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Colitis associated with biological agents

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World Journal of Gastroenterology 2012年第16期18卷 1871-1874页

作者： Hugh james Freeman Division of Gastroenterology Department of MedicineUniversity of British Columbia HospitalVancouverBCV6T 1W5Canada

In the past,there has been considerable focus on a host of drugs and chemicals that may produce colonic ***,a variety of new biological monoclonal antibody agents,usually administered by infusion,have appeared in the clinical realm over the last decade or so to treat different chronic inflammatory or malignant *** some of these agents,adverse effects have been documented,including apparently new forms of immune-mediated inflammatory bowel *** some,only limited symptoms have been recorded,but in others,severe colitis with serious complications,such as bowel perforation has been *** others,adverse effects may have a direct vascular or ischemic basis,while other intestinal effects may be related to a superimposed *** new onset cases of ulcerative colitis or Crohn's disease may also be attributed to the same agents used to treat these diseases,or be responsible for disease *** and well documented side effects have been observed with ipilimumab,a humanized monoclonal antibody developed to reduce and overcome cytotoxic T-lymphocyte antigen 4,a key negative feedback regulator of the T-cell anti-tumor *** agent has frequently been used in the treatment of different malignancies,notably,malignant *** effects with this agent occur in up to 40% and these are believed to be largely *** of these is a form of enterocolitis that may be severe,and occa-sionally,*** agents include rituximab(an antiCD20 monoclonal antibody),bevacizumab(a monoclonal antibody against the vascular endothelial growth factor) and anti-tumor necrosis factor agents,including infliximab,adalimumab and etanercept.

关键词： Biological agents Colitis Crohn's disease Inflammatory bowel disease Infliximab Ipilimumab Rituximab Ulcerative colitis

Proton pump inhibitors and an emerging epidemic of gastric fundic gland polyposis

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World Journal of Gastroenterology 2008年第9期14卷 1318-1320页

作者： Hugh james Freeman Department of Medicine (Gastroenterology) University of British ColumbiaVancouver V6T 1W5Canada

Fundic gland polyps are now commonly recognized during endoscopy. These polyps are benign, often multiple and usually detected in the gastric body and fundus. In the past, these polyps were sometimes associated with familial adenomatous polyposis. In recent years, it has become evident that increasing numbers of these polyps are being detected during endoscopic studies, particularly in patients treated with proton pump inhibitors for prolonged periods. In some, dysplastic changes in these polyps have also been reported. Recent studies have suggested that there may be no increase in risk of colon cancer with long-term proton pump inhibitor therapy. While temporarily reassuring, ongoing vigilance, particularly in those genetically predisposed to colon cancer, is still warranted.

关键词： Gastric polyps Fundic gland polyposis Gastric dysplasia Gastric cancer Colon polyps Familial polyposis coli Adenomatous polyposis coli gene mutation

Use of the Crohn's disease activity index in clinical trials of biological agents

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World Journal of Gastroenterology 2008年第26期14卷 4127-4130页

作者： Hugh james Freeman Department of Medicine(Gastroen-terology) University of British ColumbiaVancouverBritish Columbia V6T 1W5Canada

The Crohn＇s disease activity index （CDAI） has been commonly used to assess the effects of treatment with different agents in Crohn＇s disease （CD）. However, these studies may be compromised, if the results compared to a placebo or standard therapy group （in the absence of a placebo） substantially differ from the expected response. In addition, significant concerns have been raised regarding the reliability and validity of the CDAI. Reproducibility of the CDAI may be limited as significant inter-observer error has been recorded, even if measurements are done by experienced clinicians with expertise in the diagnosis and treatment of CD. Finally, many CDAI endpoints are open to subjective interpretation and have the potential for manipulation. This is worrisome as there is the potential for significant financial gain, if the results of a clinical trial appear to provide a positive result. Physicians caring for patients should be concerned about the positive results in clinical trials that are sponsored by industry, even if the trials involve respected centers and the results appear in highly ranked medical journals.

