bluuebunny/crossref_metadata_2025 huggingface dataset:
Large cell carcinoma of the lung with a rhabdoid phenotype
Authors: Kaneko Tsukasa , Honda Takayuki , Fukushima Mana , Haniuda Masayuki , Komatsu Hikotaro , Kodama Tetsuro
Published: March 2003

A variant of large cell carcinoma showing a rhabdoid phenotype, which is rare among primary lung cancers, is presented. A 59‐year‐old man was admitted to hospital for an operation. Computed tomography scans showed a mass with a smooth border, invading the thoracic wall. A right upper lobe lobectomy was carried out with resection of a part of the thoracic wall. Pathological examination showed that the tumor was mostly composed of cells with prominent eosinophilic cytoplasmic globules and giant cells, which did not adhere to each other. Cytologically, the tumor cells contained nuclei with a reticular chromatin pattern and one to two prominent nucleoli, and hyaline‐like and reticular inclusion bodies, which were immunohistochemically positive for vimentin, but not for α‐smooth muscle actin, myoglobin or pan‐actin. Radiological and laboratory examinations did not detect the presence of the tumor in other organs, indicating that the primary lesion was not situated elsewhere. Metastasis to the right adrenal gland was observed 1 year and 4 months after the operation; however, the patient has been free of the disease 3 years and 11 months after the second operation of an adrenalectomy. This case showed a relatively good prognosis, which is rare among rhabdoid tumors of various organs that generally have poor prognoses with rapid, fatal progression.
Clinicopathological features of gastric B‐cell lymphoma: A series of 317 cases
Authors: Hatano Ben , Ohshima Koichi , Tsuchiya Takeshi , Yamaguchi Takahiro , Kawasaki Chika , Kikuchi Masahiro
Published: March 2003

The stomach is a common site of extranodal malignant lymphoma. Here we examined the clinicopathological features of 317 gastric B‐cell lymphomas and characterized the differences among low‐grade mucosa‐associated lymphoid tissue (MALT) lymphomas (LG), high‐grade MALT lymphomas (HG), follicular lymphomas (FL) and diffuse large B‐cell lymphomas (DL). Cases included 126 DL, 71 HG, 98 LG, 10 FL, three Burkitt"s lymphoma and nine of undefined type. The age range of patients was as follows: LG, 14–96 years (mean, 61.1); HG, 20–87 years (mean, 63.9); DL, 16–88 years (mean, 62.8); and FL, 54–76 years (mean, 65.5). There were no differences in age with respect to tumor type. There were more women patients with LG (female : male, 55:43), while males predominated among DL patients (54:72). The sexes were represented almost equally in HG cases (34:37). Histological findings, especially in DL tumors, correlated significantly to the gross appearance of mass formation. Dutcher bodies were encountered mainly in HG or LG cases. Our results showed no differences in age, sex or site of disease between LG, HG and DL tumors. However, the grade of malignancy correlated strongly to gross appearance. Dutcher bodies were important for the diagnosis of gastric MALT lymphoma.
Carcinosarcoma of the esophagus characterized by myoepithelial and ductal differentiations
Authors: Ohtaka Masahiko , Kumasaka Toshio , Nobukawa Bunsei , Hirai Shu , Suda Koichi , Ohno Yasuhiko , Iwazaki Ryozo , Ikegami Yasushi , Fukasawa Masaki
Published: March 2003

We report a case of carcinosarcoma of the esophagus characterized by ductal and myoepithelial differentiation. A 61‐year‐old man was operated on for a polypoid tumor of the distal esophagus. Histologically, this tumor was composed of ductal structures and sarcomatous spindle cells surrounding the ducts at the central area of the tumor. The tumor was also composed of squamous cell and basaloid carcinoma in the periphery. Immunohistochemically, a few spindle cells surrounding the ductal structures showed immunopositivity for α‐smooth muscle actin and S‐100 protein. Electron microscopy revealed that the spindle cells had tonofilament and pinocytic vesicles in the cytoplasm, and basal lamina adjacent to the cytoplasmic membrane. Both of the results strongly supported the suggestion that the spindle cells may be myoepithelial cells. Basaloid carcinoma showed a gradual transition to chondrosarcomatous cells producing the matrix, which had both immunopositivities for S‐100 protein and cytokeratin. Therefore, chondrosarcomatous cells may be derived from carcinoma cells. The histogenesis of this tumor may be associated with a totipotential stem cell of esophageal mucosa, which has the potential to differentiate into squamous cells, ductal cells or myoepithelial cells.
Profile of methylated CpG sites of hMLH1 promoter in primary gastric carcinoma with microsatellite instability
Authors: Kang Gyeong Hoon , Lee Sun , Shim Yhong Hee , Kim Jin Cheon , Ro Jae Y.
Published: March 2003

A recent study using colorectal cancer cell lines has identified methylation on a small region of hMLH1 promoter (−248 to −178 relative to the transcription start site) to be critical for gene silencing, but shown that methylation on a more upstream region is frequent in cell lines with hMLH1 expression. Because cultured cell lines have a higher degree of CpG methylation than primary tumors, we attempted to examine methylation profiles of CpG sites of hMLH1 promoter in primary gastric carcinomas with or without microsatellite instability (MSI). Seven cases with MSI and six cases without MSI were assessed for the methylation status of hMLH1 promoter by bisulfite‐sequencing. All of the MSI‐positive cases previously showed loss of hMLH1 expression and six cases displayed methylated alleles in methylation‐specific PCR (MSP) for hMLH1. Sequencing analysis revealed that: (i) CpG sites were overall methylated in MSI‐positive tumors with positive MSP results; (ii) a small region (−248–178) was almost invariably methylated in MSI‐positive tumors; and (iii) the vast majority of CpG sites were unmethylated in MSI‐negative tumors, including a more upstream region (proximal to −248). Our study suggests that methylation of a more upstream region observed in colon cancer cell lines may be an acquired change during cell line establishment and it was not identified in primary gastric carcinomas without MSI.
Colliding primary lung cancers of adenosquamous carcinoma and large cell neuroendocrine carcinoma
Authors: Yazawa Takuya , Ishii Haruhiko , Ito Takaaki , Yoshiike Yasuhiro , Ogawa Nobuo , Okudela Koji , Hayashi Hiroyuki , Suzuki Takehisa , Mitsui Hideaki , Ikeda Masaichi , Kitamura Hitoshi
Published: March 2003

