bluuebunny/crossref_metadata_2025 huggingface dataset:
Incidence of Unilateral Fertilizations after Low Dose Deep Intrauterine Insemination in Spontaneously Ovulating Sows under Field Conditions
Authors: Martinez EA , Vazquez JM , Parrilla I , Cuello C , Gil MA , Rodriguez‐Martinez H , Roca J , Vazquez JL
Published: January 2006

Contents

A new procedure for non‐surgical deep intrauterine insemination (DUI) in unrestrained sows hormonally induced to ovulate, has been reported. In comparison with standard artificial insemination (AI), with this procedure, the sperm numbers inseminated can be reduced 20‐fold without reducing the reproductive performance of these hormonally treated sows. The present study evaluated, using two experiments, the reproductive performance applying 20‐fold different sperm numbers per AI dose using DUI or standard AI in spontaneously ovulating sows, under field conditions. In experiment 1, AI was applied to crossbred sows at 12, 24 and 36 h after onset of spontaneous oestrus using one of the following two regimes: (i) DUI (treatment) with 0.15 × 109 fresh boar spermatozoa in 5 ml of Beltsville thawing solution (BTS) extender (n = 95), and (ii) standard cervical AI (control) with 2.85 × 109 fresh spermatozoa in 95 ml of BTS extender (n = 95). The farrowing rates of the two groups of sows were statistically similar (NS). However, a decrease (p < 0.002) in litter size and the total number of pigs born alive was observed in sows inseminated with the DUI procedure. In experiment 2, 42 post‐weaned oestrus sows were inseminated following the same design described for experiment 1 during spontaneous oestrus. On day 6 after onset of oestrus, the proximal segment of the uterine horns of the sows were flushed under surgery to retrieve eventual embryos and evaluate the success of fertilization per cornua (e.g. occurrence of effective uni‐ vs bilateral sperm transport rendering uni‐ or bilateral, complete or partial fertilization). Retrieved embryos were assessed for cleavage and number of accessory spermatozoa. Although identical overall pregnancy rates were achieved in both insemination groups, the percentage of sows with partial bilateral fertilization and unilateral fertilization was markedly higher (p < 0.05) in the DUI group (35%) compared with the control (standard AI) group (5%), with a consequent lower (p < 0.001) percentage of viable early embryos after DUI. The number of accessory spermatozoa in the zona pellucida of the embryos was highly variable, but higher (p < 0.001) in control animals than in DUI‐AI. No accessory spermatozoa were found in oocytes retrieved from sows depicting unilateral fertilization. In conclusion, DUI in spontaneously ovulating sows with 0.15 × 109 spermatozoa renders similar farrowing rates but a lower litter size compared with use of standard AI with a 20‐fold higher sperm dose. The lower litter size ought to be related to a decreased distribution of spermatozoa after DUI leading to a higher incidence of partial bilateral and unilateral fertilization.
A Screening for the Occurrence of Autoreactive Antibodies in Sera of Pregnant and Non‐pregnant Bitches
Authors: Schäfer‐Somi S , Herkner KR , Neubauer S , Egerbacher M , Patzl M , Pollak S , Ali Aksoy O , Beceriklisoy HB , Kanca H , Findik M , Kalender H , Aslan S
Published: January 2006

Contents

Sera of healthy pregnant (group I, n = 11) and non‐pregnant (group II, n = 11) bitches were screened for autoantibodies (AAb). In both groups, blood samples were drawn every fifth day between days 5 and 55 after mating. Serum was analysed via indirect immunofluorescence (IIF) with the Canine ANA HEp‐2 Screening Kit®. In all animals, anticytoplasmic AAb were detected. Utilizing primate‐heart substrate slides AAb against contractile proteins of the cytoplasm could be observed. The predominating fluorescence pattern in pregnant animals resembled above all desmin, which was proven via Western blot. The sera were then pre‐incubated with tropomyosin, actin, vimentin, vinculin and keratin solutions, and assessed on HEp‐2 slides and on human and canine fibroblasts as well. The latter substrate was used to verify whether the detected Ab were in fact AAb. Utilizing tropomyosin, revealed elimination of the cytoplasmic fluorescences on all three substrates. It is therefore assumed, that in sera of healthy dogs, AAb against contractile structure proteins of the cytoplasm are present regularly. The majority of pregnant bitches presented with higher end‐point titres (EPT), than to be found in non‐pregnant dogs. AAb against desmin played the key role in those patterns. In addition, sera were screened for thyroid specific AAb, namely thyroglobulin, thyroid peroxidase (TPO), T3and T4, and for AAb against insulin by ELISA or Western blot (TPO). Only in two of the pregnant bitches a weak positive reaction (1 : 100) for T3‐AAb was detected.
Intracerebroventricular Infusion of Leptin into Mature Merino Rams of Different Metabolic Status: Effects on Blood Concentrations of Glucose and Reproductive and Metabolic Hormones
Authors: Celi P , Blache D , Blackberry MA , Martin GB
Published: January 2006

