bluuebunny/crossref_metadata_2025 huggingface dataset:
Expression of RET in follicular cell‐derived tumors of the thyroid gland: Prevalence and implication of morphological type
Authors: Inaba Michiko , Umemura Shinobu , Satoh Haruhiro , Abe Yoshifumi , Kurokawa Kiyoshi , Sakai Hideto , Osamura R. Yoshiyuki
Published: March 2003

Expression of the wild‐type RET proto‐oncogene has been observed in non‐medullary, follicular cell‐derived tumors (FCDT), but the relation with the histopathological features has not been fully demonstrated. To assess the expression of RET and protein products in relation to morphological types of FCDT, including follicular adenoma (FA), papillary carcinoma (PTC), follicular carcinoma (FTC) and anaplastic carcinoma (AnC), 58 non‐neoplastic and neoplastic samples using pathological paraffin sections by immunohistochemistry (IHC), reverse transcriptase–polymerase chain reaction (RT‐PCR) and laser capture microdissection (LCM) methods were analyzed. Expression of RET proto‐oncogene was detected in 27.3% of FCDT by IHC and 25.5% by RT‐PCR using a primer set at a regular break point. The present study also found higher expression ratios of RET in FA (50.0%) and the follicular variant of PTC (50.0%), in contrast to FTC (20.0%), ordinary PTC (20.0%) and poorly differentiated or AnC (14.3%) by RT‐PCR. One patient with PTC showed a discrepancy in the results by RT‐PCR using a different primer set at the C‐terminus of RET. The study found that the RET proto‐oncogene is often stimulated in FCDT, not only in PTC but also in follicular tumors (FA and FTC), and may contribute to tumorigenesis of these tumors.
Cellulose synthesizing terminal complexes and morphogenesis in tip‐growing cells of Syringoderma phinneyi (Phaeophyceae)
Authors: Schüβler Arthur , Hirn Susanne , Katsaros Christos
Published: March 2003

The intramembrane particles and cellulose synthesis of the brown alga Syringoderma phinneyi Henry et Müller were examined using replicas of freeze‐fractured apical cells. Like in other brown algae, linear terminal complexes (TCs) were found in the plasmatic fracture face (PF) of the plasmalemma, which are the putative cellulose synthases. Terminal complexes consist of a single row of particles, each particle composed of two sub‐units, and are found in close relationship with cellulose microfibril imprints. Examination of the distribution of TCs revealed a clear apico‐basal gradient, with a higher density of TCs in the apical part. This seems to reflect the tip growth of the apical cells. The rate of cellulose synthesis per TC subunit was calculated based on the dimensions of the TCs and cellulose microfibrils.
Detection of nocturnal wheezing in bronchial asthma using intermittent sleep tracheal sounds recording
Authors: Kiyokawa Hiroshi , Yonemaru Makoto , Horie Shinobu , Kasuga Ikuma , Ichinose Yuichi , Toyama Keisuke
Published: March 2003

Common clinical features of bronchial asthma include bronchoconstriction during the night, particularly while asleep. Although bronchoconstriction reduces the quality of life and can cause life‐threatening events, a clinical technique for evaluating bronchoconstriction during sleep has not been widely applied. In this study, we measured nocturnal wheezing by intermittent sleep tracheal sounds recording (ISTSR) to detect bronchoconstriction during the hours of sleep. Using ISTSR, we studied the number and duration of nocturnal wheezing episodes in 27 adult patients with bronchial asthma. Nocturnal wheezing was detected in 36 of 39 recordings. Although the pattern of hourly nocturnal wheezing count (hourly NWC pattern) varied among subjects, there appeared to be a reproducible pattern within individuals. When wheezing alternated between long and short duration, bronchoconstriction tended to be more severe. The NWC in 1 h (NWC/H) was positively correlated with subjective symptoms and inversely correlated with the morning per cent peak expiratory flow. The hourly NWC was significantly greater at 05:00 than that at midnight. Intermittent sleep tracheal sounds recording has potential to be a non‐invasive clinical tool for detecting nocturnal bronchoconstriction during hours of sleep in patients with asthma.
Heat shock proteins' mRNA expression in asthma
Authors: Tong Wancheng , Luo Weici
Published: March 2003

Objective:

The aim of the present study was to investigate the expression levels of heat shock proteins (HSP) mRNA in the peripheral blood mononuclear cells (PBMC) of patients with asthma and chronic bronchitis to elucidate the role of HSP in the pathogenesis of asthma and chronic bronchitis.

Method:

Using reverse transcription–DNA polymerase chain reaction, the expression levels of HSP70, HSP90α and HSP90β genes in PBMC in normal state and after heat shock were investigated.

Results:

No HSP70 gene but HSP90α and HSP90β expressions were found in non‐heat‐shocked PBMC of normal controls; HSP90α and HSP90β genes may be expressed in PBMC of all patients, independently of acute episodes. Expression of HSP70 was found in PBMC of asthmatic patients in acute episodes and three symptom‐free patients with Aas 3, step 2. Among patients with chronic bronchitis, no HSP70 gene expression was found in PBMC of patients in convalescent period but in PBMC of patients in acute episode. HSP90α and HSP90β genes were expressed in PBMC of both patient groups. After heat shock, expressions of the three genes increased significantly in PBMC of both normal controls and patients.

