bluuebunny/crossref_metadata_2025 huggingface dataset:
Expression of keratinocyte growth factor receptor (KGFR/FGFR2 IIIb) in vascular smooth muscle cells
Authors: Onda Munehiko , Naito Zenya , Wang Ruojiao , Fujii Takenori , Kawahara Kiyoko , Ishiwata Toshiyuki , Sugisaki Yuichi
Published: March 2003

Keratinocyte growth factor receptor (KGFR), also known as fibroblast growth factor receptor (FGFR)2 IIIb, is located in many types of epithelial cells and is activated by four known ligands (FGF‐1, FGF‐3, FGF‐7 (also known as KGF) and FGF‐10) that are predominantly synthesized by mesenchymal cells. In the early stage of atherosclerosis, vascular smooth muscle cells (VSMC) transform from a contractile to a synthetic phenotype, proliferate and migrate into the intima. Previously, FGF‐7 mRNA expression was reported in VSMC, but KGFR mRNA was not detected. In the present study, we attempted to determine whether KGFR is localized in VSMC cultured from rat aorta and VSMC in human normal and atherosclerotic coronary arteries. Expression of KGFR mRNA and its protein was detected in cultured rat VSMC by reverse transcription–polymerase chain reaction and western blot analysis, respectively. Immunohistochemically, KGFR was localized in the VSMC of the outer layer of the media in normal human coronary arteries. Furthermore, it was localized in the VSMC of the media and thickened intima of atherosclerotic arteries. Recombinant FGF‐7 and/or FGF‐10 proteins stimulated the growth of cultured rat VSMC. These findings indicate that KGFR localized in VSMC may contribute to the proliferation of VSMC in normal and atherosclerotic arteries.
Molecular phylogeny of Laminariales (Phaeophyceae) inferred from small subunit ribosomal DNA sequences
Authors: Boo Sung Min , Lee Wook Jae , Yoon Hwan Su , Kato Atsushi , Kawai Hiroshi
Published: March 2003

In order to elucidate the molecular phylogeny of the order Laminariales, complete small subunit (SSU) rDNA sequences were determined for 11 species, including representatives from all the families of the order: Pseudochorda gracilis Kawai et Nabata and P. nagaii (Tokida) Inagaki of the Pseudochordaceae, Chorda filum (L.) Stackhouse of the Chordaceae, Alaria fistulosa Postels et Ruprecht, Ecklonia cava Kjellman and Egregia menziesii (Turner) Areschoug of the Alariaceae, Agarum clathratum f. yakishiriense, I. Yamada, Kjell‐maniella crassifolia Miyabe and Laminaria japonica Areschoug of the Laminariaceae and Lessonia nigrescens Bory and Postelsia palmaeformis Ruprecht of the Lessoniaceae, The published data of Halosiphon tomentosus (Lyngbye) Jaasund and Saccorhiza poly‐schides (Lightfoot) Batters were included for tree construction. Our SSU rDNA sequences show that the Pseudochordaceae and Chordaceae are clearly separated from the strongly monophyletic group consisting of the Alariaceae, Laminariaceae and Lessoniaceae, The sequence data also show that the Pseudochordaceae is monophyletic and is distant from H. tomentosus and S. polyschides. Considering our molecular data and the reported morphology, life history and sex pheromones of the family, it appears likely that the Pseudochordaceae might have branched off first from the laminarialean lineage that leads, through the Chordaceae, to the advanced Laminariales (i.e. the Alariaceae, Laminariaceae and Lessoniaceae). The limited resolution that results from the close similarities among the SSU rDNA sequences gives a need for more informative molecular markers in order to resolve the circumscription and phylogeny of the Laminariales.
Effects of interleukin‐1β on DNA synthesis in rat alveolar type II cells in primary culture
Authors: Yang Guan Hu , Osanai Kazuhiro , Takahashi Keiji
Published: March 2003

