Medical Specialties Commons^™

Vaccines Within Vaccines: The Use Of Adenovirus Types 4 And 7 As Influenza Vaccine Vectors, Eric A. Weaver

Nebraska Center for Virology: Faculty Publications

Adenovirus Types 4 and 7 (Ad4 and Ad7) are associated with acute respiratory distress (ARD). In order to prevent widespread Ad-associated ARD (Ad-ARD) the United States military immunizes new recruits using a safe and effective lyophilized wildtype Ad4 and Ad7 delivered orally in an enteric-coated capsule. We cloned Ad4 and Ad7 and modified them to express either a GFP-Luciferase (GFPLuc) fusion gene or a centralized influenza H1 hemagglutinin (HA1-con). BALB/c mice were injected with GFPLuc expressing viruses intramuscularly (i.m.) and intranasally (i.n.). Ad4 induced significantly higher luciferase expression levels as compared with Ad7 by both routes. Ad7 transduction was restored …

Temporal Lobe Epilepsy And Surgery Selectively Alter The Dorsal, Not The Ventral, Default-Mode Network., Gaelle Eve Doucet, Christopher T Skidmore, James J. Evans, Ashwini Sharan Md, Michael R Sperling, Dorian Pustina, Joseph I Tracy

Department of Neurology Faculty Papers

The default-mode network (DMN) is a major resting-state network. It can be divided in two distinct networks: one is composed of dorsal and anterior regions [referred to as the dorsal DMN (dDMN)], while the other involves the more posterior regions [referred to as the ventral DMN (vDMN)]. To date, no studies have investigated the potentially distinct impact of temporal lobe epilepsy (TLE) on these networks. In this context, we explored the effect of TLE and anterior temporal lobectomy (ATL) on the dDMN and vDMN. We utilized two resting-state fMRI sessions from left, right TLE patients (pre-/post-surgery) and normal controls (sessions …

The Hand In Art: Hand Of Hope, John S. Taras, Md

Department of Orthopaedic Surgery Faculty Papers

The “Hand of Hope” (Fig. 1) statue was commissioned for display in the street-level lobby of my practice, The Philadelphia Hand Center, by its founders, James M. Hunter, MD, and Lawrence H. Schneider, MD. The work became a hallmark of the practice’s former Walnut Street location as well as a recognizable feature of its neighborhood.

After a sojourn of several years residing next to Thomas Eakins’ portrait of the operative theatre in “The Gross Clinic,” at Thomas Jefferson University, the sculpture has returned to grace our office’s lobby in the historic Benjamin Franklin Hotel.

Stress Sonography Of The Ulnar Collateral Ligament Of The Elbow In Professional Baseball Pitchers: A 10-Year Study., Michael G Ciccotti, Alfred Atanda, Levon N. Nazarian, Christopher C Dodson, Laurens Holmes, Steven B. Cohen

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: An injury to the ulnar collateral ligament (UCL) of the elbow is potentially career threatening for elite baseball pitchers. Stress ultrasound (US) of the elbow allows for evaluation of both the UCL and the ulnohumeral joint space at rest and with stress.

HYPOTHESIS: Stress US can identify morphological and functional UCL changes and may predict the risk of a UCL injury in elite pitchers.

STUDY DESIGN: Cross-sectional study; Level of evidence, 3.

METHODS: A total of 368 asymptomatic professional baseball pitchers underwent preseason stress US of their dominant and nondominant elbows over a 10-year period (2002-2012). Stress US examinations …

Family Planning Versus Contraception: What's In A Name?, Maria I. Rodríguez, Lale Say, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

No abstract provided.

