Northeastern Ohio Universities Colleges of Medicine

Youngstown, OH, United States

Northeastern Ohio Universities Colleges of Medicine

Youngstown, OH, United States
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von Gruenigen V.E.,University Hospitals Case Medical Center | Huang H.Q.,Roswell Park Cancer Institute | Gil K.M.,Akron General Medical Center | Gil K.M.,Northeastern Ohio Universities Colleges of Medicine | And 7 more authors.
Journal of Pain and Symptom Management | Year: 2010

Context: Women diagnosed with ovarian cancer are at risk for reduced quality of life (QOL). It is imperative to further define these declines to interpret treatment outcomes and design appropriate clinical interventions. Objectives: The primary objective of this study was to compare data obtained from ovarian cancer patients with normative data to assess the degree to which QOL differs from the norm. Secondary objectives were to examine demographic variables and determine if there was a correlation between physical/functional and social/emotional scores during chemotherapy. Methods: Patients with Stage III/IV ovarian cancer on Gynecologic Oncology Group Protocols 152 and 172 who underwent surgery followed by intravenous paclitaxel and cisplatin completed the Functional Assessment of Cancer Therapy-Ovarian. The Functional Assessment of Cancer Therapy scale includes the four domains of physical, functional, social, and emotional well-being (PWB, FWB, SWB, and EWB, respectively). Results: Ovarian cancer patients had a total QOL (Functional Assessment of Cancer Therapy-General) score similar to the U.S. female adult population. However, the reported subscale scores were 2.0 points (95% confidence interval [CI] 1.4-2.5, P < 0.001, effect size = 0.37) lower in PWB, 0.9 points (95% CI 0.3-1.5, P = 0.005, effect size = 0.13) lower in FWB, 5.0 points (95% CI 4.6-5.3, P < 0.001, effect size = 0.74) higher in SWB, and 0.8 points (95% CI 0.3-1.2, P < 0.001, effect size = 0.16) lower in EWB. Correlation between the sum of PWB and FWB and the sum of SWB and EWB was r = 0.53 (P < 0.001). Age was positively correlated with EWB (r = 0.193; 95% CI 0.09-0.29). Conclusion: Ovarian cancer patients have decreased QOL in physical, functional, and emotional domains; however, they may compensate with increased social support. At the time of diagnosis and treatment, patients' QOL is affected by inherent characteristics. Assessment of treatment outcomes should take into account the effect of these independent variables. © 2010 U.S. Cancer Pain Relief Committee.


Ferrari J.P.,Northeastern Ohio Universities Colleges of Medicine | Hemphill A.F.,Summa Health System | Xu J.,Hahnemann University | Dejesus R.A.,Johns Hopkins
Annals of Plastic Surgery | Year: 2013

Vaginal reconstructive options commonly include the use of split-thickness skin grafts or intestinal conduits. When a colonic segment is chosen, the sigmoid colon is favored because of its location, size, and durability. When circumstances preclude the use of sigmoid colon and a colonic conduit is preferred, creative means of mobilization are required. This article describes a case and technique utilizing the descending colon in a tension-free vaginoplasty. Copyright © 2012 by Lippincott Williams & Wilkins.


Williams S.H.,Ohio University | Vinyard C.J.,Northeastern Ohio Universities Colleges of Medicine | Wall C.E.,Duke University | Doherty A.H.,Northeastern Ohio Universities Colleges of Medicine | And 2 more authors.
Integrative and Comparative Biology | Year: 2011

