bluuebunny/crossref_metadata_2025 huggingface dataset:
Antioxidant status in asthma
Authors: Powell Colin V. E. , Nash Audrey A. , Powers Hilary J. , Primhak Robert A.
Published: March 2007

Reduced levels of glutathione peroxidase (GSH‐Px) have been observed in adults with asthma. This study examines the antioxidant status in children with asthma compared with a control group in a cross‐sectional analysis. Red blood cell GSH‐Px, superoxide dismutase (SOD), and plasma concentrations of retinol, vitamin C, alpha tocopherol, and cholesterol were measured in 37 subjects (26 males) with stable controlled asthma. Thirty‐five subjects (20 males) without eczema, hayfever, or recurrent respiratory symptoms were used as a control group. Children with asthma had significantly reduced red blood cell GSH‐Px activity compared with controls [median (inter‐quartile range) for asthma group, 10.25 (9.25–11.91)]; for control group, 11.75 (10.34–12.26) IU/g Hb; P = 0.0061. There were no significant differences in activity of SOD or vitamin C, retinol, or alpha tocopherol/cholesterol ratio. The reduction in GSH‐Px activity may have therapeutic and etiological implications for asthma. The effects of disease activity and treatment on antioxidant status needs for further study. Pediatr Pulmonol. 1994; 18:34–38. © 1994 Wiley‐Liss. Inc.
Improved outcome for young children with AIDS, Pneumocystis carinii pneumonia, and acute respiratory failure
Authors: Wong Hector R. , Chundu Koteswara R.
Published: March 2007

Objective: To describe the clinical course of children with acquired immunodeficiency syndrome, requiring mechanical ventilation secondary to Pneumocystis carinii pneumonia, with respect to intensive care unit outcome, long‐term survival after intensive care unit discharge, and possible predictors of outcome.

Design: Retrospective case series.

Setting: Multidisciplinary, tertiary, pediatric intensive care unit.

Patients: Thirteen consecutive patients accounting for 15 admissions to the intensive care unit, from September 1986 through December 1991, with the diagnoses of acquired immunodeficiency syndrome, P. carinii pneumonia, and acute respiratory failure requiring mechanical ventilation.

Results: All patients were less than 2 years of age and acquired human immunodeficiency virus infection perinatally. Survival after 15 admissions to the intensive care unit was 60%. Mean (± SD) and median long‐term survival for the nine intensive care unit survivors was 30 ± 12.9 months and 27 months, respectively. Maximum oxygenation index and minimum partial pressure of arterial oxygen to fraction of inspired oxygen ratio were significantly different between survivors and nonsurvivors.

Conclusions: Young children with acquired immunodeficiency syndrome who develop acute respiratory failure secondary to P. carinii pneumonia and who require mechanical ventilation may have a better acute outcome and long‐term survival than previously reported.Pediatr Pulmonol. 1994;18:114–118. © 1994 Wiley‐Liss, Inc.
Legionella and Pneumocystis pneumonias in asthmatic children on high doses of systemic steroids
Authors: Abernathy‐Carver K. J. , Fan L. L. , Boguniewicz M. , Larsen G. L. , Leung D. Y. M.
Published: March 2007

Asthma is increasingly treated as an inflammatory disease with inhaled and/or systemic corticosteroids. We report 3 cases of unusual pneumonias associated with high doses of oral steroids. Two patients contracted Legionella pneumonia and one patient contracted Pneumocystis carinii pneumonia. With increasing usage, it is important for physicians to be aware of the possible infectious complications of high dose steroids. This report highlights the risk of corticosteroid treatment in asthma in predisposing to opportunistic infections that have not heretofore been readily associated with asthma.Pediatr Pulmonol. 1994;18:135–138. © 1994 Wiley‐Liss, Inc.
The effect of transfusion on pulmonary function in patients with thalassemia major
Authors: Santamaria F. , Villa M. P. , Werner B. , Cutrera R. , Barreto M. , Ronchetti R.
Published: March 2007

Pulmonary involvement has been documented in thalassemia major (TM). We studied 12 patients with TM before and 24 hr after transfusion to evaluate the effect of transfusion on baseline lung function. Personal and family histories of respiratory illnesses were obtained by a questionnaire. Spirometry and carbon monoxide diffusion capacity (KCO) measurements were made. Blood gases (P, and S,) were determined on arterialized samples. Baseline expiratory volumes and flows were within normal range in all patients. Transfusion resulted in a significant reduction of forced expiratory volume in 1 sec (FEV1) and forced expiratory flow between 25 and 75% vital capacity (FEF25–75%). In two subgroups of patients identified by the questionnaire, those with no history of airway disease had normal baseline flows and no posttransfusion changes; those with history of airway obstruction had lower pretransfusion flows and significantly decreased posttransfusion FEV1 and FEF25–75%. The mean pretransfusion KCO value of 80% predicted for the whole group, significantly increased after transfusion (P < 0.05). Blood gases also significantly increased after transfusion (P < 0.05). When tested for the spirometric response to albuterol, patients with a history of asthma had a slightly greater increase in FEV1 and FEF25–75% than those who had never had asthma. We conclude that in our small study group, transfusion resulted in improved gas exchange and lung perfusion. The effect on flow limitation evident in some patients could, in part, be related to a preexisting bronchial hyperreactivity. Accurate evaluation of pulmonary function and of bronchial reactivity is advisable for patients with TM. Pediatr Pulmonol. 1994;18:139–143. © 1994 Wiley‐Liss, Inc.
Forced expiratory maneuvers in children aged 3 to 5 years
Authors: Kanengiser Steven , Dozor Allen J.
Published: March 2007