Conclusion:

Expression of HSP70 gene in PBMC of asthmatic and chronic bronchitis patients was different, indicating that HSP, especially HSP70, might be involved in the pathogenesis of asthma.
Pulmonary cryptococcosis: A case report and review of the Asian‐Pacific experience
Authors: LAM CHI‐LEUNG , LAM WAH‐KIT , WONG YICK , OOI GAIK C. , WONG MARIA P. , HO JAMES C. , LAM BING , TSANG KENNETH W.
Published: March 2003

Pulmonary cryptococcosis is a very rare form of pneumonia, which is seldom seen among immunocompetent patients. We report the case of a 36‐year‐old man who presented with indolent pneumonia that was subsequently diagnosed to be pulmonary cryptococcosis without other systemic involvement. Contrary to formal belief, there was evidence of residual lung fibrosis 12 months after initial presentation. The features of pulmonary cryptococcosis reported in the Asian Pacific region are also reviewed.
Characteristics of patients with lung cancer under the age of 45 years: A case control study
Authors: CORNERE MEGAN M. , FERGUSSON WENDY , KOLBE JOHN , CHRISTMAS TIMOTHY I.
Published: March 2003

Objective: The aim of this study was to define the clinical and pathological features associated with lung cancer diagnosed in persons under the age of 45 compared with lung cancer in an older population of greater than 45 years.

Methodology: A case control study was undertaken. Cases were defined as patients diagnosed with lung cancer under the age of 45 years. Controls were lung cancer patients over 45 years matched only for the date of diagnosis. Up to four controls were selected for each case. A retrospective review was undertaken of the records of a single tertiary respiratory institution which served a population of 1.2 million.

Results: Forty‐eight cases of lung cancer (< 45 years of age) were identified and were
compared to 123 matched controls with lung cancer (> 45 years of age). Of the
cases 67% were female compared with 32% female cases in the control
group (P < 0.01). The rate of adenocarcinoma was significantly higher among
cases (48%vs 27%, P = 0.001), while squamous cell
carcinoma was more common in the controls (35%vs 17%P
= 0.001). Smoking was common in both groups although less so among cases (79%vs 95%, P = 0.001)). There was no difference in survival rates
between the cases (11 months) compared with controls (8 months) (P = 0.1).

Conclusions: Young lung cancer patients were predominantly female and adenocarcinoma accounted for a disproportionate number of the histological types. Cigarette smoking appears to be the main aetiological agent but as 21% of the patients under 45 years were non‐smokers, other factors (genetic/hormonal) may also contribute. This study has not demonstrated a worse outcome in younger patients.
Skin prick test reactivity to common aeroallergens in asthmatic patients with and without rhinitis
Authors: LIAM CHONG‐KIN , LOO KOK‐LIM , WONG CATHERINE MEE‐MING , LIM KIM‐HATT , LEE TONG‐CHOW
Published: March 2003

Objective: The aim of this study was to investigate the prevalence of skin prick test (SPT) reactivity to common aeroallergens among Malaysian asthmatic patients with and without rhinitis.

Methodology: An SPT using eight aeroallergens (Dermatophagoides pteronyssinus, Dermatophagoides farinae, cat fur, cockroach, Acacia sp., Bermuda grass, Aspergillus fumigatus and Aspergillus niger) was performed on 206 asthmatic patients.

Results: One hundred and forty patients (68%) were reactive to at least one of the aeroallergens. Among the SPT‐positive patients, a positive prick test reaction to the house dust mites, D. pteronyssinus (93.6%), and D. farinae (81.4%) was most common, followed by cat fur (20.0%), cockroach (7.9%), Bermuda grass (7.9%), Acacia sp. (7.9%), A. fumigatus (0.7%) and A. niger (0.7%). A history of rhinitis was elicited in 111 (53.9%) patients and 95 (85.3%) of these patients were SPT‐positive compared with only 45 (47.4%) of 95 patients with asthma symptoms alone (P < 0.001). The presence of rhinitis and a young age of onset of asthma were independent factors for positive SPT reaction to at least one of the aeroallergens.

Conclusions: The prevalence of SPT reactivity to common aeroallergens is high among Malaysian asthmatics, particularly in those with an early age of onset and in those with coexisting rhinitis.
Interannual and interpopulation variation in Helichrysum stoechas (Asteraceae), a species of disturbed habitats in the Mediterranean region
Authors: Martin Arnaud , Puech Suzette
Published: March 2003

This study examines the interpopulation, interannual and individual variation in Helichrysum stoechas L., a perennial species that colonizes disturbed habitats in the Mediterranean region. The phenotypic variation in five populations was studied. Characters such as plant height and volume, numbers of capitula and flowers, weight of achenes and germination parameters were recorded in situ and in the laboratory for the same individuals for two consecutive years. The data were analyzed to examine the differences between populations and years compared to within‐population variation. Results show that the germination rate, the average weight of achenes and the average number of capitula per stem varied considerably from one year to another, independently of population. This year‐to‐year variation suggests that these traits exhibit phenotypic plasticity. The substantial variation in precipitation during the 2 year study may account for the observed temporal variation. There was some weak correlations between the different characters studied within each population. Significant positive correlations were observed between mean achene weight and the total number of achenes produced per plant and with plant size.
Late hemorrhagic disease of the newborn
Authors: Bör Özcan , Akgün Nejat , Yakut Ayten , Sarhuş Fatih , Köse Suna
Published: March 2003

Abstract Background: Late hemorrhagic disease of the newborn (HDN) may occur without an underlying disorder or as a secondary manifestation of an underlying disorder. It may be seen in fully breast‐fed infants without a routine supplementation of vitamin K. In contrast, idiopathic late HDN is defined as HDN without the presence of any risk factor, such as gastroenteritis or use of antibiotics. Severe hemorrhagic symptoms frequently occur.

