4701 Ogletown Stanton Rd Suite 2335
Newark DE 19713
Medical School: Pennsylvania State University College Of Medicine - 1993
Accepts Medicare: No
Participates In eRX: No
Participates In PQRS: Yes
Participates In EHR: Yes
License #: C10005136
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Awards & Recognitions
Dr. Mark Borowsky is associated with these group practices
|HCPCS Code||Description||Average Price||Average Price
Allowed By Medicare
|HCPCS Code:58548||Description:Lap radical hyst||Average Price:$3,805.00||Average Price Allowed
|HCPCS Code:58661||Description:Laparoscopy remove adnexa||Average Price:$1,405.00||Average Price Allowed
|HCPCS Code:99215||Description:Office/outpatient visit est||Average Price:$307.78||Average Price Allowed
|HCPCS Code:99222||Description:Initial hospital care||Average Price:$317.60||Average Price Allowed
HCPCS Code Definitions
- Laparoscopy, surgical, with radical hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with removal of tube(s) and ovary(s), if performed
- Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)
- Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 40 minutes are spent face-to-face with the patient and/or family.
- Initial hospital care, per day, for the evaluation and management of a patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the problem(s) requiring admission are of moderate severity. Typically, 50 minutes are spent at the bedside and on the patient's hospital floor or unit.
Medical Malpractice Cases
Medical Board Sanctions
Cardiovascular Disease (Cardiology)
Cardiovascular Disease (Cardiology)
*These referrals represent the top 10 that Dr. Borowsky has made to other doctors
Vials: Visualizing Alternative Splicing of Genes. - IEEE transactions on visualization and computer graphics
Alternative splicing is a process by which the same DNA sequence is used to assemble different proteins, called protein isoforms. Alternative splicing works by selectively omitting some of the coding regions (exons) typically associated with a gene. Detection of alternative splicing is difficult and uses a combination of advanced data acquisition methods and statistical inference. Knowledge about the abundance of isoforms is important for understanding both normal processes and diseases and to eventually improve treatment through targeted therapies. The data, however, is complex and current visualizations for isoforms are neither perceptually efficient nor scalable. To remedy this, we developed Vials, a novel visual analysis tool that enables analysts to explore the various datasets that scientists use to make judgments about isoforms: the abundance of reads associated with the coding regions of the gene, evidence for junctions, i.e., edges connecting the coding regions, and predictions of isoform frequencies. Vials is scalable as it allows for the simultaneous analysis of many samples in multiple groups. Our tool thus enables experts to (a) identify patterns of isoform abundance in groups of samples and (b) evaluate the quality of the data. We demonstrate the value of our tool in case studies using publicly available datasets.
Morcellation and the Incidence of Occult Uterine Malignancy: A Dual-Institution Review. - International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
To determine the incidence of unsuspected uterine sarcoma (UtSarc), other uterine malignancies, and potential malignancies at the time of hysterectomy or myomectomy using power morcellation.We performed a retrospective cohort study of all women undergoing myomectomy or hysterectomy using power morcellation at 2 institutions between January 1, 2004, and May 31, 2015. The primary outcome was the incidence of uterine malignancy (UM). The predefined secondary outcome was the occurrence of other conditions associated with malignant behavior. For analysis, any UtSarc or endometrial cancer was categorized as a "uterine malignancy," whereas other pathologies with cytologic atypia were categorized as "uterine premalignant disease" (UPM). All other pathological results were classified as "nonmalignant."A total of 1004 women underwent hysterectomy or myomectomy using power morcellation during the studied period. Two women (1/502; 95% confidence interval [CI], 1/4144-1/139) were found to have UM pathology, 2 endometrial carcinomas and none with UtSarc (97.5% CI, 0-1/273). Six (1/167; 95% CI, 1/455-1/77) women were found to have UPM on final pathology: 2 atypical leiomyomas, 1 STUMP (smooth muscle tumors of uncertain malignant potential), and 3 endometrial atypical hyperplasias. Women with UM had uteri that weighed more than those with NM pathology (840 g vs 217.7 g, P = 0.028), and this trend was also seen with UM and UPM (435.0 g vs 217.2 g, P = 0.081). Women with UM and UPM were more likely to have a preoperative surgical indication of "uterine leiomyoma" compared with other benign etiologies (P < 0.001).Among this cohort, all cases of unsuspected UM at the time of myomectomy or hysterectomy using power morcellation were found to be endometrial carcinoma. Unsuspected UM pathology had an incidence of 1 of 502. Factors associated with increased likelihood of UM or UPM were greater uterine weight and leiomyoma as the surgical indication.
