12605 E 16Th Ave
Aurora CO 80045
Medical School: Other - Unknown
Accepts Medicare: No
Participates In eRX: No
Participates In PQRS: No
Participates In EHR: No
License #: 49227
Request Appointment Information
Awards & Recognitions
Medical Malpractice Cases
Medical Board Sanctions
Targeting Aberrant Epigenetic Networks Mediated by PRMT1 and KDM4C in Acute Myeloid Leukemia. - Cancer cell
Transcriptional deregulation plays a major role in acute myeloid leukemia, and therefore identification of epigenetic modifying enzymes essential for the maintenance of oncogenic transcription programs holds the key to better understanding of the biology and designing effective therapeutic strategies for the disease. Here we provide experimental evidence for the functional involvement and therapeutic potential of targeting PRMT1, an H4R3 methyltransferase, in various MLL and non-MLL leukemias. PRMT1 is necessary but not sufficient for leukemic transformation, which requires co-recruitment of KDM4C, an H3K9 demethylase, by chimeric transcription factors to mediate epigenetic reprogramming. Pharmacological inhibition of KDM4C/PRMT1 suppresses transcription and transformation ability of MLL fusions and MOZ-TIF2, revealing a tractable aberrant epigenetic circuitry mediated by KDM4C and PRMT1 in acute leukemia.Copyright Â© 2016 Elsevier Inc. All rights reserved.
Medical science and the Cruelty to Animals Act 1876: A re-examination of anti-vivisectionism in provincial Britain. - Studies in history and philosophy of biological and biomedical sciences
The Cruelty to Animals Act 1876 was an important but ambiguous piece of legislation. For researchers it stymied British science, yet ensured that vivisection could continue under certain restrictions. For anti-vivisection protestors it was positive proof of the influence of their campaigns, yet overly deferent to Britain's scientific elite. In previous accounts of the Act and the rise of anti-vivisectionism, scientific medicine central to these debates has been treated as monolithic rather than a heterogeneous mix of approaches; and this has gone hand-in-hand with the marginalizing of provincial practices, as scholarship has focused largely on the 'Golden Triangle' of London, Oxford and Cambridge. We look instead at provincial research: brain studies from Wakefield and anthrax investigations in Bradford. The former case elucidates a key role for specific medical science in informing the anti-vivisection movement, whilst the latter demonstrates how the Act affected the particular practices of provincial medical scientists. It will be seen, therefore, how provincial medical practices were both influential upon, and profoundly affected by, the growth of anti-vivisectionism and the passing of the Act. This paper emphasises how regional and varied medico-scientific practices were central to the story of the creation and impact of the Cruelty to Animals Act.Copyright Â© 2014 Elsevier Ltd. All rights reserved.
C2-3 Anterior Cervical Fusion: Technical Report. - Journal of spinal disorders & techniques
Retrospective review of patients at a university hospital OBJECTIVE:: To describe the anterior approach for cervical discectomy and fusion (ACDF) at C2-3 level and evaluate its suitability for treatment of instability and degenerative disease in this region.The anterior approach is commonly used for ACDF in the lower cervical spine but is used less often in the high cervical spine.We retrospectively reviewed a database of consecutive cervical spine surgeries performed at our institution to identify patients who underwent ACDF at the C2-3 level during a 10-year period. Demographic data, clinical indications, surgical technique, complications, and immediate results were evaluated.Of the 11 patients (7 female, 4 male; mean age 46 y) identified, 7 were treated for traumatic fractures and 4 for degenerative disc disease. Three patients treated for myelopathy showed improvement in mean Nurick grade from 3.6 to 1.3. Pain was significantly improved in all patients who had preoperative pain. Solid bony fusion was achieved in 5 of 7 patients at 3-month follow-up. Complications included dysphagia in 4 patients (which resolved in 3), aspiration pneumonia, mild persistent dysphonia, and construct failure at C2 requiring posterior fusion. One patient died of a pulmonary embolism 2 weeks postoperatively.ACDF at the C2-3 level is an option for the treatment of high cervical disease or trauma but is associated with a higher rate of approach-related morbidity. Familiarity with local anatomy may help to reduce complications. ACDF at C2-3 appears to have a fusion rate similar to ACDF performed at other levels.
