• Unanticipated Acute Adrenal Insufficiency During Emergency Thoracotomy Re-Exploration

      Rawlings, J Lee; Spivey, Jerry A; Castresana, Manuel R.; Department of Anesthesiology and Perioperative Medicine (American Society of Anesthesiologists, 2010-10)
      For the last 50 years there has been a debate over the management of corticosteroid supplementation in the context of surgical or critically ill patients. At a minimum, clinicians agree that chronic corticosteroids should be continued in the perioperative or ICU setting, however in patients without a history of steroid use, acute adrenal insufficiency as the cause of hemodynamic compromise can be an elusive diagnosis. We present a case report.
    • Unconventional Coupling of 5HT7 receptors to Gs heterotrimers

      Adams, Elizabeth; Department of Pharmacology and Toxicology; Lambert, Nevin; Augusta University (2019-02-13)
      GPCRs play a major role in cell signaling through their interactions with heterotrimeric G proteins. In conventional models of GPCR-G protein coupling, agonist binding promotes a conformational change within the receptor, which then associates with G proteins, facilitating the exchange of GDP for GTP. GTP-bound G proteins dissociate from the receptor and exert their effects on downstream signaling molecules. Previous studies suggest that serotonin 5HT7 receptors associate with Gs�heterotrimers prior to agonist binding, and that 5HT7-Gs�complexes dissociate after the G protein is activated. Here we study this unconventional mode of coupling using bioluminescence resonance energy transfer (BRET) between luciferase-tagged 5HT7 receptors and Gs�heterotrimers labeled with Venus. Our results confirm that 5HT7 receptors interact with inactive (GDP-bound) Gs�heterotrimers in the absence of an agonist, and that this interaction is stabilized by the inverse agonist methiothepin. Stimulation with the endogenous agonist serotonin (5HT) decreased BRET between 5HT7 receptors and Gs, indicating that the activation of the receptor leads to 5HT7-Gscomplex dissociation. Interestingly, Gs�activation was not required for complex dissociation. These results are consistent with the hypothesis that 5HT7 receptors couple to Gs�heterotrimers via an unconventional mechanism involving ligand-sensitive complexes of receptors and inactive Gs.
    • Understanding and Promoting Breastfeeding among African American Woman of the Rural South

      Stewart, Jessica Lynn; Department of Clinical and Digital Health Sciences (2016-03)
      African American women (AAW) have lower rates of breastfeeding (BF) than whites and other U.S. minority groups. Along with its many maternal and child health benefits, research indicates BF can reduce the risk of developing triple-negative breast cancer (TNBC), an aggressive subtype of breast cancer with higher mortalities and incidence in AAW. Thus, increasing BF can be an important strategy for addressing breast cancer health disparities.This research seeks to ultimately determine whether increased awareness that BF reduces breast cancer and TNBC risk will positively alter AAW’s BF decision-making. A survey and an in-depth interview based on the Theory of Planned Behavior framework are used to examine AAW’s perceptions of breast cancer risk and prevention as well as their beliefs, attitudes and motivations that underlie BF decision-making. Preliminary analysis of 10 interviews to date showed that all of the participants had an intention and desire to BF, but many (n=6) lacked a realistic plan to manage BF and address expected barriers. When asked about breast cancer, most (n=8) demonstrated fear and avoidance of the topic. There was a general lack of knowledge, but excitement about the benefits of BF on TNBC prevention. Dissemination of this new evidence may be useful in guiding BF promotions among AAW. Also, there was a clear disconnect in BF intention versus action in this population. Further analysis will identify intervening factors that bridge the gap. 
    • Understanding the compliance of individuals with chronic ankle instability to a home exercise program

