Medical Specialties Commons^™

Brain Health: Mending The Mind After Age 50, Susan Hardwicke

Case Studies from Age in Action

Educational Objectives

1. Increase understanding of brain function and its potential to improve with age.

2. Describe an application of neuroscience, cognitive training, and nutrition for solving a problem associated with aging.

3. Evaluate neural plasticity with aging.

The Impact Of An Hematocrit Of 20% During Normothermic Cardiopulmonary Bypass For Elective Low Risk Coronary Artery Bypass Graft Surgery On Oxygen Delivery And Clinical Outcome – A Randomized Controlled Study [Isrctn35655335], Christian Von Heymann, Michael Sander, Achim Foer, Anja Heinemann, Bruce Spiess, Jan Braun, Michael Krämer, Joachim Grosse, Pascal Dohmen, Simon Dushe, Jürgen Halle, Wolfgang F. Konertz, Klaus-Dieter Warnecke, Claudia Spies

Anesthesiology Publications

Introduction

Cardiopulmonary bypass (CPB) induces hemodilutional anemia, which frequently requires the transfusion of blood products. The objective of this study was to evaluate oxygen delivery and consumption and clinical outcome in low risk patients who were allocated to an hematocrit (Hct) of 20% versus 25% during normothermic CPB for elective coronary artery bypass graft (CABG) surgery.

Methods

This study was a prospective, randomized and controlled trial. Patients were subjected to normothermic CPB (35 to 36°C) and were observed until discharge from the intensive care unit (ICU). Outcome measures were calculated whole body oxygen delivery, oxygen consumption and clinical outcome. A …

The Reckless Pursuit Of Dominion: A Situational Analysis Of The Nba And Diminishing Player Autonomy, Michael Mccann

Law Faculty Scholarship

This Article examines required genetic testing of NBA players from a situational vantage point, integrating socio-psychological, legal, and ethical analyses. The core argument may be expressed as follows: required genetic testing of NBA players appears consistent with a broader and largely deleterious agenda by the NBA to control players. Since implementation of the rookie wage scale in 1995 through the recent imposition of a paternalistic player dress code, the NBA has increasingly usurped player autonomy. The NBA's capacity to do so largely rests in its adroit manipulation of the situational influences that influence fans and media. For instance, because of …

2005 Cancer Care Annual Report, 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, with a focus on neuroblastoma.

Translation As A Function Of Modality: The Potential Of Brief Interventions, Chudley Werch, Jerry L. Grenard, Jeanpaul Burnett, Julia A. Watkins, Steve Ames, Edessa Jobli

CGU Faculty Publications and Research

The purpose of this article is to examine the potential of brief intervention (BI) as a modality for translating health behavior intervention research into practice. We discuss common definitions of BI, applications within common models of translation research, effects of BI on a range of health behaviors and across various populations, current and potential mechanisms, and uses for dissemination to practice. A number of advantages of BI suggest they are well suited for translating behavioral research. In addition, findings from 13 systematic reviews of BI effects show their potential versatility. Basic research on motivation, decision making, and persuasion may be …

Differences In Mnemonic Processing By Neurons In The Human Hippocampus And Parahippocampal Regions, Indre Viskontas, B. J. Knowlton, P. N. Steinmetz, I. Fried

Psychology

Different structures within the medial-temporal lobe likely make distinct contributions to declarative memory. In particular, several current psychological and computational models of memory predict that the hippocampus and parahippocampal regions play different roles in the formation and retrieval of declarative memories [e.g., Norman, K. A., & O'Reilly, R. C. Modeling hippocampal and neocortical contributions to recognition memory: A complementary-learning systems approach. Psychological Review, 110, 611-646, 2003]. Here, we examined the neuronal firing patterns in these two regions during recognition memory. Recording directly from neurons in humans, we find that cells in both regions respond to novel stimuli with an increase …

Gender Differences In Anterior Cruciate Ligament Injuries, Carey Ann Balderrama

Theses Digitization Project

The purpose of this study is to examine the existing literature on ACL (Anterior Cruciate Ligament) injuries as it pertains to gender. The study identifies current strategies for prevention of such injuries and outlines existing thinking on injury prevention programs.

