bluuebunny/crossref_metadata_2025 huggingface dataset:
Serum vascular endothelial growth factor levels correlate better with tumour stage in small cell lung cancer than albumin, neuron‐specific enolase or lactate dehydrogenase
Authors: MALL JULIAN W. , SCHWENK WOLFGANG , PHILIPP ANDREAS W. , MEYER‐KIPKER CATHRINE , MALL WERNER , MÜLLER JOACHIM , POLLMANN CHRISTIAN
Published: March 2003

Objective: Vascular endothelial growth factor (VEGF) is an important cytokine in the process of angiogenesis. Elevated serum levels of the cytokine may determine cancer patients who will benefit from adjuvant anti‐angiogenic therapy in the future. To correlate serum levels of VEGF with tumour stage and established prognostic markers in patients with small cell lung cancer (SCLC), a prospective study was performed on 70 patients.

Methodology: From August 1999 to May 2000, 70 consecutive patients (51 male, 19 female) with histologically proven SCLC were enrolled into the study. Staging of the disease included clinical investigation, bronchoscopy, chest X‐ray, thoracic computed tomography and ultrasound. The patients were grouped into five stages according to the Marburg classification (very limited disease (VLD), limited disease (LD), extensive disease I (EDI), extensive disease II (EDII) and extensive disease III (EDIII)). Prior to treatment, a 10 mL serum sample from each patient was examined by ELISA to quantify levels of VEGF and neuron‐specific enolase (NSE). Lactate dehydrogenase (LDH) and albumin levels were determined by photomorphometric analysis. Statistical analysis was performed using the Waller–Duncan k ratio t‐test and Pearson’s correlation test.

Results: Serum VEGF levels correlated well with tumour stage (P < 0.0001). Albumin levels were not correlated with tumour stage, but levels of NSE and LDH increased with stage progression. When patients were divided into two groups (VLD and LD vs EDI–III), VEGF levels were significantly lower in the initial stages of the disease compared with extensive disease (P < 0.0001). Serum levels of VEGF correlated better with tumour stage than did concentrations of NSE, LDH or albumin.

Conclusion: Serum VEGF levels may serve as an additional prognostic marker in the course of patients with SCLC. Further studies are needed to determine whether these patients may benefit from additional anti‐angiogenic therapy in the future.
Cigarette smoke inhibits the growth of lung fibroblasts from patients with pulmonary emphysema
Authors: NOBUKUNI Sumie , WATANABE Kentaro , INOUE Jun , WEN Fu‐Qiang , TAMARU Noriko , YOSHIDA Minoru
Published: March 2003

Objective: To investigate the proliferative characteristics of fibroblasts cultured from emphysematous lungs.

Methods: Fibroblasts were isolated and cultured from emphysematous lungs surgically resected as a consequence of lung volume reduction surgery and from non‐cancerous areas of lungs obtained following resection for lung cancer as a non‐emphysematous control. Their proliferative activities were compared, as was the effect of cigarette smoke extract (CSE) on fibroblast proliferation. After incubation with various concentrations of CSE, cells were harvested and cell numbers were counted. Growth curves were constructed and doubling time was calculated to compare the proliferative activity of fibroblasts from emphysematous and non‐emphysematous lungs.

Results: The proliferation of fibroblasts from emphysematous lungs cultured with normal medium appeared suppressed compared with non‐emphysematous lungs. The addition of CSE to the medium induced more obvious growth inhibition in emphysematous lung fibroblasts. The growth of both fibroblast cultures was inhibited by CSE and this appeared to be concentration dependent.

Conclusions: Fibroblasts from emphysematous lungs had lower proliferative activity and were more susceptible to cigarette smoke than those from non‐emphysematous lungs. Cigarette smoke may play a critical role in the development and deterioration of pulmonary emphysema by suppressing the growth of lung fibroblasts.
A case of refractory bilateral pleural effusion due to post‐irradiation constrictive pericarditis
Authors: YAMAMOTO NATSUO , NODA YOSHIAKI , MIYASHITA YOSHIHIRO
Published: March 2003

A 51‐year‐old woman suffering from dyspnoea and refractory bilateral pleural effusions is discussed. The effusion was characterized as a transudate and cardiac decompensation and renal insufficiency were initially suspected. Diuretic agents were not effective and the patient required bilateral chest water‐sealed drainage tubes for 4 months, after exclusion of neoplastic infiltration, collagen disease and other cardiac disorders. On echocardiogram, cardiac function and other findings were almost normal, except for shortening of deceleration time in transmitral flow velocity. To evaluate the reduced diastolic compliance, cardiac catheterization was performed, and revealed an elevated pressure in the right ventricle with a dip‐and‐plateau pattern, and constrictive pericarditis was diagnosed. The hydrothorax resolved after pericardiectomy and symptoms were alleviated. Three and a half years after surgery, the patient is well and taking only oral diuretics. The underlying mechanism of cardiac disorder appears to have been mixed restriction and constriction due to irradiation of her chest for breast cancer 13 years ago. Because the echocardiogram was within normal limits, the diagnosis was delayed. Radiation‐induced constrictive pericarditis should be considered if there is an unexplained transudate effusion with a normal echocardiogram.
Evidence for the expression of transient receptor potential proteins in guinea pig airway smooth muscle cells
Authors: ONG Hwei L. , BRERETON Helen M. , HARLAND M. Lyn , BARRITT Greg J.
Published: March 2003

Objective:  The present study investigates the expression of transient receptor potential (TRPC) proteins in airway smooth muscle (ASM) cells in order to determine whether these proteins may be candidate molecular counterparts of plasma membrane Ca2+‐permeable channels involved in the contraction of ASM.

