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| 1 | Correlation of MRI-determined small bowel Crohn’s disease categories with medical response and surgical pathology显示文摘AIM: To determine whether magnetic resonance imaging (MRI) can be used to categorize small bowel Crohn's disease (SB CD) into groups that correlate with response to medical therapy and surgical pathology.METHODS: Data was collected from all patients with MRI evidence of SB CD without significant colonic disease over a 32-mo period. Two radiologists, blinded to clinical findings, evaluated each MRI and grouped them based on bowel wall thickness and wall enhancement. These categories were: (1) 'fibrosis', (2) 'mild segmental hyper-enhancement and mild wall thickening', (3) 'mild segmental hyper-enhancement and marked wall thickening', (4) 'marked segmental transmural hyper-enhancement'. Patient response to additional medical therapy post-MRI was prospectively determined at 8-wk. Non-responders underwent endoscopy and were offered therapeutic endoscopy or surgery. Surgical pathology was assessed against the MRI category. RESULTS: Fifty-five patients were included. Females and category '2' patients were more likely, and patients with luminal narrowing and hold-up less likely, to respond to medical therapy (P < 0.05). Seventeen patients underwent surgery. The surgical pathologicalfindings of fibrosis and the severity of inflammation correlated with the MRI category in all cases.CONCLUSION: Our fi ndings suggest that SB CD can be grouped by the MRI f indings and that these groups are associated with patients more likely to respond to continued medical therapy. The MRI categories also correlated with the presence and level of intestinal inflammation and fibrosis on surgical pathology, and may be of prognostic use in the management of CD patients. | Ian Craig Lawrance Christopher J Welman Peter Shipman Kevin Murray | 2009 | World Journal of Gastroenterology2009，15，27： | 12 |
| 2 | Dysregulation of innate immunity in ulcerative colitis patients who fail anti-tumor necrosis factor therapy显示文摘AIM To study the innate immune function in ulcerative colitis(UC) patients who fail to respond to anti-tumor necrosis factor(TNF) therapy.METHODS Effects of anti-TNF therapy, inflammation and medications on innate immune function were assessed by measuring peripheral blood mononuclear cell(PBMC) cytokine expression from 18 inflammatory bowel disease patients pre- and 3 mo post-anti-TNF therapy. Toll-like receptor(TLR) expression and cytokine production post TLR stimulation was assessed in UC 'responders'(n = 12) and 'non-responders'(n = 12) and compared to healthy controls(n = 12). Erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP) levels were measured in blood to assess disease severity/activity and inflammation. Pro-inflammatory(TNF, IL-1β, IL-6), immuno-regulatory(IL-10), Th1(IL-12, IFNγ) and Th2(IL-9, IL-13, IL-17A) cytokine expression was measured with enzyme-linked immunosorbent assay while TLR cellular composition and intracellular signalling was assessed with FACS.RESULTS Prior to anti-TNF therapy, responders and nonresponders had similar level of disease severity and activity. PBMC's ability to respond to TLR stimulation was not affected by TNF therapy, patient's severity of the disease and inflammation or their medication use. At baseline, non-responders had elevated innate but not adaptive immune responses compared to responders(P < 0.05). Following TLR stimulation, nonresponders had consistently reduced innate cytokine responses to all TLRs compared to healthy controls(P < 0.01) and diminished TNF(P < 0.001) and IL-1β(P < 0.01) production compared to responders. This innate immune dysfunction was associated with reduced number of circulating plasmacytoid dendritic cells(p DCs)(P < 0.01) but increased number of CD4+ regulatory T cells(Tregs)(P = 0.03) as well as intracellular accumulation of IRAK4 in non-responders following TLR-2,-4 and-7 activation(P < 0.001). CONCLUSION Reduced innate immunity in non-responders may explain reduced efficacy to anti-TNF therapy. These serological markers may prove useful in predicting the outcome of costly anti-TNF therapy. | Angela C Baird Dominic Mallon Graham Radford-Smith Julien Boyer Thierry Piche Susan L Prescott Ian C Lawrance Meri K Tulic | 2016 | World Journal of Gastroenterology2016，22，41： | 10 |
