Medical Specialties Commons^™

Loss Of Sparc-Mediated Vegfr-1 Suppression After Injury Reveals A Novel Antiangiogenic Activity Of Vegf-A, Miho Nozaki, Eiji Sakurai, Brian J. Raisler, Judit Z. Baffi, Jassir Witta, Yuichiro Ogura, Rolf A. Brekken, E Helene Sage, Balamurali K. Ambati, Jayakrishna Ambati

Ophthalmology and Visual Science Faculty Publications

VEGF-A promotes angiogenesis in many tissues. Here we report that choroidal neovascularization (CNV) incited by injury was increased by excess VEGF-A before injury but was suppressed by VEGF-A after injury. This unorthodox antiangiogenic effect was mediated via VEGFR-1 activation and VEGFR-2 deactivation, the latter via Src homology domain 2-containing (SH2-containing) tyrosine phosphatase-1 (SHP-1). The VEGFR-1-specific ligand placental growth factor-1 (PlGF-1), but not VEGF-E, which selectively binds VEGFR-2, mimicked these responses. Excess VEGF-A increased CNV before injury because VEGFR-1 activation was silenced by secreted protein, acidic and rich in cysteine (SPARC). The transient decline of SPARC after injury revealed a temporal …

Exploring The Mission Of Primary Care, Martin S. Lipsky, Lisa Sharp

Community Health Faculty Publications and Presentations

Objective: This paper’s objective was to examine the mission statements of the sponsoring boards and professional organizations of the primary care specialties. Methods: Mission statements were obtained from the Web sites of the specialty boards and academies for each of the four primary care specialties of pediatrics, obstetrics-gynecology, general internal medicine, and family medicine. The mission statements were analyzed by two investigators, and the components of each mission statement were identified and categorized. Results: There were 29 distinct characteristics defined among all the mission statements. Three of the four primary care specialty organizations listed 10 components, while the American Academy …

Prophylaxis Of Dvt With Enoxaparin In Patients Undergoing Total Knee Replacement, Abid Ullah Khan Niazi, Masood Umer, Mohammad Umar

Section of Orthopaedic Surgery

Objective: To evaluate the efficacy and safety of the low molecular weight heparin as prophylaxis against thromboembolism following total knee replacement surgery.
Methods: Post-operative bilateral lower extremity colour duplex scan was performed on 55 patients subjected to total knew arthroplasty. The scan was performed 7 days after surgery for detection of DVT. All patients were given Enoxaparin 40mg subcutaneous daily for 2 weeks as prophylaxis against DVT.
Results: Two patients were diagnosed as DVT by color duplex scanning and both were distal but only one was asymptomatic. Another patient developed pulmonary embolism and died subsequently. The major and minor wound …

Long Scarf Injuries, Arshad A. Siddiqui, Muhammad Shahzad Shamim, Rashid Jooma, Ather Enam

Section of Neurosurgery

Long scarf (Dopatta) traditionally worn by females in South-East Asia have been described to make the females prone to sustain specific injuries when they ride pillion on the cycle powered rickshaw or motor bike. Two cases of females have been described.

Selective Serotonin Reuptake Inhibitors In Pediatric Depression: Is The Balance Between Benefits And Risks Favorable?, Christopher J. Kratochvil, Benedetto Vitiello, John Walkup, Graham Emslie, Bruce D. Waslick, Elizabeth B. Weller, William J. Burke, John S. March

Journal Articles: Psychiatry

Recent controversies surrounding the use of selective serotonin reuptake inhibitors (SSRIs) have highlighted the need to reassess potential benefits, as well as potential risks of this class of medications in the treatment of pediatric depression. The recent availability of data from meta-analyses of published and unpublished antidepressant trials, epidemiological studies, and the Treatment for Adolescents with Depression Study (TADS) has facilitated a reanalysis of this risk/benefit relationship. Despite reviewing similar data, various regulatory agencies have arrived at rather disparate conclusions regarding the data, resulting in continued controversy. Although all groups appear to agree that careful assessment, education regarding risks, and …

First Report Of Ophthalmomyaisis Externa In Pakistan, Azam Ali, Agha Hassan Feroze, Paul Ferrar, Asad Abbas, Mohammad Asim Beg

