bluuebunny/crossref_metadata_2025 huggingface dataset:
Continued pulmonary recovery observed after discontinuing extracorporeal membrane oxygenation
Authors: Antunes Michael J. , Cullen James A. , Holt William J. , Gauthier Theresa W. , Baumgart Stephen , Greenspan Jay S.
Published: March 2007

Extracorporeal membrane oxygenation (ECMO) is a valuable therapy for the treatment of reversible lung disease in neonates. Associated with this treatment, however, are risks for complications that increase with the duration of therapy. We evaluated alveolar‐arterial oxygen tension difference P pulmonary compliance (CL), and functional residual capacity (FRC) in 20 infants immediately after ECMO was discontinued, and again 24 hours thereafter. We measured C, by pnemotachography and eosphageal manometry and FRC by helium dilution. Mean (±SEM) values for CL and FRC increased (CL from 0.28 ± 0.02 to 0.35 ± 0.03 mL/cmH2O)/kg and FRC from 18.6 ± 1.4 to 22.2 ± 1.1 mL/kg; P < 0.05), and P and the oxygenation index (OI) decreased (200 ± 19 to 169 ± 14 mm Hg and 6.9 ± 0.44 to 5.4 ± 0.5, respectively; P < 0.02), over the 24 hour period following ECMO. Nineteen of 20 infants experienced improvement in at least two of these parameters. Improvements were found to be greatest in the infant with the worst lung function immediately after discontinuing ECMO, and in the ten infants who had not received pancuronium bromide for inducing skeletal muscle paralysis, following decannulation from ECMO. These data indicate that improvement in lung function following ECMO will generally continue over the 24 hour period following the termination of cardiopulmonary bypass, and that borderline pulmonary status may not preclude discontinuation of bypass therapy. Pediatr Pulmonol. 1994; 17:143–148. © 1994 Wiley‐Liss, Inc.
Variations in flows and pressures during jet ventilation in the infant: A model study
Authors: Belaguid A. , Guenard H.
Published: March 2007

Ventilatory flow rates with either He‐O2 (heliox) or N2‐O2, (nitrox) mixtures during high frequency jet ventilation (HFJV) were calculated using a mathematical model, and were measured in a physical monoalveolar model of the infant lung. A constant flow was delivered to the model (V,) drawing with it an entrained flow (Ve). When the inspiratory time (Tl) was long, a back flow (Vr) was generated that increased progressively as the alveolar pressure increased. In order to reduce Vr the reflux time (Trc), i.e., the time needed for the injected gas to reflux, was measured (Trm)and calculated (Trc) with the model: The Tr depends on both chest‐lung compliance and resistance to reflux as well as on the Ve/Vd ratio. For a given setting of the ventilator, values of Trm and Trc were significantly lower with heliox than nitrox (P < 0.01), and the correlation between Trm and Trc were fair with both gases. Tidal volume (VT) was calculated when the Tl was interrupted at Tr The values of VT were significantly higher with heliox than nitrox (P < 0.05). It is concluded that the evaluation of Tr during HFJV may provide useful information for setting the ventilator. Pediatr Pulmonol. 1994; 17:183–188. © 1994 Wiley‐Liss, Inc.
Pulmonary vasculitis with hemorrhage in anaphylactoid purpura
Authors: Wright Wendy K. , Krous Henry F. , Griswold William R. , Billman Glenn F. , Eichenfield Lawrence F. , Lemire Jacques M. , Reznik Vivian M.
Published: March 2007

We report a 14–year‐old female with anaphylactoid purpura (AP) who developed pulmonary hemorrhage with acute vasculitis on lung biopsy. She improved with pulse methylprednisolone, daily prednisone and ventilatory assistance. Pulmonary vasculitis is a rare but serious manifestation of AP. Pediatr Pulmonol. 1994; 17:269–271. © 1994 Wiley‐Liss, Inc.
Nebulizer delivery of tobramycin to the lower respiratory tract
Authors: Weber Allan , Smith Arnold , Williams‐Warren Judy , Ramsey Bonnie , Covert David S.
Published: March 2007

We characterized a tobramycin aerosol generated by five nebulizers: Micron One®, Pulmosonic®, Pulmo‐Aide®, De Vilbiss Model 65®, and Ultra Neb 100® by particle size and drug concentration. The Micron One nebulizer did not produce a recoverable aerosol, while the Pulmosonic had a minimal output: therefore three machines were examined for their ability to deliver tobramycin to the lower respiratory tract of patients with cystic f ibrosis (CF). The De Vilbiss 65 had the greatest output: with air as the carrier gas it produced an aerosol with >60% of the particles having a mean mass aerodynamic diameter (MMAD) of >5.5 μm. Using helox shifted the MMAD so that >65% of the particles were <5.5 μm. Increasing the power in the De Vilbiss 65 increased the output of particles >9.2 μm, without a change in the particles <3.3 μm. With air as the carrier gas the Pulmo‐Aide and the Ultra Neb 100 produced an aerosol with >60% particles, <3.3 μm MMAD. Using helox the Ultra Neb 100 increased the amount of aerosol with a 13.3 μm MMAD to 98%. Tobramycin delivery to the lower respiratory tract with the Pulmo‐Aide and Ultra Neb 100 was compared using air or helox by measuring sputum drug concentration. Pulmo‐Aide failed to produce detectable tobramycin in sputum in 2 out of 9 patients with CF. With the Ultra Neb 100, all patients had measurable sputum tobramycin immediately after administration (range, 16.2–3385 μg/g), but no statistically significant difference was found when using either compressed air, helox, or ambient air. There was no correlation between pulmonary function and sputum tobramycin content. We conclude that the Ultra Neb 100 consistently delivered tobramycin to the lower respiratory tract in patients with CF. Pediatr Pulmonol. 1994; 17:331–339. © 1994 Wiley‐Liss, Inc.
Measurement of lung diffusing capacity and functional residual capacity in lambs during the first postnatal month
Authors: Johns David P. , Jakubowska Alexandra E. , McCrabb Graeme J. , Harding Richard
Published: March 2007

