Strategic Talent Management: Implementation and Impact of a Leadership Development Program in Radiology.

The rapidity of change and increasing complexity of the academic medical center environment require a talented and engaged workforce with competencies in adaptability, capacity for working in empowered and diverse interprofessional teams, and self-efficacy. Radiology-a crosscutting field that interfaces with most other biomedical disciplines and that is often at the forefront of technological disruption-is a potentially ideal venue to focus professional and leadership development to create positive organizational value. In this report, we detail the design of and 9-year experience with a departmental leadership academy at a large academic center intended to foster team-based skills in early to midcareer faculty and staff. Over the past decade, 100 participants have completed the program with 80% retention, substantial professional growth, and increased capacity for mentoring others. This in-house, customized leadership development program is aligned with our strategic and cultural imperative to promote nimble, engaged, and empowered teams in a diverse and inclusive setting.

Acute and subchronic toxicity of inhaled toluene in male Long-Evans rats: Oxidative stress markers in brain.

The effects of exposure to volatile organic compounds (VOCs), which are of concern to the EPA, are poorly understood, in part because of insufficient characterization of how human exposure duration impacts VOC effects. Two inhalation studies with multiple endpoints, one acute and one subchronic, were conducted to seek effects of the VOC, toluene, in rats and to compare the effects between acute and subchronic exposures. Adult male Long-Evans rats were exposed to toluene vapor (n=6 per group) at a concentration of 0 or 1019 ± 14 ppm for 6h in the acute study and at 0 ± 0, 10 ± 1.4, 97 ± 7, or 995 ± 43 ppm for 6h/d, 5d/week for 13 weeks in the subchronic study. For the acute study, brains were dissected on ice within 30 min of the end of exposure, while for the subchronic study, brains were dissected 18 h after the last exposure. Frontal cortex, hippocampus, cerebellum, and striatum were assayed for a variety of oxidative stress (OS) parameters including total aconitase (TA), protein carbonyls, glutathione peroxidase (GPX), glutathione reductase (GRD), glutathione transferase (GST), γ-glutamylcysteine synthetase (GCS), superoxide dismutase (SOD), total antioxidants (TAS), NADPH quinone oxidoreductase-1 (NQO1), and NADH ubiquinone reductase (UBIQ-RD) activities using commercially available kits. Following acute exposure, UBIQ-RD, GCS and GRD were increased significantly only in the cerebellum, while TAS was increased in frontal cortex. On the other hand, subchronic exposure affected several OS markers including increases in NQO1 and UBIQ-RD. The effect of subchronic toluene exposure on SOD and TAS was greater in the striatum than in the other brain regions. TA activity (involved in maintaining iron homeostasis and an indicator of DNA damage) was inhibited in striatum and cerebellum, increased in hippocampus, and unchanged in frontal cortex. Protein carbonyls increased significantly in both the frontal cortex and cerebellum. In general, the results showed that acute exposure to toluene affected OS parameters to a lesser extent than did subchronic exposure. These results suggest that toluene exposure induces OS in the brain and this may be a component of an adverse outcome pathway for some of the neurotoxic effects reported following toluene exposure.

Minimally invasive groin dissection.

INTRODUCTION: Melanoma of the lower extremity with a positive sentinel lymph node biopsy (SLNB) mandates a groin dissection. This procedure has been associated with numerous complications; therefore we devised a modified approach. METHODS: All patients presenting with lower extremity melanomas that met criteria for SLNB had this procedure performed through an incision in the inguino-femoral region. In the event of a positive SLND, this same incision was used for the minimally invasive groin dissection (MIGD). A lighted retractor was used to improve visualization and a Ligasure (Valley-lab) was used to prevent seroma formation. RESULTS: Twenty patients met criteria for this investigation and five underwent MIGD. All patients tolerated the procedure well. There was no incidence of flap necrosis nor wound dehiscence. There was one case of seroma and cellulitis, one seroma, and one patient with lymphedema. All patients preferred the MIGD incision over traditional incisions. CONCLUSIONS: This new algorithm utilizing MIGD is well tolerated in patients. Complications appear to be minimal and patient satisfaction superior to traditional groin dissection.

The contribution of Langerhans cells to cutaneous malignancy.

The skin is at the forefront of environmental exposures, such as ultraviolet radiation and a myriad of chemicals, and is at risk for malignant transformation. The skin is a highly responsive immunological organ that contains a unique population of immature intraepidermal dendritic cells (DCs) called Langerhans cells (LCs). Although LCs show morphological and migratory changes in response to epidermal perturbation, and can function as antigen-presenting cells to activate T cells, their role in carcinogenesis is unknown. Here we review recent studies that have provided clues to the potential roles that LCs might play in the pathogenesis of skin cancer, beyond their stimulation or regulation of adaptive immunity. Understanding this role of LCs might provide new perspectives on the relevance of DC populations that are resident within other epithelial tissues for cancer.

Photoperiodic mechanisms controlling scent marking: interactions of vasopressin and gonadal steroids.

