Anatomy Commons^™

Parent- Versus Child-Reported Functional Health Status After The Fontan Procedure., Linda M. Lambert, L Luann Minich, Jane W. Newburger, Minmin Lu, Victoria L. Pemberton, Ellen A. Mcgrath, Andrew M. Atz, Mingfen Xu, Elizabeth Radojewski, Darlene Servedio, Brian W. Mccrindle, Pediatric Heart Network Investigators, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: We sought to compare perceptions of functional health status between children who had undergone a Fontan procedure and their parents.

METHODS: Fontan procedure survivors 10 to 18 years of age were included in the study if the child completed the Child Health Questionnaire (CHQ) and the parent completed the parent form to assess the child's functional health status. Comparisons were made between raw domain scores for the parent- and child-completed CHQs.

RESULTS: Between March 2003 and April 2004, 1078 Fontan survivors were screened. Of the 546 eligible and consented patients, 354 were 10-18 years of age and 328 parent/child …

Sleep-Disordered Breathing Affects Auditory Processing In 5–7 Year-Old Children: Evidence From Brain Recordings, Alexandra P.F. Key, Dennis L. Molfese, Louise O’Brien, David Gozal

Center for Brain, Biology, and Behavior: Faculty Publications

Poor sleep in children is associated with lower neurocognitive functioning and increased maladaptive behaviors. The current study examined the impact of snoring (the most common manifestation of sleep-disordered breathing) on cognitive and brain functioning in a sample of 35 asymptomatic children ages 5–7 years identified in the community as having habitual snoring (SDB). All participants completed polysomnographic, neurocognitive (NEPSY) and psychophysiological (ERPs to speech sounds) assessments. The results indicated that sub-clinical levels of SDB may not necessarily lead to reduced performance on standardized behavioral measures of attention and memory. However, brain indices of speech perception and discrimination (N1/P2) are sensitive …

Functional State Following The Fontan Procedure., Ismee A. Williams, Lynn A. Sleeper, Steven D. Colan, Minmin Lu, Elizabeth A. Stephenson, Jane W. Newburger, Welton M. Gersony, Meryl S. Cohen, James F. Cnota, Andrew M. Atz, Richard V. Williams, Renee Margossian, Andrew J. Powell, Mario P. Stylianou, Daphne T. Hsu, Pediatric Heart Network Investigators, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Despite improvements in outcomes after completion of the Fontan circulation, long-term functional state varies. We sought to identify pre- and postoperative characteristics associated with overall function.

METHODS AND RESULTS: We analyzed data from 476 survivors with the Fontan circulation enrolled in the Pediatric Heart Network Fontan Cross-sectional Study. Mean age at creation of the Fontan circulation was 3.4 plus or minus 2.1 years, with a range from 0.7 to 17.5 years, and time since completion was 8.7 plus or minus 3.4 years, the range being from 1.1 to 17.3 years. We calculated a functional score for the survivors by …

Nanofiber Scaffolds With Gradations In Mineral Content For Mimicking The Tendon-To-Bone Insertion Site, Xiaoran Li, Jingwei Xie, Justin Lipner, Xiaoyan Yuan, Stavros Thomopoulos, Younan Xia

MIIR Faculty Research

We have demonstrated a simple and versatile method for generating a continuously graded, bonelike calcium phosphate coating on a nonwoven mat of electrospun nanofibers. A linear gradient in calcium phosphate content could be achieved across the surface of the nanofiber mat. The gradient had functional consequences with regard to stiffness and biological activity. Specifically, the gradient in mineral content resulted in a gradient in the stiffness of the scaffold and further influenced the activity of mouse preosteoblast MC3T3 cells. This new class of nanofiberbased scaffolds can potentially be employed for repairing the tendon-to-bone insertion site via a tissue engineering approach.

Field Testing Adolescent Females For Cardiovascular Disease Risk, C. Jayne Brahler, Wesley R. Stephens, Betsy Donahoe Fillmore

Physical Therapy Faculty Publications

Over-fatness and poor cardiovascular (CV) fitness are well-documented risk factors for cardiovascular disease (CVD) in adults, but less is known about their association with disease risk in adolescents. This study aimed to determine the relationship between anthropometrics, fitness, and CVD risk.