Proliferation of alveolar type II cells is critical for restoration of the integrity of alveolar epithelium in alveolar injuries caused by a number of different aetiologies. Because effects of inflammatory cytokines on the proliferation of alveolar type II cells are not clear, we investigated the effects of interleukin‐1β (IL‐1β) on [3H]‐thymidine incorporation into DNA in rat alveolar type II cells in primary culture. Interleukin‐1β enhanced the [3H]‐thymidine incorporation dose and time dependently. The increase of [3H]‐thymidine incorporation was observed in parallel with increased number of rat alveolar type II cells. The effect of IL‐1β on [3H]‐thymidine incorporation was additive to effects of growth factors which were known to act as mitogenic factors for type II cells. Anti‐interleukin‐1β antibody or IL‐1 receptor antagonist partially inhibited the effects of IL‐1β on [3H]‐thymidine incorporation. Their combination completely inhibited the effects of IL‐1β. In the absence of IL‐1β, the combination inhibited the [3H]‐thymidine incorporation to a level under that in the control. Isolated alveolar type II cells were immunocytochemically stained positive with anti‐IL‐1β antibody. Reverse transcriptase–polymerase chain reaction (RT‐PCR) showed the presence of the mRNA for IL‐1β in cultured alveolar type II cells. These results demonstrate that exogenous IL‐1β stimulates DNA synthesis in alveolar type II cells and that the cells also produce IL‐1β endogenously and suggest that endogenous IL‐1β may mediate basal DNA synthesis of alveolar type II cells.
Effects of anti‐emetic drug (tropisetron) on quality of life during chemotherapy: Use of a diary‐type questionnaire and application of summary measures for assessment in a randomized, multicentre study
Authors: Kobayashi Kunihiko , Ishihara Yoko , Nukariya Naotaka , Niitani Hisanobu , Furue Hisashi ,   J OINT R ESEARCH G ROUPFOR T ROPISETRON D OUBLE‐B LIND C OMPARATIVE S TUDY
Published: March 2003

The role of tropisetron as an anti‐emetic drug in the prevention of delayed nausea and vomiting remains unclear. Therefore, effectiveness of tropisetron in patients receiving cancer chemotherapy was evaluated by application of summary measures using a quality of life (QOL) questionnaire. The diary‐type QOL self‐rating questionnaire was constituted by seven scales. A double‐blind randomized, multicentre study was performed in 33 hospitals. Quality of life was measured in 98 patients. Patients receiving cisplatin were randomized to group T (administration of tropisetron before and 4 days after cisplatin treatment) and group P (administration of tropisetron before cisplatin treatment and followed by placebo for 4 days). The rate of complete protection from delayed emesis in the groups T and P was 46.3 and 36.5%. All scales, except social wellbeing changed immediately in both groups and reached a nadir on days 2–3, after that returning to the control levels during 2 weeks after cisplatin treatment. Group T was significantly better than group P in physical wellbeing, mental wellbeing, functional wellbeing and global QOL scores summarized by area under the curve and Difmax (maximum differences of QOL scales’ score from the best score throughout the entire period). These results indicate that continuous administration of tropisetron could contribute to preventing patient QOL influenced by cisplatin treatment, and the combined use of summary measures may be useful for the evaluation of QOL in cancer clinical trial.
Bronchiolitis obliterans organizing pneumonia (BOOP) in a case of smouldering adult T‐cell leukaemia
Authors: Matsuo Kiyoshi , Tada Shinya , Kataoka Mikio , Kanehiro Arihiko , Kaneko Saori , Miyake Toshitsugu , Yamadori Ichiro , Harada Mine
Published: March 2003

Abstract:

Although various respiratory diseases have been reported in human T lymphotropic virus type‐1 (HTLV‐1) carriers or patients with adult T‐cell leukaemia (ATL), there appears to be no report of the development of bronchiolitis obliterans organizing pneumonia (BOOP) in ATL or HTLV‐1‐related disorders. We describe a 51‐year‐old male with smouldering ATL who developed BOOP during a long‐term follow up. Bronchoalveolar lavage (BAL) and transbronchial lung biopsy (TBLB) were performed in the right lower lobe B 6 with infiltrative shadows. As a result of flow cytometric analysis of peripheral lymphocytes and BAL lymphocytes, histological examination of the biopsied lung specimen, and the clinical course, we excluded the pulmonary infiltration of ATL cells and bacterial infection. Thus, he was diagnosed as having BOOP and successfully treated with corticosteroid therapy. This is probably the first report of BOOP developing in ATL. Bronchiolitis obliterans organizing pneumonia should be considered in the differential diagnosis of pulmonary complications in HTLV‐1 carriers or ATL patients since BOOP can be successfully treated by corticosteroids.
Impact of haze from forest fire to respiratory health: Indonesian experience
Authors: Aditama Tjandra Yoga
Published: March 2003

Objective:

This paper will describe the impact on the human lung of haze from forest fires in Indonesia based on data collected from different provinces.

Methodology: Data were collected from personal reports from pulmonologists working in the area as well as from province/district health offices and hospitals.

Results: These data show that there was a significant impact of haze to the human lung. There was a significant increase in respiratory conditions, lung function complaints and other related impacts.