We report an extremely rare case of primary lung cancer showing various histological elements diagnosed as the collision of an adenosquamous carcinoma and a large cell neuroendocrine carcinoma by loss of heterozygosity (LOH) analysis of the human androgen receptor (AR) and phosphoglycerate kinase (PGK‐1) genes. The tumor exhibited a tiny ground‐glass opaque shadow suggesting atypical adenomatous hyperplasia 18 months prior to surgery. However, the tumor grew rapidly, and the resected tumor consisted of two closely located nodules. The larger nodule was composed of well‐differentiated adenocarcinomatous and moderately to poorly differentiated squamous cell carcinomatous elements, while the smaller nodule consisted of a large cell neuroendocrine carcinomatous element with partial squamoid differentiation having focal continuity with the adenocarcinomatous element. Both the adenocarcinomatous and squamous cell carcinomatous elements revealed transitional features and LOH of AR and PGK‐1 genes, while the large cell neuroendocrine carcinomatous element showed a monoclonal pattern but possessed both alleles of AR and PGK‐1 genes. From these clinical and pathological results, the parental cell of the large cell neuroendocrine carcinomatous element was considered to be different from that of the adenosquamous carcinomatous element.
Combined hepatocellular and cholangiocarcinoma with marked squamous cell carcinoma components arising in non‐cirrhotic liver
Authors: Tsuneyama Koichi , Kaizaki Yasuharu , Doden Kenji , Kidani Eiichi , Harada Kenichi , Sasaki Motoko , Nakanuma Yasuni
Published: March 2003

We report a surgical case of liver tumor, 40 × 35 mm in size, with squamous cell carcinoma (SCC) and hepatocellular carcinoma (HCC) components in a 60‐year‐old Japanese man with steatohepatitis. Most of the SCC component showed typical intercellular bridge and keratinization, while most of the HCC components showed a thick trabecular pattern with mild to moderate nuclear atypia. Both components transit each other without undifferentiated foci; however, a small foci showing glandular structure was intermediated. No cyst formation was found in the liver. The primary site of the squamous cell carcinoma was not detected in general clinical and radiological examination. Immunohistochemical analysis revealed that part of the HCC components neighboring the SCC showed patchy and weak expression of cytokeratin 7. There are several possibilities for the origin of squamous cell carcinoma in this case: marked squamous metaplastic change of cholangiocarcinoma and/or HCC, and carcinoma originating from pleuripotential stem cells. Irregular fatty changes, scattered giant mitochondria and acellular fibrosis with bridging were seen in the liver; however, this patient had no episode of hepatitis‐associated viral infection. This is an interesting case of combined hepatocellular and cholangiocarcinoma with marked SCC components arising in a non‐cirrhotic fibrotic liver.
Degradation of the toxic cyanobacterium Microcystis viridis using predaceous micro‐animals combined with bacteria
Authors: Inamori Yuhei , Sugiura Norio , Iwami Norio , Matsumura Masatoshi , Hiroki Mikiya , Watanabe Makoto M.
Published: March 2003

Toxic microcystins from cyanobacteria belonging to the genus Microcystis have been responsible for the death of various animals. In batch culture experiments, pre‐dation and degradation characteristics of Microcystis viridis and its toxic metabolite, microcystin‐RR, were examined using the micro‐animals, Aeolosoma hempri‐chi and Philodina erythrophthalma combined with endemic aggregated bacteria isolated from a biofilm. Although M. viridis was favorably predated and decomposed by the two micro‐animals, the reduction of microcystin‐RR was relatively low compared to the culture with the animals in the presence of the mixed bacteria, where degradation of the toxin was enhanced under aerated conditions. The aerated bacteria could degrade the eluted toxin faster than in any other condition and an initial toxin concentration of above 40 μg L‐1 was completely degraded in 10 days. Furthermore, in a continuous bioreactor packed with biofilm carrier, a toxin level of 9.74 μg g‐1 in the inflow water was reduced by 94.0% at a hydraulic retention time of less than 12 h. Moreover, in a practical biofilm plant, a toxin concentration of 34.9 μg g‐1 was degraded at a short hydraulic retention time (HRT) of 2 h. The efficiency of toxin removal in the plant at the short HRT coincided with that of laboratory studies. It was considered that A. hemprichi and P. erythrophthalma contributed to the predation and decomposition of viable M. viridis cells, subsequently these released toxin which could be efficiently degraded by the aerated bacteria.
Ultrastructure of Stylodinium Iittorale (Dinophyceae) with special reference to the stalk and apical stalk complex
Authors: Horiguchi Takeo , Yoshizawa‐Ebata Junko
Published: March 2003