The diffusing capacity of the lung for carbon monoxide (DLCO) is an important index of lung function but is not easily measured in spontaneously breathing animals with small lung volumes. Our aim was to devise a simple rebreathing method that would allow us to make serial measurements of DLCO in spontaneously breathing lambs during their first month after birth. By adding He to the rebreathing gas mixture, we were also able to measure functional residual capacity (FRC), enabling us to normalize DLCO with respect to FRC. We have compared FRC measured by the rebreathing technique with that measured by a closed‐circuit helium dilution method (FRCcc). Using the rebreathing method we found highly significant positive correlations between DLCO and body weight (r = 0.70, P < 0.001) and between FRC and body weight (r = 0.79, P < 0.001). There was no significant change in DLCO/FRC over the first postnatal month; the mean value was 8.1± 0.6 ML/min/mmHg/mL. Rebreathing FRC was highly correlated with FRC, (r = 0.88, P < 0.001), but was lower than FRCcc by about 18%. In normal lambs DLCO and FRC, but not DLCO/FRC, increased during the first month after birth, suggesting that the increase in DLCO parallels lung growth. We conclude that the modified rebreathing method is suitable for measuring DLCO in small uncooperative spontaneously breathing animals. Pediatr Pulmonol. 1994; 17:347–353. © 1994 Wiley‐Liss, Inc.
Epidemiology of Pseudomonas cepacia colonization among patients with cystic fibrosis
Authors: John Michael , Ecclestone Edward , Hunter Elizabeth , Couroux Peter , Hussain Zafar
Published: March 2007

Colonization with Pseudmonas cepacia in patients with cystic fibrosis (CF) has been associated with increased morbidity and early death, compared with colonization by P. aeruginosa. The mode of acquisition of P. cepacia is not fully understood, although person‐to‐person spread appears likely. Recent epidemiologic studies support the importance of social contact in the spread of P. cepacia among patients with CF. This study was undertaken to investigate the epidemiology of P. cepacia colonization among patients with CF attending the CF clinic at our center. Isolates of P. cepacia were collected from patients at two CF treatment centers, including ours. Additional isolates were collected from patients without CF in the hospital ICU, from other teaching hospitals, and from the environment. Profiles of enzymes were obtained by ultrathin polyacrylamide gel electrophoresis of P. cepacia extracts. A predominant electromorphic type (ET) was found among P. cepacia isolates from patients at both centers, suggesting a common source or person‐to‐person transmission. The majority of hospital isolates fell into a single, different ET. Surveillance swabs of respiratory equipment at our CF clinic did not grow P. cepacia. Attendance of patients at CF summer camp correlated strongly with P. cepacia colonization (P < 0.0001).Pediatr Pulmonol. 1994;18:108–113. © 1994 Wiley‐Liss, Inc.
Inhibitory effects of theophylline, terbutaline, and hydrocortisone on leukotriene B4 and C4 generation by human leukocytes in vitro
Authors: Shimizu T. , Kristjánsson S. , Wennergren G. , Hansson G. C. , Strandvik B.
Published: March 2007

Leukotriene B4 (LTB4) and leukotriene C4 (LTC4) are considered to be important mediators in the pathophysiology of asthma. Theophylline, terbutaline, and hydrocortisone are drugs commonly used in the treatment of asthma. In the present study we have investigated the in vitro inhibitory effects of theophylline, terbutaline, and hydrocortisone on LTB4 and LTC4 generation from human leukocytes. After preincubation in the presence of these drugs, the cells were stimulated with the calcium ionophore A 23187 and the supernatants were analyzed for their LTB, and LTC, content using reverse‐phase high‐performance liquid chromatography (HPLC). Total leukotriene (LT) production (the combined amounts of LTB4 and LTC4) was dose‐dependently inhibited by pretreatment with theophylline, terbutaline or hydrocortisone. Therapeutic levels of hydrocortisone (5 × 10−6 M) plus theophylline (5 × 10−5 M) inhibited LTB4 and LTC4 production in an additive way, as did the combination of hydrocortisone plus terbutaline (5 × 10−8 M). A statistically significant effect of diminished LTB, generation was obtained after preincubation with therapeutic levels of theophylline plus terbutaline, but no such effect was seen for LTC4 levels. The in vitro inhibitory effects on LTB4 and LTC4 generation from human leukocytes by theophylline, terbutaline, and hydrocortisone, as well as the additive effect of hydrocortisone plus theophylline or terbutaline, add to our understanding of the therapeutic effects of these drugs in the treatment of bronchopulmonary obstruction.Pediatr Pulmonol. 1994;18:129–134. © 1994 Wiley‐Liss, Inc.
Effects of administration of aerosolized recombinant human deoxyribonuclease on resting energy expenditure in patients with cystic fibrosis
Authors: Amin Nikhil , Dozor Allen J.
Published: March 2007

