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At least 19 recordsLinked to original sources

Studies in otitis media: Children's Hospital of Pittsburgh-University of Pittsburgh progress report--2004.

OBJECTIVES/HYPOTHESIS: The present Progress Report has summarized the key otitis media clinical trials and laboratory studies conducted since 1969 by investigators at the Children's Hospital of Pittsburgh-University of Pittsburgh (Pittsburgh, PA). STUDY DESIGN: Review. METHODS: Included in the discussion are the following: 1) studies of the epidemiology and risk factors; 2) anatomy and pathology of the eustachian tube-middle ear from human temporal bone histopathological specimens; 3) physiology and pathophysiology of the eustachian tube-middle ear in humans and animal models; 4) pathogenesis; 5) otitis media in special populations (e.g., patients with cleft palate, Native Americans, patients with Down syndrome); 6) microbiology; 7) diagnosis; 8) outcomes of randomized clinical trials that evaluated efficacy of nonsurgical and surgical methods of treatment and prevention; 9) studies of certain complications and sequelae (e.g., effect of middle-ear effusion on hearing, early child development, and the vestibular system; chronic suppurative otitis media). Also included are relevant summary tables and 256 references.

Adenoidectomy↗

MFG-IRAP University of Pittsburgh.

The University of Pittsburgh is developing MFG-IRAP gene therapy for the potential treatment of arthritis. Phase II studies have commenced, including one trial in arthritis patients [225365]. A retrovirus (MFG-IRAP) is used in the ex vivo transfer of a cDNA encoding the human interleukin-1 receptor antagonist (IL-1Ra). The therapy is being tested in post-menopausal women, and involves the removal of some of their synovium, which is then transfected with the IRAP gene and reimplanted into the joint [188197]. A phase I rheumatoid arthritis trial of a therapy using the IL-1 antagonist gene therapy in synergy with soluble TNF alpha receptors was reported in March 1999 and was considered to be effective in producing an anti-arthritic effect [318398].

Animals↗

Technology evaluation: MFG-IRAP, University of Pittsburgh.

The University of Pittsburgh is developing MFG-IRAP, a retroviral vector carrying the human interleukin-1 receptor antagonist protein (IRAP) cDNA for potential treatment of arthritis. MFG-IRAP gene therapy was effective in local gene delivery to synovial lining of joints and systemically to hematopoietic stem cells, in preclinical studies. Intra-articular expression of IRAP, although transient (4 to 6 weeks), was efficacious in several animal models of arthritis. On the other hand, systemic transgene expression was prolonged (15 months), but was relatively less efficacious. Clinical data on the safety of MFG-IRAP therapy per se are limited, however, recombinant IRAP studies in humans have not resulted in any serious adverse effects. Phase II studies, including a trial in arthritis patients should provide the much anticipated MFG-IRAP efficacy data.

Animals↗

Lung and heart-lung transplantation at the University of Pittsburgh: 1982-2002.

The University of Pittsburgh lung transplantation program began in 1982 and through 2002 we have performed 576 lung and 101 heart-lung transplants. One-, 3- and 5-year survival rates over the past decade have been 77%, 62% and 55%, respectively, comparing favorably to ISHLT registry outcomes of 73%, 57% and 46%. We continue to utilize a very thorough evaluation process but have been flexible and aggressive with potential recipients with regard to age, coronary artery disease and disease state (eg., scleroderma). Despite worldwide progress in the field of lung transplantation, many difficulties remain. The limited number of lungs deemed acceptable for transplantation continues to hinder application to a greater number of patients. Our efforts in this regard have focused on cooperation with our OPO in education and detailed donor management protocols. Chronic rejection also remains a major difficulty frequently leading to death. Recent work utilizing aerosol cyclosporine in patients with established chronic rejection suggests that this therapy may prolong life. We are also hopeful that recently initiated therapies utilizing T-cell induction strategies may contribute to further improvement in outcomes.

Brain Death↗

The origin and evolution of the University of Pittsburgh Department of Neurological Surgery.