The ultrastructure of Stylodinium littorale Horiguchi et Chihara, a marine, sand‐dwelling coccoid dinoflagel‐late, was investigated with special emphasis on its stalk and the apical stalk complex. The dinoflagellate alternates between non‐motile and motile cells in its life cycle. The non‐motile cell possesses a long and distinct stalk. The stalk, consisting of a main cylindrical part and a holdfast, is firmly attached to a thecal plate (the apical pore plate). A part of its proximal portion is hollow and V‐shaped in section. The V‐shaped hollow space is underlain by a projection from the apical pore plate. An apical stalk complex is present in the motile cells and consists of a large apical pore plate and mucilaginous material. The apical pore plate is depressed into the cell, but has a narrow central tubular projection. The mucilaginous stalk‐building material is stored between this plate and the outer plate membrane. The tubular projection of the apical pore plate corresponds to the apical pore of other dinoflagellates and its lumen is filled with electron‐dense material. The structure of the apical stalk complex is compared with the homologous structure in Bysmatrum arenicola, the only other example of an apical stalk complex that has been investigated. A general ultrastructural survey revealed that S. littorale possesses a typical dinoflagellate cellular structure.
Growth rate of the carrageenophyte Kappaphycus alvarezii (Rhodophyta, Gigartinales) in vitro
Authors: José de Paula Edison , Erbert Cintia , Lima Pereira Ricardo Toledo
Published: March 2003

Unialgal cultures were established trom a 2.5 g branch ot a brown variant ot Kappaphycus alvarezii (Doty) Doty ex P. Silva, with the main objective to produce branches for monthly outplanting in the sea. Ditterent conditions were tested to optimize production ot branches in the laboratory. The best growth was obtained under culture conditions of 25 ± 2°C, 170–210 μmol photons m2 s−1, 14:10 LD photoperiod and salinity 32–35‰. Three culture media (Provasoli,‘F/2’and von Stosch) were tested. Deleterious ettects were observed in branches incubated continuously in full‐ or halt‐strength Provasoli's enriched seawater medium (PES). Exponential growth rates ot about 3% day−1 were obtained using PES, pulse‐fed 24 h per week, or other diluted media used continuously (one‐quarter strength ‘F/2’and half‐strength von Stosch). Laboratory‐grown branches with mean weights from 2.97 to 4.25 g were successfully introduced into the sea at Ubatuba, SP, Brazil (23°26.9′S, 45°0.3′W) an area with mean monthly seawater temperature from 20.3 to 28.5°C (extremes: 17.0–31.0°C). Transplantation of branches produced in unialgal culture, as done in the present study, avoids the risk of introduction of unwanted species into new areas.
Thoracoscopic procedures for intrathoracic and pulmonary diseases
Authors: Sung Sook Whan , Kim Joon Seok
Published: March 2003

Since Jacobaeus performed the first thoracoscopy to explore pleural space and mechanically broke pleural adhesions to facilitate the collapse therapy for pulmonary tuberculosis in 1910, numerous thoracic surgeons have been attempting this technique as a means of accomplishing many intrathoracic procedures previously done through open thoracotomy. As the refinement of video technology has advanced, thoracoscopic surgery has played a very important role in thoracic surgery especially since the early 1990s. Because the advantages of video‐assisted thoracoscopic surgery for patients include low post‐thoracotomy‐related morbidity, cosmetic considerations, low pain, earlier post‐operative mobilization, and a shorter operation time in some indications, surgeons have been demonstrating its increasing utility in the diagnosis and treatment of the pleura, lung, mediastinum, great vessels, pericardium, and oesophagus. The most common application of the thoracoscopic approach still remains in the management of pleuropulmonary disease. The indications for the thoracoscopic technique are very broad, but its role in the management of primary lung and oesophageal cancer has yet to be confirmed. Thus, the surgeon who uses the technique in these cancerous diseases should be prudent. In conclusion, these thoracoscopic procedures will play more important roles in the practice of thoracic surgery in the future.
A case of group II non‐specific interstitial pneumonia developed during corticosteroid therapy after acute respiratory distress syndrome
Authors: Ishioka Shinichi , Nishisaka Takashi , Maeda Akihiro , Hiyama Keiko , Yamakido Michio
Published: March 2003

Non‐specific interstitial pneumonia/fibrosis (NSIP) is a relatively new entity among idiopathic interstitial pneumonias. This disease is pathologically characterized by varying proportions of interstitial inflammation and fibrosis that appear to occur over a single, short period of time, and is clinically characterized by a generally good prognosis. Although corticosteroid therapy is widely considered to be effective for treatment of this disease, we report a case of Group II NSIP which developed during treatment with corticosteroid 4 months after acute respiratory distress syndrome (ARDS). This case suggests that any group of NSIP may be developed after ARDS, and that low‐dose corticosteroid treatment is not sufficient to prevent the development of NSIP.
Inspiratory muscle performance in endurance athletes and sedentary subjects
Authors: Eastwood Peter R. , Hillman David R. , Finucane Kevin E.
Published: March 2003

Objective: The aim of this study was to determine whether whole‐body endurance training is associated with increased respiratory muscle strength and endurance.

Methodology: Respiratory muscle strength (maximum inspiratory pressure (PImax)) and endurance (progressive threshold loading of the inspiratory muscles) were measured in six marathon runners and six sedentary subjects.

Results: PImax was similar between the two groups of subjects but the maximum threshold pressure achieved was greater in marathon runners (90 ± 8 vs 78 ± 10% of PImax, respectively, mean ± SD, P < 0.05). During progressive threshold loading, marathon runners breathed with lower frequency, higher tidal volume, and longer inspiratory and expiratory time. At maximum threshold pressure, marathon runners had lower arterial O2 saturation, but perceived effort (Borg scale) was maximal in both groups. Efficiency of the respiratory muscles was similar in both groups being 2.0 ± 1.7% and 2.3 ± 1.8% for marathon runners and sedentary subjects, respectively.

