magnetic Resonance Images (MRI) were centrally reviewed to detect ICAD using the criterion used …

Tackling The Existing Burden Of Infectious Diseases In The Developing World: Existing Gaps And The Way Forward, Zulfiqar Ahmed Bhutta, Rehana A. Salam, Jai K. Das, Zohra S. Lassi

Department of Paediatrics and Child Health

This series evaluates the effectiveness of community-based interventions (CBIs) to prevent and control infectious diseases of poverty (IDoP). Evidence from our reviews suggests that CBIs and school-based delivery platforms are effective in averting risk behaviors and reducing the disease burden. Co-implementation of interventions through existing community-based programs including immunization campaigns, antenatal care and maternal and child health programs have the potential to scale-up interventions for IDoP. Future research should focus on the process of developing and implementing efficient community-based programs through a comprehensive approach, and to gauge the effectiveness of various existing delivery models in order to improve morbidity and …

Frequency Of Cardiorenal Syndrome Type-I In Hospitalized Children With Acute Heart Failure In A Tertiary-Care Hospital, Mehjabeen Zaidi, Arshalooz Jamila Rehman, Anwarul Haque, Saleem Akhtar, Prem Kumar Maheshwar

Department of Paediatrics and Child Health

Objective: To determine the frequency of cardiorenal syndrome in hospitalized children with acute heart failure.

Study Design: Descriptive study.

Place and Duration of Study: Paediatric Intensive Care Unit, The Aga Khan University Hospital, Karachi, from December 2010 to December 2011.

Methodology: Sixty eight (68) children with acute heart failure fulfilling the selection criteria were evaluated for worsening of renal function (WRF). Serum creatinine was done at baseline and repeated at 72 hours to see the worsening of renal function. Estimated serum creatinine clearance was calculated by Schwartz formula.

Results: Mean age of patients was 43.6 ± 55.2 months. There were …

Empyema Thoracis In Children: Clinical Presentation, Management And Complications, Ali Faisal Saleem, Abdul Sattar Shaikh, Reema Sajjad Khan, Fazal Khan, Ahmad Vaqas Faruque, Muhammad Arif Mateen Khan

Department of Paediatrics and Child Health

Objective: To determine the etiology, clinical manifestation, management (medical and surgical) and complications of children with empyema thoracis in a tertiary care hospital from Karachi, Pakistan.

Study Design: Descriptive, analytical study.

Place and Duration of Study: Department of Surgery, The Aga Khan University Hospital, Karachi, from January 1996 to December 2010.

Methodology: Medical records of admitted children aged > a month to 15 years with discharge diagnosis of empyema thoracis and data was collected on demographic features, clinical manifestation, management and complications. Children managed medically were compared with those managed surgically by using interquartile range and median comparison. Mann-Whitney U test …

Subacute Sclerosing Panencephalitis: Clinical And Demographic Characteristics, Arshad Rafique, Nida Amjad, Prem Chand, Syed Sohail Zahoor Zaidi, Muhammad Suleman Rana, Khalid Ahmed, Shahnaz Ibrahim

Department of Paediatrics and Child Health

Objective: To determine the clinical and demographic characteristics of children diagnosed with Subacute sclerosing panencephalitis (SSPE).

Study Design: Case series.

Place and Duration of Study: The Aga Khan University Hospital, Karachi, from January 2000 to June 2012.

Methodology: A retrospective analysis was done, regarding medical charts of 43 children under the age of 16 years with a discharge diagnosis of SSPE. Demographic and clinical characteristics were recorded. Results were expressed as percentages.

Results: Most of the 43 patients were male (72%). The average age at presentation was 8.7 years with average duration of symptoms being 100.6 days. History of …

Evidence-Based Medicine Dalam Pelayanan Penyakit Dalam, Imam Subekti

Jurnal Penyakit Dalam Indonesia

Perkembangan masalah di bidang kedokteran, tidak terkecuali di bidang Penyakit Dalam, mengharuskan seorang dokter yang berkecimpung di pelayanan penyakit dalam untuk terus mengembangkan diri. Ada dua aspek penting yang terkandung di dalam pengertian "mengembangkan diri". Pada satu sisi, seorang dokter harus secara aktif menelaah dan meneliti, diawali dengan membuat pertanyaan untuk masalah kedokteran dari fenomena yang ada di pelayanan kedokteran sehari-hari, membuat hipotesis untuk memberikan jawaban sementara terhadap pertanyaan, dan selanjutnya membuktikan kebenaran yang digagasnya.

