bluuebunny/crossref_metadata_2025 huggingface dataset:
Purification of freshwater picoplanktonic cyanobacteria by pour‐plating in ‘ultra‐low‐gelling‐temperature agarose’
Authors: Watanabe Makoto M. , Nakagawa Megumi , Katagiri Masayuki , Aizawa Ken‐ichi , Hiroki Mikiya , Nozaki Hisayoshi
Published: March 2003

Seven unialgal cultures of picoplanktonic cyanobacteria isolated from freshwater lakes in Japan were examined in the present study. They are assignable to the Cyanobium cluster of the Synechococcus group sensu Waterbury and Rippka (1989) based on morphology, GC content, fatty acid and quinon compositions. They include one blue‐green colored strain (NIES‐680) with only phycocyanin as well as the PCC strains of Cyanobium cluster (Waterbury and Rippka 1989) and six reddish colored strains (NIES‐715, ‐717, ‐718, ‐721, ‐722 and ‐723) with both phycocyanin and phycoerythrin. All the strains examined developed colonies in pour‐plates I of 1.4%‘ultra‐low‐gel‐ling‐temperature agarose’within 1 month. The colony numbers were 12–20 × 102 c.f.u. mL‐1. Most clones derived from the colonies were axenic by the bacteria‐free check. The length of this procedure, preculture excepted, was 4–6 weeks. Colony formation in pour‐plate II of 0.6% agarose was observed in the blue‐green strain (NIES‐680) and the three reddish strains (NIES‐717,‐721 and ‐723) after 1–2 months. The number of colonies formed on pour‐plate II were 1–2 × 102 c.f.u. mL‐1, much lower than those on pour‐plate I. Only a blue‐green strain formed colonies on spread plates of 0.6% agarose. The colony numbers developed were 10–15 × 102 c.f.u. mL‐1 and similar to those on pour‐plate I. The other reddish strains did not develop colonies on spread plates. The pour‐plating method developed provides a highly efficient and successful method for obtaining axenic clonal cultures of planktonic cyanobacteria.
Flowcytometric analysis of bronchoalveolar lavage fluid cells in polymyositis/dermatomyositis with interstitial pneumonia
Authors: Kourakata Hiroyo , Takada Toshinori , Suzuki Eiichi , Enomoto Katsumi , Saito Isao , Taguchi Yoko , Tsukada Hiroki , Nakano Masaaki , Arakawa Masaaki
Published: March 2003

Objective: Interstitial lung disease (ILD) is a complication occurring in 10–30% of patients with polymyositis/dermatomyositis (PM/DM) as well as in those with progressive systemic sclerosis (PSS). Clinical features are different between these two disease states, notably with respect to the duration of manifestations, pathological findings, response to steroid therapy etc. However, dissimilarities in pulmonary inflammatory cell characteristics, which, if present at all, would be of critical importance, remain as yet to be clarified.

Methodology: The phenotypes of lymphocytes and alveolar macrophages in bronchoalveolar lavage fluid (BALF) were analysed to elucidate phenotypic peculiarity of pulmonary inflammatory cells of ILD in PM/DM. Eight PM/DM patients with ILD (mean age 47.9 years) were examined by bronchofibrescopy under local anaesthesia. Bronchoalveolar lavage was performed from the right middle lobe using four 50 mL aliquots of normal saline and the recovered fluid was compared with BALF of ILD in PSS.

Results: Bronchoalveolar lavage fluid cells of PM/DM patients with ILD showed an increased percentage of CD8+ lymphocytes, in particular CD8+ histocompatibility leucocyte antigen‐DR positive lymphocytes and CD8+ CD11b‐lymphocytes, both of which represent cytotoxic T cells. However, phenotypic differences in these lymphocytes were not found between PM and DM. The percentage of alveolar macrophages with expression of histocompatibility leucocyte antigen‐DQ was significantly different among the three groups (PM/DM, PSS, healthy volunteers).

Conclusions: Cytotoxic T cells may be major pulmonary inflammatory cells of ILD in PM/DM with no apparent difference between PM and DM. In contrast, ILD in PSS was suggested as being likely to be characterized by activated macrophage.
Tuberculin skin testing: Determinants and reaction
Authors: Lao Lily Y , De Guia Teresita S
Published: March 2003

Mantoux purified protein derivative (PPD) skin testing was performed in schoolchildren who were grouped according to positive (Group I, n = 205) and negative (Group II, n = 79) exposure to recent acid‐fast bacilli (AFB) smear‐positive tuberculosis (TB) family contact. A prospective case‐control study was undertaken to evaluate whether repeat bacille Calmette‐Guérin (BCG) vaccination, nutritional state, presence/absence of BCG scar, and degree of AFB positivity of sputum of adult TB cases affect PPD skin reactivity in these two groups. Group I with TB contacts had larger induration (13.00 ± 11.29 mm) than the Group II control group of 4.52 ± 6.20; P = 0.000. Purified protein derivative reaction as to the number of BCG vaccination(s) received showed an increase in size as the BCG vaccination is repeated with significantly larger induration in Group I than in Group II (P = 0.048). The nutritional status was subgrouped into A (weight < 10 percentile), B (weight 50–75 percentile), and C (weight > 90 percentile), which were comparable for both groups. The mean PPD induration of subgroup A in Groups I and II was not statistically different. However, the mean PPD induration was highly significant between Groups I and II in subgroup B (12.46 ± 10.70 vs 3.80 ± 5.71 mm; P = 0.000) and subgroup C (14.31 ± 11.54 vs 5.42 ± 6.70 mm; P = 0.000). Children in group I with the BCG scar were noted to have significantly greater PPD induration size than in group II (14.14 ± 11.23 vs 5.05 ± 6.24 mm; P = 0.000). The degree of AFB positivity of sputum of TB adult cases (1+ to 4+ and cavitary TB) has no effect on PPD size (P = 0.766). Close contact with individuals with active TB (AFB smear positive) is a very important factor for PPD skin conversion. Repeat BCG vaccination, malnutrition, and BCG with scars present difficulties in making a diagnosis of TB infection but did not affect PPD reactivity and did highlight the need for thorough clinical evaluation.
Clinical significance of potential pathogenic microorganisms of sputum in patients with pulmonary tuberculosis
Authors: SHIRAI MASAHIRO , HAYAKAWA HIROSHI , UCHIYAMA HIROSHI , CHIDA KINGO , NAKAMURA HIROTOSHI
Published: March 2003