Conclusions: The apparent increase in respiratory muscle endurance of athletes was a consequence of a difference in the breathing pattern adopted during loaded breathing rather than respiratory muscle strength or efficiency. This implies that sensory rather than respiratory muscle conditioning may be an important mechanism by which whole‐body endurance is increased.
Predictive values for cardiopulmonary exercise testing in sedentary Chinese adults
Authors: ONG Kian Chung , LOO Chian Min , ONG Yong Yau , CHAN Siew Pang , EARNEST Arul , SAW Seang Mei
Published: March 2003

Objective:Normative data for cardiopulmonary exercise testing (CPET) may vary among subjects of different races. The objectives of the present study were to: (i) establish normal standards for cardiopulmonary responses during incremental cycle ergometer testing in order to derive predictive equations for clinically useful variables during CPET of Chinese subjects; and (ii) determine the validity of existing prediction equations of maximal exercise performance for use in our local Chinese population.

Methodology:The maximal and submaximal cardiopulmonary responses were analysed for 95 healthy sedentary adult Chinese subjects (48 men and 47 women; aged 20–70 years) who underwent CPET using a cycle ergometer and an incremental work‐rate protocol until symptom limitation.

Results:Measurements, at maximal exercise, of oxygen uptake (V̇O2max), power output and heart rate were regressed on age, height, weight and gender. The predictive equations for these exercise parameters performed better than those published previously in out‐sample predictive accuracy. Comparison with previous studies also showed that prediction equations of V̇O2maxderived from studies based predominantly or exclusively on Caucasian populations overestimated the actual values for our subjects.

Conclusions:Previously established prediction equations for maximal exercise performance during CPET based on non‐Chinese populations may not be applicable to Chinese subjects in our population.
Resolution of native lung pneumothorax by insertion of a nitinol stent for bronchostenosis in the transplanted lung
Authors: CHHAJED PRASHANT N. , MALOUF MONIQUE A. , TAMM MICHAEL , HOPKINS PETER M. , PLIT MARSHALL , GLANVILLE ALLAN R.
Published: March 2003

Following single lung transplantation, the native lung remains a potential source of morbidity from spontaneous pneumothorax, hyperinflation, bacterial and fungal infection and malignancy. The case of a single lung transplant recipient for idiopathic pulmonary fibrosis who developed a recurrent, non‐resolving, spontaneous multiloculated pneumothorax in the native lung following thoracoscopic talc pleurodesis is reported. The pneumothorax ultimately resolved following insertion of a nitinol stent for coexisting bronchostenosis in the transplanted lung. In a single lung transplantation recipient in whom a native lung pneumothorax reoccurs or persists despite appropriate initial management, it may be useful to undertake bronchoscopy to exclude the possibility of bronchostenosis in the transplanted lung.
Metastatic lung cancer in pregnancy
Authors: WONG Catherine Mee‐Ming , LIM Kim Hatt , LIAM Chong‐Kin
Published: March 2003

Abstract:  Pregnancy complicated by lung cancer has been rarely reported. The regional incidence of this complex situation is likely to increase in the future and optimal management needs to be established to better deal with this situation. We report two patients with metastatic lung cancer complicating pregnancy to highlight the evaluation and management difficulties associated with this problem and to contribute to the limited information in the literature.
Taxonomy, anatomy and evolution of physical dormancy in seeds
Authors: Baskin Jerry M. , Baskin Carol C. , Li Xiaojie
Published: March 2003

Physical dormancy (PY) is caused by a water‐impermeable seed or fruit coat. It is known, or highly suspected, to occur in nine orders and 15 families of angiosperms (sensuAngiosperm Phylogeny Group 1998), 13 of which are core eudicots. The Zingiberales is the only monocot order, and Cannaceae (Canna) the only monocot family, in which PY is known to occur. Six of the nine orders, and 12 of the 15 families, in which PY occurs are rosids. Furthermore, six of the families belong to the Malvales. The water‐impermeable palisade layer(s) of cells are located in the seed coats of 13 of the families, and in the fruit coats of Anacardiaceae and Nelumbonaceae. In all 15 families, a specialized structure is associated with the water‐impermeable layer(s). The breaking of PY involves disruption or dislodgment of these structures, which act as environmental ‘signal detectors’ for germination. Representatives of the nine angiosperm orders in which PY occurs had evolved by the late Cretaceous or early Tertiary (Paleogene). Anatomical evidence for PY in fruits of the extinct speciesRhus rooseae(Anacardiaceae, middle Eocene) suggests that PY had evolved by 43Ma, and probably much earlier. We have constructed a conceptual model for the evolution of PY, and of PY+ physiological dormancy (PD), within Anacardiaceae. The model begins in pre‐Eocene times with an ancestral species that has large, pachychalazal, non‐dormant (ND), recalcitrant seeds. By the middle Eocene, a derived species with relatively small, partial pachychalazal, orthodox seeds and a water‐impermeable endocarp (thus PY) had evolved, and by the Oligocene, PD had been added to the seed (true seed + endocarp) dormancy mechanism. It is suggested that climatic drying (Eocene), followed by climatic cooling (Eocene–Oligocene transition), were the primary selective agents in the development of PY. An evolutionary connection between PY and recalcitrance is suggested by the relatively high concentration of these two character states in the rosids. Phylogenetic data and fossil evidence seem to support the PY→(PY+PD) evolutionary sequence in Anacardiaceae, which also may have occured in Leguminosae.
Effects of light quantity and quality on growth and reproduction of a clonal sedge,Cyperus esculentus
Authors: Li Bo , Shibuya Tomoko , Yogo Yasuhiro , Hara Toshihiko , Matsuo Kazuhito
Published: March 2003

