bluuebunny/crossref_metadata_2025 huggingface dataset:
Exercise‐induced bronchoconstriction among Malay schoolchildren
Authors: Zainudin Norzila Mohamed , Aziz Bilkis Abdul , Haifa A. L. , Deng Cheng Teik , Omar Azizi Hj
Published: March 2003

Objective: Exercise‐induced bronchoconstriction (EIB) may be demonstrated in 60–70% of asthmatic children in temperate climates. In areas of high humidity it is postulated to be low. The aim of the study was to determine the prevalence of EIB in a population of schoolchildren with wheezing, living in the humid tropical climate of Kuala Lumpur, Malaysia.

Method: We performed a cross‐sectional study using the International Study of Asthma and Allergies in Childhood questionnaire to identify 7–12‐year‐old Malay children with asthma symptoms from a primary school in central Kuala Lumpur. Sixty‐five of 76 children with ‘ever wheeze’ performed an exercise challenge test successfully in an uncontrolled environment. A random sample of 80 schoolchildren with no history of wheeze were similarly tested as controls. The relative humidity and temperature were recorded. A fall of > 15% was considered as clinically important.

Results: The prevalence of EIB in schoolchildren with ‘ever wheeze’ was 47.7%. The prevalence of EIB in children with ‘current wheeze’ was 51.6%. The prevalence of EIB in controls was 7.5%. The relative humidity during the study ranged from 41 to 90%. There was no significant relationship between different humidity levels and EIB (P = 0.58, regression analysis).

Conclusion: This study demonstrates that EIB is present in asthmatic children despite the highly humid tropical environment.
Cyclic stretch upregulates interleukin‐8 and transforming growth factor‐β1 production through a protein kinase C‐dependent pathway in alveolar epithelial cells
Authors: YAMAMOTO HIROYUKI , TERAMOTO HIDEMI , UETANI KOHSAKU , IGAWA KATSUTOSHI , SHIMIZU EIJI
Published: March 2003

Objective: Positive‐pressure mechanical ventilation can injure the lung, causing oedema and alveolar inflammation, which is termed ‘ventilator‐induced lung injury’ (VILI). We postulated that cyclic stretch upregulates the release of cytokines, which may cause lung damage, and explored which cytokines were released after cyclic stretch in type II alveolar epithelial cells (A549).

Methodology: To test this hypothesis, A549 cells were cultured on a silicoelastic membrane and interleukin (IL)‐1β, IL‐8, granulocyte–macrophage colony stimulating factor, activin, transforming growth factor (TGF)‐β1, insulin‐like growth factor‐2 and tumour necrosis factor‐α mRNA and protein were assessed after stimulation of the cells by cyclic stretch.

Results: Cyclic stretch induced activation of protein kinase C and resulted in the release of IL‐8 and TGF‐β1 from A549 cells.

Conclusions: The release of IL‐8 and TGF‐β1 from alveolar epithelial cells may be a contributing factor in alveolitis associated with VILI.
A relatively high prevalence and severity of asthma, allergic rhinitis and atopic eczema in schoolchildren in the Sultanate of Oman
Authors: AL‐RIYAMI Bazdawi M. S. , AL‐RAWAS Omar A. S. , AL‐RIYAMI Asiya A. , JASIM Lyla G. , MOHAMMED Ali J.
Published: March 2003

Objectives:  Although asthma, allergic rhinitis and eczema are among the most common chronic diseases in children worldwide, there is very limited information about the burden of these conditions in Oman. The aim of this study was to determine the prevalence and severity of symptoms of asthma, allergic rhinitis and eczema in Omani schoolchildren using the International Study of Asthma and Allergies in Childhood (ISAAC) Phase I questionnaire.

Methods:  An Arabic version of the ISAAC Phase I questionnaire was completed by parents of 3893 children aged 6–7 years and self‐completed by 3174 children aged 13–14 years, randomly selected from a nationwide sample of public schools.

Results:  The prevalence rates of reported diagnoses of asthma, allergic rhinitis and eczema were higher in older children (20.7%, 10.5% and 14.4% compared with 10.5%, 7.4% and 7.5%, respectively, in young children). In young children, 277 were current wheezers and of these 40.8% had sleep‐disturbing wheeze at least once a week and 45.1% had speech‐limiting wheeze during the past year. Similarly, 283 older children were current wheezers, and of these 30.0% had sleep‐disturbing wheeze at least once a week and 37.5% had speech‐limiting wheeze during the past year. Exercise‐induced wheeze was higher in older children (19.2%vs 6.9%; P < 0.001). Allergic rhinitis and eczema were also associated with significant sleep disturbance and limitation of activity in both age groups.