| 3 | Small bowel MRI enteroclysis or follow through:Which is optimal?显示文摘AIM:To determine if a nasojejunal tube(NJT) is required for optimal examination of enteroclysis and if patients can be examined only in the supine position.METHODS:Data were collected from all patients undergoing small bowel(SB) magnetic resonance imaging(MRI) examination over a 32-mo period.Patients either underwent a magnetic resonance(MR) follow-through(MRFT) or a MR enteroclysis(MRE) in the supine position.The quality of proximal and distal SB distension as well as the presence of motion artefact and image quality were assessed by 2 radiologists.RESULTS:One hundred and fourteen MR studies were undertaken(MRFT-49,MRE-65) in 108 patients in the supine position only.Image artefact was more frequent in MRE than in MRFT(29.2% vs 18.4%) ,but was not statistically significant(P = 0.30) .Adequate distension of the distal SB was obtained in 97.8% of MRFT examinations and in 95.4% of MRE examinations,respectively.Proximal SB distension was,however,less frequently optimal in MRFT than in MRE(P = 0.0036) ,particularly in patients over the age of 50 years(P = 0.0099) .Image quality was good in all examinations.CONCLUSION:All patients could be successfully imaged in the supine position.MRE and MRFT are equivalent for distal SB distension and artefact effects.Proximal SB distension is frequently less optimal in MRFT than in MRE.MRE is,therefore,the preferred MR examination method of the SB. | Ian C Lawrance Christopher J Welman Peter Shipman Kevin Murray | 2009 | World Journal of Gastroenterology2009，15，42： | 7 |
| 4 | Use of infliximab in the prevention and delay of colectomy in severe steroid dependant and refractory ulcerative colitis显示文摘AIM: To determine if infliximab can prevent or delay surgery in refractory ulcerative colitis (UC). METHODS: UC patients who failed to have their disease controlled with conventional therapies and were to undergo colectomy if infliximab failed to induce a clinical improvement were reviewed. Patients were primarily treated with a single 5 mg/kg infliximab dose. The Colitis Activity Index (CAI) was used to determine response and remission. Data of 8 wk response and colectomy rates at 6 mo and 12 mo were collected. RESULTS: Fifteen patients were included, 7 with UC unresponsive or intolerant to Ⅳ hydrocortisone, and 8 with active disease despite oral steroids (all but one with therapeutic dosage and duration of immunomodulation). All the Ⅳ hydrocortisone-resistant/intolerant patients had been on azathioprine/6-MP < 8 wk. At 8 wk, infliximab induced a response in 86.7% (13/15) with 40% in remission (6/15). Within 6 mo of treatment 26.7% (4/15) had undergone colectomy and surgery was avoided in 46.6% (7/15) at 12 mo. The colectomy rate at 12 mo in those on immunomodulatory therapy < 8 wk at time of infliximab was 12.5% (1/8) compared with 100% (7/7) in patients who were on long-term maintenance immunomodulators (P < 0.02). CONCLUSION: Infliximab prevented colectomy due to active disease in immunomodulatory-na?ve, refractory UC patients comparable to the use of Cyclosporine. In patients, however, on effective dosage and duration of immunomodulation at time of infliximab therapy colectomy was not avoided. | Robert P Willert Ian Craig Lawrance | 2008 | World Journal of Gastroenterology2008，14，16： | 5 |
| 5 | Use of mycophenolate mofetil in inflammatory bowel disease显示文摘AIM:To assess the efficacy and safety of mycophenolate mofetil(MMF)prospectively in inflammatory bowel disease(IBD)patients intolerant or refractory to conventional medical therapy.METHODS:Crohn's disease(CD)or ulcerative colitis/ IBD unclassified(UC/IBDU)patients intolerant or refractory to conventional medical therapy received MMF(500-2000 mg bid).Clinical response was assessed by the Harvey Bradshaw index(HBI)or colitis activity index(CAI)after 2,6 and 12 mo of therapy,as were steroid usage and adverse effects.RESULTS:Fourteen patients(9 CD/5 UC/IBDU;8M/6F;mean age 50.4 years,range 28-67 years)were treated and prospectively assessed for their response to oral MMF.Of the 11 patients who were not in remission on commencing MMF,7/11(63.6%)achieved remission by 8 wk.All 3 patients in remission on commencing MMF maintained their remission.Ten patients were still on MMF at 6 mo with 9/14(64.3%)in remission,while of 12 patients followed for 12 mo,8 were in remission without dose escalation(66.7%).Three patients were withdrawn from the MMF due to drug intolerance.There were no serious adverse events attributed due to the medication.CONCLUSION:MMF demonstrated efficacy in the management of difficult IBD.MMF appeared safe,well tolerated and efficacious for both short and long-term therapy,without the need for dose escalation.Further evaluation of MMF comparing it to conventional immunosuppressants is required. | Terrence Tan Ian Craig Lawrance | 2009 | World Journal of Gastroenterology2009，15，13： | 5 |