Methods:  Expression of TRPC mRNA was detected using specific primers and RT‐PCR. Expression of the TRPC1, TRPC3 and TRPC6 proteins was detected using antibodies in immunoprecipitation and Western blot.

Results:  Guinea pig ASM cells exhibited thapsigargin‐ and acetylcholine‐initiated Ca2+ inflow but none by 1‐oleoyl‐2‐acetyl‐sn‐glycerol. mRNA encoding each of the TRPC1 to TRPC6 proteins was detected in ASM cells. mRNA encoding TRPC1, TRPC3, TRPC4 and TRPC6 was detected in ASM cells at a concentration approximately equivalent to that in guinea pig brain. mRNA encoding TRPC2 and TRPC5 was more abundant in ASM cells than in brain. The TRPC1 protein, but not the TRPC3 or TRPC6 proteins, was detected in extracts of ASM cells, while all three proteins were detected in brain.

Conclusion:  The results provide evidence for a low level of expression of the TRPC1 to TRPC6 proteins in ASM cells. These proteins may function as store‐operated Ca2+ and/or second messenger‐activated non‐selective cation channels in ASM cells.
Genetic analysis of flowering time for eight natural populations of Arabidopsis thaliana (Brassicaceae) in Japan with special regard to the genes, FRI and FLC
Authors: Shibaike Hiroyuki , Ishiguri Yoshio , Kawano Shoichi
Published: March 2003

To understand the genetic basis of flowering time for eight natural populations of Arabidopsis thaliana (L.) Heynh. in Japan, we conducted growth experiments with and without chilling treatments, and crossing experiments of plants from Japanese populations with two well‐characterized flowering time ecotypes (Col and Ler). In order to clarify the associations between flowering time and genotype in the regions around the genes, FRI and FLC, microsatellite analysis was also conducted. Mean time to flowering for the eight Japanese populations varied from 20 to 110 days, and was longer than that for Col and Ler. Their days to flowering were shortened significantly by chilling treatment. The days to flowering of the F1 progeny and the frequency distribution of the days to flowering in F2 progeny indicated that the flowering behavior of the Japanese A. thaliana were controlled mainly by digenic interactions between the FRI and FLC loci. Moreover, microsatellite analysis of F3 progeny resulting from the representative crosses revealed that the eight Japanese A. thaliana populations could be classified into at least two groups according to their genotype at the FRI and FLC loci.
Phylogenetic placement of the enigmatic Western Australian genus Emblingia based on rbcL sequences
Authors: Chandler Gregory T. , Bayer Randall J.
Published: March 2003

Assignment of the enigmatic Australian genus Emblingia to a particular family or order has been difficult. Informative morphological characters have not as yet been found to place Emblingia conclusively into a family, though it does share a number of attributes with the Capparaceae and Resedaceae. As a result, in the past it has been put in various families (Capparaceae, Sapindaceae, Goodeniaceae and Polygalaceae), representing a number of orders, as well as in its own family, the Emblingiaceae. The current molecular study, using rbcL, shows strong support for the placement of Emblingia within the Brassicales, and possibly sister to the Resedaceae. Further morphological and molecular studies within the Brassicales are needed before finalizing the familial placement of this genus. At this time, we consider treatment of Emblingia as a monotypic family, Emblingiaceae, within the order Brassicales the most satisfactory solution.
Adaptive traits regulating dormancy and germination of invasive species
Authors: Martinez‐Ghersa Maria A. , Ghersa Claudio M. , Benech‐Arnold Roberto L. , Donough Rafael Mac , Sanchez Rodolfo A.
Published: March 2003

Weed invasion in cropland can be estimated by measuring specific constancy (Number of fields of occurence/Number of fields surveyed). Since the beginning of this century, many floristic surveys have been carried out in fields with similar soil types in the Pampas of Argentina. Thus, weed species with high constancy in maize or wheat crops over more than 60 years could be identified. Convergence among species of any trait having a selective advantage in the cropping environment would be expected. However, no evidence of such convergence was found in seed bank persistence or in dormancy and germination characteristics of summer or winter annuals selected as model species: Amaranthus retroflexus, Datura ferox, Echinochloa crus‐galli, Tagetes minuta, Avena fatua, Galinsoga parviflora. On the other hand, changes in dormancy and germination traits were recorded in seeds of E. crus‐galli and A. fatua in different agricultural systems, suggesting an adaptive value for invasion of human disturbed habitats. We used a simulation approach to investigate the importance of ecophysiologic seed phenotypes for the invasion of plants into specific human disturbed habitats. Results of the simulations showed that rainfall pattern and soil type interactions changed relative fitness of the tested phenotypes.
Neighborhood effects and genetic structure in a clonal grass: The role of the spatial structure of the environment
Authors: Herben Tomáš , Hara Toshihiko , Hadincová Věra , Krahulec František , Pecháčková Sylvie , Skálová Hana , Suzuki Jun‐Ichirou
Published: March 2003