Nasal T Cell Lymphoma: A Rare Entity, Maliha Kazi, Mubasher Ikram, Montasir Junaid

Section of Otolaryngology, Head & Neck Surgery

Nasal type of Natural Killer (NK)/T cell lymphoma manifests in the nasal cavity. Approximately 95% of them are associated with EBV(Ebstein Barr Virus) with a strong predilection for the Asian population. It has certain systemic and localized symptoms which aid in diagnosis of the condition. However, the histological criteria is pivotal in confirming the diagnosis as well as aiding in confirming the association of EBV. Nasal type of NK/T cell lymphoma has a guarded prognosis. Treatment plan include radiotherapy with concurrent chemotherapy. Despite all this, the 5-year survival rate ranges from 15-75%. A 35 years old male presented with an …

Effect Of Fontan Fenestration On Regional Venous Oxygen Saturation During Exercise: Further Insights Into Fontan Fenestration Closure, Rohit S. Loomba, Michael E. Danduran, Jennifer E. Dixon, Rohit P. Rao

Exercise Science Faculty Research and Publications

Fontan fenestration closure is a topic of great debate. The body of data regarding the risks and benefits of fenestration closure is limited yet growing. Previous studies have demonstrated that Fontan patients have less exercise capacity than those with normal cardiovascular anatomy. Differences also have been noted within various subgroups of Fontan patients such as whether Fontan is fenestrated or not. This study aimed to compare trends in regional oxygen saturations using near-infrared spectroscopy (NIRS) in patients with Fontan circulations during ramping exercise to further delineate differences between patients with and without a fenestration. It was hypothesized that Fontan patients …

One-And-A-Half Syndrome : An Unusual Cause Of Dizziness, Daniel Haimowitz Md, Facp, Cmd, Catherine M. Glew Bm, Bs, Cmd, Yelena Schpigel Md

Department of Medicine

No abstract provided.

Are Cardiovascular Risk Factors Responsible For The U-Shaped Relationship Between Running And Longevity? The Masters Athletic Study, Adrian C. Bell Do, Courtney Bennett Do, Martin E. Matsumura Md

Department of Medicine

No abstract provided.

Readmission To Paediatric Intensive Care Unit: Frequency, Causes And Outcome, Muhammad Rehan Khan, Prem Kumar, Sumaira Iram, Anwarul Haque

Department of Paediatrics and Child Health

Readmission to intensive care units is considered to be an important quality indicator in ICU settings. This study was carried out at the paediatric intensive unit (PICU) and step down units of paediatric ward at the Aga Khan University Hospital, Karachi, Pakistan, to assess the frequency, common causes and outcome of patients readmitted in PICU within 48 hours after discharge from unit. During the study period, 1022 patients were admitted in PICU, out of which 24 (2.34%) patients required readmission. Male to female ratio was 1.2:1. The mean length of stay on paediatric floor before readmission was 24 hours. Fifteen …

Systematic Analysis Of A Xenograft Mice Model For Kshv+ Primary Effusion Lymphoma (Pel), Lu Dai, Jimena Trillo-Tinoco, Lihua Bai, Baoli Kang, Zengguang Xu, Xiaofei Wen, Luis Del Valle, Zhiqiang Qin

School of Medicine Faculty Publications

Kaposi's sarcoma-associated herpesvirus is the causative agent of primary effusion lymphoma (PEL), which arises preferentially in the setting of infection with human immunodeficiency virus (HIV). Even with standard cytotoxic chemotherapy, PEL continues to cause high mortality rates, requiring the development of novel therapeutic strategies. PEL xenograft models employing immunodeficient mice have been used to study the in vivo effects of a variety of therapeutic approaches. However, it remains unclear whether these xenograft models entirely reflect clinical presentations of KSHV(+) PEL, especially given the recent description of extracavitary solid tumor variants arising in patients. In addition, effusion and solid tumor cells …

Melanoma: Attacking On Many Fronts, Michael A. Thompson

Journal of Patient-Centered Research and Reviews

No abstract provided.

