bluuebunny/crossref_metadata_2025_split huggingface dataset:
Morphometric Analysis of Vertebral Growth Using Magnetic Resonance Imaging in the Normal Skeletally Immature Spine
Authors: Zhang Hong , Sucato Daniel J. , Nurenberg Pamela , McClung Anna 
Published: May 2010

Study Design.
Morphometic analysis of the thoracic and lumbar pedicle, vertebral body, and spinal canal in the normal infantile and juvenile patients using magnetic resonance imaging (MRI).

Objective.
To 3-dimensionally characterize the growth of the vertebral column in vivo and define the accurate dynamic growth rate of the normal immature spine.

Summary of Background Data.
There is a relationship between growth of the spine and the development of spinal deformity. Currently available information regarding vertebral column growth is remarkably limited and poorly defined. The detailed morphologic research is needed to obtain accurate data with regard to growth of the vertebra, including coronal, sagittal, and axial growth information for normal states.

Methods.
A total of 34 pediatric patients with a normal straight spine who had MRI from thoracic vertebra 1 to lumbar vertebra 5 were assigned to 3 groups: infantile group (n = 11), 0 to 3 years of age; juvenile-young group (n = 16), 4 to 7 years of age; and juvenile-old group (n = 7), 8 to 10 years of age. True transverse and midsagittal MRI images were used for pedicle (width and length), vertebral body (height, depth and width), and spinal canal area measurements.

Results.
The mean increase of the pedicle width and length was 0.7 mm (16%) and 3.2 mm (18%) from the infantile to the juvenile-young, and was 0.9 mm (15%) and 2.2 mm (11%) through the juvenile-old group. The mean increase of the vertebra body width, depth, and height were 3.6 mm (15%), 4.5 mm (27%), and 3.1 mm (27%), respectively, from the infantile to the juvenile-young, and were 2.9 mm (10%), 1.9 mm (9%) and 2.1 mm (15%), respectively, through the juvenile-old group. The mean increase of the spinal canal area was 41 mm2 (19%) from the infantile to the juvenile-young and was only 1.8 mm2 (0.7%) through the juvenile-old group.

Conclusion.
The current study established the growth of the pedicle, spinal canal, and vertebral body in vivo in a sample of normal pediatric subjects. The vertebral growth rate in the infantile and the juvenile-young period was significantly greater than that in the juvenile-old period. Spinal canal growth is associated with the growth of the pedicle width and has little growth after the juvenile-young period. Pedicle screw fixation would be unlikely to influence the size of the spinal canal after the early juvenile period, but may disturb the pedicle growth in length.
Evidence of Intestinal Inflammation in Patients With Cystic Fibrosis
Authors: Werlin Steven L , Benuri‐Silbiger Ishay , Kerem Eitan , Adler Sam N , Goldin Eran , Zimmerman Joseph , Malka Netta , Cohen Limor , Armoni Shoshana , Yatzkan‐Israelit Yardena , Bergwerk Ari , Aviram Micha , Bentur Lea , Mussaffi Huda , Bjarnasson Ingvar , Wilschanski Michael 
Published: May 2010

ABSTRACTObjectives:Treatment with pancreatic enzymes fails to completely correct malabsorption and gastrointestinal symptoms in patients with cystic fibrosis (CF). The aim of the present study was to examine the small intestine of patients with CF without overt evidence of gastrointestinal disease using capsule endoscopy (CE).Methods:Patients with CF received the agile patency capsule and, depending on the result of that procedure, then underwent standard CE using the PillCam SB capsule (Given Imaging, Yokneam, Israel). A stool specimen was taken on the same day as the CE for determination of the calprotectin level.Results:Forty‐two patients with CF ages 10 to 36 years were included; 29 had pancreatic insufficiency. One patient failed to excrete the patency capsule after 36 hours and was withdrawn from the study. Pulmonary function was mild to moderate with FEV1 68.5% ± 16% predicted. Review of the CE videos showed that most of the patients had varying degrees of diffuse areas of inflammatory findings in the small bowel including edema, erythema, mucosal breaks, and frank ulcerations. There were no adverse events. Fecal calprotectin levels were markedly high in patients with pancreatic insufficiency, 258 μg/g (normal <50).Conclusions:Small bowel mucosal pathology may be detected using CE in most of the patients with CF. The high fecal calprotectin levels found are suggestive of mucosal inflammation, which may correlate with the CE findings. Additional study is required to examine the possible relation of these mucosal lesions, which may be part of a newly identified enteropathy associated with CF, with persistent intestinal malabsorption in many of these patients.
Eosinophilic Oesophagitis in Infants and Children in the Region of Southern Denmark: A Prospective Study of Prevalence and Clinical Presentation
Authors: Dalby Kasper , Nielsen Rasmus G , Kruse‐Andersen Soren , Fenger Claus , Bindslev‐Jensen Carsten , Ljungberg Susanne , Larsen Kirsten , Walsted Anne‐Mette , Husby Steffen 
Published: May 2010