Role of ventricular interdependence as an early echocardiographic sign of cardiac surgical postoperative pericardial tamponade. - The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society
Pericardial effusions are common in postoperative cardiac surgical patients. Cardiac tamponade occurs relatively infrequently postoperatively and may mimick other conditions, such as heart failure, renal failure, and pulmonary emboli. Echocardiographic examination is frequently hampered in the immediate postoperative period due to suboptimal imaging. The current case series focuses on the echocardiographic findings in tamponade in the postoperative patient with emphasis on ventricular interdependence as an early sign of impending tamponade.
Management strategies for acute spinal cord injury: current options and future perspectives. - Current opinion in critical care
Spinal cord injury is a devastating acute neurological condition with loss of function and poor long-term prognosis. This review summarizes current management strategies and innovative concepts on the horizon.The routine use of steroids in patients with spinal cord injuries has been largely abandoned and considered a 'harmful standard of care'. Prospective trials have shown that early spine stabilization within 24â€Š h results in decreased secondary complication rates. Neuronal plasticity and axonal regeneration in the adult spinal cord are limited due to myelin-associated inhibitory molecules, such as Nogo-A. The experimental inhibition of Nogo-A ameliorates axonal sprouting and functional recovery in animal models.General management strategies for acute spinal cord injury consist of protection of airway, breathing, oxygenation and control of blood loss with maintenance of blood pressure. Unstable spine fractures should be stabilized early to allow unrestricted mobilization of patients with spinal cord injuries and to decrease preventable complications. Steroids are largely considered obsolete and have been abandoned in clinical guidelines. Nogo-A represents a promising new pharmacological target to promote sprouting of injured axons and restore function. Prospective clinical trials of Nogo-A inhibition in patients with spinal cord injuries are currently under way.
15 kDa granulysin causes differentiation of monocytes to dendritic cells but lacks cytotoxic activity. - Journal of immunology (Baltimore, Md. : 1950)
Granulysin is expressed as two isoforms by human cytotoxic cells: a single mRNA gives rise to 15 kDa granulysin, a portion of which is cleaved to a 9 kDa protein. Studies with recombinant 9 kDa granulysin have demonstrated its cytolytic and proinflammatory properties, but much less is known about the biologic function of the 15 kDa isoform. In this study, we show that the subcellular localization and functions of 9 and 15 kDa granulysin are largely distinct. Nine kilodalton granulysin is confined to cytolytic granules that are directionally released following target cell recognition. In contrast, 15 kDa granulysin is located in distinct granules that lack perforin and granzyme B and that are released by activated cytolytic cells. Although recombinant 9 kDa granulysin is cytolytic against a variety of tumors and microbes, recombinant 15 kDa granulysin is not. The 15 kDa isoform is a potent inducer of monocytic differentiation to dendritic cells, but the 9 kDa isoform is not. In vivo, mice expressing granulysin show markedly improved antitumor responses, with increased numbers of activated dendritic cells and cytokine-producing T cells. Thus, the distinct functions of granulysin isoforms have major implications for diagnosis and potential new therapies for human disease.
Hydrostatic comparison of nonpenetrating titanium clips versus conventional suture for repair of spinal durotomies. - Spine
Biomechanics.To compare the hydrostatic strength of suture and nonpenetrating titanium clip repairs of standard spinal durotomies.Dural tears are a frequent complication of spine surgery and can be associated with significant morbidity. Primary repair of durotomies with suture typically is attempted, but a true watertight closure can be difficult to obtain because of leakage through suture tracts. Nonpenetrating titanium clips have been developed for vascular anastomoses and provide a close apposition of the tissues without the creation of a suture tract.Twenty-four calf spines were prepared with laminectomies and the spinal cord was evacuated leaving an intact dura. After Foley catheters were inserted from each end and inflated adjacent to a planned dural defect, the basal flow rate was measured and a 1-cm longitudinal durotomy was made with a scalpel. Eight repairs were performed for each material, which included monofilament suture, braided suture, and nonpenetrating titanium clips. The flow rate at 30, 60, and 90 cm of water and the time needed for each closure were measured.There was no statistically significant difference in the baseline leak rate for all 3 groups. There was no difference in the leakage rate of durotomies repaired with clips and intact specimens at any pressure. Monofilament and braided suture repairs allowed significantly more leakage than both intact and clip-repaired specimens at all pressures. The difference in leak rate increased as the pressure increased. Closing the durotomy with clips took less than half the time of closure with suture.Nonpenetrating titanium clips provide a durotomy closure with immediate hydrostatic strength similar to intact dura whereas suture repair with either suture was significantly less robust. The use of titanium clips was more rapid than that of suture repair.