Background: Bacterial culture of sputum is frequently positive in patients with pulmonary tuberculosis (TB). However, it remains to be clarified whether detection of potential pathogenic microorganisms (PPM) in sputum represents bacterial infection or only colonization of the respiratory tract. In the present study, we investigated the clinical significance of PPM in patients with pulmonary TB.

Methodology: Sputum culture for PPM was studied in 174 pulmonary TB patients (117 males and
57 females, mean age of 71 years) on the day of admission. Ninety‐seven patients
(63 males and 34 females, mean age of 67.1 years) also underwent transtracheal aspirates
(TTA). Quantitative culture of sputum and TTA was performed to distinguish infection
from colonization. The results were evaluated as follows: more than 106
or 105 c.f.u./mL indicated infection in the case of sputum or TTA samples, respectively. We also compared various clinical parameters between patients with PPM and patients with non‐potential pathogenic microorganisms (non‐PPM).

Results: Potential pathogenic microorganisms were positive in 44% and 24% of sputum and TTA specimens, respectively. However, quantitative culture for PPM showed positive findings in only 11% and 3% of sputum and TTA specimens, respectively. A comparative study of the clinical features revealed that PPM patients had a lower bodyweight and lower serum albumin levels than non‐PPM patients. A fatal outcome was also more common in PPM patients than in non‐PPM patients. Logistic regression analysis further confirmed that PPM clearly contributed to a fatal outcome in addition to the previously established parameters including age, performance status, haemoglobin, albumin and radiographic disease extent.

Conclusion: Although sputum PPM represent only colonization of the upper respiratory tract in TB patients, they are associated with a poor prognosis.
Can serial qualitative polymerase chain reaction monitoring predict outcome of pulmonary tuberculosis treatment?
Authors: CHIERAKUL NITIPATANA , CHAIPRASERT ANGKANA , TINGTOY NIPA , ARJRATANAKUL WIYADA , PATTANAKITSAKUL SA‐NGA
Published: March 2003

Background: The aim of this study was to assess the use of qualitative one‐tube nested polymerase chain reaction (PCR) for monitoring the treatment response in smear‐positive pulmonary tuberculosis, and the factors determining the negative conversion of sputum smear, culture, and PCR during treatment.

Methodology: A total of 53 patients receiving a standard short course of chemotherapy with 24 months follow‐up period after treatment cessation were included in the study. Sputum specimens were collected serially for smear, culture, and PCR until the treatment was complete.

Results: The conversion rate for sputum culture, smear, and PCR at 8 weeks after treatment
were 84.9, 58.5, and 47.1%, and at 16 weeks of treatment were 100, 88.7,
and 79.2%, respectively. At the end of the treatment period, there were four
PCR persisters, one of whom had disease relapse. Only cavitary disease had an influence
over the negative conversion of the smear and PCR at 8 weeks (RR 3.5, 95%
CI 1.04–11.95, P = 0.04 for smear; RR 5.06, 95% CI 1.196–21.42,
P = 0.03 for PCR).

Conclusion: Qualitative PCR was not useful for monitoring therapy in smear‐positive pulmonary tuberculosis. Mycobacterium DNA was cleared slowly in cavitary disease. The PCR may be performed at the time of treatment cessation to identify those with potential for disease relapse.
Colocalization of CA19‐9 and KL‐6 to epithelial cells in dilated bronchioles in a patient with idiopathic pulmonary fibrosis complicated by diffuse alveolar damage
Authors: SHIMIZU Yuji , HAMADA Tetsuya , TANAKA Yoshiki , SASAKI Atsushi , NEMOTO Toshikazu
Published: March 2003

A 73‐year‐old woman with idiopathic pulmonary fibrosis (IPF) had an elevated serum CA19‐9 level, but not KL‐6. Her condition worsened and she subsequently died and this was associated with a rise in the serum KL‐6 level. At autopsy, the lung showed a honeycomb appearance macroscopically and, microscopically, hyaline membrane formation was seen. Immunohistochemical staining revealed partial colocalization of KL‐6 and CA19‐9 to dilated bronchiolar cells. These features suggest that the mechanisms that cause the synthesis and release of CA19‐9 and KL‐6 from damaged lung tissue in IPF are likely to differ from those in diffuse alveolar damage. In addition, serum KL‐6 levels may reflect the severity of disease more sensitively than CA19‐9 levels.
p38 Mitogen‐activated protein kinase and c‐Jun‐NH2‐terminal kinase regulate interleukin‐8 and RANTES production in hyperosmolarity stimulated human bronchial epithelial cells
Authors: FURUICHI Sachiko , HASHIMOTO Shu , GON Yasuhiro , MATSUMOTO Ken , HORIE Takashi
Published: March 2003

Objective: We have previously shown that p38 mitogen‐activated protein kinase (MAPK) regulates, at least in part, hyperosmolarity induced interleukin (IL)‐8 expression in human bronchial epithelial cells (BEC). In the previous study, hyperosmolarity also activated c‐Jun‐NH2‐terminal kinase (JNK); however, the role of the JNK signalling pathway has not been determined. In the present study, we examined the role of the JNK signalling pathway in hyperosmolarity induced IL‐8 and RANTES production by BEC using the novel inhibitor of the JNK signalling pathway CEP 11004 in order to clarify these issues.