Contents

In mature Merino rams, nutrition is one of the external cues that most strongly affects the reproductive centres of the preoptic‐hypothalamic continuum. The signalling pathways that link dietary status and the activity of the neurones that produce gonadotrophin‐releasing hormone signals are thought to be partly hormonal in nature to reflect the amount of body reserves. Among the hormones thought to be involved are insulin and leptin. This study tested whether recombinant bovine leptin infused (0.4 μg/h) into the third cerebral ventricle would stimulate pulsatile luteinizing hormone (LH) secretion in mature Merino rams when their energy status was low or decreasing, during both chronic (fasting) and acute reductions of energy balance. Leptin may interact with other hormones that depend on energy availability, so we also monitored changes in circulating concentrations of insulin, thyroid hormones, growth hormone, prolactin and adrenocorticotrophin. Overall, our data do not support this hypothesis. The dietary regimes induced clear responses in the metabolic profiles of the animals but there was no clear effect of central leptin administration on LH pulse frequency. The relationships between the hormonal systems measured in the present study add weight to the contention that leptin plays only a permissive role in the nutritional control of the reproductive axis and that other hormonal signals (particularly insulin) or pathways are acting in concert with leptin to stimulate the reproductive axis.
Bacteriological Findings and Hormonal Profiles in the Postpartum Balady Goats
Authors: Ababneh M M , Degefa T
Published: January 2006

Contents

Twenty‐six Balady goats categorized according to parity into primiparous and pluriparous goats were used to investigate bacterial flora of the genital tract and hormonal profiles during the postpartum (PP) period. Escherichia coli and Staphylococcus aureus were isolated in pure or mixed culture from the uterus. Arcanobacterium pyogenes was isolated from swabs obtained from the vagina and cervix of one primiparous goat. Uteri and cervices but not vaginas were free of bacterial contamination by day 10 PP except for one pluriparous goat with scanty E. coli contamination on day 25 PP. Fluctuating oestradiol 17β (E2) levels demonstrated resumption of follicular activity as early as day 13 PP in both parity groups. Progesterone (P4) levels remained low at basal levels throughout the study period. Higher concentrations of 15‐keto‐13,14‐dihydroprostaglandin F2α (PGFM) were observed during the first week PP compared with the rest of the PP period. PGFM concentrations dropped to low basal level by day 10 PP and remained constantly low throughout the study period. P4, E2 and PGFM profiles were not different between the different parity groups. In conclusion, intrauterine infection is not common in goats with normal kidding. E. coli was the most common intrauterine bacterial isolate. E2 and P4 profiles were consistent with resumption of follicular growth but not ovulation. High PGFM concentrations coincided with the fast regression phase of uterine involution. Hormonal profile and bacterial contamination and clearance were similar to those reported in other related species and not related to parity.
Meiotic Competence of Canine Oocytes Embedded in Collagen Gel
Authors: Otoi T , Shimizu R , Naoi H , Wongsrikeao P , Agung B , Taniguchi M
Published: January 2006

Contents

The present study was conducted to examine the meiotic competence of canine oocytes embedded in collagen gel, and to investigate the effects of timed exposure of the oocytes embedded in collagen gel to gonadotrophins during maturation culture, on their nuclear maturation. Cumulus–oocyte complexes (COCs) were collected from bitches at the anoestrous and dioestrous stages of the reproductive cycle. In the first experiment, half of the COCs were embedded in collagen gels. The COCs with or without collagen‐gel embedding were cultured in a TCM‐199 medium supplemented with 0.1 IU/ml human menopausal gonadotropin (hMG) and 10 IU/ml human chorionic gonadotropin (hCG) for 72 h. In the second experiment, the COCs embedded in collagen gels were cultured in TCM‐199 medium with gonadotrophins (hMG and hCG) for various periods (0, 24, 48 and 72 h) and then cultured in the medium without gonadotrophins until reaching total culture period (72 h). The percentage of the oocytes reaching metaphase I and metaphase II (MI/MII) was significantly higher (p < 0.05) in COCs with collagen‐gel embedding than in COCs without collagen‐gel embedding. The percentage of oocytes that were arrested at the germinal vesicle stage was significantly lower (p < 0.05) in oocytes cultured with gonadotrophins than in oocytes cultured without gonadotrophins. However, there were no significant differences in the percentages of oocytes that reached each stage of meiosis among the groups, irrespective of the duration of exposure to gonadotrophins. These observations indicate that embedding of COCs by collagen gel enhances the meiotic competence of canine oocytes, but removal of hormone supplement from maturation medium does not improve the ability of the oocytes to reach MII stage.
The Prediction of Parturition Date in Canine Pregnancy
Authors: Luvoni GC , Beccaglia M
Published: January 2006

Contents

In bitches, the length of gestation is highly variable when measured from the day of mating, thus prediction of parturition may be greatly inaccurate when determined from this point. The ability to precisely predict the duration of pregnancy is of practical importance for managing parturition or planning caesarean section and this review analyses the methods that can be used to accurately forecast the day of parturition. At the time of breeding, determination of the luteinizing hormone surge and the initial rise in progesterone provide reliable information on gestational length of the bitch, but when pregnancy is ascertained, ultrasonography is the most useful tool to predict the delivery day. In fact, by ultrasonographic measurements of the extra‐foetal and foetal structures an accurate prediction can be made both in early and late pregnancy.
Motility and Plasma Membrane Integrity of Spermatozoa in Fractionated Stallion Ejaculates after Storage
Authors: Kareskoski AM , Reilas T , Andersson M , Katila T
Published: January 2006