Peran Tindakan Revaskularisasi Terhadap Kesintasan Pasien Non St Elevation Myocardial Infarction (Nstemi), Gerie Amarendra, Lukman H. Makmun, Dono Antono, Esthika Dewiasty

Jurnal Penyakit Dalam Indonesia

Pendahuluan. Pengaruh revaskularisasi terhadap kesintasan pasien non ST elevation myocardial infarction (NSTEMI) masih belum jelas. Waktu revaskularisasi yang optimal pada pasien NSTEMI belum ditemukan. Penelitian ini bertujuan mengetahui pengaruh revaskularisasi terhadap kesintasan pasien NSTEMI, juga mengetahui pengaruh waktu revaskularisasi terhadap kesintasan pasien NSTEMI.

Metode. Penelitian dengan disain kohort retrospektif diakukan terhadap 300 pasien non ST elevation myocardial infarction yang dirawat di RSUPNCM pada kurun waktu Desember 2006-Maret 2011. Data klinis, laboratorium, elektrokardiografi (EKG), ekokardiografi, dan angiografi koroner dikumpulkan. Pasien yang telah terhitung enam bulan setelah onset kemudian dihubungi melalui telepon untuk melihat status mortalitasnya. Perbedaan kesintasan revaskularisasi ditampilkan …

Faktor Risiko Methicillin Resistant Staphylococcus Aureus Pada Pasien Infeksi Kulit Dan Jaringan Lunak Di Ruang Rawat Inap, Mochamad Iqbal Hassarief Putra, Suhendro Suwarto, Tonny Loho, Murdani Abdullah

Jurnal Penyakit Dalam Indonesia

Pendahuluan: Infeksi kulit dan jaringan lunak (IKJL) oleh MRSA di ruang rawat inap merupakan masalah nosokomial yang meningkat prevalensinya setiap tahun. Hal tersebut akan meningkatkan angka mortalitas, biaya dan lama rawat bila tidak dikelola dengan baik. Faktor-faktor risiko terjadinya infeksi MRSA pada pasien IKJL di ruang rawat inap penting untuk diketahui agar dapat dilakukan upaya-upaya pencegahan dan pengendalian terhadap faktor-faktor risiko tersebut sehingga pada gilirannya diharapkan kejadian MRSA pada pasien IKJL dapat dicegah atau dikendalikan. Tujuan: Mengetahui proporsi IKJL oleh MRSA dan mempelajari faktor-faktor yang berhubungan dengan risiko terinfeksi MRSA pada penderita IKJL di ruang rawat inap Rumah Sakit …

Syndrome Of Inappropriate Antidiuretic Hormone Secretion (Siadh) Akibat Kemoterapi Pada Pasien Lansia Dengan Keganasan, Velma Herwanto, Parlindungan Siregar, Shufrie Effendy, Andhika Rachman

Jurnal Penyakit Dalam Indonesia

Hiponatremia merupakan suatu kondisi yang sering ditemukan pada pasien-pasien dengan keganasan. Keadaan hiponatremia dapat terjadi bersamaan atau mendahului diagnosis suatu keganasan. Hiponatremia terkait kanker bisa mempengaruhi respon terhadap terapi kanker maupun kesintasan pasien. Kami laporkan sebuah kasus hiponatremia pada pasien lansia dengan keganasan yang disebabkan oleh syndrome of inappropriate anti diuretic hormone secretion (SIADH).

Pengaruh Penggunaan Antibiotika Terhadap Lama Hari Sakit Dan Lama Kehilangan Hari Kerja Pada Pasien Infeksi Pernapasan Akut Bagian Atas Pada Pelayanan Kesehatan Primer, Gunawan Gunawan, Suhendro Suwarto, Cleopas Martin Rumende, Kuntjoro Harimurti

Jurnal Penyakit Dalam Indonesia

Pendahuluan: Prevalensi infeksi saluran pernapasan bagian atas akut (ISPA) di komunitas masih tinggi dan menyebabkan morbiditas dan penurunan kualitas hidup masyarakat secara luas. Etiologi tersering dari infeksi pernapasan akut di luar negeri adalah virus, selain itu terdapat etiologi bakteri yang memerlukan terapi antibiotika yang spesifik. Penggunaan antibiotika untuk infeksi pernapasan akut berlebihan, dan hal ini menyebabkan peningkatan resistensi bakteri terhadap antibiotika. Penelitian ini bertujuan untuk mengetahui pola etiologi infeksi pernapasan akut, kesesuaian pemberian antibiotika dan perbedaan rerata lama sakit dan lama kehilangan hari kerja.