Methods
: Between March 1987 and May 1997, we evaluated 15 infants with idiopathic late HDN, who were diagnosed by detailed history, physical examination and laboratory findings.

Results
: The age (mean~SD) at onset of symptoms was 62.4~33.9 days. All children were breast‐fed infants and were born at term from healthy mothers. The delivery histories were uneventful. There was no history of vitamin K administration at birth. Signs and symptoms of the patients were convulsions (47%), feeding intolerance and poor sucking (47%), irritability (33%) and pallor (20%). In physical examination; there was bulging or full fontanel in 10 patients (67%), diminished or absent neonatal reflexes in nine patients (60%) and ecchymosis in three patients (20%). Before administration of vitamin K, prothrombin time (PT) was 76.1~43.0 s and partial thromboplastin time (PTT) was 123.4~68.8 s. Six to 12 h after administration of vitamin K, PT was 15.6~1.8 s and PTT was 33.4~1.0 s. Neurologic, gastrointestinal and skin hemorrhagic findings were found in 11 (73%), three (20%) and three patients (20%), respectively. There were both neurologic and skin bleeding symptoms in two patients. The mortality in the present study was 33%.

Conclusions
: Late HDN results in severe hemorrhage, especially hemorrhage in the central nervous system. Administration of vitamin K (1 mg, i.m.) at the birth can reduce these severe complications.
Epidemiology of influenza‐associated encephalitis‐encephalopathy in Hokkaido, the northernmost island of Japan
Authors: Togashi Takehiro , Matsuzono Yoshihiro , Narita Mitsuo
Published: March 2003

Abstract

Background
: It is well known that acute onset brain dysfunction, which usually is diagnosed as encephalitis or encephalopathy, occurs in association with influenza. However, this may have been underestimated as a rather infrequent event. Sixty‐four infants and children developed encephalitis‐encephalopathy during the five recent influenza seasons in Hokkaido, the northernmost island of Japan.

Methods
: Inquiries were sent at the end of each season, from October 1994 to March 1999, to 94 hospitals and institutes in Hokkaido which accept pediatric age patients, asking if there were any admitted cases of encephalitis or encephalopathy.

Results
: The patients were 42 boys and 22 girls and 47 (73.4%) were 4 years of age or younger. None of them had received an influenza vaccine nor had an oral administration of aspirin. Most of the patients became comatose with or without convulsions within a few days of the onset of fever. Twenty‐eight (43.8%) patients died and 13 (20.3%) had neurological sequelae. Patients with clotting disorders, elevations of serum creatine kinase and/or aspartate aminotransferase and alanine aminotransferase, and brain CT abnormalities had a poor prognosis compared with patients without. Among these affected patients, the influenza genome (H3) was detected by polymerase chain reaction in nine cerebrospinal fluid samples, influenza virus A (H3N2) was isolated in 18 nasopharyngeal swab samples and a four‐fold or greater rise in serum hemagglutinin inhibition antibody titer against H3N2 was observed in seven patients.

Conclusions
: It appears urgent to promote vaccination against influenza in young children to prevent these devastating disease conditions.
Altered anti‐oxidant status and increased lipid peroxidation in marasmic children
Authors: Tatli M Mansur , Vural Huseyin , Koc Ahmet , Kosecik Mustafa
Published: March 2003

Abstract Background: Protein energy malnutrition (PEM) is a common pediatric health problem in developing countries. Although the clinical features of PEM are well known, its pathophysiology is still unclear. Free radicals have been implicated in pathogenesis of PEM. In the present study, oxidant/anti‐oxidant status in marasmus was investigated.

Methods
: Red cell glutathione, glutathione peroxidase and superoxide dismutase and their related cofactors, serum selenium and copper, were studied in marasmic and control children. Serum lipid peroxidation was also evaluated to assess oxidative stress.

Results
: The red cell glutathione levels and glutathione peroxidase activities were found to be significantly lower in the marasmic children than in the controls. Red cell superoxide dismutase (SOD) activity was not different between two groups. Serum selenium and copper concentrations were significantly lower in the marasmic children than in the control subjects. The malondialdehyde concentration, which is an index of lipid peroxidation, was significantly higher in the marasmic group compared with the controls.

Conclusion
: The anti‐oxidant defense system was affected in marasmic children. Reduced anti‐oxidant status and increased oxidative stress occurs in marasmic children.
Systemic effects of transdermal testosterone for the treatment of microphallus in children
Authors: Arisaka Osamu , Hoshi Megumi , Kanazawa Sanae , Nakajima Daisuke , Numata Michio , Nishikura Kiyoshi , Oyama Mariko , Nitta Akihisa , Kuribayashi Takeo , Kano Kenichi , Nakayama Yuko , Yamashiro Yuichiro
Published: March 2003

Abstract

Objectives
: To elucidate the metabolic effects of topical testosterone for the treatment of microphallus in children.

Methods
: We administered 5% testosterone ointment to 50 prepubertal boys for the treatment of microphallus, allowing us to observe its metabolic effect on plasma concentrations of testosterone as a marker of transdermally absorbed testosterone, insulin‐like growth factor (IGF)‐I as a marker of growth hormone secretion status, and osteocalcin as a marker of bone metabolic turnover.

Results
: Transdermal application of testosterone for 30 days at a dose that affects penile growth increased mean (±SD) plasma testosterone concentrations from 7.5±5.1 to 31.0±8.2 ng/dL (pre‐ vs post‐treatment, respectively; P<0.01). This was associated with a slight but statistically significant elevation of IGF‐I concentrations (117.2±76.9 vs 154.4±81.5 ng/mL; P<0.05). No significant change in osteocalcin levels was found.