Conclusion: Further studies, especially cohort studies, should be undertaken so that the long‐term impact of pollution from forest fires can be known.
Intravenous magnesium sulfate in acute severe asthma
Authors: Boonyavorakul Chaichan , Thakkinstian Ammarin , Charoenpan Poonkasem
Published: March 2003

Objective:

Intravenous magnesium sulfate (MgSO4), as an adjunctive medication to the standard treatment of acute asthma, improves admission rate or severity score in acute severe asthma patients.

Methodology:

We conducted a randomized double‐blind placebo controlled trial with subjects from the emergency room, Ramathibodi Hospital, Bangkok, Thailand. Patients, aged 15–65 years with acute severe asthma attack, whose severity scores were greater than 4 and who were willing to be enrolled in a study during March to November 1997 participated in the study. Randomly allocated patients received either 2 g intravenous MgSO4 or placebo, sterile water, as an adjunctive medication to standard therapy for acute asthma. The medication was diluted in 50 mL of 0.9% normal saline.

Measurement:

Severity scores were measured by two investigators using Fischl's indices. The times interval of measurements were at the initial (0), 60, 120, 180, and 240 min from receipt of treatment. Patients were hospitalized if the severity scores at 240 min exceeded 1. Risk ratio (RR) and 95% confidence interval (CI) of RR were applied to estimate the risk of admission. Analysis of variance with repeated measurement on time was used to determine the severity score between two groups.

Results:

Thirty‐four patients with acute severe asthma were enrolled in the present study. One patient from the placebo group was excluded because he did not consent to undergoing peak expiratory flow rate. Seventeen patients received MgSO4 and 16 patients received placebo. The general characteristics between the two groups were not significantly different, which reflected the quality of randomization. The admission rates of the placebo and MgSO4 group were 25.00% and 17.65%, respectively. Patients who received MgSO4 had preventive risk to be hospitalized 0.71 times relative to patients who received placebo. However, this preventive risk did not reach statistical significance (95% CI of RR = 0.19–2.67). The severity score at any time between the two groups was also not statistically significantly different (P = 0.366).

Conclusion:

With the present evidence, the hypothesis was not confirmed. Magnesium sulphate as an adjunct to standard therapy did not improve either admission rate or severity score in patients with acute severe asthma.
Effect of Burkholderia cepacia infection in the clinical course of patients with cystic fibrosis: A pilot study in a Sydney clinic
Authors: SONI Rajeev , MARKS Guy , HENRY Deborah A. , ROBINSON Michael , MORIARTY Carmel , PARSONS Stephen , TAYLOR Peter , MAHENTHIRALINGAM Eshwar , SPEERT David P. , BYE Peter T.
Published: March 2003

Background: Colonisation with Burkholderia cepacia complex in patients with cystic fibrosis (CF) has been associated with adverse outcomes. The aim of the present study was to determine the actuarial survival of CF patients colonized with B. cepacia and to evaluate the efficacy of the Royal Prince Alfred Hospital segregation policy. A secondary aim was to characterize the specific genomovars and strains of B. cepacia isolated in an Australian clinic.

Methods: Retrospective review of spirometric and microbiological data on all patients colonized with B. cepacia. Each B. cepacia‐colonized subject was matched with three case‐control subjects. Phenotype and genomovar typing, random amplified polymorphic DNA strain type and B. cepacia epidemic strain marker analyses were performed. The effect of B. cepacia colonization on transplant‐free survival was estimated by Cox's proportional hazards regression using the entire clinic population.

Results:

Fifteen patients were colonized with B. cepacia, of whom six (40%) had died from CF‐related disease by August 1998, compared with 30 of 173 (17.3%) of the entire clinic population. Cepacia status had a significant adverse effect on survival, with a hazard ratio of 2.16 (95% confidence interval 1.0–4.69; P = 0.05). The outcome was variable in subgroups of B. cepacia.

Discussion: Colonization with B. cepacia had a significant adverse effect on survival within the study population. Genomovar and strain typing contributed usefully in accessing the effectiveness of the hospital's segregation policy in preventing cross‐colonization.
Effects of suplatast tosilate on cytokine profile of bronchoalveolar cells in allergic inflammation of the lung
Authors: MATSUMOTO Kazuhiko , HAYAKAWA Hiroshi , IDE Kyotaro , SUDA Takafumi , CHIDA Kingo , HASHIMOTO Hisakuni , SATO Atsuhiko , Nakamura Hirotoshi
Published: March 2003

Objective: Suplatast tosilate is an anti‐allergic agent that inhibits IgE antibody production. It appears to have an inhibitory effect on the production of Th2 cytokines (interleukin (IL)‐4, IL‐5) in vitro. In the present study, we investigated the effects of suplatast on eosinophil infiltration and cytokine mRNA expression in bronchoalveolar lavage (BAL) fluid in a Brown Norway (BN) rat model of bronchial asthma.

