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Pamela C Roehm

Publications and source records attributed to Pamela C Roehm.

7 recordsLinked to original sources

Constitutive neuregulin-1/ErbB signaling contributes to human vestibular schwannoma proliferation.

Vestibular schwannomas (VSs) are benign tumors that arise from the Schwann cells (SCs) lining the vestibular nerve. VS cells survive and proliferate far from neurons and axonally derived growth factors. We have previously shown that VSs produce the glial growth factor, neuregulin-1 (NRG1), and its receptors, ErbB2 and ErbB3. In the present work, we explore the contribution of constitutive NRG1:ErbB signaling to human VS cell proliferation. We confirm that human VSs, which express markers of immature and denervated SCs, also express endogenous NRG1 and activated ErbB2. We find that a blocking anti-NRG1 antibody and trastuzumab (Herceptin, HCN), a humanized anti-ErbB2 inhibitory monoclonal antibody, effectively inhibit NRG1 induced SC proliferation. Treatment of primary VS cultures with anti-NRG1 or HCN reduces cell proliferation in the absence of exogenous NRG1. Furthermore, conditioned medium from VS cell cultures contains NRG1 and stimulates SC proliferation in SC cultures, an effect that is inhibited by anti-NRG1 and HCN. These data suggest an autocrine pathway of VS growth stimulation involving NRG and ErbB receptors. Inhibition of constitutive NRG:ErbB signaling reduces VS cell proliferation in vitro and may have therapeutic potential for patients with VSs.

Animals↗

Cochlear implant explantation as a sequela of severe chronic otitis media: case report and review of the literature.

INTRODUCTION: In the 1980s, intracranial and inner ear infections were feared complications in patients with recurrent or chronic otitis media (COM) who had undergone cochlear implantation. Current studies show a low incidence of such complications. We present a case of a patient who developed severe COM requiring cochlear explantation. CASE: Our patient had a previous cleft palate repair and as a three-year-old was implanted with a Nucleus-24 implant. She developed chronic otorrhea in the implanted ear, which was managed by her pediatrician until her cochlear implant stopped functioning. Radiographic imaging revealed erosion of the cochlea and extrusion of the distal electrode medially in the petrous apex. SETTING: Tertiary care university hospital. INTERVENTION/RESULTS: The patient underwent cochlear explantation, subtotal petrosectomy, obliteration of ear, and intravenous antibiotic therapy. One month later she was implanted in the contralateral ear. CONCLUSION: COM poses potentially severe complications in patients receiving cochlear implants. Patients receiving cochlear implants who are at high risk for COM require follow-up for an extended period of time.

Anti-Bacterial Agents↗

Disseminated histoplasmosis presenting as a unilateral cranial nerve VIII mass: a case report.

OBJECTIVE: To report a unique presentation of disseminated histoplasmosis. STUDY DESIGN: Case report. SETTING: University hospital, tertiary referral center. PATIENT: Our patient presented with vertigo, tinnitus, and unilateral hearing loss, and was initially found to have a 5-mm enhancing left internal auditory canal mass, as revealed by a magnetic resonance imaging (MRI) scan. Subsequently, the patient developed multiple focal neurologic deficits. INTERVENTIONS: Magnetic resonance imaging and treatment with intravenously administered amphotericin B, with subsequent oral administration of itraconazole. MAIN OUTCOME MEASURES: Clinical presentation and imaging findings of Histoplasmosis involving the cranial nerve VIII. RESULTS: A subsequent MRI scan revealed enlargement of the initial lesion and multiple parenchymal lesions. Further workup revealed a pulmonary lesion; the diagnosis of disseminated histoplasmosis was made on the basis of bronchoalveolar lavage culture. CONCLUSION: Infectious processes, including disseminated histoplasmosis, should be considered in the differential of internal auditory canal masses, especially in the setting of rapid progression of symptoms.

Bronchoalveolar Lavage Fluid↗

Strategies to preserve or regenerate spiral ganglion neurons.

PURPOSE OF REVIEW: Degeneration of spiral ganglion neurons following hair cell loss carries critical implications for efforts to rehabilitate severe cases of hearing loss with cochlear implants or hair cell regeneration. This review considers recently identified neurotrophic factors and therapeutic strategies which promote spiral ganglion neuron survival and neurite growth. Replacement of these factors may help preserve or regenerate the auditory nerve in patients with extensive hair cell loss. RECENT FINDINGS: Spiral ganglion neurons depend on neurotrophic factors supplied by hair cells and other targets for their development and continued survival. Loss of this trophic support leads to spiral ganglion neuron death via apoptosis. Hair cells support spiral ganglion neuron survival by producing several peptide neurotrophic factors such as neurotrophin-3 and glial derived neurotrophic factor. In addition, neurotransmitter release from the hair cells drives membrane electrical activity in spiral ganglion neurons which also supports their survival. In animal models, replacement of peptide neurotrophic factors or electrical stimulation with an implanted electrode attenuates spiral ganglion neuron degeneration following deafferentation. Cell death inhibitors can also preserve spiral ganglion neuron populations. Preliminary studies show that transfer of stem cells or neurons from other ganglia are two potential strategies to replace lost spiral ganglion neurons. Inducing the regrowth of spiral ganglion neuron peripheral processes to approximate or contact cochlear implant electrodes may help optimize signaling from a diminished population of neurons. SUMMARY: Recent studies of spiral ganglion neuron development and survival have identified several trophic and neuritogenic factors which protect these specialized cells from degeneration following hair cell loss. While still preliminary, such strategies show promise for future clinical applications.

Animals↗

Adenosquamous carcinoma of the upper aerodigestive tract: a clinicopathologic study of 12 cases and review of the literature.

PURPOSE: Adenosquamous carcinoma is an uncommon, controversial neoplasm. To further comprehend its natural history, the clinical and pathological features of 12 new cases were reviewed and analyzed collectively with those described in the English literature. MATERIALS AND METHODS: Twelve cases of adenosquamous carcinoma of the upper aerodigestive tract with adequate follow-up and available microscopic slides and paraffin tissue blocks were identified in the anatomic pathology files of Presbyterian Hospital of the University of Pittsburgh Medical Center over the period 1983-2001. RESULTS: The 8 men and 4 women ranged in age from 34 to 81 years (mean, 62.8 years). The larynx (5 cases) and the floor of the mouth (4 cases) were the most common sites of origin. Nine patients had cervical lymph nodes positive for carcinoma (8 at diagnosis), 7 experienced local recurrences, and 2 developed distant metastases. Four of 10 (40%) patients with follow-up died of disease. Combining our cases with those in the literature (total of 58 cases) revealed similar findings: 64.7% were associated with positive cervical lymph nodes, 46.7% experienced local recurrences, 23.1% developed distant metastases, and 42.9% died of their disease at a mean follow-up period of 24.7 months. CONCLUSIONS: Adenosquamous carcinoma is an aggressive neoplasm with a tendency for early lymph node metastasis, frequent local recurrence, occasional distant metastasis, and death from disease, usually within 2-3 years. Surgery with neck dissection is the treatment of choice.

Adult↗