Conclusion:  Allergic conditions in Omani schoolchildren are common and associated with significant morbidity. Further research is required to identify the local risk factors for allergy to allow better understanding and management of these conditions.
The impact of tobacco on lung health in China
Authors: ZHANG Hong , CAI Baiqiang
Published: March 2003

Abstract:  China has the largest production and consumption of tobacco worldwide. It has witnessed a dramatic increase in tobacco consumption over the past two decades, with more than 34.8 million cartons of cigarettes being produced and 34.7 million sold annually. Approximately 67% of males and 4% of females aged over 15 years in China are smokers, and the total of over 320 million Chinese smokers represents about one‐third of all smokers worldwide. The continuous, rapid increase in the number of Chinese smokers is largely due to teenagers taking up smoking. Among teenagers aged 15–19 years, 18% of men and 0.28% of women (making a total of 9 million teenagers) are smokers. The prevalence of passive smoking is very high at 53.5%, about 0.3 billion people aged above 15 years were affected. The average daily consumption of tobacco per person in China rose from one cigarette in 1952 to 10 cigarettes in 1990, a rate similar to that of the USA 40 years earlier. It seems inevitable that China will witness a substantial increase in mortality following this increase in smoking. Based on current smoking rates, the predicted deaths attributed to smoking in China will rise to 3 million in 2050. If the current smoking pattern in China remains unchanged, 100 million men now under 30 years will die from smoking‐related diseases. The respiratory system is harmed most by tobacco smoke. Over two‐thirds of all deaths related to smoking in China are attributed to chronic obstructive pulmonary disease (COPD), lung cancer and pulmonary tuberculosis. The morbidity of COPD alone in China is estimated at over 3%, or 25 million people, of whom 72% were smokers. The Chinese government consistently supports smoking control and advocates smoking abstinence via laws to restrain the sale and advertising of tobacco. These actions have been successful in some aspects, and in particular, more people are aware that ‘cigarette smoking is harmful to health’. In future, the emphasis of smoking control should be directed at restraining teenagers and adolescents from smoking. Cigarette smoking has already caused significant ill‐health to the Chinese population with over 1 million people dying each year of various disorders caused by smoking. However, the peak of smoking‐induced diseases is still to come and therefore, it is very important to strengthen anti‐smoking measures so as to have a far‐reaching effect on the future health of the Chinese population.
Clonal plants as cooperative systems: Benefits in heterogeneous environments
Authors: Hutchings Michael
Published: March 2003

All natural environments are spatially and temporally heterogeneous. Consequently, their ability to provide essential resources for the growth of plants is variable. Modular plant species produce repeated basic structures which, in the case of clonal species, are called ramets. Ramets belonging to the same clone are distributed throughout the environment in space and time, and therefore they may be located in sites which differ in resource‐providing quality. The connections between ramets may allow resources to be shared, enabling the clone to behave as a cooperative system. As a result of such physiological integration, ramets can survive in conditions where there is lethal shortage of a resource because they are connected to, and supported by, ramets located in conditions where there is ample supply of the same resource. Physiological integration between connected ramets presents opportunities for heterogeneous environments to be exploited to an extent that is only just becoming apparent. As heterogeneity is ubiquitous in natural environments, it may be expected that plants, as relatively immobile organisms, will have evolved the capacity to cope with it by making appropriate localized morphological and/or physiological plastic responses. Recent studies suggest that such responses not only enable clonal species to cope with environmental heterogeneity, but that under some circumstances they can benefit more from environments which are heterogeneous rather than homogeneous, even when both types of environment contain the same amount of resources. Studies on Glechoma hederacea (Lamiaceae) that illustrate this phenomenon are described.
From pollen dynamics to adaptive dynamics
Authors: De Jong Tom J.
Published: March 2003

On plants with many flowers, bumblebees tend to visit more flowers in sequence. This induces pollen transfer between flowers on the same plant (geitonogamy). Consequently, in self‐compatible plants the selfing rate increases with the number of simultaneously open flowers on the plant, and pollen export to other plants in the population can be a decelerating function of the number of flowers. I argue that geitonogamy is important in relation to two phenomena. First, it may explain the low number of seeds per flower and the size‐dependent sex allocation observed in some species. Applying sex allocation theory to the boraginaceous Cynoglossum officinale and Echium vulgare shows that hermaphroditism is stable in both species. The predicted evolutionarily stable values for seeds per flower are close to observed values in the field. The model generally predicts that seeds per flower increase with plant size. This prediction is fine for C. officinale but E. vulgare defies the theory. Second, geitonogamy is important in the evolution of dioecy, as already suggested by Darwin. With abiotic pollination the export of pollen to other plants is likely to be proportional to the number of flowers produced, while it decelerates in animal‐pollinated plants. Dioecy can then evolve gradually in a species with abiotic pollination, provided that inbreeding depression exceeds 50%, geitonogamous selfing increases with the number of flowers and that genetic variation exists. With complete pollen discounting as in the models of geitonogamous pollination by animals, hermaphroditism is always stable. The model explains Darwin’s observation that dioecy is more common in wind‐pollinated species and in species in which individuals are large, reproducing with many flowers.
Environmental factors and survival strategies of annual plant species in the Negev Desert, Israel
Authors: Gutterman Yitzchak
Published: March 2003

Several environmental factors have pronounced influences on the complementary sets of survival strategies, at different stages of the plant life cycle, of some of the most common annual plants in the Negev Desert, Israel. Plasticity of seed germination may spread germination over time and thus reduce the risk to species survival. This plasticity may be affected by day length during seed development and maturation and by position of seeds on mother plants. Post‐seed maturation dry storage temperatures may affect the duration of after‐ripening. The tiny, dust‐like seeds produced by some plants that are dispersed by wind after maturation may escape massive seed predation and remain in large seed banks in the soil. Seeds of other species are protected in lignified structures in aerial seed banks on dead, dry, lignified mother plants. Seed dispersal strategies from these aerial seed banks by rain may also prevent massive seed collection by animals. The ‘cautious’ or ‘opportunistic’ germination strategy and seedling drought tolerance may increase seedling survival in many of the plant species under the unpredictable amounts and distribution of rain in these desert areas. Factors such as amount of rain, temperature, relative humidity, time of the beginning of soil wetting (day or night), seed size and history and the depth of seeds in the soil may affect germination percentages. Day length and soil water content during plant development may have a pronounced influence on plant age at first flowering, seed yield and plant life span.
Smoke as a germination cue
Authors: Staden Johannes Van , Brown Neville A. C. , Jäger Anna K. , Johnson Tafline A.
Published: March 2003

