The University of Maryland School of Medicine (abbreviated UMSOM), located in Baltimore City, Maryland, U.S., is the medical school of the University of Maryland, Baltimore and is affiliated with the University of Maryland Medical Center and Medical System. Established in 1807 as the College of Medicine of Maryland, it is the first public and the fifth oldest medical school in the United States. It was also the first medical school to institute a residency training program. UMB SOM's campus includes Davidge Hall, which was built in 1812, and is the oldest building in continuous use for medical education in the Northern Hemisphere.In addition to an MD degree, the UMB SOM offers PhD programs through the Graduate Program in Life Sciences. It also offers several joint degree programs: a Medical Scientist Training Program (MSTP) MD/PhD, a joint MD/DDS (Doctor of Dental Surgery), the MD/MPH (Master of Public Health) program, and the PhD/DPT (Doctor of Physical Therapy). The University of Maryland School of Medicine was ranked 12th in U.S. News and World Report's 2021 rankings of "Best Medical Schools: Primary Care", and 34th in "Best Medical Schools: Research". In 2013, the school offered admission to 6.3% of applicants. Since 2006, the medical school dean has been E. Albert Reece.
Elderly patients exhibit heightened susceptibility to postoperative complications following general anesthesia and surgery, yet the molecular mechanisms driving this age-dependent vulnerability remain poorly defined. We performed RNA sequencing on olfactory bulb (OB), hippocampus (HI), lung, and spleen from young (3-month, m), late middle-aged (17 m), and geriatric (27 m) male C57BL/6 mice 24 h after 2 h of exposure to isoflurane anesthesia and laparotomy (ISO/OP). Short-term ISO/OP elicited pronounced, age-dependent transcriptional remodeling across tissues. Late middle-aged mice exhibited robust activation of stress- and metabolism-associated pathways in the OB and HI, accompanied by suppression of lipid, synaptic, and structural maintenance programs. In contrast, young adults displayed limited responses, characterized by modest and adaptive synaptic remodeling in the HI. Peripheral organs showed a parallel age-dependent divergence. Late middle-aged mice exhibited amplified immune and inflammatory signaling in the lung and spleen alongside suppression of structural, regulatory, and metabolic homeostatic programs, whereas young adults demonstrated attenuated, metabolically adaptive transcriptional responses. Circulating extracellular vesicles (EVs) mirrored tissue-level shifts, indicating a systemic transition from adaptive plasticity in 3 m to stress and immune dominant signaling by 17 m. Geriatric mice displayed a distinct response pattern, characterized by activation of stress and detoxification programs in brain tissues, altered circadian gene expression in lung and spleen, and extensive remodeling of EV protein cargo enriched for inflammatory and growth factor-related signatures. Together, these findings indicate that late middle-age is associated with amplified peri-anesthetic biological reactivity across central and peripheral systems, suggesting an under-recognized window for perioperative risk stratification and preventative intervention.
Advances in understanding the molecular landscape of gastroesophageal junction (GEJ) adenocarcinoma underscore the need for biomarker-driven treatment approaches. The Society of Surgical Oncology (SSO) Gastrointestinal (GI) Disease Site Working Group has developed practice guidelines for the biomarker-based management of nonmetastatic GEJ adenocarcinoma, with specific integration of microsatellite instability (MSI) status. Although multimodal therapy has improved outcomes, treatment strategies for GEJ adenocarcinoma remain largely stage-based rather than biomarker-directed. With emerging evidence supporting the prognostic and predictive roles of MSI-high (MSI-H), human epidermal growth factor receptor 2 (HER2), and other novel targets, there is an urgent need for clear guidance on how to incorporate biomarkers into the management of resectable disease. These guidelines provide evidence-based recommendations to support precision oncology in GEJ cancer care.
Transglutaminase 2 (TG2) expression is required for epidermal squamous cell carcinoma cancer stem cell survival. However, the molecular signaling mechanisms triggered by TG2 that mediate this survival action are not well understood. Here we show that TG2 is constitutively expressed in ECS cells, where it interacts with α6/β4 integrin to stimulate FAK and Src signaling, leading to PI3K activation of phosphoinositide-dependent kinase 1 (PDK1). PDK1 inhibits Hippo signaling, leading to enhanced nuclear accumulation of YAP1, which interacted with and stabilized ΔNp63α to enhance epidermal squamous cell carcinoma spheroid formation, invasion, and migration. Overall, these findings suggest that constitutive TG2 expression results in stabilization of ΔNp63α, leading to maintenance of cancer stem cell properties and enhanced tumor formation. Cancer Res; 76(24); 7265-76. ©2016 AACR.
Medullary thyroid cancer (MTC) is a rare neuroendocrine malignancy arising from parafollicular C cells. Diagnosis is based on cytologic and histologic features, supported by biochemical testing for calcitonin and carcinoembryonic antigen, RET germline testing, and appropriate imaging. This educational review, developed by the Society of Surgical Oncology's Endocrine and Head and Neck Disease Site Working Group, provides an updated overview of the diagnosis and management of MTC, emphasizing evolving surgical principles and the integration of targeted therapies. Ongoing multidisciplinary collaboration and participation in clinical trials remain essential to further refine prognostic tools, optimize treatment sequencing, and improve patient outcomes in MTC.
Hyperosmolar hyperglycemic state (HHS) is an underrecognized diabetic emergency with high morbidity and mortality. Many features of HHS overlap with those of diabetic ketoacidosis but key differentiators for HHS are serum osmolality greater than 320 mOsm/kg, lack of metabolic acidosis, and minimal to no presence of ketones. HHS is often triggered by an underlying illness-most commonly infection but may also be triggered by stroke, acute coronary syndrome, and other acute illnesses. Treatment guidelines recommend aggressive volume-repletion of osmotic losses in addition to insulin therapy, plus treatment of the underlying cause.