By improving pulmonary function in patients with cystic fibrosis (CF), recombinant human deoxyribonuclease (rhDNase) may affect resting energy expenditure (REE). To examine this hypothesis, we measured REE by indirect calorimetry in seven patients with CF before (day 0) and 2 weeks after (day 15) administration of aerosolized rhDNase. Baseline REE was higher in all patients than predicted for age, sex, and weight (mean ± SEM 128±4.9%; range, 116–147%). After 2 weeks of aerosolized rhDNase, mean forced vital capacity (FVC) (in % of predicted values) improved significantly from 54.1 ± 2.2 to 66.3±4.2% (mean improvement, 12.3%; 95% Cl, 2.8,21; P < 0.05) and REE decreased by 11.0% (95% Cl 3.2, 17.5; P < 0.05). In addition, the larger the improvement in FVC in response to rhDNase the greater the decrease in energy expenditure (r – 0.88). The REE decreased in all patients who had an increase in FVC and remained unchanged in two patients who had no change in FVC. We conclude that patients with CF whose lung function improve in response to aerosolized rhDNase have an acute and proportionate reduction in their resting energy expenditure.Pediatr Pulmonol. 1994;18:150–154. © 1994 Wiley‐Liss, Inc.
Benzyl‐benzoate foam: Effects on mite allergens mattress, serum and nasal secretory IgE to Dermatophagoides pteronyssinus, and bronchial hyperreactivity in children with allergic asthma
Authors: Sette Luciano , Comis Aldo , Marcucci Francesco , Sensi Laura , Piacentini Giorgio L. , Boner Attilio L.
Published: March 2007

Home mattresses of 24 asthmatic children with house dust mite allergy were sprayed with either benzyl‐benzoate foam or placebo in a double blind fashion, 10 days before the children left the residential house for asthmatic children lstituto Pi XII (located in the Italian Alps in an environment free of mites) and went back to their own home for the Christmas and Easter holidays. A further group of 8 children, whose mattresses received no treatment, was kept as an absolute control. Two days after spraying, benzyl‐benzoate or placebo were vacuumed from the mattresses. Acarex test was performed immediately before spraying and at the end of each holiday period of 20 and 10 days, respectively. Bronchial hyperreactivity as well as serum and nasal secretory specific IgE for Dermatophagoides pteronyssinus were assessed in all children immediately before leaving and within 48 hr after returning to the residential house. The results of the study show that sprayed benzyl‐benzoate foam was no more effective than placebo in reducing the level of house dust mite recovered from patients' mattresses, or in reducing bronchial hyperreactivity and IgE concentration in serum and nasal secretions.Pediatr Pulmonol. 1994;18:218–227. ©1994 Wiley‐Liss, Inc.
Pulmonary mechanics in ventilated preterm infants with respiratory distress syndrome after exogenous surfactant administration: A comparison between two surfactant preparations
Authors: Choukroun M. L. , Llanas B. , Apere H. , Fayon M. , Galperine R. I. , Guenard H. , Demarquez J. L.
Published: March 2007

The effects of two surfactant preparations on lung mechanics have been studied on 24 ventilated premature infants with respiratory distress syndrome (RDS): 13 were given artificial surfactant (Exosurf Neonatal, Burroughs–Wellcome) and 11 natural porcine surfactant (Curosurf, Laboratoire Serono France). Measurements of respiratory system compliance (Cdyn Crs) and resistance (Rrs) were performed immediately before surfactant administration and repeated 6, 18, 24, 48, and 72 hours later. With Exosurf treatment, 6 hours after surfactant administration inhaled O2 concentration (FIO2) could be lowered from (0.72 ± 0.20, to 0.62 ± 0.33; P < 0.05), whereas (Crs)did not change (0.37 mL/cmH2O/kg, ± 0.14 vs. 0.39 ± 0.12, NS). After 24 hours and during the following days a significant increase in (Crs) occurred (24 hours post‐Exosurf: 0.51 ± 0.18, P < 0.05). With Curosurf treatment, the improvement in oxygenation was greater and FIO2 could be lowered much more after 6 hours (from (FIO2), 0.78 2 ± 0.23 to 0.34 ± 0.11, P < 0.01). This was associated with an increase in (Crs) (from 0.39 ± 0.09 to 0.59 ± 0.17, P < 0.05). During the following days, (Crs) was significantly higher in the group treated with Curosurf. Resistance was not altered by the type of surfactant preparation used except after 72 hours, when Rrs increased in the group treated with Exosurf. In conclusion, Curosurf appears to be more effective than Exosurf with regard to immediate pulmonary changes in ventilator treated premature infants with RDS. A rapid increase in (Crs) after Curosurf treatment indicates that recruitment of new functional areas of the lung is likely to be associated with a stabilization of small airways and alveolar units.Pediatr Pulmonol. 1994;18:273–278 © Wiley‐Liss, Inc. © Wiley‐Liss, Inc.
Measurement of thoracic gas volume in patients born prematurely: Should occlusion be made at end‐inspiration or end‐expiration?
Authors: Yüksel B. , Greenough A.
Published: March 2007

It has been suggested that in infants born at term thoracic gas volume (TGV) may be more accurately estimated in a plethysmograph if end‐inspiratory (TGVI,) rather than end‐expiratory (TGVE,) occlusions are used. The aim of this study was to assess whether the timing of occlusion affected TGVI results in patients born very prematurely. Fifteen children with a median gestational age of 28 weeks (range 23–34) and postnatal age of 10 months (range 624) were studied. Measurements of TGV and airway resistance (Raw) were made in a whole body plethysmograph after sedation with chloral hydrate. End‐expiratory and end‐inspiratory occlusions were performed randomly in each subject. Overall, TGVI, was significantly lower than TGVE, (median, TGVI, 233 mL; range, 130–498. Median TGVI, 250 mL; range, 132–604; P < 0.05; 95% confidence intervals for the difference, 4–50 mL). In 13 infants, TGVI, was lower than TGVE, the remaining two patients did not differ significantly from the rest of the group and neither had neonatal chronic lung disease. In only five infants did TGVI, lie below the 95% confidence intervals of TGVE, however, two‐way analysis of variance with replicated measurements showed a significant difference between TGVI, and TGVE, (P < 0.05). The median Raw was 55 cmH2O/L/s (range, 36–71). A significant positive correlation was found between Raw and TGVE,‐TGVI, (r2 = 0.5, P < 0.01). We conclude that in children born very prematurely and with high Raw, occlusion at end‐expiration rather than end‐inspiration yields higher TGV results at follow‐up.Pediatr Pulmonol. 1994;18:295–298 © Wiley‐Liss, Inc.
Ability of new lung function tests to assess methacholine‐induced airway obstruction in infants
Authors: Benoist Marie R. , Brouard Jean J. , Rufin Patrick , Delacourt Christophe , Waernessyckle Serge , Scheinmann Pierre
Published: March 2007