There is no consensus about reproducibility and reliability of spirometry in young children. We evaluated forced expiratory maneuvers from 98 children aged 3 to 5 years with a variety of respiratory disorders before and after bronchodilator treatment. Forced vital capacity (FVC) and forced expiratory volume in 1 sec (FEV,) were analyzed for reproducibility by the American Thoracic Society criteria and for reliability based on the coefficient of variation (CVYo). Over 90% of the patients cooperated, however, while 95% could exhale for at least 1 second, very few generated an FEV, on all 6 “best” efforts. This clearly improved with age. Of all patients nearly 60% performed reproducible pre‐and postbronchodilator sets of FVC but only 32% performed reproducible sets of FEV1. Based on the CV%, those patients who could reproducibly perform an FVC and FEV, did it quite reliably (mean CV%, 9.38 and 7.01 for FVC and FEV1, respectively). We conclude that while some very young children can perform spirometry, reliability of performance cannot be assumed in this age group. Pediatr Pulmonol. 1994;18:144–149. © 1994 Wiley‐Liss, Inc.
Ventilation–perfusion relationships in preterm infants after surfactant treatment
Authors: Bowen Winslade , Martin Camilia R. , Krauss Alfred N. , Auld Peter A. M.
Published: March 2007

Arterial‐alveolar partial pressure differences for oxygen, carbon dioxide, and nitrogen were measured before and after surfactant replacement therapy on 15 occasions in 14 ventilator‐dependent preterm infants with hyaline membrane disease (HMD). Eight treatments resulted in a significant improvement in arterial partial pressure of oxygen (PaO2) 2 hr after treatment; 7 did not. Neither group showed any significant change in arterial‐alveolar partial pressure differences for oxygen, nitrogen, and carbon dioxide. This observation suggests that if surfactant replacement therapy produces an improvement in PaO2 it does so by recruitment of atelectatic alveoli with a balanced ventilation perfusion ratio rather than by redistribution of ventilation within already ventilated alveoli.Pediatr Pulmonol. 1994;18:155–162. © 1994 Wiley‐Liss, Inc.
The Hering–Breuer deflationary reflex in the newborn infant
Authors: Marsh Michael J. , Fox Grenville F. , Hoskyns E. Wren , Milner Anthony D.
Published: March 2007

Initial observations on healthy term infants using the forced partial expiratory flow‐volume technique with an inflatable jacket suggested that this technique was stimulating the Hering‐Breuer deflationary reflex,1 a reflex which has not been systematically studied in man. To investigate this fully, esophageal pressure, jacket pressure, flow and volume at the mouth were recorded during the forced partial expiratory flow‐volume maneuver on 10 infants (mean age, 3.1 days; birth weight, 3533 g; gestation, 39.8 weeks). A total of 186 measurements were performed at different points in the respiratory cycle. In 159 (85%) recordings inspiratory effort was evident with a fall in esophageal pressure within 166 msec; in some cases this occurred before the jacket was fully inflated. This was associated with a reduction of 23.4 cm H2O in mean intrathoracic pressure, which was 2.5 times that occurring during normal tidal breathing. In the remaining 27 measurements a plateau pressure was associated with closure of the upper airway. When the squeeze was applied at low lung volumes (end‐expiration) the inspiratory effort occurred significantly earlier (133 msec) and stronger (reducing peak intrathoracic pressure to 15.8 cm H2O) than when applied at end‐inspiration (181 msec with a reduction in intrathoracic pressure to 25.2 cm H2O). The observed inspiratory response was highly consistent, representing the deflationary reflex as described by Hering and Breuer in 1868.2,3 The stronger and more rapid onset of inspiration at low lung volume supports the claim made by Breuer that it has a protective role on functional residual capacity (FRC) in young infants.Pediatr Pulmonol. 1994;18:163–169. © 1994 Wiley‐Liss, Inc.
Diaphragmatic paralysis in children: A review of 11 cases
Authors: Commare M. C. , Kurstjens S. P. , Barois A.
Published: March 2007

We reviewed 11 pediatric cases of diaphragmatic paralysis related to nonspinal‐cord injury which were managed in our Intensive Care Unit over the past 10 years. Three cases were secondary to birth trauma, 7 followed surgical procedures for congenital heart disease, and 1 occurred in association with injuries sustained in a motor vehicle accident. The paralysis was bilateral in 8 children. The diagnosis was initially suspected on clinical grounds because of respiratory distress, impossibility of weaning from the ventilator, and paradoxical abdominal respiratory movements. Confirmatory investigations included chest radiography, which revealed elevation of the affected hemidiaphragm, fluoroscopy and ultrasound, both of which demonstrated diminished diaphragmatic movement. Electromyography exhibited a failure of diaphragmatic response to phrenic nerve stimulation in 8 patients. All patients were mechanically ventilated: tracheostomy was required in 5 patients. Physiotherapy was considered a beneficial adjuvant measure. Diaphragmatic plication was attempted without success in 3 children. Seven children recovered without sequelae: Partial respiratory autonomy was achieved after an average of 2.6 months, complete autonomy after an average of 5.4 months. Two patients developed chronic lung disease; one of them remains unresponsive, and one child died following accidental extubation. We conclude that the diagnosis of diaphragmatic paralysis is predominantly clinical, and that the outcome of patients treated by adequate endotracheal mechanical ventilation is usually favorable.Pediatr Pulmonol. 1994;18:187–193. © 1994 Wiley‐Liss, Inc.
The use of aerosolized pentamidine for prophylaxis of Pneumocystis carinii pneumonia in children with leukemia
Authors: O'Sullivan Brian P. , Spaulding Rhoda
Published: March 2007