Contents

With the aim of investigating properties of stallion seminal plasma to eventually improve semen‐handling techniques, sperm motility and plasma membrane integrity were analysed in different fractions of the ejaculates after storage. Semen was collected using a computer‐controlled automated phantom that separates the ejaculates into five successive cups. Samples containing seminal plasma and skim milk extender were compared with samples stored in skim milk extender after the removal of seminal plasma by centrifugation. Fractionated ejaculates were stored cooled for 24 h after dilution with extender (Expt 1) or frozen in liquid nitrogen (Expt 2). In Expt 1, cup 1 was pre‐sperm fluid, cups 2 and 3 sperm‐rich fractions, and cup 4 sperm‐poor fractions. In Expt 2, cups 1 and 2 were sperm‐rich fractions, and cups 3 and 4 sperm‐poor fractions. One sample (WE) represented the whole ejaculate in both experiments. Motility parameters were determined with a Hamilton‐Thorn Motility Analyzer, and plasma membrane integrity was assessed using carboxyfluorescein diacetate and propidium iodide staining and fluorescence microscopy. The removal of seminal plasma lowered motility values, but not plasma membrane integrity, in both experiments. No significant differences between cups were observed after cooled storage. The cups differed significantly in most post‐thaw motility parameters, and the sperm‐rich fraction showed higher post‐thaw motility than the whole ejaculate.
Influence of Seasons, Extenders, Slow and Rapid Freezing on Seminal Characters in Korean Native Bucks
Authors: Choe Chang‐Yong , Kim Jung‐Gon , Cho Sang‐Rae , Son Dong‐Soo , Kim Young‐Keun , Balasubramanian S , Choe Sang‐Yong , Rho Gyu‐Jin
Published: January 2006

Contents

The success of AI technology is based on both semen quality and freezing process. In order to establish the semen freezing techniques in Korean native bucks, factors affecting the success were evaluated in the present study. Semen collected by electro‐ejaculation from bucks during four distinct seasons was evaluated for semen volume and pH, sperm motility and survivability. The semen volume, concentration and total cell were higher in spring, summer and less in winter. Yet, there were no seasonal differences in the proportional data of live sperm, motility score and pH of semen among seasons. The percentage of live sperm after thawing was found to increase with increased concentration of lactose in Tris‐Egg yolk‐glycerol (TY‐G), being highest in TY‐G supplemented with 180 mm lactose (TYL180‐G), but did not differ between TY‐G and TYL120‐G. Sperm motility was enhanced by employing 2.0 h equilibration time with rapid freezing method. In conclusion, semen could be frozen with high success rates for further use of AI in breeding techniques and to preserve the Korean native bucks.
Parvovirus Antibodies in Vaccinated Gilts in Field Conditions – Results with HI and ELISA tests
Authors: Oravainen J , Hakala M , Rautiainen E , Veijalainen P , Heinonen M , Tast A , Virolainen JV , Peltoniemi OAT
Published: January 2006

Contents

This study was conducted to determine the antibody response for porcine parvovirus (PPV) of 39 gilts in field conditions after vaccination. Gilts from four herds endemically infected with PPV were injected twice with a commercial vaccine of inactivated PPV andErysipelothrix rhusiopathiae. The PPV antibodies were analysed both with haemagglutination inhibition (HI) and enzyme‐linked immunosorbent assay (ELISA) in order to study the agreement between these methods. The possible association between high‐antibody titres and reproductive failure (repeat breeding, culling for infertility, ≤6 piglets born alive) was also investigated. In these study herds, endemically infected by PPV, most gilts (84.6%) had not seroconverted by the age of 6 months. On‐field vaccination resulted in a consistent increase of humoral immunity not exceeding the antibody level of 1 : 512 in the majority of gilts in all herds examined. The agreement between ELISA and HI tests was moderate (Spearman'sρ = 0.87,κ = 0.63). The seroconversion over the level >1 : 512 by mid‐pregnancy was not associated with reproductive failure.
Pulmonary arterial hypertension: New insights and new hope
Authors: MARTIN Kevin B. , KLINGER James R. , ROUNDS Sharon I. S.
Published: January 2006

Abstract:  Pulmonary arterial hypertension (PAH) is a devastating disorder characterized by abnormal increased vasoconstriction and vascular remodelling. In this review we discuss the pathophysiology, genetic basis and clinical features of this disorder. Current therapy of PAH is based on an understanding of its pathogenesis, and we review current treatment options based on the pathophysiology of the disease. We discuss three promising novel therapies studied in animal models and human tissue. All three therapies appear to prevent and reduce pulmonary arterial medial hyperplasia through their anti‐proliferative and/or pro‐apoptotic effects: serotonin transporter inhibitors by blocking serotonin uptake; dichloroacetate by activating voltage‐gated potassium channels; and simvastatin by preventing activation of small GTPases.
Involvement of PKC, p38 MAPK and AP‐2 in IL‐1β‐induced expression of cyclooxygenase‐2 in human pulmonary epithelial cells
Authors: CHEN Ping , CAI Ying , YANG Zhi‐Gang , ZHOU Rui , ZHANG Guang‐Shen , DOMANN Frederick , FANG Xiang
Published: January 2006

Objective:  The aim of this study was to identify the signal molecules involved in IL‐1β‐induced expression of cyclooxygenase (COX)‐2 in human pulmonary epithelial (A549) cells.

Methods:  A549 cells were stimulated with IL‐1β in the presence or absence of H‐7 (a protein kinase C inhibitor), SB203580 (a p38 mitogen‐activated protein kinase inhibitor) and PD098059 (a mitogen‐activated and extracellular regulated kinase kinase (MEK1) inhibitor). The A549 cells were also transfected with adenovirus vector encoding activator protein (AP)‐2α, or a plasmid containing a dominant‐negative gene (AP‐2Δ), in the presence or absence of IL‐1β.

Results:  IL‐1β induced expression of the COX‐2 mRNA and protein in A549 cells in a time‐ and dose‐dependent manner. SB203580 and H‐7, but not PD098059, inhibited IL‐1β‐induced expression of COX‐2 protein. Overexpression of AP‐2α increased expression of the COX‐2 protein, whereas AP‐2Δ decreased IL‐1β‐induced COX‐2 expression.

