Demaretta S Rush

Interests

Teaching

My expertise is in gynecologic pathology, but I am comfortable teaching any area of pathology.

Research

I am most interested in clinically applicable projects and collaborations with clinical colleagues. My recently concluded and ongoing projects include investigation of PAX8 staining patterns in cholangiocarcinoma, investigation of FOX03 expression in human ovarian tissue (in collaboration with reproductive endocrinology/gynecology and cell biology at the University of Florida), investigation of vigilin expression in breast cancer, investigation of the utility of fallopian tube cytology in gynecologic cancers, and molecular changes in flutamide treated patients (all in collaboration with gynecologic oncology at the University of Arizona), and correlation of radiographic and histopathologic findings in carotid artery plaques (in collaboration with radiology and vascular surgery at the University of Arizona.

Courses

Scholarly Contributions

Chapters

• Rush, D. S., & Wilkinson, E. J. (2019). Benign Disease of The Vulva. In Blaustein's Pathology of the Female Genital Tract, 7th ed.. Springer.
• Rush, D. S., & Wilkinson, E. J. (2019). Premalignant and Malignant Tumors of the Vulva. In Blaustein's Pathology of the Female Genital Tract, 7th ed.. Springer.

Journals/Publications

• Rush, D. S., Kinson, M. S., Santamaria Flores, E., Cardenas-Goicoechea, S. J., & Moawad, N. S. (2022). Occult Synchronous Bilateral Fallopian Tube Cancers: Hysterectomy and Bilateral Salpingectomy for a Benign Indication. Journal of Gynecologic Surgery, 38(2), 170-172. doi:10.1089/gyn.2021.0135
• Mogor, O., Hargrave, E., Rush, D., & Hatch, K. (2019). Mucinous adenocarcinoma of the endometrium with metastasis to the clitoral glans after pelvic exenteration for radiation resistant vaginal cuff recurrence. Gynecologic oncology reports, 27, 46-49.
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  Mucinous adenocarcinoma of the endometrium (MACE) is a rare subtype of endometrial adenocarcinoma that often presents a significant diagnostic challenge due to its variation from the conventional morphologic appearance of endometrioid epithelium. This case report is of a woman who has survived 4 years after pelvic exenteration and subsequent vulvectomy for recurrent MACE.
• Woo, H. H., Lee, S. C., Stoffer, J. B., Rush, D., & Chambers, S. K. (2019). Phenotype of vigilin expressing breast cancer cells binding to the 69 nt 3'UTR element in CSF-1R mRNA. Translational oncology, 12(1), 106-115.
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  Vigilin, a nucleocytoplasmic shuttling protein, post-transcriptionally suppresses proto-oncogene c-fms expression (encoding CSF-1R) in breast cancer by binding to a 69 nt cis-acting 3-UTR element in CSF-1R mRNA. CSF-1R is an important mediator of breast cancer development, metastasis, and survival. We confirm that vigilin decreases in vitro reporter luciferase activity as well as the translation rate of target mRNAs. We further explore the mechanism of suppression of CSF-1R. We show that the 69 nt binding element has profound effects on translation efficiency of CSF-1R mRNA, not seen in the presence of mutation of the element. Also, mutation of the 69 nt element in the CSF-1R mRNA 3'UTR both interferes with direct vigilin binding and obviates effect of vigilin overexpression on translational repression of CSF-1R. We show that stable vigilin binding requires the full length 69 nt CSF-1R element, including the 26 nt pyrimidine-rich core. Furthermore, titration of endogenous vigilin and other proteins which bind the 69 nt element, by exogenously introduced CSF-1R mRNA 3'UTR containing the pyrimidine-rich sequence, increases the adhesion, motility, and invasion of breast cancer cells. This phenotypic effect is not seen when the 69 nt element is deleted. Lastly, we are the first to show that human breast tissues exhibit strong vigilin expression in normal breast epithelium. Our pilot data suggest decreased vigilin protein expression, along with shift from the nucleus to the cytoplasmic location, in the transition to ductal carcinoma in situ.
• Amensag, S., Goldberg, L., O'Malley, K. A., Rush, D. S., Berceli, S. A., & McFetridge, P. S. (2017). Pilot assessment of a human extracellular matrix-based vascular graft in a rabbit model. Journal of vascular surgery, 65(3), 839-847.e1.
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  Herein we describe a small-diameter vascular graft constructed from rolled human amniotic membrane (hAM), with in vitro evaluation and subsequent in vivo assessment of its mechanical and initial biologic viability in the early postimplantation period. This approach for graft construction allows customization of graft dimensions, with wide-ranging potential clinical applicability as a nonautologous, allogeneic, cell-free graft material.
• Carpenter, A. M., Rush, D. S., & Moawad, N. S. (2017). The Curious Case of the Uterine Cyst. Journal of minimally invasive gynecology, 24(6), 884-885.
• Patel, V., Wilkinson, E. J., Chamala, S., Lu, X., Castagno, J., & Rush, D. (2017). Endometrial Thickness as Measured by Transvaginal Ultrasound and the Corresponding Histopathologic Diagnosis in Women With Postmenopausal Bleeding. International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists, 36(4), 348-355.
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  Endometrial thickness as measured by transvaginal ultrasound (TVUS) is being increasingly used as a first-line method to evaluate patients with vaginal bleeding. Our study aims to examine correlation between the histopathologic diagnosis and the results of TVUS and find a threshold that could reliably exclude carcinoma. We included women, age 55 years and above, who presented with postmenopausal bleeding and had a TVUS within 30 days of their endometrial biopsy. Total of 304 patients met our criteria and were divided into 4 groups. Patients in group A (n=198) had benign/atrophic endometrium, group B (n=44) had polyps, group C (n=30) had hyperplasia, and group D (n=32) had carcinoma. The endometrial thickness obtained by TVUS was compared with the histopathologic finding of the endometrial biopsy. The mean endometrial thickness was 7.5, 12.1, 14.8, and 16.9 mm for groups A to D, respectively. Statistical analysis showed that very low endometrial thickness (3 to 4 mm) would be ideal to use as a threshold to maximize sensitivity. Three of 32 patients in group D had an endometrial thickness ≤4 mm. At a threshold of 4 mm, the sensitivity is 90.6% and increases to 96.9% when decreasing the threshold to 3 mm. However, other parameters such as test accuracy, specificity, and positive predictive values are very low at these thresholds. Sensitivity can be maximized to 96.9% using a threshold of 3 mm. However, this would call into question the cost-effectiveness of this method. Postmenopausal bleeding remains the most reliable indicator of endometrial pathology.