      Patel, Annie; Department of Physical Therapy (Augusta University, 2021-05)
      Ankle sprains are one of the most common injuries caused by physical activity such as running, kicking, or loss of balance 1. However, the majority of people never seek proper medical treatment, and this tends to lead to chronic ankle instability (CAI) 2. CAI is described by a subjective feeling of the ankle giving way or being unstable 3. CAI may develop after one, or repeated, ankle sprains due to weakened ligaments. Ligaments are structures that connect a bone to another bone crossing a joint to provide it with stability. The development of CAI is caused by a pattern of instability on the lateral side of an ankle. The ankle will repeatedly give out or sprain again because the ligaments have become damaged1. CAI is a problem because the continuous spraining can lead to a decrease in range of motion, strength, postural control, and movement of the ankle 4. However, there are treatments to remedy this form of injury. The proper treatment for acute ankle sprains would be applying ice, rest, and elevation to allow the ligaments to heal. Further treatments include looking at an ankle’s range of motion, exercise, and manual therapy in order to promote proper healing and recovery. CAI is best treated through proper physical therapy 5.
    • Unnecessary Workup of Asymptomatic Neonates in the Era of Group B Streptococcus Prophylaxis

      Buckler, Brad; Bell, Jason; Sams, Ralph; Cagle, William; Bell, Sue Anne; Allen, Carla; Sutherland, Donald E.; Bhatia, Jatinder; Department of Pediatrics; Department of Pediatrics; et al. (2010-08-22)
      Asymptomatic term neonates born to mothers who are Group B Streptococcus (GBS) unknown or GBS positive but â inadequatelyâ treated prior to delivery do not require invasive laboratory evaluation. We conducted a retrospective cohort study of mother/baby dyads born from January 1, 2005 until September 30, 2007 at the Medical College of Georgia. Their current protocol is to obtain a Complete Blood Count with Differential (CBC with D), Blood Culture (BC), and C-reactive protein (CRP) after birth. Mother/baby dyads (n = 242) that met inclusion criteria were reviewed. Of these 242 babies 25 (10%) were started on antibiotics after the initial lab values were known. None of the blood cultures were positive and the CRP's were normal. The 2002 GBS guidelines call for laboratory evaluation of â at-riskâ neonates, but the workup of these babies is not only costly, it does not provide any advantage over old fashioned clinical observation for the evaluation and treatment of early onset GBS sepsis.
    • An unusual case of peripartum cardiomyopathy manifesting with multiple thrombo-embolic phenomena.

      Ibebuogu, Uzoma N; Thornton, John W; Reed, Guy L; Department of Medicine (2007-12-31)
      ABSTRACT: Peripartum cardiomyopathy (PPCM) is a rare form of heart failure with a reported incidence of 1 per 3000 to 1 per 4000 live births and a fatality rate of 20%-50%. Onset is usually between the last month of pregnancy and up to 5 months postpartum in previously healthy women. Although viral, autoimmune and idiopathic factors may be contributory, its etiology remains unknown. PPCM initially presents with signs and symptoms of congestive heart failure and rarely with thrombo-embolic complications. We report an unusual case of PPCM in a previously healthy postpartum woman who presented with an acute abdomen due to unrecognized thromboemboli of the abdominal organs. This case illustrates that abdominal pain in PPCM may not always result from hepatic congestion as previously reported, but may occur as a result of thromboemboli to abdominal organs. Further research is needed to determine the true incidence of thromboemboli in PPCM.
    • Uracils at nucleotide position 9â 11 are required for the rapid turnover of miR-29 family

      Zhang, Zhuo; Zou, Jun; Wang, Guo-Kun; Zhang, Jun-Tao; Huang, Shuang; Qin, Yong-Wen; Jing, Qing; Department of Biochemistry and Molecular Biology (2011-02-1)
      MicroRNAs are endogenous small RNA molecules that regulate gene expression. Although the biogenesis of microRNAs and their regulation have been thoroughly elucidated, the degradation of microRNAs has not been fully understood. Here by using the pulseâ chase approach, we performed the direct measurement of microRNA lifespan. Five representative microRNAs demonstrated a general feature of relatively long lifespan. However, the decay dynamic varies considerably between these individual microRNAs. Mutation analysis of miR-29b sequence revealed that uracils at nucleotide position 9â 11 are required for its rapid decay, in that both specific nucleotides and their position are critical. The effect of uracil-rich element on miR-29b decay dynamic occurs in duplex but not in single strand RNA. Moreover, analysis of published data on microRNA expression profile during development reveals that a substantial subset of microRNAs with the uracil-rich sequence tends to be down-regulated compared to those without the sequence. Among them, Northern blotting shows that miR-29c and fruit fly bantam possess a relatively rapid turnover rate. The effect of uracil-rich sequence on microRNA turnover depends on the sequence context. The present work indicates that microRNAs contain sequence information in the middle region besides the sequence element at both ends.
    • Ureteral Clipping Simplifies Hand-Assisted Laparoscopic Donor Nephrectomy