Cyclooxygenase-2 Expression In Hamster And Human Pancreatic Neoplasia, Pamela L. Crowell, C. Max Schmidt, Michele T. Yip-Schneider, Jesse J. Savage, Dean A. Hertzler Ii, William O. Cummings

Scholarship and Professional Work – COPHS

Cyclooxygenase-2 (COX-2) has been implicated in the development of gastrointestinal malignancies. The aim of the present study was to determine COX-2 expression/activity throughout stages of experimental and human pancreatic neoplasia. COX-2 immunohistochemistry was performed in pancreata of hamsters subjected to the carcinogen N-nitrosobis-(2-oxopropyl)amine (BOP) and in human pancreatic tumors. COX-2 activity was determined by prostaglandin E₂ assay in tumor versus matched normal pancreatic tissues. The activity of the COX inhibitor sulindac was tested in the PC-1 hamster pancreatic cancer model. COX-2 expression was elevated in all pancreatic intraepithelial neoplasias (PanINs) and adenocarcinomas. In BOP-treated hamsters, there were significant …

The Role Of Radiation Therapy On Medically Inoperable Clinically Localized Non-Small Cell Lung Patients: London Regional Cancer Program (Lrcp) Clinical Experience, Michael Lee, Edward Yu, Robert Ash, Patricia Tai, Larry Stitt, George Rodrigues, Rashid Dar, Mark Vincent, Richard Inculet, Richard Malthaner

Oncology Presentations

Lung cancer is the most frequent cause of cancer death in both men and women in North America. In 2006, an estimated 22,700 Canadians will be diagnosed with lung cancer and 19,300 will die of it (Canadian Cancer Statistics 2006).

Approximately 15-20% of NSCLC patients present with early or localized disease.

Surgical resection of T1-2N0 NSCLC remains the treatment of choice for this population, and results in a 5-year survival rate of 50-70%.

Patients deemed medically inoperable have been treated with non-surgical therapies, such as radiation therapy(RT), while some patients have simply been observed without any tumor therapy because of …

Cyclosporin Versus Tacrolimus For Liver Transplanted Patients, Elizabeth Haddad, Vivian Mcalister, Elizabeth Renouf, Richard Malthaner, Mette S. Kjaer, Lise Lotte Gluud

Surgery Publications

A systematic review of randomized clinical trials (RCT) was undertaken to evaluate the beneficial and harmful effects of immunosuppression with cyclosporin versus tacrolimus for liver transplanted patients. MEDLINE, EMBASE, Cochrane Central and Hepato-Biliary Group Controlled Trials Registers were searched. Using fixed and random effects model, relative risk (RR), values <1 favoring>tacrolimus, with 95% confidence intervals (CI) were calculated. Of 717 potentially relevant references, 16 RCTs were eligible for inclusion. Mortality and graft loss at 1 year were significantly reduced in tacrolimus-treated recipients (Death: RR 0.85, 95% CI 0.73-0.99; graft loss: RR 0.73, 95% CI 0.61-0.86). Tacrolimus reduced the number of recipients …

Body Contouring After Massive Weight Loss, Edited By A. Aly, Vivian Mcalister

Data and Test Instruments

Nowhere is the failure of the health care system, as currently managed, more evident than in the surgical care of obesity. A marked contrast has emerged between surgery in the United States and Canada for these patients. It is not clear whether the reluctance to supply surgical services in Canada is due to a bias in favour of “more deserving” patients or whether the considerably higher rate of obesity surgery in the US is due to the excesses of private enterprise. Governments have acknowledged that an element of the former proposition is true by referring obese patients to centres in …

Relief Of Symptoms, Side Effects, And Psychological Distress Through Use Of Complementary And Alternative Medicine In Women With Breast Cancer, Cecile A. Lengacher, Mary P. Bennett, Kevin E. Kip, Lois Gonzalez, Paul Jacobsen, Charles E. Cox

Nursing Faculty Publications

No abstract provided.

Children's Mercy Hospital Annual Report 2005, Children's Mercy Hospital

Children's Mercy Annual Reports

Annual report for The Children's Mercy Hospital in Kansas City MO, a pediatric medical center.

A View From The Sun Parlor: A History Of Pediatrics In Portland, Maine, J Daniel Miller

Histories

Publication includes a written history, posters, photographs, and charts pertaining to the early years of pediatrics in Portland, Maine.

