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Plasma Citrulline Concentrations in Neonates and Infants with or without Gastrointestinal Disease and Bowel Resection

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Food and Nutrition Sciences 2016年第12期7卷 1063-1069页

作者： Oscar R. Herrera Michael C. Storm Richard A. Helms Department of Clinical Pharmacy University of Tennessee Health Science Center Memphis TN USA State of Tennessee Center of Excellence in Pediatric Pharmacokinetics and Therapeutics Memphis TN USA Department of Pediatrics University of Tennessee Health Science Center Memphis TN USA

Various studies have shown a role for citrulline as a gut mass biomarker in patients with short bowel syndrome. Our hypothesis is that plasma citrulline is both a gastrointestinal (GI) function and a gut mass marker. Our objective was to validate previous observations, by prospectively analyzing plasma citrulline concentrations in patients with GI disease with or without bowel resection, compared to patients without GI disease. Plasma from blood samples of parenteral nutrition fed neonates and infants was obtained. Samples were analyzed by ion-exchange chromatography. Data collected included age, diagnoses and surgical documentation of bowel resection. Patients were classified into 3 main groups: those without GI disease nor resection (Group 1), those with GI disease but no resection (Group 2), and those with GI disease and resection (Group 3). Group medians were compared using Kruskal-Wallis ANOVA. Seventeen samples were evaluated. Patients in Group 3 were older compared to patients in Groups 1 and 2;median age (in days) 156 vs. 12 vs. 57 respectively. Median (range) plasma citrulline concentrations were 20.9 (14.9 - 29.0) μmol/L, 8.7 (0.5 - 20.0) μmol/L and 9.6 (5.9 - 13.2) μmol/L for Groups 1, 2 and 3 respectively. There were significant differences among medians and sample distributions between Groups 1 and 2 and between 1 and 3 (p < 0.05). No differences were observed between Groups 2 and 3. Patients without GI disease and no resection had significantly higher plasma citrulline concentrations than patients with GI disease with or without resection at the time of assessment.

关键词： Plasma Citrulline Gastrointestinal Function Biomarker Neonates Infants Parenteral Nutrition

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The Application and Indications for Sentinel Lymph Node Biopsy in Pediatric Solid Tumors: Current Status and Future Directions

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International Journal of Clinical Medicine 2014年第18期5卷 1130-1141页

作者： Nathan M. Hinkle Alpin D. Malkan John A. Sandoval Department of Surgery St. Jude Children’s Research Hospital Memphis USA Department of Surgery University of Tennessee Health Science Center Memphis USA

Oncologic staging of many solid organ malignancies involves an understanding of how cancers spread via the lymphatic system, and ultimately may involve evaluation of the primary nodal drainage basin by performing a sentinel lymph node biopsy. In the adult population, there are well established indications for sentinel lymph node biopsy in diseases like melanoma and breast cancer. However, its use and relevance in the pediatric population is less defined. This review details the history and development of sentinel lymph node biopsy technique, advanced lymph node mapping techniques currently under investigation, and the applications of sentinel node biopsy towards childhood cancers.

关键词： Sentinel Lymph Node Biopsy Pediatric Melanoma Spitz Nevus Atypical Spitzoid Tumor Spitzoid Melanoma Rhabdomyosarcoma Nonrhabdomyosarcoma Soft Tissue Sarcoma Breast Cancer

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Emergence of New Injectable Lipid Emulsions in the USA: Guidance for Pediatric Clinicians

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Food and Nutrition Sciences 2019年第7期10卷 823-833页

作者： Oscar R. Herrera Lisa A. Caviness Richard A. Helms Department of Clinical Pharmacy and Translational Science University of Tennessee Health Science Center Memphis TN USA State of Tennessee Center for Pediatric Experimental Therapeutics Memphis TN USA Department of Pediatrics University of Tennessee Health Science Center Memphis TN USA

With the advent of new, particularly mixed-oil lipid emulsions approved by the United States Food & Drug Administration (FDA), clinicians have more options when choosing one as part of the parenteral nutrition support of patients. Lipid products long-standing availability in Europe and other parts of the world has certainly facilitated the process in the United States, where there was little evolution before 2014. These newer oil-based emulsions are finding their way to be used in pediatrics, as studies are being carried out that will result in pediatric labeling. Pediatric clinicians may find themselves wondering how these lipid emulsions are different from those that have come before;whether the same dosing or administration practices apply as with the traditional soybean-oil lipid emulsion, and if they can be used for other more emergent interventions. We present this review of the current lipid emulsions available in the U.S. market, highlighting the differences among them, as well as, providing some practical information for clinicians that can assist them in their day-to-day duties.