Methods: Bronchial epithelial cells that had been pre‐incubated with SB 203580, CEP 11004 or a combination of these were exposed to a hyperosmolar medium and then the p38 MAPK and JNK phosphorylation activity in these cells and IL‐8 and RANTES concentrations in the culture supernatants were determined.

Results: The results showed that: (i) hyperosmolarity induced the threonine and tyrosine phosphorylation of p38 MAPK and JNK; (ii) SB 203580, as the specific inhibitor of p38 MAPK activity, and CEP 11004 attenuated hyperosmolarity induced p38 MAPK and JNK activity, respectively; (iii) SB 203580 and CEP 11004, but not PD 98059, partially attenuated IL‐8 and RANTES production; and (iv) a combination of SB 203580 and CEP 11004 attenuated IL‐8 and RANTES production in an additive fashion.

Conclusion: These results indicate that p38 MAPK and the JNK pathway regulate hyperosmolarity induced IL‐8 and RANTES production by BEC.
The pathophysiological significance of prognostic factors for fatal outcome in lower respiratory tract infections
Authors: TRAKADA Georgia , GOGOS Charalampos , BASIARIS Charalampos , SPIROPOULOS Kostas
Published: March 2003

Objective:  The aim of this study was to determine prognostic factors for outcome in patients with lower respiratory tract infections (LRTI). LRTI are an heterogeneous group of disorders, including acute bronchitis, pneumonia, superinfection of chronic bronchitis and influenza.

Methodology:  A total of 616 patients with LRTI were retrospectively reviewed with regard to epidemiological, clinical, laboratory and radiographical data. Prognostic analysis included a univariate as well as a multivariate approach, in order to identify parameters associated with death.

Results:  The parameters found to be significantly different between survivors and non‐survivors in the univariate analysis, were respiratory rate, Pao2, heart rate, systolic and diastolic blood pressure, platelet count, urea, creatinine, previous admission to the hospital in the last year and cavitations visible on the chest radiograph.

Conclusions:  LRTI remain a widespread problem and have a significant impact on primary healthcare resources. The great variability seen in rates of hospital admission and lengths of stay in part reflects uncertainty among physicians in assessing the severity of the illness. According to our data, Pao2 and heart rate were most closely associated with patient death and are readily defined and available at presentation.
Successful treatment of Langerhans cell histiocytosis with 2‐chlorodeoxyadenosine
Authors: GOH Nicole S. L. , MCDONALD Christine F. , MACGREGOR Duncan P. , PRETTO Jeffrey J. , BRODIE Graeme N.
Published: March 2003

Abstract:  Langerhans cell histiocytosis (LCH) is a rare disorder which frequently involves the lungs of affected adults. Recent evidence suggests it is a clonal neoplastic disorder. Prognosis in this disease is variable, but in its multisystem form or when associated with progressive respiratory dysfunction, prognosis is poor. Recent case reports and a phase II trial of the antimonocyte drug 2‐chlorodeoxyadenosine (2CDA) have described success in treating LCH. We used 2CDA to treat a young Australian man with LCH involving lungs and bone. A complete symptomatic remission was achieved with no evidence of recurrence some 5 years after completion of chemotherapy.
Demography and reproductive strategies of a polycarpic perennial, Trillium apetalon (Trilliaceae)
Authors: OHARA MASASHI , TAKADA TAKENORI , KAWANO SHOICHI
Published: March 2003

To investigate the connection between demographic strategies and reproductive strategies of a polycarpic perennial herb, Trillium apetalon Makino, we conducted three
studies. First, we monitored the fate of individuals and the flowering behavior of
T. apetalon for 12 years and used a transition matrix model to analyze the
demography of the population. The analysis revealed that it takes a long time for
individuals to go through one‐leaf stage in juveniles. Elasticity analysis showed
that the survival of flowering individuals was a decisive factor in the dynamics
of the population. Furthermore, we found that the average remaining lifetime of flowering
individuals was high relative to the other three stages. Second, to elucidate the
demographic consequences of organ preformation, we investigated the development of
flower buds for future years. We observed three to six flower buds per rhizome, suggesting
that flower buds for the next 3–6 years were ready in advance in this plant.
Third, the results of breeding experiments clarified that although this species appears
to have a substantial capacity for both inbreeding and outbreeding, inbreeding plays
an important role in seed production, and that crossing experiments (direct cross‐pollination
and self pollination) yielded similar seed‐ovule ratios to those obtained from open‐pollinated
individuals. Our three studies suggest that the adult survival and continuous flowering
strategies of T. apetalon obtained from demographic analysis are closely interlinked with breeding systems and preformation of flower buds.
Herpes zoster in immunocompetent and immunocompromised Japanese children
Authors: Takayama Naohide , Yamada Hideo , Kaku Hidefumi
Published: March 2003

Abstract Background: To confirm epidemiological features of herpes zoster among children with or without immunosuppression, herpes zoster patients who had presented to this hospital were retrospectively investigated.

Methods
: Medical records were reviewed for the 92 cases of pediatric herpes zoster patients diagnosed during the period from 1981 to 1998. The age at onset of herpes zoster and of varicella, the interval between varicella and zoster, the dermatomal distribution of herpes zoster and complications were compared between immunocompetent and immunocompromised children.