We assessed the ability of innovative lung function tests to detect bronchial obstruction induced by methacholine bronchial challenge. Fifty‐five recurrently wheezy infants (mean age 16 ± 5.2 months) free of respiratory symptoms underwent baseline lung function tests. Forty‐two completed the methacholine challenge. Maximal flow at functional residual capacity (V̇maxFRC) was obtained using the squeeze technique; compliance and resistance of the respiratory system (Crs, Rrs,) was measured with the passive expiratory flow volume technique; tidal volume breathing patterns were analyzed from recordings of respiratory rate (RR), tidal volume (V̇T), and inspiratory time divided by total cycle of duration (Ti/Ttot). Expiratory tidal flow volume (V̇/VT) curves were described with multiple indices such as the ratio of expiratory time necessary to reach peak tidal expiratory flow (Fpet) to expiratory time (Tme/Te). Transcutaneous oxygen tension (PICO2) was measured as an indicator of response to methacholine challenge. Of 42 infants 41 responded to methacholine by a change 3. 2 standard deviations from baseline values. The mean SD unit changes were 9.8 in (PICO2), 3.7 for V̇maxFRC. 2.8 for Crs, 2.09 for Rrs 3.1 for RR, 1.6 for T1/Ttot, 2.2 for Tme/Te, 3.9 for PFvt. We conclude that these noninvasive lung function tests, especially V̇maxFRC and Fpet, can be used to detect minor or moderate airway obstruction. Further studies are needed to determine the value of the tests in assessing bronchial disease and effects of its treatment.Pediatr Pulmonol. 1994;18:308–316 © Wiley‐Liss, Inc.
Effect of passive smoking, asthma, and respiratory infection on lung function in Australian children
Authors: Haby Michelle M. , Peat Jennifer K. , Woolcock Ann J.
Published: March 2007

We have calculated normal standards for lung function of Australian children and have estimated the effects on lung function of passive smoking, current asthma, past asthma, and a current respiratory infection. Three cross‐sectional samples of children in school years 3–5 (aged 8–11 years) were studied. The 2765 children were from two rural regions of NSW and from the city of Sydney. Details of passive smoking and respiratory illness were collected by a questionnaire sent to parents. Forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1), peak expiratory flow rate (PEFR), and forced mid‐expiratory flow rate (FEF25–75%) were used as measures of lung function. Airway responsiveness was assessed by histamine inhalation test. Data from 1278 “normal” children were used in regression analysis to calculate prediction models for lung function. Passive smoking was associated with reduced FEV1, PEFR, and FEF25–75%. Children with current asthma had reduced FEV1 and FEF25–75% and children with past asthma had reduced FEF25–75%. Children with a current respiratory infection had reduced FVC1, FEV1, PEFR, and FEF25–75% The effects of these deficits on the future lung function of these children is not known but is likely to be important.Pediatr Pulmonol. 1994;18:323–329 © Wiley‐Liss, Inc.
Cytotoxic drug‐induced pulmonary disease in infants and children
Authors: Fauroux Brigitte , Meyer‐Milsztain Arlette , Boccon‐Gibod Liliane , Leverger Guy , Clément Annick , Biour Michel , Tournier Guy
Published: March 2007

The increased survival rate of malignant diseases due to more aggressive treatments contributes to the occurrence of drug‐induced pulmonary diseases (DIPD). We reviewed, retrospectively over a 10‐year period, 15 children (8 girls) who presented a DIPD. Their mean age was 9 years (range, 1 to 17 years), with an underlying malignant disease in 14 (9 leukemias). Three typical patterns have emerged from this analysis: (1) acute hypersensitivity lung disease caused by methotrexate (in 6 patients) or azathioprine (in 1 patient). This acute syndrome consisted of alveolar‐interstitial infiltrate with a hypercellularity on bronchoalveolar lavage (BAL) (mean, 714,286 cells/mL; range, 180,00—2,940,000 cells/ml) and an increase of lymphocyte counts (mean, 39%; range 1144%) with predominantly CD8‐suppressor/cytotoxic lymphocytes. Inhibition of leukocyte migration or leukocyte aggregation in the presence of low drug concentrations was positive in the 5 cases tested. Lung function tests showed a restrictive pattern and the outcome of DIPD was always favorable. (2) Chronic pneumonitis/fibrosis was seen in 6 patients who received a variable association of cyclophosphamide (3 patients), bleomycin (2 patients), BCNU (2 patients), and melphalan (1 patient). Symptoms of an alveolar‐interstitial pneumonitis developed progressively. BAL showed a moderate increase of total cell numbers (mean, 495,000 cells/mL; range, 150,000—900,000 cells/mL). Lung function tests showed a restrictive pattern. Despite corticosteroid treatment in 4 children, one died after bleomycin lung injury and 2 had functional lung impairment. (3) Noncardiogenic pulmonary edema occurred in 2 patients with leukemia treated with recombinant interleukin II. BAL showed hypercellularity and outcome was rapidly favorable. This study reports on the occurrence and severity of DIPD in infants and children. DIPD may be underdiagnosed because of inefficiencies in systematic lung evaluation in children treated with cytotoxic drugs.Pediatr Pulmonol. 1994;18:347–355. ©1994 Wiley‐Liss, Inc.
Effects of Pseudomonas aeruginosa colonization on lung function and anthropometric variables in children with cystic fibrosis
Authors: Pamukcu A. , Bush A. , Buchdahl R.
Published: March 2007

