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James Dunn, MD

  • James Chung Yu Dunn

Especialidades

Surgery

Trabajo y Educación

Formación Profesional

Harvard Medical School, Boston, MA, 6/1/1992

Internado

UCLA Health Sciences, Los Angeles, CA, 6/23/1993

Residencia

UCLA Health Sciences, Los Angeles, CA, 6/23/1999

Compañerismo

Riley Hospital for Children at Indiana University Health, Indianapolis, IN, 6/30/2001

Certificaciones Médicas

General Surgery, American Board of Surgery

Pediatric Surgery, American Board of Surgery

Todo Publicaciones

New insights and interventions for short bowel syndrome. Current pediatrics reports Rouch, J. D., Dunn, J. C. 2017; 5 (1): 1-5

Abstract

This review summarizes recent innovations in the treatment of patients with short bowel syndrome.The use of surgical procedures, growth factor stimulation, and bioengineering approaches to increase absorptive surface area of the intestine is examined. While the morphology of the intestine is clearly altered by these interventions, it is less clear that the overall function of the intestine is improved.Continued innovations will likely bring about new therapeutic options for patients with short bowel syndrome. Careful evaluations of the impact of these interventions await controlled clinical trials.

View details for DOI 10.1007/s40124-017-0119-6

View details for PubMedID 28367359

A novel culture system for adult porcine intestinal crypts CELL AND TISSUE RESEARCH Khalil, H. A., Lei, N. Y., Brinkley, G., Scott, A., Wang, J., Kar, U. K., Jabaji, Z. B., Lewis, M., Martin, M. G., Dunn, J. C., Stelzner, M. G. 2016; 365 (1): 123-134

Abstract

Porcine models are useful for investigating therapeutic approaches to short bowel syndrome and potentially to intestinal stem cell (ISC) transplantation. Whereas techniques for the culture and genetic manipulation of ISCs from mice and humans are well established, similar methods for porcine stem cells have not been reported. Jejunal crypts were isolated from murine, human, and juvenile and adult porcine small intestine, suspended in Matrigel, and co-cultured with syngeneic intestinal subepithelial myofibroblasts (ISEMFs) or cultured without feeder cells in various culture media. Media containing epidermal growth factor, noggin, and R-spondin 1 (ENR medium) were supplemented with various combinations of Wnt3a- or ISEMF-conditioned medium (CM) and with glycogen synthase kinase 3 inhibitor (GSK3i), and their effects were studied on cultured crypts. Cell lineage differentiation was assessed by immunohistochemistry and quantitative polymerase chain reaction. Cultured porcine cells were serially passaged and transduced with a lentiviral vector. Whereas ENR medium supported murine enteroid growth, it did not sustain porcine crypts beyond 5days. Supplementation of Wnt3a-CM and GSK3i resulted in the formation of complex porcine enteroids with budding extensions. These enteroids contained a mixture of stem and differentiated cells and were successfully passaged in the presence of GSK3i. Crypts grown in media supplemented with porcine ISEMF-CM formed spheroids that were less well differentiated than enteroids. Enteroids and spheroids were transfected with a lentivirus with high efficiency. Thus, our method maintains juvenile and adult porcine crypt cells long-term in culture. Porcine enteroids and spheroids can be successfully passaged and transduced by using lentiviral vectors.

View details for DOI 10.1007/s00441-016-2367-0

View details for Web of Science ID 000378877600011

View details for PubMedID 26928041

Basic fibroblast growth factor eluting microspheres enhance distraction enterogenesis JOURNAL OF PEDIATRIC SURGERY Rouch, J. D., Scott, A., Jabaji, Z. B., Chiang, E., Wu, B. M., Lee, S. L., Shekherdimian, S., Dunn, J. C. 2016; 51 (6): 960-965