关键词： Lipid Emulsions Fatty Acids Parenteral Nutrition Pediatrics

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地震作用下钢筋混凝土桥梁结构易损性分析

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土木工程学报 2004年第6期37卷 47-51页

作者： H.Hwang 刘晶波 The memphis University美国清华大学

针对缺乏桥梁结构地震破坏数据的地区 ,考虑地震地面运动、局部工程场地条件和桥梁本身参数的不确定性 ,给出了一种地震作用下钢筋混凝土结构易损性曲线的系统性分析方法 ,对美国中东部受NewMadrid地震带影响的高速公路系统混凝土连续... 详细信息

针对缺乏桥梁结构地震破坏数据的地区 ,考虑地震地面运动、局部工程场地条件和桥梁本身参数的不确定性 ,给出了一种地震作用下钢筋混凝土结构易损性曲线的系统性分析方法 ,对美国中东部受NewMadrid地震带影响的高速公路系统混凝土连续桥梁结构易损性进行分析 ,并给出了桥梁结构的易损性曲线 ,表明本文方法对该类地区桥梁结构的易损性分析具有适用性。

关键词：桥梁混凝土地震易损性曲线回归分析不确定性

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Incidence of Parenteral Nutrition-Associated Liver Disease in Infants on Prolonged Parenteral Nutrition with a Soybean-Based Lipid Emulsion: A 7-Year Experience

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Food and Nutrition Sciences 2020年第10期11卷 899-910页

作者： Catherine M. Crill Oscar R. Herrera Lindsay H. Stuart Michael L. Christensen Department of Clinical Pharmacy and Translational Science University of Tennessee Health Science Center Memphis Tennessee USA Pharmacy Department Le Bonheur Children’s Hospital Memphis Tennessee USA Department of Pediatrics University of Tennessee Health Science Center Memphis Tennessee USA

Parenteral nutrition associated liver disease (PNALD) is a significant complication in infants receiving long-term parenteral nutrition (PN). Chronic administration of PN has been associated with its development. Our purpose is to characterize our incidence of PNALD over an extended period and identify risk factors for its development, including administration of soybean-based injectable lipid emulsions (ILEs) as we transit to novel ILEs in our practice. Infants receiving 30 days or more of PN were included. PNALD was defined as a direct bilirubin ≥ 2 mg/dL. Data collected included: patient demographics, clinical and enteral feeding characteristics. Macronutrient intake was recorded using these cut-offs: glucose infusion rate (GIR) of ≤14 mg/kg/min or above, protein doses of ≤3 g/kg/day or above and lipid doses of ≤2 g/kg/day or above. A total of 349 infants were included, with an annual incidence of PNALD ranging between 34% - 54%. Infants with PNALD were younger by gestation (27 vs. 29.5 weeks) and smaller by birthweight (900 vs. 1248 grams). Sepsis, GI disease including necrotizing enterocolitis and bowel resection were significantly associated with an increased risk for development of PNALD. PNALD infants received lower protein doses (3.0 vs 3.3 g/kg/day, p = 0.014) while receiving higher GIR (11.4 vs 10.7 mg/kg/min, p = 0.012) compared to non-PNALD infants. Low birth weight, sepsis and bowel resection remain strong indicators of risk for PNALD. No single macronutrient increased our infants’ risk for PNALD. The use of newer ILEs when available should be evaluated for their impact on PNALD development.

关键词： Parenteral Nutrition Infants Lipid Emulsions Liver Disease Cholestasis

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The timing of reproduction in Florida Scrub-jays: the effect of supplemental food

The timing of reproduction in Florida Scrub-jays: the effect...

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23rd International Ornithological Congress

作者： Stephan J.Schoech Reed Bowman Dept. of Biology Univ. Memphis Memphis TN 38152 USA Archbold Biological Station Lake Placid FL 33862 USA

＜正＞ An ongoing study of Florida Scrub-Jays （Aphelocoma coerulescens） found that jays in their natural habitat at Archbold Biological Station （ABS） always began to breed later and to exhibit much more inter-year variation in the time of first laying than jays in an urban environment nearby. Between-population comparisons of blood chemistry in breeding females suggested that access to high protein food played a role in early breeding in the

关键词： food supplementation clutch initiation anthropogenic food food values

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The Presenting Symptom of Metastatic Prostate Carcinoma: Case of a Large Supraclavicular Mass and Review of Literature

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International Journal of Otolaryngology and Head & Neck Surgery 2013年第5期2卷 207-210页

作者： Cory A. Vaughn Kaitlin R. Jaqua Ryan K. Meacham Fransisco Vieira Department of Otolaryngology Head & Neck Surgery University of Tennessee Memphis USA MD Candidate University of Tennessee Health Science Center Memphis USA

Prostate cancer is the most common noncutaneous malignancy of American males and typically presents with genitourinary symptoms, however, head and neck extension is a rare finding. We present a case of a 53-year-old male initially presenting with a large supraclavicular mass as the only complaint. After an initial non-diagnostic FNA biopsy, PSA levels, histology and immunohistochemical findings were consistent with metastatic prostatic adenocarcinoma. The patient was started on anti-hormonal treatment after diagnosis. Due to the increasing reports of such cases, we suggest PSA levels and appropriate immunohistochemical staining should be obtained on all unknown neck masses.