| 6 | Preventing infective complications in inflammatory bowel disease显示文摘Over the past decade there has been a dramatic change in the treatment of patients with Crohn’s disease and ulcerative colitis,which comprise the inflammatory bowel diseases(IBD).This is due to the increasing use of immunosuppressives and in particular the biological agents,which are being used earlier in the course of disease,and for longer durations,as these therapies result in better clinical outcomes for patients.This,however,has the potential to increase the risk of opportunistic and serious infections in these patients,most of which are preventable.Much like the risk for potential malignancy resulting from the use of these therapies long-term,a balance needs to be struck between medication use to control the disease with minimization of the risk of an opportunistic infection.This outcome is achieved by the physician’s tailored use of justified therapies,and the patients’education and actions to minimize infection risk.The purpose of this review is to explore the evidence and guidelines available to all physicians managing patients with IBD using immunomodulating agents and to aid in the prevention of opportunistic infections. | Justine Mill Ian C Lawrance | 2014 | World Journal of Gastroenterology2014，20，29： | 4 |
| 7 | Iron:An emerging factor in colorectal carcinogenesis显示文摘The carcinogenic potential of iron in colorectal cancer(CRC) is not fully understood.Iron is able to undergo reduction and oxidation,making it important in many physiological processes.This inherent redox property of iron,however,also renders it toxic when it is present in excess.Iron-mediated generation of reactive oxygen species via the Fenton reaction,if uncontrolled,may lead to cell damage as a result of lipid peroxidation and oxidative DNA and protein damage.This may promote carcinogenesis through increased genomic instability,chromosomal rearrangements as well as mutations of proto-oncogenes and tumour suppressor genes. Carcinogenesis is also affected by inflammation which is exacerbated by iron.Population studies indicate an association between high dietary iron intake and CRC risk.In this editorial,we examine the link betweeniron-induced oxidative stress and inflammation on the pathogenesis of CRC. | Anita CG Chua Borut Klopcic Ian C Lawrance John K Olynyk Debbie Trinder | 2010 | World Journal of Gastroenterology2010，16，6： | 3 |
| 8 | Continuous Therapy With Certolizumab Pegol Maintains Remission of Patients With Crohn’s Disease for up to 18 Months显示文摘 | Gary R. Lichtenstein Ole ?. Thomsen Stefan Schreiber Ian C. Lawrance Stephen B. Hanauer Ralph Bloomfield William J. Sandborn | 2010 | Clinical Gastroenterology and Hepatology2010，，7： | 2 |
| 9 | Stevens-Johnson syndrome complicating adalimumab therapy in Crohn's disease显示文摘The anti-tumor necrosis factor(TNF)αmedications demonstrate efficacy in the induction of remission and its maintenance in numerous chronic inflammatory conditions.With the increasing number of patients receiving anti-TNFαagents,however,less common adverse reactions will occur.Cutaneous eruptions complicating treatment with an anti-TNFαagent are not uncommon,occurring in around 20%of patients. Adalimumab,a fully humanized antibody against TNFα, may be expected to cause minimal immune-mediated skin reactions compared to the chimeric monoclonal antibody,infliximab.We,however,report a case of Stevens-Johnson syndrome that required hospitalization and cessation of adalimumab in a patient with Crohn’ s disease(CD).In this case report,a 29-year-old male with colonic and perianal CD with associated erythema nodosum and large joint arthropathy developed severe mucositis,peripheral rash and desquamation,fevers and respiratory symptoms concomitant with a second dose of 40 mg adalimumab after a 2 mo break from adalimumab therapy.Skin biopsies of the abdominal wall confirmed erythema multiforme and the patient was on no other drugs and infective etiologies were excluded.The patient responded rapidly to IV hydrocortisone and was able to be commenced on infliximab without recurrence of the Stevens-Johnson syndrome.Desquamating skin reactions have now been described in three of the TNFαantagonists(infliximab,etanercept and adalimumab).These reactions can be serious and prescribers need to be aware of the potential mucocutaneous side effects of these agents,especially as Stevens-Johnson syndrome is associated with significant morbidity and mortality. | Muna Salama Ian Craig Lawrance | 2009 | World Journal of Gastroenterology2009，15，35： | 2 |