Methodology: Suplatast (50 mg/kg per day) was administered intraperitoneally for 15 consecutive days to 8‐week‐old male BN rats that had been actively sensitized to ovalbumin (OA) and alum and rats were challenged with OA aerosol to induce allergic bronchial inflammation. The control group was examined 48 h after antigen inhalation to measure the cell count and cell fraction in BAL fluid. Reverse transcription‐polymerase chain reaction using primers for IL‐4, IL‐5, interferon (IFN)‐γ and β‐actin was used to semiquantitatively measure mRNA expression in BAL cells 24 h after antigen inhalation.

Results: Suplatast was found to decrease the total cell count and the eosinophil count. The mean total cell count in BAL in the suplatast‐treated group was 18.8 × 105 and the mean eosinophil count was 7.8 × 105 compared with 73.0 × 105 and 48.9 × 105, respectively, in the control group. Suplatast also suppressed expression of IL‐4 and IL‐5 mRNA in BAL cells. However, there were no significant changes in IFN‐γ expression.

Conclusions: Suplatast was found to have an inhibitory effect on eosinophil infiltration in a rat model of bronchial asthma. It also appeared to inhibit allergic inflammation by altering the cytokine profile.
Bronchial hyperresponsiveness in patients with squamous cell lung cancer
Authors: INOUE RYUJI , NISHIMURA YOSHIHIRO , KADO TETSUJI , YOKOYAMA MITSUHIRO
Published: March 2003

Objective: The aim of this study was to examine the relationship between bronchial hyperresponsiveness, both in vivo and in vitro, and the type of lung cancer (squamous cell or adenocarcinoma).

Methodology: We measured airway responsiveness by methacholine inhalation test in 33 patients with squamous cell lung cancer and 44 patients with lung adenocarcinoma. In addition, airway smooth muscle reactivity to acetylcholine was measured in vitro in specimens from some patients.

Results: Seventeen of 33 patients with squamous cell cancer and three of 44 patients with adenocarcinoma showed bronchial hyperresponsiveness (BHR). Multiple regression analysis as used to assess the log of the minimum cumulative dose to decrease respiratory conductance vs six variables: cancer phenotype, FEV1 (%predicted), FEV1/FVC (%), smoking pack years, gender and the location of tumour. The phenotype (squamous cell cancer) was the only factor associated with BHR. However, there was no significant difference in airway smooth muscle reactivity to acetylcholine in vitro in bronchial muscle samples from squamous cell cancer patients (n = 6) and adenocarcinoma patients (n = 6).

Conclusion: The present findings suggest that bronchial hyperresponsiveness in patients with squamous cell lung cancer is not determined solely by bronchial smooth muscle hyperreactivity.
Lower respiratory tract infection in hospitalized children
Authors: YIN Chong Chia , HUAH Lim Woan , LIN Jenny Tang Poh , Goh Anne , LING Ho , MOH Chay Oh
Published: March 2003

Objective:  The aim of the present study was to investigate the aetiology and antibiotic‐resistance patterns of community‐acquired lower respiratory tract infection (LRTI) in 1999 and compare it with data from 1995 and 1988.

Methodology:  A prospective observational study of LRTI in hospitalized children at KK Women's & Children's Hospital, Singapore, was undertaken.

Results:  A positive isolate was found in 58% of patients (671/1158), comprising viruses (n = 477, 41.2%), non‐type B Haemophilus influenzae (n = 101, 8.7%), Streptococcus pneumoniae (n = 66, 5.7%), Mycoplasma pneumoniae (n = 92, 8%), Moraxella catarrhalis (n = 19, 1.6%) and other bacteria (n = 19, 1.6%). Mixed virus‐bacteria (n = 104, 9%) infections were comprised mostly of virus‐H. influenzae combinations. In 1999, S. pneumoniae resistance rates were penicillin 44.6% (17%, 1995), amoxycillin 3% (18%, 1995; MIC 0.5–2 µg/mL reclassified as susceptible in 1999), erythromycin 55% (30%, 1995), trimethoprim‐sulfamethoxazole (TMP/SMX) 60% (23%, 1995). H. influenzae resistance rates were amoxycillin 26.7% (38%, 1995), erythromycin 99% (37%, 1995), TMP/SMX 98% (37%, 1995). There were 15 cases of empyema of which seven were proven S. pneumoniae and there was one pneumococcal death (0.08%).