Conclusions
: When using testosterone ointment as a treatment for microphallus, it should be borne in mind that this application has systemic effects.
Effect of dexamethasone therapy on pulmonary function in chronic lung disease: A comparison of disease types
Authors: Mizobuchi Masami , Manabe Chiyo , Yonetani Masahiko , Nakao Hideto , Uetani Yoshiyuki
Published: March 2003

Abstract
 

Background
: In the present study, we investigated the effect of dexamethasone (DEX) therapy on extubation and pulmonary function in patients with chronic lung disease (CLD) who required long‐term mechanical ventilation. In addition, we compared the effects of DEX therapy among CLD types.

Methods
: Twenty‐two CLD patients who were ventilator dependent for 28 days or longer received DEX therapy for the purposes of extubation. A tapering dose of DEX, starting from 0.5 mg/kg per day, was administered for 7 days. Pulmonary function was measured at initiation of administration and 4 days after initiation. We evaluated static respiratory system compliance (Crs) and static respiratory system resistance (Rrs) adjusted by bodyweight. Chronic lung disease types were categorized according to the classification of the Ministry of Health and Welfare Research Project. We compared the effect of DEX therapy among CLD types.

Results
: Dexamethasone therapy was started at a mean (±SD) 45±11 days after birth and 32.1±1.3 weeks of postconceptional age in infants with a mean bodyweight of 939±153 g. After DEX therapy, extubation was successful in all 22 patients. Following DEX administration, Crs was significantly increased from 0.69±0.13 to 1.17±0.21 mL/cm H2O per kg. In contrast, Rrs did not show any clear changes. Comparing CLD types, no difference was observed for Crs and Rrs in each disease type.

Conclusions
: Dexamethasone was administered to CLD patients requiring long‐term mechanical ventilation for the purposes of extubation and extubation was successful in all patients. It was found that Crs was increased in all patients following DEX, regardless of CLD type. The increase in Crs following DEX administration may have been related to successful extubation.
Quantitation of human herpesvirus 6 DNA in infant with exanthem subitum by microplate PCR‐hybridization assay
Authors: Abe Tomoko , Yoshikawa Tetsushi , Ihira Masaru , Suzuki Kyoko , Suga Sadao , Nishida Mikio , Nagata Minoru , Asano Yoshizo
Published: March 2003

Abstract

Background
: Quantitative analysis of human herpesvirus 6 (HHV‐6) genome is important for monitoring active virus infection. The purpose of our study is to evaluate the reliability of a hybridization‐based microtiter plate assay (polymerase chain reaction enzyme‐linked immunosorbent assay (PCR ELISA)) for quantifying the virus genome.

Methods
: Semiquantitative analysis of the virus genome was carried out in 31 (18 male and 13 female) infants with primary HHV‐6 infection. If the HHV‐6 virus could be isolated from the peripheral blood mononuclear cells (PBMC), the infants were defined as being infected with HHV‐6. The PCR ELISA method was used to determine the virus load. A titration of the virus was also carried out in the samples obtained during the acute phase of exanthem subitum.

Results
: Specificity of the method was demonstrated by a lack of amplification of human herpesvirus 7 and cytomegalovirus DNA. The upper and lower detection limits of the method were 58 and 5800 copies of the virus genome, respectively. The quantity of HHV‐6 DNA in the PBMC during the acute phase (879 ±975 copies/104 PBMC) was significantly higher than during the convalescent phase (54 ±76 copies/104 PBMC). Furthermore, the virus load in acute phase plasma (53 ±75 copies/μL) was also significantly higher than in the convalescent phase samples (2 ±9 copies/μL). Virus load in both PBMC and plasma gradually increased after the onset of exanthem subitum until about day 3 to 4 of the illness, but then decreased quickly. However, there was no significant association between virus load and the numbers of infected cells.

Conclusion
: Virus load in both PBMC and plasma gradually increased after the onset of exanthem subitum until about day 3 and day 4 of the illness, respectively, then it decreased quickly. These results indicate that our PCR ELISA system is reliable for monitoring active HHV‐6 infection in vivo.
Intravenous low‐dose erythromycin administration for infants with feeding intolerance
Authors: Nogami Keiji , Nishikubo Toshiya , Minowa Hideki , Uchida Yumiko , Kamitsuji Hidekazu , Takahashi Yukihiro
Published: March 2003

Abstract

Background
: This study was undertaken to determine the efficacy of low‐dose intravenous erythromycin (EM) administration in infants with feeding intolerance.

Methods
: The subjects were 26 infants who would not accept enteral feeding within 5 days after birth. Fourteen infants (gestational age: 30.6±5.4 weeks and birthweight: 1466±825 g) were given EM intravenously at a dose of 1 mg/kg, three times daily (EM group). Doses were increased to 2 mg/kg in five infants who showed a poor response. Twelve infants (gestational age: 30.5±5.0 weeks and birthweight: 1317±672 g) were observed without EM administration (non‐EM group). Blood concentrations of EM at 2 h after administration were measured on 8 (±2) days after the start of EM administration in the EM group.

