Indiana University School of Medicine - Terre Haute

terrehaute.medicine.iu.edu/
Terre Haute, IN, United States
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Bhimji S.,Stryker Orthopaedics | Meneghini R.M.,Indiana University School of Medicine - Terre Haute
Journal of Arthroplasty | Year: 2014

Initial implant stability is crucial to cementless knee arthroplasty fixation. The objective of this study was to evaluate the stability of two baseplates with different fixation features: a monoblock porous tantalum baseplate featuring two hexagonal pegs alone, and a modular design featuring a keel with four adjuvant cruciform pegs. A physiologically relevant test method previously described was used to evaluate compression and liftoff of the baseplates during stair descent. The porous tantalum baseplate with dual-hex peg fixation experienced greater rocking motions and liftoff compared to the baseplate with a keel and adjuvant pegs. Liftoff and displacement motion is likely deleterious and may inhibit biological fixation due to the physical separation of the baseplate from the bone. © 2014 Elsevier Inc.


Bhimji S.,Stryker Orthopaedics | Meneghini R.M.,Indiana University School of Medicine - Terre Haute
Journal of Arthroplasty | Year: 2012

Initial implant stability is crucial to cementless knee arthroplasty success. The objective of this study was to develop a physiological relevant methodology that incorporates torsion, shear, and compression forces to evaluate two tibial component designs that feature either a keel or cylindrical porous metal pegs. The data were compared with a simplified compression loading scenario. Results show a loading profile that combines compressive, shear, and torsional loads results in significantly larger motions than occur when loading in compression only. When comparing between a keeled and a pegged device, the new method shows significant differences in tibial component subsidence/liftoff at the anterior and posterior locations, which were lacking in the simplified test model. To accurately assess implant stability, studies should use physiological relevant loading. © 2012 Elsevier Inc.


Martin J.M.,Butler University | Warman D.M.,University of Indianapolis | Lysaker P.H.,Roudebush Medical Center | Lysaker P.H.,Indiana University School of Medicine - Terre Haute
Schizophrenia Research | Year: 2010

An increasing number of studies have used the Beck Cognitive Insight Scale (BCIS) to understand the reasoning of individuals with psychotic disorders. Less is known, however, about "normal" levels of insight and how non-psychiatric individuals compare to those with psychosis. The present study examined the structure of the BCIS in a non-psychiatric population and made comparisons between the scores of non-psychiatric individuals and those with psychosis. Participants were 418 students at American universities and 93 outpatients at a VA Medical Center with SCID-confirmed diagnoses of schizophrenia or schizoaffective disorder. Confirmatory factor analysis supports the 2-factor, 15-item structure previously reported for the BCIS, with one factor called self reflectiveness and the other called self certainty. Reliability analyses suggest strong internal consistency and test-retest results. Further, the BCIS subscales and composite index reliably distinguished between non-psychiatric and patient groups, though receiver operating characteristic (ROC) analysis did not suggest a particular cutoff score for predicting patient status. These results suggest that the BCIS is a valid measure to use in a non-psychiatric population, and that it reliably distinguishes between non-psychiatric individuals and those with psychotic disorders. © 2010 Elsevier B.V.


Amarsaikhan N.,Indiana University School of Medicine - Terre Haute | Templeton S.P.,Indiana University School of Medicine - Terre Haute
Frontiers in Microbiology | Year: 2015

The prevalence of fungal infections has increased concurrently with increases in immune suppressive therapies and susceptible individuals. Opportunistic fungal pathogens such as Aspergillus fumigatus may exhibit invasive growth and dissemination resulting in a high mortality rate. Herein, we discuss how immune sensing of germination directs innate immune responses and programs adaptive responses that could promote or impair immune protection during periods of heightened susceptibility. In infected individuals, Th1 responses are the most protective, while Th2 responses lead to poor disease outcomes. In particular, the roles of β-glucan and chitin co-recognition in shaping Th1- and Th2-type immunity to fungal infection are explored. We discuss how fungal responses to environmental stresses could result in decreased immune protection from infection, particularly in response to anti-fungal drugs that target β-glucan synthesis. Furthermore, we consider how experimental modulation of host-pathogen interactions might elucidate the mechanisms of protective and detrimental immunity and the potential of current and future studies to promote the development of improved treatments for patients that respond poorly to existing therapies. © 2015 Amarsaikhan and Templeton.