Fire is a major environmental selective force that influences plant communities in many parts of the world. Reproductive strategies have evolved as adaptations to the various factors generated by, and/or associated with, fire. This is particularly true for seeds, in which strategies have evolved that respond to both the physical and chemical germination cues that may be associated with fires. Some of these cues are clearly of a primary nature, while others may play a secondary and/or highly specific, or even permissive, role in the germination process. Clearly, there must be considerable interaction between the physical and chemical cues generated by wild fires. Smoke is the most striking chemical factor. Smoke released from burning vegetation contains a chemical signal that triggers germination of both fire climax and non‐fire climax species from different parts of the world. It is used in horticulture to stimulate seed germination of wildflower species and can break dormancy and improve germination of vegetable crops, such as lettuce and celery. Smoke can be applied to seeds immediately before sowing, or the seeds may be pretreated and stored until conditions are appropriate for sowing. Both smoke and aqueous smoke‐water are active in this respect. The active constituent(s) is volatile, thermostable, water soluble and long‐lasting in aqueous solution and in the soil. Attempts to identify the active compound(s) and to determine the mechanism(s) of action have been unsuccessful. Smoke treatment is effective on many seeds that have a light requirement for germination. A very clear concentration effect, resembling that of hormonal responses has been established with aqueous smoke solutions. Smoke extracts interact with gibberellins, cytokinins, abscisic acid and ethylene in photoblastic and in thermodormant seeds. However, despite these interactions it remains questionable whether smoke acts via hormones in stimulating seed germination. There is a clear connection between smoke and life history traits. Smoke may well be the overriding trigger for germination in relation to specific growth habits, regeneration strategies, seed storage, seed sizes, dispersal modes and structures for a large number of species growing in fire‐prone habitats. It is becoming increasingly clear that smoke as a germination (or growth regulating) cue must have evolved as part, or as a consequence of fire, as an evolutionary factor. As such, it is probably a very old development and serves as an additional protection mechanism to ensure germination at optimal times for seedling survival.
‘Thawing’ of ‘frozen’ variation in an adventive, facultatively apomictic, clonal weed
Authors: Chapman Hazel , Brown Jennifer
Published: March 2003

Radiation of adventive, sexually reproducing organisms into a new environment has been well documented, but less is understood about the patterns and processes of geographical radiation in adventive species with uniparental reproduction (parthenogenesis or apomixis), usually associated with ‘frozen’ variation within maternal lineages. In this study we have used Pilosella officinarum to test the hypothesis that sexual reproduction becomes important in the radiation of adventive facultatively apomictic species. Within its native Europe P. officinarum is an extremely variable species, with eight subspecies and a range of ploidy levels. Pentaploids are always apomictic. However, early chromosome analyses of New Zealand adventive populations, carried out during the 1980s, discovered only pentaploid, apomictic clones. Similar observations were made in an early 1990s study of the same sites. Since then, a range of ploidy levels, including aneuploids, and a plethora of morphological variation, has been recorded. In this paper, we use a combination of image analysis and chromosome counts to show that sexual reproduction has become an important avenue for adaptive radiation in New Zealand populations of P. officinarum. Current populations probably comprise complex among‐subspecies hybrids, and possibly among‐species hybrids, which are at least partially capable of sexual reproduction and various forms of back‐crossing. Somatic mutation may also play an important role in creating morphological variation. DNA fingerprinting did not contribute to this study because this technique failed to distinguish between morphological types observed in the field.
Effect of socioeconomic status on the blood pressure in children living in a developing country
Authors: Soylu Alper , Kavukçu Salih , Türkmen Mehmet , Çabuk Nur , Duman Murat
Published: March 2003

Abstract Background: Lower socioeconomic status has been reported to favor higher blood pressure both during childhood and adulthood, because obesity is more prevalent among this population. The aim of the present study was to evaluate the effect of socioeconomic status on blood pressure and prevalence of obesity among children living in a developing country.

Methods
: Prepubertal primary school children (total number 1024, male/female ratio 513/511, mean age 10.32~0.60 years) living in Izmir, a metropolis of Turkey, were enrolled in the present study. The children were classified into three groups according to the locations of their schools as those from the well‐developed (WD; n=290), moderately developed (MD, n=356) and underdeveloped (UD, n=378) areas. Body mass index (BMI), ratio of BMI to the 50th percentile value of BMI for that age (BMI%) and systolic (SBP) and diastolic blood pressures (DBP) were determined in all children. Each socioeconomic group was subdivided into three subgroups with respect to BMI% as those with less than 90% (SG(<90)), 90–110% (SG(90–110)), and more than 110% (SG(>110)). Then, mean SBP and DBP in each subgroup of the WD, MD and UD groups were compared with the corresponding blood pressure values of each other to evaluate the effect of socioeconomic status on the blood pressure. In addition, the SBP and DBP of each subgroup were compared with other subgroups within that group to evaluate the effect of BMI on blood pressure.

