Medical Specialties Commons^™

Neurovascular Unit Dysfunction And Blood-Brain Barrier Hyperpermeability Contribute To Schizophrenia Neurobiology: A Theoretical Integration Of Clinical And Experimental Evidence, S. Najjar, S. Pahlajani, V. De Sanctis, J. N.H. Stern, A. Najjar, D. Chong

Journal Articles

No abstract provided.

Microtubule-Targeting Agents Can Sensitize Cancer Cells To Ionizing Radiation By An Interphase-Based Mechanism, D. Markowitz, G. Ha, R. Ruggieri, M. Symons

Journal Articles

No abstract provided.

Repurposing Mebendazole As A Replacement For Vincristine For The Treatment Of Brain Tumors, M. De Witt, A. Gamble, D. Hanson, D. Markowitz, C. Powell, S. Al Dimassi, M. Atlas, J. Boockvar, R. Ruggieri, M. Symons

Journal Articles

No abstract provided.

Peritoneal Mesothelioma In A Young Woman: Case Report Of Radiopathologic Findings And Review Of The Literature, Amy L Ellenbogen, Stephanie Barak, Esma A. Akin

Radiology Faculty Publications

Peritoneal mesothelioma is a rare diagnosis most often seen in middle-aged men and exceedingly rarely in individuals in their teens and twenties. Diagnosis is often delayed secondary to nonspecific presenting symptoms and a misconception that there must be a history of asbestos exposure to garner such a diagnosis. Here, we present the case of a 21 year-old female with a histologically confirmed diagnosis of peritoneal mesothelioma and review the key radiologic and histologic findings of this rare diagnosis.

A Role For B Cells In Organic Dust Induced Lung Inflammation, Jill A. Poole, Ted R. Mikuls, Michael J. Duryee, Kristi J. Warren, Todd A. Wyatt, Amy J. Nelson, Debra J. Romberger, William W. West, Geoffrey M. Thiele

Journal Articles: Internal Medicine

BACKGROUND: Agriculture organic dust exposures induce lung disease with lymphoid aggregates comprised of both T and B cells. The precise role of B cells in mediating lung inflammation is unknown, yet might be relevant given the emerging role of B cells in obstructive pulmonary disease and associated autoimmunity.

METHODS: Using an established animal model, C57BL/6 wild-type (WT) and B-cell receptor (BCR) knock-out (KO) mice were repetitively treated with intranasal inhalation of swine confinement organic dust extract (ODE) daily for 3 weeks and lavage fluid, lung tissues, and serum were collected.

RESULTS: ODE-induced neutrophil influx in lavage fluid was not reduced …

Combined-Modality Hypofractionated Radiotherapy For Elderly Patients With Glioblastoma: Setting A New Standard., B. A. Vellayappan, L. M. Halasz, J. P. S. Knisely, E. L. Chang, S. S. Lo

Journal Articles

No abstract provided.

Abnormal Glycosylation In Joubert Syndrome Type 10., Megan S Kane, Mariska Davids, Michelle R Bond, Christopher J Adams, Megan E Grout, Ian G Phelps, Gilbert Vezina, +Several Additional Authors

Neurology Faculty Publications

BACKGROUND: The discovery of disease pathogenesis requires systematic agnostic screening of multiple homeostatic processes that may become deregulated. We illustrate this principle in the evaluation and diagnosis of a 5-year-old boy with Joubert syndrome type 10 (JBTS10). He carried the OFD1 mutation p.Gln886Lysfs*2 (NM_003611.2: c.2656del) and manifested features of Joubert syndrome.