Kreuzer S.,140 Business Center Drive | Leffers K.,140 Business Center Drive | Leffers K.,Indiana University School of Medicine - Terre Haute | Kumar S.,140 Business Center Drive
Clinical Orthopaedics and Related Research | Year: 2011

Background: The direct anterior approach (DAA) for hip resurfacing arthroplasty is a technically difficult approach but theoretically reduces the soft tissue trauma to the hip because it does not require muscle detachments from the bone. Furthermore, the patient is in the supine position facilitating fluoroscopy to control component placement. However, the complications associated with the learning curve and functional outcome scores are not well defined in the literature. Questions/purposes: We therefore asked how our first 57 operations using the anterior approach and special table extension compared with that in the literature with regard to (1) complication rate; (2) functional outcome scores; (3) component placement; and (4) length of stay. Methods: We retrospectively reviewed 51 patients who underwent 57 hip resurfacing procedures using a DAA. There were 45 men and six women with an average age of 51 years (range, 31-63 years) and a body mass index of 28.7 kg/m2 (range, 19.7-42.0 kg/m2). The minimum followup was 0.3 months (mean, 8.7 months; range, 0.3-24.9 months). Results: There were three atraumatic (5%) and one posttraumatic (1.8%) femoral neck fractures. Average HOOS scores were equal to or better than averages reported for total hip arthroplasty. Average cup inclination was 36.5° (range, 25°-48°). The average length of stay was 2.11 days (range, 1-4 days). Conclusions: The surgical approach for anterior hip resurfacing is technically difficult but may have some clinical benefits. Surgeons interested in using the DAA for hip resurfacing should be very familiar with the DAA for total hip arthroplasty and with hip resurfacing. Level of Evidence: Level IV, retrospective study. See Guidelines for Authors for a complete description of levels of evidence. © 2010 The Association of Bone and Joint Surgeons®.


Tacha D.,Biocare Medical | Zhou D.,Biocare Medical | Cheng L.,Indiana University School of Medicine - Terre Haute
Applied Immunohistochemistry and Molecular Morphology | Year: 2011

PAX8 is a nephric-lineage transcription factor and is a crucial transcription factor for organogenesis of the thyroid gland, kidney, and Müllerian system. PAX8 is shown to be expressed in a high percentage of kidney and ovarian carcinomas. Limited information is known about the specificity of PAX8 in various neoplastic tumors. This comprehensive study examines the immuno-histochemical expression of PAX8 in multiple normal and neoplastic tissues including renal cell carcinoma and ovarian cancers. Renal cell carcinomas stained positive for PAX8 in 90% (110 of 122) of the cases and 100% of normal kidney stained PAX8 positive. In all cases of ovarian cancers 79% (181 of 229) expressed PAX8, and in thyroid cancer, PAX8 was expressed in 90% (9 of 10) cases. In endometrial cancers, 84% (113 of 134) of the cases were positive and in cervical cancer, 98% (1 of 60) squamous cell carcinomas cases were negative and 83% (5 of 6) cervical adenocarcinomas were positive. In bladder cancers, 93% of all the cases were negative including all bladder adenocarcinomas. PAX8 expression was observed in only one case of lung cancer (99% negative) and was 100% negative in cancers of the colon, breast, prostate, liver, testicular, stomach, esophagus, melanoma, gastrointestinal stromal tumors, leiomyosarcoma, and pheochromocytoma. The PAX8 specificity has been demonstrated in over 1100 cases of normal and neoplastic tissues. PAX8 is a specific and sensitive marker for renal cell and ovarian carcinomas and should be a valuable addition to the histopathology laboratory. © 2011 Lippincott Williams & Wilkins, Inc.


Kinney V.C.,Indiana State University | Heemeyer J.L.,Indiana State University | Pessier A.P.,San Diego Zoos Institute for Conservation Research | Lannoo M.J.,Indiana University School of Medicine - Terre Haute
PLoS ONE | Year: 2011

To fully comprehend chytridiomycosis, the amphibian disease caused by the chytrid fungus Batrachochytrium dendrobatidis (Bd), it is essential to understand how Bd affects amphibians throughout their remarkable range of life histories. Crawfish Frogs (Lithobates areolatus) are a typical North American pond-breeding species that forms explosive spring breeding aggregations in seasonal and semipermanent wetlands. But unlike most species, when not breeding Crawfish Frogs usually live singly-in nearly total isolation from conspecifics-and obligately in burrows dug by crayfish. Crayfish burrows penetrate the water table, and therefore offer Crawfish Frogs a second, permanent aquatic habitat when not breeding. Over the course of two years we sampled for the presence of Bd in Crawfish Frog adults. Sampling was conducted seasonally, as animals moved from post-winter emergence through breeding migrations, then back into upland burrow habitats. During our study, 53% of Crawfish Frog breeding adults tested positive for Bd in at least one sample; 27% entered breeding wetlands Bd positive; 46% exited wetlands Bd positive. Five emigrating Crawfish Frogs (12%) developed chytridiomycosis and died. In contrast, all 25 adult frogs sampled while occupying upland crayfish burrows during the summer tested Bd negative. One percent of postmetamorphic juveniles sampled were Bd positive. Zoospore equivalents/swab ranged from 0.8 to 24,436; five out of eight frogs with zoospore equivalents near or >10,000 are known to have died. In summary, Bd infection rates in Crawfish Frog populations ratchet up from near zero during the summer to over 25% following overwintering; rates then nearly double again during and just after breeding-when mortality occurs-before the infection wanes during the summer. Bd-negative postmetamorphic juveniles may not be exposed again to this pathogen until they take up residence in crayfish burrows, or until their first breeding, some years later. © 2011 Kinney et al.