      Brown, James A.; Sajadi, Kamran P.; Wynn, James J.; Department of Surgery (2010)
    • Use of Dexmedetomidine as Adjuvant for the Anesthetic Management of Obese Children with Obstructive Sleep Apnea Undergoing Tonsillectomy and Adenoidectomy

      Mendiola, Raul A.; Florentino-Pineda, Ivan; Department of Anesthesiology and Perioperative Medicine (Society for Pediatric Anesthesia, 2009-03)
      Obstructive sleep apnea (OSA) in children is most commonly associated with tonsillar and adenoid hypertrophy. Use of opioids and residual amounts of inhaled agents can cause severe respiratory depression and thus represent an added risk to patients with OSA in the immediate postoperative period. Dexmedetomidine, a specific alpha 2-adrenergic receptor agonist, is known for its hypnotic, sedative, analgesic and sympatholytic properties. It potentiates analgesia with the advantages of minimal respiratory compromise, rapid onset and clearance. Because dexmedetomidine has been shown to be effective as an analgesic and sedative agent while minimizing respiratory compromise, it offers a safer alternative as an adjuvant for the anesthetic management of obese pediatric patients with OSA undergoing tonsillectomy and adenoidectomy.
    • The Use of Dexmedetomidine During Nasotracheal Intubation in a Patient with CHARGE Syndrome

      Crews, Lindsay K; Mattingly, Diana; Florentino-Pineda, Ivan; Department of Anesthesiology and Perioperative Medicine (Society for Pediatric Anesthesia, 2010-03)
      CHARGE Syndrome (CS), also known as Hall-Hittner syndrome, is a congenital disorder comprised of multiple anomalies (coloboma, heart defect, atresia choanal, retarded growth and development, genital hypoplasia, ear anomalies/deafness). First described in 1979 by Hall and Hittner, it is caused by a mutation in the gene CHD7 on chromosome 8.1 Facial and upper airway features of CS, including midface hypoplasia, micrognathia, cleft lip, and palate, anterior larynx, and subglottic stenosis, make the airway management of these patients a challenge for the anesthesiologist. Because difficult airway management is a concern, spontaneous ventilation is recommended until the airway is secured. We report the use of dexmedetomidine (DEX) for deep sedation in a CS patient who required nasotracheal intubation using a fiberoptic bronchoscope (FB) while breathing spontaneously.
    • Use of ethinylestradiol/drospirenone combination in patients with the polycystic ovary syndrome.

      Mathur, Ruchi; Levin, Olga; Azziz, Ricardo; Cedars-Sinai Medical Center, Los Angeles, CA (Dove Medical Press, 2008-08-27)
      Polycystic ovary syndrome (PCOS) is one of the most common endocrine/metabolic disorders found in women, affecting approximately 105 million women worldwide. It is characterized by ovulatory dysfunction, often presenting as oligomenorrhea or amenorrhea and either clinical or biochemical hyperandrogenism. Combined oral contraceptive (COC) therapy has long been a cornerstone of care for women with PCOS. COC therapy often provides clinical improvement in the areas of excessive hair growth, unpredictable menses, acne, and weight gain. One of the main issues in COC therapy is choosing the most appropriate progestin component to provide the greatest anti androgenic effects. Drospirenone, a relatively new progestin, has shown benefit in the PCOS population when used in conjunction with ethinyl estradiol. We now review the role of COCs in PCOS, focusing specifically on drospirenone. Controversy over metabolic effects of COCs in PCOS is also discussed.
    • The Use of Games as Pedagogical Adjuncts in Nursing Education

