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Richmond, VA, United States

Tang Y.,Virginia Commonwealth University | Suddarth B.,Virginia Commonwealth University | Du X.,Hunter Holmes ire Medical Center | Matsumoto J.A.,University of Virginia
Emergency Radiology | Year: 2014

Acute cerebellitis is a postinfectious or postvaccinal disorder that predominantly affects children. The typical magnetic resonance imaging appearance has been previously described as cerebellar hemispheric cortical edema. Here, we report a rare case of respiratory syncytial virus-related cerebellitis with transient diffusion restriction of cerebellar peduncles and dentate nucleus. Differential diagnoses are also discussed. © 2013 Am Soc Emergency Radiol.

Gorgey A.S.,Hunter Holmes ire Medical Center | Shepherd C.,Rehabilitation Hospital of Indiana
Journal of Spinal Cord Medicine | Year: 2010

Background: Skeletal muscle atrophy is a common adaptation after spinal cord injury (SCI) that results in numerous health-related complications. Neuromuscular electrical stimulation (NMES) has been recognized as an effective tool, which attenuates atrophy and evokes hypertrophy. Objective: To investigate the effects of NMES resistance training (RT) on individual muscle groups and adipose tissue of the right thigh after stimulation of the knee extensor muscle group in a man with chronic SCI. Participant: A 22-year-old man with a complete SCI sustained in a motorcycle accident 5 years prior to participation in this study. Methods: The participant underwent training twice a week for 12 weeks, including unilateral progressive RT of the right knee extensor muscle group using NMES and ankle weights. The stimulation was applied to knee extensors while the participant was sitting in his wheelchair. A series of T1-weighted magnetic resonance images were acquired for the whole right thigh prior to and after training. Skeletal muscle cross-sectional areas were measured of the whole thigh, knee extensors, hip adductors, hamstrings, and sartorius and gracilis muscle groups. Additionally, intramuscular fat and subcutaneous fat of the thigh were measured. Results: At the end of 12 weeks, the participant was able to lift 17 lbs during full knee extension. Average skeletal muscle cross-sectional areas increased in all of the measured muscle groups (12%-43%). Hypertrophy ranging from 30% to 112% was detected in multiaxial slices after the NMES RT protocol. Intramuscular fat decreased by more than 50% and subcutaneous fat increased by 24%. Conclusion: Unilateral NMES RT protocol evoked hypertrophy in the knee extensor and adjacent skeletal muscle groups and was associated with a reduction in intramuscular fat in a person with a chronic SCI. Additionally, subcutaneous adipose tissue cross-sectional areas increased in response to RT. © 2010 by the American Paraplegia Society.

Shankaran S.,Hunter Holmes ire Medical Center | Bearman G.M.L.,North Hospital
Current Infectious Disease Reports | Year: 2012

Oseltamivir and Zanamivir are the two main Neuraminidase inhibitors used for the treatment of Influenza. Oseltamivir resistance has been identified in nonpandemic influenza viruses, as well as H1N1 pandemic Influenza A viruses. Resistance is associated with increased morbidity, and poorer outcomes in severely immunocompromised hosts. Newer neuraminidase inhibitors, increased vaccination and combination therapy may be alternatives for the treatment of Influenza in this setting. © 2012 Springer Science+Business edia, LLC.

Sell S.A.,Virginia Commonwealth University | Sell S.A.,Hunter Holmes ire Medical Center | McClure M.J.,Virginia Commonwealth University | Ayres C.E.,Virginia Commonwealth University | And 2 more authors.
Journal of Biomaterials Science, Polymer Edition | Year: 2011

The process of electrospinning has proven to be highly beneficial for use in a number of tissue-engineering applications due to its ease of use, flexibility and tailorable properties. There have been many publications on the creation of aligned fibrous structures created through various forms of electrospinning, most involving the use of a metal target rotating at high speeds. This work focuses on the use of a variation known as airgap electrospinning, which does not use a metal collecting target but rather a pair of grounded electrodes equidistant from the charged polymer solution to create highly aligned 3D structures. This study involved a preliminary investigation and comparison of traditionally and airgap electrospun silk-fibroin-based ligament constructs. Structures were characterized with SEM and alignment FFT, and underwent porosity, permeability, and mechanical anisotropy evaluation. Preliminary cell culture with human dermal fibroblasts was performed to determine the degree of cellular orientation and penetration. Results showed airgap electrospun structures to be anisotropic with significantly increased porosity and cellular penetration compared to their traditionally electrospun counterparts. © Koninklijke Brill NV, Leiden, 2011.

Bose N.,Hunter Holmes ire Medical Center | Bena J.,Cleveland Clinic | Chatterjee S.,Cleveland Clinic
Arthritis Research and Therapy | Year: 2015

Introduction: In patients with systemic sclerosis (SSc), digital ischemia results from an occlusive microvasculopathy that may not respond adequately to conventional vasodilators. Endothelin receptor antagonists can potentially modify the fibroproliferative vascular remodeling in SSc, and hence their use may be justified in the management of digital ischemia. The objective of this clinical trial was to evaluate the effect of ambrisentan, a selective endothelin type A receptor antagonist, on microvascular blood flow in patients with limited systemic sclerosis (SSc) using laser Doppler perfusion imaging (LDPI). Methods: In this randomized, double-blind, placebo controlled study we enrolled 20 patients with limited SSc. Fifteen patients received ambrisentan 5 mg daily for one month and then 10 mg daily for two months, and five received a placebo. There were three visits: weeks 0 (baseline), one and 12. Three patient-oriented questionnaires were completed at each visit: Scleroderma-Health Assessment Questionnaire (S-HAQ), Raynaud Condition Score (RCS), and Pain-Visual Analog Scale (P-VAS). At each visit, LDPI was used to obtain three blood flow readings involving regions of interest in second to fifth fingers of the non-dominant hand at room temperature (25°C) and after cooling (10°C) for two minutes. Results: There were 16 females (80%); mean age was 50 years. None of the differences in blood flow (as measured by LDPI) were significant both at baseline and after cooling. However, patients in the ambrisentan group showed significant improvement in the patient-oriented outcomes: RCS (P = 0.001) and S-HAQ score (P = 0.005). Conclusions: This pilot study did not show evidence of significant increase in digital blood flow over time; however, there was an improvement in RCS and S-HAQ score. We conclude that continuous use of ambrisentan for three months does not seem to significantly improve digital blood flow in SSc patients. Trial registration: Clinicaltrials.gov NCT01072669. Registered 19 February 2010. © Bose et al.

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