Results
: The BMI and BMI% of the UD group were significantly lower than that of the WD and MD groups (P<0.05). In addition, the number of children with a BMI of more than 95% for their age was significantly lower in the UD group compared with the WD and MD groups (1.7, 1.9 and 0.5% in the WD, MD and UD groups, respectively, P<0.05). The SBP and DBP were positively correlated with BMI% in each group and in all of the subjects cumulatively (r=0.26, P<0.001 for SBP and r=0.34, P<0.001 for DBP). The SBP and DBP were significantly higher in SG(>110) than in SG(90–110) and were also higher in SG(90–110) than in SG(<90) in each group. Mean DBP values in all subgroups of the MD and UD groups were significantly lower than the respective subgroups of the WD group. The SBP of SG(<90) and SG(90–110) of the UD group were significantly lower than those of the corresponding subgroups of the WD and MD groups.

Conclusion
: Obesity is not more prevalent among the children of lower socioeconomic classes in Turkey as a developing country. In addition, independent of anthropometric structure, DBP and SBP were shown to be related to the socioeconomic status in childhood age groups and both values were determined to decrease in accordance with a decrease in the socioeconomic level.
Coronary risk factors in Turkish schoolchildren: Randomized cross‐sectional study*
Authors: Uçar Birsen , Kiliç Zübeyir , Çolak Ömer , Öner Setenay
Published: March 2003

AbstractBackground: There is a strong association between the extent of atherosclerotic lesions in aorta and coronary arteries and antemortem risk factors in children and young adults. Cardiovascular diseases are the most common cause of death in adults in Turkey. However, the data about the extent of coronary risk factors in Turkish children is very limited. The aim of this cross‐sectional study was to investigate the prevalence of coronary risk factors in Turkish schoolchildren living in Eskişehir, Turkey.

Methods: A randomly selected population of 4026 schoolchildren, aged between 7 and 18 years, residing in urban and rural parts of Eskişehir were evaluated for coronary risk factors, using previously predicted risk threshold values.

Results: Hypertension was found in 4.8% of the girls and 3.8% of the boys, 14.9% of the girls and 10.8% of the boys had abnormal lipid values, 18.2% of the girls and 26.4% of the boys had elevated total body fat percentages, 20.7% of the girls and 14.5% of the boys had physical inactivity and 3.8% of the girls and 11.4% of the boys were regular smokers. Urban children had higher rates of hypercholesterolemia; however, rural children had higher rates of physical inactivity. When the modifiable risk factors were considered, excluding family history, 47.7% of the children had at least one risk factor and 11.7% of them exhibited two or more risk factors.

Conclusions: Turkish schoolchildren living in Eskişehir had considerably high levels of coronary risk factors. The interventional measures established in childhood, during which the lifestyle and habits responsible for coronary heart diseases are acquired, will be very effective for preventing and modifying the risk factors predisposing children to coronary heart disease.
Sepsis in children
Authors: Oda Keiko , Matsuo Yusaku , Nagai Kensuke , Tsumura Naoki , Sakata Yasutaka , Kato Hirohisa
Published: March 2003

Abstract Background: Sepsis remains lethal to children. At our institution, we have noted that approximately 2% of all hospitalized patients have had sepsis. In the present study, we analyzed episodes of sepsis that occurred in our ward.

Methods
: Sepsis that occurred in our institution between January 1984 and December 1998 was reviewed and analyzed.

Results
: Three hundred and sixty‐six episodes of sepsis in 244 admitted patients were analyzed. Sepsis occurred in approximately 2% of all hospitalized patients. Forty‐three of 244 patients were under 1 year of age. Eighty‐seven percent (212/244) of cases had underlying diseases. Hematologic disorders or neoplasms were the most common underlying disease, comprising 55% of all patients (133/244). Two‐hundred and fifty‐one of 366 episodes of sepsis were acquired during hospitalization. We identified 409 causative agents. There were 25 polymicrobial infections (25/366; 7%). Gram‐positive bacteria comprised 68% of all organisms (280/409). Staphylococcus aureus was the most common organism, comprising 18% of causing agents (75/409). Sixty‐six organisms came from the insertion of a central venous catheter. Eighty‐one patients experienced recurrent episodes of sepsis. In terms of complications, respiratory distress was the most common complication (36 episodes) and there were 15 episodes of shock. Thirty‐seven patients died of sepsis. Sepsis caused by Gram‐negative bacteria showed significantly higher mortality than Gram‐positive bacteria (11/43 (26%) vs 15/146 (10%); P=0.053).

Conclusions
: In our institution, approximately 20% of septic patients were under 1 year of age and 90% had underlying diseases. The causative agents of sepsis affected the outcome.
Differences in transcutaneous bilirubin readings in Japanese term infants according to feeding method
Authors: Itoh Susumu , Kondo Masatoshi , Kusaka Takashi , Isobe Kenichi , Onishi Shoju
Published: March 2003

Background
: Controversy has existed for many years over whether infant feeding methods are related to serum bilirubin concentrations during the first few days of life. Differences in initial jaundice patterns according to the feeding method until 72 h after birth have not been elucidated hitherto. The difference may become clear in Japanese neonates because jaundice shows a much higher peak bilirubin concentration and a later peak in Japanese neonates than in Caucasian neonates.