The aim of this study was to evaluate how lung function and growth changed over time in children with cystic fibrosis (CF) colonized with Pseudornonas aeruginosa (Pa) compared with those free of the organism. A total of 192 children attended our cystic fibrosis clinic between 1982 and 1992. Sixty‐two of these had three or more annual assessments for lung function, and 117 had three or more annual assessments for height and weight. When lung function was expressed as a standard deviation score (SDS), forced expiratory volume in 1 second (FEV1) and forced expiratory flow at 25% of vital capacity (FEF25) decreased significantly more with respect to height in colonized compared with noncolonized children: FEV1 −0.052 versus −0.015 SDS/cm (P < 0.05); FEF1, −0.060 versus −0.007 SDS/cm (P < 0.05); forced vital capacity (FVC), −0.034 versus −0.012 (NS). In actual values those patients colonized with Pa increased their FEV, by 16.4 versus 31.6 mL/cm (P < 0.01); FVC by 28.8 versus 41.4 ML/cm, P < 0.01; and FEF25 by −0.001 versus 0.015 mL/cm, P < 0.01. In terms of height, colonized children grew at 5.63 versus 6.96 cm/yr, P < 0.001, and height SDS decreased in colonized compared with noncolonized children at −0.031 versus 0.08 SDS/yr, P < 0.05. Clinically, most children with CF, with or without Pa, grew within ± SD of the norm for weight and height. However, in terms of lung function despite optimum pulmonary management colonized children deteriorated significantly faster. © 1995 Wiley‐Liss, Inc.
Successful treatment of severe neonatal lobar emphysema by high‐frequency oscillatory ventilation
Authors: Kohlhauser Christina , Popow Christian , Helbich Thomas , Hermon Michael , Weninger Manfred , Herold Christian J.
Published: March 2007

We successfully used high‐frequency oscillatory ventilation (HFOV) for treating severe acquired lobar emphysema in two premature newborn infants (birth weights, 1,450 and 1,300 g). After successful weaning from mechanical ventilation for hyaline membrane disease, they needed additional ventilatory support because they developed severe lobar emphysema compressing the residual lung. In both patients, radiographic signs of lobar emphysema disappeared completely after 3 days of HFOV. Diagnosis and follow‐up were confirmed by high‐resolution computed tomography. We conclude that HFOV may be a useful noninvasive method for treating severe lobar emphysema. © 1995 Wiley‐Liss, Inc.
Prevalence of respiratory symptoms in Swiss children: Is bronchial asthma really more prevalent in boys?
Authors: Sennhauser Felix H. , Kühni Claudia E.
Published: March 2007

Precise epidemiological data for the prevalence of childhood asthma were lacking for Switzerland until recently. In 1990 we performed a stratified cluster sampling of schoolchildren (aged 7, 12, and 15 years), using a parent completed questionnaire to obtain data for the 12 months prevalence of asthma symptoms and the lifetime prevalence of asthma diagnosis. A response rate of 97.5% enabled us to analyse 4,353 completed questionnaires. The prevalence of any asthma symptom during the last 12 months was 17.5% while only 4.8% of the children reported the diagnostic label “asthma.” The 12 months prevalence of chronic night cough was 12% and is comparable to other European data. Wheeze (5.9%) was reported less often in Switzerland than in England. At the age of 7 years asthma symptoms such as wheeze, morning tightness, and allergen‐induced symptoms were reported more often in boys than in girls; at the age of 12 and 15 the male preponderance was no more evident. For all asthma symptoms the male: female ratio decreased with increasing age of the children, while independently of age twice as many boys than girls reported the diagnostic label “asthma.” We conclude that asthma symptom prevalence in Swiss schoolchildren is within the lower range of European data. Chronic night cough might be a more appropriate variable to compare prevalence rates between regions with different cultural and linguistic backgrounds than the symptom of wheeze. Evidence exists for a substantial underdiagnosis of bronchial asthma in Swiss children, especially in girls. Further evaluation is needed to define risk factors for underdiagnosis and the associated risk for under‐treatment. © 1995 Wiley‐Liss, Inc.
Interrelationship between postocclusional oscillatory pressure transients and standard lung function in healthy and asthmatic children
Authors: Frey Urs , Kraemer Richard
Published: March 2007

We studied the correlation between characteristics of the postocclusional oscillatory airway opening pressure transients after flow interruption and body height, the degree of pulmonary hyperinflation [measured by thoracic gas volume (TGV)], and the degree of airway obstruction [measured by airway resistance (Raw)] and maximal expiratory flow at 50% vital capacity (MEF50) in 10 healthy and 50 asthmatic children age 7–16 years. Focusing on the damped oscillatory change in pressure, the first derivative of the shutter cutve was analyzed, featuring natural frequency f0 and damping factor din the time domain, and frequency FFS and power AFS in the frequency domain. A maximal frequency was found at ∼80 Hz without two peak distribution as described in dogs. Multiple linear forward step analysis revealed that ω0, (the undamped, natural frequency) and AFS were related to body height (P < 0.001). The damping factor d (independent of body height) was related to TGV and MEF50 (P < 0.001), and FFS to Raw (P < 0.001). The analysis of the postocclusional pressure transients after airflow interruption provides information on the resistive, elastic and inertive properties of the thoraco‐pulmonary system. The measurements obtained are influenced by the end‐expiratory resting level (or the degree of pulmonary hyperinflation) and the degree of airway obstruction. © 1995 Wiley‐Liss, Inc.
Sensitivity and specificity of oropharyngeal suction versus bronchoalveolar lavage in identifying respiratory tract pathogens in children with chronic pulmonary infection
Authors: Avital Avraham , Uwyyed Kamal , Picard Elie , Godfrey Simon , Springer Chaim
Published: March 2007