Conclusion:  Protein kinase C, p38 mitogen‐activated protein kinase and transcriptional factor AP‐2α may play important roles in regulating IL‐1β‐induced COX‐2 expression in human pulmonary epithelial cells.
Hypoxia‐sensitive molecules may modulate the development of atherosclerosis in sleep apnoea syndrome
Authors: HAYASHI Motonori , FUJIMOTO Keisaku , URUSHIBATA Kazuhisa , TAKAMIZAWA Akemi , KINOSHITA Osamu , KUBO Keishi
Published: January 2006

Objectives:  Obstructive sleep apnoea hypopnoea syndrome (OSAHS) is associated with increased morbidity and mortality due to cardiovascular disease. In order to examine the association between OSAHS and cardiovascular disease, this study measured hypoxia‐inducible and atherosclerosis‐associated molecules in the peripheral blood.

Methods:  In this study peripheral blood was obtained early in the morning from 60 consecutive male patients with OSAHS (AHI ≥10 events/h) and 30 male control subjects without OSAHS (AHI <5 events/h). Serum levels of heat shock protein‐70 (Hsp‐70), tissue factor (TF), monocyte chemotactic protein‐1 (MCP‐1), highly sensitive C‐reactive protein (hs‐CRP), hepatocyte growth factor and plasma vascular endothelial growth factor were measured and their relationship with severity and hypoxaemia in OSAHS examined.

Results:  Serum hs‐CRP, TF, MCP‐1 and Hsp‐70 levels were significantly higher in OSAHS compared with control subjects. Categorization of the patients into mild (10 ≤ AHI < 30 events/h), moderate (30 ≤ AHI < 60 events/h) and severe (AHI ≥ 60 events/h) OSAHS subgroups showed that serum levels of hs‐CRP, TF and Hsp‐70 increased with severity. The hs‐CRP, TF, MCP‐1 and Hsp‐70 levels in the non‐obese OSAHS group were also significantly higher than those in the control group whereas there was no difference in BMI between the two groups. Repetitive hypoxaemia significantly correlated with hs‐CRP, TF and Hsp‐70 levels and appeared to be a significant determinant for these molecules.

Conclusions:  These findings suggest that CRP, TF and Hsp‐70 may be upregulated by repetitive hypoxaemia in OSAHS and may be involved in the development of the atherogenic process in OSAHS.
Anaerobic metabolism of inspiratory muscles in COPD
Authors: EASTWOOD Peter R. , Van Der TOUW Tom J. , STURDY Gavin A. , JENKINS Sue C. , HILLMAN David R.
Published: January 2006

Objective:  The purpose of this study was to determine if the respiratory muscles of patients with COPD could be made to function anaerobically, as evidenced by an increase in arterial blood lactate concentration ([lactate]a) during specific loading of the inspiratory muscles and, if so, the effect of a programme of high‐intensity inspiratory muscle training on this function.

Methods:  In seven patients with COPD (FEV1 = 33 ± 14% of predicted), measurements of [lactate]a were made each minute during progressive inspiratory threshold loading to voluntary exhaustion. These tests were performed before and after an 8‐week programme of specific high‐intensity inspiratory muscle training, combined with general whole‐body exercise training.

Results:  During inspiratory muscle loading small increases in [lactate]a (0.83 ± 0.32 mM) were observed in two subjects before training, and in five subjects after training (0.69 ± 0.57 mM). [Lactate]a only increased when the inspiratory work rate exceeded 6.9 cm H2O L/min per kilogram of body weight, and when baseline maximum inspiratory pressure exceeded 65 cm H2O.

Conclusions:  The results of this study demonstrated that it is possible for COPD patients to increase inspiratory muscle work rate to a level requiring a major energy contribution from anaerobic glycolytic metabolism. This was only seen when inspiratory muscle strength and endurance were sufficient to allow it. Some patients who failed to demonstrate an increase in [lactate]a at baseline did so after a programme of high‐intensity inspiratory muscle training.
Longitudinal profile of antibodies against SARS‐coronavirus in SARS patients and their clinical significance
Authors: MO Hongying , ZENG Guangqiao , REN Xiaolan , LI Hui , KE Changwen , TAN Yaxia , CAI Chaoda , LAI Kefang , CHEN Rongchang , CHAN‐YEUNG Moira , ZHONG Nanshan
Published: January 2006

Background:  Severe acute respiratory syndrome (SARS) is a newly discovered disease caused by a novel coronavirus. The present study studied the longitudinal profile of antibodies against SARS‐coronavirus (SARS‐CoV) in SARS patients and evaluated the clinical significance of these antibodies.

Methods:  Two methods, ELISA and indirect immunofluorescent assay, were used for the detection of the anti‐SARS‐CoV IgG and IgM in 335 serial sera from 98 SARS patients. In 18 patients, serum antibody profiles were investigated and antibody neutralization tests were performed from 7 to 720 days after the onset of symptoms.

Results:  The ratios of positive IgG/IgM by ELISA were 0/0, 45.4/39.4, 88.6/71.4, 96/88, 100/48.6, 100/30.9, 100/17.1, 100/0 per cent, respectively, on 1–7, 8–14, 15–21, 22–28, 29–60, 61–90, 91–180 and 181–720 days after the onset of symptoms. Antibodies were not detected within the first 7 days of illness, but IgG titre increased dramatically on day 15, reaching a peak on day 60, and remained high until day 180 from when it declined gradually until day 720. IgM was detected on day 15 and rapidly reached a peak, then declined gradually until it was undetectable on day 180. Neutralizing viral antibodies were demonstrated in the convalescence sera from SARS patients.