Results
: Digestive perturbations and intestinal gasless and/or atonic shadows on X‐ray findings markedly improved in the EM group soon after the treatment. Comparing the EM group and non‐EM group, the postnatal ages at the start of successful enteral feeding were 9.1±3.2 days and 14.0±4.1 days, respectively (P<0.01). The postnatal ages at feeding of 100 mL/kg per day were 15.2±4.0 days and 23.4±6.2 days, respectively (P<0.01). The blood EM concentrations of 1 mg/kg and 2 mg/kg were 0.29±0.28 μg/mL and 0.57±0.20 μg/mL, respectively (P<0.05). No adverse effect on cardiac status or in blood examinations was observed in any infant in the EM group.

Conclusion
: These results suggest that intravenous low‐dose EM administration is a useful and safe treatment of feeding intolerance in infants including extremely low‐birthweight infants.
Relationships between the children and the parents for coronary risk factors
Authors: Uçar Birsen , Kiliç Zübeyir , Sönmez Hulki Meltem , Ata Necmi , Özdamar Kazim
Published: March 2003

Abstract

Background
: We aimed to investigate the relation of coronary risk factors in children to coronary heart disease (CHD) or coronary risk factors in their parents.

Methods
: A sample of 252 parents of 164 children with two or more coronary risk factors were included in this study. The control group consisted of 175 parents of 114 children with no risk factors. Both groups were evaluated for coronary risk factors and CHD. The children in the groups were separated into sex and age groups consisting of 7 to 11‐years‐olds, 12 to 15‐years‐old and 16 to 18‐years‐old.

Results
: Many lipid parameters related with coronary risk factors in the mothers of 7 to 11‐year‐old girls, in the fathers of 7 to 11‐year‐old girls and 16 to 18‐year‐old boys were at higher levels than in the control group. Anthropometric parameters, especially those of reflecting body fatness such as skinfold thickness measurements and total bodyfat percentage values were at higher levels in the fathers of 12–15‐ and 16 to 18‐year‐old girls. The higher levels of most of the anthropometric and biochemical parameters in the fathers of 16 to 18‐year‐old boys were striking. Hyperlipidemia prevalences in the fathers of 7 to 11‐year‐old girls and boys were higher than the control parents. In the study group, the girls positively correlated with both their parents for total cholesterol levels and positively correlated with only their mothers for height, bodyfat percentage, triglycerides and low‐density lipoprotein‐ cholesterol (LDL‐C) levels. However, the boys positively correlated with their mothers for weight and with their fathers for bodyfat percentage, diastolic blood pressure (BP) values and serum LDL‐C levels. The proportion of individuals who had ischemic findings on treadmill exercise testing was significantly greater than control group in only the fathers of 12 to 15‐year‐old boys (P<0.05).

Conclusions
: The parents, especially the fathers of children with coronary risk factors have higher levels of coronary risk factors than those in the control group. There is a familial aggregation of body fatness and adverse lipid levels in the families of the children with coronary risk factors. The parents of children recognized as having coronary risk factors should be evaluated for these risk factors too.
Molecular epidemiology of methicillin‐resistant Staphylococcus aureus in a pediatric ward
Authors: Murono Koichi , Hirano Yoshiki , Zhang Jiwei , Saijo Masayuki , Fujita Kozo
Published: March 2003

Background
: Nosocomial infections caused
by methicillin‐resistant Staphylococcus aureus (MRSA) are one of the most serious problems in pediatric wards. Epidemiological analysis of strains isolated in the ward is essential for infection control. There have been few reports in which a molecular epidemiological study of MRSA was performed in pediatric wards.

Methods
: Fifty‐six MRSA strains isolated in the pediatric ward of Asahikawa Medical College Hospital between 1995 and 1997 were studied. Fifty‐two and four isolates were obtained from 27 patients and from two medical staff members, respectively. Forty‐one isolates were regarded as colonizing strains and 15 were causes of infections. Genotypes of the isolates were investigated by pulsed‐field gel electrophoresis (PFGE).

Results
: The PFGE patterns of 56 isolates were classified into nine types: type A, its subtypes, A1 and A2, and types B through to G. Seventeen isolates were type A, 32 were type A1, and one of each type of A2 and B through to G were identified. Fifty of 56 isolates, which were isolated from 24 of 29 cases, belonged to type A or its subtypes.

Conclusions
: The predominant strain of MRSA isolates in the pediatric ward was a certain strain that may be originated from the one clone. Cross‐infection control therefore is the major procedure in the prevention of MRSA dissemination in the ward.
Management of childhood diseases in the Byzantine period: II − Exanthematic diseases
Authors: Ramoutsaki Ioanna A. , Dimitriou Helen , Kalmanti Maria
Published: March 2003

The aim of this review was to explore the procedures used for the treatment of childhood exanthematic diseases during the Byzantineperiod. The most often reported ones were psoriasis, undefined rashes in parts of the body, ulcerous rashes, blisters, lichens and soakedulcers. The physicians of the period managed the above problems with appropriate diet and remedies of herbal, veterinary and chemicalorigin in the form of baths, poultices and concoctions. They largely based their principles on the ancient Greek medical tradition. Theiraccurate remarks were reflected in their terminology. Many of the terms of this period are still in use, although current treatmentmodalities are quite different from the Byzantine remedies.
Identifying service needs of children with disruptive behavior problems using a Nominal Group Technique
Authors: Keatinge Diana R. , Tarren‐Sweeney Michael , Vimpani Graham , Hazell Philip , Callan Ken
Published: March 2003