The purpose of this study was to compare the pathogens obtained by oropharyngeal suction (OPS) and bronchoalveolar lavage (BAL) in children with chronic pulmonary infections. Forty‐four children (mean age of 6.1 years; range 4 months to 15 years) were included in the study (27 children with recurrent localized lung infection, 5 with bronchiectasis, 5 with cystic fibrosis, 2 with foreign body aspiration, 2 with bronchiolitis obliterans, and 3 children with recurrent episodes of cough and shortness of breath). In 27 out of 44 BAL samples (61%) bacterial cultures were positive. The sensitivity of OPS in detecting the same BAL pathogen was 89% (24/27 samples), the specificity was 94% (16/47 samples), and the predictive value was 91% (40/44 samples). Hemophilus infhenzae β‐lactamase negative was the main organism recovered from BAL in non‐cystic fibrosis patients with recurrent or persistent pneumonia. We conclude that OPS is a simple and efficient noninvasive procedure which may be helpful in the diagnosis and treatment of recurrent or chronic pulmonary infection. Pediatr Pulmonol. 1995; 20:40–43. © 1995 Wiley‐Liss, Inc.
Comparison of effects of an intrapulmonary percussive ventilator to standard aerosol and chest physiotherapy in treatment of cystic fibrosis
Authors: Homnick Douglas N. , White Fred , de Castro Carol
Published: March 2007

Impaired mucociliary clearance due to defective ion and water transport and the effects of chronic airway infections lead to stasis of secretions and progressive pulmonary damage in patients with cystic fibrosis (CF). Methods to improve removal of tenacious lung secretions in CF patients contribute to slowing the decline in respiratory function. We have evaluated an intrapulmonary percussive ventilator (IPV), which is a device designed to enhance airway clearance and preserve lung function. A previous pilot study by us had determined that the device was acceptable to patients and is safe. We undertook a 6 month parallel comparative trial of the IPV versus standard, manual chest physiotherapy in 16 CF children and adults. No significant differences in spirometric measures, numbers of hospitalizations, use of oral or IV antibiotics, or anthropometric measurements were detected between the standard aerosol chest physiotherapy group and the IPV group over the duration of the trial. Patient acceptance, as determined by participant survey, was good. The device appeared to be safe and durable. It was concluded that the IPV is as effective as standard aerosol and chest physiotherapy in preserving lung function and anthropometric measures, and there was no difference in the use of antibiotics and hospitalizations. Pediatr Pulmonol. 1995; 20:50–55. © 1995 Wiley‐Liss, Inc.
Cross‐sectional study of bone density in asthmatic children
Authors: Hopp Russell J. , Degan Janice A. , Phelan James , Lappe Joan , Gallagher G. Chris
Published: March 2007

The emphasis in treatment of asthma in children has shifted from bronchodilators to inhaled anti‐inflammatory medications, including inhaled corticosteroids (ICS). Children with chronic asthma and moderate to severe symptoms have been targeted as particularly deserving of maintenance therapy with ICS. We have previously reported a cross‐sectional study of bone density in children treated with ICS. There was no significant difference between the total bone density of asthmatic patients and controls. We sought to extend the information available on bone density in asthmatic children by evaluating 15 asthmatic subjects taking daily ICS (beclo‐methasone dipropionate) and comparing them with age‐ and sex‐matched controls. We compared total and regional bone density, bone age, and calcium intakes in these subjects. Asthmatic subjects were on ICS for 4–60 months, with doses ranging from 200 to 450 μg/day. There was no significant difference between asthmatics and matched controls for height, weight, % RDA Ca2+, or bone age. The asthmatic subjects had bone density (total and regional measurements) equivalent to their controls. These results provide additional support for the safety of low‐dose ICS on bone density in asthmatic children. Pediatr Pulmonol. 1995; 20:189–192. © 1995 Wiley‐Liss, Inc.
Long‐term pulmonary functional outcome of bronchopulmonary dysplasia and premature birth
Authors: Parat Sophie , Moriette Guy , Delaperche Marie‐Francoise , Escourrou Pierre , Denjean André , Gaultier Claude
Published: March 2007

Pulmonary function and exercise tolerance were evaluated in late childhood in two groups of prematurely born children: one group with bronchopulmonary dysplasia (BPD) [n] = 15; gestational age at birth (GA): 29.6 ± 2.8 weeks; birth weight (BW): 1,367 ± 548 g; age at test: 7.9 ± 0.6 years, and a second group without significant neonatal lung disease [pre‐term (PT)] (n = 9; GA: 30.3 ± 1.7 weeks; BW: 1,440 ± 376 g; age at test: 7.8 ± 0.22 years). The results were compared with a control group of children of similar ages and heights, born at term [term born (TB)]. We observed that total lung resistance (RL) was significantly higher in BPD (11 ± 3 cmH2O/L/s), and in PT (9 ± 2) than in TB [5 ± 1; (P < 0.001 and P < 0.05, respectively)]. In BPD RL was higher than in PT (P < 0.05). Dynamic lung compliance (CLdY) was decreased in BPD (43 ± 11 mL/cmH2O) and in PT (56 ± 17) compared with TB (76 ± 20) (P < 0.001 and P < 0.05), and also in BPD compared with PT (P < 0.05). Forced expiratory volume in 1 second (FEV1) and FEV1/forced vital capacity (FVC) were lower in BPD (1.07 ± 0.15 L and 72 ± 7%) than in PT (1.29 ± 0.23 L, and 80 ± 7%) (P < 0.05). Exercise tests were performed in six boys with BPD. The ratio between minute ventilation at maximal workload (VEmax ) and the predicted value of maximal voluntary ventilation (MVV) was elevated in the six BPD boys tested, compared with five boys of Group 2 and five TB boys (87 ± 15% vs. 62 ± 14% and 65 ± 13%) (P < 0.05). We conclude that: (1) prematurity and BPD is followed by long‐term airway obstruction and a mild degree of exercise intolerance and; (2) premature birth without BPD may be followed by a milder degree of airway obstruction in childhood than in infants who developed BPD during the neonatal period. Pediatr Pulmonol. 1995; 20:289–296. © 1995 Wiley‐Liss, Inc.
Oral and inhaled steroids in croup: A randomized, placebo‐controlled trial
Authors: Geelhoed G. C. , Macdonald W. B. G.
Published: March 2007