Descriptive and quantitative analyses of electromyograms (EMG) from the jaw adductors during feeding in mammals have demonstrated both similarities and differences among species in chewing motor patterns. These observations have led to a number of hypotheses of the evolution of motor patterns, the most comprehensive of which was proposed by Weijs in 1994. Since then, new data have been collected and additional hypotheses for the evolution of motor patterns have been proposed. Here, we take advantage of these new data and a well-resolved species-level phylogeny for mammals to test for the correlated evolution of specific components of mammalian chewing motor patterns. We focus on the evolution of the coordination of working-side (WS) and balancing-side (BS) jaw adductors (i.e., Weijs' Triplets I and II), the evolution of WS and BS muscle recruitment levels, and the evolution of asynchrony between pairs of muscles. We converted existing chewing EMG data into binary traits to incorporate as much data as possible and facilitate robust phylogenetic analyses. We then tested hypotheses of correlated evolution of these traits across our phylogeny using a maximum likelihood method and the Bayesian Markov Chain Monte Carlo method. Both sets of analyses yielded similar results highlighting the evolutionary changes that have occurred across mammals in chewing motor patterns. We find support for the correlated evolution of (1) Triplets I and II, (2) BS deep masseter asynchrony and Triplets I and II, (3) a relative delay in the activity of the BS deep masseter and a decrease in the ratio of WS to BS muscle recruitment levels, and (4) a relative delay in the activity of the BS deep masseter and a delay in the activity of the BS posterior temporalis. In contrast, changes in relative WS and BS activity levels across mammals are not correlated with Triplets I and II. Results from this work can be integrated with dietary and morphological data to better understand how feeding and the masticatory apparatus have evolved across mammals in the context of new masticatory demands. © 2011 The Author.


Vinyard C.J.,Northeastern Ohio Universities Colleges of Medicine | Williams S.H.,Ohio University | Wall C.E.,Duke University | Doherty A.H.,Northeastern Ohio Universities Colleges of Medicine | And 2 more authors.
Integrative and Comparative Biology | Year: 2011

The establishment of a publicly-accessible repository of physiological data on feeding in mammals, the Feeding Experiments End-user Database (FEED), along with improvements in reconstruction of mammalian phylogeny, significantly improves our ability to address long-standing questions about the evolution of mammalian feeding. In this study, we use comparative phylogenetic methods to examine correlations between jaw robusticity and both the relative recruitment and the relative time of peak activity for the superficial masseter, deep masseter, and temporalis muscles across 19 mammalian species from six orders. We find little evidence for a relationship between jaw robusticity and electromyographic (EMG) activity for either the superficial masseter or temporalis muscles across mammals. We hypothesize that future analyses may identify significant associations between these physiological and morphological variables within subgroups of mammals that share similar diets, feeding behaviors, and/or phylogenetic histories. Alternatively, the relative peak recruitment and timing of the balancing-side (i.e., non-chewing-side) deep masseter muscle (BDM) is significantly negatively correlated with the relative area of the mandibular symphysis across our mammalian sample. This relationship exists despite BDM activity being associated with different loading regimes in the symphyses of primates compared to ungulates, suggesting a basic association between magnitude of symphyseal loads and symphyseal area among these mammals. Because our sample primarily represents mammals that use significant transverse movements during chewing, future research should address whether the correlations between BDM activity and symphyseal morphology characterize all mammals or should be restricted to this "transverse chewing" group. Finally, the significant correlations observed in this study suggest that physiological parameters are an integrated and evolving component of feeding across mammals. © 2011 The Author.


Borbouse L.,Indiana University | Dick G.M.,West Virginia University | Payne G.A.,Indiana University | Berwick Z.C.,Indiana University | And 5 more authors.
American Journal of Physiology - Heart and Circulatory Physiology | Year: 2010

