The relationships of infant and childhood diet to growth and acute lymphoblastic leukemia

Diet during infancy and childhood can affect growth, onset of puberty and disease susceptibility throughout the life course. The goal of this research was to describe the associations of early life diet (birth – five years of age) with hormone levels and pubertal development in healthy adolescent females and with the risk of pediatric acute lymphoblastic leukemia (ALL), the most common form of pediatric cancer, in a population of boys and girls. Chapter 1 summarizes what is known about the early life diet and childhood growth, hormone levels and risk of acute lymphoblastic leukemia. It identifies gaps in the literature which led to the research described in this dissertation. Chapter 2 discusses findings on the effects of early life diet on serum insulin like growth factor-1 levels and breast development in healthy adolescent females. Child’s weekly dairy consumption from 3-5 years was inversely associated with the odds ratio of thelarche whereas child’s weight and maternal overweight during pregnancy were positively associated with the odds ratio of thelarche at 10.8 years. Chapter 3 discusses identification of two novel risk factors for pediatric ALL: longer duration of milk formula feeding and later introduction of solids foods. Chapter 4 describes research into windows of susceptibility for solid food introduction in ALL. Compared to children introduced to solids before 6 months of age, children introduced to solid foods at or after 7 months of age are at increased odds of ALL with a dose-response relationship between age at introduction to solids and the odds ratio of ALL. Potential mechanisms for the associations reported in chapters 3 & 4 are discussed. Chapter 5 details the association of age- and sex-adjusted height and weight at time of diagnosis with the odds ratio of ALL. The relationship of height at diagnosis to ALL is unclear, owing in part to inconsistencies in study methodology. Using a population of matched controls, we report no association of height at diagnosis with ALL. Children with low weight-for-age or weight-for-height were at increased odds of ALL. Finally, chapter 6 summarizes these findings and discusses their public health implications.Nutritional Science

Aorto-enteric Fistula Following Abdominal Aorta Surgery

Forty-six aorto-enteric fistuiae following abdominal aorta surgery are here recorded. A number of these have never before been recorded in the literature. For the first time sixteen cases of these aorto-enteric fistulae that were subjected to surgical intervention have been tabulated. Twelve of these had definitive surgery either immediately or eventually. The definitive procedures are also tabulated. An attempt was made to produce a fistula in dogs. Of twelve dogs, one died six months postoperatively of massive rectal hemorrhage due to an aortoduodenal fistula that followed the implantation of a Teflon vessel graft into the abdominal aorta. The cause of this fistula was infection and a hematoma. The etiologic factors for the development of these fistulae are recorded from the literature and from personal communications. These factors are: use of homografts, use of nylon grafts, poor vessel suture technic, formation of a hematoma at the suture line, too great porosity of synthetic grafts, infection of the graft, injury of the host vessel. pulsatile thrust of the aorta, redundancy of the grafts, and direct contact of bowel with the vessel anastomosis. Successful treatment of an aorto-enteric fistula following abdominal aortic surgery requires the following: prompt recognition of the presence of the fistula, control of hemorrhage, resection of the homograft or nylon graft, replacement of the graft with a Dacron or Teflon prosthesis, interposition of living tissue between the vessel anastomosis and the bowel, and careful placement of sutures in the vessel anastomosis. If infection of the graft coexists the graft must be excised and the aorta closed by sutures

Phenylketonuria

Genome research is emerging as a new and important tool in biology used to obtain information on gene sequences, genomic interaction, and how genes work in concert to produce the final syndrome or phenotype. Defect in phenylalanine hydroxylase (PAH) gene result in Phenylketonuria (PKU). Molecular studies using the brain of the mouse model for PKU (PAHenu2) showed altered expression of several genes including upregulation of orexin A and a low activity of branched chain aminotransferase. These studies suggest that a single gene (PAH) defect is associated with altered expression, transcription and translation of other genes. It is the combination of the primary gene defect, the altered expression of other genes, and the new metabolic environment that is created, which lead to the phenotype

Marked Verbal Forms in the Neo-Aramaic Dialects of Christian Barwar and Christian Urmi

This study analyzes three unmarked-marked verbal pairs that exist in the Neo-Aramaic dialects of Christian Barwar and Christian Urmi. Each pair is analyzed for the opposing forms' formal and functional differences, with an emphasis on function. It is argued that despite the fact that the morphemes affixed to the marked forms are aspectual prefixes, the marked forms' main functional differences from their unmarked counterparts are pragmatic ones. Chapter I presents an introduction to the study, including information about the dialects analyzed and the study itself. Chapter II focuses on the marked forms that signal relationships between events in the discourse. This chapter first explores the unmarked qaṭəl form versus the marked bəd-qaṭəl form, wherein it is argued that the marked form signals to the listener to interpret the marked event in relation to another event in the nearby discourse. The same unmarked qaṭəl form is then presented in opposition to the marked i-qaṭəl form, and it is claimed that the marked form indicates a sequence-final event. Chapter III is an analysis of the unmarked qṭille form versus the marked qəm-qaṭəl form, and it is determined that the marked form is used to represent the event from the point of view of the object. Chapter IV presents concluding remarks