It was the objective of this study to compare the efficacy of oral dexamethasone and inhaled budesonide in children hospitalized with croup, using a three‐way, double blind, randomized, placebo‐controlled clinical trial design. The trial was carried out in the Emergency Department Observation Ward of a tertiary pediatric hospital. The subjects for the study were 80 children (age range 5 to 158 months) who were hospitalized with croup. Children received either 2 mg of nebulised budesonide, dexamethasone syrup (0.6 mg/kg) or a placebo. Median duration of hospitalization was shorter for children treated with dexamethasone (12 hr) and budesonide (13 hr) compared to placebo (20 hr) (P < 0.03). There was no significant difference in hospitalization time between children treated with dexamethasone and budesonide. Median time to a croup score of ⩽1 was shorter for children treated with dexamethasone (2 hr) or budesonide (3 hr) compared to those who received placebo (8 hr) (P < 0.01). Croup scores for both steroid groups were significantly lower than the placebo group by 1 hr and remained so subsequently. The croup scores did not differ significantly in the 2 steroid treated groups. Six of the 30 children (20%) in the placebo group required adrenaline after the first hour compared to none of the 50 children in the steroid treated groups (P < 0.02). We conclude that oral dexamethasone and inhaled budesonide are both effective in reducing symptoms and duration of hospitalization in children with croup. Pediatr Pulmonol. 1995; 20:355–361. © 1995 Wiley‐Liss, Inc.
Respiratory inductive plethysmography in the evaluation of lower airway obstruction during methacholine challenge in infants
Authors: Rusconi Franca , Gagliardi Luigi , Aston Hazel , Silverman Michael
Published: March 2007

Respiratory inductive plethysmography (RIP) is a simple technique for an objective, noninvasive assessment of thoracoabdominal asynchrony, which in turn is an indirect measure of airway obstruction. We evaluated different indices of asynchrony obtained by RIP before and after methacholine‐induced airway obstruction. Bronchial obstruction was elicited by progressive doubling concentrations of methacholine until a > 15% fall in the transcutaneous oxygen tension (PIcO2) had developed. Maximal expiratory flow rates at functional residual capacity (FRC) (VmaxFRC) was obtained by the squeeze technique before and after the challenge. Fifteen infants with a history of wheezing were studied after sedation. Thoracoabdominal movements were recorded with RIP bands placed around either the upper or the lower ribcage (RC) and around the abdomen (AB). An inspiratory asynchrony index (IAI) and an expiratory asynchrony index (EAI) were calculated as determined by the lag of RC relative to AB at start of inspiration and of expiration, respectively. The total time in asynchrony (TTA: the percentage of time in which the RC and the AB signals were in opposite direction) and Φ (an angle derived from a Lissajous loop) were also calculated. All subjects responded to the challenge. The median fall in PIcO2 following methacholine challenge was 23.6% and in VmaxFRC was 43%. A large scatter of baseline values was found for all indices with the exception of TTA. There was no correlation between TTA and age, length, or VmaxFRC. The IAI and EAI with the RC band in the upper position were the most sensitive indices, both within subjects (65% of the subjects had a significant change in IAI and 80% in EAI) and for the group as a whole (median values increased for IAI, P = 0.007, and for EAI, P = 0.017). TTA and Φ were less sensitive, and a great discrepancy was observed between the two measurements. Poor results were obtained with the RC band in the lower position. No correlations were found between the changes in IAI and EAI, with the RC band around the lower chest and VmaxFRC. We conclude that IAI and EAI, measured with the RC band in the upper position and another band around the abdomen, can detect changes in thoracoabdominal asynchrony in most infants. The usefulness of assessing IAI and EAI in infants with acute lower airway obstruction needs to be determined. Pediatr Pulmonol. 1995; 20:396–402. © 1995 Wiley‐Liss, Inc.
RASSF1A promoter methylation is frequently detected in both pre‐malignant and non‐malignant microdissected prostatic epithelial tissues
Authors: Aitchison Alan , Warren Anne , Neal David , Rabbitts Pamela
Published: March 2007

Background

The RASSF1A gene is a tumor suppressor gene inactivated by hypermethylation in a very wide variety of malignant tumors including prostate cancer.

Methods

In this study we have used laser capture microdissection to provide pure cell populations to investigate the methylation status of 16 CpG sites in the promoter region of this gene in prostatic intra‐epithelial neoplasia, in histologically normal epithelial cells associated with these lesions and in epithelial cells from benign prostatic hyperplasia.

Results

Unexpectedly, frequent methylation, detected by sequence analysis following bisulphite treatment, was observed in benign epithelium as well as in the lesions associated with prostatic intra‐epithelial neoplasia and at high risk of cancer formation. Fifty percent or more CpG sites were methylated in 7/14 prostatic intra‐epithelial neoplasms, 8/11 histologically normal epithelial cells and 8/12 specimens of benign prostatic tissue.