Poster Presentations

• Rush, D., Morgan, L., & Bracamonte, E. R. (2022, October). A rare Case of Urorectal Septum Malformation Sequence. Society for Pediatric Pathology Annual Meeting. Rochester NY: SPP.
• Rush, D., & Meiklejohn, K. (2020, October). An Unusual Case of Placental Coccidiodomycosis. CAP Annual Meeting. Virtual: College of American Pathologists.
• Rush, D. S., Collinsworth, A., & Isom, J. A. (2018, March). PAX8 expression in cholangiocarcinoma. United States and Canadian Academy of Pathology Annual Meeting. Vancouver, BC, Canada: United States and Canadian Academy of Pathology.
• Rush, D., & Gupta, D. (2017, April). Unusual presentation of multifocal cardiac rhabdomyoma requiring orthotopic heart transplantation. International Society for Heart and Lung Transplantation annual meeting. San Diego: International Society for Heart and Lung Transplantation.
• Rush, D., Swenson, H. L., Nick, H., & Rhoton-Vlasak, A. (2017, March). FOX03A expression in human ovarian tissue samples. Society for Reproductive Investigation Annual Meeting. Orlando, FL: Society for Reproductive Investigation.
• Rush, D., Vertes, E., & Robert, A. A. (2017, February). Synchronous Endometrial Adenocarcinoma and Marginal Zone Lymphoma. Florida Society of Pathology Winter Meeting. Orlando, FL: Florida Society of Pathology.
• Rush, D. S., Kinson, M. S., Cardenas-Goicoechea, S. J., & Moawad, N. S. (2016, August/September). Bilateral primary fallopian tube carcinoma; a case report and review of the literature. Society of Laparoscopic Surgeons Annual Meeting. Boston: Society of Laparoscopic Surgeons.