We report our experience giving aerosolized pentamidine as prophylaxis for Pneumocystis carinii pneumonia (PCP) to 9 children (mean age, 7.33 years; range 3–17 years) with leukemia who were unable to tolerate trimethoprim‐sulfamethoxazole (TMP‐SMX) due to allergy or myelosuppression. The dose of pentamidine was modified for each child to correct for weight and approximate alveolar ventilation. We were able to administer the drug to younger children by using a cushioned face mask in place of the standard mouthpiece. One child experienced moderate coughing with administration of pentamidine. He and four others with a past medical history suggestive of reactive airways disease were pretreated with inhaled albuterol. No other adverse effects were noted. Treatment lasted an average of 8.11 ± 4.1 months per child; no case of PCP occurred. We conclude that aerosolized pentamidine can be administered to even very young children and may be of benefit to all immunosuppressed children unable to use TMP‐SMX prophylaxis. The adjusted dose used here appears to be safe, but further studies regarding drug delivery and efficacy are needed.Pediatr Pulmonol. 1994;18:226–231. ©1994 Wiley‐Liss, Inc.
The effects of Bone Marrow transplantation on pulmonary function in children
Authors: Quigley Patricia M. , Yeager Andrew M. , Loughlin Gerald M.
Published: March 2007

The effects of current methods of bone marrow transplantation (BMT) on pulmonary function in children have not been extensively studied. We reviewed serial pulmonary function tests (PFTs) in 25 children (median age, 9 yr; range, 4—15) who received allogeneic (n = 14) or autologous (n = 11) BMT for neoplastic diseases at The Johns Hopkins Hospital. The PFTs were obtained before BMT and at 6 months (early) and 15 months (late) after transplant. In all but 6 patients, PFTs were normal before BMT. A mild transient decline in carbon monoxide diffusing capacity (DLcO) was observed early after BMT but returned to baseline levels in the late post‐BMT period. A trend towards worsening of PFTs with increasing age of patients was observed. The presence of graft‐versus‐host disease (GVHD) and pretransplant seropositivity for cytomegalovirus (CMV) were associated with significant decrements in several measurements of pulmonary function in the early post‐BMT period. Patients given bulsulfan‐containing preparative regimens tended to have less impairment of PFTs than those given other regimens using other combination high‐dose chemotherapeutic agents or total body irradiation. These findings suggest that abnormalities in PFTs are common in the first months after BMT in pediatric patients but are not consistently associated with impairment of lung function when studied 15 months post‐transplant.Pediatr Pulmonol. 1994;18:361–367. ©1994 Wiley‐Liss, Inc.
Irreversibility of birth‐related changes in the pulmonary circulation
Authors: Levine Gail L. , Goetzman Boyd W. , Milstein Jay M. , Bennett Stephen H.
Published: March 2007

We hypothesized that establishing conditions of hypoxia and fluid filling of the airways in lungs of newborns would reproduce the high levels of pulmonary vascular resistance (PVR) observed in the fetal state. We assessed the hemodynamics of the left pulmonary circulation of 1‐to 3‐day‐old lambs during a variety of airway states while attempting to reestablish fetal conditions. Eleven animals were studied during both normoxemia and hypoxemia in a baseline airway state with a positive end‐expiratory pressure (PEEP) of 4 cm H2O, and in experimental airway states, of atelectasis, and fluid filling to 15 and 30 mL/kg and with PEEP of 12 cm HO. PVR increased while pulmonary blood flow decreased with all airway state changes as compared to baseline, suggesting a passive mechanism for these changes. With the addition of hypoxemia there was a further increase in PVR in all states accompanied by an increase in pulmonary blood flow, indicating that active vasoconstriction was responsible for the increase in PVR. The combined effects of hypoxemia and fluid filling, designed to approximate the fetal state, increased PVR to only 20–30% of fetal values. Thus, additional factors appear to be important in maintaining the high PVR of the fetal state. We speculate that ventilation of the lungs at birth irreversibly alters these factors.Pediatr Pulmonol. 1994;18:368–373.©1994 Wiley‐Liss, Inc.
Short‐term effects of three chest physiotherapy regimens in patients hospitalized for pulmonary exacerbations of cystic fibrosis: A cross‐over randomized study
Authors: Braggion C. , Cappelletti L. M. , Cornacchia M. , Zanolla L. , Mastella G.
Published: March 2007

The aim of our study was to compare the short‐term efficacy of three different chest physiotherapy (CPT) regimens (PD, postural drainage; PEP, positive expiratory pressure physiotherapy; HFCC, high‐frequency chest compression physiotherapy) on patients with cystic fibrosis (CF) hospitalized for an acute pulmonary exacerbation. Sixteen patients with CF, 8 males, 8 females, aged 15‐27 years (mean, 20.3±4), met the inclusion criteria: 1) age over 14 years; 2) mild or moderate airway obstruction; 3) sputum volume > 30 mliday; 4) being proficient in PD and PEP CPT. Patients at admission had (mean±SD) forced volume in 1 second (FEV,), 52.2±21.9 percent predicted; Shwachman‐Kulczycki clinical score 65.1±11 points; Chrispin‐Norman chest radiography score 18.6±4.3 points. The three CPT regimens and a control‐treatment (CONT) were administered in a random sequence, each patient receiving each treatment twice a day (in 50 minute sessions) for 2 consecutive days. During CONT and for 30 minutes after each session only spontaneous coughing was allowed. Wet and dry weight of sputum were recorded during the 50‐minute sessions and 30 minutes afterward. Lung function was measured before and 30 minutes after each session. For each treatment a score was given by the patient for efficacy, and by both the patient and the physiotherapist for tolerance.