A dominant plant of temperate nutrient‐poor grasslands, Festuca rubra, has been used as a model species to assess biotic effects of fine‐scale environmental heterogeneity in the field and its genetic differentiation in response to this variation. Using experimental data, it is shown that this heterogeneity is partly due to interspecific variation in competitive abilities in the ‘matrix’ plants. Festuca rubra possesses remarkable intraspecific differentiation in its parameters of spatial spreading and competitive performance, and in their plasticity under cultured conditions. This morphological plastic response to the environment is weaker in the field. This indicates that in the field individuals use only a fraction of the full potential range of plasticity to respond to variation in competitive environments. A random amplified polymorphic DNA study has shown that populations of F. rubra consist of a high number of coexisting genets. The genet size distribution is strongly skewed, indicating high early stage mortality and lower larger genet mortality. There should be continuous seedling regeneration in order to maintain this genetic structure. The data presented here display major features that distinguish clonal expansion from vertical competition. These are: (i) absence of integration over the whole plant; (ii) potentially unlimited size; (iii) large and unpredictable environmental variation experienced by different parts of the genet; and (iv) absence of a size‐determined competition outcome at the genet level, and thus higher potential for species‐specific effects.
Interclonal differences, plasticity and trade‐offs of life history traits of Cyperus esculentus in relation to water availability
Authors: LI BO , SHIBUYA TOMOKO , YOGO YASUHIRO , HARA TOSHIHIKO , YOKOZAWA MASAYUKI
Published: March 2003

Cyperus esculentus is an exotic clonal (or pseudoannual) weed in Japan,
and its range is steadily increasing. To investigate its interclonal variation and
phenotypic plasticity in response to water availability, five clones of C. esculentus,
collected from different sites in Japan, were grown singly in pots placed outdoors
under dry and wet conditions. All the traits examined showed considerable variation
among the five clones. However, two clones from Tochigi were similar to each other;
thus, they might have originated from the same founder population. The clone from
Ibaraki was quite different from the others. Therefore, it is suggested that the
Japanese populations of C. esculentus might have resulted from multiple introductions
of genotypes from geographically separated and, hence, genetically differentiated,
source populations. All the clones also showed considerable plasticity in response
to water availability. Clones with a larger ramet number had a greater plasticity,
whereas tuber size was invariant across water treatments. Highly plastic traits had
generally low interclonal variation in plasticity. All the clones had high productivity
and produced more ramets and tubers under wet conditions than under dry conditions.
Moreover, water availability could partially regulate the mode of its reproduction;
wet conditions favored tuber production (vegetative propagation) while dry conditions
favored sexual reproduction. A number of trade‐offs occurred between the traits of
clonal growth, storage and sexual reproduction, indicating that allocation among
the competing functions/organs is mutually exclusive in plants. The results obtained
here suggest that C. esculentus is more likely to invade wet habitats than dry habitats.
Analysis of IgG subclasses in chronic active Epstein–Barr virus infection
Authors: Wakiguchi Hiroshi , Hisakawa Hiroaki , Hosokawa Takatoshi , Kubota Haruo , Kurashige Takanobu
Published: March 2003

Abstract Background: Although elevated serum levels of immunoglobulins are frequently observed in patients with chronic active Epstein–Barr virus (EBV) infection, there have been no reports concerning levels of IgG subclasses.

Methods
: Serum levels of IgG subclasses were measured by the enzyme‐linked immunosorbent assay (ELISA) in 30 children with severe chronic active EBV infection.

Results
: Serum levels of IgG1 were elevated in most patients, except for one who showed an abnormally low level of IgG1 and progressive hypogammaglobulinemia. Serum levels of IgG2, IgG3 and IgG4 in the patients were comparable to those in control children, while abnormally low levels of IgG2, IgG3 and IgG4 were observed in six, three and four cases, respectively.

Conclusion
: Although not always susceptible to bacterial infections, low levels of IgG2 were frequently observed in patients with chronic active EBV infection and elevated IgG1 is responsible for the increase of serum IgG in these patients.
Nasal mupirocin treatment of pharynx‐colonized methicillin resistant Staphylococcus aureus: Preliminary study with 10 carrier infants
Authors: Hayakawa Takahiro , Hayashidera Tadashi , Katsura Sachiko , Yoneda Kozo , Kusunoki Takashi
Published: March 2003

Abstract Background: Nosocomial methicillin‐resistant Staphylococcus aureus (MRSA) infection in infants has become a serious concern and a new means of preventing the transmission of MRSA in the community needs to be considered.

Methods
: We performed nasal mupirocin treatment on 10 infants who were MRSA‐positive either in the nose or the pharynx and evaluated the effect of mupirocin on the eradication of MRSA.

Results
: Eradication of MRSA from the nose was successful in two cases and eradication from the pharynx in six (66.6%) of nine cases. The number of treatments required to achieve eradication varied; within three courses for nose carriers and from one to seven courses for pharynx carriers. Eradication was unsuccessful even after five to seven treatments in three pharynx‐limited carriers.