Society of Gynecologic Oncology recommendations for the prevention of ovarian cancer. - Cancer
Mortality from ovarian cancer may be dramatically reduced with the implementation of attainable prevention strategies. The new understanding of the cells of origin and the molecular etiology of ovarian cancer warrants a strong recommendation to the public and health care providers. This document discusses potential prevention strategies, which include 1) oral contraceptive use, 2) tubal sterilization, 3) risk-reducing salpingo-oophorectomy in women at high hereditary risk of breast and ovarian cancer, 4) genetic counseling and testing for women with ovarian cancer and other high-risk families, and 5) salpingectomy after childbearing is complete (at the time of elective pelvic surgeries, at the time of hysterectomy, and as an alternative to tubal ligation). The Society of Gynecologic Oncology has determined that recent scientific breakthroughs warrant a new summary of the progress toward the prevention of ovarian cancer. This review is intended to emphasize the importance of the fallopian tubes as a potential source of high-grade serous cancer in women with and without known genetic mutations in addition to the use of oral contraceptive pills to reduce the risk of ovarian cancer. Cancer 2015. Â© 2015 American Cancer Society.Â© 2015 American Cancer Society.
Next-Gen Sequencing-Based Mapping and Identification of Ethyl Methanesulfonate-Induced Mutations in Arabidopsis thaliana. - Current protocols in molecular biology / edited by Frederick M. Ausubel ... [et al.]
Forward genetic analysis using ethyl methanesulfonate (EMS) mutagenesis has proven to be a powerful tool in biological research, but identification and cloning of causal mutations by conventional genetic mapping approaches is a painstaking process. Recent advances in next-gen sequencing have greatly invigorated the process of identifying EMS-induced mutations corresponding to a specific phenotype in model genetic hosts, including the plant Arabidopsis thaliana and the nematode Caenorhabditis elegans. Next-gen sequencing of bulked F2 mutant recombinants produces a wealth of high-resolution genetic data, provides enhanced delimitation of the genomic location of mutations, and greatly reduces hands-on time while maintaining high accuracy and reproducibility. In this unit, a detailed procedure to simultaneously map and identify EMS mutations in Arabidopsis is described. Curr. Protoc. Mol. Biol. 108:7.18.1-7.18.16. Â© 2014 by John Wiley & Sons, Inc.Copyright Â© 2014 John Wiley & Sons, Inc.
Transforming growth factor Î²-mediated suppression of antitumor T cells requires FoxP1 transcription factor expression. - Immunity
Tumor-reactive T cells become unresponsive in advanced tumors. Here we have characterized a common mechanism of T cell unresponsiveness in cancer driven by the upregulation of the transcription factor Forkhead box protein P1 (Foxp1), which prevents CD8âº T cells from proliferating and upregulating Granzyme-B and interferon-Î³ in response to tumor antigens. Accordingly, Foxp1-deficient lymphocytes induced rejection of incurable tumors and promoted protection against tumor rechallenge. Mechanistically, Foxp1 interacted with the transcription factors Smad2 and Smad3 in preactivated CD8âº T cells in response to microenvironmental transforming growth factor-Î² (TGF-Î²), and was essential for its suppressive activity. Therefore, Smad2 and Smad3-mediated c-Myc repression requires Foxp1 expression in T cells. Furthermore, Foxp1 directly mediated TGF-Î²-induced c-Jun transcriptional repression, which abrogated T cell activity. Our results unveil a fundamental mechanism of T cell unresponsiveness different from anergy or exhaustion, driven by TGF-Î² signaling on tumor-associated lymphocytes undergoing Foxp1-dependent transcriptional regulation.Copyright Â© 2014 Elsevier Inc. All rights reserved.
The spring-loaded genome: nucleosome redistributions are widespread, transient, and DNA-directed. - Genome research
Nucleosome occupancy plays a key role in regulating access to eukaryotic genomes. Although various chromatin regulatory complexes are known to regulate nucleosome occupancy, the role of DNA sequence in this regulation remains unclear, particularly in mammals. To address this problem, we measured nucleosome distribution at high temporal resolution in human cells at hundreds of genes during the reactivation of Kaposi's sarcoma-associated herpesvirus (KSHV). We show that nucleosome redistribution peaks at 24 h post-KSHV reactivation and that the nucleosomal redistributions are widespread and transient. To clarify the role of DNA sequence in these nucleosomal redistributions, we compared the genes with altered nucleosome distribution to a sequence-based computer model and in vitro-assembled nucleosomes. We demonstrate that both the predicted model and the assembled nucleosome distributions are concordant with the majority of nucleosome redistributions at 24 h post-KSHV reactivation. We suggest a model in which loci are held in an unfavorable chromatin architecture and "spring" to a transient intermediate state directed by DNA sequence information. We propose that DNA sequence plays a more considerable role in the regulation of nucleosome positions than was previously appreciated. The surprising findings that nucleosome redistributions are widespread, transient, and DNA-directed shift the current perspective regarding regulation of nucleosome distribution in humans.