Metode: Penelitian ini merupakan penelitian observasional analitik dengan pengambilan data secara potong lintang dan …

Parameter Akhir Resusitasi Makrosirkulasi Dan Mikrosirkulasi Pada Sepsis Berat Dan Renjatan Septik, Robert Sinto, Suhendro Suwarto

Jurnal Penyakit Dalam Indonesia

Sepsis berat dan renjatan septik telah menjadi masalah kesehatan yang utama di seluruh dunia. Untuk menekan angkamortalitas dini, upaya resusitasi yang dilakukan pada keadaan sepsis berat dan renjatan septik harus ditujukan padapencapaian target parameter makrosirkulasi maupun mikrosirkulasi, khususnya yang telah terbukti berhubungan denganmortalitas dini. Parameter tersebut meliputi tekanan vena sentral, rerata tekanan arteri, produksi urin, saturasi oksigen venasentral, hematokrit, laktat, bersihan laktat, dan ekses basa standar. Kelebihan dan keterbatasan tiap parameter harusdipahami dengan baik dalam upaya interpretasi yang tepat terhadap hasil pemeriksaan parameter tersebut.

Proporsi Dan Faktor-Faktor Yang Berhubungan Dengan Kejadian Hipotensi Postprandial Pada Usia Lanjut, Rachmat Hamonangan, Idrus Alwi, Edy Rizal Wahyudi, Siti Setiati

Jurnal Penyakit Dalam Indonesia

Pendahuluan: Hipotensi postprandial sebenarnya sering terjadi dan saat ini dikenal sebagai masalah klinis yang penting. Studi-studi yang ada menunjukkan bahwa prevalensi hipotensi postprandial pada usia lanjut cukup tinggi. Hipotensi postprandial merupakan prediktor mortalitas pada orang usia lanjut dan menyebabkan banyak sekuele yang signifikan pada subyek yang terkena. Hingga saat ini, penelitian-penelitian yang berkaitan dengan hipotensi postprandial lebih banyak dilakukan pada kelompok usia lanjut di negara-negara maju yang definisi usia lanjut, proporsi penyakit, proporsi obat-obatan yang digunakan serta proporsi asupan yang berbeda dengan kelompok usia lanjut di negara berkembang khususnya Indonesia. Tujuan. Mengetahui proporsi dan faktor-faktor yang berhubungan dengan kejadian …

Perubahan Kendali Glikemik Dan Plasminogen Activator Inhibitor-1 (Pai-1) Pada Penyandang Diabetes Melitus Tipe-2 Yang Berpuasa Ramadhan Di Rsupn Cipto Mangunkusumo, Khomimah Khomimah, Sarwono Waspadji, Em Yunir, Murdani Abdullah

Jurnal Penyakit Dalam Indonesia

Pendahuluan: Penyandang diabetes melitus (DM) mempunyai risiko tinggi mengalami penyakit kardiovaskular (PKV), yang progresivitasnya dipercepat oleh penurunan kapasitas fibrinolisis. Penyandang DM yang berpuasa Ramadhan mengalami berbagai perubahan yang dapat memengaruhi kendali glikemik dan status fibrinolisisnya. Penelitian ini bertujuan mengetahui penurunan fruktosamin dan plasminogen activator inhibitor-1 (PAI-1).

Metode: Penelitian dikerjakan dengan metode kuasi eksperimental one group design self control study pada penyandang DM tipe-2 yang berpuasa Ramadhan dan berusia 40-60 tahun.

Hasil: Penelitian ini menunjukkan sebagian besar subjek memiliki 3 faktor risiko PKV dan dengan kendali glikemik yang jelek sebelum puasa Ramadhan. Terdapat penurunan yang bermakna pada glukosa …

Perubahan Kadar Fibrinogen Plasma Dan Korelasinya Dengan Perubahan Kadar Hs-Crp Dan Aktivitas Fibrinolisis Pada Sindroma Koroner Akut, Dedy G. Sudrajat, Djumhana Atmakusuma, Idrus Alwi, Kuntjoro Harimurti

Jurnal Penyakit Dalam Indonesia

Pendahuluan: Peningkatan kadar fibrinogen yang menetap merupakan faktor risiko yang kuat untuk kejadian penyakit jantung koroner (PJK). Di sisi lain peningkatan fibrinogen plasma dapat merupakan respon fase akut. Pada kondisi ini peningkatan fibrinogen plasma bukan merupakan faktor risiko PJK. Penelitian ini bertujuan untuk mengetahui apakah kadar fibrinogen plasma meningkat pada fase akut dan tetap tinggi pada fase pasca akut dan mengetahui korelasi antara perubahan kadar fibrinogen plasma dengan perubahan aktivitas inflamasi dan fibrinolisis.