Conclusions
: These data suggest that the effect of nasal mupirocin treatment on pharynx‐colonized MRSA is limited and that repetitive treatment is necessary in some cases. However, in view of the possibility of preferential pharyngeal colonization of Staphylococcus aureus in infancy, nasal mupirocin treatment deserves further evaluation for eradication not only of nose‐ but also of pharynx‐colonized MRSA.
Partial left ventriculectomy in children and adolescents
Authors: Linde Leonard M , Kawaguchi Akira
Published: March 2003

Abstract Theoretical aspects, pediatric indications and initial results of a new operation, partial left ventriculectomy, are presented.
Kinetics of palmitic acid transport in insulin‐dependent diabetic pregnancies: In vitro study
Authors: Nandakumaran Moorkath , Makhseed Ma’Asoumah , Al‐Rayyes Samer , Al‐Yatama Majda , Devarajan Lakshminarayanan
Published: March 2003

Abstract Backgound: The paucity of data relating to transport kinetics of free fatty acids (FFA) in pregnant diabetic women prompted the undertaking of the present study.

Methods
: Transport kinetics of a model FFA, palmitic acid, have been investigated in Type I diabetic pregnancies, using in vitro perfusion of isolated placental lobules. National Cancer Tissue Culture medium diluted with Earle’s buffered salt solution was used as the perfusate and control placental lobules were perfused for comparison.

Results
: In five Type I diabetic women, the palmitic acid transport fraction (TF) averaged 5.6~0.42% of injected maternal bolus dose, representing 11.8~2.1% that of tritiated water used as reference. In control perfusions (n=5), the palmitic acid TF represented 10.2~1.3% of tritiated water TF. Differential transport rates of palmitic acid for 10, 25, 50, 75 and 90% of efflux in fetal veins differed significantly from the corresponding values for tritiated water in both study and control series. However, palmitic acid transport rates for the various efflux fractions in the two series were not significantly different. For kinetic parameters, such as area under the curve, clearance, elimination constant, time for maximum response, absorption rate and elimination rate, the values for palmitic acid in the diabetic and control series also did not differ significantly.

Conclusion
: Transport kinetics of palmitic acid in Type I human diabetic pregnancies in in vitro conditions do not differ significantly from those observed in normal pregnancies.
Methylenetetrahydrofolate reductase polymorphism in Kawasaki disease
Authors: Tsukahara Hirokazu , Hiraoka Masahiro , Saito Masakazu , Nishida Kouich , Kobata Ritsuyo , Tsuchida Shinya , Toyooka Michiyo , Kimura Hideki , Gejyo Fumitake
Published: March 2003

Abstract Background: A genetic aberration in the 5,10‐methylenetetrahydrofolate reductase (MTHFR) gene (677 C to T substitution) has been shown to result in reduced enzyme activity. The hypothesis tested in the present study was that a higher proportion of Kawasaki disease (KD) patients with coronary artery lesions (CAL) would have the T677 allele compared with patients without CAL and healthy subjects.

Methods
: Genotypes for MTHFR were determined in 75 KD patients (male : female ratio 52:23) and 238 healthy subjects (male : female ratio, 110:128) by the polymerase chain reaction and restriction fragment length polymorphism method.

Results
: The results indicated that female KD patients had a significantly higher frequency of the TT genotype compared with female control subjects. In the female population, the frequency of the TT genotype in patients with initial coronary aneurysm was significantly lower than in patients without this manifestation. Analysis of the data for the male population showed that the frequency of the TT genotype in KD patients developing coronary stenosis, occlusion or myocardial infarction was higher than that in those without these manifestations, although the difference was statistically insignificant.

Conclusions
: The TT genotype may protect female KD patients against initial aneurysm formation and predispose male KD patients to severe coronary complications. Further large‐scale studies may be required to confirm the contribution of homocysteine in the coronary sequelae of KD.
Formation of propentdyopents and biliverdin, oxidized metabolites of bilirubin, in infants receiving oxygen therapy
Authors: Kunikata Tetsuya , Itoh Susumu , Ozaki Takashi , Kondo Masatoshi , Isobe Kenichi , Onishi Shoju
Published: March 2003

Abstract Background: Bilirubin has antioxidative effects. When bilirubin reacts with reactive oxygen species, oxidized metabolites of bilirubin are formed, such as biliverdin and propentdyopents. A decrease in serum bilirubin concentration and an increase in serum and urinary oxidized metabolites of bilirubin may indicate the protective action of bilirubin against reactive oxygen species.

Methods
: In the in vitro study, we measured the oxidative products of bilirubin formed through the action of O2– by the xanthine–xanthine oxidase system, either as free bilirubin or bilirubin‐human serum albumin complex. In the clinical investigation, serum concentrations of (ZZ)‐bilirubin (4Z, 15Z‐bilirubin), the subfraction and biliverdin, and urinary propentdyopent absorption, were measured in blood and urine samples, respectively, collected from 30 5‐day‐old neonates with birth weights of 1500–3624 g who had been hospitalized at the Ehime Prefectural Hospital and who had not undergone phototherapy.

Results
: In the in vitro study, a significant formation of propentdyopents was observed in aqueous solution. A statistically significant correlation was found between serum (ZZ)‐bilirubin concentration and serum biliverdin concentration (r=0.82, P<0.0001), but not between serum (ZZ)‐bilirubin concentration and urinary propentdyopent absorption. Serum (ZZ)‐ and serum (ZE)‐bilirubin and biliverdin concentrations, and urinary propentdyopent absorption were compared between the groups with and without oxygen therapy. No significant differences were found in serum (ZZ)‐bilirubin, serum (ZE)‐bilirubin and biliverdin concentration, urinary propentdyopent absorption, serum biliverdin/serum (ZZ)‐bilirubin, or urinary propentdyopent absorption/serum (ZZ)‐bilirubin. Neither a decrease in serum bilirubin concentration nor an increase in serum biliverdin concentration and urinary propentdyopent absorption after oxygen therapy were demonstrated in the present study.