ABSTRACTObjective:Eosinophilic oesophagitis (EE) is a clinical entity characterised by a set of symptoms and eosinophilic infiltration of the oesophageal epithelium. Recent reports indicate that EE is increasingly diagnosed in paediatric patients. We aimed to evaluate the epidemiology of paediatric EE in a European population.Design:Infants and children in the Region of Southern Denmark were prospectively referred for further evaluation of symptoms of gastroesophageal reflux disease (GERD) after treatment failure with a proton pump inhibitor. The evaluation included endoscopy, 24‐hour oesophageal pH‐metry, histology of oesophageal biopsies, and investigations for food allergy (double‐blind, placebo‐controlled food challenge, skin prick test, S‐IgE antibodies, atopy patch test).Results:Of the 78 referred patients, 28 qualified for a diagnosis of GERD. Six children had >15 eosinophils per high‐power field in biopsies from the oesophageal mucosa and qualified for the diagnosis of EE. The median age at diagnosis was 9.6 years. In 4 of the 6 patients, food allergy was confirmed by double‐blind, placebo‐controlled food challenge. In the Region of Southern Denmark with a paediatric population of 256,164 between 0 and 16 years of age, a yearly incidence of EE of 0.16/10,000 was estimated.Conclusion:We report a European prospective study of EE. It was documented in 6 of 78 patients with symptoms of GERD corresponding to an annual incidence of 0.16/10,000 infants and children.
Congenital Diaphragmatic Hernia: Long‐term Risk of Gastroesophageal Reflux Disease
Authors: Peetsold Marieke G , Kneepkens CM Frank , Heij Hugo A , IJsselstijn Hanneke , Tibboel Dick , Gemke Reinoud JBJ 
Published: May 2010

ABSTRACTObjectives:Gastroesophageal reflux disease (GERD) is a well‐recognized consequence of congenital diaphragmatic hernia (CDH). Results of studies examining predictive factors for early and late GERD are inconclusive. The aim of this study was to assess the incidence of early (<2 years) and late GERD (≥6 years) following CDH repair and to identify predictive variables.Patients and Methods:Of 183 patients born with high‐risk CDH, 107 survived and 38 were excluded. Perinatal and postnatal data of 69 eligible patients were analysed to identify variables predictive for early GERD. For the follow‐up study, 58 patients (84%) (ages 12.1 ± 3.4 years; range 6–17) completed a standardised questionnaire. Results were compared with those from a healthy control group (n = 83). Patients who had a score indicating increased risk of GERD underwent further diagnostic assessment. Predictive factors for early and late GERD were identified using multivariate regression analysis.Results:Early GERD was demonstrated in 27 patients (39%). Patch closure and intrathoracic position of the stomach were independent predictive variables for early GERD. At the time of follow‐up, 9 of 58 patients (16%) had symptoms suggestive of GERD. In 7 patients (12%), late GERD was confirmed. For late GERD, however, no perinatal or postnatal risk factors were identified.Conclusions:Early GERD is more common in CDH patients with patch closure or intrathoracic position of the stomach. Predictive factors for late GERD could not be identified and screening for early GERD does not protect for future GERD; therefore, long‐term follow‐up for GERD in CDH survivors is mandatory.
Evidence of a Generalized Defect of Acinar Cell Function in Shwachman‐Diamond Syndrome
Authors: Stormon Michael O , Ip Wan F , Ellis Lynda , Schibli Susanne , Rommens Johanna M , Durie Peter R 
Published: May 2010