Microinjection of arginine vasopressin (Avp) into the rostral hypothalamus of Syrian hamsters induces a form of scent marking known as flank marking. The ability of Avp to stimulate flank marking is mediated by the vasopressin 1a receptor (Avpr1a). In hamsters housed in long 'summer-like' photoperiods, the amount of flank marking and the number of Avpr1a receptors in the rostral hypothalamus are regulated by testosterone. However, hamsters housed in short 'winter-like' photoperiods for 6-8 weeks continue to flank mark at high levels despite significant reductions in the circulating levels of testosterone. In the present study, we compared the effects of gonadal steroids on Avp-induced flank marking and Avpr1a binding and affinity in hamsters housed in short photoperiods and those housed in long photoperiods. In long-photoperiod-housed hamsters, castration significantly reduced the amount of Avp-induced flank marking; however, in short-photoperiod-housed hamsters there were no significant differences between gonadally regressed and castrated hamsters. Surprisingly, Avpr1a receptor binding, but not affinity, in the medial preoptic area and the medial preoptic nucleus was significantly reduced in long-photoperiod-housed castrates as well as short-photoperiod-housed gonadally regressed and castrated hamsters, compared with long-photoperiod-housed gonadally intact hamsters. These data demonstrate that in short photoperiods Avp-induced flank marking is independent of gonadal hormones, despite gonadal steroid-dependent reductions in Avpr1a binding.

Early determinants of H2O2-induced endothelial dysfunction.

Reactive oxygen species (ROS) can stimulate nitric oxide (NO(*)) production from the endothelium by transient activation of endothelial nitric oxide synthase (eNOS). With continued or repeated exposure, NO(*) production is reduced, however. We investigated the early determinants of this decrease in NO(*) production. Following an initial H(2)O(2) exposure, endothelial cells responded by increasing NO(*) production measured electrochemically. NO(*) concentrations peaked by 10 min with a slow reduction over 30 min. The decrease in NO(*) at 30 min was associated with a 2.7-fold increase in O(2)(*-) production (p < 0.05) and a 14-fold reduction of the eNOS cofactor, tetrahydrobiopterin (BH(4), p < 0.05). Used as a probe for endothelial dysfunction, the integrated NO(*) production over 30 min upon repeated H(2)O(2) exposure was attenuated by 2.1-fold (p = 0.03). Endothelial dysfunction could be prevented by BH(4) cofactor supplementation, by scavenging O(2)(*-) or peroxynitrite (ONOO(-)), or by inhibiting the NADPH oxidase. Hydroxyl radical (()OH) scavenging did not have an effect. In summary, early H(2)O(2)-induced endothelial dysfunction was associated with a decreased BH(4) level and increased O(2)(*-) production. Dysfunction required O(2)(*-), ONOO(-), or a functional NADPH oxidase. Repeated activation of the NADPH oxidase by ROS may act as a feed forward system to promote endothelial dysfunction.

Embryonic stem cell-derived endothelial cells may lack complete functional maturation in vitro.

Stem cell therapies will only become clinically relevant if the stem cells differentiated in vitro function as their in vivo counterparts. Here, we employed our previously developed techniques for deriving endothelial cells (>96% purity) from mouse embryonic stem cells (ESC) and compared these with mouse aortic endothelial cells (MAEC) obtained from thoracic aortas. Immunocytochemical analysis of ESC-derived endothelial cells (EC) demonstrates that both cell types are positive for the EC markers endothelial nitric oxide synthase (eNOS), Flk-1, Flt-1, vascular endothelial cadherin (VEcad), platelet-endothelial cell adhesion molecule-1 (PECAM-1), and CD34. However, ESC-derived EC express slightly lower levels of PECAM-1 and VE-cadherin, and significantly lower levels of acetylated low-density lipoprotein (LDL) uptake and von Willebrand factor. Although ESC-derived EC do express VE-cadherin, the VE-cadherin in the ESC-derived EC did not localize as well at the cell-cell junctions as in the MAEC. Interestingly, ESC-derived EC express much greater levels of the endothelial and hematopoietic stem cell marker CD34 and vasculogenic and angiogenic sprouting than MAEC. These results indicate that ESC-derived EC share some key characteristics of 'mature' EC, while retaining markers of alternate phenotypes including immature endothelium.

Testicular hormone exposure during adolescence organizes flank-marking behavior and vasopressin receptor binding in the lateral septum.

Adolescence is a period during which many social behaviors emerge. One such behavior, flank marking, is a testosterone-modulated scent marking behavior that communicates dominance status between adult male Syrian hamsters. Testosterone modulates flank-marking behavior by altering neural transmission of vasopressin within a forebrain circuit. This study tested whether testicular hormones secreted during adolescence play purely a transient activational role in the display of flank-marking behavior, or whether adolescent steroid hormone secretions also cause long-term organizational changes in vasopressin binding within brain regions underlying flank-marking behavior. We tested this hypothesis by manipulating whether testicular secretions were present during adolescent development and then tested for flank-marking behavior and vasopressin receptor binding within the flank-marking neural circuit in young adulthood. Specifically, males were gonadectomized immediately before or after adolescence, replaced with testosterone 6 weeks following gonadectomy in young adulthood, and behavior tested 1 week later. Adult testosterone treatment activated flank-marking behavior only in males that were exposed to testicular hormones during adolescence. In addition, males exposed to testicular hormones during adolescence exhibited significantly less vasopressin receptor binding within the lateral septum than males deprived of adolescent hormones, suggesting that hormone-dependent remodeling of synapses normally occurs in the lateral septum during adolescence. These data highlight the importance of gonadal steroid hormone exposure during adolescence for the organization of neural circuits and social behavior.