Cyclin D1 And P16 Expression In Recurrent Nasopharyngeal Carcinoma, Ho-Sheng Lin, Gerald J. Berry, Zijie Sun, Willard E. Fee Jr

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Cyclin D1 and p16 are involved in the regulation of G1 checkpoint and may play an important role in the tumorigenesis of nasopharyngeal carcinoma (NPC). Previous studies have examined the level of expression of cyclin D1 and p16 in primary untreated NPC but no such information is available for recurrent NPC. We set out in this study to examine the expression level of cyclin D1 and p16 in recurrent NPC that have failed previous treatment with radiation +/- chemotherapy.

Patients and methods

A total of 42 patients underwent salvage nasopharyngectomy from 1984 to 2001 for recurrent NPC after …

Effect Of Changes In Contractility On The Index Of Myocardial Performance In The Dysfunctional Left Ventricle, Steven J. Lavine

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

The index of myocardial performance has prognostic power in patients with cardiomyopathy and following myocardial infarction. As the index of myocardial performance has been shown to be preload and afterload dependent, the effect of altering contractility on IMP and its components with left ventricular dysfunction has been incompletely delineated.

Methods

Chronic left ventricular dysfunction was induced in 10 canines using coronary microsphere embolization. Each dog was instrumented and imaged with 2D echo and Doppler. At the same atrially paced rate, contractility was increased with a dobutamine infusion and then following 4 weeks of oral digoxin.

Results

With chronic …

Genistein Inhibits Radiation-Induced Activation Of Nf-Κb In Prostate Cancer Cells Promoting Apoptosis And G2/M Cell Cycle Arrest, Julian J. Raffoul, Yu Wang, Omer Kucuk, Jeffrey D. Forman, Fazlul H. Sarkar, Gilda G. Hillman

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

New cancer therapeutic strategies must be investigated that enhance prostate cancer treatment while minimizing associated toxicities. We have previously shown that genistein, the major isoflavone found in soy, enhanced prostate cancer radiotherapy in vitro and in vivo. In this study, we investigated the cellular and molecular interaction between genistein and radiation using PC-3 human prostate cancer cells.

Methods

Tumor cell survival and progression was determined by clonogenic analysis, flow cytometry, EMSA analysis of NF-κB, and western blot analysis of cyclin B1, p21^WAF1/Cip1, and cleaved PARP protein.

Results

Genistein combined with radiation caused greater inhibition in PC-3 …

Hydroxyurea And Sickle Cell Anemia: Effect On Quality Of Life, Samir K. Ballas, Franca B. Barton, Myron A. Waclawiw, Paul Swerdlow, James R. Eckman, Charles H. Pegelow, Mabel Koshy, Bruce A. Barton, Duane R. Bonds

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

The Multicenter Study of Hydroxyurea (HU) in Sickle Cell Anemia (MSH) previously showed that daily oral HU reduces painful sickle cell (SS) crises by 50% in patients with moderate to severe disease. The morbidity associated with this disease is known to have serious negative impact on the overall quality of life(QOL) of affected individuals.

Methods

The data in this report were collected from the 299 patients enrolled in the MSH. Health quality of llife (HQOL) measures were assessed in the MSH as a secondary endpoint to determine if the clinical benefit of HU could translate into a measurable …

Fast Drying Of Fine Needle Aspiration Slides Using A Hand Held Fan: Impact On Turn Around Time And Staining Quality, Mirza A. Baig, Lamia Fathallah, Jining Feng, Mujtaba Husain, David G. Grignon, Mousa A. Al-Abbadi

Wayne State University Associated BioMed Central Scholarship

Abstract

To analyze the impact of using a hand held fan to speed the air-drying process during immediate adequacy evaluation of Fine Needle Aspirations. The effect on turn around time and staining quality is evaluated.

Two mirror image air-dried smears for each pass were prepared. One was subjected to a small hand-held fan with a fan diameter of 7 cm held an average distance of 3 to 5 cm from the slide. The other smear was left to dry without a fan. A total of 93 consecutive pairs were evaluated over a 2-month duration.