Wet and dry weights of sputum collected during the sessions were greater for all CPT regimens than for CONT (P < 0.001, P < 0. 0001). No significant differences between the three CPT regimens for both wet and dry weights were found when the number of coughs was taken into account. No significant changes in lung function occurred. Tolerance and efficacy scores were similar for all regimens. We concluded that there were no differences in the short‐term efficacy between the three CPT regimens on hospitalized patients with CF. © 1995 Wiley‐Liss, Inc.
Diaphragmatic flutter in three babies with bronchopulmonary dysplasia and respiratory syncytial virus bronchiolitis
Authors: Adams J. A. , Zabaleta I. A. , Sackner M. A.
Published: March 2007

Abnormalities of respiratory control, especially apnea, have been reported previously in infants with respiratory syncytial virus (RSV) infections. This is the first report of yet another abnormality of respiratory control, diaphragmatic flutter (DF), in infants with RSV infection. The presentation of these infants did not differ from the usual clinical presentation of RSV infection. While being monitored with respiratory inductive plethysmography for occurrences of apnea known to be common in RSV infection, DF was detected. This abnormality consisted of high frequency, diaphragmatic contractions which were intermittent in nature. They lasted no more than 4 days and were not associated with change in arterial oxygen saturation or heart rate. These infants were discharged free of DF and no further episodes have been observed over a 12‐month period. © 1995 Wiley‐Liss, Inc.
Late pulmonary function following repair of tracheoesophageal fistula or esophageal atresia
Authors: Robertson Dale F. , Mobaireek Khalid , Davis G. Michael , Coates Allan L.
Published: March 2007

Although tracheoesophageal fistula and esophageal atresia (TEF‐EA) are surgically correctable, late respiratory complications have been reported. We administered a respiratory and gastrointestinal symptom questionnaire and performed standard pulmonary function tests (PFT's) and methacholine challenge testing on an unselected group of 25 subjects with TEF‐EA who underwent surgery at our institution between 1963 and 1985. Results were compared to predicted normals, as well as 10 sibling controls. While the mean values of lung function test results for the TEF‐EA group were within the normal range, they were significantly different from their siblings. Thirteen of the 25 TEF‐EA group (52%), but none (0%) of the controls, had abnormal pulmonary function. This was classified as restrictive in 9 (36%). obstructive in 3 (12%), and mixed in 1. In addition, airway hyperreactivity [defined as a positive methacholine challenge (PC20 ⩽ 8 mg/mL)], was found in 6 of 18 TEF‐EA subjects and 4 of the 9 controls who were evaluated. Comparison of TEF‐EA subjects with normal and abnormal PFTs showed no difference in the incidence of tracheomalacia, esophageal strictures or dilatation, recurrent pneumonias, or gastroesophageal reflux. The respiratory symptom score in the subjects and controls was similar, and did not correlate with abnormal pulmonary function. The cause of the pulmonary function abnormalities remains unexplained. Pediatr Pulmonol. 1995; 20:21–26. © 1995 Wiley‐Liss, Inc.
Inhaled nitric oxide improves oxygenation in piglets with meconium aspiration
Authors: Barrington Keith J. , Finer Neil N. , Peliowski Abraham , Etches Philip C. , Graham Andrew J. , Chan Winston K. Y.
Published: March 2007

We hypothesized that nitric oxide (NO) inhalation in a model of meconium aspiration in newborn piglets would decrease pulmonary vascular resistance. Seven neonatal piglets were obtained at less than 48 hr of age and instrumented under fentanyl anesthesia. Inhaled NO (40 parts per million) was administered during normoxia and again after hypoxia was induced by reducing FiO, to 0.13. During normoxia NO inhalation caused a fall in pulmonary artery pressure from a mean of 3.15 (SD 0.8) kPa to 2.84 (SD 0.7) kPa (P < 0.01). Hypoxia (mean arterial 0, saturation 35%) increased PA pressures to a mean of 5.4 (SD 1.6) kPa and NO administration during hypoxia decreased PA pressures to 3.6 (SD 1.2) kPa (P < 0.001). In order to determine the effects of NO in a model of meconium aspiration, 6 to 7 mUkg of 20% human meconium in normal saline was instilled into the trachea. This procedure induced hypoxemia (mean SaO, 43.4%, SD 19), respiratory acidosis, (mean PaCO, 12.1 kPa, SD 0.5; mean pH 7.04, SD 0.03), and pulmonary arterial hypertension (mean pulmonary artery pressure 6.0 kPa, SD 1.3) despite ventilation with 90% oxygen. Inhaled NO was then administered in concentrations of 5, 10, 20, 30, 40, 60, and 80 parts per million in random order according to a Latin square design. After meconium instillation, NO inhalation led to significant increases in mean arterial saturation of between 18 and 24 percentage points at all doses, and to statistically significant decreases in pulmonary arterial pressure (from 6.0 kPa, SD 1.3 to 5.1 kPa, SD 1.5, P < 0.01) and pulmonary vascular resistance index (from 0.033 kPa/mL/min/kg, SD 0.003 to 0.029 kPa/mL/min/kg, SD 0.003, P < 0.01). Systemic blood pressure, cardiac index and systemic vascular resistance index did not change. The ratio between pulmonary and systemic vascular resistances fell, therefore, from a mean of 0.54 (SD 0.18) to 0.46 (SD 0.14). The effects of NO inhalation after meconium aspiration were qualitatively different to the effects during aveolar hypoxia, in that there was a lesser fall in the PAP and PVR1 and a significant increase in SaO2. These results suggest that inhaled NO may be beneficial in meconium aspiration syndrome in human neo‐nates, improving oxygenation by decreasing extrapulmonary shunting and by improving ventilationiperfusion ratios. Pediatr Pulmonol. 1995; 20:27–33. © 1995 Wiley‐Liss, Inc.
Effects of combined treatment with rhDNase and airflow oscillations on spinnability of cystic fibrosis sputum in vitro
Authors: Dasgupta Bonnie , Tomkiewicz Robert P. , Boyd William A. , Brown Neil E. , King Malcolm
Published: March 2007