Canopy shade reduces light quantity and quality, and hence affects plant growth and development. In order to investigate the respective effects of varying light quantity and quality on a clonal plantCyperus esculentus, a controlled‐environment study was conducted in growth chambers, in which four light environments were created using either green filters or neutral shade cloth. The experiment was harvested five times at approximately 2‐week intervals after transplanting. Results revealed that numbers of ramets and tubers, total leaf area, and the branching index of rhizomes were affected only by light quantity, while leaf and sheath lengths, leaf area ratio, leaf blade weight fraction, sheath weight fraction, stalk weight fraction, internode length of rhizomes, number of rhizomes, node number of rhizomes, total dry weight, percentage of flowering ramets, and flower weight fraction were affected by both light quality and quantity. Light quantity or quality had little influence on rhizome length, biomass allocation to rhizomes and tubers, and the ratio of tuber number to rhizome number. It is concluded that light quality and quantity had significant effects on growth, sexual reproduction (i.e. the percentage of flowering ramets and sexual reproductive allocation) and associated traits, but did not affect relative vegetative reproduction or storage (i.e. the tuber weight fractions and the fraction of rhizomes differentiated into tubers) inC. esculentus. Therefore, light quantity and quality have differential effects on the growth and morphology ofC. esculentus.
Distribution and variation of sexual and agamospermous populations of Stevia (Asteraceae: Eupatorieae) in the lower latitudes, Mexico
Authors: Soejima Akiko , Yahara Tetsukazu , Watanabe Kuniaki
Published: March 2003

Cytogeographical studies have revealed the distribution of sexual diploids and agamospermous polyploids of Stevia ovata and four related species: Stevia nepetifolia, Stevia oligophylla, Stevia origanoides and Stevia triflora in Mexico. These species are distributed mainly in the temperate and subhumid montane region. Agamospermous triploids are the forms most abundantly and widely distributed geographically in each of the five species. Diploids occur in low frequencies except in S. origanoides. For the five species, diploids are restricted mainly to the temperate montane ranges of the south‐western Pacific side of Mexico, but they also occur sporadically in the relatively isolated areas from Oaxaca to Durango, Mexico D. F. and Nuevo Leon. Although the distribution of the temperate forests must have moved southward and northward following climatic fluctuations, even in the lower latitudes of Mexico, the largely stable temperate vegetation could have been maintained along the Y‐shaped montane ranges (Sierra Madre del Oriental, Sierra Madre del Occidental, Sierra Madre del Sur and the Trans‐Mexico Volcanic Belt) and have provided some refuge areas. The present distribution ranges of sexual diploids of some species of Stevia in Mexico indicate that diploids were not restricted to a single refuge during the last ice age.
Comparison of the fatty acid composition of total lipids and phospholipids in breast milk from Japanese women
Authors: Wang Liwen , Shimizu Yukiko , Kaneko Sono , Hanaka Satoko , Abe Toshiaki , Shimasaki Hiroyuki , Hisaki Harumi , Nakajima Hiroshi
Published: March 2003

Abstract Fatty acid (FA) composition of total lipids (TL) and phospholipids (PL) in breast milk obtained from 20 normal delivery healthy women in Tokyo, Japan was analyzed. Total lipids were extracted from the samples and then PL, consisting of phosphatidylcholine (PC), phosphatidylethanolamine (PE), phosphatidylserine (PS), sphingomyelin (Sph) and phosphatidylinositol (PI), were separated by two‐dimensional thin‐layer chromatography. The FA composition of TL and PL was analyzed by gas liquid‐chromatography. Compared with previous reports, the contents of eicosapentaenoic acid (EPA; 20:5n‐3) and docosahexaenoic acid (DHA; 22:6n‐3) in TL from Japanese women were higher than those from Chinese and Canadian women, which may be caused by different dietary habits and food types consumed by those populations. The contents of arachidonic acid (AA; 20:4n‐6), EPA and DHA in PE and PI were much higher than those in PC. In addition, no significant correlation of EPA or DHA content was found between TL and PL. The findings indicate that PL especially PE and PI in human milk may be a source of EPA and DHA for infants in the rapid developmental stage. These results should be considered in infant formula production.
Psychological characteristics and biofeedback mitigation in preadolescents with eating disorders
Authors: Pop‐Jordanova Nada
Published: March 2003

Abstract Background: Anorexia and bulimia nervosa are considered to be the most serious eating disorders in female adolescents, with a multifactorial etiology and severe medical complications. It is interesting to investigate the specific relationships of these diseases to emotional stress, coping mechanisms and biofeedback mitigation.

Methods
: The study comprised 76 obese and 27 anorectic girls, as well as 35 healthy girls as a control group. Psychological assessment was performed using the Eysenck Personality Questionnaire, Emotional Profile Index, General Anxiety Scale, Minnesota Multiphasic Personality Inventory and Cornell Medical Index. The therapy was multimodal, including a biofeedback relaxation system based on electrodermal response (EDR).

Results
: Scores obtained from psychometric instruments, in particular concerning basic anxiety, intrafamily conflicts, self‐defense and depression, showed that anorexia nervosa and hyperphagia are specifically stress related. Personality characteristics and the environment, as models for habits, modified the manner of coping with stress differently for anorexia and hyperphagia. The EDR biofeedback was shown to be an effective support for mitigation of eating disorders in preadolescents, with better results for anorectic girls. The correlated difference in personality profiles suggested the use of specific animated sequences.

