Rohit Kohli

Professor of Pediatrics (Clinical Scholar)

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Overview

Dr. Kohli received his medical degree from the Armed Forces Medical College, India in 1999 and his MS in clinical investigation from Northwestern University in 2006. While at Northwestern he first spent three years as a pediatric gastroenterology and hepatology fellow and then subsequently as a transplant hepatology trainee before relocating to the University of Cincinnati in 2007. He was faculty at Cincinnati Children’s and leading the pediatric liver transplant program before he again relocated to USC/Children’s Hospital Los Angeles in 2016.

His research work has focused on the pathogenesis of obesity related fatty liver disease (NAFLD). In particular, he has focused upon the role of bile acid signaling as a mechanism for NAFLD resolution after weight loss surgery. His work has also shed light on reactive oxygen stress in the generation and regulation of the extreme stage of this disease; nonalcoholic steatohepatitis (NASH). He has published many peer-reviewed articles including articles in Nature, Nature Reviews, The Journal of Biological Chemistry, Hepatology, Journal of Pediatrics, and The American Journal of Physiology. He is the author of many book chapters and review articles. He also is the recipient of the 2007 George Ferry Young Investigator Award from the Children’s Digestive Health and Nutrition Foundation, a Fellowship award from the American Association for the Study of Liver Diseases, Takeda Research Innovation Award from the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Foundation. He is currently funded by the NIH as an independent scientist through the R01 mechanism.

He currently leads The George Donnell Society for Pediatric Scientists at Children’s Hospital Los Angeles.

Publications

  • Effect of N-acetyl cysteine in children with metabolic dysfunction-associated steatotic liver disease-A pilot study J Pediatr Gastroenterol Nutr. 2024 Jul 08. . View in PubMed
  • Advocacy in pediatric gastroenterology: An academic clinician’s impact and guide J Pediatr Gastroenterol Nutr. 2024 Jul; 79(1):6-9. . View in PubMed
  • Exposure to per- and polyfluoroalkyl substances and alterations in plasma microRNA profiles in children Environ Res. 2024 Jun 25; 119496. . View in PubMed
  • Changes in plasma concentrations of per- and Polyfluoroalkyl substances after bariatric surgery in adolescents from the Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) study Sci Total Environ. 2024 Jun 20; 930:172840. . View in PubMed
  • The combined pioglitazone and topiramate therapy for management of pediatric patients with severe MASLD Saudi J Gastroenterol. 2024 May 10. . View in PubMed
  • Associations of dietary sugars with liver stiffness in Latino adolescents with obesity differ on PNPLA3 and liver disease severity Liver Int. 2024 Apr 18. . View in PubMed
  • Spatially resolved immune exhaustion within the alloreactive microenvironment predicts liver transplant rejection Sci Adv. 2024 Apr 12; 10(15):eadm8841. . View in PubMed
  • Intestinal FGF15 regulates bile acid and cholesterol metabolism but not glucose and energy balance JCI Insight. 2024 Apr 08; 9(7). . View in PubMed
  • CHALF Score: A Novel Tool to Rapidly Risk Stratify Children in Need of Liver Transplant Evaluation During Acute Liver Failure Transplantation. 2024 Apr 01; 108(4):930-939. . View in PubMed
  • Response Regarding Application of the CHALF Score in Pediatric Acute Liver Failure Transplantation. 2024 Apr 01; 108(4):e66-e67. . View in PubMed
  • Hepatic Encephalopathy in Children Indian J Pediatr. 2024 Mar; 91(3):280-285. . View in PubMed