Six anthropometric indicators of body fatness, seven measures of fitness, and seven metabolic and hemodynamic CVD risk factors were measured in a convenience sample of 28 female high school students (15-18 years of age). A tally was made of the number of factors for which each subject was outside the normal reference range (CVD risk).

Correlation analyses were completed …

Frequency And Spatial Characteristics Of Highfrequency Neuromagnetic Signals In Childhood Epilepsy, Jing Xiang, Yang Liu, Yingying Wang, Elijah G. Kirtman, Cincinnati Children’S Hospital Medical Center Kotecha, Yangmei Chen, Xiaolin Huo, Hisako Fujiwara, Nat Hemasilpin, Ki Lee, Francesco T. Mangano, James Leach, Blaise Jones, Ton Degrauw, Douglas Rose

Center for Brain, Biology, and Behavior: Faculty Publications

Purpose. Invasive intracranial recordings have suggested that high-frequency oscillation is involved in epileptogenesis and is highly localized to epileptogenic zones. The aim of the present study is to characterize the frequency and spatial patterns of high-frequency brain signals in childhood epilepsy using a non-invasive technology. Methods. Thirty children with clinically diagnosed epilepsy were studied using a whole head magnetoencephalography (MEG) system. MEG data were digitized at 4 000 Hz. The frequency and spatial characteristics of high-frequency neuromagnetic signals were analyzed using continuous wavelet transform and beamformer. Threedimensional magnetic resonance imaging (MRI) was obtained for each patient to localize magnetic sources. …

Peer-Led Team Learning: A Prospective Method For Increasing Critical Thinking In Undergraduate Science Courses, Ian J. Quitadamo, C. Jayne Brahler, Gregory J. Crouch

Physical Therapy Faculty Publications

This study examined the impact of peer-led team learning (PLTL) on critical thinking gains in science and math courses at a research university in the Pacific Northwest.

Universal Screening For Extracardiac Abnormalities In Neonates With Congenital Heart Disease., Javier H. Gonzalez, Girish S. Shirali, Andrew M. Atz, Sarah N. Taylor, Geoffrey A. Forbus, Sinai C. Zyblewski, Anthony M. Hlavacek

Manuscripts, Articles, Book Chapters and Other Papers

Extracardiac or genetic abnormalities (EGA) represent a factor in the morbidity of patients with congenital heart disease. We evaluated the way neonates with CHD are screened at our institution and determined the yield for the screening tests. We reviewed the charts of 223 neonates with structural CHD. Subjects were categorized into 6 groups: univentricular, left-sided obstructive lesions, right-sided obstructive lesions, septal defects, conotruncal defects (CTD), and other. We reviewed which patients underwent cranial ultrasonogram (CUS), abdominal ultrasonogram (AUS), and/or genetic studies (GS) as well as their results. There was a high prevalence of EGA in each group by CUS (32% …

Chronic Elbow Dislocation Treated With Open Reduction And Lateral Ulnar Collateral Ligament Reconstruction, Louis Joseph Rubino, Michael A. Herbenick, Ryan P. Finnan, Philip A. Anloague

Physical Therapy Faculty Publications

In the United States, chronic unreduced elbow dislocations are rare injuries. We report the successful short-term outcome of a chronic elbow dislocation treated with open reduction and lateral ulnar collateral ligament reconstruction using a split semitendinosus allograft in a figure-of-8 technique without use of hinged external fixation. The authors have obtained the patient’s written informed consent for print and electronic publication of the case report.

Impairments In Attention In Occasionally Snoring Children: An Event-Related Potential Study, Maria E. Barnes, Elizabeth A. Huss, Krista N. Garrod, Eric Van Raay, Ehab Dayyat, Dennis L. Molfese

Center for Brain, Biology, and Behavior: Faculty Publications

Objective—To determine whether minimal snoring is benign in children.