Abstract A recent study used both qualitative and quantitative methods to examine families' perceptions of service needs for children with disruptive behavior problems. Focusing on the qualitative component of the study, the present paper discusses the modified Nominal Group Technique used in focus groups attended by carers living in rural, regional or metropolitan contexts. Three questions posed to each focus group sought to identify families' concerns about health facilities and/or related support services currently available to them, the benefits they perceived in these services and the changes needed to make these services more appropriate or accessible to them. Major themes in the responses relating to each of these questions included concerns about a lack of, or perceived need for, access to help/support, benefits in schools that accommodated the needs of the children, and support from the community. Families' recommendations for change included increased access to health care advice, information and/or support systems.
Correlation between work experiences and physical assessment in Japan
Authors: Yamauchi Toyoaki
Published: March 2003

Abstract The purpose of this study was to obtain baseline data of Japanese nurses’ knowledge, skills and attitudes concerning physical assessment. The design of the study was survey research, using a self‐administered questionnaire. Nurses with more experience were more knowledgeable about almost all physical assessment skills. Fourteen of the physical assessment skills were used more often by respondents with more experience in nursing practise. Ten of the physical assessment skills were cited as more difficult to carry out by respondents with less experience in nursing. The group with more clinical practise experience had more knowledge of physical assessment skills, used the skills more frequently and had less difficulty in using them. The results of this study indicated that Japanese nurses learn physical assessment skills ‘on the job’.
Evaluation of functional bladder capacity in Japanese children
Authors: Hamano Satoshi , Yamanishi Tomonori , Igarashi Tatsuo , Murakami Shino , Ito HARUO
Published: March 2003

Background: Functional bladder capacity is a very important factor in the diagnosis of children with voiding disorders. Because Japanese children are thought to have somewhat smaller functional bladder capacity compared with Western children, the convenient formula (so‐called Koff formula) bladder capacity (in ounces) = age (in years) + 2 is not suitable for use in Japanese children.

Methods: We measured the bladder capacities of 131 Japanese children aged 5–15 years without clinical voiding pattern abnormalities to develop a practical guideline for the prediction of normal bladder capacity for age.

Results: An approximate formula relates age and bladder capacity as: bladder capacity (mL) = 25 × (age (years) + 2).

Conclusions: The formula presented is thought to be a useful guide for the diagnosis of small, normal or large bladder capacity and offers information on voiding disorders in Japanese children.
Simultaneous production of granulocyte colony‐stimulating factor and parathyroid hormone‐related protein in bladder cancer
Authors: Ueno Munehisa , Ban Shin‐Ichi , Ohigashi Takashi , Nakanoma Takashi , Nonaka Shoichi , Hirata Risa , Iida Masahiro , Deguchi Nobuhiro
Published: March 2003

A case of bladder cancer with simultaneous production of granulocyte colony‐stimulating factor (G‐CSF) and parathyroid hormone‐related protein (PTHrP) is reported. An 81‐year‐old male patient was admitted to the Saitama Medical School for treatment of gross hematuria, leukocytosis and hypercalcemia and diagnosed as having advanced bladder cancer. Immediately after a cystectomy was carried out, his white cell count and serum calcium levels returned to normal. However, the tumors recurred locally and the recurrence was accompanied by an increase in the serum G‐CSF and PTHrP levels with a recurrent elevation of white cell count and the serum calcium level. The production of G‐CSF and PTHrP in the tumor cells was confirmed by immunohistochemistry.
Trans‐mesosigmoid cutaneous ureterostomy
Authors: SATO SHINJI , SOEJIMA KYOKO , KANEKO ARATA , TSUKAHARA TSUNEHIRO , TOKUDA YUJI , KANO TAKEHIRO , TAKAGI NORITO , NAKAMURA KOUJI , KURATOMI KAZUNARI , ICHIGI YASUHISA , MASAKI ZENJIRO
Published: March 2003

Background
: A new method was developed in order to create a single stoma cutaneous ureterostomy in which both ureters traverse the abdominal cavity and yet are buttressed by the mesosigmoid and covered by its visceral peritoneum.

Methods
: The long mesenterium which is attached to the most mobile part of the sigmoid colon was used for the bilateral ureteral pathway. Tunnels for the ureteral path were made just underneath the visceral peritoneum on the bilateral side of the mesosigmoid. Through the tunnels both ureteral ends were brought from the retroperitoneal space to the mesenterocolonic junction (MCJ) and the MCJ is then approximated and sutured to the inside of the ureteral tract through the abdominal wall. The ureters brought outside the skin, are conjoined and sutured to the V skin flap. Eight patients who carried a high risk for operation and/or had a bladder tumor judged to be incurable underwent this cutaneous ureterostomy.

Results
: All cases except one with low urinary output could be managed without catheter indwelling during the follow‐up period. Three patients suffered from paralytic ileus and one required laparotomy for mechanical ileus during the short postoperative period. Postoperative excretory urography evaluated 14 kidneys during the follow‐up period from 2 to 61 months and showed normal upper urinary tract in 11 and a mildly hydronephrotic tract in three.

Conclusions
: Transmesosigmoid cutaneous ureterostomy provides a single catheterless stoma even when the available ureters are relatively short. It appears to be a good method for supravesical urinary diversion when indicated.
Primary and salvage urethroplasty using Mathieu meatal‐based flip‐flap technique for distal hypospadias
Authors: Hayashi Yutaro , Sasaki Shoichi , Kojima Yoshiyuki , Maruyama Tetsuji , Tozawa Keiichi , Mizuno Kentaro , Kohri Kenjiro
Published: March 2003

Abstract Background: Numerous surgical procedures have been attempted for correction of distal hypospadias. The Mathieu procedure was employed in this study for secondary cases as well as primary cases.