Neurological surgery at the University of Pittsburgh began more than 60 years ago with the arrival of Stuart Niles Rowe. During the years, the department has been led by four men, each of whom guided the department into the future in his unique way. These men and many other dedicated physicians, nurses, and staff members have contributed to this organization and created an environment where neurosurgery flourishes. This article describes the development of neurosurgery within the "Steel City" and outlines the origin and growth of the Department of Neurological Surgery at The University of Pittsburgh Medical Center.

Academic Medical Centers↗

Examining the range of health care reform. University of Pittsburgh Task Force on Health Care Financing.

On December 16, 1991, Senator Harris Wofford invited the president of the University of Pittsburgh Medical Center to convene a group of its leaders for a roundtable discussion of health care issues. At that meeting, J. Dennis O'Connor, Ph.D., chancellor of the University of Pittsburgh, offered to appoint a multidisciplinary group of people from western Pennsylvania to collect data to analyze future policy options relative to health care and make its findings available to the senator, other legislators, and health policy makers. The chancellor invited representatives from the community, the University of Pittsburgh Medical Center, the University's Faculty of Arts and Sciences, and other academic and health care institutions in the area to participate in the analytical process. The task force met frequently over a 10-month period to develop a report, a portion of which is excerpted here.

Health Policy↗

Simultaneous pancreas-kidney transplantation at the University of Pittsburgh.

Analysis of the SPK program at the University of Pittsburgh has led to a number of observations: 1. Under tacrolimus-based immunosuppression, without antibody induction, it has been possible to achieve (a) One- and 3-year actuarial patient survival rates of 98% and 95% (b) One- and 3-year actuarial kidney survival rates of 95% and 87% (c) One- and 3-year actuarial pancreas survival rates of 86% and 80% 2. Steroid withdrawal has been achieved in over half of the successfully transplanted recipients, with excellent outcomes and a low rate (4.7%) of subsequent rejection. 3. Bone marrow augmentation has been associated with (a) less rejection (b) less pancreatic graft loss to rejection (c) an increased ability to withdraw steroids 4. Rejection has been associated with a rising serum lipase. 5. Renal allograft rejection in SPK patients with elevated serum lipase levels has been seen in the setting of normal renal function. 6. Enteric drainage has been associated with a reasonably low complication rate. 7. SPK transplantation is a successful therapeutic option in selected type I diabetics with end-stage renal disease.

Adult↗

Comparison of University of Wisconsin and University of Pittsburgh solutions for heart transplantation.

The effectiveness of University of Wisconsin (UW) and University of Pittsburgh (UP) solutions for the preservation of rat hearts was compared. Lewis rat hearts were preserved with UW (group A, n = 45) or UP (group B, n = 45) solution for 0 or 24 h and then transplanted heterotopically into the recipients' abdomen. Ten recipients in each group were observed to obtain 1-week graft survival rates. Tissue water content and tissue content of adenine nucleotides were measured 2 h after transplantation in six grafts from each group. Six hearts preserved for 0 h and seven hearts preserved for 24 h were taken from each group 24 h after grafting for histopathology. The 1-week graft survival rates of groups A24 and B24 were 60% and 10%, respectively. In the 24-h preserved grafts, adenosine triphosphate (ATP) and energy charge [(ATP + adenosine diphosphate/2)/(ATP + adenosine diphosphate + adenosine monophosphate)] of groups A and B were 0.972 +/- 0.165 and 0.200 +/- 0.123 mg/g wet tissue (P < 0.05) and 74.4% and 61.1% (P < 0.05), respectively. The tissue water content of group A24 was 71.7%, whereas that of group B24 was 74.1% (P < 0.05). Histopathology revealed more severe muscle edema and necrosis and infiltration of polymorphonuclear cells in group B24 than in group A24. We conclude that UW solution is more appropriate for rat heart preservation than UP solution.