Conclusion:  The persistence of detectable IgG antibodies and neutralizing viral antibodies for up to 720 days suggest that SARS patients may be protected from recurrent SARS‐CoV infection for up to 2 years.
Inflammatory subtypes in asthma: Assessment and identification using induced sputum
Authors: SIMPSON Jodie L. , SCOTT Rodney , BOYLE Michael J. , GIBSON Peter G.
Published: January 2006

Objective:  The authors sought to investigate the detection of non‐eosinophilic asthma using induced sputum. Although this is an important subtype of clinical asthma, its recognition is not standardized.

Methods:  Adult non‐smokers with asthma and healthy controls underwent sputum induction and hypertonic saline challenge. Non‐eosinophilic asthma was defined as symptomatic asthma with normal sputum eosinophil counts. The normal range for sputum eosinophil count was determined using the 95th percentile from the healthy control group as a cut‐off point.

Results:  The recognition of non‐eosinophilic asthma using eosinophil proportion was in agreement with a definition based on absolute eosinophil count (kappa 0.67). Non‐eosinophilic asthma was a stable subtype over both the short term (4 weeks) and longer term (5 years, kappa 0.77). Airway inflammation in asthma could be categorized into four inflammatory subtypes based on sputum eosinophil and neutrophil proportions. These subtypes were neutrophilic asthma, eosinophilic asthma, mixed granulocytic asthma and paucigranulocytic asthma. Subjects with increased neutrophils (neutrophilic asthma and mixed granulocytic asthma) were older and had an increased total cell count and cell viability compared with other subtypes.

Conclusion:  Induced sputum eosinophil proportion is a good discriminator for eosinophilic asthma, providing a reproducible definition of a homogenous group. The remaining non‐eosinophilic subjects are heterogeneous and can be further classified based on the presence of neutrophils. These inflammatory subtypes have important implications for the investigation and characterization of airway inflammation in asthma.
Effect of simulated altitude during sleep on moderate‐severity OSA
Authors: BURGESS Keith R. , COOPER Jacky , RICE Anthony , WONG Keith , KINSMAN Tahnee , HAHN Allan
Published: January 2006

Objective:  These studies were conducted to test the hypothesis that isobaric hypoxia would switch OSA to central sleep apnoea (CSA).

Methods:  Five adult men (mean age 54.2 ± 5.5 years, mean BMI 29.9 ± 6.7 kg/m2) with moderate OSA underwent overnight polysomnography at three altitudes. The highest altitude was simulated in a normobaric hypoxic chamber.

Results:  The obstructive respiratory disturbance index fell from 25.5 ± 14.4/h at 60 m to 17.3 ± 9.2/h at 610 m and 0.5 ± 0.7/h at 2750 m (P = 0.004 compared with 60 m). The central respiratory disturbance index rose from 0.4 ± 0.5/h at 60 m to 8.1 ± 5.8/h at 610 m and 78.8 ± 29.7/h at 2750 m (P < 0.001 compared with 60 m). Mean sleep SaO2 fell from 94 ± 1% at 60 m to 93 ± 1% at 610 m to 85 ± 4% at 2750 m (P < 0.001 compared with 60 m).

Conclusion:  Moderate severity OSA at sea level (60 m) was completely replaced by severe CSA at a simulated altitude of 2750 m. The authors believe that the OSA resolved because of an increased respiratory rate and an increase in upper airway tone, whereas CSA developed because of hypocapnia in non‐rapid eye movement sleep.
High plasma levels of factor VIII: An important risk factor for isolated pulmonary embolism
Authors: ERKEKOL FerdaÖNER , ULU Arzu , NUMANOGLU Numan , AKAR Nejat
Published: January 2006

Objective:  The aim of the study was to investigate whether factor V Leiden and prothrombin G20210A mutations, elevated levels of factor VIII and factor IX are associated with pulmonary embolism (PE).

Methods:  Sixty‐four patients with objectively documented PE and 64 control subjects were included in this study. The authors divided the 64 subjects with PE into those with PE and deep vein thrombosis (combined form of venous thromboembolism, n = 26) and those with PE without deep vein thrombosis (isolated PE n = 38).

Results:  There was no significant difference between the PE groups and the control subjects with regard to the presence of factor V Leiden and prothrombin mutations and elevated levels of factor IX. Using the 90th percentile measured in control subjects (P90 = 168 U/dL) as a cut‐off point for factor VIII levels, the authors found an 11‐fold increased risk for both isolated PE patients and patients with a combined form of venous thromboembolism who have factor VIII levels >168 U/dL compared with individuals having factor VIII levels below this cut‐off point. The risk was not affected by adjustments for other possible risk factors.

Conclusions:  Elevated plasma factor VIII levels were found to be a significant, independent risk factor for PE.
Recent air travel and venous thromboembolism resulting in hospital admission
Authors: HUGHES Rodney , HEUSER Trish , HILL Sarah , RYDER‐LEWIS Simon , WEATHERALL Mark , HOPKINS Raewyn , BEASLEY Richard
Published: January 2006

Objective:  The objective of the study was to determine the proportion of patients admitted to hospital with a deep vein thrombosis (DVT) or pulmonary embolism (PE) in whom recent air travel was documented in the medical records.

Methods:  A retrospective review of the medical records of patients with a primary or secondary discharge diagnosis of DVT or PE in four hospitals in New Zealand was undertaken. From the medical records information was collected on demographic details, documentation of the presence of risk factors and results of radiological investigations. Strict radiological criteria were applied to ensure that the diagnosis of DVT or PE was firmly established.