Conclusion

These observations suggest that methylation of the RASSF1A gene is present in both pre‐malignant and benign epithelia and suggests quantitation is required for it to be an effective marker of early prostate cancer. Prostate 67: 638–644, 2007. © 2007 Wiley‐Liss, Inc.
Identity development as a lens to science teacher preparation
Authors: Luehmann April Lynn
Published: March 2007

Concepts and findings from research on identity development are employed to better understand why current science teacher preparation programs are failing to prepare teachers who are able and choose to implement the vision for science education articulated in professional standards. Identity theory is used as a theoretical lens to make sense of and better address some of the unique challenges of becoming a reform‐minded science teacher, a professional identity that does not reflect the common norm in the profession; these challenges include the emotional risk and possible need for “repair work,” lack of familiarity with and buy‐in into complex practices of inquiry, and the need for opportunities to participate in competent practice and have this participation acknowledged. Two basic design principles for science teacher preparation are identified as a result of this analysis: (a) the need to create safe places and scaffolded ways for beginning science teachers to try on and develop their identities as reform‐minded science teachers, which may include capitalizing on the unique opportunities of practice teaching in out‐of‐school contexts; and (b) the need to offer opportunities to be recognized, by self and others, as reform‐minded teachers through ongoing, structured, and supported reflection. © 2007 Wiley Periodicals, Inc. Sci Ed 91:822–839, 2007
Threep‐value consistent procedures for multiple comparisons with a control in direction‐mixed families
Authors: Kwong Koon Shing , Cheung Siu Hung , Holland Burt , Wang Yanhui
Published: March 2007

In clinical studies, it is common to compare several treatments with a control. In such cases, the most popular statistical technique is the Dunnett procedure. However, the Dunnett procedure is designed to deal with particular families of inferences in which all hypotheses are either one sided or two sided. Recently, based on the minimization of average simultaneous confidence interval width, a single‐step procedure was derived to handle more general inferential families that contained a mixture of one‐ and two‐sided inferences. But that single‐step procedure is unable to guarantee the condition ofp‐value consistency which means that when a hypothesis with a certainp‐value is rejected, all other hypotheses with smallerp‐values are also rejected. In this paper, we present a single‐step procedure and two stepwise procedures which arep‐value consistent. The two proposed stepwise procedures provide more powerful testing methods when compared with single‐step procedures. The extent of their superiority is demonstrated with a simulation study of average power. Selected critical values are tabulated for the implementation of the three proposed procedures. Additional simulation studies provide evidence that the new stepwise procedures are robust to moderate changes in the underlying probability distributions, and the proposed step‐up procedure is uniformly more powerful than the resampling‐based Hochberg step‐up approach in all considered distribution models. Finally, we provide a practical example with sample data extracted from a medical experiment. Copyright © 2007 John Wiley & Sons, Ltd.
Rapid Desensitization of Lipolysis in the Visceral and Subcutaneous Adipocytes of Rats
Authors: Mori Shinobu , Nojiri Hiroshi , Yoshizuka Naonobu , Takema Yoshinori
Published: March 2007

In adipocytes, short and long term stimulation of β adrenergic receptors (βAR) induces the desensitization to catecholamines, leading to a decrease in the intracellular accumulation of cAMP, but the roles played by this in lipolysis is not clear. In this study, we assessed the catecholamine‐induced desensitization of lipolysis and compared this in adipocytes isolated from visceral and subcutaneous fat tissues of rats. When adipocytes were pretreated with isoproterenol (ISO), the norepinephrine (NE)‐induced lipolysis was significantly reduced dose‐ and time‐dependently. A similar reduction of the lipolytic response was also found in NE‐, dobutamine‐, terbutaline‐ or BRL37344‐induced lipolysis. The ISO‐ and each βAR agonist‐induced lipolysis in the visceral fat was not only higher than in the subcutaneous fat, but also markedly reduced by ISO‐ or NE‐pretreatment. These results showed that short‐term treatment of three subtypes of βAR by each agonist induces a rapid reduction in the lipolytic response to βAR stimulation. This suggests some common mechanism for the rapid desensitization of βAR‐agonist‐induced lipolysis, in contrast with previous reports on the characteristics of βAR subtypes. In addition, the regional difference of adipose tissue not only in inducing lipolysis but also in rapid desensitization was also apparent.
A REPLY TO ANDREW SHRYOCK'S REVIEW OF COLONIAL EFFECTS: THE MAKING OF NATIONAL IDENTITY IN JORDAN (IJMES 38 [2006]: 478–79)
Authors: MASSAD JOSEPH
Published: March 2007

In his review of my book, Andrew Shryock asserts, “The interpretive key to Colonial Effects is located in its first paragraph,” in the preface, where I state that I am a “Palestinian Jordanian.” Indeed, this discovery—namely, that my national identity is the determining factor of my scholarship—is the interpretive key to Shryock's own grossly misrepresentative review. All his subsequent observations follow neatly in its footsteps.
IMMIGRATION, RETURN, AND THE POLITICS OF CITIZENSHIP: RUSSIAN MUSLIMS IN THE OTTOMAN EMPIRE, 1860–1914
Authors: Meyer James H.
Published: March 2007

Based upon research undertaken in Turkey, Russia, Azerbaijan, and the Crimea, this article consists of three principal and interconnected fields of inquiry. The first focuses upon changing Russian and Ottoman policies toward the immigration of Russian Muslims to the Ottoman Empire in the second half of the 19th century. The second examines questions that complicate the historiographical narrative surrounding this immigration, including issues such as Muslim return immigration to Russia and the retention of Russian citizenship by Muslim immigrants in the Ottoman Empire. The third examines the increasingly contested nature of citizenship and its role in the relations between Russian Muslims and the Russian and Ottoman bureaucracies. This section investigates battles between Ottoman and Russian bureaucrats who assert authority over Muslims of ambiguous citizenship status and the strategies deployed by Russian Muslims to take advantage of this ambiguity in their dealings with the bureaucracies of both empires.