Procedure—22 rarely snoring children (mean age=6.9 years, 11 females) and age- and sexmatched controls participated in an auditory oddball task wearing 128-electrode nets. Parents completed Conner’s Parent Rating Scales-Revised Long (CPRS-R:L).

Results—Snorers scored significantly higher on 4 CPRS-R:L subscales. Stepwise regression indicated that two ERP variables from a region of the ERP that peaked at 844 ms post-stimulus onset predicted CPRS-R:L ADHD Index scores.

Conclusions—Occasional snorers according to parental report do exhibit ADHD-like behaviors. Basic sensory processing is longer than in controls, suggesting that delayed frontal activation requires more effort in …

Design And Rationale Of A Randomized Trial Comparing The Blalock-Taussig And Right Ventricle-Pulmonary Artery Shunts In The Norwood Procedure., Richard G. Ohye, J William Gaynor, Nancy S. Ghanayem, Caren S. Goldberg, Peter C. Laussen, Peter C. Frommelt, Jane W. Newburger, Gail D. Pearson, Sarah Tabbutt, Gil Wernovsky, Lisa M. Wruck, Andrew M. Atz, Steve D. Colan, James Jaggers, Brian W. Mccrindle, Ashwin Prakash, Michael D. Puchalski, Lynn A. Sleeper, Mario P. Stylianou, Lynn Mahony, Pediatric Heart Network Investigators, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: The initial palliative procedure for patients born with hypoplastic left heart syndrome and related single right ventricle anomalies, the Norwood procedure, remains among the highest risk procedures in congenital heart surgery. The classic Norwood procedure provides pulmonary blood flow with a modified Blalock-Taussig shunt. Improved outcomes have been reported in a few small, nonrandomized studies of a modification of the Norwood procedure that uses a right ventricle-pulmonary artery shunt to provide pulmonary blood flow. Other nonrandomized studies have shown no differences between the two techniques.

METHODS: The Pediatric Heart Network designed a randomized clinical trial to compare outcomes for …

Functional Status, Heart Rate, And Rhythm Abnormalities In 521 Fontan Patients 6 To 18 Years Of Age., Andrew D. Blaufox, Lynn A. Sleeper, David J. Bradley, Roger E. Breitbart, Allan Hordof, Ronald J. Kanter, Elizabeth A. Stephenson, Mario Stylianou, Victoria L. Vetter, J Philip Saul, Pediatric Heart Network Investigators

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: Our objective was to determine the relationship between functional outcome and abnormalities of heart rate and rhythm after the Fontan operation.

METHODS: The National Heart, Lung, and Blood Institute Pediatric Heart Network conducted a cross-sectional analysis of patients who had undergone a Fontan procedure at the 7 network centers. Analysis was based on 521 patients with an electrocardiogram (n = 509) and/or bicycle exercise test (n = 404). The Child Health Questionnaire parent report and the oxygen consumption at the anaerobic threshold were used as markers of functional outcome.

RESULTS: Various Fontan procedures had been performed: intracardiac lateral tunnel …

Management Of Pediatric Acute Appendicitis In The Computed Tomographic Era., Kuojen Tsao, Shawn D. St Peter, Patricia A. Valusek, Troy L. Spilde, Scott J. Keckler, Abhilash Nair, Daniel J. Ostlie, G W. Holcomb Iii

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND/PURPOSE: The treatment options for complicated appendicitis in children continue to evolve. Optimal management of complicated appendicitis relies on an accurate preoperative diagnosis. We examined the accuracy of our preoperative diagnosis including computed tomography (CT) and the influence on the management of children with perforated and nonperforated appendicitis.

METHODS: Following IRB approval, a 6-year review of all patients that underwent an appendectomy for suspected appendicitis was performed. Treatments included immediate operations and initial nonoperative management (antibiotic therapy +/- percutaneous drainage of abscess). Appendicitis was confirmed by histological examination.