Results
: The mean age at onset of zoster in immunocompetent children was 8.5~4.0 years and in immunosuppressed children was 9.7~3.8 years. The age at onset of varicella was significantly lower (1.6~1.8 years) in immunocompetent than in immunosuppressed children (4.6~2.7 years). The interval between varicella and zoster was 6.2~3.2 years in immunocompetent children. More than 80% of patients with acute leukemia or malignant lymphoma had herpes zoster within 2 years after diagnosis of malignancy. Lesions of herpes zoster were most frequently found in the thoracic nerve regions. Five of 11 zoster patients with cutaneous dissemination, three of five zoster patients having aseptic meningitis and three of four patients complicated facial palsy were children without underlying disease.

Conclusions
: The present study confirmed that varicella in the first year of life was a risk factor in immnocompetent children, as reported previously. Herpes zoster in children without immunosuppression was found not to be as mild as generally accepted.
Usefulness of serum fibrinogen degradation product‐E in sporadic cases of classical hemolytic uremic syndrome
Authors: Aihara Yukoh , Nakamura Tomoko , Unayama Takao , Yoshida Yoshiyuki , Yokota Shumpei
Published: March 2003

Abstract Background: Hemolytic uremic syndrome (HUS) associated with Shiga toxin (Stx)‐producing Escherichia coli O157:H7 infection is one of the diseases causing acute renal failure in young children. Although HUS is still a serious disease in children, no reliable predictive markers for HUS nor markers of disease severity are available so far. Recently, we experienced a sporadic case of typical HUS caused by Stx‐producing E. coli O157:H7 and detected, at the prodromal stage, a high level of serum fibrin/fibrinogen degradation product‐E (FDP‐E) fraction.

Methods
: To assess the usefulness of FDP‐E for the treatment of HUS in clinical practice, we retrospectively examined serum levels of FDP‐E in 22 patients with bloody diarrhea with or without HUS.

Results
: There were significantly increased levels of serum FDP‐E in patients with HUS, but not in those without HUS. Furthermore, serum levels of FDP‐E may correlate with disease severity in patients with HUS.

Conclusions
: These results suggest that serum levels of FDP‐E may be a useful marker of HUS in clinical practice.
Uroguanylin level in umbilical cord blood
Authors: Tsukahara Hirokazu , Sekine Kyoichi , Uchiyama Mayumi , Miura Masakazu , Nakazato Masamitsu , Date Yukari , Tsunezawa Wataru , Kotsuji Fumikazu , Nishida Koichi , Hiraoka Masahiro , Mayumi Mitsufumi
Published: March 2003

Abstract
 

Background
: Uroguanylin is a novel natriuretic and diuretic peptide originally isolated from urine.

Methods
: To determine whether uroguanylin has a physiologic role during the perinatal period, uroguanylin levels in umbilical cord plasma obtained at the time of delivery were measured by radioimmunoassay and compared with cord serum osmolality.

Results
: Mean (±SD) cord plasma uroguanylin concentrations (8.8±2.1 fmol/mL) were higher compared with normal adult values. The extent of maturity, mode of delivery and gender did not appear to influence cord uroguanylin levels. The uroguanylin concentration had a significant positive correlation with cord serum osmolality.

Conclusion
: These findings support some regulatory role of this peptide in perinatal renal and cardiovascular adaptation.
Cyclobilirubin formation by in vitro photoirradiation with neonatal phototherapy light
Authors: Yasuda Saneyuki , Itoh Susumu , Imai Tadashi , Isobe Kenichi , Onishi Shoju
Published: March 2003

Abstract
 

Background
: The main mechanism of phototherapy for neonatal hyperbilirubinemia is the production and excretion of (EZ)‐ and (EE)‐cyclobilirubin (4E,15Z‐ and 4E,15E‐cyclobilirubin). Thus, the clinical efficacy of the light source for phototherapy must be evaluated by cyclobilirubin formation from (ZZ)‐bilirubin in in vitro photoirradiation.

Methods
: In the present study, we investigated the in vitro production pattern of bilirubin photoisomers by phototherapy light from the bilirubin–human serum albumin complex.

Results
: No clear difference was found in the curves relative to (ZZ)‐bilirubin and its photoisomers under aerobic and anaerobic conditions. The ratio of (EZ)‐cyclobilirubin to (ZZ)‐bilirubin increased proportionately to the dose of irradiating light and no photoequilibrium state was observed analogous to that found in configurational photoisomerization. The concentration of (EZ)‐ and (EE)‐cyclobilirubin increased proportionately with the grade of the percentage decrease in A460 nm from 0 to 23%. With a percentage decrease in A460 nm of 23% or more, the cyclobilirubin concentrations reached a steady state. The reason for this appears to be that the concentration of (ZZ)‐bilirubin, a substrate for photoisomers, dropped below 1 mg/100 mL. Biliverdin was produced only in trace amounts. However, the absorption at 520–700 nm increased after a percentage decrease in A460 nm of more than 23%.

Conclusions
: The results of the present study show that little bilirubin photooxidation occurred with in vitro aerobic photoirradiation. Before the concentration of cyclobilirubin reaches a steady state, it is theoretically valid to use the percentage decrease in A460 nm for the evaluation of the clinical efficacy of the light source.
End‐tidal carbon monoxide is predictive for neonatal non‐hemolytic hyperbilirubinemia
Authors: Okuyama Hiroko , Yonetani Masahiko , Uetani Yoshiyuki , Nakamura Hajime
Published: March 2003

Abstract

Background
: The aim of the present study was to evaluate the value of an end‐tidal carbon monoxide corrected for inhaled carbon monoxide concentration (ETCOc) at the early neonatal period. The value would be useful for predicting subsequent hyperbilirubinemia in non‐hemolytic full‐term infants.