Abdomen↗

7. Survey of Results of Whole Body Imaging Using the PET/CT at the University of Pittsburgh Medical Center PET Facility.

Purpose: At the University Of Pittsburgh Medical Center, over 100 oncology studies have been performed using a combined PET/CT scanner. The scanner is a prototype, which combines clinical PET and clinical CT imaging in a single unit. The sensitivity achieved using three-dimensional PET imaging as well as the use of the CT for attenuation correction and image fusion make the device ideal for clinical oncology. Clinical indications imaged on the PET/CT scanner include, but are not limited to, tumor staging, solitary pulmonary nodule evaluation, and evaluation of tumor reoccurrence in melanoma, lymphoma, colorectal cancer, lung cancer, pancreatic cancer, head and neck cancer, and renal cancer.Methods: For all studies, seven millicuries of F(18)-fluorodeoxyglucose is injected and a forty-five minute uptake period is allowed prior to positioning the patient in the scanner. A helical CT scan is acquired over the region, or regions of interest followed by a multi-bed whole body PET scan for the same axial extent. The CT scan is used to correct the PET data for attenuation. The entire imaging session lasts 1-1.5 hours depending on the number of beds acquired, and is generally well tolerated by the patient.Results and Conclusion: Based on our experience in over 100 studies, combined PET/CT imaging offers significant advantages, including more accurate localization of focal uptake, distinction of pathology from normal physiological uptake, and improvements in evaluating therapy. These benefits will be illustrated with a number of representative, fully documented studies.

Journal Article↗

Cardiac transplantation at the University of Pittsburgh: 1994 update.

During the past 14 years, 746 hearts have been transplanted at the University of Pittsburgh. Immunosuppression has evolved from a CsA-based protocol with or without lympholytic prophylaxis to a tacrolimus-based protocol. Tacrolimus offers comparable survival to the conventional immunosuppression but is associated with lesser side effects and lower recurrent rejection. It also serves as an effective rescue agent for intractable rejection in patients receiving CsA-based immunosuppression. However, the shortage of donors, chronic rejection, and the morbidity associated with chronic use of nonspecific immunosuppression remain the major limitations in clinical transplantation. Currently, research at the University of Pittsburgh focuses on the induction of donor-specific transplantation tolerance in order to eliminate the morbidity associated with nonspecific immunosuppression and on left ventricular-assist devices as a bridge and/or an alternative to cardiac transplantation.

Actuarial Analysis↗

Phase II jaw movements and masseter muscle activity during chewing in Papio anubis.

It was proposed that the power stroke in primates has two distinct periods of occlusal contact, each with a characteristic motion of the mandibular molars relative to the maxillary molars. The two movements are called phase I and phase II, and they occur sequentially in that order (Kay and Hiiemae [1974] Am J. Phys. Anthropol. 40:227-256, Kay and Hiiemae [1974] Prosimian Biology, Pittsburgh: University of Pittsburgh Press, p. 501-530). Phase I movement is said to be associated with shearing along a series of crests, producing planar phase I facets and crushing on surfaces on the basins of the molars. Phase I terminates in centric occlusion. Phase II movement is said to be associated with grinding along the same surfaces that were used for crushing at the termination of phase I. Hylander et al. ([1987] Am J. Phys. Anthropol. 72:287-312; see also Hiiemae [1984] Food Acquisition and Processing, London: Academic Press, p. 257-281; Hylander and Crompton [1980] Am J. Phys. Anthropol. 52:239-251, [1986] Arch. Oral. Biol. 31:841-848) analyzed data on macaques and suggested that phase II movement may not be nearly as significant for food breakdown as phase I movement simply because, based on the magnitude of mandibular bone strain patterns, adductor muscle and occlusal forces are likely negligible during movement out of centric occlusion. Our goal is to better understand the functional significance of phase II movement within the broader context of masticatory kinematics during the power stroke. We analyze vertical and transverse mandibular motion and relative activity of the masseter and temporalis muscles during phase I and II movements in Papio anubis. We test whether significant muscle activity and, by inference, occlusal force occurs during phase II movement. We find that during phase II movement, there is negligible force developed in the superficial and deep masseter and the anterior and posterior temporalis muscles. Furthermore, mandibular movements are small during phase II compared to phase I. These results suggest that grinding during phase II movement is of minimal importance for food breakdown, and that most food breakdown on phase II facets occurs primarily at the end of phase I movement (i.e., crushing during phase I movement). We note, however, that depending on the orientation of phase I facets, significant grinding also occurs along phase I facets during phase I.