Treatment with either rhDNase or high‐frequency oscillation has been shown to be effective in improving the physical and transport properties of airway secretions in cystic fibrosis (CF). The objects of this in vitro study was to examine whether combined treatment with oscillation and rhDNase results in greater change of CF sputum spinnability than either treatment by itself. Aliquots of sputum (0.4 g) from eight CF patients were subjected to the following protocols for 15 minutes and then followed for a total of 30 minutes: (1)incubation with 0.04 ml DNase 50 μg rhDNasenormal saline (10% dilution) at 37°C to achieve 5 μg DNase/g of sputum final concentration; (2)airflow oscillation at 27 Hz similar to the airflow magnitude produced by a commercial high‐frequency chest compression (HFCC) device; (3)negative control with no treatment; (4)positive (dilution) control, incubating with 10% saline by volume; (5)combination of DNase and oscillation, and (6)combination of saline and oscillation. For each protocol, sputum spinnability (in mm, mean ± SD) was measured by means of a filancemeter at baseline, 15, and 30 minutes. Treatment with DNase decreased spinnability significantly more than either saline or oscillation at 15 and 30 minutes (P < 0.02 and P < 0.04, respectively). Incubation with saline or oscillation of CF sputum for 15 and 30 minutes decreased spinnability significantly compared with control. The combination of DNase and oscillation decreased spinnability significantly more than treatment with DNase alone (3.74 ± 0.45 vs. 6.54 ± 0.73 at 15 minutes, P < 0.01). The combination of saline and oscillation over 15 minutes decreased spinnability similarly to the application of DNase alone over the same period of time (7.84 ± 1.91 ± 6.54 ± 0.73, respectively). These in vitro results demonstrate an optimal effect on sputum spinnability when DNase and oscillation are used concomitantly. This suggests that combining biochemical (rhDNase) and physical (HFCC) treatments in CF patients may provide greater benefits than treatment with one modality at a time. Pediatr Pulmonol. 1995; 20:78–82. © 1995 Wiley‐Liss, Inc.
A critical assessment of uncalibrated respiratory inductance plethysmography (Respitrace®) for the measurement of tidal breathing parameters in newborns and infants
Authors: Jackson E. , Stocks J. , Pilgrim L. , Dundas I. , Dezateux C.
Published: March 2007

We have compared results obtained with an uncalibrated respiratory inductance plethysmograph (RIP) with those of a face mask and pneumotachograph (PNT) for the computerized measurement of the time to reach peak tidal expiratory flow as a ratio of total expiratory time (tpTEF:tE). Simultaneous measurements were made in 32 healthy neonates aged 0–3 weeks, 35 healthy infants aged 5–82 weeks, and 28 infants aged 15–94 weeks with physician diagnosed recurrent wheeze. The group mean (±SD) values of tpTEF:tE determined using a PNT were 0.455 (±0.129), 0.263 (±0.077), and 0.232 (±0.089) for the neonates, healthy infants and infants with recurrent wheeze respectively. RIP gave mean (±SD) values that were 0.055 (±0.044) and 0.025 (±0.104) lower than the PNT in healthy neonates and infants with recurrent wheeze respectively; RIP values were 0.002 (±0.073) higher in the healthy infants over 4 weeks of age than measurements by PNT. Although the difference between the two measurements was not related to the thoracoabdominal phase angle, as measured from Lissajous figures, examination of the RIP ribcage and abdominal signals revealed that many healthy subjects, while appearing clinically in phase, had ribcage and abdominal signals that differed markedly from each other in terms of convexity/concavity during early expiration. This may explain the lack of agreement between the two methods. We conclude that uncalibrated RIP should be used with caution for the determination of tpTEF:tE, even in subjects whose ribcage and abdomen appear to move synchronously. The measurement of tpTEF:tE did not differentiate between the healthy infants and infants with recurrent wheezing. Pediatr Pulmonol. 1995; 20:119–124. © 1995 Wiley‐Liss, Inc.
Relationship between an index of tidal flow and lower respiratory illness in the first year of life
Authors: Adler Alan , Tager Ira B. , Brown Randall W. , Ngo Long , Hanrahan John P.
Published: March 2007

The ratio of time to tidal peak flow (Tme) to total tidal expiratory time (Te) has been reported to be decreased in infants who later develop wheezing lower respiratory tract illness (LRI) in the first year of life. The relationship between Tme/ Te to the subsequent occurrence of LRI was studied in 98 infants in whom the first measurement of pulmonary function (PFT) was made before the age of 6 months and before the occurrence of any LRI. Occurrence of LRI was evaluated by standardized questionnaires at well‐baby visits, through biweekly telephone calls to mothers, and review of all visits to physicians. Tme/ Te was derived from 10 tidal breathing loops during stable respiration. Partial expiratory flow‐volume curves were obtained with the rapid compression technique, and passive respiratory mechanics were evaluated by the single breath occlusion technique. Analysis of Tme/ Te was stratified by age (⩽ 10 weeks, > 10 weeks to 6 months) to take into account the age‐related decline in Tme/ Te. Among 80 infants first tested at ⩽10 weeks, Tme/ Te was 12.4% shorter in those who developed a LRI vs. those who did not (P = 0.46); for 18 infants tested after 10 weeks, the difference was 1.9% (P = 0.39). Among male infants, the decrease in Tme/ Te was observed only for those studied at 40 weeks (16%, P = 0.16). For females, decreases were observed for those tested at 10 weeks (11%, P = 0.83) and those tested after 10 weeks (17.5%, P = 0.09). Poisson regression analysis which included data for multiple measurements of Tme/ Te, over the first year of life and adjusted for age‐at‐test and maternal smoking during pregnancy also demonstrated a greater decrease in Tme/ Te in female infants who subsequently develop an LRI (P = 0.08). Level of Tme/ Te was not consistently related to level of respiratory system resistance (RRS) or flow at functional residual capacity (V̇FRc). Level of V̇FRC has been shown previously to be related to the occurrence of LRI and in this study to RRS(P = 0.007). The results indicate (1) a shortened Tme/ Te is only weakly associated with the development of LRI in the first year of life; (2) this ratio is a less precise and an epidemiologically less useful measure than is VFRC to investigate groups of infants with and without LRI and without clinically significant underlying lung disease. Pediatr Pulmonol. 1995; 20:137–144. © 1995 Wiley‐Liss, Inc.
Efficacy of surfactant therapy in infants managed with CPAP
Authors: Alba Jorge , Agarwal Ravi , Hegyi Thomas , Hiatt I. Mark
Published: March 2007

Surfactant rescue therapy can be utilized effectively early in the course of respiratory distress syndrome (RDS) in infants weighing > 1,000 g and treated exclusively with continuous positive airway pressure (CPAP) therapy. Thirteen infants (BW, 1,774 ± 580 g; GA, 31 ± 3 weeks) comprising the CPAP/SURFACTANT group were compared with 12 infants (BW, 1,753 ± 556 g; GA, 31 ± 2 weeks) who comprised the intermittent mandatory ventilation (IMV)/ surfactant group, and with 14 infants (BW, 1,776 ± 332 g; GA, 32 ± 2 weeks) treated with CPAP before surfactant was clinically available.