Section of Ophthalmology

Two individuals presented to the Aga Khan University Opthalmology service with foreign-body sensation, pain and redness in one of their eyes. Slit-lamp biomicroscopy revealed tiny larvae crawling around the conjunctival sac. They were mechanically removed under topical anaesthesia and preserved for light microscopy and photography. Comprehensive liaison was established with the Australian Centre for International Agriculture Research for identification of these larvae. Their morphology characterized them as members of fruit-fly, Oestridae family. At least one of them was positively identified as first instar larva of Oestrus ovis. This report describes the first instance of such infections in Southern Pakistan, as …

Description Of Twelve Cases Of Nephrogenic Fibrosing Dermopathy And Review Of The Literature, Fabian A. Mendoza, Carol M. Artlett, Nora Sandorfi, Kevin Latinis, Sonoles Piera-Velazquez, Sergio A. Jimenez

Selected Works of Sergio Jiménez, MD, MACR

ABSTRACT

Objectives: To review the clinical and laboratory features of twelve cases of nephrogenic fibrosing dermopathy (NFD) studied at our institution and of 70 previously described cases in the literature.

Methods: Clinical evaluation and laboratory studies of twelve patients with NFD associated with chronic hemodialysis or peritoneal dialysis for end-stage renal disease and a review of 23 previous publications describing 70 patients with this disease.

Results: Eleven patients undergoing chronic hemodialysis and one patient undergoing chronic peritoneal dialysis for end-stage renal failure developed a severe and progressive cutaneous fibrotic process with woody induration of legs, thighs, hands and forearms, and …

Keeping Their Options Open: Acute Versus Persistent Infections, S. Furukawa, S. L. Kuchma, G. A. O'Toole

Dartmouth Scholarship

No abstract provided.

Cataract Blindness And Visual Outcome Of Cataract Surgery In A Tribal Area In Pakistan, K M. Anjum, Bilal Mazhar Qureshi, M A. Khan, Azam Ali, Khabir Ahmad

Department of Surgery Docs

Abstract

Aim: To estimate the rates of cataract blindness and cataract surgical coverage and to assess the visual outcome of cataract surgery among individuals aged ⩾50 years in Orakzai Agency, Pakistan.

Methods: 1600 individuals aged ⩾50 years were selected using probability proportional to size sampling. The main outcome measure was bilateral cataract blindness which was defined as visual acuity of <3/60 in the better eye with best available correction and with obvious central lens opacities/absence of red reflex in both eyes.

Results: A total of 1549 people were examined; the coverage rate was 96.8%. Of individuals who were examined, 958 (61.8%) were men. The overall prevalence of bilateral cataract blindness was 4.8% (95% CI: 3.8% to 5.9%). Women had a 2.1-fold …

Uterine Perivascular Epithelioid Cell Tumour Presenting As A Cervical Mass, Najamul Sahar Azad, Shahid Pervez, Naila Kayani, Aliya Begum Aziz

Department of Pathology and Laboratory Medicine

Perivascular Epithelioid Cell Tumour (PEComa) also known as myelomelanocytic tumours are uncommon, recently described mesenchymal tumours that include angiomyolipoma, clear cell "sugar" tumour of the lung, lymphangioleiomyoma and tumours composed predominantly of epithelioid cell morphology. A predilection for uterus has been described. However up till now only 14 cases of uterine PEComas have been described. All of these were seen in adult females in the peri and post menopausal age group (from 40-75years), and almost all were located in the region of body of uterus. A single case in the upper cervical region has been reported with uterine PEComatoses. We …

Maternal And Fetal Complications Of Antiphospholipid Syndrome: A Case Report With Long-Term Follow-Up, Tahira Naru, Mohammad Khurshid, Zafar Nazir

Department of Obstetrics & Gynaecology

We report a case of a 26- year old woman having antiphospholipid syndrome in pregnancy with long-term follow up. She presented with recurrent miscarriages, venous thrombosis, avascular necrosis of femoral head, mid-cerebral artery infarction and skin ulcers. Antiphospholipid syndrome is a recognized disorder of pregnancy. Diagnosis requires a high index of suspicion when evaluating women with recurrent pregnancy losses and vascular thrombosis. A low dose aspirin combined with heparin can reduce morbidity and improves the pregnancy outcome.