Methods
: In the present study, we investigated variations in the transcutaneous bilirubin reading (TcB) obtained within 72 h after birth among 177 breast‐fed and 494 formula‐fed healthy Japanese term neonates.

Results
: There was no difference between TcB in formula‐fed and breast‐fed infants until the first 30 h, after which time the rate of increase in TcB was lower in formula‐fed infants. Among breast‐fed neonates, a good linear regression between time after birth and TcB was maintained. Similarly, weight losses in breast‐fed infants at 24–48 h and 48–72 h after birth were greater than those in formula‐fed infants.

Conclusions
: The jaundice pattern in Japanese neonates from 30 to 72 h after birth according to the feeding method was different from that in Caucasian neonates.
A study of mismatch negativity in newborns
Authors: Tanaka Masaaki , Okubo Osami , Fuchigami Tatsuo , Harada Kensuke
Published: March 2003

Abstract
 

Background
: Although newborns are presumed to have cognitive ability, studies on the objective cognitive ability of neonates are making little progress.

Methods
: We gave auditory and visual stimuli to newborns whose conceptional age ranged from 35 to 43 weeks and recorded the mismatch negativity (MMN) that is said to reflect the process by which stimuli are detected automatically. We compared the waveform and latency of the MMN.

Results
: The mismatch negativity waveform in newborns was similar to that of adults. The MMN latency tended to shorten with an advance in conceptional age and was especially shortened between 36 and 37 weeks of fetal life. In some newborns whose clinical course indicated a possibility of their having cognitive dysfunction, the MMN latency was prolonged.

Conclusions
: Newborns also have cognitive ability and MMN is useful for objectively evaluating the cognitive ability in newborns.
Balloon valvuloplasty for congenital heart disease: Immediate and long‐term results of multi‐institutional study
Authors: Echigo Shigeyuki
Published: March 2003

Abstract

Background and Objectives
: Several studies have been reported in Japan. However, the reports consist of small series at individual institutions. We evaluated the immediate to long‐term results of balloon valvuloplasty (BVP) of congenital pulmonary and aortic stenosis at multi‐institutions in Japan.

Methods and Results
: Immediate and follow‐up data were obtained from eight institutions in Japan. In our series of 172 cases of pulmonary valuvuloplasty excluding critical pulmonary stenosis, the mean pressure gradient decreased immediately after BVP from 61~27 mmHg to 28~20 mmHg and the reduced gradient continued at follow‐up in most cases. The BVP for critical pulmonary stenosis could be accomplished in 35 of 39 patients. The mean right ventricular systolic pressure decreased from 102~29 mmHg to 62~23 mmHg. One of them required the surgical operation for perforation of the right ventricular outflow tract. In BVP for congenital aortic valvular stenosis of 77 cases excluding critical aortic stenosis, the mean pressure gradient decreased immediately after BVP from 68~24 mmHg to 34~23 mmHg. Thirty‐one cases (55%) were free from any interventions in long‐term follow‐up. The BVP for critical aortic stenosis was performed in 29 neonates. The overall mortality rate was 34% and 24% of the patients required repeat intervention. The remaining 42% was free from any interventions.

Conclusions
: Balloon valvuloplasty for congenital pulmonary valvular stenosis is a safe and effective procedure and the initial treatment of choice. In spite of an occasional major complication, BVP for critical pulmonary stenosis is effective in many infants. Balloon aortic valvuloplasty is palliative. However, this procedure has the efficacy in deferring the surgical intervention. Balloon valvuloplasty for neonatal critical aortic stenosis is a useful method to recover from serious conditions.
Surfactant protein (SP) B associations and interactions with SP‐A in white and black subjects with respiratory distress syndrome
Authors: Floros Joanna , Fan Ruzong , Diangelo Susan , Guo Xiaoxuan , Wert John , Luo Junming
Published: March 2003

Abstract

Background
: The etiology of respiratory distress syndrome (RDS) is multifactorial and/or multigenic. Surfactant protein A (SP‐A) and/or SP‐B genetic variants have been identified as risk or protection factors for RDS.

Methods
: We genotyped subjects with and without RDS for the SP‐B intron 4 size variants (invariant (inv), deletion (del), insertion (ins) and for four (–18 (A/C), 1013 (A/C), 1580 (C/T), 9306 (A/G)) SP‐B single nucleotide polymorphisms (SNP), to study case–control associations in black and white subjects. We also determined whether specific SP‐B variants interact with RDS susceptibility or protective SP‐A variants to enhance or reduce risk for RDS.

Results
: Based on odds ratio: (1) the SP‐B intron 4 del variant in white subjects is more of an RDS risk factor for males and for subjects of 28 weeks <gestational age (GA)<33 weeks; (2) the SP‐B intron 4 ins variant in black subjects is more of an RDS risk factor in females; (3) in white subjects, SP‐A1 (6A2/6A2) or SP‐A2 (1A0/1A0 or 1A0/*) genotypes in subjects of certain GA and with a specific SP‐B genotype (9306 (A/G) or del/*) are associated with an enhanced risk for RDS; (4) in black subjects, SP‐A1 (6A3/6A3 or 6A3/*) genotypes in subjects of 31 weeks ≤ GA ≤ 35 weeks and with the SP‐B (1580 (T/T)) genotype are associated with a reduced risk for RDS.