Methods
: The ETCOc levels were measured every 6 h during the first 72 h of life in healthy, full‐term, non‐hemolytic, newborn Japanese infants using a breath carbon monoxide analyzer. The ETCOc levels in hyperbilirubinemic infants were compared with those in non‐hyperbilirubinemic infants. Hyperbilirubinemia was defined as the level of the peak total serum bilirubin concentration (TBC) greater than or equal to 257 μmol/L (15.0 mg/dL). The ETCOc measurement for predicting subsequent hyperbilirubinemia was evaluated with a receiver–operating characteristic (ROC) curve.

Results
: Fifty‐one infants were enrolled in the study. Seven of the 51 infants developed hyperbilirubinemia. The ETCOc levels in non‐hyperbilirubinemic infants were decreased in the first 72 h after birth. However, those in the hyperbilirubinemic infants were not decreased significantly, and were higher than those in non‐hyperbilirubinemic infants at 42, 48, 54 and 66 h of age. The ETCOc level at 42 h of age was the most predictive of subsequent hyperbilirubinemia by ROC analysis. At the cut‐off level of 1.8 μL/L (p.p.m.), the sensitivity, the specificity, the positive predictive value and negative predictive value were 86, 80, 40 and 97%, respectively.

Conclusion
: Increased ETCOc level in the early neonatal period is associated with subsequent hyperbilirubinemia, even in infants without hemolytic disease. The ETCOc measurement may be useful as a screening test for predicting hyperbilirubinemia without hemolytic diseases.
Functional immaturity of cord blood monocytes as detected by impaired response to hepatocyte growth factor
Authors: Jiang Qi , Azuma Eiichi , Hirayama Masahiro , Iwamoto Shotaro , Kumamoto Tadashi , Kobayashi Michihiro , Yamamoto Hatsumi , Sakurai Minoru , Komada Yoshihiro
Published: March 2003

Abstract

Background
: Monocytes as antigen‐presenting cells play an important role in host defense and transplantation. However, there are little reports on cord blood monocytes, and the role of monocytes in cord blood transplantation is largely unknown.

Methods and Results
: There are several cytokines affecting monocyte function. These include interferon‐γ, interleukin‐4, interleukin‐10, granulocyte macrophage‐colony stimulating factor and hepatocyte growth factor (HGF). We investigated the effect of these cytokines on antigen‐presenting capacity (APC) of cord and adult blood monocytes. Using either mononuclear cells or purified CD4+ T cells as responder cells, HGF enhanced APC of adult monocytes most effectively among these cytokines. In contrast, cord blood monocytes failed to respond to HGF. As HLA, costimulatory and adhesion molecules may affect APC function, we examined these antigens of monocytes following HGF stimulation. The HGF upregulated integrin α5 subunit (CD49e) and intercellular adhesion molecule‐1 (CD54) was expressed in adult blood monocytes, but not in cord blood. In kinetic studies, HGF downregulated c‐met protein/HGF receptor expression of adult monocytes in lower concentrations and at shorter incubation time as compared with that of cord blood.

Conclusions
: The results suggest that impaired response of cord blood monocytes to HGF may be responsible, in large part, for their functional immaturity.
Risk of irregular menstrual cycles and low peak bone mass during early adulthood associated with age at menarche
Authors: Anai Takanobu , Miyazaki Fumiko , Tomiyasu Toshiko , Matsuo Toshiko
Published: March 2003

Abstract

Background
: The risk of irregular menstrual cycles and low peak bone mass of the lumbar spine in young adult women, associated with age at menarche, has not been clearly defined. The aim of this study was to investigate this further.

Methods
: A total of 180 college females aged 20–23 years were surveyed about menstruation, exercise, and calcium intake by means of a questionnaire. We also measured vertebral bone mineral density in these women by dual energy X‐ray absorptiometry. The subjects were divided into six groups according to their age at menarche. Comparisons were made of the mean body mass index (BMI) and T‐scores (the ratio to the mean bone mineral density of young adult Japanese women) among those groups, and odds ratios of irregular menstrual cycles and low peak bone mass less than 87% (– 1 standard deviation (SD) of T‐scores were calculated using the mean menarcheal age (12 years) group as a control.

Results
: The mean BMI and T‐scores were significantly lower in delayed menarche groups (equal to or more than 13 years) compared with early menarche groups (equal to or less than 12 years). The odds ratios of irregular menstrual cycles were 5.9 (95% confidence intervals (CI) 1.7–20.6), 13.7 (95% CI 3.6–51.6), and 73 (95% CI 6.5–813.9) in the 13‐, 14‐, and more than 14 years menarcheal age groups, respectively. The odds ratio of low peak bone mass less than 87% (– 1SD) was 3.4 (95% CI 1.1–10.3) in the 14 years menarcheal age group.

Conclusions
: Young adult women with delayed menarche may be at high risk for irregular menstrual cycles and low peak bone mass.
Cerebral metabolism and regional cerebral blood flow during moderate systemic cooling in newborn piglets
Authors: Okubo Kensuke , Itoh Susumu , Isobe Kenichi , Kusaka Takashi , Nagano Keiko , Kondo Masatoshi , Onishi Shoju
Published: March 2003

Abstract

Background
: Clinical trials of hypothermic therapy in asphyxiated infants have started recently. However, clinical studies have been delayed by the difficulty in selecting infants with a bad neurological prognosis and by the concern regarding adverse effects of hypothermia. The purpose of this study is to examine the effects of systemic cooling on cerebral metabolism (CMR) and the regional cerebral blood flow (rCBF) in newborn piglets.