Laparoscopic Surgery In Children--Anaesthetic Considerations, Aliya Ahmed

Department of Anaesthesia

Laparoscopic surgery has several advantages over conventional surgery for the patient. An increasing number of diagnostic and surgical procedures are being done laparoscopic not only in adults but also in paediatrics patients. In addition to the routine anaesthetic considerations for any surgical patient, the choice of the anaesthetic technique in patients undergoing laparoscopic procedures should consider the patient's underlying cardio respiratory functions induced by the pneumoperitoneum and carbon dioxide [CO2] insufflations. This article describes the physiological alterations induced by laparoscopic procedures in children and the anaesthetic implications of laparoscopic in the paediatric patient population.

American College Of Obstetricians And Gynecologists Practice Bulletins: An Overview, Suneet P. Chauhan, Vincenzo Berghella, Maureen Sanderson, Everett F. Magann, John C. Morrison

Department of Obstetrics and Gynecology Faculty Papers

Objective The purpose of this study was to review the American College of Obstetricians and Gynecologists practices bulletins to quantify the type of recommendations and references and determining whether there are any differences between obstetric and gynecologic bulletins. Study design All practice bulletins published from June 1998 to December 2004 were reviewed. Odds ratios and 95% confidence intervals were calculated. Results The 55 practice bulletins contained 438 recommendations of which 29% are level A, 33% level B, and 38% level C. The 55 bulletins cite 3953 references of which 17% are level I, 46% level II, 34% level III, and …

Treponema Denticola In Disseminating Endodontic Infections, F. Foschi, Jacques Izard, H. Sasaki, V. Sambri, C. Prati, R. Müller, P. Stashenko

Department of Food Science and Technology: Faculty Publications

Treponema denticola is a consensus periodontal pathogen that has recently been associated with endodontic pathology. In this study, the effect of mono-infection of the dental pulp with T. denticola and with polymicrobial “red-complex” organisms (RC) (Porphyromonas gingivalis, Tannerella forsythia, and T. denticola) in inducing disseminating infections in wild-type (WT) and severe-combined-immunodeficiency (SCID) mice was analyzed. After 21 days, a high incidence (5/10) of orofacial abscesses was observed in SCID mice mono-infected with T. denticola, whereas abscesses were rare in SCID mice infected with the red-complex organisms or in wild-type mice. Splenomegaly was …

Coronary Artery Bypass Surgery In Guillain Barre Syndrome, Omer Ashraf, Hasanat Sharif

Department of Surgery Docs

Guillain Barre Syndrome (GBS) is a rare autoimmune inflammatory polyneuropathy with established acute phase morbidity and mortality. Despite the positive outcome in majority of cases, there is hesitance in subjecting these patients to major surgical interventions under general anaesthesia. This case documents the successful undertaking of major coronary artery grafting under cardiopulmonary bypass and general anaesthesia, in a GBS patient. A review of the pathology is presented and the controversy addressed.

Do Cd1-Restricted T Cells Contribute To Antibody-Mediated Immunity Against Mycobacterium Tuberculosis?, Mark L. Lang, Aharona Glatman-Freedman

Dartmouth Scholarship

No abstract provided.

Translational Regulation Of Nuclear Gene Cox4 Expression By Mitochondrial Content Of Phosphatidylglycerol And Cardiolipin In Saccharomyces Cerevisiae, Xuefeng Su, William Dowhan

Faculty, Staff and Student Publications

Previous results indicated that translation of four mitochondrion-encoded genes and one nucleus-encoded gene (COX4) is repressed in mutants (pgs1Delta) of Saccharomyces cerevisiae lacking phosphatidylglycerol and cardiolipin. COX4 translation was studied here using a mitochondrially targeted green fluorescence protein (mtGFP) fused to the COX4 promoter and its 5' and 3' untranslated regions (UTRs). Lack of mtGFP expression independent of carbon source and strain background was established to be at the translational level. The translational defect was not due to deficiency of mitochondrial respiratory function but was rather caused directly by the lack of phosphatidylglycerol and cardiolipin in mitochondrial membranes. Reintroduction of …