  • Vagal activation alters prandial bile acid composition and glycemia in patients with hypoglycemia after Roux-en-Y gastric bypass surgery Neurogastroenterol Motil. 2024 Feb 11; e14763. . View in PubMed
  • Finance, race, ethnicity, and spoken language impact clinical outcomes for children with acute liver failure Pediatr Transplant. 2024 Feb; 28(1):e14686. . View in PubMed
  • Circulating microRNA expression and nonalcoholic fatty liver disease in adolescents with severe obesity World J Gastroenterol. 2024 Jan 28; 30(4):332-345. . View in PubMed
  • Protein biomarkers GDF15 and FGF21 to differentiate mitochondrial hepatopathies from other pediatric liver diseases Hepatol Commun. 2024 Jan 01; 8(1). . View in PubMed
  • Technical optimization of spatially resolved single-cell transcriptomic datasets to study clinical liver disease Sci Rep. 2024 02 13; 14(1):3612. . View in PubMed
  • Lysophosphatidic acid receptor 1 antagonist (EPGN2154) causes regression of NASH in preclinical NASH models Hepatol Commun. 2023 Dec 01; 7(12). . View in PubMed
  • Technical optimization of spatially resolved single-cell transcriptomic datasets to study clinical liver disease Res Sq. 2023 Sep 05. . View in PubMed
  • Effects of Dietary Sugar Reduction on Biomarkers of Cardiometabolic Health in Latino Youth: Secondary Analyses from a Randomized Controlled Trial Nutrients. 2023 Jul 27; 15(15). . View in PubMed
  • Spatially resolved immune exhaustion within the alloreactive microenvironment predicts liver transplant rejection Res Sq. 2023 Jul 03. . View in PubMed
  • Model for End-Stage Liver Disease/Pediatric End-Stage Liver Disease exception policy and outcomes in pediatric patients with hepatopulmonary syndrome requiring liver transplantation Liver Transpl. 2023 Feb 01; 29(2):134-144. . View in PubMed
  • Special Population: Pediatric Nonalcoholic Fatty Liver Disease Clin Liver Dis. 2023 05; 27(2):471-482. . View in PubMed
  • Presence of Alpha 1 Antitrypsin Risk Variants is Not Associated With Histologic Severity of Pediatric NAFLD J Pediatr Gastroenterol Nutr. 2023 08 01; 77(2):166-170. . View in PubMed
  • Clinical spectrum and genetic causes of mitochondrial hepatopathy phenotype in children Hepatol Commun. 2023 06 01; 7(6). . View in PubMed
  • Sarcopenia is associated with osteopenia and impaired quality of life in children with genetic intrahepatic cholestatic liver disease Hepatol Commun. 2023 11 01; 7(11). . View in PubMed
  • Paired Liver:Plasma PFAS Concentration Ratios from Adolescents in the Teen-LABS Study and Derivation of Empirical and Mass Balance Models to Predict and Explain Liver PFAS Accumulation Environ Sci Technol. 2023 10 10; 57(40):14817-14826. . View in PubMed
  • Serum biomarkers correlated with liver stiffness assessed in a multicenter study of pediatric cholestatic liver disease Hepatology. 2023 02 01; 77(2):530-545. . View in PubMed
  • GI Multisociety Strategic Plan on Environmental SustainabilityGastroenterology. 2022 Dec; 163(6):1695-1701. e2. . View in PubMed
  • GI multisociety strategic plan on environmental sustainability Hepatology. 2022 Dec; 76(6):1836-1844. . View in PubMed
  • Liver Transpl 2022 Aug 21; 134-144. . View in PubMed
  • Pediatric NASH therapies: A speedbump on the road to success Hepatology. 2022 08; 76(2):292-294. . View in PubMed
  • Impact of long-term administration of maralixibat on children with cholestasis secondary to Alagille syndrome Hepatol Commun. 2022 08; 6(8):1922-1933. . View in PubMed
  • Nature or Nurture in the Pathogenesis of Biliary Atresia? J Pediatr. 2022 07; 246:10-11.e1.. View in PubMed
  • Changes in Resting Energy Expenditure After Sleeve Gastrectomy: a Review of the Literature Obes Surg. 2022 07; 32(7):2484-2487. . View in PubMed
  • Clinical Value of Surveillance Biopsies in Pediatric Liver Transplantation Liver Transpl. 2022 05; 28(5):843-854. . View in PubMed