METHODS: We integrated exome sequencing, MALDI-TOF mass spectrometry analyses of plasma and cultured dermal fibroblasts glycomes, and full clinical evaluation of the proband. Analyses of cilia formation and lectin staining were performed by immunofluorescence. Measurement of cellular nucleotide sugar levels was performed with high-performance anion-exchange chromatography with pulsed amperometric …

Hemiataxia: A Novel Presentation Of Anti-Nmda Receptor Antibody Mediated Encephalitis In An Adolescent., Greg D Phillips, Gillian N Jones, Maureen Callaghan, Marc P Difazio

Neurology Faculty Publications

Anti-NMDA receptor antibody associated encephalitis as a cause of new-onset neuropsychiatric manifestations in children and adults can represent a significant diagnostic challenge for clinicians. Clinical signs often include encephalopathy, new-onset psychosis, and movement phenomenon. Although orofacial dyskinesias were initially identified as a characteristic movement phenomenon in this type of encephalitis, an expanded range of abnormalities has recently been reported, including isolated ataxia. We report a case of isolated hemiataxia in a young adult with mild initial psychiatric manifestations. A personal and family history of preceding neuropsychiatric symptoms produced diagnostic confusion and resulted in a significant diagnostic and therapeutic delay. Our …

The Effect Of Hiv Infection And Hcv Viremia On Inflammatory Mediators And Hepatic Injury-The Women's Interagency Hiv Study., Sheila M Keating, Jennifer L Dodge, Philip J Norris, John Heitman, Stephen J Gange, Audrey L French, Marshall J Glesby, Brian R Edlin, Patricia S Latham, Maria C Villacres, Ruth M Greenblatt, Marion G Peters

Pathology Faculty Publications

Hepatitis C virus infection induces inflammation and while it is believed that HIV co-infection enhances this response, HIV control may reduce inflammation and liver fibrosis in resolved or viremic HCV infection. Measurement of systemic biomarkers in co-infection could help define the mechanism of inflammation on fibrosis and determine if HIV control reduces liver pathology. A nested case-control study was performed to explore the relationship of systemic biomarkers of inflammation with liver fibrosis in HCV viremic and/or seropositive women with and without HIV infection. Serum cytokines, chemokines, growth factors and cell adhesion molecules were measured in HIV uninfected (HIV-, n = …

Human Liver Sinusoid On A Chip For Hepatitis B Virus Replication Study, Young Bok (Abraham) Kang, Siddhartha Rawat, Nicholas Duchemin, Michael Bouchard, Moses Noh

Faculty Publications - Biomedical, Mechanical, and Civil Engineering

We have developed a miniature human liver (liver-sinusoid-on-a-chip) model using a dual microchannel separated by a porous membrane. Primary human hepatocytes and immortalized bovine aortic endothelial cells were co-cultured on opposite sides of a microporous membrane in a dual microchannel with continuous perfusion. Primary human hepatocytes in this system retained their polygonal morphology for up to 26 days, while hepatocytes cultured in the absence of bovine aortic endothelial cells lost their morphology within a week. In order to demonstrate the utility of our human-liver-sinusoid-on-a-chip, human hepatocytes in this system were directly infected by Hepatitis B Virus (HBV). Expression of the …

Cancer Care Annual Report 2016-2017, Children's Mercy Hospital

Cancer Center Annual Reports

Annual report of cancer care and oncology services at the Children's Mercy Hospital, Kansas City MO, a pediatric medical center. This report has a focus on sarcomas.

Surviving As A Cancer Survivor: A Case Report Of Radiation-Induced Autonomic Dysfunction, Daphne Sy, Mark Schauer

Research Day

While radiation and chemotherapy have achieved high rates of cure for Hodgkin lymphoma, the medical community is only now starting to characterize the long-term effects of treatment on these young cancer survivors, many decades later. Mantle radiation has been implicated in significantly increased cardiovascular risks, pulmonary fibrosis, other cancers, and thyroid disease over the patient’s lifetime. However, new syndromes are still being discovered within this population as they age. The purpose of this case study was to consider the unique health issues of cancer survivors, and how their treatment history should prompt us to broaden our differentials. Our patient presented …

Long-Term Outcome Of 487 Patients With Early-Stage Extra-Nodal Marginal Zone Lymphoma, S. Teckie, S. Qi, M. Chelius, S. Lovie, M. Hsu, A. Noy, C. Portlock, J. Yahalom

Journal Articles

No abstract provided.