A 5 mL/kg dose of Exosurf Neonatal (Burroughs‐Wellcome) was administered to infants intratracheally when the FiO2 requirement reached 0.40 to maintain the PO2 above 50 torr. Infants in the CPAP/surfactant group were intubated solely for surfactant administration and extubated within 18 ± 6 min of treatment. The CPAP/surfactant group was treated at a mean age of 12.3 ± 9.3 h, and the IMV/surfactant group at 10.2 ± 9.8 h. Alveolar‐arterial oxygen gradient (AaDO2), oxygenation index (OI), and mean airway pressure (MAP) were determined immediately before and after surfactant therapy, and at comparable times for the CPAP‐ only group.

A significant difference was found in pre‐treatment AaDO2, OI, and MAP between the CPAP/ surfactant group and IMV/surfactant group, but not between the CPAP/surfactant group and the CPAP‐only group. Similarly, a significant difference in AaDO2, OI, and MAP continued post‐treatment was noted. However, a significant difference was also found at this time between the CPAP/surfactant group and the CPAP‐ only group. In addition, a significant difference was noted in AaDO2 and OI pre‐ and post‐treatment within each surfactant‐treated group. Furthermore, in the CPAP‐only group AaDO2 and OI actually worsened (212 ± 70 vs. 239 ± 68; 4.0 ± 1 vs. 4.5 ± 2, respectively). There was a significant reduction in the duration of oxygen therapy (3 ± 2 vs. 5 ± 2 vs. 4.5 ± 2 days, respectively) as well as in the total days of hospitalization (30 ± 10 vs. 42 ± 15 vs. 43 ± 12 days, respectively).

We conclude that in this small group of infants surfactant administration was effective and safe. It appeared to improve the course of RDS and shorten the duration of oxygen exposure and days of hospitalization. Pediatr Pulmonol. 1995; 20:172–176. © 1995 Wiley‐Liss, Inc.
Time trends in acute childhood asthma in Basque country, Spain
Authors: Benito J. , Bayon J. Lopez , Montiano J. , Sanchez J. , Mintegui S. , Vazquez C.
Published: March 2007

To investigate recent changes in the epidemiology of acute asthma in children in a hospital setting, data from the Basque region of Bizkaia, Spain were reviewed for the period between 1987 and 1992. Over this period there was a 18% drop in hospital emergency visits for asthma in children aged 2‐14 years from 1,697/100,000 to 1,382/100,000. It was associated with a decline in the number of annual episodes per patient and in the number of patients needing further hospital treatment for the same episode. Paradoxically, hospital admission rates rose by 35.9% from 298/100,000 to 405/100,000. A trend toward decreasing length of hospital stay, a fall in the number of intensive care unit admissions, and an absence of in‐hospital deaths were observed. Comparing data from September 1987 with those of September 1992, a trend has been noticed toward greater intensity of emergency room treatment with increases in the number of doses of nebulized ß‐‐agonists administered and in courses of oral prednisolone given. In September 1992 more patients were on maintenance “anti‐inflammatory” inhaled therapy than in 1987. Pediatr Pulmonol. 1995; 20:184–188. © 1995 Wiley‐Liss, Inc.
Home testing for pediatric obstructive sleep apnea syndrome secondary to adenotonsillar hypertrophy
Authors: Jacob S. V. , Morielli A. , Mograss M. A. , Ducharme F. M. , Schloss M. D. , Brouillette R. T.
Published: March 2007

The objective of this study was to determine the accuracy and practicality of home testing for pediatric obstructive sleep apnea syndrome (OSAS) secondary to adenotonsillar hypertrophy. Twenty‐one children aged 2‐12 years and referred for possible OSAS were studied twice, once at home and once in the sleep laboratory. The home test consisted of two parts: (1) a cardiorespiratory recording of saturation (SaO2), pulse rate, pulse waveform, electrocardiogram, and respiratory inductive plethysmography; and (2) an 8‐hour videotape recording of the sleeping child. In the laboratory, standard nocturnal polysomnography including electroencephalography was performed. Experiences with another 62 children who underwent home testing alone were also reviewed and are reported. At home, saturation, respiratory, and video data were obtained 96.4 ± 13.3% (mean ± SD) 99.4 ± 1.6%, and 90.0 ± 7.8% of the time, respectively. The sleep efficiency was greater at home than in the laboratory, 91.1 ± 3.9% vs. 86.1 ± 7.2%, with a mean difference of 5.0% (P < 0.01). The median environmentally induced movement/arousal index was lower in the home than in the laboratory, 0.0 (inter‐quartile range, 0.0‐0.3) vs. 2.4/hr (inter‐quartile range 1.2–4.2), with a median difference of 2.4/hr (P < 0.001). Study duration, apne/dhypopnea index, desaturation index, respiratory and spontaneous movement/arousal indices, and oxygen saturation during sleep were similar for home and laboratory studies. Although neither sleep state nor PCO2, (transcutaneous or end‐tidal) was measured in the home, this information would have modified patient management in, at most, one case. In the second group of 62 children, exclusively studied at home, all studies were successfully recorded despite a wide range of sleep efficiencies, apne/dhypopnea indices, and desaturation indices. We conclude that home testing, using a simplified cardiorespiratory montage plus video recording, is accurate and of practical use in the routine evaluation of OSAS in patients with adenotonsillar hypertrophy. Pediatr Pulmonol. 1995; 20:241–252. © 1995 Wiley‐Liss, Inc.
The significance of sweat Cl/Na ratio in patients with borderline sweat test
Authors: Augarten Arie , Hacham Shoshana , Kerem Eitan , Kerem Bat Sheva , Szeinberg Amir , Laufer Joseph , Doolman Ram , Altshuler Ruth , Blau Hana , Bentur Lea , Gazit Ephraim , Katznelson Daniel , Yahav Yaacov
Published: March 2007