ABSTRACTBackground:Because the acinar cells of the exocrine pancreas in patients with Shwachman‐Diamond syndrome (SDS) are severely depleted, we hypothesized that a similar deficiency may be present in acinar cells of the parotid gland.Patients and Methods:We determined serum pancreatic isoamylase and parotid amylase activities in 16 patients with SDS, 13 healthy controls, and 13 disease controls (cystic fibrosis or fibrosing pancreatitis). Parotid amylase and electrolyte concentrations were measured in stimulated parotid gland secretions. Starch digestion was assessed by breath hydrogen testing in patients with SDS (with and without enzyme supplements) and healthy controls.Results:Serum pancreatic and parotid isoamylase values were lower in the patients with SDS than in the healthy controls (P < 0.0001 and P = 0.0002, respectively). Serum pancreatic isoamylase, but not parotid isoamylase, was significantly lower in the disease controls than in the healthy controls (P < 0.0001 and P = 0.17, respectively). Secreted parotid gland amylase concentration (units per milligram of protein) in patients with SDS was lower than that in the healthy controls (P = 0.04), whereas the disease controls were comparable to the healthy subjects (P = 0.09). Secreted parotid chloride concentration was inversely correlated with amylase concentration in the patients with SDS (P = 0.01), but no correlation was seen in the healthy controls or disease controls. When patients with SDS ingested starch without enzyme supplementation, their breath hydrogen excretion was significantly higher than that in the healthy controls (P = 0.009). Following starch ingestion with enzymes, breath hydrogen in the patients with SDS was lower (P < 0.05) than with no enzyme treatment, and no different from controls (P = 0.37).Conclusions:Mutations in the SBDS gene cause a generalized functional abnormality of exocrine acinar cells.
Impacts of selective logging on population structure and dynamics of a canopy tree (Olea capensis) in Kakamega forest
Authors: Tsingalia Mugatsia 
Published: May 2010

AbstractThis study assessed the impacts of logging on the population structure and dynamics of Elgon teak (Olea capensis), a canopy dominant in Kakamega forest. The objective was to ascertain and determine the regeneration status of this tree species in view of its commercial value. A comparison was made between logged and unlogged sections at three sites in the forest. Pairwise comparisons of the differences in the population structure among three sites and the differences in the mean tree size revealed significant differences in all three study sites. Results also revealed a variation in stem density that was dependent on the block of forest under study. Results of the spatial contagion revealed that O. capensis had a varied clumped distribution in all the study sites. Clumping was highest in the Kisere forest. These results point to logging as the major factor that explains the differences in population structure and stem density in different parts of Kakamega forest. And while intermittent recruitment may explain clumped distribution, logging appears to explain the variation in the degree of clumping.
The activity of an insectivorous bat Neoromicia nana on tracks in logged and unlogged forest in tropical Africa
Authors: Monadjem Ara , Ellstrom Magnus , Maldonaldo Cristina , Fasel Nicolas 
Published: May 2010

AbstractLogging activities and the associated creation of roads and tracks can disturb and fragment forests, which may lead to a loss of forest‐dependent species and possibly favour nonforest generalists and edge species. The effects of such disturbance are poorly known for African insectivorous bats. We studied the activity patterns of insectivorous bats in a tropical African forest at Kibale National Park, Uganda, using an Anabat bat detector. The echolocation calls of the vespertilionid bat Neoromicia nana were the most frequently detected. This species was most active in the first 5 h after sunset with activity declining rapidly after midnight until sampling finished at 01:00 h. There was no difference in activity of N. nana levels between logged or undisturbed forest; however, this species exhibited higher levels of activity along the wide tracks running through the two forests than either 30 m off these tracks or along the narrow forest trails. The wing morphology and echolocation call of N. nana may be constraining it to flying in uncluttered space on the edge of the forest, penetrating mostly along wider tracks and roads. Further research (in particular radio‐telemetry) is required to test and validate these data.
Intra‐arterial therapy with cisplatin suspension in lipiodol and 5‐fluorouracil for hepatocellular carcinoma with portal vein tumour thrombosis
Authors: Nagamatsu H. , Hiraki M. , Mizukami N. , Yoshida H. , Iwamoto H. , Sumie S. , Torimura T. , Sata M. 
Published: May 2010