Conclusions
: In the in vitro study, we demonstrated for the first time that propentdyopents were produced from (ZZ)‐bilirubin by the xanthine–xanthine oxidase system but biliverdin was not. In the in vivo study, serum biliverdin concentration and urinary propentdyopent absorption seem to have a different relationship to serum (ZZ)‐bilirubin concentration in sick and early neonates.
Rotavirus infection in children in Japan
Authors: Zhou Yumei , Li Lei , Kim Bosu , Kaneshi Kunio , Nishimura Shuichi , Kuroiwa Toshimasa , Nishimura Takashi , Sugita Kumiko , Ueda Yuichi , Nakaya Shigekazu , Ushijima Hiroshi
Published: March 2003

Abstract Currently, a high morbidity of rotavirus diarrhea has been seen in children in developed and developing countries. Improvement of the vaccines is necessary in order to reduce the burden of diarrhea caused by rotavirus. A survey of rotavirus infection from diarrheal stool specimens in children of seven regions in Japan was conducted from 1984 to 1999. The present study discusses the survey results and reviews the national and international data of more than 23 papers and congress proceedings about rotavirus infection in Japan. We analyze the prevalence of rotavirus infection in acute diarrheal in‐ and outpatients, the distribution of rotavirus G‐serotypes and surveillance data for seasonality and age groups in Japan. The data indicated that rotavirus is the most important cause of diarrhea in Japan among young children, with the prevalence ranging from approximately 9.7 to 88%. The most common rotavirus strains belonged to serotype G1, specifically since 1993. Serotypes G2, G3 and G4 had also been documented to be predominantly based in the area and year before 1992. However, untypeable rotavirus strains had been found each year, with a prevalence up to 56.7% which suggests that rare serotypes (except G1–4) or new serotypes might exist. Unexpectedly, in Tokyo and Sapporo from 1998 to 1999, G9 was found to be the first most prevailing serotype with a high prevalence of 52.9 and 71.4%, respectively. Despite these data from different geographic areas, the year under investigation was relatively clear in respect to seasonality, with a peak of rotavirus activity in late winter (February) through early spring (March). Age distribution had also characterized that the infection was predominant among children aged 1–2 years of age, although it was also common in children of 2–3 years. In addition, mixed infection with bacteria was documented.
Hypercalciuria in children with febrile convulsions
Authors: Papadimitriou Anastasios , Nicolaidou Polyxeni , Garoufi Anastasia , Georgouli Helen
Published: March 2003

Abstract
 

Background
: The purpose of the present study was to investigate whether idiopathic hypercalciuria may be implicated in the pathogenesis of febrile convulsions.

Methods
: We studied 38 children (22 boys) with febrile convulsions (mean (±SD) age 3.25±1.09 years) and 45 healthy children (28 boys) of similar age who served as controls. Twenty‐four hour urine calcium and phosphate, as well as serum calcium, phosphate, alkaline phosphatase and intact parathyroid hormone (PTH) concentrations were determined.

Results
: Hypercalciuria (urine Ca >4.0 mg/kg bodyweight per 24 h) was found in nine children with febrile convulsions (23.7%) and in three controls (6.7%). Hypercalciuric children excreted significantly more phosphate in their urine (37.0±11.6 mg/kg bodyweight per 24 h) than normocalciuric children (18.7±8.7 mg/kg bodyweight per 24 h) and controls (20.2±7.6 mg/kg bodyweight per 24 h). They also had higher serum intact PTH concentrations (49.87±15.36 pg/mL) than normocalciuric (35.39±15.67 pg/mL) and control children (28.21±14.00 pg/mL). According to the calcium‐loading test, eight of nine children with hypercalciuria had the renal type of the disorder. Furthermore, hypercalciuric children had significantly more convulsive episodes (2.77±1.98) than normocalciuric children (1.86±1.24).

Conclusions
: Our results suggest that renal hypercalciuria may be implicated in the pathogenesis of febrile convulsions.
Toxocara seroprevalence and childhood asthma among Malaysian children
Authors: Chan Patrick Wk , Anuar Abdullah Khairul , Fong Mun Y , Debruyne Jessie A , Ibrahim Jamaiah
Published: March 2003

Abstract

Background
: The larva of Toxocara spp., a common animal roundworm, may infect non‐compatible hosts, causing a profound immunological reaction with marked eosinophil and IgE responses, not unlike in atopy. In this study, we determined the seroprevalence of Toxocara exposure in 66 asthmatic and 58 non‐asthmatic children.

Methods
: Exposure to Toxocara was determined by examining the serum samples of the children for specific IgG antibodies to L2 Toxocara larvae, using a commercially available diagnostic kit.

Results
: There was no significant difference in the mean age, sex, social class, residence type and presence of domestic pets at home between the two children groups. Children with bronchial asthma were observed to have higher Toxocara seropositivity than that of the non‐asthmatic controls (21.2 vs 8.6%, P=0.047).