Novel Wavelet-Based Segmentation Of Prostate Cbct Images With Implanted Calypso Transponders., Y. Liu, Z. Saleh, Y. Song, M. Chan, X. Li, C. Shi, X. Qian, X. Tang

Journal Articles

Segmentation of prostate Cone Beam CT (CBCT) images is an essential step towards real-time adaptive radiotherapy (ART). It is challenging for Calypso patients, as more artifacts generated by the beacon transponders are present on the images. We herein propose a novel wavelet-based segmentation algorithm for rectum, bladder, and prostate of CBCT images with implanted Calypso transponders. For a given CBCT, a Moving Window-Based Double Haar (MWDH) transformation is applied first to obtain the wavelet coefficients. Based on a user defined point in the object of interest, a cluster algorithm based adaptive thresholding is applied to the low frequency components of …

The More Igrt Systems, The Merrier?, B. Sun, J. Chang, Y. Rong

Journal Articles

No abstract provided.

A Preliminary Longitudinal Study Of White Matter Alteration In Cocaine Use Disorder Subjects, Liangsuo Ma, Joel L. Steinberg, Qin Wang, Joy M. Schmitz, Edward L. Boone, Ponnada A. Narayana, F. Gerard Moeller

Radiology Publications

Background

Previous diffusion tensor imaging (DTI) studies have consistently shown that subjects with cocaine use disorder (CocUD) had altered white matter microstructure in the corpus callosum. It is believed that these alterations are due to preexisting factors, chronic cocaine use, or both. However, there is no published longitudinal DTI study on human cocaine users yet which could shed light on the relationship between cocaine use and DTI findings.

Methods

This study used a longitudinal design and DTI to test if the white matter microstructure shows quicker alteration in CocUD subjects than controls. DTI data were acquired from eleven CocUD subjects …

A Randomized Prospective Long-Term (> 1 Year) Clinical Trial Comparing The Efficacy And Safety Of Radiofrequency Ablation To 980nm Laser Ablation Of The Great Saphenous Vein, Malcolm Sydnor, John Mavropoulos, Natalia Slobodnik, Luke Wolfe, Brian Strife, Daniel Komorowski

Radiology Publications

Purpose

To compare the short- and long-term (>1 year) efficacy and safety of radiofrequency ablation (ClosureFAST™) versus endovenous laser ablation (980 nm diode laser) for the treatment of superficial venous insufficiency of the great saphenous vein.

Materials and methods

Two hundred patients with superficial venous insufficiency of the great saphenous vein were randomized to receive either radiofrequency ablation or endovenous laser ablation (and simultaneous adjunctive therapies for surface varicosities when appropriate). Post-treatment sonographic and clinical assessment was conducted at one week, six weeks, and six months for closure, complications, and patient satisfaction. Clinical assessment of each patient was conducted …

Glypican-3 And Cd81 Promote Development Of Hepatocellular Carcinoma And Hepatoblastoma Through Negative Selection., Yuhua Xue, Wendy Mars, William Bowen, Aatur D. Singhi, Sarangarajan Ranganathan, George K. Michalopoulos

Hepatobiliary Cancers: Pathobiology and Translational Advances

No abstract provided.

Genomic Analysis Of Chimeric Human Cytomegalovirus Vaccine Candidates Derived From Strains Towne And Toledo, Nicolás M. Suárez, Betty Lau, George M. Kemble, Ronzo Lee, Edward S. Mocarski, Gavin W. G. Wilkinson, Stuart P. Adler, Michael A. Mcvoy, Andrew J. Davison