Aliment Pharmacol Ther 2010; 32: 543–550SummaryBackground  Portal vein tumour thrombosis is a negative prognostic factor for hepatocellular carcinoma (HCC).Aim  To assess the efficacy of cisplatin in lipiodol emulsion combined with 5‐fluorouracil (5‐FU) for patients with HCC and portal vein tumour thrombosis.Methods  The study subjects were 51 patients with the above‐specified criteria who received injection of cisplatin suspension in lipiodol emulsion followed by intra‐arterial infusion of 5‐FU. The primary objective was to determine tumour response to the treatment, while the secondary objectives were safety and tolerability. Independent factors for survival were also assessed.Results  Ten patients had complete response and 34 patients had partial response (response rate, 86.3%). The median survival for all 51 patients was 33 months, while that for 10 complete response patients and 21 patients who showed disappearance of HCC following additional therapies was 39 months. The single factor that significantly influenced survival was therapeutic effect. Treatment was well tolerated and severe toxicity was infrequent, with only grade 3 toxicity (thrombocytopenia) in one patient.Conclusions  The present study demonstrated the efficacy of hepatic arterial infusion chemotherapy using cisplatin‐lipiodol emulsion and 5‐FU without serious adverse effects in patients with unresectable HCC and portal vein tumour thrombosis.
Treatment of ulcerative colitis with adalimumab or infliximab: long‐term follow‐up of a single‐centre cohort
Authors: Gies N. , Kroeker K. I. , Wong K. , Fedorak R. N. 
Published: May 2010

Aliment Pharmacol Ther 2010; 32: 522–528SummaryBackground  Randomized, controlled trials have demonstrated that anti‐TNF agents are efficacious in inducing remission in cases of Crohn’s disease and ulcerative colitis. However, response rates for anti‐TNF agents in ‘real life’ clinical practice are less well‐defined.Aims  To examine the response rates and long‐term outcomes of infliximab and adalimumab treatment for out‐patients with ulcerative colitis and to study the variables associated with response rates.Methods  In a prospective study, a single‐centre out‐patient cohort was treated and followed up according to a structured protocol of clinical care. Response to treatment was assessed using a physician’s global assessment that focused on normalization of bowel frequency, absence of blood with defecation and tapering of corticosteroids to zero.Results  Fifty‐three ulcerative colitis patients were included in the study. Responses to induction therapy were 96.4% (27/28) for infliximab and 80% (20/25) for adalimumab (P = 0.0889). Responses to maintenance therapy were similar: infliximab 77.8% (14/18) and adalimumab 70.0% (14/20) (P = 0.7190). Multivariate analyses of the induction and maintenance responses did not reveal confounding elements. No new safety signals were identified.Conclusions  This long‐term follow‐up of a single‐centre cohort of ulcerative colitis patients demonstrates that ‘real‐life’ out‐patient treatment with infliximab and adalimumab is effective in induction and maintenance of response.
New genetic variant that might improve warfarin dose prediction in African Americans
Authors: Schelleman Hedi , Brensinger Colleen M. , Chen Jinbo , Finkelman Brian S. , Rieder Mark J. , Kimmel Stephen E. 
Published: May 2010

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT Variants in the CYP2C9 (i.e. *2 and *3) and VKORC1 (i.e. 1173C/T or −1639G/A) genes have been shown to influence warfarin dose requirements. However, these factors seem to explain less of the dose variability in African Americans who have a lower prevalence of the CYP2C9*2 and *3 and VKORC1 1173T alleles. WHAT THIS STUDY ADDS In African Americans, the VKORC1 rs17886199 variant was statistically significantly associated with log‐transformed warfarin maintenance dose, independent of the influence of VKORC1 1173C>T and CYP2C9*2 and *3. However, replication of our finding is needed to confirm the association of rs1786199 SNP in African Americans, since Limdi et al.[3] did not examine the effect of this SNP because the prevalence of the rs1786199 A‐allele was too low.AIMSTo raise hypotheses with regards to whether genetic variants in the VKORC1, CYP2C9, EPHX1, GGCX and ALB genes might influence warfarin dose in African Americans and Caucasians, independent of the effects of the VKORC1 1173C>T and CYP2C9*2 and *3 variants.METHODSFrom a prospective cohort study, we obtained additional DNA on 36 Caucasian and 22 African American warfarin users who reached maintenance dose and genotyped them for tagSNPs (r2 < 0.8) in VKORC1, EPHX1, GGCX and ALB genes, and one exonic CYP2C9 SNP. Linear regression models were fitted to estimate the relationship (P value) between log‐transformed maintenance dose and each SNP and the amount of the warfarin dose variability accounted for by each SNP (partial R2).RESULTSIn African Americans, the VKORC1 rs17886199 A‐allele was associated with a lower dose (GG = 46.3 mg and GA = 25.6 mg; P= 0.002), independent of the VKORC1 1173C>T and CYP2C9*2 and *3 variants. Even after applying Bonferroni correction, the P value would still be considered statistically significant. The VKORC1 rs17886199 variant was not found in Caucasians. In Caucasians, the EPHX1 rs1051741 T‐allele was associated with a lower dose (CC = 41.3 mg and CT = 30.0 mg; P= 0.04). The latter was no longer statistically significant after applying Bonferroni correction.CONCLUSIONSOur pilot study suggests that the VKORC1 rs17886199 variant could influence warfarin maintenance dose among African Americans, even after accounting for the influence of the VKORC1 1173C>T variant. Future studies with a larger sample size will be needed to confirm our findings.
Influence of methotrexate exposure on outcome in patients treated with MBVP chemotherapy for primary central nervous system lymphoma
Authors: Blasco Hélène , Senecal Delphine , Le Gouge Amélie , Pinard Emmanuelle , Benz‐de Bretagne Isabelle , Colombat Philippe , Hulot Jean‐Sébastien , Chatelut Etienne , Le Guellec Chantal 
Published: May 2010