Conclusion
: The observed relationship between exposure to Toxocara infection and bronchial asthma in Malaysian children warrants further evaluation. An understanding of any possible contribution to the pathogenesis of childhood asthma provides a potential avenue for prevention.
Balloon dilatation and stent implantation for vascular stenosis
Authors: Nakanishi Toshio
Published: March 2003

Abstract

Backgound
: Previous results show that the success rate of balloon angioplasty for pulmonary artery stenosis is low. Mortality and morbidity are significant in balloon angioplasty for coarctation of the aorta.

Methods
: A review of the experience of balloon angioplasty for pulmonary artery stenosis and coarctation of the aorta at our institution was performed. A review of scientific reports of balloon angioplasty for these lesions was investigated.

Results
: Review of our results indicates that balloon angioplasty for pulmonary artery stenosis can be performed with a high success rate (80–90%), (i) by performing it at an appropriate time, (ii) by using high‐pressure balloons, (iii) by using stents, and (iv) by using intravascular ultrasound (IVUS). Major complications occurred in 3% at our institution in balloon angioplasty for pulmonary artery stenosis. Incomplete dilation has been noted in 10–25% of patients of coarctation of the aorta. Aortic aneurysm has been reported in 2–7% of patients. Re‐stenosis and/or hypertension also occur. The re‐stenosis rate may be decreased if the aorta is dilated until signs of intimal tear are observed. Systemic hypertension may be noted in the long term after balloon angioplasty of coarctation of the aorta, even in patients with fairly good anatomical repair. The mechanisms for hypertension are not clear, but residual stenosis, even mild, may result in upper body hypertension.

Conclusions
: Although there are significant limitations in the procedures, balloon angioplasty is effective in the management of pulmonary artery stenosis and coarctation of the aorta.
Longitudinal estimation of signal‐averaged electrocardiograms in patients with Kawasaki disease
Authors: Kuramochi Yukio , Takechi Nobuyuki , Ohkubo Takashi , Ogawa Shunichi
Published: March 2003

Background
: Myocarditis associated with Kawasaki (KD) disease is prominent, but rarely detected by conventional methods. The hypothesis of this study is to see if signal‐averaged electrocardiogram can detect myocarditis with KD.

Methods
: We obtained signal‐averaged electrocardiograms from 71 patients with KD (mean age 2.8 ± 2.9 years) in the acute (1st−4th week), subacute (5–7th week), and chronic (8th week or later) phases (mean study period 3.5 ± 1.7 years). Sixteen patients who had pericardial effusion, bundle branch block or myocardial ischemia were excluded from this study. The results were compared with those of Holter and 12‐lead electrocardiograms, echocardiography and serum myocardial enzymes. They were also contrasted with the course of each patient.

Results
: The incidence of abnormal findings
on signal‐averaged electrocardiogram was 18.2% in the acute phase
versus 10.9% in the subacute and chronic phases. It differed
significantly higher than the other conventional tests (P < 0.05). Four patients had abnormalities of signal‐averaged electrocardiograms through all three phases. Among these four, two had reduced left ventricular contractility. However, these changes were transient and resolved in the subacute phase. All patients had good courses and no residue.

Conclusion
: This study shows the possibility that signal‐averaged electrocardiogram is more useful to detect myocarditis associated with KD than the other conventional tests. However, we could not define the prognostic value of abnormal signal‐averaged electrocardiograms during this study period.
Central venous catheters in pediatric patients – subclavian venous approach as the first choice
Authors: Çitak Agop , Karaböcüo}lu Metin , Üçsel Raif , Uzel Nedret
Published: March 2003

Background
: It is critical to establish a safe and functional i.v. access in severely sick patients. We evaluated the frequency of application and complications of central venous catheters in a pediatric intensive care unit.

Methods
: Pediatric patients in whom central venous catheters were inserted between March 1997 and May 1999 in the Pediatric Emergency Room and Intensive Care Unit were enrolled in this study. Patients were evaluated with respect to age, sex, weight, central venous catheter indication, site, duration of catheter stay and complications.

Results
: During the study period a total of 156 central venous catheters were successfully inserted into 146 patients. Of the 156 central venous catheter attempts, 148 (94.9%) were placed into the subclavian vein, six were inserted into the femoral vein, and two into the jugular vein. In 156 attempts, arterial injuries ocurred in 20 cases (12.8%). Pneumothorax developed in two patients on mechanical ventilation. Three catheters had to be removed due to catheter related infections. The mortality rate was 0%.

Conclusions
: We concluded that subclavian central venous catheterization is a safe procedure with minimal complications in pediatric patients. Arterial injury was the most frequent complication. In experienced hands, the succes rate was 100%. Subclavian central venous catheter insertion may be considered as the first approach in critically ill patients.
Management of childhood diseases during the Byzantine period: IV − Juvenile diabetes mellitus
Authors: Ramoutsaki Ioanna A , Dimitriou Helen , Markaki Erasmia‐A , Kalmanti Maria
Published: March 2003

Although Byzantine physicians seemed to recognize the clinical entity and the symptoms of juvenile diabetes mellitus very well, they did not mention many details about the treatment of the disease. Most probably they treated the young patients in the same way as the adults. It is worth mentioning that diabetes was considered a difficult medical problem.
Nitric oxide metabolites in the urine of full‐term and preterm infants
Authors: Dzik Jolanta M , Dobrzan´ska Anna , Gruszfeld Dariusz , Walajtys‐Rode Elzbieta
Published: March 2003

Background
: In newborn full‐term and preterm infants the urine nitrites and nitrates (NOx) were measured, in order to investigate the effects of different pathological conditions (infection, hypoxia) on systemic nitric oxide production.