Methods: The length of the skin flap is determined by measuring the distance from the meatus to the glans tip and then the ventral meatal‐based skin flap is incised. The proximal skin flap is flipped and anastomosed to the distal urethral plate. Additionally, subcutaneous tissue of the flipped flap is sutured to cover the original suture lines completely.

Results: The Mathieu urethroplasty was successful in one stage in 13 of the 16 primary repair cases (81%). Twelve of the 13 (92%) who underwent a secondary Mathieu procedure were successfully repaired with no problems. An overall success rate of 86% was achieved at the first operation for both primary and secondary cases. In the remaining 14% of the cases, success was achieved with only one additional procedure.

Conclusions: The Mathieu flip‐flap procedure is feasible for relatively short urethral defects if the ventral penile skin demonstrates adequate mobility and there is no chordee. Even in patients who require revisional hypospadias surgery, the Mathieu procedure can give excellent functional and cosmetic results.
Deformation of the bladder due to collateral circulation caused by thrombosis of the left femoral vein
Authors: Nishimura Taiji , Yoshida Kazuhiro , Tomita Masaru , Abe Hiroyuki , Miura Takafumi , Uchikoba Takushi
Published: March 2003

Abstract A thrombus in the lower extremities as well as in its collateral circulation in the pelvis are not unusual conditions; however, bladder deformation due to such collateral circulation has not previously been reported. A case is presented of bladder deformation to the right due to collateral circulation caused by a thrombus in the lower left extremity in a 51‐year‐old man.
Retrograde ureteroscopic endopyelotomy using the holmium:YAG laser
Authors: Hibi Hatsuki , Yamada Yoshiaki , Mizumoto Hiroyuki , Okada Masaki , Mitsui Kenji , Taki Tomohiro , Honda Nobuaki , Fukatsu Hidetoshi
Published: March 2003

Abstract
Background
: We report our experience of retrograde ureteroscopic endopyelotomy using the holmium laser for ureteropelvic junction (UPJ) obstruction not associated with upper tract stones.

Methods
: We carried out this procedure on five patients through an 8‐Fr semirigid ureteroscope. The ureter was not stented before the procedure and balloon dilation was not necessary before retrograde insertion of the ureteroscope. The obstruction was incised with the holmium laser using a 200 µm fiber in a linear fashion. After completion of the incision, a 12‐Fr double‐J ureteral stent was left for 6 weeks. Thereafter, patients were monitored with renal scan and/or ultrasound and excretory urography at 3–6 month intervals.

Results
: Hydronephrosis was obviously improved in four cases (80%) at an average follow up of 12.8 months (4–23 months). Although the number of treated patients was small, retrograde ureteroscopic endopyelotomy for UPJ obstruction using the holmium laser achieved good results.

Conclusions
: We recommend that this procedure be used initially because it is less invasive and has a favorable outcome.
High‐dose chemotherapy with peripheral blood stem cell transplantation for advanced testicular cancer
Authors: KOSHIDA KIYOSHI , KATO HIROAKI , MIZOKAMI ATSUSHI , MORISHITA HIROSHI , SETO CHIKASHI , KOMATSU KAZUTO , KOU EITETSU , UCHIBAYASHI TADAO , SHIOBARA SHINTARO , NAMIKI MIKIO
Published: March 2003

Background
: The aim of this study was to investigate the efficacy and safety of high‐dose chemotherapy (HDCT) for the treatment of patients with advanced testicular cancer.

Methods
:

Fourteen patients were treated with high‐dose carboplatin, etoposide and cyclophosphamide (with or without THP‐adriamycin) followed by peripheral blood stem cell transplantation. The treatment was used for two refractory cases, a second relapse, and for consolidation after the first relapse in one case each. It was also used for nine cases as part of the first‐line treatment following primary conventional‐dose chemotherapy, and for one case as the first salvage for a late recurrent tumor of teratoma with malignant transformation.

Results
:

The first two patients who received intensive pretreatment with cisplatin‐based chemotherapy did not respond to HDCT. The two patients who were treated with HDCT as the first or second salvage therapy achieved successful outcomes. The results for the subsequent nine patients (consisting of two with stage IIIC, five with IIIB2, one with IIB, and one extragonadal seminoma) were two progressive disease, three no change and four partial remission. Only three are alive with NED following salvage surgery. Finally, a case of teratoma with malignant transformation did not respond well to two cycles of HDCT. There were no marked adverse reactions except one episode of severe neutropenic colitis.

Conclusions
:

The results demonstrated the limited efficacy of HDCT even in cases with a good to intermediate risk rating according to classification by the International Germ Cell Cancer Collaborative Group. Because treatment for relapse after HDCT is extremely difficult, new HDCT regimens consisting of drugs that are not used in induction chemotherapy need to be established.
New simple method of transabdominal ultrasound to assess the degree of benign prostatic obstruction: Size and horizontal shape of the prostate
Authors: Watanabe Takeshi , Miyagawa Ikuo
Published: March 2003

Background: Transabdominal ultrasound has been the standard clinical tool for evaluating prostatic size; however, the severity of benign prostatic obstruction does not always correspond to the size of the prostate. The purpose of this study was to consider the utility of two parameters, (i) the prostatic volume (Pvol) and (ii) the ratio of the height : width of the maximum horizontal section of prostate (H : W) obtained by transabdominal ultrasound, in screening the degree of benign prostatic obstruction. The results were compared with the linear passive urethral resistance relation (lin‐PURR) obtained by pressure‐flow studies.

Methods: Fifty‐one men with lower urinary tract symptoms were prospectively evaluated in regard to urodynamic parameters, transabdominal ultrasound volume of the prostate, and calculation of lin‐PURR.