The average time needed for air-drying …

Arterial Blood Pressure Monitoring In Overweight Critically Ill Patients: Invasive Or Noninvasive?, Ali Araghi, Joseph J. Bander, Jorge A. Guzman

Wayne State University Associated BioMed Central Scholarship

Abstract

Introduction

Blood pressure measurements frequently guide management in critical care. Direct readings, commonly from a major artery, are considered to be the gold standard. Because arterial cannulation is associated with risks, alternative noninvasive blood pressure (NIBP) measurements are routinely used. However, the accuracy of NIBP determinations in overweight patients in the outpatient setting is variable, and little is known about critically ill patients. This prospective, observational study was performed to compare direct intra-arterial blood pressure (IABP) with NIBP measurements obtained using auscultatory and oscillometric methods in overweight patients admitted to our medical intensive care unit.

Method

Adult critically ill …

Characterization Of Pancreatic Lesions From Mt-Tgfα, Ela-Myc And Mt-Tgfα/Ela-Myc Single And Double Transgenic Mice, Dezhong Liao, Yong Wang, Jiusheng Wu, Nazmi Adsay, David Grignon, Fayyaz Khanani, Fazlul H. Sarkar

Wayne State University Associated BioMed Central Scholarship

Abstract

In order to identify good animal models for investigating therapeutic and preventive strategies for pancreatic cancer, we analyzed pancreatic lesions from several transgenic models and made a series of novel findings. Female MT-tgfα mice of the MT100 line developed pancreatic proliferation, acinar-ductal metaplasia, multilocular cystic neoplasms, ductal adenocarcinomas and prominent fibrosis, while the lesions in males were less severe. MT-tgfα-ES transgenic lines of both sexes developed slowly progressing lesions that were similar to what was seen in MT100 males. In both MT100 and MT-tgfα-ES lines, TGFα transgene was expressed mainly in proliferating ductal cells. Ela-myc transgenic mice with a …

Incidence Of Post Myocardial Infarction Left Ventricular Thrombus Formation In The Era Of Primary Percutaneous Intervention And Glycoprotein Iib/Iiia Inhibitors. A Prospective Observational Study, Arshad Rehan, Manpreet Kanwar, Howard Rosman, Sujood Ahmed, Arshad Ali, Julius Gardin, Gerald Cohen

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Before the widespread use of primary percutaneous coronary intervention (PCI) and glycoprotein IIb/IIIa inhibitors (GP IIb/IIIa) left ventricular (LV) thrombus formation had been reported to complicate up to 20% of acute myocardial infarctions (AMI). The incidence of LV thrombus formation with these treatment modalities is not well known.

Methods

92 consecutive patients with ST-elevation AMI treated with PCI and GP IIb/IIIa inhibitors underwent 2-D echocardiograms, with and without echo contrast agent, within 24–72 hours.

Results

Only 4/92 (4.3%) had an LV thrombus, representing a significantly lower incidence than that reported in the pre-PCI era. Use of contrast agents …

Peroxisomal Proliferator Activated Receptor-Γ Deficiency In A Canadian Kindred With Familial Partial Lipodystrophy Type 3 (Fpld3), Gordon A. Francis, Gang Li, Robin Casey, Jian Wang, Henian Cao, Todd Leff, Robert A. Hegele

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Familial partial lipodystrophy (Dunnigan) type 3 (FPLD3, Mendelian Inheritance in Man [MIM] 604367) results from heterozygous mutations in PPARG encoding peroxisomal proliferator-activated receptor-γ. Both dominant-negative and haploinsufficiency mechanisms have been suggested for this condition.

Methods

We present a Canadian FPLD3 kindred with an affected mother who had loss of fat on arms and legs, but no increase in facial, neck, suprascapular or abdominal fat. She had profound insulin resistance, diabetes, severe hypertriglyceridemia and relapsing pancreatitis, while her pre-pubescent daughter had normal fat distribution but elevated plasma triglycerides and C-peptide and depressed high-density lipoprotein cholesterol.

Results

The mother and …

Increased Therapeutic Potential Of An Experimental Anti-Mitotic Inhibitor Sb715992 By Genistein In Pc-3 Human Prostate Cancer Cell Line, David A. Davis, Sarah H. Sarkar, Maha Hussain, Yiwei Li, Fazlul H. Sarkar

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Kinesin spindle proteins (KSP) are motor proteins that play an essential role in mitotic spindle formation. HsEg5, a KSP, is responsible for the formation of the bipolar spindle, which is critical for proper cell division during mitosis. The function of HsEg5 provides a novel target for the manipulation of the cell cycle and the induction of apoptosis. SB715992, an experimental KSP inhibitor, has been shown to perturb bipolar spindle formation, thus making it an excellent candidate for anti-cancer agent. Our major objective was a) to investigate the cell growth inhibitory effects of SB715992 on PC-3 human prostate cancer …