Conclusions
: The SP‐B polymorphisms are important determinants for RDS. These may identify differences between black and white subjects, as well as, between males and females regarding the risk for RDS. Furthermore, SP‐A susceptibility or protective alleles, in specific SP‐B background, are associated, based on OR, with an increased or reduced risk for RDS.
Postoperative speech development based on cleft types in children with cleft palate
Authors: Nakajima Toshiko , Mitsudome Akihisa , Yosikawa Atsushige
Published: March 2003

Abstract

Background
: The purpose of this historical cohort study was to compare the speech development of children with three types of cleft palate while controlling for some confounding factors.

Methods
: Subjects included 28 children with bilateral cleft lip and palate (BCLP), 74 with unilateral cleft lip and palate (UCLP), 33 with isolated cleft palate (ICP), and 168 normal control children. Children with cleft palate attended a speech clinic in Fukuoka, had attained adequate velopharyngeal function after palatoplasty carried out within 18 months after birth, and had no syndromic diseases, persistent hearing loss, mental retardation, or central nervous system problems.

Results
: Children with BCLP began using two‐word sentences later than other children (3 months, P<0.01). However, the difference based on sex was also statistically significant. Female patients started using two‐word sentences earlier than male patients (2 months, P<0.01). Children with BCLP had lower verbal scores on the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) than other children (12.4–14.9 points, P<0.01). There was no significant difference based on sex.

Conclusions
: The results of this research indicate the following: speech development of children with ICP and UCLP was similar to that of normal children; however, speech development of children with BCLP was delayed compared with other children with or without cleft palate.
Nucleated red blood cell counts and erythropoietin levels in high‐risk neonates
Authors: Vatansever Ülfet , Acuna Betül , Demİr Muzaffer , KarasalİhoĞlu Serap , Ekuklu Galip , Ener Seralp , Pala Özer
Published: March 2003

Background
: The presence of increased numbers of nucleated red blood cells (NRBC) and increased levels of erythropoietin (EPO) in the circulation of neonates has been associated with states of relative hypoxia. The aim of this study is to assess the pattern of NRBC counts and EPO levels in a group of high‐risk neonates under stress conditions and determine the short‐term outcome for these babies by using these parameters.

Methods
: There were 69 high‐risk neonates; 14 intrauterine growth retarded (IUGR), 25 preterm infants, 18 term infants with asphyxia and 12 infants of diabetic mothers. Control groups included healthy, term infants delivered either vaginally (n = 18) or with cesarean section (n = 19). Three blood samples were obtained from each infant within 12 h (initial), 3 days and 7 days after birth to measure NRBC counts and EPO levels. Neonatal and short‐term outcomes at 3 and 6 months of age were determined.

Results
: There was no significant difference among the groups with regard to the initial serum EPO concentrations. The initial NRBC counts were significantly lower in the control groups compared with the study groups (P = 0.002). While there was no significant difference between patients with good and poor outcome in terms of EPO concentrations of initial samples, a significant difference existed in terms of NRBC counts (P = 0.038).

Conclusions
: Both serum EPO level and NRBC count provide limited clinical benefit in the detection of pathological conditions of the neonatal period, but NRBC count determination seems to be especially helpful in predicting short‐term neurodevelopmental outcome.
Factors that affect television viewing time in preschool and primary schoolchildren
Authors: Songül Yalçin Siddika , TuĞrul Belma , Naçar NazIre , Tuncer Murat , Yurdakök KadrIye
Published: March 2003

Background: Excessive viewing of television (TV) has been linked to aggressive behavior, violence and childhood obesity.

Methods: A cross‐sectional study was conducted among preschool children and primary schoolchildren in Ankara during March and April 1999 to detect the factors that affect TV viewing time and to evaluate their parents’ knowledge, attitudes and practices with regard to TV. The parents were asked to fill out a questionnaire about TV habits of their family, the number and location of TVs in the household and the effect of TV on children. Of 400 questionnaires, 350 answered the questions appropriately for this study. Children were divided into two groups, preschool children and primary schoolchildren. Television viewing time was given daily, as a mean of weekday.

Results: The mean age for becoming a TV viewer was 2.7 ± 1.6 years. Of all, 62% of children spent ≥ 2h/day watching TV and 8.3% of children spent > 4 h. The TV viewing time of child was significantly and positively correlated with that of siblings, mother and father for both groups. Age and sleeping time of the child, age and the education level of mother, presence of TV in the child's room and the starting age watching TV did not affect the viewing time. One‐half of parents reported that the TV programs watched included violence, and one‐third thought TV depicts child abuse, especially emotional abuse.