Targeted Therapy For Cutaneous Melanoma: Beyond Braf..., Michael A. Davies

Journal of Patient-Centered Research and Reviews

The development and regulatory approval of vemurafenib and dabrafenib for metastatic melanoma patients with activating BRAF mutations has demonstrated that personalized targeted therapy strategies can provide significant clinical benefit in this highly aggressive disease. However, these agents are not beneficial in patients who do not have activating BRAF mutations, representing over half of all melanoma patients. Recent studies have demonstrated that melanomas have the highest rate of somatic mutations among the major cancers. Based on this information, additional personalized treatment strategies are now in various stages of clinical development and testing. These efforts are being guided by the lessons learned …

Sentinel Lymph Node Biopsy In Head And Neck Melanoma: A Review, Martin Corsten, Stephanie Johnson-Obaseki

Journal of Patient-Centered Research and Reviews

The incidence of melanoma in the United States continues to rise. Head and neck melanomas comprise approximately 20% of all primary cutaneous melanomas. Sentinel lymph node (SLN) biopsy (SLNB) has become the standard of care for staging in melanoma. It has a number of advantages, including the addition of prognostic information, accurate staging, and the potential to add completion lymph node dissection (CLND) or adjuvant therapy when indicated. Furthermore, it may allow for the identification of patients who would benefit from inclusion in clinical trials; this advantage may be amplified based on the introduction of novel targeted therapies.

SLNB does …

Recurrent Acute Myocardial Infarction In Patients With Immune Thrombocytopenic Purpura, Fengyi Shen, Tonga Nfor, Tanvir Bajwa

Journal of Patient-Centered Research and Reviews

Immune thrombocytopenic purpura (ITP), also known as idiopathic thrombocytopenic purpura, is an acquired immune-mediated disease of adults and children characterized by a transient or persistent decrease of platelets and, depending upon the degree of thrombocytopenia, an increased risk of bleeding. The use of standard treatments for acute myocardial infarction (AMI), such as antiplatelet agents and anticoagulants, pose serious problems in patients with ITP due to the potential higher risk of bleeding complications. There are no current guidelines available for management of ITP patients with AMI. In this brief review of the limited available literature, we discuss the proposed pathophysiological link …

A Rendezvous With An Unexpected Diagnosis, Helen C. Williams, Alexandria Rogers

Journal of Patient-Centered Research and Reviews

A personal account of skin cancer explores a caregiver’s emotional encounter with malignant melanoma, following her podiatrist’s initial diagnosis when she presented for an ingrown toenail.

Headstrong Intervention For Pediatric Migraine Headache: A Randomized Clinical Trial., Michael A. Rapoff, Mark Connelly, Jennifer Bickel, Scott W. Powers, Andrew D. Hershey, Janelle R. Allen, Cynthia W. Karlson, Catrina C. Litzenburg, John M. Belmont

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The purpose of this study was to evaluate the efficacy of a self-guided CD-ROM program ("Headstrong") containing cognitive-behavioral self-management strategies versus an educational CD-ROM program for treating headaches, headache-related disability, and quality of life.

METHODS: Participants were 35 children ages 7-12 years with migraine recruited from one university medical center and two children's hospital headache clinics. Participants were randomly assigned to complete the Headstrong or educational control CD-ROM program over a 4-week period. Data on headache frequency, duration, and severity, migraine-related disability, and quality of life (QOL) were obtained at baseline, post-intervention, and 3-months post-intervention.

RESULTS: At post-intervention, Headstrong …

Adiponectin Inhibits Tumor Necrosis Factor-Α-Induced Vascular Inflammatory Response Via Caveolin-Mediated Ceramidase Recruitment And Activation., Yajing Wang, Xiaoliang Wang, Wayne Bond Lau, Yuexing Yuan, David Booth, Jing-Jing Li, Rosario Scalia, Kyle Preston, Erhe Gao, Walter Koch, Xin-Liang Ma

Department of Medicine Faculty Papers

RATIONALE: Anti-inflammatory and vascular protective actions of adiponectin are well recognized. However, many fundamental questions remain unanswered.

OBJECTIVE: The current study attempted to identify the adiponectin receptor subtype responsible for adiponectin's vascular protective action and investigate the role of ceramidase activation in adiponectin anti-inflammatory signaling.