Methods
: Urine nitrites and nitrates were determined by means of the Griess reaction, after reduction of nitrates to nitrites with nitrate reductase.

Results
: The NOx level was higher in preterm (278 nmol/mL) than full‐term (176 nmol/mL) infants. Low NOx (115 nmol/mL) levels accompanied generalized infections, while its high contents (650 nmol/mL) was found in cytomegalovirus and one case of Pneumocystis carinii infection. Moderate increase of NOx production was observed in infants with local pulmonary infections and encephalopathies.

Conclusion
: The results indicate urinary NOx level is lowered in infants with life‐threatening generalized infection. A possibility of a rapid test based on newborn urinary NOx level determination is considered.
Inflammatory changes in the lungs of premature infants with symptomatic patent ductus arteriosus
Authors: Nakamura Toshihiko , Takasaki Jiro , Ogawa Yunosuke
Published: March 2003

Background
: The aim of the study was to observe the inflammatory changes during the therapy for symptomatic patentductus arteriosus (sPDA).

Methods
: We investigated biochemically the sample of the tracheobroncheal aspirates (TA) from 11 intubated prematureinfants. Three i.v. doses of indomethacin (0.2 mg/kg) were administered with 24‐h intervals. The samples were dividedinto two groups, the effective occasions (n = 10) and non‐effective occasions (n = 6). Theamounts of myeloperoxidase (MPO), soluble L‐selectin (sL‐selectin) in TA, and the polymorphonuclear leukocytes (PMN) of peripheralblood stream and TA were analyzed before and after treatment of sPDA with indomethacin.

Results
: In effective occasions, there were significant decreases of peripheral PMN and MPO and PMN in TA. However, thisgroup had a significant increase of sL‐selectin. In non‐effective occasions, five out of six samples had decreases of MPO and PMNin TA, but not significantly. In contrast, there was a significant decrease of sL‐selectin.

Conclusion
: These data suggested that anti‐inflammatory change after closure of sPDA may be caused by not only indomethacinitself, but also ductal closure itself. However, futher study is necessary to clarify the relationship between the closure of theductus itself and anti‐inflammatory action in the lung.
Meatus tightly covered by the prepuce is associated with urinary infection
Authors: Hiraoka Masahiro , Tsukahara Hirokazu , Ohshima Yusei , Mayumi Mitsufumi
Published: March 2003

Background
: Almost all newborns have phimosis, which is known as one of the risk factors for urinary infection. The present study analyzed which specific prepuce conditions correlated with the development of febrile urinary infection in Japanese male infants.

Methods
: The subjects consisted of 100 children, 64 boys and 36 girls, with febrile urinary infection. Prepuces were classified by their retractability in the male patients and in 714 healthy boys.

Results
: Ninety‐four percent of first febrile urinary infections occurred before 7 months of age in boys, whereas only 37% of the girls had first infections by that age. The prepuce covered the external urethral meatus in 96% of the healthy boys aged 3 years or less. A gentle retraction maneuver could not uncover the urethral meatus in approximately 40% of the boys aged 0−6 months. The frequency started to decline spontaneously after that age. Male patients aged 0−6 months significantly more often had tightly covered meatus than did healthy neonates (85%vs 42%, P < 0.0001).

Conclusions
: These findings indicate that it is specifically those boys whose external urethral meatus are tightly covered with foreskin who constitute the high‐risk group for urinary infection. Awareness of this observation should help with diagnosing and managing urinary infection in young boys.
DNA damage in children treated with imipramine for primary nocturnal enuresis
Authors: Dündaröz RuŞen , Türkbay Tümer , Sürer Ilhami , Gök Faysal , Denlİ Metin , Baltaci Volkan
Published: March 2003

Background
: Despite the fact that primary nocturnal enuresis (PNE) is self‐limited and pathologically benign, the emotional stress and inconvenience that it produces, warrants treatment. Imipramine is one of the widely used drugs in PNE treatment. Although some mutagenic effects were suggested in imipramine administration, this toxicity has never been investigated in enuretic patients. The aim of this study was to evaluate the association of exposure to imipramine with DNA damage.

Methods
: Thirty‐five children treated with imipramine for at least 4.5 months who were in otherwise good health were accepted into the investigation. Twenty healthy sisters or brothers of the patients who did not use any long‐term drugs were studied simultaneously as the control group. Comet assay was used to evaluate DNA damage.

Results
: Damaged (limited and extensive migrated) cells of the enuretic children who were taking imipramine were statically higher than that of the control group (P < 0.05) indicating a detectable DNA damaging effect of imipramine in human lymphocytes.