Abstract

The purpose of this study was to determine if distraction enterogenesis using self-expanding polycaprolactone (PCL) springs is a potential therapy for short bowel syndrome. Sustained release basic fibroblast growth factor (bFGF) microspheres have been shown to induce angiogenesis and intestinal regeneration in tissue engineered scaffolds. We hypothesized that the provision of bFGF-loaded microspheres would increase angiogenesis and thereby enhance the process of enterogenesis.A 10-mm segment of rodent jejunum was isolated and an encapsulated PCL spring inserted. Blank or bFGF-loaded microspheres were delivered to the segment. After 4weeks, jejunal segments were assessed for lengthening, morphology, quantification of blood vessels, and ganglia.Lengthened intestinal segments receiving bFGF microspheres demonstrated significantly increased microvascular density compared to those with blank microspheres. There were also significantly more submucosal and myenteric ganglia in the segments that received bFGF microspheres. Segments achieved similar lengthening and final muscular thickness in both blank and bFGF groups, but the bFGF microsphere caused a significant increase in luminal diameter of the jejunal segment.Sustained release bFGF microspheres enhanced distraction enterogenesis through improved vascularity. The synergy of growth factors such as bFGF with distraction enterogenesis may yield improved results for the future treatment of patients with short bowel syndrome.

View details for DOI 10.1016/j.jpedsurg.2016.02.065

View details for Web of Science ID 000378908600018

View details for PubMedID 26995517

Mechanical lengthening in multiple intestinal segments in-series JOURNAL OF PEDIATRIC SURGERY Scott, A., Rouch, J. D., Huynh, N., Chiang, E., Shekherdimian, S., Lee, S. L., Wu, B. M., Dunn, J. C. 2016; 51 (6): 957-959

Abstract

Current models of mechanical intestinal lengthening employ a single device in an isolated segment. Here we demonstrate that polycaprolactone (PCL) springs can be deployed in-series to lengthen multiple intestinal segments simultaneously to further increase overall intestinal length.A Roux-en-y jejunojejunostomy with a blind Roux limb was created in the proximal jejunum of rats. Two encapsulated 10-mm PCL springs were placed in-series into the Roux limb and were secured with clips. After 4weeks, the lengthened segments were retrieved for histological analyses.Lengthening two intestinal segments simultaneously was achieved by placing two PCL springs in-series. The total combined length of the lengthened segments in-series was 454mm. The two jejunal segments with PCL springs (252 and 202mm) were significantly longer than control segments without the spring (141mm, p<0.05).Spring-mediated lengthening can be achieved using multiple springs placed sequentially. The use of the Roux-en-y surgical model allowed easy insertion of springs in a blind Roux limb and arrange them in-series. Combined with relengthening techniques, we can use these methods to increase the length of small intestine to reach clinical significance.1 Experimental.

View details for DOI 10.1016/j.jpedsurg.2016.02.058

View details for Web of Science ID 000378908600017

View details for PubMedID 27013424

Long-term renewable human intestinal epithelial stem cells as monolayers: A potential for clinical use JOURNAL OF PEDIATRIC SURGERY Scott, A., Rouch, J. D., Jabaji, Z., Khalil, H. A., Solorzano, S., Lewis, M., Martin, M. G., Stelzner, M. G., Dunn, J. C. 2016; 51 (6): 995-1000

Abstract

Current culture schema for human intestinal stem cells (hISCs) frequently rely on a 3D culture system using Matrigel, a laminin-rich matrix derived from murine sarcoma that is not suitable for clinical use. We have developed a novel 2D culture system for the in vitro expansion of hISCs as an intestinal epithelial monolayer without the use of Matrigel.Cadaveric duodenal samples were processed to isolate intestinal crypts from the mucosa. Crypts were cultured on a thin coat of type I collagen or laminin. Intestinal epithelial monolayers were supported with growth factors to promote self-renewal or differentiation of the hISCs. Proliferating monolayers were sub-cultured every 4-5days.Intestinal epithelial monolayers were capable of long-term cell renewal. Less differentiated monolayers expressed high levels of gene marker LGR5, while more differentiated monolayers had higher expressions of CDX2, MUC2, LYZ, DEF5, and CHGA. Furthermore, monolayers were capable of passaging into a 3D culture system to generate spheroids and enteroids.This 2D system is an important step to expand hISCs for further experimental studies and for clinical cell transplantation.1 Experimental.