Functional Analysis Of The Amine Substrate Specificity Domain Of Pepper Tyramine And Serotonin N-Hydroxycinnamoyltransferases, Sei Kang, Kiyoon Kang, Gap Chae Chung, Doil Choi, Atsushi Ishihara, Dong-Sun Lee, Kyoungwhan Back

Faculty, Staff and Student Publications

Pepper (Capsicum annuum) serotonin N-hydroxycinnamoyltransferase (SHT) catalyzes the synthesis of N-hydroxycinnamic acid amides of serotonin, including feruloylserotonin and p-coumaroylserotonin. To elucidate the domain or the key amino acid that determines the amine substrate specificity, we isolated a tyramine N-hydroxycinnamoyltransferase (THT) gene from pepper. Purified recombinant THT protein catalyzed the synthesis of N-hydroxycinnamic acid amides of tyramine, including feruloyltyramine and p-coumaroyltyramine, but did not accept serotonin as a substrate. Both the SHT and THT mRNAs were found to be expressed constitutively in all pepper organs. Pepper SHT and THT, which have primary sequences that are 78% identical, were used as models …

Comparison Of Two Methods (Precipitation Manual And Fully Automated Enzymatic) For The Analysis Of Hdl And Ldl Cholesterol, Jawaid Jabbar, Imran Siddiqui, Qaiser Raza

Department of Pathology and Laboratory Medicine

Objective:
To compare accuracy and throughput time for the measurement of HDL and LDL cholesterol by manual precipitation and fully automated enzymatic methods.
Methods:
Fifty, serum samples collected over a 4 months period (February - May 2004) were analyzed for HDL and LDL cholesterol by two different methods i.e. precipitation manual and automatic enzymatic method in the section of chemical pathology, Department of Pathology and Microbiology, Aga Khan University Hospital, Karachi Pakistan.
Results:
The mean standard deviation for HDL Cholesterol by precipitation method and automated method were 43.12 +/- 8.97mg/dl and 43.86 +/- 10.34mg/dl respectively (p-value = 0.301). The …

The Million Death Study In India: Cam It Help In Monitoring The Millennium Development Goals?, Zulfiqar A. Bhutta

Department of Paediatrics and Child Health

No abstract provided.

Indentation Fracture Of Bovine Cortical Bone: Acoustic Emission Technique, Ashkan Safari, Ger Reilly, Brendan Mccormack

Conference Papers

Indentation cutting may result in microcracking and main crack growth which was previously reported. In this study, we recorded the AE signals produced by cracking processes during cutting on cortical bone, measuring the cutting force and correlating between load-displacement curves and AE activities.

Cutting Rate Effect On Temperature During Cortical Bone Sawing, Hamid Khalili Parsa, Ger Reilly, Brendan Mccormack

Conference Papers

When bone is cut the occurrence of thermal damage to the bone is of major concern to the surgeon. If the temperature exceeds 44°C for longer than 1 min, bone repair is impaired (Eriksson et al, 1984) and necrosis may occur. Repeated use of cutting blades may reduce the cutting efficiency (Wevers et al, 1987; Toksvig-Larsen et al, 1992). Wevers et al also found that there is a greater force required to cut cortical bone using a blunt saw compared to new one.

Androgen Excess Disorders In Women: The Severe Insulin-Resistant Hyperandrogenic Syndrome, Hair-An, Kristin M. Rager, Hatim A. Omar

Pediatrics Faculty Publications

HAIR-AN syndrome (hyperandrogenism, insulin resistance, acanthosis nigricans) is a subset of the polycystic ovary syndrome, where the patients demonstrate severe insulin resistance. It is theorized that both genetic and environmental factors, such as obesity, give rise to the development of HAIR-AN. Diagnosis is primarily clinical, with laboratory values lending further support. Treatment is aimed at decreasing insulin resistance, regulating ovulation, and decreasing acne, acanthosis nigricans, and hirsutism.