Conclusion
: Our finding suggests that the difference in comet scores between two groups was induced by the imipramine treatment. The other possibility to be considered is the psychological stress of the children who were concerned by the symptoms and their parent's anxiety. As our preliminary data were based on a limited number of children, further research is needed considering the importance of this possible toxic effects which may be associated with mutagenicity.
Formal service utilization by the frail elderly at home during the last 6 months of life
Authors: Kobayashi Nami
Published: March 2003

Abstract The purpose of this study was to examine how the use of medical/social services by elderly persons changes over time as they approach death. This research was conducted at a public visiting nursing office in Tokyo. Nursing records of all elderly persons, those who died at home or died within 1 week of hospital admission between April 1993 and June 1997 were reviewed. The percent of patients using each type of medical or social service was calculated for three time periods before death: more than 6 months, 1–6 months and within 1 month. This retrospective examination clearly demonstrates a shift in specific service usage by elderly persons during the months prior to death. As terminal illness becomes more advanced, the use of medical services increases more remarkably than the use of social services. The increase in nurse visits is far greater than that of home aid visits. Visiting nurses should demonstrate their skills of care appropriate to the changeable conditions of the elderly and their families in the terminal stage.
Mild hypomania phenomenon in Japanese puerperal women
Authors: Hasegawa Masami
Published: March 2003

Abstract After childbirth, women in other countries have been reported to have elation and associated features of hypomania within the first 5 days postpartum. However, there has been no research on this phenomenon in Japan. The characteristics of postpartum mild hypomania in Japanese mothers are discussed here. The usefulness of the Japanese version of ‘The Highs' self‐rating scale is evaluated and the prevalence of mild hypomania phenomenon for 5 days postpartum is measured. One hundred and nineteen pregnant women in Mie, Japan, agreed to participate in this research. The Japanese women reported feeling elated, especially on the first postpartum day. They also reported feeling the need for less sleep. Many women felt that they could reduce their sleep during hospitalization. There was a relationship between the primipara and the multipara in the obstetric factors selected for study and the occurrence of mild hypomania after delivery. There were not clear correlations in ‘The Highs' scores for the nursing actions. It is suggested that the after‐effect of stress would be highly correlated to elation, and there is some biological mechanism triggered especially on the first day postpartum.
An Ethnomethodologic Analysis of Accounts of Feeding Elders in Long‐term Care
Authors: Pierson Charon A.
Published: March 2003

28–29 March 2000 Yamaguchi University School of Medicine, Ube, Japan (Local Organizers: Junko Yoneda and Susumu Tomonaga, Yamaguchi University)
Australian clinical nurse supervisors’ ethical decision‐making style
Authors: Berggren Ingela , Bégat Ingrid , Severinsson Elisabeth
Published: March 2003

This paper explores clinical nurse supervisors’ ethical styles with regard to supervision in health care. Eighty‐six registered nurses, all with experience of supervising clinical nurses and students in nursing, completed a specifically designed questionnaire. A qualitative interpretative content analysis identified three core themes: (i) ‘Is it safe?’; (ii) ‘Is it right?’; and (iii) ‘Is it kind?’, describing the clinical nurse supervisors’ ethical styles. The first core theme ‘Is it safe?’ covered the supervisors’ rules, codes and values that guide their supervisory actions, as well as two subthemes: (i) empowerment and (ii) integrity. The second core theme ‘Is it right?’ described the supervisors’ responsibility and advocacy as well as the ethical dilemmas experienced in the supervisory process. The third core theme ‘Is it kind?’ included the supervisors’ relationships with patients, professionals and supervisees. The results demonstrate the value of offering a support system, such as clinical supervision, which helps nurses to explore their professional identity for the benefit of the patients.
Development of the Chronic Obstructive Pulmonary Disease Activity Rating Scale: Reliability, validity and factorial structure
Authors: Morimoto Michiko , Takai Kenichi , Nakajima Kazuo , Kagawa Koujiro
Published: March 2003

Abstract The purpose of the present study was to develop the Chronic Obstructive Pulmonary Disease (COPD) Activity Rating Scale (CARS) to measure life‐related activity in patients with COPD, and to confirm its reliability and constructive validity in a factorial structure model. The subjects consisted of 114 patients with COPD. An 88‐item life‐related activity list, generated previously from a literature review, was administered. The secondary structural model consisted of four factors with 12 items. The results of the confirmatory factor analysis by structural equation modeling showed the fit criteria to be statistically significant. The internal consistency of the 12 items was highly reliable (Cronbach's α = 0.924). The CARS score was correlated with pulmonary function tests, breathlessness, and the health‐related quality of life (QOL) scales in Pearson correlation coefficient. The results suggest that the COPD Activity Rating Scale is a valid scale for the assessment of life‐related activity in patients with COPD.
Medication trends and documentation of pain management following surgery
Authors: Manias Elizabeth
Published: March 2003

Abstract The purpose of the present study was to examine prescribing and administering activities for sedative and analgesic medication in postoperative patients, and to describe nurses’ documentation practices for pain management in nursing notes. A prospective audit was undertaken of medication order charts and nursing notes of 100 patients on the operation day and over the first four days following surgery. Almost all patients received some form of infusion, while the use of ‘as required’ analgesics varied from one‐third to over two‐thirds of patients during the postoperative period. Few patients were prescribed fixed‐order analgesics or sedative medications. An audit of nursing entries found that nurses had documented inadequately in four major areas: pain assessment, use of non‐pharmacological interventions, use of pharmacological interventions, and outcome of interventions. The findings contribute to improving our understanding of nurses’ pain management and identify the need to use clinical judgement that is individualized to patients’ needs.