  • Exposure to per- and Polyfluoroalkyl Substances and Markers of Liver Injury: A Systematic Review and Meta-Analysis Environ Health Perspect. 2022 04; 130(4):46001. . View in PubMed
  • Stratification by obesity class, rather than age, can identify a higher percent of children at risk for non-alcoholic fatty liver disease and metabolic dysfunction Pediatr Obes. 2022 03; 17(3):e12862. . View in PubMed
  • Clinical Intervention to Reduce Dietary Sugar Does Not Affect Liver Fat in Latino Youth, Regardless of PNPLA3 Genotype: A Randomized Controlled Trial J Nutr. 2022 07 06; 152(7):1655-1665. . View in PubMed
  • Adaptation of Imaging Mass Cytometry to Explore the Single Cell Alloimmune Landscape of Liver Transplant Rejection Front Immunol. 2022; 13:831103. . View in PubMed
  • Evaluation of Fontan-associated Liver Disease and Ethnic Disparities in Long-term Survivors of the Fontan Procedure: A Population-based Study Ann Surg. 2022 09 01; 276(3):482-490. . View in PubMed
  • Non-invasive biomarkers of Fontan-associated liver disease JHEP Rep. 2021 Dec; 3(6):100362. . View in PubMed
  • Living Donor Versus Deceased Donor Pediatric Liver Transplantation: A Systematic Review and Meta-analysis Transplant Direct. 2021 Oct; 7(10):e767. . View in PubMed
  • PNPLA3 Genotype, Arachidonic Acid Intake, and Unsaturated Fat Intake Influences Liver Fibrosis in Hispanic Youth with Obesity Nutrients. 2021 May 12; 13(5). . View in PubMed
  • Pediatric Nonalcoholic Fatty Liver Disease Pediatr Clin North Am. 2021 12; 68(6):1309-1320. . View in PubMed
  • Hepatic Ago2 Regulates PPARa for Oxidative Metabolism Linked to Glycemic Control in Obesity and Post Bariatric Surgery Endocrinology. 2021 04 01; 162(4). . View in PubMed
  • The Role of FGF19 and MALRD1 in Enterohepatic Bile Acid Signaling Front Endocrinol (Lausanne). 2021; 12:799648. . View in PubMed
  • A Diet High in Fat and Fructose Induces Early Hepatic Mitochondrial Aging J Pediatr Gastroenterol Nutr. 2021 07 01; 73(1):99-102. . View in PubMed
  • Assessment of the role of FGF15 in mediating the metabolic outcomes of murine Vertical Sleeve Gastrectomy (VSG) Am J Physiol Gastrointest Liver Physiol. 2020 Sep 23. . View in PubMed
  • Emerging New Diagnostic Modalities and Therapies of Nonalcoholic Fatty Liver Disease Curr Gastroenterol Rep. 2020 Aug 19; 22(10):52. . View in PubMed
  • Hepatic Deficiency of Augmenter of Liver Regeneration Predisposes to Nonalcoholic Steatohepatitis and Fibrosis Hepatology. 2020 11; 72(5):1586-1604. . View in PubMed
  • Initial assessment and ongoing monitoring of lysosomal acid lipase deficiency in children and adults: Consensus recommendations from an international collaborative working group Mol Genet Metab. 2020 02; 129(2):59-66. . View in PubMed
  • Rebaudioside affords hepatoprotection ameliorating sugar sweetened beverage- induced nonalcoholic steatohepatitis Sci Rep. 2020 04 21; 10(1):6689. . View in PubMed
  • Designing Clinical Trials in Pediatric Nonalcoholic Steatohepatitis: Tips for Patient Selection and Appropriate Endpoints Hepatol Commun. 2019 Dec; 3(12):1563-1570. . View in PubMed
  • When the beverage is sweet, how does the liver feel? Curr Treat Options Pediatr. 2019 Dec; 5(4):458-465.. View in PubMed
  • Severe Late-Onset Acute Cellular Rejection in a Pediatric Patient With Isolated Small Intestinal Transplant Rescued With Aggressive Immunosuppressive Approach: A Case Report Transplant Proc. 2019 Nov; 51(9):3181-3185. . View in PubMed
  • Immunologic benefit of maternal donors in pediatric living donor liver transplantation Pediatr Transplant. 2019 11; 23(7):e13560. . View in PubMed
  • Case series and systematic review of acquired diaphragmatic hernia after liver transplantation Pediatr Transplant. 2018 12; 22(8):e13296. . View in PubMed