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT Although treated using the same high‐dose methotrexate (HD‐MTX)‐based multiagent chemotherapy, patients with primary central nervous system lymphoma (PCNSL) have significant differences in outcome. However, little information has been published about factors influencing outcome in PCNSL. As it is known that the pharmacokinetics of MTX vary considerably between subjects leading to different exposure in patients receiving the same dose, it is important to evaluate its role in response to chemotherapy. WHAT THIS STUDY ADDS This study is the first to evaluate the exposure–response relationship in patients treated with MBVP chemotherapy. We found that patients who were early non‐responders to MBVP chemotherapy had poor survival, whatever the salvage regimen. Tumour response at early evaluation was not associated with MTX pharmacokinetics and increasing the dose would probably not improve results.AIMSAlthough the standard treatment for primary central nervous system lymphoma (PCNSL) consists of three cycles of MBVP (methotrexate, BCNU, VP16, methylprednisolone) and radiotherapy, early failure of treatment may require modification of the treatment. However, our understanding of the outcome in such patients and of the factors involved in early failure of treatment is poor. In addition to known prognostic factors, we evaluated the influence of methotrexate (MTX) exposure on the response to MBVP chemotherapy in patients treated for PCNSL after the first two cycles.METHODSWe retrospectively analyzed all patients with PCNSL treated with the MBVP regimen over the previous 10 years. Clinical, personal data and known prognostic factors were studied. The parameters of MTX exposure were estimated using a population pharmacokinetic approach with NONMEM. Objective response (OR), overall survival (OS) and failure‐free survival (FFS) were evaluated in all patients.RESULTSThirty‐seven patients were studied. We observed lower FFS and OS (0.49 years) in patients who were not able to receive the planned treatment (group 1, n= 12) than in those who received three cycles (8.04 years) (group 2, n= 25). Known prognostic factors were comparable in both groups, but mean dose of MTX and mean AUC tended to be lower in patients who failed prematurely or showed no response after two cycles.CONCLUSIONSWe found that patients who were early non‐responders to MBVP chemotherapy had poor survival, without major influence of MTX exposure. It is thus probably unlikely that increasing the dose of MTX would improve outcome.
What do asthmatics have to fear from food and additive allergy?
Authors: Gillman A. , Douglass Jo A. 
Published: May 2010

SummaryInternational studies report marked increases in the prevalence of food allergy, along with increases in hospital admissions and emergency presentations for severe allergic reactions due to foods. The prevalence of self‐reported food allergy is common, but generally exceeds that which can be verified from challenge studies, although nut allergies appear to be an important exception to this rule. Studies examining food allergy deaths suggest that those who die of food allergy usually have co‐existent asthma. Adolescents and young adults are at most risk, and adrenaline auto‐injectors are sub‐optimally used. Food chemical sensitivity is very commonly reported but not usually verified by challenge testing. However, the exception to this is sulphite sensitivity, which can elicit reproducible reactions in some. The increasing prevalence of severe food allergies and awareness of its risk in those with asthma demands an especially rigorous approach to the diagnosis and management of co‐existent food allergy and asthma, especially in young people who appear to be at most risk from death from severe food allergy. Cite this as: A. Gillman and Jo A. Douglass, Clinical & Experimental Allergy, 2010 (40) 1295–1302.