      Merriweather, Jeanette; Wright, Stephanie; College of Nursing (Georgia Health Science University, 2012)
      The use of games as a pedagogical strategy to promote active learning in the classroom and clinical area is an idea whose time has come (Skiba, 2008). Current evidence strongly suggests that innovative teaching strategies improve learning outcomes. Although lecture format is the traditional method of teaching that delivers a large amount of information in a short period of time, it has not shown to produce widespread critical thinking in the classroom setting (Blakely, Skirton, Cooper, Allum & Nelmes, 2008). Among the many reasons for using gaming as an instructional strategy is that it allows students to engage in active learning, critical thinking, problem solving and enjoy the value of fun in learning. When the process of learning is perceived as fun, students may experience less stress and anxiety. Information that might be considered dry and boring can be delivered in an atmosphere that is stimulating, enjoyable, and conducive to learning (Royse & Newton, 2007).
    • Use of Sigma Receptor Ligands to Prevent Retinal Ganglion Cell Apoptosis Characteristic of Diabetic Retinopathy

      Martin, Pamela M; Department of Cellular Biology and Anatomy (2003-04)
      (First Paragraph)Diabetic retinopathy is a major sight-threatening disease and is the leading cause of blindness among working-aged Americans, affecting approximately 10 to 12 million persons (Wu, 1995). Although retinal vasculature is particularly vulnerable to damage in diabetes, other retinal cells are at risk. Very recently, Barber et al. (1998) documented increased apoptosis of neural retinal cells in experimental diabetes in rats and diabetes mellitus in humans. Notably, retinal ganglion cells (RGCs) were found to be at particular risk. Ganglion cell death in diabetic retinopathy is thought to be mediated via overstimulation o f N-methyl-D-aspartate (NMDA) receptors by glutamate. oRl is a nonopiate and nonphencyclidine-binding site that has numerous pharmacological and physiological functions. In some studies, agonists for aR l have been shown to afford neuroprotection against overstimulation of the NMDA receptor. The purpose of these studies was to evaluate the potential use of aR ligands, particularly those that bind specifically to o R l, as neuroprotective agents in the treatment of RGC apoptosis characteristic of diabetic retinopathy. A detailed description of the retina, followed by information about diabetes and the mechanisms thought to be involved in the pathogenesis of diabetic retinopathy, particularly the apoptotic death of RGCs associated with diabetic retinopathy, is provided below.
    • Use of the Video RIFL (Rigid Flexible Laryngoscope) as an Adjunct to Direct Laryngoscopy

      Setty, Harsha; Gallen, Thomas; Dubin, Stevin; Department of Anesthesiology and Perioperative Medicine (Society for Airway Management, 2010-09)
      The ASA difficult airway algorithm incorporates different modalities in its progression. It is not uncommon for the user to fail at direct laryngoscopy, thus requiring an alternate method for securing an airway. Frequently, the alternate modalities include supraglottic airways, rigid videolaryngoscopes, or flexible fiberoptic bronchoscopes. We retrospectively reviewed charts from February 2009 to February 2010 on patients intubated in the operating room using the Video RIFL.
    • Use-dependent Antagonism of Nicotinic Acetylcholine Receptors as a Novel Treatment for Drug Addiction