  • Postprandial Uridine Physiology Is Altered by Obesity Gastroenterology. 2018 11; 155(5):1645-1646. . View in PubMed
  • Hepatology. 2018 10; 68(4):1644-1646. . View in PubMed
  • “Twin” Biliary Trees in a Patient With Heterotaxy Syndrome J Pediatr Gastroenterol Nutr. 2018 06; 66(6):e158. . View in PubMed
  • Liver transplantation in children: state of the art and future perspectives Arch Dis Child. 2018 02; 103(2):192-198. . View in PubMed
  • Increased glycine-amidated hyocholic acid correlates to improved early weight loss after sleeve gastrectomy Surg Endosc. 2018 02; 32(2):805-812. . View in PubMed
  • The presence and severity of nonalcoholic steatohepatitis is associated with specific changes in circulating bile acids Hepatology. 2018 02; 67(2):534-548. . View in PubMed
  • Bile acid metabolism and signaling: potential therapeutic target for nonalcoholic fatty liver disease Clin Transl Gastroenterol. 2018 06 29; 9(6):164. . View in PubMed
  • Quantitative Liver MRI-Biopsy Correlation in Pediatric and Young Adult Patients With Nonalcoholic Fatty Liver Disease: Can One Be Used to Predict the Other? AJR Am J Roentgenol. 2018 Jan; 210(1):166-174.. View in PubMed
  • Response to Letters Regarding the NASPGHAN NAFLD Guidelines J Pediatr Gastroenterol Nutr. 2017 Sep 01. . View in PubMed
  • Mixed-lineage kinase 3 pharmacological inhibition attenuates murine nonalcoholic steatohepatitis JCI Insight. 2017 Aug 03; 2(15). . View in PubMed
  • Hepatic Natural Killer T-cell and CD8+ T-cell Signatures in Mice with Nonalcoholic Steatohepatitis Hepatol Commun. 2017 Jun; 1(4):299-310. . View in PubMed
  • Response to the Letters Regarding the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition NAFLD Guidelines J Pediatr Gastroenterol Nutr. 2017 11; 65(5):e115-e116. . View in PubMed
  • Hepatic Issues and Complications Associated With Inflammatory Bowel Disease: A Clinical Report From the NASPGHAN Inflammatory Bowel Disease and Hepatology Committees J Pediatr Gastroenterol Nutr. 2017 04; 64(4):639-652. . View in PubMed
  • NASPGHAN Clinical Practice Guideline for the Diagnosis and Treatment of Nonalcoholic Fatty Liver Disease in Children: Recommendations from the Expert Committee on NAFLD (ECON) and the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) J Pediatr Gastroenterol Nutr. 2017 02; 64(2):319-334. . View in PubMed
  • Treatment of Inferior Vena Cava Obstruction Following Pediatric Liver Transplantation: Novel Use of a Customized Endovascular Stent J Pediatr. 2017 01; 180:256-260. . View in PubMed
  • Impact of Fibroblast Growth Factors 19 and 21 in Bariatric Metabolism Dig Dis. 2017; 35(3):191-196. . View in PubMed
  • Alpha 1-antitrypsin levels can differentiate allelic phenotypes Dig Liver Dis. 2016 Dec; 48(12):1510-1511. . View in PubMed
  • Prospective Assessment of Correlation between US Acoustic Radiation Force Impulse and MR Elastography in a Pediatric Population: Dispersion of US Shear-Wave Speed Measurement Matters Radiology. 2016 Nov; 281(2):544-552. . View in PubMed
  • In Children With Nonalcoholic Fatty Liver Disease, Cysteamine Bitartrate Delayed Release Improves Liver Enzymes but Does Not Reduce Disease Activity ScoresGastroenterology. 2016 12; 151(6):1141-1154. e9. . View in PubMed
  • Fibroblast growth factor 21 correlates with weight loss after vertical sleeve gastrectomy in adolescents Obesity (Silver Spring). 2016 11; 24(11):2377-2383. . View in PubMed
  • Lysosomal Acid Lipase Deficiency Unmasked in Two Children With Nonalcoholic Fatty Liver Disease Pediatrics. 2016 10; 138(4). . View in PubMed
  • Bariatric Surgery: The Rise and Fall of Bile Acids Surg Obes Relat Dis. 2016 05; 12(4):770-771. . View in PubMed