The microglial sensome revealed by direct RNA sequencing. - Nature neuroscience
Microglia, the principal neuroimmune sentinels of the brain, continuously sense changes in their environment and respond to invading pathogens, toxins and cellular debris. Microglia exhibit plasticity and can assume neurotoxic or neuroprotective priming states that determine their responses to danger. We used direct RNA sequencing, without amplification or cDNA synthesis, to determine the quantitative transcriptomes of microglia of healthy adult and aged mice. We validated our findings using fluorescence dual in situ hybridization, unbiased proteomic analysis and quantitative PCR. We found that microglia have a distinct transcriptomic signature and express a unique cluster of transcripts encoding proteins for sensing endogenous ligands and microbes that we refer to as the sensome. With aging, sensome transcripts for endogenous ligand recognition were downregulated, whereas those involved in microbe recognition and host defense were upregulated. In addition, aging was associated with an overall increase in the expression of microglial genes involved in neuroprotection.
Genomic analysis identifies targets of convergent positive selection in drug-resistant Mycobacterium tuberculosis. - Nature genetics
M. tuberculosis is evolving antibiotic resistance, threatening attempts at tuberculosis epidemic control. Mechanisms of resistance, including genetic changes favored by selection in resistant isolates, are incompletely understood. Using 116 newly sequenced and 7 previously sequenced M. tuberculosis whole genomes, we identified genome-wide signatures of positive selection specific to the 47 drug-resistant strains. By searching for convergent evolution--the independent fixation of mutations in the same nucleotide position or gene--we recovered 100% of a set of known resistance markers. We also found evidence of positive selection in an additional 39 genomic regions in resistant isolates. These regions encode components in cell wall biosynthesis, transcriptional regulation and DNA repair pathways. Mutations in these regions could directly confer resistance or compensate for fitness costs associated with resistance. Functional genetic analysis of mutations in one gene, ponA1, demonstrated an in vitro growth advantage in the presence of the drug rifampicin.
Intraperitoneal chemotherapy in a pregnant woman with ovarian cancer. - Obstetrics and gynecology
Ovarian cancer diagnosed in pregnancy is rare. There is limited evidence to guide the choice of optimal chemotherapeutic management for treatment of disease during pregnancy.A 36-year-old primigravid woman was diagnosed with stage IIB grade III serous adenocarcinoma at 12 weeks of gestation. After extensive counseling, she opted for intraperitoneal chemotherapy. She received four cycles during the course of the pregnancy, and treatment was complicated by thrombocytopenia and mild preeclampsia. Delivery occurred by cesarean at 37 weeks of gestation, resulting in the birth of a live male neonate weighing 4 pounds 11 ounces with bilateral congenital talipes equinovarus.Pregnant women with ovarian cancer should be offered the opportunity to maximize their survival, including standard chemotherapeutic regimens used in nonpregnant patients.
Multiplexed Illumina sequencing libraries from picogram quantities of DNA. - BMC genomics
High throughput sequencing is frequently used to discover the location of regulatory interactions on chromatin. However, techniques that enrich DNA where regulatory activity takes place, such as chromatin immunoprecipitation (ChIP), often yield less DNA than optimal for sequencing library preparation. Existing protocols for picogram-scale libraries require concomitant fragmentation of DNA, pre-amplification, or long overnight steps.We report a simple and fast library construction method that produces libraries from sub-nanogram quantities of DNA. This protocol yields conventional libraries with barcodes suitable for multiplexed sample analysis on the Illumina platform. We demonstrate the utility of this method by constructing a ChIP-seq library from 100 pg of ChIP DNA that demonstrates equivalent genomic coverage of target regions to a library produced from a larger scale experiment.Application of this method allows whole genome studies from samples where material or yields are limiting.
Map & Directions
4701 Ogletown Stanton Rd Suite 2335 Newark, DE 19713
774 Christiana Rd Suite 201
86 Omega Dr Omega Professional Center, Building B-86
111 Continental Dr Suite 406
4701 Ogletown Stanton Rd Ste 4200