关键词： Crohn's disease Crohn's disease activity index Clinical trials Infliximab Adalimumab Corticosteroids Azathioprine

Recent advances in nanomaterials for high-performance Li–S batteries

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Journal of Energy Chemistry 2020年第8期29卷 86-106,I0004页

作者： james E.Knoop Seongki Ahn Joint School of Nanoscience and Nanoengineering North Carolina Agricultural and Technical State UniversityGreensboroNC 27401USA Research Organization for Nano and Life Innovation Waseda University513WasedatsurumakichoShinjuku-kuTokyo 162-0041Japan

This article reviews nanotechnology as a practical solution for improving lithium-sulfur batteries. Lithiumsulfur batteries have been widely examined because sulfur has many advantageous properties such as a high crustal abundance, low environmental impact, low cost, high gravimetric(2600 W h kg-1) and volumetric(2800 W h L-1) energy densities, assuming complete conversion of sulfur to lithium sulfide(Li2S)upon lithiation. However, lithium-sulfur batteries have not yet reach commercialization due to demerits involving the formation of soluble lithium polysulfides(Li2Sn, n=3–8), low electrical conductivity, and low loading density of sulfur. These issues arise mainly due to the polysulfide shuttle phenomenon and the inherent insulating nature of sulfur. To overcome these issues, strategies have been pursued using nanotechnology applied to porous carbon nanocomposites, hollow one-dimensional carbon nanomaterials, graphene nanocomposites, and three-dimensional carbon nanostructured matrices. This paper aims to review various solutions pertaining to the role of nanotechnology in synthesizing nanoscale and nanostructured materials for advanced and high-performance lithium–sulfur batteries. Furthermore, we highlight perspective research directions for commercialization of lithium–sulfur batteries as a major power source for electric vehicles and large-scale electric energy storage.

关键词： Nanotechnology Lithium–sulfur batteries Carbon nanomaterials Nanocomposite sulfur 3D nanostructured materials

Analysis of the Oscillatory Flows of Multiple Shock Waves in a Constant Area Duct

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Journal of Thermal Science 2024年第3期33卷 794-806页

作者： K james Jintu KIM Heuy Dong Department of Mechanical Engineering Andong National UniversityAndong36729Republic of Korea CAD-IT Korea Co. Ltd.Seoul08591Republic of Korea

The oscillatory response of multiple shock waves to downstream perturbations in a supersonic flow is studied numerically in a rectangular *** shock waves are formed inside the duct at a shock Mach number of *** duct has an exit height of H,and the effect of duct resonance on multiple shock oscillations is investigated by attaching exit ducts of lengths 0H,50H,and *** downstream disturbance frequency varied from 10 Hz to 200 Hz to explore the oscillation characteristics of the multiple shock *** oscillatory response of shock waves under self-excited and forced oscillation conditions are analyzed in terms of wall static pressure,shock train leading-edge location,shock train length,and the size of the separation *** extent of the initial shock location increases with an increase in exit duct length for the self-excited oscillation *** analysis of the shock train leading edge and the spectral analysis of wall static pressure variations are *** variation in the shock train length is analyzed using the pressure ratio method for self-excited as well as forced *** RMS amplitude of the normalized shock train length(ζ_(ST))increases with an increase in the exit duct length for the self-excited oscillation *** the downstream perturbation frequency is increased,ζ_(ST)is decreased for exit duct *** all exit duct designs and downstream forcing frequencies,the size of the separation bubble grows and shrinks during the shock oscillations,demonstrating the dependence on duct resonance and forced oscillations.

关键词： shock train downstream disturbance supersonic flow shock wave boundary layer interaction duct resonance flow separation

Adult autoimmune enteropathy

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World Journal of Gastroenterology 2008年第8期14卷 1156-1158页

作者： Hugh james Freeman Department of Medicine (Gastroenterology) University of British Columbia Vancouver BC Canada

Recent reports have suggested that autoimmune enteropathy involving the small bowel may occur in adults as well as in children. Apparently, the endoscopic and histological changes are similar to celiac disease before treatment, but these are not altered by any form of dietary restriction, including a gluten-free diet. As in celiac disease, histologic changes in gastric and colonic biopsies have also been recorded. Anti-enterocyte antibodies detected with immunofluorescent methods have been reported by a few laboratories, but these antibodies appear not to be specific and may simply represent epiphenomena. A widely available, reproducible and quantitative anti-enterocyte antibody assay is needed that could be applied in small bowel disorders that have the histological appearance of celiac disease, but fail to respond to a gluten-free diet.