King M.W.,Indiana University School of Medicine - Terre Haute | Neff A.W.,Indiana University | Mescher A.L.,Indiana University
Anatomical Record | Year: 2012

The roles of inflammation and immune cell reactivity triggered by amputation have only recently begun to be addressed in investigations of epimorphic regeneration, although studies of tissue repair in mammals clearly show the importance of the immune system in determining the quality of the repair process. Here, we first review inflammation-related work in non-mammalian systems of epimorphic regeneration which suggests that regeneration of an amputated appendage requires continuous modulation of the local immune response, from the first hours after amputation through the period of blastema patterning. We then present data on the effects of anti-inflammatory and proinflammatory agents on regeneration of larval Xenopus hindlimbs. Treatment with the glucocorticoid beclomethasone immediately after amputation inhibits regeneration in regeneration-complete stage 53 limbs. Other anti-inflammatory agents, including the inhibitors of cyclooxygenase-2 (COX-2) activity celecoxib and diclofenac, applied similarly to larvae amputated at stage 55, when the capacity for limb regeneration is normally being lost, restore regenerative capacity. This suggests that although injury-related events sensitive to glucocorticoids are necessary for regeneration, resolution of the inflammatory response may also be required to allow the complete regenerative response and normal blastema patterning. Conversely, if resolution of inflammation is prevented by local treatment of amputated limbs with beryllium, a strong immunoadjuvant, regeneration is inhibited, and gene expression data suggest that this inhibition results from a failure of normal blastema patterning. Both positive and negative effects of immune- or inflammation-related activities occur during anuran limb regeneration and this underscores the importance of considering immune cells in studies of epimorphic regeneration. © 2012 Wiley Periodicals, Inc.


Heemeyer J.L.,Indiana State University | Lannoo M.J.,Indiana University School of Medicine - Terre Haute
Copeia | Year: 2012

Movements are risky behaviors to animals, and amphibians are no exception, yet most species of amphibians exhibit cyclic annual movements. Crawfish Frogs (Lithobates areolatus) are a relatively understudied species of North American amphibian considered to be "Near Threatened" globally. To better understand the biology of this species, and in particular to assess the role that movements play in affecting survivorship, we radio tracked 48 Crawfish Frog adults in 20092010. Our study encompassed a total of 7,898 telemetered-frog days; individual frogs were tracked for up to 606 days. These data demonstrate two behaviors previously undocumented in this species: 1) migration distances that averaged nearly 0.5 km, and for one frog was approximately 1.2 km; and 2) philopatry to upland burrows excavated by crayfish. Together, these findings indicate that Crawfish Frogs have a remarkable ability to home to distant upland burrow sites. Burrow fidelity in Crawfish Frogs involves, in part, following similar migration routes to and from breeding wetlands. Burrow fidelity also occurs after ranging movements, and again often involves individual frogs following the same circuit across years. We demonstrate that movements are hazardous for Crawfish Frogs (about 12 times riskier than burrow dwelling), and therefore have survival consequences. Our data further suggest that adult Crawfish Frogs are not typically moving long distances from one upland burrow to another to populate new sites; instead two mechanismsadults varying breeding wetlands across years and juvenile dispersionare primarily responsible for the colonization of new habitats. © 2012 by the American Society of Ichthyologists and Herpetologists.


Mescher A.L.,Indiana University | Neff A.W.,Indiana University | King M.W.,Indiana University School of Medicine - Terre Haute
PLoS ONE | Year: 2013

Tissue and organ regeneration, unlike development, involves an injury that in postembryonic animals triggers inflammation followed by resolution. How inflammation affects epimorphic regeneration is largely uninvestigated. Here we examine inflammation and its resolution in Xenopus laevis hindlimb regeneration, which declines during larval development. During the first 5 days postamputation, both regeneration-competent stage 53 and regeneration-deficient stage 57 hindlimbs showed very rapid accumulation of leukocytes and cells expressing interleukin-1β and matrix metalloproteinase 9. Expression of genes for factors mediating inflammatory resolution appeared more persistent at stages 55 and 57 than at stage 53, suggesting changes in this process during development. FoxP3, a marker for regulatory T cells, was upregulated by amputation in limbs at all three stages but only persisted at stage 57, when it was also detected before amputation. Expression of genes for cellular reprogramming, such as SALL4, was upregulated in limbs at all 3 stages, but markers of limb patterning, such as Shh, were expressed later and less actively after amputation in regeneration-deficient limbs. Topical application of specific proinflammatory agents to freshly amputated limbs increased interleukin-1β expression locally. With aqueous solutions of the proinflammatory metal beryllium sulfate, this effect persisted through 7 days postamputation and was accompanied by inhibition of regeneration. In BeSO 4-treated limbs expression of markers for both inflammation and resolution, including FoxP3, was prolonged, while genes for cellular reprogramming were relatively unaffected and those for limb patterning failed to be expressed normally. These data imply that in Xenopus hindlimbs postamputation inflammation and its resolution change during development, with little effect on cellular dedifferentiation or reprogramming, but potentially interfering with the expression of genes required for blastema patterning. The results suggest that developmental changes in the larval anuran immune system may be involved in the ontogenetic loss of epimorphic regeneration in this system. © 2013 Mescher et al.

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