Methods
: The rCBF in the seven parts of the brain were measured with colored microspheres. The blood samples for the measurement of cerebral oxygen consumption (CMRO2) and cerebral glucose consumption (CMRglc) was collected from the umbilical artery and the superior sagittal sinus.

Results
: Reductions of cerebral cortex temperature to 32°C decreased blood flow in all brain regions. In particular, blood flow in the brainstem decreased more significantly than in any other region. The total cerebral blood flow (CBF), CMRO2 and CMRglc, respectively, decreased to 32.3~3.9 mL/100 g per min, 2.8~1.0 mLO2/100 g per min and 22~12 mmol/100 g per min at 32°C (41, 53 and 46% of the initial value). The CBF decreased in parallel with CMRO2 and CMRglc down to 35°C, but CBF decreased to a greater extent than CMRO2 and CMRglc at below 35°C.

Conclusions
: The indication of hypothermic therapy and the degree of cooling have to be performed very carefully. Systemic cooling is especially dangerous for the total asphyxiated infants who might have damage to the brainstem because the blood flow in the brainstem has significantly decreased during hypothermia.
Effect of insulin on transport kinetics of alpha‐aminoisobutyric acid in the perfused human placental lobule in vitro
Authors: Nandakumaran Moorkath , Makhseed Ma’Asoumah , Al‐Rayyes Samer , Akanji Abayomi O , Sugathan Thattaruparambil N
Published: March 2003

Abstract

Background
: The limited data available on the role of insulin on maternal‐fetal transport of amino acids prompted us to undertake this study.

Methods
: Transport kinetics of a model amino acid, alpha‐aminoisobutyric acid (AIB) was investigated in perfusion of isolated human placental lobules in vitro in non steady‐state conditions and the effect of therapeutic dose of insulin was assessed in parallel series of perfusions. National Culture and Tissue Collection medium diluted with Earle’s buffered salt solution was used as the perfusate and tritiated water was used as the reference marker for comparison.

Results
: In five successful perfusions with insulin, differential transport rate indices of AIB for 10, 25, 50, 75 and 90% of efflux fractions in the fetal venous outflow averaged 0.76, 1.03, 1.02, 1.09, 1.04 and 1.03 times those of reference values, respectively. The indices differed significantly than in controls for 10, 25 and 50% efflux fractions, but not in the case of 75 and 90% efflux values. The AIB transport fraction (TF), expressed as percentage of injected maternal dose, averaged 29.4 ± 5.4% and 38.7 ± 6.2% of the corresponding reference marker value in control and insulin series, respectively. With regards to the pharmacokinetic transport parameters, the absorption and elimination rates of the amino acid were significantly higher in the study group than in the control.

Conclusion
: We conclude that insulin, in physiological and therapeutic doses, stimulates maternal‐fetal AIB transport in vitro, in the perfused human placental lobule.
Crush syndrome of children in the Marmara Earthquake, Turkey
Authors: Dönmez Osman , Meral Adalet , Yavuz Mahmut , Durmaz Oguzhan
Published: March 2003

Abstract

Background
: Crush syndrome is defined as traumatic rhabdomyolysis with systemic and local complications.

Methods
: Crush syndrome and its related complications were diagnosed on the basis of clinical and biochemical data. In this study, we evaluated 20 children with crush syndrome transferred to our center in Bursa during the Marmara earthquake, 1999. We investigated the clinical and laboratory findings of these children.

Results
: Serum creatine kinase, aspartate aminotransferase, and alanine aminotransferase levels were high in all patients. Fifty‐five percent of the patients (n=11) had one extremity injury and 45% (n=9) had multiple extremity injuries. Fasciotomy was required in 15 children. Serum muscle enzymes and D‐dimer levels were high in children with multiple extremity injuries. Acute renal failure developed in 35% (n: 7/20) of them. Peak serum creatine kinase level was positively correlated with aspartate aminotransferase, alanine aminotransferase, hospitalization time, serum urea and creatinine (P<0.05).

Conclusions
: Crush syndrome was more severe in children with multiple extremity injuries and acute renal failure frequently developed in these children. Peak serum creatine kinase level as well as potassium, urea, uric acid, creatinine, lactic dehydrogenase, aspartate aminotransferase, alanine aminotransferase, and calcium levels were the helpful biochemical parameters in estimating the severity of crush syndrome.
Morphological differences between glomerular epithelial cells (GEC) excreted during chemotherapy with antineoplastic drugs and GEC excreted in renal diseases
Authors: Watanabe Akihiro , Kakihara Toshio , Hara Masanori , Tanaka Atsushi , Kanno Katsue , Imai Chihaya , Ikarashi Yukie , Okubo Soichiro , Yanagihara Toshio , Uchiyama Makoto
Published: March 2003

Abstract

Background
: To better understand the mechanisms of glomerular epithelial cell (GEC) injuries in various diseases, we compared GEC excreted during chemotherapy (antineoplastic drugs) and GEC excreted in renal diseases.

Methods
: For 19 patients undergoing chemotherapy (85 courses), 69 patients with IgA nephropathy and 16 patients with Henoch‐Schölein purpura nephritis, the number of excreted GEC and GEC casts were counted by an immunofluorescent study. The morphological features of GEC were also studied in an immunofluorescent study combined with Hoechst stain.