This investigation tested the hypothesis that metabolic syndrome decreases the relative contribution of specific K+ channels to coronary reactive hyperemia. Ca2+-activated (BKCa), voltage-activated (KV), and ATP-dependent (KATP) K + channels were investigated. Studies were conducted in anesthetized miniature Ossabaw swine fed a normal maintenance diet (11% kcal from fat) or an excess calorie atherogenic diet (43% kcal from fat, 2% cholesterol, 20% kcal from fructose) for 20 wk. The latter diet induces metabolic syndrome, increasing body weight, fasting glucose, total cholesterol, and triglyceride levels. Ischemic vasodilation was determined by the coronary flow response to a 15-s occlusion before and after cumulative administration of antagonists for BK Ca (penitrem A; 10 μg/kg iv), KV (4-aminopyridine; 0.3 mg/kg iv) and KATP (glibenclamide; 1 mg/kg iv) channels. Coronary reactive hyperemia was diminished by metabolic syndrome as the repayment of flow debt was reduced ∼30% compared with lean swine. Inhibition of BK Ca channels had no effect on reactive hyperemia in either lean or metabolic syndrome swine. Subsequent inhibition of KV channels significantly reduced the repayment of flow debt (∼25%) in both lean and metabolic syndrome swine. Additional blockade of KATP channels further diminished (∼45%) the repayment of flow debt in lean but not metabolic syndrome swine. These data indicate that the metabolic syndrome impairs coronary vasodilation in response to cardiac ischemia via reductions in the contribution of K+ channels to reactive hyperemia. Copyright © 2010 the American Physiological Society.


Borbouse L.,Indiana University | Dick G.M.,West Virginia University | Payne G.A.,Indiana University | Payne B.D.,Indiana University | And 6 more authors.
American Journal of Physiology - Heart and Circulatory Physiology | Year: 2010

This investigation was designed to examine the hypothesis that impaired function of coronary microvascular large-conductance Ca2+-activated K+ (BKCa) channels in metabolic syndrome (MetS) significantly attenuates the balance between myocardial oxygen delivery and metabolism at rest and during exercise-induced increases in myocardial oxygen consumption (MV̇O2). Studies were conducted in conscious, chronically instrumented Ossabaw swine fed a normal maintenance diet (11% kcal from fat) or an excess calorie atherogenic diet (43% kcal from fat, 2% cholesterol, 20% kcal from fructose) that induces many common features of MetS. Data were collected under baseline/resting conditions and during graded treadmill exercise before and after selective blockade of BKCa channels with penitrem A (10 μg/kg iv). We found that the exercise-induced increases in blood pressure were significantly elevated in MetS swine. No differences in baseline cardiac function or heart rate were noted. Induction of MetS produced a parallel downward shift in the relationship between coronary venous PO2 and MV̇O2 (P < 0.001) that was accompanied by a marked release of lactate (negative lactate uptake) as MV̇O2 was increased with exercise (P < 0.005). Inhibition of BKCa channels with penitrem A did not significantly affect blood pressure, heart rate, or the relationship between coronary venous PO2 and MV̇O2 in lean or MetS swine. These data indicate that BKCa channels are not required for local metabolic control of coronary blood flow under physiological (lean) or pathophysiological (MetS) conditions. Therefore, diminished function of BKCa channels does not contribute to the impairment of myocardial oxygen-supply demand balance in MetS. Copyright © 2010 American Physiological Society.


Druzinsky R.E.,University of Illinois at Chicago | Doherty A.H.,Northeastern Ohio Universities Colleges of Medicine | De Vree F.L.,University of Antwerp
Integrative and Comparative Biology | Year: 2011

There is a deep and rich literature of comparative studies of jaw muscles in mammals but no recent analyses employ modern phylogenetic techniques to better understand evolutionary changes that have occurred in these muscles. In order to fully develop and utilize the Feeding Experiments End-user Database (FEED), we are constructing a comprehensive ontology of mammalian jaw muscles. This process has led to a careful consideration of nomenclature and homologies of the muscles and their constituent parts. Precise determinations of muscle attachments have shown that muscles with similar names are not necessarily homologous. Using new anatomical descriptions derived from the literature, we defined character states for the jaw muscles in diverse mammalian species. We then mapped those characters onto a recent phylogeny of mammals with the aid of the Mesquite software package. Our data further elucidate how muscle groups associated with the feeding apparatus differ and have become highly specialized in certain mammalian orders, such as Rodentia, while remaining conserved in other orders. We believe that careful naming of muscles and statistical analyses of their distributions among mammals, in association with the FEED database, will lead to new, significant insights into the functional, structural, and evolutionary morphology of the jaw muscles. © 2011 The Author.