Recently a few cystic fibrosis (CF) patients with borderline or normal sweat tests have been reported. These patients present a diagnostic challenge. We aimed to study the sweat CINa ratio in cystic fibrosis patients and to assess whether this ratio could be used as a diagnostic criteria. The mean sweat CINa ratio of 3 groups was compared: Group A: 71 CF patients carrying 2 mutations known to be associated with severe disease presentation (ΔF508, W1282X, G542X, N1303K, 1717‐1G → A). Group B: 10 compound heterozygous patients who carry one mutation associated with mild clinical disease (3849 + 10 kb C → T). Group C: 142 normal subjects. Sweat chloride levels higher than those of sodium were found in 96% of patients in Group A as compared to 3% of patients in Group C. In Group B 40% of the patients had sweat chloride levels higher than or equal to sodium levels. The mean Cl/Na ratio of Group A (1.2 ± 0.1) differed significantly from that of Group B (0.94 ± 0.1) and both groups had significant higher mean CINa ratio compared to Group C (0.7 ± 0.4) (P < 0.001). Thus in individuals with a borderline sweat test and a Cl/Na ratio < 1 the diagnosis of CF should be considered. However, a Cl/Na ratio < 1 does not exclude CF, since patients carrying mild mutations may have sweat sodium levels higher than those of chloride. Our findings suggest that the sweat CINa ratio in CF is genetically determined and it may be of help in establishing the diagnosis of CF in patients with a borderline sweat test. Pediatr Pulmonol. 1995; 20:369–371. © 1995 Wiley‐Liss, Inc.
Evaluation of the interrupter technique for measuring change in airway resistance in 5‐year‐old asthmatic children
Authors: Phagoo S. B. , Wilson N. M. , Silverman M.
Published: March 2007

The interrupter technique is a noninvasive method for measuring airway resistance during quiet breathing which requires minimal subject cooperation. It, therefore, has enormous potential for use in young children unable to cooperate with conventional lung function tests. We evaluated the interrupter technique during bronchial challenge with methacholine administered by the tidal breathing method in 10 5‐year‐old asthmatic children. The mouth pressure/time [Pmo(t)] curve obtained following brief airflow interruption during the expiratory phase of quiet breathing was analyzed to determine the interrupter resistance R,int using four different methods: RintC, a smooth curve fit with back‐extrapolation; RintEO, calculated from the pressure change after the postinterruption oscillations had decayed (end‐oscillation); RintL two‐point linear fit with back‐extrapolation; and RintEL, calculated from the pressure change at the end of the period of interruption. The four Rint methods were compared for repeatability and sensitivity with the direct measurement of resistance by the forced oscillation technique (Rrs) and with an independent method of measuring the response to challenge, utilizing the change in transcutaneous oxygen tension (PtcO2). The sensitivity of the methods was defined by a sensitivity index (SI), the change after challenge expressed in multiples of the baseline standard deviation. The PtCo2 method had the lowest variability and was by far the most sensitive method (geometric mean SI 18.9), at least 1 doubling concentration more sensitive than the other techniques in every subject (P < 0.05). RintL was more sensitive than the other interrupter methods (geometric mean SI: RintL 4.2; RintC 1.O; RintEO 2.7; RintEL 3.1; P < 0.05) and similar in sensitivity to Rrs (geometric mean SI 4.6) in 7 out of 10 children in which this could be measured. We conclude that the interrupter method provides a simpler method than the oscillation technique for assessing airway obstruction in this age group. Pediatr Pulmonol. 1995; 20:387–395. © 1995 Wiley‐Liss, Inc.
Effects of dietary saw palmetto on the prostate of transgenic adenocarcinoma of the mouse prostate model (TRAMP)
Authors: Wadsworth Teri L. , Worstell Teresa R. , Greenberg Norman M. , Roselli Charles E.
Published: March 2007

BACKGROUND

Several of the proposed mechanisms for the actions of the liposterolic extract of saw palmetto (SPE) are exerted on known risk factors for prostate cancer (CaP). This study investigated whether SPE could prevent the progression of CaP in a transgenic adenocarcinoma of the mouse prostate (TRAMP) model.

METHODS

Two different doses of SPE designed to deliver 50 mg/kg/day SPE and 300 mg/kg/day SPE were administered in a custom diet to TRAMP mice for 12 or 24 weeks. Body and organ weights were used to evaluate toxicity, and radioimmunoassay was used to measure plasma and tissue androgen levels to monitor effects of SPE on 5α reductase activity. Prostate tissues were evaluated histologically to determine the effect of treatment on tumor grade, cell proliferation, and apoptosis.

RESULTS

Treatment with 300 mg/kg/day SPE from 4 to 24 weeks of age significantly reduced the concentration of 5α‐dihydrotestosterone (DHT) in the prostate and resulted in a significant increase in apoptosis and significant decrease in pathological tumor grade and frank tumor incidence.