| 10 | Vedolizumab for ulcerative colitis: Real world outcomes from a multicenter observational cohort of Australia and Oxford显示文摘BACKGROUND Vedolizumab(VDZ),a humanised monoclonal antibody that selectively inhibits alpha4-beta7 integrins is approved for use in adult moderate to severe ulcerative colitis(UC)patients.AIM To assess the efficacy and safety of VDZ in the real-world management of UC in a large multicenter cohort involving two countries and to identify predictors of achieving remission.METHODS A retrospective review of Australian and Oxford,United Kingdom data for UC patients.Clinical response at 3 mo,endoscopic remission at 6 mo and clinical remission at 3,6 and 12 mo were assessed.Cox regression models and Kaplan Meier curves were performed to assess the time to remission,time to failure and the covariates influencing them.Safety outcomes were recorded.RESULTS Three hundred and three UC patients from 14 centres in Australia and United Kingdom,[60%n=182,anti-TNF naïve]were included.The clinical response was 79%at 3 mo with more Australian patients achieving clinical response compared to Oxford(83%vs 70%P=0.01).Clinical remission for all patients was 56%,62%and 60%at 3,6 and 12 mo respectively.Anti-TNF naive patients were more likely to achieve remission than exposed patients at all the time points(3 mo 66%vs 40%P<0.001,6 mo 73%vs 46%P<0.001,12 mo 66%vs 51%P=0.03).More Australian patients achieved endoscopic remission at 6 mo compared to Oxford(69%vs 43%P=0.01).On multi-variate analysis,anti-TNF naïve patients were 1.8(95%CI:1.3-2.3)times more likely to achieve remission than anti-TNF exposed(P<0.001).32 patients(11%)had colectomy by 12 mo.CONCLUSION VDZ was safe and effective with 60%of UC patients achieving clinical remission at 12 mo and prior anti-TNF exposure influenced this outcome. | Samba Siva Reddy Pulusu Ashish Srinivasan Krupa Krishnaprasad Daniel Cheng Jakob Begun CharlotteKeung Daniel Van Langenberg Lena Thin Tamara Mogilevski Peter De Cruz Graham Radford-Smith Emma Flanagan Sally Bell Soleiman Kashkooli Miles Sparrow Simon Ghaly Peter Bampton Elise Sawyer Susan Connor Quart-ul-ain Rizvi Jane M Andrews Gillian Mahy Paola Chivers Simon Travis Ian Craig Lawrance | 2020 | World Journal of Gastroenterology2020，26，30： | 2 |
| 11 | Inter-observer agreement for Crohn’s disease sub-phenotypes using the Montreal Classification: How good are we? A multi-centre Australasian study显示文摘 | Krupa Krishnaprasad Jane M. Andrews Ian C. Lawrance Timothy Florin Richard B. Gearry Rupert W.L. Leong Gillian Mahy Peter Bampton Ruth Prosser Peta Leach Laurie Chitti Charles Cock Rachel Grafton Anthony R. Croft Sharon Cooke James D. Doecke Graham L. Rad | 2011 | Journal of Crohn’s and Colitis2011，，3： | 2 |
| 12 | To clot or not to clot? That is the question in central venous catheters显示文摘 | Cadman A Lawrance J A Fitzsimmons L | 2004 | Clin Radiol2004，59，4： | 1 |
| 13 | A New Autoregressive Time Series Model in Exponential Variables (NEAR (1) 显示文摘 | LAWRANCE A J LEWIS P A W | 1981 | Advances in Applied Probability1981，13，： | 1 |
| 14 | Maintenance therapy with certolizumab pegol for Crohn's disease 显示文摘 | Schreiber S Khaliq-Kareemi M Lawrance IC | 2007 | N Engl J Med2007，357，： | 1 |
| 15 | A mixed time series exponential model显示文摘 | Lawrance A J Lewis P A W | 1982 | Management Science1982，9，： | 1 |
| 16 | In situ investigation of the calcium-induced proteolytic and salting-in mechanisms causing tenderization in calcium-enhanced muscle显示文摘 | Lawrance T E Dikeman M E Stephens J W | 2003 | Meat Sci2003，66，： | 1 |
| 17 | Griffith, Control and bank performance 显示文摘 | Lawrance Fogelberg John M | 2000 | Journal of Financial and Strategic Decisions2000，，3： | 1 |
| 18 | A battery management system for stand-alone Photovoltaic energe systems显示文摘 | Duryea S Islam S Lawrance W | 2001 | IEEE Industry Applications Magazine2001，7，3： | 1 |
| 19 | Effects of a peptide analogue of the amphiphilic domain of the common neurotrophin recepter on nerve growth factor-mediated motility of human neuroblastoma cells显示文摘 | Wang W Dostaler S M Lawrance G | 1998 | Journal of Neurochemistry1998，70，6： | 1 |
| 20 | Radiation dose reduction at a price : the effectiveness of a male gonadal shield during helical CT scans 显示文摘 | Lawrance T Daner Kevin A Caseiotta Yusuf E Erdi | 2007 | BMC Medical Imaging2007，16，： | 1 |
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