Results: A significant positive correlation was found between Pvol and the degree of benign prostatic obstruction. When the ultrasonographic parameters of greater than 30 mL Pvol and 0.8 H : W were adopted as provisional cut‐off points for detecting patients with obstruction, the selected 10 cases had lin‐PURR > 3. In addition, there were six cases classified with lin‐PURR ≥ 3 despite the fact that their Pvol was less than 30 mL. Their H : W values were > 0.8.

Conclusions: Transabdominal ultrasound is useful as a screening test for evaluating the prostate. In addition to the size of the prostate, the parameter of the horizontal shape (H : W ratio) makes an assessment of the degree of benign prostatic obstruction more reliable.
Predictive value of renal histological changes for postoperative renal function improvement in children with congenital ureteropelvic junction stenosis
Authors: Erbagci Ahmet , Yaĝci Faruk , Sarica Kemal , Bakir Kemal
Published: March 2003

Background: The aim of this study was to evaluate the relationship between renal function, as measured by diuretic radionuclide renography, and the outcome of pyeloplasty. A study was designed to evaluate renal parenchymal biopsy specimens derived from children undergoing corrective surgery for ureteropelvic junction (UPJ) stenosis, and compare these to preoperative and postoperative renal function status.

Methods: Thirty‐five children with congenital unilateral UPJ stenosis were evaluated. In addition to all conventional diagnostic procedures for UPJ stenosis, differential renal functional (DRF) activity was assessed in each of these children by obtaining 99mTc diethylenetriaminepentaacetic acid renogram curves. All children underwent dismembered pyeloplasty, and follow‐up renogram evaluation was conducted 6 and 12 months after surgical repair. Biopsy specimens from renal cortical regions obtained during the surgical correction of UPJ stenosis were evaluated, and changes in renal histology were graded from I to V according to their severity. Spearman's correlation test was used to compare the histological evaluation results and the basal, 6‐ and 12‐month follow‐up DRF findings. A Wilcoxon paired test was used to evaluate statistical differences between values.

Results: The findings showed a positive correlation between the severity of histological changes and DRF activity. All kidneys (22) with a DRF activity value of < 40% preoperatively demonstrated at least grade III changes when biopsy specimens were examined. Of children with a DRF activity value > 40% (13), only three showed severe histological changes. Histological grades were correlated between basal (r = –0.4; P = 0.019), 6‐month (r = 0.54; P = 0.002) and 12‐month (r = 0.54; P = 0.02) findings. In the Wilcoxon paired test, there was a statistically significant difference between basal and 6‐month values (P < 0.05), and also between basal and 12‐month values (P < 0.01). There was no statistically significant difference between 6‐ and 12‐month values (P > 0.20).

Conclusion: Comparative evaluation of postoperative renal function with DRF activity and renal parenchymal histological alterations revealed a close correlation in terms of renal function improvement potential following reconstructive surgery in children with UPJ stenosis.
Transitional cell carcinoma of the ureteral stump eight years after nephrectomy for benign disease
Authors: INUI MASASHI , YAMASHITA MOTOKI , TAKETA SHIGEO , TAKENAKA IKUMASA , KAKEHI YOSHIYUKI
Published: March 2003

Abstract A case of primary carcinoma of the ureteral stump is reported. A 68‐year‐old man presented with asymptomatic gross hematuria. He had undergone a right nephrectomy for a benign disease previously. Cystoscopy and left ureteroscopy showed no abnormalities. A computed tomography showed a solid mass on the region of the right ureteral stump. He underwent a right ureterectomy and bladder cuff resection. A pathological examination showed transitional cell carcinoma.
Giant bladder diverticulum due to previous bullet injury: Findings of gadolinium‐enhanced magnetic resonance imaging
Authors: SUZUKI KAZUMI , TANAKA OSAMU , SAITO TETSUO , TOKUE AKIHIKO
Published: March 2003

Abstract Non‐obstructive acquired giant bladder diverticulum is rare. An 84‐year‐old man presented with difficulty in urination. Radiological examinations including pelvic magnetic resonance imaging, urethrocystography and urethrocystoscopy demonstrated a giant bladder diverticulum with normal infravesical urinary tract. The patient had a past history of gunshot bladder injury and underwent surgical removal of the bullet. The giant bladder diverticulum was thought to be associated with the injury or the operation.
Endoscopic removal of intravesical thermometer using a rigid nephroscope and forceps
Authors: NISHIYAMA KENRYU , SHIMADA TAKESHI , YAGI SHIZUO , KAWAHARA MOTOSHI , NAKAGAWA MASAYUKI
Published: March 2003

Intravesical thermometers are occasionally encountered in urologic practice. In the present paper, we describe the removal of a thermometer from the bladder of a woman who presented with irritable bladder symptoms. The thermometer was removed intact transurethrally using a rigid nephroscope and forceps, even though both ends of the thermometer were embedded in the bladder wall. Our retrieval technique may be of general use in such cases, and it should be attempted before resorting to open surgery.
Appendicovesicostomy for pubescent patients with neurogenic bladder using umbilicus as a stomal site
Authors: Uda Akiko , Hayashi Yutaro , Kojima Yoshiyuki , Okamura Takehiko , Sasaki Shoichi , Kohri Kenjiro
Published: March 2003

We experienced two cases of neurogenic bladder in which clean intermittent catheterization (CIC) had been performed since early childhood. In both cases, CIC had not provided adequate voiding control and incontinence persisted. According to the Mitrofanoff Principle, we used the appendix as a catheterizable conduit, which was constructed to the umbilicus.