Syed M.I.,Dayton Interventional Radiology | Syed M.I.,Wright State University | Yu B.,Northwestern University | Akhter T.,Northeastern Ohio Universities Colleges of Medicine | Shaikh A.,Dayton Interventional Radiology
Perspectives in Vascular Surgery and Endovascular Therapy | Year: 2011

An adult male with nutcracker syndrome was treated successfully by placement of a self-expanding stent in the left renal vein via a right internal jugular vein approach with a provocative Valsalva maneuver. Previous case reports have described renal vein stenting for this condition via common femoral vein approach. However, this study proposes the right internal jugular vein approach as a safer method for the treatment of nutcracker syndrome since the stent can be easily captured along the guidewire if undersized. This technique is based on the realization that the left renal vein diameter may increase by 50% to 58% during the Valsalva maneuver. © The Author(s) 2011.


Patel N.P.,Northeastern Ohio Universities Colleges of Medicine and Pharmacy | Tantri M.D.P.,Northeastern Ohio Universities Colleges of Medicine
Cleft Palate-Craniofacial Journal | Year: 2010

Median cleft lip is a midline vertical cleft through the upper lip. This is a rare anomaly with very few cases described in the literature. Median cleft lip has been thought to be associated with hypertelorism or hypotelorism. It is caused by the failure of fusion of the medial nasal prominences. In this case report, a 4 1/2-year-old girl with a median cleft is presented. The patient has no other anomalies of the nose or alveolus. The patient has normotelorism. A shortened bifid frenulum of the upper lip is present. A technique using an elliptical excision of the cleft with muscle approximation is described.


Edwards J.M.,Indiana University | Neeb Z.P.,Indiana University | Alloosh M.A.,Indiana University | Long X.,Indiana University | And 6 more authors.
Cardiovascular Research | Year: 2010

Aims Stenting attenuates restenosis, but accelerated coronary artery disease (CAD) adjacent to the stent (peri-stent CAD) remains a concern in metabolic syndrome (MetS). Smooth muscle cell proliferation, a major mechanism of CAD, is mediated partly by myoplasmic Ca2+ dysregulation and store-operated Ca2+ entry (SOCE) via canonical transient receptor potential 1 (TRPC1) channels is proposed to play a key role. Exercise is known to prevent Ca2+ dysregulation in CAD. We tested the hypothesis that MetS increases SOCE and peri-stent CAD and exercise attenuates these events.Methods and results Groups (n = 9 pigs each) were (i) healthy lean Ossabaw swine fed standard chow, (ii) excess calorie atherogenic diet fed (MetS), and (iii) aerobically exercise trained starting after 50 weeks of development of MetS (XMetS). Bare metal stents were placed after 54 weeks on diets, and CAD and SOCE were assessed 4 weeks later. Coronary cells were dispersed proximal to the stent (peri-stent) and from non-stent segments, and fura-2 fluorescence was used to assess SOCE, which was verified by Ni 2+ blockade and insensitivity to nifedipine. XMetS pigs had increased physical work capacity and decreased LDL/HDL (P < 0.05), but no attenuation of robust insulin resistance, glucose intolerance, hypertriglyceridaemia, or hypertension. CAD was greater in peri-stented vs. non-stented artery segments. MetS had the greatest CAD, SOCE, and TRPC1 and STIM1 mRNA and protein expression, which were all attenuated in XMetS.Conclusion This is the first report of the protective effect of exercise on native CAD, peri-stent CAD, SOCE, and molecular expression of TRPC1, STIM1, and Orai1 in MetS.

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