Metode: Desain penelitian adalah studi prospektif dengan metode pengambilan sampel secara konsekutif. Pengambilan sampel fase akut untuk hs-CRP, aktivitas fibrinolisis, dan fibrinogen masing-masing diambil pada …

Review: Zinc’S Functional Significance In The Vertebrate Retina, Harris Ripps, Richard L. Chappell

Publications and Research

This review covers a broad range of topics related to the actions of zinc on the cells of the vertebrate retina. Much of this review relies on studies in which zinc was applied exogenously, and therefore the results, albeit highly suggestive, lack physiologic significance. This view stems from the fact that the concentrations of zinc used in these studies may not be encountered under the normal circumstances of life. This caveat is due to the lack of a zinc-specific probe with which to measure the concentrations of Zn2+ that may be released from neurons or act upon them. However, a …

Mir-143 Acts As A Tumor Suppressor By Targeting N-Ras And Enhances Temozolomide-Induced Apoptosis In Glioma., Lin Wang, Zhu-Mei Shi, Cheng-Fei Jiang, Xue Liu, Qiu-Dan Chen, Xu Qian, Dong-Mei Li, Xin Ge, Xie-Feng Wang, Ling-Zhi Liu, Yong-Ping You, Ning Liu, Bing-Hua Jiang

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Therapeutic applications of microRNAs (miRNAs) in RAS-driven glioma were valuable, but their specific roles and functions have yet to be fully elucidated. Here, we firstly report that miR-143 directly targets the neuroblastoma RAS viral oncogene homolog (N-RAS) and functions as a tumor-suppressor in glioma. Overexpression of miR-143 decreased the expression of N-RAS, inhibited PI3K/AKT, MAPK/ERK signaling, and attenuated the accumulation of p65 in nucleus of glioma cells. In human clinical specimens, miR-143 was downregulated where an adverse with N-RAS expression was observed. Furthermore, overexpression of miR-143 decreased glioma cell migration, invasion, tube formation and slowed tumor growth and angiogenesis in …

Production Of Recombinant Human Coagulation Factor Ix By Transgenic Pig, Weijie Xu

Department of Chemical and Biomolecular Engineering: Dissertations, Theses, and Student Research

Hemophilia B is the congenital bleeding disorder caused by deficiency in functional coagulation factor IX (FIX) and about 28,000 patients worldwide in 2012. And current treatment is restricted to protein-replacement therapy, which required FIX concentrates for patients’ life-time. Approximately 1 billion units FIX were consumed in 2012. However, still about 70-80% patients, mostly in developing countries, received inadequate or no treatment because of the unavailable and/or unaffordable FIX concentrates. Considering safety reasons, e.g. transmission of blood-borne diseases, the recombinant human FIX (rFIX) is recommended other than the plasma-derived FIX. However, only one rFIX is currently available on the market. The …

Nut Midline Carcinoma In A Pregnant Woman, Jill N. D'Souza, Md, David M. Cognetti, Md, Ryan N. Heffelfinger, Md, James J. Evans, Md, Madalina Tuluc, Md, Jurij R. Bilyk, Marc R. Rosen, Md

Department of Otolaryngology - Head and Neck Surgery Presentations and Grand Rounds

NUT midline carcinoma is a rare, highly aggressive tumor that involves midline structures, particularly in the head, neck and mediastinum. It is characterized by NUT gene translocations on chromosome 15. It typically impacts teenagers or young adults, and has a fulminant course leading to death in less than a year in most cases despite aggressive chemoradiotherapy. Due to its location, this tumor is frequently considered inoperable. We present a case of a sinonasal NUT midline carcinoma with orbital invasion discovered during the workup of sinusitis in a young, pregnant woman. The tumor was managed with definitive excision to negative margins …

Cervical Spine Osteomyelitis After Esophageal Dilation In Patients With A History Of Laryngectomy Or Pharyngectomy And Pharyngeal Irradiation, Richard A. Goldman, Md, Jill N. D'Souza, Md, Adam J. Luginbuhl, Md, Joshua E. Heller, Md, Joseph M. Curry, Md, David M. Cognetti, Md

Department of Otolaryngology - Head and Neck Surgery Presentations and Grand Rounds

Dysphagia is a common sequela of the treatment of head and neck cancer and is frequently managed with esophageal dilation in patients with dysphagia secondary to hypopharyngeal stenosis. Reported complications of esophageal dilation include bleeding, esophageal perforation, and mediastinitis. We examine four cases of cervical spine osteomyelitis presenting as a delayed complication of esophageal dilation for hypopharyngeal stenosis in patients with a history of laryngectomy or pharyngectomy and radiation with or without chemotherapy. The history of head and neck surgery and radiation in these patients further complicates the management of the cervical spine osteomyelitis.