Animals↗

Behavioral assessment of social performance: a rating system for social phobia.

The Social Performance Rating Scale (SPRS) is a modification of the rating system for behavioral assessment of social skills, originally developed by Trower, P., Bryant, B., & Argyle, M. (1978). Social skills and mental health. Pittsburgh: University of Pittsburgh Press) and subsequently adapted by Turner and colleagues (e.g., Turner, S.M., Beidel, D.C., Dancu, C.V., & Keys, D.J. (1986). Psychopathology of social phobia and comparison to avoidant personality disorder. Journal of Abnormal Psychology, 95, 389-394). Designed to yield ratings of social performance appropriate for use in a socially phobic population and based on videotaped role plays, the five SPRS ratings are gaze, vocal quality, speech length, discomfort, and conversation flow. The sum of these ratings provides an internally consistent total score. In an initial study of the psychometric properties of the SPRS, three groups were assessed: individuals with social phobia, another anxiety disorder, or no psychological disorder. Inter-rater reliability for individual items and the total score proved excellent, and positive evidence for convergent, divergent, and criterion-related validity was obtained.

Adult↗

Inflammatory cytokine and nitric oxide responses in pediatric sepsis and organ failure.

OBJECTIVE: To examine the relationship of circulating proinflammatory and anti-inflammatory cytokine concentrations to nitric oxide and organ failure in pediatric sepsis. DESIGN: Prospective study. SETTING: Pediatric intensive care unit (ICU), children's Hospital of Pittsburgh, University of Pittsburgh. PATIENTS: Nineteen patients with a diagnosis of sepsis admitted to the pediatric ICU. Twelve uninfected critically iII patients served as controls. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Plasma interleukin (IL)-10, IL-6, and nitrite/nitrate concentrations were measured and compared with an index of organ failure daily for 3 days after presentation with the sepsis syndrome. Children with increased plasma IL-6 concentrations (n = 6) had increased plasma nitrite/nitrate concentrations (p < 0.01 on each day), increased organ failure scores (p < .05 on days 1 and 3), and the highest plasma IL-10 concentrations (p < .05 on days 1 and 3, p = .054 on day 2) when compared with children with sepsis and undetectable IL-6 concentrations. Children with sepsis and detectable IL-6 concentrations, and children with undetectable IL-6 concentrations, both had increased nitrite/nitrate concentrations (p < .005 on days 1 through 3) and increased IL-10 concentrations (p < .05 on days 1 and 2) compared with controls. Children with increased IL-6 concentrations had higher organ failure on each day (p < .01), and children with undetectable IL-6 concentrations had higher organ failure on days 1 and 2 only (p < .005) when compared with controls. Organ failure improved over time in the children with undetectable IL-6 concentrations (p < .005). CONCLUSIONS: Increased plasma nitrite/nitrates and increased organ failure scores occurred in the children with sepsis who had an exaggerated proinflammatory state, despite a pronounced anti-inflammatory response. When the anti-inflammatory response predominated and the proinflammatory state was dampened, organ failure status improved.

Adolescent↗

Design and implementation of a library-based information service in molecular biology and genetics at the University of Pittsburgh.

SETTING: In summer 2002, the Health Sciences Library System (HSLS) at the University of Pittsburgh initiated an information service in molecular biology and genetics to assist researchers with identifying and utilizing bioinformatics tools. PROGRAM COMPONENTS: This novel information service comprises hands-on training workshops and consultation on the use of bioinformatics tools. The HSLS also provides an electronic portal and networked access to public and commercial molecular biology databases and software packages. EVALUATION MECHANISMS: Researcher feedback gathered during the first three years of workshops and individual consultation indicate that the information service is meeting user needs. NEXT STEPS/FUTURE DIRECTIONS: The service's workshop offerings will expand to include emerging bioinformatics topics. A frequently asked questions database is also being developed to reuse advice on complex bioinformatics questions.

Computational Biology↗