Conclusions
: The results confirmed the hypothesis that obesity and anorexia nervosa could be related to different types of emotional stress and coping mechanisms, and accordingly be differently mediated by biofeedback technique.
Influence of emission from rice straw burning on bronchial asthma in children
Authors: Torigoe, Katsumi , Hasegawa, Satoshi , Numata, Osamu , Yazaki, Satoshi , Matsunaga, Masamichi , Boku, Naoki , Hiura Makoto , Ino Haruyoshi
Published: March 2003

Abstract

Background
: Emission from rice straw burning (ERSB) is observed everywhere after harvest of rice in Niigata Prefecture every year. Pediatricians and many guardians in this district have had the impression that ERSB may induce asthma attack. Recent studies have suggested that particulate air pollution plays a role in the exacerbation of asthma. The authors investigated relationship of ERSB to asthma attack in children.

Methods
: A questionnaire on rice straw burning (RSB) was circulated to guardians and pediatric institutions. Change in the monthly number of children with asthma attack (CAA) for 5 years from January 1994 to December 1998 was investigated. In addition, change in the number of CAA from the meteorologic conditions and RSB was investigated from the fourth week of August to the third week of September in 1996, 1997 and 1998. Challenge test exposure to ERSB was tried on a volunteer adult with chronic asthma. The situation of air pollution was examined by measuring suspended particulate matter (PM10). The relationship between PM10 and the number of CAA was studied.

Results
: A majority of the guardians had the impression that ERSB induces asthma attack. Pediatricians replied similarly to the questionnaire. The number of CAA visiting our emergency room and admitted to our ward increased in the season of RSB. The PM10 had a significant correlation with the number of CAA. It was suggested that the increase in CAA may be not due to the meteorologic conditions, but to the influence of ERSB.

Conclusion
: The ERSB has made an issue of air pollution. Furthermore, the possibility that ERSB induces or exacerbates asthma attack has become clear in the present study. Therefore, it is recommended that RSB should be abolished for the health of inhabitants, especially children with asthma.
Assessment of disease activity and extent by magnetic resonance imaging in ulcerative colitis
Authors: Nozue Tomio , Kobayashi Akio , Takagi Yasuo , Okabe Hitoshi
Published: March 2003

Abstract Background: We determined whether magnetic resonance imaging (MRI) could determine the activity and site of involvement in ulcerative colitis.

Methods
: Colonoscopy, double‐contrast barium enema and gadodiamide‐enhanced MRI were performed prospectively in six patients with ulcerative colitis, including three females aged 10–22 years, both in the active and the remission stages.

Results
: Characteristic findings of MRI in the active stage of ulcerative colitis were loss of haustral markings and thickening and contrast enhancement of the colonic wall. In five of six patients, the site of disease distribution determined by MRI was in accordance with that determined by colonoscopy.

Conclusions
: Gadodiamide‐enhanced MRI is a safe and useful method of determining disease activity and extent in patients with ulcerative colitis.
Overview of rotavirus infections in Korea
Authors: Seo Jeong Kee , Sim Jay G
Published: March 2003

Abstract Rotavirus is the most common cause of acute watery diarrhea in young Korean children. Rotavirus vaccine will soon be available, and information is urgently required about the serotype distribution of recent epidemics and clinical characteristics of rotavirus infection in Korean children before the implementation of a vaccination program against rotavirus. We reviewed published studies of the past 20 years, carried out on Korean children with rotavirus gastroenteritis. Rotavirus was estimated to be responsible for 46% of 4668 hospitalized Korean children with acute gastroenteritis. Rotavirus gastroenteritis was most prevalent among children aged 6–24 months, which accounted for 84% of all cases. Asymptomatic rotavirus infection was common. Rotavirus was one of the most commonly identified enteric pathogens in nosocomial diarrhea. Vomiting, respiratory symptoms and fever were prominent symptoms in rotavirus gastroenteritis. Transient elevation of liver enzymes, pulmonic infiltration and rarely afebrile convulsion were also observed. The epidemic peak, which occurred in November of the last 15 years, has been moving toward late winter and early spring in recent years. No apparent cause has been found to explain this alteration of peak seasonality. All serotyping studies in Korea for the past 10 years until 1997 revealed that G1 was most prevalent (45–81%). Interestingly, the predominant G serotype of the recent outbreaks in 1998 and 1999 was not G1 but G4. Approximately 95% of rotavirus isolates in recent outbreaks belonged to serotype G1, 2, 3 or 4.
Mutation analysis of phenylketonuria in Yamagata prefecture, Japan
Authors: Kimura Toshiyuki , Ikeda Hiroyuki , Akaba Kazuhiro , Guldberg Per , Güttler Flemming , Maki Kazuko , Aikawa Shogo , Hayasaka Kiyoshi
Published: March 2003

Background
: We have screened 309 914 newborns in Yamagata prefecture, Japan, since 1977 and have detected four patients with phenylketonuria (PKU). We analyzed the phenylalanine hydroxylase (PAH) gene of the four patients to study the genetic background in this area and the genotype–phenotype relationship in these patients.

Methods
: Mutations of the PAH gene were screened by denaturing gradient gel electrophoresis analysis and the sequences were determined.

Results
: Three cases were compound heterozygotes of six different mutations of the PAH gene and the remaining case was a homozygote. Of the six detected mutations, K115fs is novel, whereas the others have been previously detected among Chinese and/or Japanese patients.

Conclusions
: The incidence and genetic basis in Yamagata prefecture was similar to that of other parts of Japan. Analysis of the genotype is useful to understand the clinical variation in some families.
Retinopathy of prematurity: Mutations in the Norrie disease gene and the risk of progression to advanced stages
Authors: Haider Mohammad Z , Devarajan Lakshminaran V , Al‐Essa Mazen , Srivastva Braham S , Kumar Harsh , Azad Rajvardhan , Rashwan Nabil
Published: March 2003

Abstract

Background
: Retinopathy of prematurity (ROP) is a retinal vascular disease that occurs in infants with short gestational age and low birth weight and may lead to retinal detachment and blindness. Missense mutations in the Norrie disease (ND) gene have been associated with the risk of progression to advanced stages in cases of ROP from the US and also in clinically similar ND and familial exudative vitreoretinopathy.