CONCLUSIONS

Dietary supplementation with SPE may be effective in controlling CaP tumorigenesis. SPE suppression of prostatic DHT levels lends support to the hypothesis that inhibition of the enzyme 5α‐reductase is a mechanism of action of this substance. Prostate 67: 661–673, 2007. © 2007 Wiley‐Liss, Inc.
HSP27 and HSP70 interact with CD10 in C4‐2 prostate cancer cells
Authors: Dall'Era Marc A. , Oudes Asa , Martin Daniel B. , Liu Alvin Y.
Published: March 2007

BACKGROUND

CD10 is a ∼100 kDa transmembrane metallo‐endopeptidase. CD10 is strongly expressed by normal prostate epithelium. While only 30% of primary prostate tumors express CD10, it is strongly expressed by most lymph node metastases. The function of CD10 and the interaction between CD10 and other cellular proteins in prostate cancer (CaP) is not well defined. Cellular context may ultimately determine its biologic function in CaP. In this study, we compared CD10 mRNA and protein expression between benign and malignant prostate cells and employed proteomic analysis to identify proteins that interact with CD10 in C4‐2 prostate cancer cells.

METHODS

CD10 mRNA and protein expression was compared using RT‐PCR and Western blotting. CD10‐protein complexes were isolated by immunoprecipitation using anti‐CD10 monoclonal antibodies. Eluted fractions were combined, trypsinized, and the resulting peptides analyzed by µLC‐ESI‐MS/MS. The parent proteins were identified by searching MS/MS spectra against a human protein database using SEQUEST.

RESULTS

There were no differences in CD10 mRNA length or CD10 protein molecular weight between normal tissue and CaP. We identified 75 proteins unique to or heavily enriched in the CD10 immunoprecipitates by proteomic analysis. The 27 kDa heat shock protein (HSP27) and HSP70 were identified in three separate precipitations. Protein identification by proteomics was confirmed by Western blotting. Protein complexes immunopurified from C4‐2 protein extracts using anti‐HSP27 and anti‐HSP70 antibodies were found to contain CD10.

CONCLUSIONS

The function of CD10 in prostate cancer is largely unknown. In the C4‐2 CaP cell line, CD10 was found to interact with both HSP27 and HSP70. Prostate 67: 714–721, 2007. © 2007 Wiley‐Liss, Inc.
Reactive oxygen species mediate androgen receptor‐ and serum starvation‐elicited downstream signaling of ADAM9 expression in human prostate cancer cells
Authors: Shigemura Katsumi , Sung Shian‐Ying , Kubo Hiroyuki , Arnold Rebecca S. , Fujisawa Masato , Gotoh Akinobu , Zhau Haiyen E. , Chung Leland W.K.
Published: March 2007

BACKGROUND

The A Disintegrin And Metalloprotease (ADAM) family is a group of transmembrane proteins containing cell adhesive and proteolytic functional domains. ADAM9 expression was shown to be mediated by androgen receptor (AR) and stress conditions. This study determined a common mediator responsible for ADAM9 protein regulation which supports human prostate cancer (PCa) cell growth and survival.

METHODS

ADAM9 protein expression was measured under androgen, anti‐androgen, hydrogen peroxide, and/or serum starvation conditions in PCa cells. The roles of reactive oxygen species (ROS) were assessed in the presence or absence of recombinant catalase, or in cells stably transfected with either catalase‐ or a control neo‐cDNA expression vector. ROS was assayed by dihydroethidium (DHE) followed by FACS analysis.

RESULTS

ADAM9 protein expression was upregulated by androgen in AR‐positive but not in AR‐negative PCa cells. The anti‐androgen bicalutamide effectively blocked this induction. While serum starvation enhanced ADAM9 expression in AR‐positive PCa cells, this stress condition did not alter ADAM9 expression in AR‐negative PCa cells. Parallel results also showed that androgen treatment or serum starvation enhanced ROS only in AR‐positive but not in AR‐negative PCa cells. ROS appears to be a common downstream mediator of androgen‐ or serum starvation‐induced ADAM9 expression since addition of hydrogen peroxide or introduction of catalase, either enhanced or abolished respectively ADAM9 protein expression by both AR‐positive and ‐negative PCa cells.

CONCLUSIONS

These findings suggest that ROS is: a common mediator responsible for ADAM9 protein induction in human PCa cells, downstream from AR, and stress response signaling. Prostate 67: 722–731, 2007. © 2007 Wiley‐Liss, Inc.
On the mechanism of action and selectivity of the corn herbicide topramezone: a new inhibitor of 4‐hydroxyphenylpyruvate dioxygenase
Authors: Grossmann Klaus , Ehrhardt Thomas
Published: March 2007

Topramezone is a new, highly selective herbicide of pyrazole structure for the post‐emergence control of broadleaf and grass weeds in corn. The biokinetic properties and mode of action of topramezone were investigated in plants of Setaria faberi Herrm, Sorghum bicolor (L.) Moench, Solanum nigrum L. and the crop species corn (Zea mays L.). Within 2–5 days after treatment, topramezone caused strong photobleaching effects on the shoot, followed by plant death of sensitive weeds. The selectivity of topramezone between corn and the weed species has been quantified as above 1000‐fold. By virtue of the plant symptoms and the reversal of the effects in Lemna paucicostata L. by adding homogentisate, it was hypothesized that topramezone blocks the formation of homogentisate, possibly through inhibition of 4‐hydroxyphenylpyruvate dioxygenase (4‐HPPD). Indeed, topramezone strongly inhibited 4‐HPPD activity in vitro, with I50 values of 15 and 23 nM for the enzyme isolated from S. faberi and recombinant enzyme of Arabidopsis thaliana L. respectively. The enzyme activity from corn was approximately 10 times less sensitive. After root and foliar application of [14C]topramezone, equivalent to field rates of 75 g ha−1, the herbicide was rapidly absorbed and systemically translocated in the plant. Only marginal differences between leaf uptake and translocation of topramezone by the weeds and corn were found. Metabolism of foliar‐applied [14C]topramezone was far more rapid in corn than in the weeds. A more rapid metabolism combined with a lower sensitivity of the 4‐HPPD target enzyme contributes to the tolerance of corn to topramezone. Copyright © 2007 Society of Chemical Industry