Measuring Sustained Attention After Traumatic Brain Injury: Differences In Key Findings From The Sustained Attention To Response Task (Sart), John Whyte, Patricia Grieb-Neff, Christopher Gantz, Marcia Polansky

Department of Rehabilitation Medicine Faculty Papers

Clinical reports after traumatic brain injury (TBI) suggest frequent difficulties with sustained attention, but their objective measurement has proved difficult. In 1997, Robertson and colleagues reported on a new sustained attention assessment tool, the sustained attention to response task (SART). Individuals with TBI were reported to produce more errors of commission on the SART than control participants, and both groups showed a relationship between SART errors and everyday lapses of attention as measured by the cognitive failures questionnaire (CFQ). Although few direct replications of these findings have been reported, the SART has been used widely as a measure of sustained …

Na+/K+ -Atpase Regulates Tight Junction Formation And Function During Mouse Preimplantation Development., Michelle I Violette, Pavneesh Madan, Andrew J Watson

Obstetrics & Gynaecology Publications

Research applied to the early embryo is required to effectively treat human infertility and to understand the primary mechanisms controlling development to the blastocyst stage. The present study investigated whether the Na(+)/K(+)-ATPase regulates tight junction formation and function during blastocyst formation. To investigate this hypothesis, three experimental series were conducted. The first experiments defined the optimal dose and treatment time intervals for ouabain (a potent and specific inhibitor of the Na(+)/K(+)-ATPase) treatment. The results demonstrated that mouse embryos maintained a normal development to the blastocyst stage following a 6-h ouabain treatment. The second experiments investigated the effects of ouabain treatment …

Physiological Effects On Demography: A Long‐Term Experimental Study Of Testosterone’S Effects On Fitness, W. Reed, M. Clark, P. Parker, S. Raouf, N. Arguedas, D. Monk, E. Snajdr, V. Nolan, E. Ketterson

Biology Department Faculty Works

Understanding physiological and behavioral mechanisms underlying the diversity of observed life‐history strategies is challenging because of difficulties in obtaining long‐term measures of fitness and in relating fitness to these mechanisms. We evaluated effects of experimentally elevated testosterone on male fitness in a population of dark‐eyed juncos studied over nine breeding seasons using a demographic modeling approach. Elevated levels of testosterone decreased survival rates but increased success of producing extra‐pair offspring. Higher overall fitness for testosterone‐treated males was unexpected and led us to consider indirect effects of testosterone on offspring and females. Nest success was similar for testosterone‐treated and control males, …

Lactate Versus Non-Lactate Metabolic Acidosis: A Retrospective Outcome Evaluation Of Critically Ill Patients, Kyle J. Gunnerson, Melissa Saul, Shui He, John A. Kellum

Anesthesiology Publications

Introduction

Acid–base abnormalities are common in the intensive care unit (ICU). Differences in outcome exist between respiratory and metabolic acidosis in similar pH ranges. Some forms of metabolic acidosis (for example, lactate) seem to have worse outcomes than others (for example, chloride). The relative incidence of each type of disorder is unknown. We therefore designed this study to determine the nature and clinical significance of metabolic acidosis in critically ill patients.

Methods

An observational, cohort study of critically ill patients was performed in a tertiary care hospital. Critically ill patients were selected on the clinical suspicion of the presence of …

The Shepherd’S Center Of Richmond: Opportunities For Meaning And Personal Growth Through Service, Linda Frank

Case Studies from Age in Action

Educational Objectives

1. To inform Virginians about The Shepherd’s Center of Richmond, a non-profit service organization by, with, and for older adults.

2. To demonstrate the impact of volunteer service as a means to finding a sense of meaning and purpose in later life.

Parish Nursing: A Vital Piece To The Puzzle Of Care For Older Adults, Donna B. Coffman

Case Studies from Age in Action

Educational Objectives

1. To generate awareness of the emerging practice of faith community/parish nursing and its implications for the overall improvement of health care.

2. To explore specific ways parish nursing can help meet the holistic health needs of older adults in local congregations

Elderfriends: Relieving Loneliness Among Elders, Kiersten Seeger Ware, Sarah Coble

Case Studies from Age in Action

Educational Objectives

1. To discuss social isolation among older adults.

2. To promote awareness of the ElderFriends program, an intervention newly established in greater Richmond

3. To seek friendly visitors for the ElderFriends program.