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Medical Rounds

Getting Pumped

For patients with cirrhosis of the liver awaiting transplant, it’s not uncommon to experience a buildup of fluid in the abdomen. When water leaks out of blood vessels and into the peritoneal cavity, it has nowhere to go and no way to move.

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New Clues to Alzheimer’s Onset

There’s no mistaking that Alzheimer’s disease poses a major threat: Some 5.3 million Americans live with the disorder—a number likely to double over the next 20 years as baby boomers age. Well aware of that, a team of Johns Hopkins psychiatrists has spent years teasing out which early patient symptoms foreshadow an Alzheimer’s diagnosis.

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The Doctor Is … On

Thanks to a new telemedicine initiative by Howard Country General Hospital, elementary school students are getting appointments with Johns Hopkins physicians without ever leaving the nurse’s office. The program is aimed at schools with high numbers of students who don’t have health insurance or a primary care provider.

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Stents on a Stick

When the U.S. Food and Drug Administration approved the use of tissue plasminogen activator (tPA) in 1996, it was a watershed moment for stroke treatment. Many ischemic stroke patients who were destined for a lifetime of extreme disability or death often went on to live productive lives.

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All in the Algorithm

Pediatric craniofacial surgeon Anand Kumar's heart goes out to newborns with Pierre Robin sequence, a congenital condition marked by a severely small mandible and a cleft soft palate, putting them at high risk of airway obstruction, as the tongue frequently falls to the back of the throat.

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One Hairy Problem?

Conventional wisdom has long blamed age-related hearing loss almost entirely on the death of sensory hair cells in the inner ear. However, recent work by otolaryngology researcher Paul Fuchs and graduate student Stephen Zachary suggests another story.

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The number of additional organ transplants made possible in the U.S. each year, if all goes as planned with new efforts, led by transplant surgeon Dorry Segev, to transplant organs from HIV-positive donors in recipients also infected with the virus. In March, Segev’s Johns Hopkins team became the first in the nation to do an HIV-positive kidney transplant and the first in the world to execute an HIV-positive liver transplant. Segev is now working with 30 other hospitals in the U.S. to get similar surgeries going across the country. Look for more on Segev’s six-year fight to win federal approval for HIV-positive transplant surgery in the next issue of Hopkins Medicine magazine.

At the Bench

“You can think of metastasis as The Amazing Race. [Metastatic] cells encounter many different challenges as they attempt to grow and spread, and some cells are better at different events than others, so traveling in a group makes sense.”

Cell biologist Andrew Ewald, summarizing new research in mice suggesting that cancer cells rarely form metastatic tumors on their own, as conventional wisdom once held, but instead prefer to travel in groups to increase their collective chances of survival. The Johns Hopkins scientists reported on their work in the Feb. 1 Proceedings of the National Academy of Sciences. 

At the Bench

“Our experiments show that the architecture and function of our lab-made intestine strikingly resemble those of the healthy human gut, giving us real hope that our model could be used as the backbone for replacement intestine.”

David Hackam, surgeon-in-chief of the Johns Hopkins Children’s Center, whose team from Johns Hopkins and the University of Pittsburgh used stem cells to grow healthy intestine atop a 3-D scaffold made of a substance used in surgical sutures. Their laboratory-created intestine successfully regenerated gut tissue in the colons of dogs with missing gut lining—holding promise for creating an implantable intestine as replacement therapy for a range of devastating disorders.