Pediatrics Publications

Human cytomegalovirus (HCMV) is an important opportunistic pathogen in immunocompromised patients and a major cause of congenital birth defects when acquired in utero. In the 1990s, four chimeric viruses were constructed by replacing genome segments of the high passage Towne strain with segments of the low passage Toledo strain, with the goal of obtaining live attenuated vaccine candidates that remained safe but were more immunogenic than the overly attenuated Towne vaccine. The chimeras were found to be safe when administered to HCMV-seronegative human volunteers, but to differ significantly in their ability to induce seroconversion. This suggests that chimera-specific genetic differences …

Nfatc3 And Vip In Idiopathic Pulmonary Fibrosis And Chronic Obstructive Pulmonary Disease, A. M. Szema, E. Forsyth, B. Ying, S. A. Hamidi, J. J. Chen, S. Hwang, J. C. Li, D. S. Dwyer, J. M. Ramiro-Diaz, L. V. Gonzalez Bosc, +1 Additional Author

Journal Articles

No abstract provided.

Neurosurgery Concepts: Key Perspectives On Imaging Characteristics Of Spinal Metastases, Surgery For Low Back Pain, Anesthesia For Disc Surgery, And Laminectomy Versus Laminectomy And Fusion For Lumbar Spondylolisthesis., Carlito Lagman, Lawrance K Chung, Luke Macyszyn, Winward Choy, Zachary A Smith, Nader S Dahdaleh, Angela M Bohnen, Jin M Cho, Chaim B Colen, Edward Duckworth, Anand V Germanwala, Peter Kan, Alexander A Khalessi, Chae-Yong Kim, Sandi Lam, Gordon Li, Michael Lim, Jonathan H Sherman, Vincent Y Wang, Gabriel Zada, Isaac Yang

Neurological Surgery Faculty Publications

No abstract provided.

Childhood Obesity: Physiological And Psychological Implications And Ethical Responsibilities, Connie S. Lewis

Journal of Health Ethics

Childhood obesity continues to be a health concern in the United States with physiological and psychological consequences. Research conducted in schools may address the physiological effects and exacerbate negative psychological effects, including weight bias and stigmatization. In the home, children are dependent on parents/caregivers to provide a healthy diet and exhibit a healthy lifestyle.The ethical theory, ethics of care, emphasizes dependence and interdependence on others, and ethical and moral responsibilities in the parent/child relationship. The assurance of ethical considerations involving children in research and parental provision for healthy dietary provision is of utmost importance. Any action or inaction that results …

Prophylactic Use Of Metformin To Decrease The Incidence Of Breast Cancer In High Risk, Predisposed Women, Aly Dahl

Physician Assistant Scholarly Project Posters

• Breast cancer is one of the most common types of cancer in American women and is the second leading cause of mortality.

• In 2015, 234,190 new diagnoses were made and 40,730 deaths from breast cancer.

• Along with a thorough history from the patient, there are also several risk assessment models that should be utilized, such as the common Gail-2 model.

• Any women with a significant family history should also be educated on genetic counseling and/or testing to detect a BRCA1 or 2 mutation.

• Numerous individuals who are positive for this gene elect to undergo prophylactic …

Type 2 Diabetes In Native Americans: The Influence Of Historical And Cultural Factors On Incidence, Prevalence, And Strategies For Patient Education, Disease Prevention, And Management, Tim Olsen

Physician Assistant Scholarly Project Posters

Type 2 diabetes (DM2) was virtually nonexistent among Native American, Alaska Native, and Canadian First Nations people prior to the 1950s. Due to historical, cultural, environmental, and psychosocial factors, Native people suffer disproportionately higher rates of DM2 than other populations. This literature review aims to examine the influence of these factors and investigate whether insight and knowledge into them, as well as culturally sensitive approaches to disease education, prevention, and self-management can be beneficial to providers working among Native communities. The results suggested that culturally sensitive approaches are indeed of value in promoting more effective care, and that lack of …

Human Cytomegalovirus Interleukin-10 Enhances Matrigel Invasion Of Mda-Mb-231 Breast Cancer Cells, Cendy Valle Oseguera, Juliet Spencer

Biology Faculty Publications

Background: While some risk factors for breast cancer are well-known, the influence of other factors, particularly virus infection, remains unclear. Human cytomegalovirus (HCMV) is widespread in the general population, and both molecular and epidemiological evidence has indicated links between HCMV and breast cancer. The HCMV protein cmvIL-10 is a potent suppressor of immune function that has also been shown to promote proliferation and migration of breast cancer cells. In this study, the impact of cmvIL-10 on tumor cell invasion through a simulated basement membrane was investigated.