METHODS AND RESULTS: Adiponectin significantly reduced tumor necrosis factor (TNF)α-induced intercellular adhesion molecule-1 expression and attenuated TNFα-induced oxidative/nitrative stress in human umbilical vein endothelial cells. These anti-inflammatory actions were virtually abolished by adiponectin receptor 1 (AdipoR1-), but not AdipoR2-, knockdown (KD). Treatment with adiponectin significantly increased neutral ceramidase (nCDase) activity (3.7-fold; P87% of adiponectin-induced nCDase …

Primary Care For Melanoma: Should We Be Screaming For Screening?, Dennis J. Baumgardner, Alexandria Rogers

Journal of Patient-Centered Research and Reviews

The incidence of cutaneous malignant melanoma continues to rise in the United States. This deadly disease is potentially curable if caught at an early stage, however screening programs remain controversial. The United States Preventive Services Task Force cites insufficient evidence to recommend screening, by total-body skin examination (TBSE), for early detection of cutaneous melanoma. While definitive studies may be cost-prohibitive in the United States, more recent evidence suggests that organized programs to increase TBSE reduce mortality from melanoma. The positive impact of TBSE, and education regarding risk reduction and skin self-examination, is most likely to be cost-effective in high-risk patients …

The Molecular Biology And Treatment Of Malignant Melanoma With Brafv600 Mutations, Michael P. Mullane

Journal of Patient-Centered Research and Reviews

Since 2011, the treatment options for metastatic malignant melanoma have significantly changed. In that year, ipilimumab, an anti-CTLA4 monoclonal antibody, and vemurafenib, a potent inhibitor of mutated-BRAF (V600E and V600K), were approved by the U.S. Food and Drug Administration (FDA). In 2013, dabrafenib, another inhibitor of mutated-BRAF, and trametinib, a MEK inhibitor, were approved by the FDA. Most recently, combination therapy with dabrafenib and trametinib was approved. This article will describe a patient with metastatic malignant melanoma with BRAF^V600E who has responded very well to vemurafenib monotherapy. We will then explore the molecular basis, pharmacologic development and clinical outcomes …

Utility Of Recommendation Letters And Correlation With Specific Residency Applicant Qualities, Joseph E. Patruno Md, Amanda B. Flicker Md, Craig Koller Med, Amy B. Smith Phd, Hubert K. Huang Ms, Med, Taylor N. Weilnau

Department of Obstetrics & Gynecology

No abstract provided.

Gender Differences In Perceptions And Self-Reported Driving Behaviors Among Teenagers. (Poster), Gavin C. Barr Jr. Md, Kathleen E. Kane Md, Robert D. Barraco Md, Timarie Rayburg Do, Lauren Dugan Do, Chadd K. Kraus Do, Mph, Marna R. Greenberg Do, Mph, Facep, Valerie Rupp Rn, Bsn, Kimberly Hamilton, Bryan G. Kane Md

Department of Emergency Medicine

No abstract provided.

A Statewide Survey Of Institutional Trauma Human Resource Allocation And Associated Patient Mortality, Bryan G. Kane Md, Quincy Gerrald Do, Catherine Fischer Do, Kevin Vong Do, Mary Sibley Do, Justin Binstead Do

Department of Emergency Medicine

No abstract provided.

Does Destination Determine Destiny? A Statewide Analysis Of Trauma Center Mortality, Bryan G. Kane Md, Quincy Gerrald Do, Catherine Fischer Do, Kevin Vong Do, Mary Sibley Do, Justin Binstead Do

Department of Emergency Medicine

No abstract provided.

Introduction Of Evidence-Based Diagnostic Order Sets In An Electronic Medical Record Is Associated With An Increase In Laboratory Orders, Bryan G. Kane Md, Justin Arnold Do, Joshua Morrison Do, Ryan Southworth Do, William Greenhut Do, Will Russell Do, Jeremy Selley Do, Michael Stanley Do

Department of Emergency Medicine

No abstract provided.