RESULTS: One thousand seventy-eight patients underwent appendectomy for suspected appendicitis. Preoperative CT …

Current Significance Of Meconium Plug Syndrome., Scott J. Keckler, Shawn D. St Peter, Troy L. Spilde, Kuojen Tsao, Daniel J. Ostlie, G W. Holcomb Iii, Charles L. Snyder

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The significance of meconium plug syndrome is dependent on the underlying diagnosis. The incidence of pathologic finding, particularly Hirschsprung's disease, contributing to the presence of these plugs, has been debated. However, there are little recent data in the literature. Therefore, we reviewed our experience with meconium plugs as a cause of abdominal distension to evaluate the associated conditions and incidence of Hirschsprung's disease.

METHODS: We reviewed the records of newborns with meconium plugs found in the distal colon on contrast enema from 1994 to 2007. Demographics, radiologic findings, histologic findings, operative findings, and clinical courses were reviewed.

RESULTS: During …

The Mind-Body Connection: The Association Between Adolescent Locus Of Control And Indicators Of Physical Health, C. Jayne Brahler, James Cropper

Physical Therapy Faculty Publications

Locus of control (LOC) describes an individual’s generalized beliefs or expectancies that their reinforcements are under internal versus external control (1). An individual exhibits either an internal or external LOC. This study examines the link between LOC and selected health risk factors in adolescents. A convenience sample of 167 high school physical education students completed a 13-item LOC questionnaire based on Rotter’s 1966 instrument.

Various anthropometric measurements, blood pressure, body mass index (BMI), and body fat were recorded on all subjects. A subsample of 61 female students received blood chemistry analysis that included a lipid profile, hemoglobin A1c (HbA1c), Apo …

Three Dimensional Echocardiography In Congenital Heart Defects., Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

Three dimensional echocardiography (3DE) is a new, rapidly evolving modality for cardiac imaging. Important technological advances have heralded an era where practical 3DE scanning is becoming a mainstream modality. We review the modes of 3DE that can be used. The literature has been reviewed for articles that examine the applicability of 3DE to congenital heart defects to visualize anatomy in a spectrum of defects ranging from atrioventricular septal defects to mitral valve abnormalities and Ebstein's anomaly. The use of 3DE color flow to obtain echocardiographic angiograms is illustrated. The state of the science in quantitating right and left ventricular volumetrics …

Is Electrical Stimulation A Predictive Tool For Autonomic Dysfunction In Males With Diabetes?, Susan Dorothy Rand

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to examine whether electrical stimulation can be used as a predictive tool to assess autonomic dysfunction in males with diabetes. The study was designed to better understand the extent of autonomic nervous system (ANS) dysfunction in the diabetic population.

Controls and patients with diabetes were recruited from the community at large and the Loma Linda University Diabetes Treatment Center and were managed by a physician. Twelve (12) people with diabetes and thirteen (13) control subjects participated. Mean age (years) for people with diabetes was 52.4 +/- 6.1 and 47.2 +/-11.1 for controls (p =0.05). …

Survival After Bidirectional Cavopulmonary Anastomosis: Analysis Of Preoperative Risk Factors., Mark A. Scheurer, Elizabeth G Hill, Nagavardhan Vasuki, Scott Maurer, Eric M. Graham, Varsha Bandisode, Girish S. Shirali, Andrew M. Atz, Scott M. Bradley

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: Prognostic factors for survival after bidirectional cavopulmonary anastomosis for functionally single ventricle are not well defined. We analyzed preoperative hemodynamic and echocardiographic data to determine risk factors for death or transplantation at least 1 year after bidirectional cavopulmonary anastomosis.

METHODS: Data for all patients who underwent bidirectional cavopulmonary anastomosis before 5 years of age at our institution from September 1995 through June 2005 were analyzed. Available preoperative echocardiograms and catheterizations were reviewed. Survivors were compared with those who died or underwent transplantation. Bivariable associations between demographic and clinical risk factors and survival status (alive without transplantation vs dead or …

Smoking During Pregnancy Affects Speech-Processing Ability In Newborn Infants, Alexandra P.F. Key, Melissa Ferguson, Dennis L. Molfese, Kelley Peach, Victoria J. Molfese

Center for Brain, Biology, and Behavior: Faculty Publications

BACKGROUND: Tobacco smoking during pregnancy is known to adversely affect development of the central nervous system in babies of smoking mothers by restricting utero–placental blood flow and the amount of oxygen available to the fetus. Behavioral data associate maternal smoking with lower verbal scores and poorer performance on specific language/auditory tests.