Results: MDA-MB-231 breast cancer cells exhibited invasion through a matrigel layer that was significantly …

Proton Pump Inhibitors (Ppis): A Review Of The Efficacy, Usage, And Current Literature Recommendations, Travis M. Booke

Physician Assistant Scholarly Project Posters

• As Klepser, Collier, and Cochran (2013) noted, PPIs are a class of agents that reduce acid secretion by parietal cells in the stomach by irreversibly blocking H+/K+ adenosine triphosphate. They are commonly prescribed for many gastrointestinal (GI) conditions including gastric and duodenal ulcers, gastroesophageal reflux disease (GERD), upper gastrointestinal bleeding, and Helicobacter pylori infections. They are frequently utilized in the primary care setting. The purpose of this study was to examine the efficacy, usage, and current literature on PPIs.

• There were several complications noted with PPI usage. Gomm et al. (2016) found that that use of PPI is …

Analysis Of Metabolic Syndrome As A Modifiable Risk Factor For Prostate Cancer, Michael Butler

Physician Assistant Scholarly Project Posters

• Prostate cancer and metabolic syndrome are both prevalent among men in developed countries with peak incidence after age 50.

• Prostate cancer has no known modifiable risk factors.

• Most risk factors for metabolic syndrome are modifiable.

• If metabolic syndrome is identified as contributing to the risk of prostate cancer it would give an element of self determination to men at risk for prostate cancer.

• Past studies provide conflicting results in the correlation between these two conditions.

• A literature review was performed to evaluate consistencies in current literature.

• Metabolic syndrome or its components do not …

Metformin And Vitamin B12 Deficiency: Consequences And Patient Monitoring, Kathryn Dietz

Physician Assistant Scholarly Project Posters

• The incidence of type 2 diabetes has been increasing at a rapid rate in the United States.

• Metformin is recommended as the first line treatment to be started at the time of diagnosis in all patients without contraindications and has been associated with vitamin B12 deficiency.

• There are currently no clinical guidelines for the routine monitoring of B12 levels in this population.

• The purpose of this scholarly project is to determine if there are consequences of this deficiency and to make recommendations for screening patients.

• It includes current research that focuses on the pathophysiology of …

The Effect Of Statins In Primary Prevention On All-Cause Mortality, Brian Adams

Physician Assistant Scholarly Project Posters

During routine yearly physicals, primary care providers often evaluate serum laboratory lipid levels. Many of these patients have no past medical history of cardiovascular events related to atherosclerotic disease. Some patients do not have secondary risk factors, such as diabetes mellitus or smoking history.

Previous cardiovascular events provide stronger indications for the use of HMG-CoA reductase inhibitors (statins). In the absence of these, the provider may turn to current guidelines, in this case the 2013 the American College of Cardiology and the American Heart Association published the 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular …

The Postnatal Management Of Gestational Diabetes, Savannah Prodzinski

Physician Assistant Scholarly Project Posters

• Diabetes mellitus is growing substantially in our nation. Between its natural progression and effects on other body systems, this epidemic is costing us billions of dollars a year.

• Although gestational diabetes typically resolves after pregnancy, women who have had gestational diabetes in the past have a largely increased risk for the development of diabetes mellitus in the future.

• Several things contribute to the development of GDM and DM: decline in β-cell function, lower adiponectin levels and HgbA1C levels in the third trimester.

• Intervening during the critical time after delivery in women with gestational diabetes, will theoretically …