Genome-Wide Methylation Analyses In Glioblastoma Multiforme, Rose K. Lai, Yanwen Chen, Xiaowei Guan, Darryl Nousome, Charu Sharma, Peter Canoll, Jeffrey Bruce, Andrew E. Sloan, Etty Cortes, Jean-Paul Vonsattel, Tao Su, Lissette Delgado-Cruzata, Irina Gurvich, Regina M. Santella, Quinn Ostrom, Annette Lee, Peter Gregersen, Jill Barnholtz-Sloan

Publications and Research

Few studies had investigated genome-wide methylation in glioblastoma multiforme (GBM). Our goals were to study differential methylation across the genome in gene promoters using an array-based method, as well as repetitive elements using surrogate global methylation markers. The discovery sample set for this study consisted of 54 GBM from Columbia University and Case Western Reserve University, and 24 brain controls from the New York Brain Bank. We assembled a validation dataset using methylation data of 162 TCGA GBM and 140 brain controls from dbGAP. HumanMethylation27 Analysis Bead-Chips (Illumina) were used to interrogate 26,486 informative CpG sites in both the discovery …

A Randomized Trial Of Bevacizumab For Newly Diagnosed Glioblastoma., Mark R Gilbert, James J Dignam, Terri S Armstrong, Jeffrey S Wefel, Deborah T Blumenthal, Michael A Vogelbaum, Howard Colman, Arnab Chakravarti, Stephanie Pugh, Minhee Won, Robert Jeraj, Paul D Brown, Kurt A Jaeckle, David Schiff, Volker W Stieber, David G Brachman, Maria Werner-Wasik, Ivo W Tremont-Lukats, Erik P Sulman, Kenneth D Aldape, Walter J Curran, Minesh P Mehta

Department of Radiation Oncology Faculty Papers

BACKGROUND: Concurrent treatment with temozolomide and radiotherapy followed by maintenance temozolomide is the standard of care for patients with newly diagnosed glioblastoma. Bevacizumab, a humanized monoclonal antibody against vascular endothelial growth factor A, is currently approved for recurrent glioblastoma. Whether the addition of bevacizumab would improve survival among patients with newly diagnosed glioblastoma is not known.

METHODS: In this randomized, double-blind, placebo-controlled trial, we treated adults who had centrally confirmed glioblastoma with radiotherapy (60 Gy) and daily temozolomide. Treatment with bevacizumab or placebo began during week 4 of radiotherapy and was continued for up to 12 cycles of maintenance chemotherapy. …

Natural History Of Untreated Prostate Specific Antigen Radiorecurrent Prostate Cancer In Men With Favorable Prognostic Indicators, Andrew Renshaw

All Publications

No abstract provided.

Mouse Models For Pseudoxanthoma Elasticum: Genetic And Dietary Modulation Of The Ectopic Mineralization Phenotypes., Qiaoli Li, Haitao Guo, David W Chou, Annerose Berndt, John P Sundberg, Jouni Uitto

Department of Dermatology and Cutaneous Biology Faculty Papers

Pseudoxanthoma elasticum (PXE), a heritable ectopic mineralization disorder, is caused by mutations in the ABCC6 gene. Null mice (Abcc6(-/-) ) recapitulate the genetic, histopathologic and ultrastructural features of PXE, and they demonstrate early and progressive mineralization of vibrissae dermal sheath, which serves as a biomarker of the overall mineralization process. Recently, as part of a mouse aging study at The Jackson Laboratory, 31 inbred mouse strains were necropsied, and two of them, KK/HlJ and 129S1/SvImJ, were noted to have vibrissae dermal mineralization similar to Abcc6(-/-) mice. These two strains were shown to harbor a single nucleotide polymorphism (rs32756904) in the …

Proximal Biceps Tenodesis: An Anatomic Study And Comparison Of The Accuracy Of Arthroscopic And Open Techniques Using Interference Screws., Thomas J Kovack, John D Idoine, Paul B Jacob

Ambulatory and Primary Care Articles

PURPOSE: To (1) better define the anatomy of the proximal shoulder in relation to the long head of the biceps tendon, (2) compare the length-tension relationship of the biceps tendon in the native shoulder with that after arthroscopic and open tenodesis techniques using interference screws, and (3) provide surgical recommendations for both procedures based on study findings.

STUDY DESIGN: Descriptive laboratory study.

METHODS: Twenty fresh-frozen cadaveric shoulders were dissected for analysis. Initial anatomic measurements involving the proximal long head of the biceps tendon (BT) were made, which included: the labral origin to the superior bicipital groove (LO-SBG), the total tendon …