OBJECTIVES: In the current study we examined the effects of maternal smoking during pregnancy on newborns’ speech processing ability as measured by event-related potentials (ERPs).

METHOD: High-density ERPs were recorded within 48 hr of birth in healthy newborn infants of smoking (n = 8) and nonsmoking …

High Dietary Fat Intake Is Not Associated With High Levels Of Circulating Lipoproteins Or Total Cholesterol, C. Jayne Brahler, C. Wilson, Janine Baer

Physical Therapy Faculty Publications

The objective of this study was to determine the association between dietary intake of fats, waist to hip ratio (WHR), body mass index (BMI), and blood lipoproteins and total cholesterol (TC) using food frequency data in one group of apparently healthy, urban African American women and their daughters (n = 110). Subjects were fasted when blood was drawn, waist and hip circumferences and body weight and height were measured, and WHR and BMI were calculated.

Average daily total fat intakes were 91.46 g and 77.83 g for mothers and daughters, respectively, but average LDL levels of 104.4 g/L and 103.1 …

Gastroesophageal Reflux Disease And Fundoplication In Infants And Children, Shawn D. St Peter, G W. Holcomb Iii

Manuscripts, Articles, Book Chapters and Other Papers

Gastroesophageal reflux disease (GERD) can be one of the most distressing conditions developing at different ages in infants and children. The disease itself is a complex process along with ongoing dynamic anatomic and physiologic changes occurring during normal development. Therefore among referring physicians, considerations regarding the role of surgery for GERD in children varies widely depending on individual experiences in managing these patients. These varied opinions result in discrepancies in the operative experience with fundoplication among pediatric surgeons. It is unclear how much of the current opinions stem from published evidence, particularly with regard to the safety and efficacy of …

Using Pareto Fronts To Evaluate Polyp Detection Algorithms For Ct Colonography, Adam Huang, Jiang Li, Ronald M. Summers, Nicholas Petrick, Amy K. Hara

Electrical & Computer Engineering Faculty Publications

We evaluate and improve an existing curvature-based region growing algorithm for colonic polyp detection for our CT colonography (CTC) computer-aided detection (CAD) system by using Pareto fronts. The performance of a polyp detection algorithm involves two conflicting objectives, minimizing both false negative (FN) and false positive (FP) detection rates. This problem does not produce a single optimal solution but a set of solutions known as a Pareto front. Any solution in a Pareto front can only outperform other solutions in one of the two competing objectives. Using evolutionary algorithms to find the Pareto fronts for multi-objective optimization problems has been …

Validating Pareto Optimal Operation Parameters Of Polyp Detection Algorithms For Ct Colonography, Jiang Li, Adam Huang, Nicholas Petrick, Jianhua Yao, Ronald M. Summers, Maryellen L. Giger (Ed.), Nico Karssemeijer (Ed.)

Electrical & Computer Engineering Faculty Publications

We evaluated a Pareto front-based multi-objective evolutionary algorithm for optimizing our CT colonography (CTC) computer-aided detection (CAD) system. The system identifies colonic polyps based on curvature and volumetric based features, where a set of thresholds for these features was optimized by the evolutionary algorithm. We utilized a two-fold cross-validation (CV) method to test if the optimized thresholds can be generalized to new data sets. We performed the CV method on 133 patients; each patient had a prone and a supine scan. There were 103 colonoscopically confirmed polyps resulting in 188 positive detections in CTC reading from either the prone or …

Guidelines And Standards For Performance Of A Pediatric Echocardiogram: A Report From The Task Force Of The Pediatric Council Of The American Society Of Echocardiography., Wyman W. Lai, Tal Geva, Girish S. Shirali, Peter C. Frommelt, Richard A. Humes, Michael M. Brook, Ricardo H. Pignatelli, Jack Rychik, Pediatric Council Of The American Society Of Echocardiography