Conclusion: It was found that the TV watching habits of parents had an influence on those of their children. Therefore, pediatricians should take ‘TV histories’ of children and their parents and educate parents how to become good TV viewers.
The measurement of stress in pregnancy
Authors: Ruiz Roberta , Fullerton Judith
Published: March 2003

Stress is thought to be one of the biopsychosocial factors that contribute to adverse pregnancy outcomes, such as preterm labor and low birthweight. Identification of these factors (as in total number), and measurement of their individually perceived importance (severity) could lead to opportunities for intervention, and improved pregnancy outcome. A pilot study of the Daily Hassles Scale, was conducted in order to determine the appropriateness of its use among pregnant women. Daily hassles were thought to be a valid proxy for prenatal stress. Content and construct validity were determined among a sample of four content experts and 30 pregnant women. The Daily Hassles Scale proved to be a reliable (internally consistent) measure of stress (alpha reliability coefficient of 0.90). Further adaptation of the scale to include hassles specific to pregnancy and further testing of its usefulness among diverse multicultural and ethnic populations is warranted.
Care for chronically ill children and elderly in the People’s Republic of China
Authors: Davis Anne J. , Martinson Ida
Published: March 2003

This paper examines home care for urban chronically ill elderly and children in the People’s Republic of China. Seventy‐five families with a chronically ill child living at home and 75 families with a chronically ill elderly person living at home responded to in‐depth interview questions. These data provide insights into many dimensions of this home care situation including the severity of the illness and problems experienced by family caregivers. Study results show the difficulties of home health‐care and provide a basis for nursing’s role in China’s future home care.
Histologic evaluation of spermatic veins in patients with varicocele
Authors: Tanji Nozomu , Fujiwara Takashi , Kaji Hiroko , Nishio Shunji , Yokoyama Masayoshi
Published: March 2003

Background: Information concerning varicocele is limited in spite of its clinical importance. This study intends to clarify anatomical features of varicocele.

Methods: Spermatic veins were obtained from varicocele patients at surgery. Areas of two distinct portions (extracellular matrix and smooth muscle) were measured by a micro computer imaging device image analysis system on histologic slides with Masson trichrome stain. In addition, we evaluated the shape and arrangement of the smooth muscle fibers by a scanning electron microscope (SEM).

Results: Masson trichrome stain revealed that grade of varicocele partly correlated with thickness of the wall and with amount of the smooth muscle fibers. In the patients with grade 3 varicocele, SEM examination showed marked hypertrophy of longitudinal smooth muscle fibers, which were discriminated clearly from the inner circular fibers.

Conclusions: This study indicated that morphological changes occurred in the muscle layers of varicoceles in the worst grade of varicocele. These structural changes which result from abnormal venous blood circulation may cause development of varicocele, resulting in male infertility.
NAT2 gene polymorphism as a possible marker for susceptibility to bladder cancer in Japanese
Authors: Inatomi Hisato , Katoh Takahiko , Kawamoto Toshihiro , Matsumoto Tetsuro
Published: March 2003

Background
: N‐acetyltransferase (NAT) is known to metabolize the carcinogen arylamine. The polymorphism of the NAT2 gene is an important determinant of individual susceptibility to bladder cancer. There are significant interethnic differences in NAT2 allele frequencies. The relationship between NAT2 genotypes and bladder cancer in a Japanese population was investigated.

Methods
: A case control study on 85 bladder cancer patients and 146 control subjects was conducted. NAT2 alleles were differentiated by polymerase chain reaction‐based restriction fragment length polymorphism (PCR‐RFLP) methods using originally created PCR primers and genomic DNA extracted from peripheral white blood cells. The NAT2 genotypes were determined by the combination of three known NAT2 mutant type alleles (M1, M2, M3) and the wild type allele.

Results
: NAT2 slow genotypes were associated with bladder cancer risk (odds ratio adjusted for age and gender, 4.23; 95% confidence interval [CI], 1.76–10.81). Among those with NAT2 slow genotypes/smoker, there was a significantly increased risk of 7.80 (95% CI, 1.66–57.87) when the NAT2 rapid genotypes/non‐smoker were considered the reference group. This suggested a possible interaction between NAT2 slow genotypes/smoking status and bladder cancer risk. It was also shown that bladder cancer patients with NAT2 slow genotypes were more likely to have a high grade tumor (G3) or an advanced stage tumor (< pT2–pT4). However, no association between NAT2 genotypes and the survival rate of invasive bladder cancer patients was recognized.

Conclusion
: It was demonstrated that the NAT2 slow acetylation genotype is an important genetic determinant for bladder cancer in a Japanese population.
Expression of growth factors after the release of ureteral obstruction in the rat kidney
Authors: Oka Akihiro , Tanji Nozomu , Toshino Akihiko , Miyauchi Yuuki , Yokoyama Masayoshi
Published: March 2003

Background
: Little is known about the mechanisms underlying recovery from hydronephrosis. Using a rat kidney model, we investigated the possible contribution of growth factors during regeneration after hydronephrosis.

Methods
: After the unilateral ureteral obstruction for 7 days, the obstruction was released by ureterocystostomy. Epidermal growth factor (EGF), hepatocyte growth factor (HGF) and transforming growth factor‐β1 (TGF‐β1) were studied using immunohistochemistry and semiquantitative reverse transcriptase–polymerase chain reaction (RT‐PCR).

Results
: The immunoreaction of EGF in the medulla of both obstructed and contralateral kidneys increased after releasing the obstruction. The release of ureteral obstruction brought further increased immunoreaction of HGF to both the cortex and the medulla of the contralateral kidney. The immunoreaction of TGF‐β1 also increased in the interstitium especially around the blood vessels in the post‐obstructed kidney. The expression of HGF and EGF mRNA in both kidneys and TGF‐β1 mRNA in the obstructed kidney were increased after releasing the obstruction.