Results:  In 60 of 576 (10.4%) patients with a confirmed venous thromboembolism there was documentation of recent air travel; in 31 of these 60 subjects no other risk factors were recorded. In those cases in whom details of the air travel had been recorded, it had been undertaken in the previous 1 week in 65.0%, and in 43.3% the air travel was of at least 10‐h duration.

Conclusion:  Long distance air travel is an important risk factor for venous thromboembolism requiring hospital admission and represents a significant public health problem in New Zealand.
Simkania negevensis and newly diagnosed asthma: A case‐control study in 1‐ to 6‐year‐old children
Authors: KORPPI Matti , PALDANIUS Mika , HYVÄRINEN Anne , NEVALAINEN Aino
Published: January 2006

Background:  Simkania negevensis is an intracellular bacterium, sharing many characteristics with Chlamydophila and Chlamydia species. S. negevensis infection has been associated with bronchiolitis in infants and with pneumonia and exacerbations of COPD in adults.

Objective:  The aim of the present study was to evaluate, in a case‐control setting, whether S. negevensis serology had any association with the onset of asthma in children.

Methods:  S. negevensis‐specific IgM, IgA and IgG antibodies were measured by microimmunofluorescence in 104 children below school‐age with newly diagnosed asthma, and in 122 control children.

Results:  S. negevensis‐specific IgM was detected in two (2%) cases and in nine (8%) of the controls. IgG was detected in 12 (12%) cases and 12 (10%) of the controls. IgA antibodies were absent in all children. The age distribution of the 35 children with S. negevensis‐specific antibodies was even, the positivity rate being 11% in the 12‐ to 23‐month‐old group and 20–23% in the children aged between 2 and 5 years.

Conclusion:  Although S. negevensis appears to cause infections in the Finnish preschool‐aged population, there was no association with asthma.
Positron emission tomography with CT in the evaluation of non‐small cell lung cancer in populations with a high prevalence of tuberculosis
Authors: LOW Su‐Ying , ENG Philip , KENG Gilbert H.W. , NG David C.E.
Published: January 2006

Objective and background:  To determine the utility of positron emission tomography with CT (PET‐CT) in the evaluation of non‐small cell lung cancer (NSCLC) in an Asian context where tuberculosis rates are moderately high.

Methods:  Case records of consecutive patients with NSCLC undergoing PET‐CT at the Singapore General Hospital over a 1‐year period were retrospectively reviewed. The authors evaluated the sensitivity and specificity of PET‐CT at their institution using surgical pathology or the tincture of time as the gold standard.

Results:  A total of 54 patients underwent PET‐CT during this period. Seven patients were evaluated for solitary pulmonary nodule, for which PET‐CT gave a sensitivity of 100% and specificity of 75%. There was one patient with false positive PET‐CT due to active tuberculosis. In total, 41 patients underwent PET‐CT for staging of NSCLC. There was one false positive (patient was found to have active tuberculous lymphadenitis) and one false negative for NSCLC. This gave a sensitivity of 92.3% and a specificity of 95%. Histology from the adrenal glands was available in two patients with PET‐CT that was positive for adrenal metastases. One proved to be benign whereas the other was consistent with metastasis. Two patients had PET‐CT positive for liver metastases, which was verified by histology. Two patients with positive PET‐CT for lesions in the colon turned out to be benign histologically.

Conclusions:  Positron emission tomography with CT for the evaluation and follow‐up of solitary pulmonary nodule and NSCLC can provide additional useful information to conventional radiology for treatment planning and a non‐invasive determination of prognosis. However, physicians need to be aware of the limitations of this imaging modality, particularly when tuberculosis has a high prevalence in the population.
Intrapleural cisplatin and OK432 therapy for malignant pleural effusion caused by non‐small cell lung cancer
Authors: ISHIDA Atsuko , MIYAZAWA Teruomi , MIYAZU Yuka , IWAMOTO Yasuo , ZAIMA Mika , KANOH Koji , SUMIYOSHI Hidetaka , DOI Masao
Published: January 2006

Objective:  To evaluate the efficacy of combined intrapleural therapy with cisplatin, an antineoplastic agent, and OK432, a sclerosing agent, in controlling malignant pleural effusions, when compared with monotherapy with either agent.

Methods:  A total of 49 non‐small cell lung cancer patients with malignant pleural effusion were randomly assigned to one of three groups: intrapleural cisplatin therapy (n = 17), intrapleural OK432 therapy (n = 17), or both (n = 15). They were compared in terms of success rate, duration of indwelling chest tube and adverse reactions.

Results:  Rates of pleural effusion recurrence within 180 days following cisplatin, OK432, or combination therapy were 64.7%, 52.9% and 13.3%, respectively, being significantly lower in the combination therapy group (P = 0.01). The mean duration of chest tube drainage was 8.4 days, 5.5 days and 12.9 days, respectively, being significantly longer in the combination therapy group (P < 0.001). All procedures were well tolerated.

Conclusions:  Although chest tube drainage took longer because of the time required for multiple administration of the agents, intrapleural combination therapy with cisplatin and OK432 was more effective in controlling malignant pleural effusions due to non‐small cell lung cancer than monotherapy with either agent.
Maintaining exercise capacity and quality of life following pulmonary rehabilitation
Authors: COCKRAM Joanne , CECINS Nola , JENKINS Sue
Published: January 2006

Objective:  The optimum method for sustaining the benefits gained from pulmonary rehabilitation (PR) has not been determined. In this report the authors describe the 4‐year referral and uptake patterns to a hospital‐based outpatient PR programme, and the sustained benefits of PR in patients with COPD attending a community‐based maintenance exercise programme.