  • Pediatric Nonalcoholic Fatty Liver Disease: A Report from the Expert Committee on Nonalcoholic Fatty Liver Disease (ECON) J Pediatr. 2016 05; 172:9-13. . View in PubMed
  • Let the bile flow! Hepatology 2015 Dec; 62(6):1870. . View in PubMed
  • Familial homozygous hypercholesterolemia: When to turn to transplant? Pediatr Transplant. 2015 Sep; 19(6):577-9.. View in PubMed
  • Neurologic outcome of urea cycle disorder liver transplant recipients may be predicted by pretransplant neurological imaging Pediatr Transplant. 2015 Aug; 19(5):527-30. . View in PubMed
  • The evaluation of hepatic fibrosis scores in children with nonalcoholic fatty liver disease Dig Dis Sci. 2015 May; 60(5):1440-7. . View in PubMed
  • Improvement in liver histology is associated with reduction in dyslipidemia in children with nonalcoholic fatty liver disease J Pediatr Gastroenterol Nutr. 2015 Mar; 60(3):360-7. . View in PubMed
  • Bile Acid Signaling: Mechanism for Bariatric Surgery, Cure for NASH? Dig Dis. 2015; 33(3):440-6.. View in PubMed
  • The role of small heterodimer partner in nonalcoholic fatty liver disease improvement after sleeve gastrectomy in mice Obesity (Silver Spring). 2014 Nov; 22(11):2301-11. . View in PubMed
  • Effect of guanylate cyclase-C activity on energy and glucose homeostasis Diabetes. 2014 Nov; 63(11):3798-804. . View in PubMed
  • Duodenal nutrient exclusion improves metabolic syndrome and stimulates villus hyperplasia Gut. 2014 Aug; 63(8):1238-46. . View in PubMed
  • High prevalence of hepatitis B non-immunity in paediatric non-alcoholic fatty liver disease patients Dig Liver Dis. 2014 Aug; 46(8):760-1. . View in PubMed
  • NHE1 deficiency in liver: implications for non-alcoholic fatty liver disease Biochem Biophys Res Commun. 2014 Jul 25; 450(2):1027-31. . View in PubMed
  • FXR is a molecular target for the effects of vertical sleeve gastrectomy Nature. 2014 May 08; 509(7499):183-8. . View in PubMed
  • IL-17 signaling accelerates the progression of nonalcoholic fatty liver disease in mice Hepatology. 2014 May; 59(5):1830-9. . View in PubMed
  • There’s more under the nonalcoholic fatty liver disease umbrella than an elevated alanine aminotransferase level J Pediatr. 2014 Apr; 164(4):684-6. . View in PubMed
  • Mixed lineage kinase 3 deficient mice are protected against the high fat high carbohydrate diet-induced steatohepatitis Liver Int. 2014 Mar; 34(3):427-37. . View in PubMed
  • Vertical sleeve gastrectomy reduces hepatic steatosis while increasing serum bile acids in a weight-loss-independent manner Obesity (Silver Spring). 2014 Feb; 22(2):390-400. . View in PubMed
  • Use of magnetic resonance elastography to assess hepatic fibrosis in children with chronic liver disease J Pediatr. 2014 Jan; 164(1):186-8. . View in PubMed
  • Diabetes: the search for mechanisms underlying bariatric surgery Nat Rev Endocrinol. 2013 Oct; 9(10):572-4. . View in PubMed
  • MLK3 promotes metabolic dysfunction induced by saturated fatty acid-enriched diet Am J Physiol Endocrinol Metab. 2013 Aug 15; 305(4):E549-56. . View in PubMed
  • A surgical model in male obese rats uncovers protective effects of bile acids post-bariatric surgery Endocrinology. 2013 Jul; 154(7):2341-51. . View in PubMed
  • A multidisciplinary clinical program is effective in stabilizing BMI and reducing transaminase levels in pediatric patients with NAFLD J Pediatr Gastroenterol Nutr. 2013 Jul; 57(1):119-23. . View in PubMed
  • Weight loss induced by Roux-en-Y gastric bypass but not laparoscopic adjustable gastric banding increases circulating bile acids J Clin Endocrinol Metab. 2013 Apr; 98(4):E708-12. . View in PubMed
  • Fatty liver disease in children–what should one do? Indian J Pediatr. 2013 Mar; 80 Suppl 1:S109-14.. View in PubMed
  • Advances in the surgical treatment of morbid obesity Mol Aspects Med. 2013 Feb; 34(1):84-94. . View in PubMed