      Hall, Brandon J; Department of Pharmacology and Toxicology (2011-11)
      The contributions of nicotinic acetylcholine receptors (nAChRs) to the onset and maintenance of drug addiction are well known, but these receptors are too often overlooked as potential targets for addiction treatment. The goal of this study was to demonstrate that use-dependent antagonism of nAChRs by the compound bis (2, 2, 6, 6-tetramethyl-4-piperidinyl) sebacate (BTMPS) offers a novel approach to treatment for drug addiction, and that positive outcomes of this treatment can be demonstrated across different classes of abusive drugs, nicotine or morphine in all three phases of an animal model of what is known as the drug abuse cycle: 1) binge-intoxication, 2) withdrawal-negative affect, and 3) preoccupation-anticipation. Different groups of rats were allowed to self-administer drugs of abuse (nicotine or morphine) on a 24 hr basis for a period of 14 days to establish binge-intoxication. Upon completion of self-administration, each rat was evaluated for withdrawal-negative affect. Subsequent to acute withdrawal the rats were placed in standard housing cages for a period of six weeks. At the end of the six week period, each rat was examined for unrewarded drug seeking responses, or preoccupation-anticipation, for another 14 day period preoccupation-anticipation. Injections of vehicle or BTMPS were administered to the animals during each behavioral phase of the study. Treatment with BTMPS significantly reduced the self-administration of both nicotine and morphine compared to vehicle treated animals. BTMPS treated animals also displayed reduced acute withdrawal symptoms when compared to their vehicle treated counterparts. When intervention occurred during self-administration or acute withdrawal, BTMPS treatment resulted in a significant reduction in drug-seeking responses after a protracted period of abstinence from drug. However, delaying treatment with the compound until the drug seeking phase of the study was ineffective against reducing drug seeking behavior. Administration of BTMPS alone did not appear to elicit adverse side effects in the animals, neither affecting their motivation to obtain food nor compromising the animals' performance during the behavioral procedures in the study. Thus, the resultsof this study support the hypothesis that use-dependent antagonism of nAChRs offers the potential for an alternative approach to treatment of substance abuse and drug addiction.
    • Usefulness of the paralens fluorescent microscope adaptor for the identification of mycobacteria in both field and laboratory settings.

      Kuhn, Walter; Armstrong, Derek; Atteberry, Suzanne; Dewbrey, Euline; Smith, Diane; Hooper, Nancy; Department of Emergency Medicine (2010-06-17)
      The presence of acid-fast bacilli (AFB) in laboratories has traditionally been demonstrated using the fluorochrome method, which requires a fluorescent microscope or the Ziehl-Neelsen (ZN) method employing light microscopy. Low sensitivity of the ZN method and high costs of fluoroscopy make the need for a more effective means of diagnosis a top priority, especially in developing countries where the burden of tuberculosis is high. The QBC ParaLens attachment (QBC Diagnostic Inc., Port Matilda, PA) is a substitute for conventional fluoroscopy in the identification of AFB. To evaluate the efficacy of the ParaLens LED (light-emitting diode) system, the authors performed a two-part study, looking at usefulness, functionality and durability in urban/rural health clinics around the world, as well as in a controlled state public health laboratory setting. In the field, the ParaLens was durable and functioned well with various power sources and lighting conditions. Results from the state laboratory indicated agreement between standard fluorescent microscopy and fluorescent microscopy using the ParaLens. This adaptor is a welcome addition to laboratories in resource-limited settings as a useful alternative to conventional fluoroscopy for detection of mycobacterial species.
    • Using digital mammography with tomosynthesis to detect breast cancer

      Balaji, Charan; Dodd, Alexandra; Ibrahim, Muaz; Pan, Alexander; Rosema, Danielle; Upchurch, Andrew (2015-03-09)
      Does the use of tomosynthesis in combination with digital mammography result in better screening and detection rate for breast cancer?
    • Using peptide-based vaccines to enhance adoptive cell therapy with genetically engineered T cells