Methods:  Entry and exit data were mapped for all patients referred to the PR service over the review period. All eligible patients were offered a community‐based maintenance exercise programme upon completion of PR. A total of 21 patients underwent follow‐up assessment of functional exercise capacity, quality of life (QOL) and health‐care utilization.

Results:  Over a 4‐year period, 467 patients (80% with COPD) were referred to the programme, of whom 230 entered PR. In total, 172 patients completed PR, with attrition (25%) being mostly due to medical problems. Of the 84 patients who elected for the community‐based programme, 46 were still attending at follow up and 21 patients with moderate‐to‐severe COPD (44.9 ± 12.6 (mean ± SD) FEV1% predicted) were reassessed at 18.4 ± 11.9 months post PR. Significant improvements (mean change (95% confidence interval)) persisted in 6‐min walk distance (41.1 m (15.7–66.5)), distance walked in 20 min (195.1 m (82.3–308)) and in QOL (Chronic Respiratory Disease Questionnaire) (11.0 points (4.4–17.6)) (P < 0.01). The QOL improvements exceeded the minimum clinically important difference. A trend towards a reduction in COPD‐related hospital admissions, bed‐days and emergency department presentations was observed in the 12 months following PR. Self‐reported adherence with the home exercise programme indicated that 67% of patients were exercising at least 3–5 days each week in addition to attending a class.

Conclusion:  For patients with moderate‐to‐severe COPD, a weekly community‐based maintenance exercise class, supervised by a physiotherapist, combined with a home exercise programme is an effective intervention for maintaining improvements following PR.
CT bronchoscopy in the diagnosis of Williams–Campbell syndrome
Authors: GEORGE Jojy , JAIN Rajeev , TARIQ Syed M.
Published: January 2006

Abstract:  Williams–Campbell syndrome, a rare disorder, is characterized by a congenital deficiency of cartilage, typically involving the fourth to the sixth order bronchi, and resulting in expiratory airway collapse and bronchiectasis. The authors report a patient with Williams–Campbell syndrome with type II respiratory failure due to extensive cystic bronchiectasis and secondary emphysema. CT of the thorax showed the affected bronchi had characteristic ballooning on inspiration and collapse on expiration. Three‐dimensional images of the tracheobronchial tree were constructed from a volume of data acquired by thin‐slice CT scanning. Apart from confirming expiratory collapse of the affected bronchi, these images revealed an absence of the cartilage ring impressions in the bronchial wall, extending bilaterally from the mainstem down to subsegmental bronchi, suggesting cartilage deficiency.
Gefitinib‐induced lung injury successfully treated with high‐dose corticosteroids
Authors: SETO Takashi , SEKI Nobuhiko , UEMATSU Kazutsugu , TANIGAKI Toshimori , SHIOYA Sumie , KOBOYASHI Toshiki , UMEMURA Shinobu , EGUCHI Kenji
Published: January 2006

Abstract:  A 55‐year‐old man was treated with gefitinib for disseminated pleural lesions, 1 year after resection of the left lower lobe for non‐small cell lung cancer. After 6 weeks of continuous daily treatment with oral gefitinib, he developed dyspnoea on exertion and a non‐productive cough. CXR and CT revealed focal areas of ground‐glass opacity (GGO) in the right upper lobe. Despite gefitinib being discontinued, high‐resolution CT revealed extension of GGO and restructuring of lung parenchyma, suggesting acute interstitial pneumonia. Transbronchial biopsy revealed acute‐phase diffuse alveolar damage. After administration of methylprednisolone pulse therapy (1 g/day intravenously) for three consecutive days, the areas of GGO shrank on high‐resolution CT and symptoms resolved. Diffuse alveolar damage caused by gefitinib can be successfully treated in the early phase with high‐dose corticosteroids. Patients receiving gefitinib should be carefully examined for symptoms and undergo CT if their condition deteriorates.
Multiple tracheobronchial mucosal lesions in two cases of Churg–Strauss syndrome
Authors: MATSUSHIMA Hidekazu , TAKAYANAGI Noboru , KURASHIMA Kazuyoshi , TOKUNAGA Daido , UBUKATA Mikio , KAWABATA Yoshinori , SUGITA Yutaka
Published: January 2006

Abstract:  Churg–Strauss syndrome (CSS) is characterized by hypereosinophilia and a systemic necrotizing vasculitis seen almost exclusively in patients with asthma. The most common pathological findings in the chest in CSS are eosinophilic pneumonia, necrotizing vasculitis and granulomatous inflammation (extravascular granuloma). However, tracheobronchial mucosal lesions have rarely been reported in CSS. The authors report two patients with CSS who had multiple tracheobronchial mucosal lesions that were found by fibreoptic bronchoscopy. They were tiny nodular lesions and necrotizing bronchial inflammation with many eosinophils was observed upon pathological examination. The authors concluded that tracheobronchial mucosal lesions may be one of the manifestations of vasculitis seen in CSS.
Hepatopulmonary syndrome can show spontaneous resolution: Possible mechanism of portopulmonary hypertension overlap?
Authors: UMEDA Akira , TAGAWA Manabu , KOHSAKA Takao , MIYAKAWA Tomoo , KAWASAKI Kazuteru , KITAMURA Masayuki , NAKANO Miwako
Published: January 2006