Methods
: We have screened two ND gene mutations, namely A105T and Val60Glu, by polymerase chain reaction–restriction fragment length polymorphism (PCR‐RFLP) and allele‐specific PCR methods, respectively, in 210 Kuwaiti premature newborns to replicate these findings in a different ethnic group.

Results
: In the Kuwaiti premature newborn cohort, 115 of 210 babies had no eye problems and served as controls, while 95 were cases of ROP. In 71 of 95 ROP cases, the disease regressed spontaneously on or before stage 3, while in 24 of 95 ROP cases the disease progressed to advanced stages 4 and 5. In case of missense mutation (A105T), the AA genotype was detected in 96% of controls compared with 87% of ROP cases (NS); similarly no significant difference was found between spontaneously regressed ROP cases and those who progressed to advanced stages. For the Val60Glu mutation, no significant association was detected between the genotype and progression of ROP to advanced stages.

Conclusions
: Unlike data from the US, our findings from a Kuwaiti cohort of ROP cases and controls suggest a lack of association between the two ND gene mutations (A105T and Val60Glu) and ROP and the risk of progression of the disease to advanced stages.
Omega‐3 polyunsaturated fatty acid enriched diet attenuates stress‐induced lactacidemia in 10‐day‐old rats
Authors: Skalski Miroslow , Goto Masakatsu , Ravindranath Thyyar , Myers Thomas , Zeller W Patrick
Published: March 2003

Abstract

Background
: Lactacidemia is often seen under stress conditions including septic shock in the newborn. Under stress conditions, plasma catecholamine concentrations are increased and play an important role in lactate metabolism. Our previous study shows that perinatal feeding of omega‐3 polyunsaturated fatty acid enriched diet (ω‐3PUFA) attenuates lactacidemia of endotoxic shock in 10‐day‐old rats. In the omega‐6 fatty acids series, decosapentanoic acid, two series prostaglandins and four series leukotrienes are synthesized through linoleic acids. As plasma lactate concentration correlates with the outcome of septic shock in the newborn, it is important to understand the effects of ω‐3PUFA on lactate metabolism. Thus, we tested the hypothesis that perinatal feeding of omega‐3 polyunsaturated fatty acid enriched diet (ω‐3PUFA) alters responses to catecholamines and attenuates the stress‐induced lactacidemia in 10‐day‐old rats.

Methods
: Ten‐day‐old rats which perinatally fed ω‐3PUFA. Lactacidemia was induced by swimming for 5 min. Ten‐day‐old rats which perinatally fed ω‐6PUFA were controls. Omega‐6 fatty acids series are contained in animal fats and corn oil. Adrenergic blockers were used to assess roles of catecholamines in swimming‐induced lactacidemia.

Results
: Swimming increased plasma lactate concentration less (P<0.05) in rats fed ω‐3PUFA than rats fed ω‐6PUFA. Swimming increased plasma concentrations of glucose and glucagon, cyclic adenosine monophosphate (cAMP) concentration and phosphoenolypruvate carboxykinase mRNA in the liver, and cAMP concentration in the hindlimb muscle more (P<0.05) in rats fed ω‐3PUFA than in rats fed ω‐6PUFA. Phentolamine and propranolol enhanced swim‐induced lactacidemia in the ω‐3PUFA group, while they decreased the lactacidemia in the ω‐6PUFA group. Propranolol enhanced swimming‐induced hyperglycemia in the ω‐6PUFA group more than in the ω‐3PUFA group.

Conclusions
: ω‐3PUFA might increase β‐adrenergic response in the liver and increase gluconeogenesis in response to stress, resulting in decreased lactacidemia.
Serum zinc status in chronic hepatitis B and its relationship to liver histology and treatment results
Authors: Selimoğlu Mukadder Ayşe , Aydoğdu Sema , Ünal Fatih , Yüce Gül , Yağci Raşit Vural
Published: March 2003

Abstract

Background
: It is known that cytotoxic T lymphocytes are responsible for viral clearance in chronic hepatitis B (HBV) infection. Zinc deficiency affects development of acquired immunity by preventing certain functions of T lymphocytes. We investigated the serum zinc levels and the relationship to liver histopathology and response to interferon alpha (IFN‐α) and lamivudine combination therapy in 28 children with chronic HBV infection.

Methods
: A course of IFN‐α was injected as 5 million U/m2 subcutaneously, thrice a week for 6 months and lamivudine 4 mg/kg per day orally, for 1 year. Normalization of alanine aminotransferase (ALT), loss of HBV DNA, hepatitis B e antigen (HBeAg) seroconversion altogether was considered as end of therapy response (ETR).

Results
: The ETR was achieved in eight (30.7%) patients. Serum zinc concentrations of 20 healthy children and patients was not significantly different (P>0.05). While pretreatment serum ALT, zinc, histological activity index (HAI) and portal inflammation scores were statistically higher in children who had ETR (P<0.005, P<0.05, P<0.05 and P<0.05, respectively), pretreatment serum HBV DNA was lower (P<0.005). Serum zinc level was correlated with HAI and portal inflammation scores (P<0.01 and P<0.01).