关键词： Celiac disease Autoimmune enteropathy Anti-enterocyte antibodies Anti-goblet cell antibodies Antibodies in celiac disease

Adult eosinophilic gastroenteritis and hypereosinophilic syndromes

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World Journal of Gastroenterology 2008年第44期14卷 6771-6773页

作者： Hugh james Freeman Department of Medicine (Gastroen-terology) University of British ColumbiaVancouver V6T 1W5Canada

Eosinophilic gastroenteritis (EGE) in the adult is a distinctive pathologically-based disorder characterized by an eosinophil-predominant mucosal inflammatory process. Most often,the disorder is detected during endoscopic investigation for abdominal pain or diarrhea. Other causes of gastric and intestinal mucosal eosinophilia require exclusion,including parasitic infections and drug-induced causes. Occasionally,the muscle wall or serosal surface may be involved. EGE appears to be more readily recognized,in large part,due to an evolution in the imaging methods used to evaluate abdominal pain and diarrhea,in particular,endoscopic imaging and mucosal biopsies. Def inition of EGE,however,may be diffi cult,as the normal ranges of eosinophil numbers in normal and abnormal gastric and intestinal mucosa are not well standardized. Also,the eosinophilic inflammatory process may be either patchy or diffuse and the detection of the eosinophilic infiltrates may vary depending on the method of biopsy fixation. Treatment has traditionally focused on resolution of symptoms,and,in some instances,eosinophil quantification in pre-treatment and post-treatment biopsies. Future evaluation and treatment of EGE may depend on precise serological biomarkers to aid in defi nition of the long-term natural history of the disorder and its response to pharmacological or biological forms of therapy.

关键词： Eosinophils Eosinophilic gastroenteritis Eosinophilic gastritis Eosinophilic enteritis

Insurance coverage for male infertility care in the United States

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Asian Journal of Andrology 2016年第3期18卷 339-341,I0006页

作者： james M Dupree Department of Urology Divisions of Andrology and Health Services Research and Department of Obstetrics and Gynecology University of Michigan 1500 E Medical Center Drive 3875 Taubman Center SPC 5330 Ann Arbor M148109-5330 USA.

Infertility is a common condition experienced by many men and women, and treatments are expensive. The World Health Organization and American Society of Reproductive Medicine define infertility as a disease, yet private companies infrequently offer insurance coverage for infertility treatments. This is despite the clear role that healthcare insurance plays in ensuring access to care and minimizing the financial burden of expensive services. In this review, we assess the current knowledge of how male infertility care is covered by insurance in the United States. We begin with an appraisal of the costs of male infertility care, then examine the state insurance laws relevant to male infertility, and close with a discussion of why insurance coverage for male infertility is important to both men and women. Importantly, we found that despite infertility being classified as a disease and males contributing to almost half of all infertility cases, coverage for male infertility is often excluded from health insurance laws. Excluding coverage for male infertility places an undue burden on their female partners. In addition, excluding care for male infertility risks missing opportunities to diagnose important health conditions and identify reversible or irreversible causes of male infertility. Policymakers should consider providing equal coverage for male and female infertility care in future health insurance laws.

关键词： health policy insurance male infertility public policy

Refractory celiac disease and sprue-like intestinal disease

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World Journal of Gastroenterology 2008年第6期14卷 828-830页

作者： Hugh james Freeman Department of Medicine (Gastroenterology) University of British Columbia Vancouver BC Canada

Celiac disease is a gluten-dependent small intestinal mucosal disorder that causes malabsorption, often with diarrhea and weight loss. Diagnosis is based on detection of typical biopsy changes in the proximal small bowel, followed by evidence for an unequivocal response to a gluten-free diet. Refractoriness in celiac disease may be due to poor diet compliance, sometimes intentional, or consumption of ubiquitious sources of gluten. Alternatively, the original diagnosis may not be correct (eg., duodenal Crohn's disease), or a second cause for symptoms may be present (eg., collagenous colitis, functional bowel disorder). In some with recurrent symptoms, a complication may be present (eg., collagenous sprue, small bowel carcinoma, lymphoma). In some, a response to a gluten-free diet can not be unequivocally defined, and more precise historical terms have been used including "sprue-like intestinal disease" or "unclassified sprue". Although a "wastebasket diagnosis", these likely represent a heterogeneous group, and some, but not all, may develop lymphoma. Precise definition will be critical in the future as an array of new treatments, including biological agents, may emerge.

关键词： Refractory celiac disease Refractory sprue Unclassified sprue Celiac disease Intestinal lymphoma T-cell enteropabhy