Conclusions
: These results suggest that various growth factors may be involved in the post‐obstructive tubular recovery and interstitial damage in the rat kidney.
Poorly differentiated sarcoma of the prostate causing obstructive acute renal failure: A case report
Authors: Mukouyama Hideki , Sugaya Kimio , Ogawa Yoshihide , Koyama Yuzo , Hatano Tadashi , Toda Takayoshi
Published: March 2003

A 12‐year‐old boy presented to the Naha Municipal Hospital complaining of back pain. After intravenous pyelography, computed tomography, magnetic resonance imaging, ultrasonography and biopsy, he was suspected to have sarcoma of the prostate and was referred to the University of the Ryukyus Hospital. Acute renal failure of the post renal type was evident, accompanied by minimal hydronephrosis. Emergency hemodialysis and right ureterostomy were performed, as was a transurethral prostate biopsy. The specimen showed a poorly differentiated sarcoma not otherwise classifiable. After recovery from surgery, chemotherapy was attempted over 2 months, but the patient died of tumor 250 days after admission.
Epidermoid cyst of the penis: A case report and review of the literature
Authors: Suwa Michihiro , Takeda Masayuki , Bilim Vladimir , Takahashi Kota
Published: March 2003

Abstract Penile cysts are uncommon. A case of a 7‐year‐old boy with an epidermoid cyst of the penis is reported. He had an asymptomatic, slowly growing soft mass in the frenulum of the penis. Excision of the mass was performed, and the diagnosis was epidermoid cyst of the penis. No recurrence has been noted within the year since excision. To our knowledge, there have been no previous reports of malignancy developing in cystic disease of the penis. In such cases, clinicians should attempt more appropriate management, involving either watchful observation or complete excision of the cyst, by considering the embryogenesis and nature of the disease.
Direct screening of the IMP‐1 metallo‐β‐lactamase gene (blaIMP) from urine samples by polymerase chain reaction
Authors: Katsuno Satoshi , Takashi Munehisa , Ohshima Shinichi , Ohta Michio , Kato Nobuo , Kurokawa Hiroshi , Arakawa Yoshichika
Published: March 2003

Abstract Background: As Gram‐negative bacterial isolates producing plasmid‐mediated IMP‐1 metallo‐β‐lactamase usually demonstrate resistance to various broad‐spectrum β‐lactams, including cephamycins and carbapenems, transmission and proliferation of these microorganisms in clinical settings could become a clinical threat in the near future. According to previous studies by the same authors, IMP‐1‐producing strains are usually isolated from urine samples. Therefore, in this study, a polymerase chain reaction (PCR) was applied for direct screening of the IMP‐1 metallo‐β‐lactamase gene in urine samples.

Method: Urine samples were collected from 273 inpatients to whom various broad‐spectrum β‐lactams, including carbapenems, had been administered in 57 hospitals in 1997. DNA templates for PCR analyses were prepared directly from 19 urine samples from which Serratia marcescens strains demonstrating high‐level resistance (minimal inhibitory concentration > 128 μg/mL) to both ceftazidime and cefoperazone–sulbactam were later isolated.

Results: The IMP‐1 metallo‐β‐lactamase gene (bla&Igr;&Mgr;&Rgr;)‐specific 578 bp fragments were able to be amplified successfully in eight of the 19 samples. In the seven strains isolated from the eight samples, the presence of blaIMP was also detected by a DNA hybridization analysis. The lower limit of the PCR method was determined as 1 × 102 CFU of blaIMP‐bearing bacterial cells per 1 mL of urine sample. No false positive result was found.

Conclusion

The PCR‐aided direct screening of blaIMP is applicable to early recognition of IMP‐1‐producing bacteria in urine samples. This method would help to prevent nosocomial and interhospital transmission of this kind of hazardous bacteria, as well as the advancement of rigorous infection control.
Acute normovolemic hemodilution for radical prostatectomy: Can it replace preoperative autologous blood transfusion?
Authors: Terada Naoki , Arai Yoichi , Matsuta Yosuke , Maekawa Shinya , Okubo Kazutoshi , Ogura Keiji , Matsuda Norimasa , Yonei Akitomo
Published: March 2003

Abstract Background: Although preoperative autologous blood donation (PAD) is accepted as a standard of care for radical prostatectomy, it is costly, time‐consuming and has risks associated with blood storage. Acute normovolemic hemodilution (ANH) is reported to be less expensive and to preserve blood components more effectively than PAD. In the present study, the efficacy and safety of these two autologous blood‐collection techniques were compared.

Methods: The study included 16 consecutive patients scheduled for radical prostatectomy. The first eight patients underwent conventional preoperative autologous blood donation of 400 mL 1 week before the operation (PAD group) and the second eight patients underwent acute normovolemic hemodilution followed by immediate operation (ANH group). All blood collected was transfused in the perioperative period. Preoperative and postoperative hematocrit levels in these two groups were compared.

Results: There were no differences in preoperative hematocrit, time of operation or operative blood loss between the two groups. In the ANH group, 1080 ± 160 mL of blood were collected. The postoperative hematocrit level did not differ significantly between the groups. No patient in either group received allogeneic blood transfusion or experienced an adverse event directly related to blood transfusion.

Conclusion: The two blood‐conservation strategies resulted in similar postoperative hematologic outcomes. Given its advantages, which include lower cost, lower risk and higher convenience, ANH is one of the procedures that may replace conventional PAD for use in radical prostatectomy.