View details for DOI 10.1016/j.jpedsurg.2016.02.074

View details for Web of Science ID 000378908600025

View details for PubMedID 26995514

Development of Functional Microfold (M) Cells from Intestinal Stem Cells in Primary Human Enteroids PLOS ONE Rouch, J. D., Scott, A., Lei, N. Y., Solorzano-Vargas, R. S., Wang, J., Hanson, E. M., Kobayashi, M., Lewis, M., Stelzner, M. G., Dunn, J. C., Eckmann, L., Martin, M. G. 2016; 11 (1)

Abstract

Intestinal microfold (M) cells are specialized epithelial cells that act as gatekeepers of luminal antigens in the intestinal tract. They play a critical role in the intestinal mucosal immune response through transport of viruses, bacteria and other particles and antigens across the epithelium to immune cells within Peyer's patch regions and other mucosal sites. Recent studies in mice have demonstrated that M cells are generated from Lgr5+ intestinal stem cells (ISCs), and that infection with Salmonella enterica serovar Typhimurium increases M cell formation. However, it is not known whether and how these findings apply to primary human small intestinal epithelium propagated in an in vitro setting.Human intestinal crypts were grown as monolayers with growth factors and treated with recombinant RANKL, and assessed for mRNA transcripts, immunofluorescence and uptake of microparticles and S. Typhimurium.Functional M cells were generated by short-term culture of freshly isolated human intestinal crypts in a dose- and time-dependent fashion. RANKL stimulation of the monolayer cultures caused dramatic induction of the M cell-specific markers, SPIB, and Glycoprotein-2 (GP2) in a process primed by canonical WNT signaling. Confocal microscopy demonstrated a pseudopod phenotype of GP2-positive M cells that preferentially take up microparticles. Furthermore, infection of the M cell-enriched cultures with the M cell-tropic enteric pathogen, S. Typhimurium, led to preferential association of the bacteria with M cells, particularly at lower inoculum sizes. Larger inocula caused rapid induction of M cells.Human intestinal crypts containing ISCs can be cultured and differentiate into an epithelial layer with functional M cells with characteristic morphological and functional properties. This study is the first to demonstrate that M cells can be induced to form from primary human intestinal epithelium, and that S. Typhimurium preferentially infect these cells in an in vitro setting. We anticipate that this model can be used to generate large numbers of M cells for further functional studies of these key cells of intestinal immune induction and their impact on controlling enteric pathogens and the intestinal microbiome.

View details for DOI 10.1371/journal.pone.0148216

View details for Web of Science ID 000369528400076

View details for PubMedID 26820624

Intestinal Bioengineering. Clinical transplants Dunn, J. C. 2016; 32: 1-4

Abstract

This review summarizes bioengineering innovations in the treatment of patients with short bowel syndrome. Bioengineering approaches aim to increase the overall intestinal tissue mass. While the morphology of the intestine is clearly altered by these interventions, it remains to be shown that the overall function of the intestine is improved. Continued innovations will likely bring about new therapeutic options for patients with short bowel syndrome. Careful evaluations of the impact of these interventions await controlled clinical trials.

View details for PubMedID 28564517

Scalability of an endoluminal spring for distraction enterogenesis. Journal of pediatric surgery Rouch, J. D., Huynh, N., Scott, A., Chiang, E., Wu, B. M., Shekherdimian, S., Dunn, J. C. 2016; 51 (12): 198892

Abstract

Techniques of distraction enterogenesis have been explored to provide increased intestinal length to treat short bowel syndrome (SBS). Self-expanding, polycaprolactone (PCL) springs have been shown to lengthen bowel in small animal models. Their feasibility in larger animal models is a critical step before clinical use.Juvenile mini-Yucatan pigs underwent jejunal isolation or blind ending Roux-en-y jejunojejunostomy with insertion of either a PCL spring or a sham PCL tube. Extrapolated from our spring characteristics in rodents, proportional increases in spring constant and size were made for porcine intestine.Jejunal segments with 7mm springs with k between 9 and 15N/m demonstrated significantly increased lengthening in isolated segment and Roux-en-y models. Complications were noted in only two animals, both using high spring constant k>17N/m. Histologically, lengthened segments in the isolated and Roux models demonstrated significantly increased muscularis thickness and crypt depth. Restoration of lengthened, isolated segments back into continuity was technically feasible after 6weeks.Self-expanding, endoluminal PCL springs, which exert up to 0.6N force, safely achieve significant intestinal lengthening in a translatable, large-animal model. These spring characteristics may provide a scalable model for the treatment of SBS in children.