Production Of Il-16 Correlates With Cd4+ Th1 Inflammation And Phosphorylation Of Axonal Cytoskeleton In Multiple Sclerosis Lesions, Dusanka S. Skundric, Juan Cai, William W. Cruikshank, Djordje Gveric

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Multiple sclerosis (MS) is a central nervous system-specific autoimmune, demyelinating and neurodegenerative disease. Infiltration of lesions by autoaggressive, myelin-specific CD4+Th1 cells correlates with clinical manifestations of disease. The cytokine IL-16 is a CD4+ T cell-specific chemoattractant that is biased towards CD4+ Th1 cells. IL-16 precursor is constitutively expressed in lymphocytes and during CD4+ T cell activation; active caspase-3 cleaves and releases C-terminal bioactive IL-16. Previously, we used an animal model of MS to demonstrate an important role for IL-16 in regulation of autoimmune inflammation and subsequent axonal damage. This role of IL-16 in MS is largely unexplored. Here …

Gastric Stromal Tumors: Clinical Presentations, Diagnosis And Outcome, Dildar Hussain, Hasnain Zafar, Asad Jamil Raja

Section of General Surgery

Objective: To determine the clinical presentations, of gastric stromal tumors with diagnostic methods, pathology and outcome after surgery.
Study Design: A case series.
Duration and Setting: From January 1988 to December 2002 at The Aga Khan University Hospital, Karachi.
Patients and Methods: All patients of age 14 years and above, diagnosed histopathologically to have gastric stromal tumors were included. The data of these patients was collected retrospectively from January 1988 to December 1998, and prospectively from January 1999 to December 2002. All the patients were studied as a single group.
Results: There were 11 patients. Their mean age was …

Necrotizing Fasciitis Of The Breast, Saira Nizami, Kamran Mohiuddin, Mohisin-E-Azam, Hasnain Zafar, Muhammad Ashraf Memon

Section of General Surgery

Necrotizing fasciitis is a potentially fatal condition that can affect any part of the body. It can occur after trauma, around foreign bodies in surgical wounds, or can be idiopathic. We describe a case of necrotizing fasciitis involving the breast following an initial debridement of an inflammatory lesion.

Earthquake Relief Experience Of Aga Khan University Trauma Team, Masood Umer, Haroon Rashid, Hasnain Zafar, Kamran Majeed

Section of General Surgery

The volatile geo-political situation of the country after the events of September 11, compelled the department of Surgery at Aga Khan University (AKU) to initiate the formation of a comprehensive disaster plan and trauma team. Since its inception the trauma team has stood the test of time during multiple disaster situations in Karachi. This includes the bus bombing of the French engineers, Hyderi mosque bomb blast and various other bomb blasts inside the city of Karachi. All these disasters were successfully managed within the premises of AKU. This earthquake relief activity was the first of its kind when the AKU …

Investigation Of Cell Surface Phenotypes At Mucosal Sites In Response To Murine Cytomegalovirus Infection, Mary Esther Bruorton

MUSC Theses and Dissertations

The salivary gland is the predominant effector site of mucosal immune responses in the oral cavity. In mice, the salivary glands are known to receive immune lymphocytes stimulated in inductive sites such as the gut- and nasal-associated lymphoid tissues, thus, allowing the production of antigen-specific antibodies in saliva. However, the potential of the salivary gland as a mucosal inductive site has not been fully explored. In order to investigate this concept, we have developed a model resulting in a focused salivary gland infection using intraglandular delivery of tissue culture-derived murine cytomegalovirus (tcMCMV). Utilizing this route of infection, we were capable …

Inflammatory Myofibroblastic Tumor Of The Lung In An Adolescent Boy, S Sheikh, Saulat H. Fatimi, N Yaqoob

Section of Cardiothoracic Surgery

Inflammatory myofibroblastic tumors of the lung are rare, here, an unusual case is described. A 14-year-old boy presented with a history of weight loss and clubbing and was found to have a solitary circumscribed mass in right lower lobe treated with lobectomy. This case indicates the need for early and complete removal of the inflammatory myofibroblastic tumor of the lung.