  • Isolated unilateral cytomegalovirus retinitis: a rare long-term complication after pediatric liver transplantation Pediatr Transplant. 2013 Feb; 17(1):E16-9. . View in PubMed
  • Fibroblast growth factor-19 action in the brain reduces food intake and body weight and improves glucose tolerance in male rats Endocrinology. 2013 Jan; 154(1):9-15. . View in PubMed
  • An adolescent girl with belly pain: one gallbladder too many? J Pediatr Gastroenterol Nutr. 2012 Dec; 55(6):e142.. View in PubMed
  • The role of the gut hormone GLP-1 in the metabolic improvements caused by ileal transposition J Surg Res. 2012 Nov; 178(1):33-9. . View in PubMed
  • Treating pediatric nonalcoholic fatty liver disease with cysteamine: is adiponectin the key? J Pediatr. 2012 Oct; 161(4):579-81.. View in PubMed
  • Pediatric nonalcoholic fatty liver disease: Prevalence, diagnosis, risk factors, and management Clin Liver Dis (Hoboken). 2012 Sep; 1(4):125-128. . View in PubMed
  • Retrospective review of the incidence of cytomegalovirus infection and disease after liver transplantation in pediatric patients: comparison of prophylactic oral ganciclovir and oral valganciclovir Liver Transpl. 2012 Mar; 18(3):347-54. . View in PubMed
  • Insulin concentration modulates hepatic lipid accumulation in mice in part via transcriptional regulation of fatty acid transport proteins PLoS One. 2012; 7(6):e38952. . View in PubMed
  • NASH animal models: are we there yet? J Hepatol. 2011 Oct; 55(4):941-3.. View in PubMed
  • Molecular insights from bariatric surgery Rev Endocr Metab Disord. 2011 Sep; 12(3):211-7. . View in PubMed
  • Mechanisms of lipotoxicity in NAFLD and clinical implications J Pediatr Gastroenterol Nutr. 2011 Aug; 53(2):131-40. . View in PubMed
  • Relations of steatosis type, grade, and zonality to histological features in pediatric nonalcoholic fatty liver disease J Pediatr Gastroenterol Nutr. 2011 Feb; 52(2):190-7. . View in PubMed
  • High-fructose, medium chain trans fat diet induces liver fibrosis and elevates plasma coenzyme Q9 in a novel murine model of obesity and nonalcoholic steatohepatitis Hepatology. 2010 Sep; 52(3):934-44. . View in PubMed
  • Intestinal adaptation after ileal interposition surgery increases bile acid recycling and protects against obesity-related comorbidities Am J Physiol Gastrointest Liver Physiol. 2010 Sep; 299(3):G652-60. . View in PubMed
  • Rapid progression of NASH in childhood J Pediatr Gastroenterol Nutr. 2010 Apr; 50(4):453-6. . View in PubMed
  • Nonalcoholic steatohepatitis in children: a multicenter clinicopathological study Hepatology. 2009 Oct; 50(4):1113-20. . View in PubMed
  • Mitochondrial reactive oxygen species signal hepatocyte steatosis by regulating the phosphatidylinositol 3-kinase cell survival pathway J Biol Chem. 2007 Jul 20; 282(29):21327-36. . View in PubMed
  • Roles of phosphatidylinositol 3-kinase and osteopontin in steatosis and aminotransferase release by hepatocytes treated with methionine-choline-deficient medium Am J Physiol Gastrointest Liver Physiol. 2006 Jul; 291(1):G55-62. . View in PubMed
  • Carnitine treatment inhibits increases in cerebral carnitine esters and glutamate detected by mass spectrometry after hypoxia-ischemia in newborn rats Stroke. 2006 Feb; 37(2):524-30. . View in PubMed
  • Mesalamine-induced pneumonitis during therapy for chronic inflammatory bowel disease: a pediatric case report J Pediatr Gastroenterol Nutr. 2005 Oct; 41(4):479-82. . View in PubMed
  • Relative elevations of serum alanine and aspartate aminotransferase in muscular dystrophy J Pediatr Gastroenterol Nutr. 2005 Jul; 41(1):121-4. . View in PubMed
  • Differential diagnosis of recurrent abdominal pain: new considerations Pediatr Ann. 2004 Feb; 33(2):113-22. . View in PubMed