Results
: Glomerular epithelial cells were detected in 78% of the chemotherapy courses and in 94% of the patients with renal diseases. The GEC casts were observed in 2% of chemotherapy courses, while in renal diseases GEC casts were observed in 60% of the patients. Proteinuria (>30 mg/dL) and hematuria were not identified in any of the chemotherapy courses. The morphology and size of GEC were more variable than that in patients with nephropathy. Furthermore, GEC in patients undergoing chemotherapy often showed small nuclei and fragmented nuclei, which were rarely observed in patients with nephropathy.

Conclusions
: These results showed that the detachment of podocytes was not directly associated with proteinuria or hematuria. The findings also suggest that GEC are damaged via an apoptotic process by chemotherapy. On the contrary, GEC may be detached through a non‐apoptotic process in renal diseases.
Low plasma levels of hemostatic proteins during the induction phase in children with acute lymphoblastic leukemia: A retrospective study by the JACLS
Authors: Hongo Teruaki , Okada Shuichi , Ohzeki Takehiko , Ohta Hideaki , Nishimura Shin‐Ichiro , Hamamoto Kazuko , Yagi Keiko , Misu Hideo , Eguchi Naohiro , Suzuki Nobuhiro , Horibe Keizo , Ueda Kazuhiro ,   The Japan Association of Childhood Leukemia Study (JACLS)
Published: March 2003

Background
: Thromboembolic and bleeding events are serious complications associated with the administration of L‐asparaginase (ASP) during the induction phase in children with acute lymphoblastic leukemia (ALL). Prophylactic supplementation of plasma‐derived coagulation products remains controversial. The purposes of this study were to examine the plasma levels of hemostatic proteins during the induction phase and the efficacy of prophylactic replacement of plasma‐derived products.

Methods
: A multicenter retrospective survey on the incidence of hemostatic complications and the frequency of prophylactic replacement of plasma‐derived products among children with ALL who underwent ASP therapy was conducted. All patients were treated according to the Japan Association of Childhood Leukemia Study (JACLS) ALL‐97 protocol.

Results
: Thirty‐six (67%) of the 54 JACLS‐treatment centers responded and provided information on 127 patients. Clinically
relevant hemostatic complications occurred in two patients (1.6%;
2/127); one patient suffered intracranial bleeding 5 days
after beginning the protocol, and the second patient suffered an ischemic attack during an ASP treatment. The administration of ASP
(10 000 u/m2 × six doses) led to significant reductions in the plasma fibrinogen (180 ± 74 to 105 ± 57 mg/dL), antithrombin III (AT III) (126 ± 21 to 73 ± 18%), and plasminogen levels (97 ± 17 to 52 ± 18%). These laboratory parameters returned to normal levels 2 weeks after completion of the ASP treatment. Forty‐eight patients (38%) received AT III concentrate (AT III‐supplement group). The AT III level of the AT III‐supplement group was significantly lower than that of the AT III non‐supplement group, not only during the ASP therapy, but also prior to the ASP therapy. A greater percentage of patients in the AT III‐supplement group received fresh‐frozen plasma and in greater amounts than those in the AT III non‐supplement group.

Conclusions
: Severe hemorrhage and thrombosis were uncommon in the ALL patients who underwent ASP therapy in comparison with the degree of coagulation changes. Prophylactic administration of AT III concentrate or fresh‐frozen plasma did not demonstrate clear beneficial effects in the treatment of ALL in preventing thromboembolic events.
Nursing students’ response to a case study in ethics
Authors: Davis Anne J. , Ota Katsumasa , Suzuki Mariko , Maeda Jukai
Published: March 2003

This paper describes the responses of undergraduate nursing students to an ethical clinical case study. Students in a baccalaureate program were given a case study before a lecture on ethical principles and the same case study after this lecture. These responses raise questions about the content of nursing ethics classes in Japan. The place of individual patient rights and the role of the family in a situation of non‐disclosure about diagnosis and prognosis were major issues for the students. The responses reveal the problem of the ‘nurse‐in‐the‐middle’ between the patient and others whose values differ. Students’ post‐lecture responses emphasized communication among the people involved.
Day surgery patients' convalescence at home: Does enhanced discharge education make a difference?
Authors: Young Jeanne , O’Connell Bev , McGregor Sandy
Published: March 2003

Abstract The day surgery concept has been adopted and used widely. To date, there is limited in‐depth research that has reviewed patients' experiences convalescing from day surgery and the degree to which community, medical, allied health and social assistance is required. In addition, research indicates that day surgery patients' educational preparedness may influence patients' abilities to better self‐manage their postoperative recovery. Using a simple interrupted time series design, this study evaluated and compared the efficacy of the existing generic educational instructions with specially designed procedure‐specific instructions. During data collection within Stage 1 and Stage 2 all subjects were asked to complete the Postoperative Symptoms Diary that contained a specifically developed postoperative Symptom Measurement Scale and Symptom Management Index. These patients were interviewed, via telephone, on the 10th day after discharge. The findings revealed that 91% of patients stated they were satisfied having their operation as a day procedure while the most frequently reported symptoms were pain, tiredness and immobility. In addition, it was found that patients needed carer assistance for an average of 3 days. The enhanced teaching package had no effect on patient recovery and their ability to self‐manage. Thus, it was indicated that patient recovery and ability to self‐manage at home may be related to the patient's own healing abilities and understanding of self‐care.
Characteristics of patients referred for discharge planning from a geriatric ward at a national university hospital in Japan: Implications for improving hospital programs
Authors: Murashima Sachiyo , Nagata Satoko , Toba Kenji , Ouchi Yasuyoshi , Sagawa Yoko
Published: March 2003