关键词： Neck Mass Prostate Adenocarcinoma Metastasis

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Evaluation and Management of Massive Endotracheal Hemorrhage in Pediatric Patients: A Case Report and Review of Literature

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International Journal of Otolaryngology and Head & Neck Surgery 2013年第6期2卷 236-239页

作者： Cory Vaughn Mona Shete Rose Mary Stocks Jerome Thompson University of Tennessee Health Science Center Memphis USA

Massive hemoptysis is a frightening and life-threatening event in children. Prompt, aggressive evaluation and management are necessary. The most common cause of hemoptysis in a pediatric patient is infectious, but other various etiologies including tracheotomy related problems, cystic fibrosis, bronchiectasis, congenital anomalies of the cardiopulmonary vasculature and suction trauma must be considered as well. Presented is a report of a case of acute, massive endotracheal hemorrhage with multiple methods of management including balloon tamponade, highly selective embolization, and mainstem occlusion. This case is an addition to our previously reported case series of nine pediatric patients with massive pulmonary hemorrhage. Various diagnostic and management techniques of hemoptyis in pediatric patients are discussed with an extensive review of the literature.

关键词： Pediatric Massive Hemoptysis Endotracheal Tube Management

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Diabetic foot ulcer:A comprehensive review of pathophysiology and management modalities

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World Journal of Clinical Cases 2023年第8期11卷 1684-1693页

作者： Joel M Raja Miguel A Maturana Sharif Kayali Amir Khouzam Nephertiti Efeovbokhan Department of Internal Medicine University of Tennessee Health Science CenterMemphisTN 38119United States Department of Cardiology NEA Baptist JonesboroJonesboroAR 72401United States

Diabetic foot ulcer (DFU) is a debilitating and severe manifestation ofuncontrolled and prolonged diabetes that presents as ulceration, usually locatedon the plantar aspect of the foot. Approximately 15% of individuals with diabeteswill eventually develop DFU, and 14%-24% of them will require amputation ofthe ulcerated foot due to bone infection or other ulcer-related complications. Thepathologic mechanisms underlying DFU are comprise a triad: Neuropathy,vascular insufficiency, and secondary infection due to trauma of the *** local and invasive care along with novel approaches like stem celltherapy pave the way to reduce morbidity, decrease amputations, and preventmortality from DFU. In this manuscript, we review the current literature withfocus on the pathophysiology, preventive options, and definitive management ofDFU.

关键词： Diabetes Ulcer Foot Antibiotics Revascularization Cell therapy

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Modulation of Oxidative Stress Responses by Vitamin E, or Vitamin A plus Vitamin C Treatment in Human Retinal Pigment Epithelial Cells

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Natural Science 2015年第12期7卷 558-570页

作者： Jinggang Yin Christina S. Winborn Fridtjof Thomas Quynh T. Tran John C. Lang Edward Chaum From the Departments of Ophthalmology University of Tennessee Health Science Center Memphis USA Preventive Medicine University of Tennessee Health Science Center Memphis USA Department of Chemistry and Biochemistry University of Texas at Arlington Arlington USA Anatomy and Neurobiology University of Tennessee Health Science Center Memphis USA

The purpose of this study was to characterize the potential of vitamins to protect the retinal pig-ment epithelium (RPE) from oxidative stress (OS). We have previously shown that OS induces the expression of AP1 transcription factors (FOSB, CFOS and ATF3), but is modulated by pretreatment with vitamin C (200 μM). We propose that OS-induced AP1 expression can be used as a biomarker of OS to test the efficacy of vitamins to limit the impact of OS in the RPE. Here we examined the efficacy of vitamin E or combined vitamin A plus vitamin C to modulate OS-induced AP1 expression in the RPE. We pretreated human ARPE-19 cells with vitamin E (0 - 7.5 μM) or with combined vitamin A (10 or 15 μM) plus vitamin C (50 or 100 μM) for 3 days prior to exposure to 500 μM H2O2 OS for 1 - 4 h. AP1 expression was assessed using qRT-PCR. Pretreatment with ≥2.5 μM vitamin E significantly decreased OS-induced AP1 expression at 1 - 4 h OS, compared to controls. Lower doses of vitamin E were ineffective at modulating OS responses. Pretreatment with 100 μM vitamin C combined with 15 μM vitamin A protected RPE cells from OS-induced AP1 expression. There is an additive and potentially protective effect of 100 μM vitamin C and 15 μM vitamin A on FOSB expression at 4 h, and a potentially protective effect of 100 μM vitamin C and 15 μM vitamin A on CFOS expression at 1 h OS. A protective effect was also seen with 15 μM vitamin A pretreatment alone on ATF3 expression. Thus, “sub-therapeutic” levels of multiple vitamins may protect RPE cells better than higher doses of a single vitamin. This OS-induced AP1 expression biomarker assay may be useful to identify complex antioxidant formulations as therapeutics for degenerative diseases that are thought to be caused by OS, like age-related macular degeneration.

关键词： Vitamin Supplementation AP1 Transcription Factors Oxidative Stress Retinal Pigment Epithelium Age-Related Macular Degeneration

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