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Incidence And Outcome Of Cardiopulmonary Resuscitation In Patients With Shunted Single Ventricle: Advantage Of Right Ventricle To Pulmonary Artery Shunt., Eric M. Graham, Geoffrey A. Forbus, Scott M. Bradley, Girish S. Shirali, Andrew M. Atz

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Disaggregating The Relative Influence Of Genetic, Environmental And Individual Factors On Ldl And Hdl Cholesterols And Bmi For A Sample Of African American (Aa) Mothers And Daughters, C. Jayne Brahler, Jewel Harden, Michelle Mchone, Matthew Soules, Eric Evans, Ann Alyanak, Fred Diakpieng, Paul M. Vanderburgh

Health and Sport Science Faculty Publications

There are many reports about the associations between blood lipids, body mass index (BMI) and dietary cholesterol intakes both within the individual and between related individuals. The purpose of this descriptive research project was to investigate the relationships between LDL and HDL cholesterols, body mass index and dietary cholesterol intakes for a sample of African American (AA) mothers and their daughters and to attempt to separate the contribution of genetic versus environmental factors. Mother and daughter participants (n =42 and 66, respectively) were 12-14-hours fasted when blood samples were drawn, heights and weights measured, and 24 hour food recalls completed.

Indentation Fracture Of Bovine Cortical Bone: Acoustic Emission Technique, Ashkan Safari, Ger Reilly, Brendan Mccormack

Conference Papers

Indentation cutting may result in microcracking and main crack growth which was previously reported. In this study, we recorded the AE signals produced by cracking processes during cutting on cortical bone, measuring the cutting force and correlating between load-displacement curves and AE activities.

The Effect Of Handling Time On Temporal Discounting In Two New World Primates, Alexandra G. Rosati, Jeffrey R. Stevens, Marc D. Hauser

Center for Brain, Biology, and Behavior: Faculty Publications

Foraging decisions in nonhuman animals often require choosing between small, immediate food rewards and larger, more delayed rewards. Faced with such choices, animals typically discount or devalue the future quite strongly. Although discounting studies often focus on delays to reward access, other temporal intervals contribute to foraging rate, and thus may potentially influence discounting levels. Here, we examine the effect of handling time, the time required to process and consume food, on discounting in cottontop tamarins, Saguinus oedipus, and common marmosets, Callithrix jacchus, two species that differ in levels of temporal discounting. We presented subjects with a discounting task under …

Hybrid Committee Classifier For A Computerized Colonic Polyp Detection System, Jiang Li, Jianhua Yao, Nicholas Petrick, Ronald M. Summers, Amy K. Hara, Joseph M. Reinhardt (Ed.), Josien P.W. Pluim (Ed.)

Electrical & Computer Engineering Faculty Publications

We present a hybrid committee classifier for computer-aided detection (CAD) of colonic polyps in CT colonography (CTC). The classifier involved an ensemble of support vector machines (SVM) and neural networks (NN) for classification, a progressive search algorithm for selecting a set of features used by the SVMs and a floating search algorithm for selecting features used by the NNs. A total of 102 quantitative features were calculated for each polyp candidate found by a prototype CAD system. 3 features were selected for each of 7 SVM classifiers which were then combined to form a committee of SVMs classifier. Similarly, features …

Wavelet Analysis In Virtual Colonoscopy, Sharon Greenblum, Jiang Li, Adam Huang, Ronald M. Summers, Armando Manduca (Ed.), Amir A. Amini (Ed.)

Electrical & Computer Engineering Faculty Publications

The computed tomographic colonography (CTC) computer aided detection (CAD) program is a new method in development to detect colon polyps in virtual colonoscopy. While high sensitivity is consistently achieved, additional features are desired to increase specificity. In this paper, a wavelet analysis was applied to CTCCAD outputs in an attempt to filter out false positive detections. 52 CTCCAD detection images were obtained using a screen capture application. 26 of these images were real polyps, confirmed by optical colonoscopy and 26 were false positive detections. A discrete wavelet transform of each image was computed with the MATLAB wavelet toolbox using the …