      Fan, Aaron; Department of Neuroscience and Regenerative Medicine (6/27/2018)
      Adoptive cell therapy (ACT) of retrovirally transduced (RV) CD8 T cells is a powerful technique that has shown promise in tumor eradication in cancer patients. However, some major barriers to current methods are that ACT is expensive, time consuming, and requires harmful and toxic adjunct procedures. The Celis laboratory has demonstrated the use of TriVax, a potent peptide vaccination strategy that dramatically expands ACT cell populations and bypasses the necessity for adjunct procedures. The purpose of my thesis project was to enhance current methods of ACT+TriVax by testing an antigen-specific antitumor response of RV CD8 T cells and if it could be improved with constitutively active STAT5 (CA-STAT5) expression, a protein activated downstream several cytokine pathways that have been shown to play a role in increasing CD8 T cell persistence and resistance to apoptosis. Here, I aimed to test the hypothesis that CA-STAT5 in CD8 T cells enhances an antitumor effect by increasing T cell persistence and efficacy. My results show that TriVax administration selectively expanded frequencies of the ACT cell population expressing gp100-TCR in both blood and spleen. When co-transduced with CA-STAT5, an even higher fold expansion of antigen-specific cells was observed. +CA-STAT5 T cells were able to expand more robustly than -CA-STAT5 T cells upon repeated antigen stimulation (vaccine boost), demonstrating nearly 4000-fold increases in antigen-specific CD8 T cells. +CA-STAT5 T cells also seemed to persist longer in vivo over time, and they expressed lower levels of surface PD-1. Using B16F10 melanoma, ACT+TriVax of these cell populations into tumor-bearing mice demonstrated a powerful antitumor effect, leading to tumor regression in treated groups. CA-STAT5 seemed to recapitulate similar antitumor effects our laboratory observed previously with combinatorial anti-PD-L1 treatment or IL2/anti-IL2 mAb complexes (IL2Cx), suggesting a potential role for STAT5 in resisting the PD-1/PD-L1 inhibitory pathway. Altogether, these results demonstrate that RV CD8 T cells expressing gp100-TCR and CA-STAT5 are capable of antigen-dependent expansion in response to TriVax. CA-STAT5 plays a role in increasing T cell proliferation and persistence, as well as increasing efficacy through resistance to PD-1/PD-L1 inhibition.

      Overlie, Benjamin; Saunders-Cummings, William; Department of Biological Sciences; Bates, Christopher; Christy, Charlotte; Augusta University (2019-02-13)
      The Spring Ladies� Tresses orchid (Spiranthes vernalis�Engelmann & A. Gray) is a native wildflower found in the lawns of Augusta University's Summerville campus. The origin of these plants is unknown. Orchids usually grow slowly from seed, leading to lifecycles that can take 5+ years. Despite this, individuals are present in lawns known to be two years old or less. Thus, either these plants are reproducing with unusual speed, or some arrived with landscaping materials such as sod. We are attempting to use chloroplast DNA sequences to determine their degree of relatedness. �For this, a strongly conserved gene,�MATk, and a hypothetical reading frame,�ycf1, were chosen.�YCF1�is considered variable enough to show differences at the population level. Standard techniques for DNA extraction, amplification with PCR, and sequencing are being used. �The data will be used to address two questions: �1) Is�ycf1�variable enough to distinguish among individual plants?; and, if so, 2) Are the campus plants all closely related or do distinctive subpopulations exist?
    • Utrophin Up-Regulation by an Artificial Transcription Factor in Transgenic Mice

      Mattei, Elisabetta; Corbi, Nicoletta; Di Certo, Maria Grazia; Strimpakos, Georgios; Severini, Cinzia; Onori, Annalisa; Desantis, Agata; Libri, Valentina; Buontempo, Serena; Floridi, Aristide; et al. (2007-08-22)
      Duchenne Muscular Dystrophy (DMD) is a severe muscle degenerative disease, due to absence of dystrophin. There is currently no effective treatment for DMD. Our aim is to up-regulate the expression level of the dystrophin related gene utrophin in DMD, complementing in this way the lack of dystrophin functions. To this end we designed and engineered several synthetic zinc finger based transcription factors. In particular, we have previously shown that the artificial three zinc finger protein named Jazz, fused with the appropriate effector domain, is able to drive the transcription of a test gene from the utrophin promoter â Aâ . Here we report on the characterization of Vp16-Jazz-transgenic mice that specifically over-express the utrophin gene at the muscular level. A Chromatin Immunoprecipitation assay (ChIP) demonstrated the effective access/binding of the Jazz protein to active chromatin in mouse muscle and Vp16-Jazz was shown to be able to up-regulate endogenous utrophin gene expression by immunohistochemistry, western blot analyses and real-time PCR. To our knowledge, this is the first example of a transgenic mouse expressing an artificial gene coding for a zinc finger based transcription factor. The achievement of Vp16-Jazz transgenic mice validates the strategy of transcriptional targeting of endogenous genes and could represent an exclusive animal model for use in drug discovery and therapeutics.