Conclusion
: This study showed the relationship of serum zinc status to liver histopathology and to the ETR and may be a preliminary study leading new studies focusing on zinc status in patients with chronic HBV infection.
Dysrhythmia as a cause of syncope in children without neurological or cardiac morphological abnormalities
Authors: Kilic Ayhan , Ozer Sema , Turanli Guzide , Ayabakan Canan , Celiker Alpay , Ozme Sencan
Published: March 2003

Background
: Arrhythmias are among the malignant causes of syncope. This study has been undertaken to determine the relative incidence and significance of dysrhythmia in the pathogenesis of syncope among patients referred to a pediatric cardiology unit.

Methods
: Between March 1997 and March 1999, 105 consecutive patients (59 female, 46 male) aged 11.5 ± 3.6 years without neurologic or cardiac morphologic causes were evaluated for at least one episode of syncope. A pediatric cardiologist and a pediatric neurologist evaluated all the patients. Routine chest X‐ray, 12‐lead electrocardiogram (ECG), electroencephalography (EEG), 24‐h Holter monitoring and echocardio­graphy were carried out. When deemed necessary, further tests were undertaken for the cases of syncope which were unexplained by routine tests.

Results
: The cause of syncope was identified as vasovagal in 25.7% (n = 27) and related to dysrhythmia in 30.5% (n = 32). The cause was migraine‐associated syncope in two children, psychogenic syncope in three children and orthostatic hypotension in one patient. The cause was unknown in 36.2% (n = 38).

Conclusion
: We conclude that dysrhythmia is a significant and frequent cause in children referred to pediatric cardiology units. The combination of ECG, Holter monitoring, electrophysiologic study, transtelephonic ECG and head‐up tilt test can identify the underlying cause of syncope in as many as 58% of these patients that present with syncope.
Patients diagnosed with Kawasaki disease before the fifth day of illness have a higher risk of coronary artery aneurysm
Authors: Nomura Yuichi , Masuda Kiminori , Yoshinaga Masao , Sameshima Koji , Miyata Koichiro
Published: March 2003

Background
: A fever lasting for at least 5 days is an essential characteristic of the original diagnostic criteria ofKawasaki disease (KD). However, it is not difficult for an experienced physician to confirm the diagnosis of KD before the fifth day offever. The aim of this study is to investigate the effect of intravenous gamma globulin therapy (IVGG) in KD initiated before the fifth day of illness.

Methods
: A total of 125 patients treated with IVGG were divided into group A (IVGG was initiated before the fifth dayof illness, n= 46) and group B (IVGG was initiated at the fifth day or after, n= 79). Patients’ characteristics,laboratory findings, treatments and outcomes were compared between the groups.

Results
: White blood cell count value, C‐reactive protein and Harada's score showed no difference between thegroups. A significantly higher average value of alanine aminotransferase (ALT) was observed in group A. Although the treatments were identicalin both groups, the average duration of fever from the initial day of IVGG in group A was significantly longer than in group B. Theincidence of aneurysm in group A was significantly higher than that in group B. Stepwise regression analysis using aneurysm as a dependentvariable revealed that group A and ALT were significant.

Conclusions
: Patients diagnosed with KD before the fifth day of illness showed a poor response to IVGG. This observationmight be related to high ALT values. Further examination concerning the modification of treatment in such patients is necessary.
Parents associated with children in measuring acute and delayed nausea and vomiting*
Authors: Lo Li‐Hua , Hayman Laura L.
Published: March 2003

The purpose of this study was to identify the relationship between parents and children in measuring children’s acute and delayed nausea and vomiting induced by cancer chemotherapy. Twenty parent–child dyads participated in the study. Both instruments: Adapted Rhodes Index of Nausea and Vomiting by parent and by child (8–18 years old) were used every 12 h. The reliability and validity of these instruments have been established. There were significantly moderate to strong associations between parents and children in measuring these symptoms from Day 1 to Day 3 (total scores: r = 0.85–0.93; nausea scores: r = 0.67–0.93; and vomiting scores: r = 0.91–0.99, all P < 0.01). Therefore, parents’ observation of their children’s symptoms was strongly associated with their child’s self‐report of symptoms. Parents were able to assess their children’s acute and delayed nausea and vomiting because in this sample almost all parents accompanied their children all day long.
Reliability and validity of a Japanese quality of life scale for the elderly with dementia
Authors: Yamamoto‐Mitani Noriko , Abe Toshiko , Yamada Yukari , Yamazato Chieko , Amemiya Hiroko , Sugishita Chieko , Kamata Keiko
Published: March 2003

Abstract This paper examines reliability and validity of an instrument measuring the quality of life of elderly Japanese people with dementia. The instrument is a translation of an American instrument. The instrument has 48 items with binary answer format over five domains: ‘social interaction’, ‘awareness of self’, ‘enjoyment of activities’, ‘feelings and mood’, and ‘response to surroundings’. Altogether, 321 elderly in various facilities/services in Japan were evaluated by their formal caregivers. Factor analysis supported the domain of ‘enjoyment of activities’, but the domains of ‘awareness of self’ and ‘response to surroundings’ were statistically overlapped. The domains of ‘social interaction’ and ‘feeling and mood’ were not supported. Test–retest reliability was generally satisfactory except for the domain of ‘response to surroundings’. Interrater reliability was relatively low for domain scores but the total score was acceptable. Thus, the instrument showed moderate reliability and validity and further improvement is needed.
The movement of physical restraint‐free care for the elderly in Japan and Japanese culture
Authors: Akamine Yoriko
Published: March 2003

Abstract For a long time in Japan, there was no legal control or guidelines in the use of physical restraints at both acute and long‐term care facilities. Keeping the elderly in bed or binding them in beds, wheel chairs or geriatric‐chairs was commonly done. This seems to be related to a chief characteristic of the Japanese.