View details for DOI 10.1016/j.jpedsurg.2016.09.023

View details for PubMedID 27665493

Mouse model of endoscopically ablated enteric nervous system JOURNAL OF SURGICAL RESEARCH Khalil, H. A., Kobayashi, M., Rana, P., Wagner, J. P., Scott, A., Yoo, J., Dunn, J. C. 2016; 200 (1): 117-121

Abstract

Current transgenic animal models of Hirschsprung disease are restricted by limited survival and need for special dietary care. We used small animal colonoscopy to produce chemically ablated enteric nervous system in the distal colon and rectum of normal mice.Adult C57BL/6 mice underwent colonoscopy with submucosal injection of 75-100L of saline (n=2) or 0.002% (n=2), 0.02% (n=15), or 0.2% (n=2) benzalkonium chloride (BAC). Each mouse received 1-3 injections in the distal colon and rectum. Mice were sacrificed on postprocedure day 7 or 28. Injection sites were analyzed histologically and with immunostaining for -tubulin III.Submucosal injection of 0.02% BAC resulted in megacolon and obliteration of 828.8% of myenteric ganglia at the injection site on postprocedure day 7 compared with normal colon. This effect was sustained until day 28. Injection of 0.002% BAC had little effect on the myenteric neuronal network at these time points. Multiple injections of 0.002% or 0.02% BAC (up to three injections per mouse) were well tolerated. Injection of 0.2% BAC caused acute toxicity or death.A novel model of chemically ablated enteric nervous system in the mouse colon and rectum is introduced. This model can be valuable in evaluating targeted cell delivery therapies for Hirschsprung disease.

View details for DOI 10.1016/j.jss.2015.07.034

View details for Web of Science ID 000366840700018

View details for PubMedID 26299595

Spring-mediated distraction enterogenesis in-continuity. Journal of pediatric surgery Huynh, N., Rouch, J. D., Scott, A., Chiang, E., Wu, B. M., Shekherdimian, S., Dunn, J. C. 2016; 51 (12): 198387

Abstract

Distraction enterogenesis has been investigated as a novel treatment for patients with short bowel syndrome (SBS) but has been limited by loss of intestinal length during restoration and need for multiple bowel surgeries. The feasibility of in-continuity, spring-mediated intestinal lengthening has yet to be demonstrated.Juvenile mini-Yucatan pigs underwent in-continuity placement of polycaprolactone (PCL) degradable springs within jejunum. Methods used to anchor the spring ends to the intestine included full-thickness sutures and a high-friction surface spring. Spring constant (k) was 6-15N/m. Bowel was examined for length and presence of spring at 1 to 4weeks.Animals tolerated in-continuity lengthening without bowel obstruction for up to 29days. In-continuity jejunum with springs demonstrated intestinal lengthening by 1.47-fold 0.11. Five springs had detached prematurely, and lengthening could not be assessed. Histologically, in-continuity jejunum showed significantly increased crypt depth and muscularis thickness in comparison to normal jejunum.Self-expanding endoluminal springs placed in continuity could lengthen intestine without obstruction in a porcine model. This is the first study showing safety and efficacy of a self-expanding endoluminal device for distraction enterogenesis. This is proof-of-concept that in-continuity spring lengthening is feasible and demonstrates its therapeutic potential in SBS.Level 3.

View details for DOI 10.1016/j.jpedsurg.2016.09.024

View details for PubMedID 27692863

Concise Review: The Potential Use of Intestinal Stem Cells to Treat Patients With Intestinal Failure. Stem cells translational medicine Hong, S. N., Dunn, J. C., Stelzner, M., Martn, M. G. 2016

Abstract

: Intestinal failure is a rare life-threatening condition that results in the inability to maintain normal growth and hydration status by enteral nutrition alone. Although parenteral nutrition and whole organ allogeneic transplantation have improved the survival of these patients, current therapies are associated with a high risk for morbidity and mortality. Development of methods to propagate adult human intestinal stem cells (ISCs) and pluripotent stem cells raises the possibility of using stem cell-based therapy for patients with monogenic and polygenic forms of intestinal failure. Organoids have demonstrated the capacity to proliferate indefinitely and differentiate into the various cellular lineages of the gut. Genome-editing techniques, including the overexpression of the corrected form of the defective gene, or the use of CRISPR (clustered regularly interspaced short palindromic repeats)/Cas9 to selectively correct the monogenic disease-causing variant within the stem cell, make autologous ISC transplantation a feasible approach. However, numerous techniques still need to be further optimized, including more robust ex vivo ISC expansion, native ISC ablation, and engraftment protocols. Large-animal models can to be used to develop such techniques and protocols and to establish the safety of autologous ISC transplantation because outcomes in such models can be extrapolated more readily to humans.The field of intestinal stem cell biology has exploded over the past 5 years with discoveries related to in vivo and in vitro stem cell identity and function. The goal of this review article is to highlight the potential use of these cells to treat various epithelial disorders of the gut and discuss the various roadblocks that will be encountered in the coming years.