Abstract:  Hepatopulmonary syndrome (HPS) (hypoxaemia due to intrapulmonary vasodilation and a right‐to‐left shunt associated with liver disease) resolves after liver transplantation. The authors describe a case of spontaneous resolution of HPS prior to liver transplantation. This patient was diagnosed with HPS associated with extra‐hepatic biliary atresia when she was 10 years old. She exhibited digital clubbing, facial vascular dilation, cyanosis, and suffered from dyspnoea during exercise. The patient's PaO2 at rest was 53.8 mm Hg in room air and a Technetium‐99m macro‐aggregated albumin lung perfusion scan demonstrated a right‐to‐left shunt. Although her symptoms and laboratory data supported a diagnosis of HPS, she nevertheless showed spontaneous resolution within 2 years. When she was 14 years old, pulmonary hypertension was evident upon examination of her echocardiogram. HPS may be improved or masked by an accidental overlap with pulmonary hypertension in the terminal stage of liver disease.
Pulmonary surfactant proteins and lipids as modulators of inflammation and innate immunity
Authors: CHIBA Hirofumi , PIBOONPOCANUN Surapon , MITSUZAWA Hiroaki , KURONUMA Koji , MURPHY Robert C. , VOELKER Dennis R.
Published: January 2006

Objectives:  The pulmonary surfactant system of the human lung consists of unique lipids and proteins that contribute to the biophysical and innate immune properties of the organ. Surfactant protein A (SP‐A) is an oligomeric protein consisting of 18 protomers with collagen and lectin–like domains that recognizes glycoconjugates, lipids and protein determinants on both host cells and invading microorganisms. The authors examined the interaction of SP‐A with Mycoplasma pneumoniae and the influence of the protein upon the innate immune response to the bacteria.

Methodology:  The authors quantified SP‐A interaction with bacteria using ELISA, and identified the major surface ligand by thin layer chromatography, HPLC and mass spectrometry. The inflammatory response of human and rat macrophages was measured by quantifying tumour necrosis factor‐α secretion using ELISA, and nitric oxide production.

Results:  SP‐A bound the bacteria with high affinity and enhanced the inflammatory response of human and rat macrophages to the organism and its membranes. Analysis of the interaction of SP‐A with the bacteria revealed that the major ligand was a phospholipid. The lipid ligand was purified by a combination of thin layer and HPLC, and identified by mass spectrometry. The mass spectrometry demonstrated that the SP‐A reactive lipid consisted of several disaturated molecular species of phosphatidylglycerol (PtdGro). Additional experiments were performed to determine if disaturated PtdGro was capable of interfering with the action of SP‐A as an inhibitor of bacterial lipopolysaccharide‐induced inflammatory mediator production by macrophages. The disaturated PtdGro failed to alter the anti‐inflammatory action of SP‐A but unexpectedly these same studies revealed that unsaturated PtdGro can modify the host response to lipopolysaccharide.

Conclusions:  These findings reveal that both the lipids and proteins of pulmonary surfactant play a role in regulating the host response to invading microorganisms.
New concepts in collectin‐mediated host defense at the air–liquid interface of the lung
Authors: McCORMACK Francis X.
Published: January 2006

Objectives:  Surfactant proteins A (SP‐A) and D are collectins that play key roles in innate immune defense of the lung. Recent studies suggest that these proteins have a direct effect on the growth and viability of Gram‐negative bacteria, Mycoplasma pneumoniae and Histoplasma capsulatum.

Methodology:  The researchers examined membrane permeabilization by BAL fluid of mice that were sufficient or deficient in surfactant proteins, of rough and smooth LPS‐containing membranes, and of genetically altered bacteria. The permeability assay is based on the ability of agents to promote access of impermeable dyes propidium iodide and ELF97 to intracellular targets.

Results:  The permeabilizing activity of concentrated BAL material from SP‐A+/+ mice was substantially greater than that from SP‐A–/– animals, and was sensitive to hyperoxic exposure. Oxidation of the collectins in vitro also blocked their antimicrobial effects. Rough but not smooth LPS conferred susceptibility of model bacterial membranes to permeabilization by the collectins. The screening of genetically engineered SP‐A mice with a Pseudomonas aeruginosa signature tagged mutagenesis library has revealed several pathways which are required for resistance to the permeabilizing effects of SP‐A, including those required for salicylate biosynthesis and flagellar function.

Conclusion:  The researchers conclude that the pulmonary collectins directly permeabilize bacteria in an LPS‐dependent and rough LPS‐specific manner. Oxidative damage blocks the permeabilizing activity of alveolar lining fluid and purified proteins. The mechanism(s) of permeabilization is not known, but the crystal structure of SP‐A reveals a hydrophobic cleft lined by charged residues which may play a role in membrane perturbation.
Biology of alveolar type II cells
Authors: MASON Robert J.
Published: January 2006

Abstract:  The purpose of this review is to highlight the many metabolic properties of alveolar type II cells, their production of surfactant, their role in innate immunity, and their importance in the repair process after lung injury. The review is based on the medical literature and results from our laboratory. Type II cells produce and secrete pulmonary surfactant and for that purpose they need to synthesize the lipids of surfactant. One of the regulators of lipogenesis is the transcription factor sterol regulatory element binding protein‐1c (SREBP‐1c). This is a key transcription factor regulating fatty acid synthesis. Type II cells also proliferate to restore the epithelium after lung injury, clear alveolar fluid by transporting sodium from the apical to the basolateral surface, and participate in the innate immune response to inhaled materials and organisms. The type II cell is, in many ways, the defender of the alveolus. However, the type II cells work in concert with the other cells in the gas exchange regions of the lung to keep the alveoli open and reduce inflammation due to irritants in the air we breathe.