320 E North Ave
Pittsburgh PA 15212
Medical School: Other - Unknown
Accepts Medicare: No
Participates In eRX: No
Participates In PQRS: No
Participates In EHR: No
License #: MD438934
Taxonomy Codes:207RC0000X 207RI0011X
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Recurrent stroke as a presenting feature of acquired partial lipodystrophy. - Indian journal of endocrinology and metabolism
Acquired partial lipodystrophy (PL) (Barraquer-Simons syndrome) is a rare condition with onset in childhood, and it is characterized by progressive loss of subcutaneous fat in a cephalocaudal fashion. This report describes a case of acquired PL in a 16-year-old girl, who had progressive loss of facial fat since 3 years. Systemic lupus erythematosus (SLE), anticardiolipin antibody, primary hypothyroidism, diabetes, and dyslipidemia may antedate the development of complications such as cerebrovascular stroke and cardiovascular disease. The girl had developed recurrent left hemiparesis, and withdrawn from school due to poor performance.
A rare case of Silver-Russell syndrome associated with growth hormone deficiency and urogenital abnormalities. - Indian journal of endocrinology and metabolism
Silver-Russell syndrome (SRS) is a very rare genetic disorder. This is usually characterized by asymmetry in the size of the two halves or other parts of the body.We are presenting a case of SRS with growth hormone (GH) deficiency and urogenital abnormalities.A 15-year-old boy a product of non-consanguineous marriage brought with a history of short stature and poor development of secondary sexual characters. There were no adverse perinatal events, but weighed 1500 g (<3(rd)centile) at birth. He had delayed developmental milestones. He has had a poor appetite and feeding difficulties since childhood. On physical examination, he had a broad forehead, triangular facies, and low-set prominent ears. Asymmetry of the face, upper and lower extremities was noted, with hemihypertrophy on the right side. His height was 119 cm (<3(rd)centile) and weight was 18 kg which were low (<3(rd)centile) as per his age. He was biochemically euthyroid and GH stimulation testing with clonidine (0.15 mg/m(2)) showed low GH levels at 30', 60', and 90' were 1.7, 1.6, and 1.1ng/ml, respectively. On micturatingcystourethrogram, grade V complex was noted on the right side. Dimercaptosuccinic acid (DMSA) showed normal functioning kidneys. He was started on recombinant GH with a height velocity of 10 cm/year.Urogenital abnormalities are rare but well described anomalies associated with SRS, and all cases have to be screened for them. GH deficiency is not uncommon in SRS, and GH treatment proves to be beneficial.
Delayed manifestation of a mid-esophageal tear with profuse hemorrhage after transesophageal echocardiogram. - Echocardiography (Mount Kisco, N.Y.)
Esophageal injury or perforation is a rare but life threatening complication of transesophageal echocardiogram (TEE). Most of the patients manifest symptoms within 24 hours of the procedure and upper esophagus is the most common site of injury. We report a patient who underwent TEE for the evaluation of severe valvular insufficiency and 4 days after the procedure developed an esophageal tear in its mid portion associated with profuse upper gastrointestinal bleeding. Though delayed esophageal perforation in the lower segment has been previously reported after a perioperative TEE, no such report exists to our knowledge, in the setting of a nonsurgical TEE.
Nuclear localization of KLF4 is associated with an aggressive phenotype in early-stage breast cancer. - Clinical cancer research : an official journal of the American Association for Cancer Research
The KrÃ¼ppel-like transcription factor KLF4/GKLF induces both malignant transformation and a slow-growth phenotype in vitro. Although KLF4 expression is increased in most cases of breast cancer, it was unknown whether these cases represent a distinct subtype with a different clinical outcome.We examined expression of KLF4 by immunostaining 146 cases of human primary infiltrating ductal carcinoma of the breast. Staining patterns were correlated with clinical outcome and with established prognostic factors.Subcellular localization exhibited case-to-case variation. Tumors with high nuclear staining and low cytoplasmic staining were termed type 1. For patients with early-stage disease (i.e., stage I or IIA), type 1 staining was associated with eventual death because of breast cancer (hazard ratio, 2.8; 95% confidence interval, 1.23-6.58; P = 0.011). The association was stronger in patients with early-stage cancer and small primary tumors (i.e., < or =2.0 cm in diameter; hazard ratio, 4.3; 95% confidence interval, 1.75-10.62; P < 0.001). For patients with early-stage disease, multivariate analysis indicated that type 1 staining was independently associated with outcome (adjusted hazard ratio 2.6; 95% confidence interval, 1.10-6.05; P = 0.029). Type 1 staining was also associated with high histological grade (P = 0.032), increased expression of Ki67 (P = 0.016), and reduced expression of BCL2 (P = 0.032). In vitro, KLF4 was localized within the nucleus of transformed RK3E epithelial cells, consistent with a nuclear function of this transcription factor during induction of malignant transformation.The results suggest that localization of KLF4 in the nucleus of breast cancer cells is a prognostic factor and identify KLF4 as a marker of an aggressive phenotype in early-stage infiltrating ductal carcinoma.
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320 E North Ave Pittsburgh, PA 15212
4 Allegheny Ctr East Commons Professional Building, 8Th Floor
320 E North Ave
320 E North Ave Emergency Medicine Residency Office