View details for DOI 10.5966/sctm.2016-0153

View details for PubMedID 27638919

A multicenter study to standardize reporting and analyses of fluorescence-activated cell-sorted murine intestinal epithelial cells AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY Magness, S. T., Puthoff, B. J., Crissey, M. A., Dunn, J., Henning, S. J., Houchen, C., Kaddis, J. S., Kuo, C. J., Li, L., Lynch, J., Martin, M. G., May, R., Niland, J. C., Olack, B., Qian, D., Stelzner, M., Swain, J. R., Wang, F., Wang, J., Wang, X., Yan, K., Yu, J., Wong, M. H. 2013; 305 (8): G542-G551

Abstract

Fluorescence-activated cell sorting (FACS) is an essential tool for studies requiring isolation of distinct intestinal epithelial cell populations. Inconsistent or lack of reporting of the critical parameters associated with FACS methodologies has complicated interpretation, comparison, and reproduction of important findings. To address this problem a comprehensive multicenter study was designed to develop guidelines that limit experimental and data reporting variability and provide a foundation for accurate comparison of data between studies. Common methodologies and data reporting protocols for tissue dissociation, cell yield, cell viability, FACS, and postsort purity were established. Seven centers tested the standardized methods by FACS-isolating a specific crypt-based epithelial population (EpCAM+/CD44+) from murine small intestine. Genetic biomarkers for stem/progenitor (Lgr5 and Atoh 1) and differentiated cell lineages (lysozyme, mucin2, chromogranin A, and sucrase isomaltase) were interrogated in target and control populations to assess intra- and intercenter variability. Wilcoxon's rank sum test on gene expression levels showed limited intracenter variability between biological replicates. Principal component analysis demonstrated significant intercenter reproducibility among four centers. Analysis of data collected by standardized cell isolation methods and data reporting requirements readily identified methodological problems, indicating that standard reporting parameters facilitate post hoc error identification. These results indicate that the complexity of FACS isolation of target intestinal epithelial populations can be highly reproducible between biological replicates and different institutions by adherence to common cell isolation methods and FACS gating strategies. This study can be considered a foundation for continued method development and a starting point for investigators that are developing cell isolation expertise to study physiology and pathophysiology of the intestinal epithelium.

View details for DOI 10.1152/ajpgi.00481.2012

View details for Web of Science ID 000325809200002

View details for PubMedID 23928185

View details for PubMedCentralID PMC3798732

A nomenclature for intestinal in vitro cultures AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY Stelzner, M., Helmrath, M., Dunn, J. C., Henning, S. J., Houchen, C. W., Kuo, C., Lynch, J., Li, L., Magness, S. T., Martin, M. G., Wong, M. H., Yu, J. 2012; 302 (12): G1359-G1363

Abstract

Many advances have been reported in the long-term culture of intestinal mucosal cells in recent years. A significant number of publications have described new culture media, cell formations, and growth patterns. Furthermore, it is now possible to study, e.g., the capabilities of isolated stem cells or the interactions between stem cells and mesenchyme. However, at the moment there is significant variation in the way these structures are described and named. A standardized nomenclature would benefit the ability to communicate and compare findings from different laboratories using the different culture systems. To address this issue, members of the NIH Intestinal Stem Cell Consortium herein propose a systematic nomenclature for in vitro cultures of the small and large intestine. We begin by describing the structures that are generated by preparative steps. We then define and describe structures produced in vitro, specifically: enterosphere, enteroid, reconstituted intestinal organoid, induced intestinal organoid, colonosphere, colonoid, and colonic organoid.