Physiological fictions and the fin-de-siÃ¨cle female brain. - Nineteenth-century French studies
An important area of French medical research in the first half of the nineteenth-century was the supposedly anomalous, sensation-based functioning of the female brain (Drs. Voisin, Virey, Brachet, Briquet). This paper explores the late-century resurgence of such theory around the question of whether women could support an intense advanced education. It examines the conflicted attitudes of four females, the novelists Rachilde, Georges de Peyrebrune and Daniel Lesuer, and a medical doctor, Georgette DÃ©ga, as they tried to resist or rationalize the dogma that saw the female as a mentally diminished male. The juxtaposition of medical and fictional texts demonstrates that the so-called "automatic" functioning of the female brain led to her being embodied, in the male mind, as a symbol of the dreaded unconscious.
Spinal duraplasty materials and hydrostasis: a biomechanical study: laboratory investigation. - Journal of neurosurgery. Spine
Dural tears are a frequent complication of spinal surgery and contribute to significant morbidity. Occasionally, dural tears cannot be closed primarily and dural patch grafts must be utilized. No data exist on the comparative immediate hydrostatic strength of various patch materials used alone or with a biological adhesive in a spinal dural tear model. Thus, the authors conducted this study to determine the comparative effectiveness of various patch materials used with and without biological adhesive.Twenty-four thoracic spines from calves were prepared with laminectomies and spinal cord evacuation, leaving the dura intact. Foley catheters were inflated on either side of a planned dural defect, and baseline hydrostasis was measured using a fluid column at 30, 60, and 90 cm of H(2)O. A standard dural defect (1 Ã— 2 cm) was created, and 8 patches of each material (human fascia lata, Duragen, and Preclude) were sutured in place using 5-0 Prolene hemo-seal running sutures. Hydrostasis was again tested at the same pressures. Finally, a hydrogel sealant (Duraseal) was placed over the defect and hydrostasis was again tested. Results were analyzed with repeated measures ANOVA.The leakage rate increased significantly at each pressure tested for all conditions. There was no difference in leakage among the 3 patch materials at any of the pressures or for either condition (with or without sealant). All patch materials allowed significantly greater leakage than the intact condition at all pressures. The use of sealant reduced leakage significantly at the 30 and 60 mm Hg pressures to levels similar to the intact condition. At 90 mm Hg, leakage of the sealed construct was greater than at the intact condition but significantly less than without the use of sealant.All 3 dural patch materials were of similar hydrostatic strength and allowed greater leakage than at the intact condition. The use of sealant reduced the amount of leakage at all pressures compared with patching alone but allowed more leakage than the intact state at a high hydrostatic pressure (90 mm Hg).
15 kDa Granulysin versus GM-CSF for monocytes differentiation: analogies and differences at the transcriptome level. - Journal of translational medicine
Granulysin is an antimicrobial and proinflammatory protein with several isoforms. While the 9 kDa isoform is a well described cytolytic molecule with pro-inflammatory activity, the functions of the 15 kDa isoform is less well understood. Recently it was shown that 15 kDa Granulysin can act as an alarmin that is able to activate monocytes and immature dendritic cells. Granulocyte Macrophage Colony Stimulating Factor (GM-CSF) is a growth factor widely used in immunotherapy both for in vivo and ex vivo applications, especially for its proliferative effects.We analyzed gene expression profiles of monocytes cultured with 15 kDa Granulysin or GM-CSF for 4, 12, 24 and 48 hours to unravel both similarities and differences between the effects of these stimulators.The analysis revealed a common signature induced by both factors at each time point, but over time, a more specific signature for each factor became evident. At all time points, 15 kDa Granulysin induced immune response, chemotaxis and cell adhesion genes. In addition, only 15 kDa Granulsyin induced the activation of pathways related to fundamental dendritic cell functions, such as co-stimulation of T-cell activation and Th1 development. GM-CSF specifically down-regulated genes related to cell cycle arrest and the immune response. More specifically, cytokine production, lymphocyte mediated immunity and humoral immune response were down-regulated at late time points.This study provides important insights on the effects of a novel agent, 15 kDa granulysin, that holds promise for therapeutic applications aimed at the activation of the immune response.
Map & Directions
12605 E 16Th Ave Aurora, CO 80045
12605 E 16Th Ave
13123 E 16Th Ave