Abstract The purpose of the present study was to identify the characteristics of patients from a geriatric ward who were referred for discharge planning support, a service provided by the first multidisciplinary department for discharge planning among the national university hospitals in Japan. From October 1997 to May 1999, 335 patients were discharged; 23 patients (6.9%) were referred. The referred patients were older and more frequently diagnosed with malignancy, dementia and respiratory infection. In addition, they had lower activities of daily living (ADL) and instrumental ADL scores. Those characteristics, which may be related to the longer hospital stay and lower rate of returning home of the referred patients, can be assessed early in hospitalization to identify patients at risk for difficult discharge planning. It is important to identify patients who need earlier intervention by formalized discharge planning so that the current situation of overly long hospitalization in Japan will improve.
Community nurses: An urgent need
Authors: Jayasekara J. G. A. R. S.
Published: March 2003

Abstract When families could not manage to care for the sick, they turned to people who could provide home nursing care. Gradually, however, the sick were moved to institutions and nursing became institution‐based. This trend accelerated in almost all countries around the world. Today we see that nurses participate in curative functions, and are concerned with uncommon and/or complex diseases. Very few nurses work in the community to provide services such as illness prevention, encouraging and supporting communities and individuals to participate in their own health care, health promotion and maintenance, and assisting with rehabilitation that address the health needs outside of institutions aimed towards achieving an optimal quality of life.
Study on the correlation between depression and quality of life for Korean women
Authors: Jho Mi‐Young
Published: March 2003

Abstract Korean women have many experiences of the negative impacts caused by changes in biological, psychological and socioeconomic environments. Therefore, they often have unique health problems that require specific attention. In particular, depression is a health problem that severely impacts on quality of life for women. The purpose of this study is to investigate the correlation between depression and quality of life for Korean women. The subjects of the study were 474 women (20–60 years) living in Seoul and were chosen by convenient sampling from 12 March to 18 April 2000. The data were collected by a structured questionnaire that included general characteristics, the Center for Epidemiologic Studies Depression Scale and the SmithKline Beecham ‘Quality of Life’ Scale. The data were analyzed by the SAS 6.12 program, which included descriptive statistics: t‐test, ANOVA, and Pearson correlation coefficient. The mean score of depression was 18.5 (range: 4–52), and the mean score of the quality of life was 153.7 (range: 65–230). In the general characteristics, there was a statistically significant difference in the degree of depression according to education (F = 5.62, P = 0.0009), marital status (F = 9.20, P = 0.0001), family structure (F = 3.97, P = 0.0036), level of income (F = 10.79, P = 0.0001), type of job (F = 2.99, P = 0.0191), stressors in the job (F = 2.56, P = 0.0198) and sexual activity (F = − 2.56, P = 0.0109). As for the general characteristics, there was a statistically significant difference in the degree of the total score for quality of life according to education (F = 5.24, P = 0.0015), level of income (F = 11.15, P = 0.0001), employment status (F = 2.23, P = 0.0268), job satisfaction (F = 4.42, P = 0.0155) and stressors in the job (F = 2.62, P = 0.0174). Significantly, there was a negative relationship between depression and quality of life (γ = − 0.5984, P = 0.0001). The most significant negative relationship among the five factors of quality of life was between depression and the psychological well‐being factor (γ = − 0.5708, P = 0.0001). In conclusion, the results of this study will contribute to the development of a nursing intervention program for decreasing depression, preventing depression and promoting quality of life for Korean women.
Challenges of measuring and linking patient outcomes to nursing interventions in acute care settings
Authors: O'Connell Bev O. , Warelow Phil J.
Published: March 2003

Abstract Measuring and linking patient outcomes to nursing intervention is an important task that has professional, financial and political ramifications. The importance and complexity of measuring patient outcomes accurately should not be overlooked, as there are a number of emergent factors that influence this process. These include the turbulent context of practise, variations in care due to the large number of health professionals, individual patient characteristics impacting on outcomes, determining appropriate nursing outcome measures, nursing's lack of autonomy within the system and difficulties experienced while trying to link patient outcomes to nursing interventions. So that the results reflect reality, it is important for researchers in the field to take note and consider these factors when measuring patient outcomes. The present article aimed to examine and discuss a number of these factors as they relate to the evaluation of patient care.
Role expectations of nurses in health service facilities for the elderly
Authors: Takemura Yukie , Kanda Katsuya , Matsumoto Akiko , Yamagishi Manaho
Published: March 2003

Abstract In order to investigate nurses’ roles in health service facilities for the elderly in Japan, questionnaires were mailed to institutional managers, nurse managers and care work leaders of all registered facilities. Among 2244 facilities, responses were received from 479. Role expectations of nursing personnel were largely similar among the managers of the three fields. They regarded medical treatment, medication administration, health status monitoring and general care management as within the domain of nursing, whereas they regarded environmental regulation, recreational activities and rehabilitation as less suited to nursing personnel. Although there was basic agreement, care work leaders were more likely to expect nursing personnel to participate in matters of personal care, and nurse managers were more likely to view matters related to admission/discharge, which were actually shared with support counselors, as belonging to the domain of nursing. Role expectations of nursing personnel will change especially at the margins of other professions, as the other professions develop.
Perceptions about menopause and health practises among women in northeast Thailand
Authors: Chirawatkul Siriporn , Patanasri Kalaya , Koochaiyasit Choosri
Published: March 2003

Abstract The purpose of the present qualitative study was to understand health perceptions and practises among Thai menopausal women. One hundred and forty‐two women aged 45–59 participated in the study in 1999. Data gathered from observations, focus group discussions, and in depth interviews were analyzed by using the hermeneutic phenomenological method. Four main themes emerged as characteristic of the health perceptions, practises and worldviews of the participants. These findings contribute to a deeper understanding of what it is like to be a menopausal woman, and why certain health activities are practised.