View details for DOI 10.1152/ajpgi.00493.2011

View details for Web of Science ID 000305398600001

View details for PubMedID 22461030

Risk Factors for Parenteral Nutrition-associated Liver Disease Following Surgical Therapy for Necrotizing Enterocolitis JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION Duro, D., Mitchell, P. D., Kalish, L. A., Martin, C., Mccarthy, M., Jaksic, T., Dunn, J., Brandt, M. L., Nobuhara, K. K., Sylvester, K. G., Moss, R. L., Duggan, C. 2011; 52 (5): 595-600

Abstract

The aim of the study was to prospectively determine risk factors for the development of parenteral nutrition-associated liver disease (PNALD) in infants who underwent surgery for necrotizing enterocolitis (NEC), the most common cause of intestinal failure in children.: From February 2004 to February 2007, we diagnosed 464 infants with NEC, of whom 180 had surgery. One hundred twenty-seven patients were available for full analysis. PNALD was defined as serum direct bilirubin 2 mg/dL or ALT 2 the upper limit of normal in the absence of sepsis after 14 days of exposure to PN.Median gestational age was 26 weeks and 68% were boys. Seventy percent of the cohort developed PNALD and the incidence of PNALD varied significantly across the 6 study sites, ranging from 56% to 85% (P = 0.05). Multivariable logistic regression analysis identified small-bowel resection or creation of jejunostomy (odds ratio [OR] 4.96, 95% confidence interval [CI] 1.97-12.51, P = 0.0007) and duration of PN in weeks (OR 2.37, 95% CI 1.56-3.60, P < 0.0001) as independent risk factors for PNALD. Preoperative exposure to PN was also associated with the development of PNALD; the risk of PNALD was 2.6 (95% CI 1.5-4.7; P = 0.001) times greater in patients with 4 weeks of preoperative PN compared with those with less preoperative PN use. Breast milk feedings, episodes of infection, and gestational age were not related to the development of PNALD.The incidence of PNALD is high in infants with NEC undergoing surgical treatment. Risk factors for PNALD are related to signs of NEC severity, including the need for small-bowel resection or proximal jejunostomy, as well as longer exposure to PN. Identification of these and other risk factors can help in the design of clinical trials for the prevention and treatment of PNALD and for clinical assessment of patients with NEC and prolonged PN dependence.

View details for DOI 10.1097/MPG.0b013e31820e8396

View details for Web of Science ID 000289671900018

View details for PubMedID 21464752

Risk Factors for Intestinal Failure in Infants with Necrotizing Enterocolitis: A Glaser Pediatric Research Network Study JOURNAL OF PEDIATRICS Duro, D., Kalish, L. A., Johnston, P., Jaksic, T., Mccarthy, M., Martin, C., Dunn, J. C., Brandt, M., Nobuhara, K. K., Sylvester, K. G., Moss, R. L., Duggan, C. 2010; 157 (2): 203-U50

Abstract

To determine risk factors for intestinal failure (IF) in infants undergoing surgery for necrotizing enterocolitis (NEC).Infants were enrolled in a multicenter prospective cohort study. IF was defined as the requirement for parenteral nutrition for >or= 90 days. Logistic regression was used to identify predictors of IF.Among 473 patients enrolled, 129 had surgery and had adequate follow-up data, and of these patients, 54 (42%) developed IF. Of the 265 patients who did not require surgery, 6 (2%) developed IF (OR 31.1, 95% CI, 12.9 - 75.1, P < .001). Multivariate analysis identified the following risk factors for IF: use of parenteral antibiotics on the day of NEC diagnosis (OR = 16.61, P = .022); birth weight < 750 grams, (OR = 9.09, P < .001); requirement for mechanical ventilation on the day of NEC diagnosis (OR = 6.16, P = .009); exposure to enteral feeding before NEC diagnosis (OR=4.05, P = .048); and percentage of small bowel resected (OR = 1.85 per 10 percentage point greater resection, P = .031).The incidence of IF among infants undergoing surgical treatment for NEC is high. Variables characteristic of severe NEC (low birth weight, antibiotic use, ventilator use, and greater extent of bowel resection) were associated with the development of IF.

View details for DOI 10.1016/j.jpeds.2010.02.023

View details for Web of Science ID 000279871700011

View details for PubMedID 20447649