Conclusions:  Pneumococcal pneumonia needs to be treated aggressively due to its high morbidity. Amoxycillin still remains useful for treating pneumococcus despite an increasing resistance to penicillin, erythromycin and TMP/SMX. Judicious use of antibiotics is needed to curb the increasing rate of antibiotic‐resistance.
Influence of the rheological properties of airway mucus on cough sound generation
Authors: HASHIMOTO Yasushi , MURATA Akira , MIKAMI Masashi , NAKAMURA Seiichi , YAMANAKA Eiichi , KUDOH Shoji
Published: March 2003

Objectives:  There have been several reports regarding the role of airway mucus in cough sound generation, but the properties of the mucus that influence cough sound generation remain unclear. The aim of this study was to elucidate the influence of the rheological properties of airway mucus on cough sound generation.

Methodology:  The acoustic properties of voluntary cough sounds from 15 patients with chronic productive cough and nine controls with dry cough were analyzed by dividing the energy envelope of the sounds into three phases and computing the root mean square values and the duration of each phase as a proportion of the total cough duration. The rheological properties of the airway mucus (yield value, ciliary transportability and spinability) were also measured. Differences between productive and dry cough sounds, and correlations between the acoustic properties of cough sounds and the rheological properties of the airway mucus, were analyzed.

Results:  The acoustic properties of productive and dry cough sounds differed significantly (P < 0.05). The acoustic properties of second phase cough sounds correlated significantly with the yield value and ciliary transportability of the airway mucus (P < 0.05).

Conclusions:  The rheological properties of the airway mucus influenced cough sound generation.
Molecular systematics of Trilliaceae II. Phylogenetic analyses of Trillium and its allies using sequences of rbcL and matK genes of cpDNA and internal transcribed spacers of 18S–26S nrDNA
Authors: Osaloo Shahrokh Kazempour , Kawano Shoichi
Published: March 2003

Coding regions of the rbcL and matK genes of cpDNA and internal transcribed spacers (ITS) of nuclear ribosomal DNA were sequenced to study phylogenetic relationships within and among all four genera of Trilliaceae: Trillium, Paris, Daiswa and Kinugasa. The rbcL gene has evolved much slower than matK and in particular ITS; hence the phylogenetic trees based on the rbcL gene show a much lower resolution than trees based on either matK or ITS. The general topology of phylogenetic trees resulting from separate parsimony analyses of the matK and ITS sequences are relatively congruent, with the exception of the placement of T. pusillum. Both matK and ITS phylogenies reveal that T. rivale diverges at the base of the trees. In both trees, Paris, Daiswa and Kinugasa form a relatively weakly supported group. Within this group, the allo‐octaploid Kinugasa japonica is the sister group of Daiswa species. The Paris–Daiswa–Kinugasa group, the major Trillium group, and T. undulatum and T. govanianum showed a loosely related topology, but their affinities are not evident according to these two molecular markers. However, phylogenetic analysis of amino acid sequences derived from matK shows that T. rivale together with clades T. undulatum–T. govanianum, Daiswa–Kinugasa and Paris is basally diverged as a sister group to the remainder of Trillium.
Pollination and evolution in neotropical Annonaceae
Authors: Gottsberger Gerhard
Published: March 2003

The most prominent pollination mode in neotropical Annonaceae is pollination by beetles. Flowers are protogynous and have fruity, spicy or unpleasant odors. The floral chambers, formed by the petals closing over the flower center, emit these specific odors which entice the beetles to enter the flowers. There, the beetles are sheltered from daylight and predators and encounter food (tissues and pollen) as well as opportunities for mating. The amount of food offered, the thickness of the petal tissue and the dimension of the flowers increases with size, number and voraciousness of the attracted beetles. Three main groups of beetle‐pollinated Annonaceae can be distinguished. Two of them have relatively small floral chambers, exhibit diurnal and/or nocturnal anthesis and are visited and pollinated by relatively small beetles (Nitidulidae, Curculionidae, Chrysomelidae). Large flowers with a large pollination chamber and very thick petals are associated with nocturnally active, large and voracious dynastid scarab beetles, which are attracted by strong odors promoted principally by thermogenetic processes of the flowers during the time of the beetles’ main activity. The dynastid beetle‐pollinated species appear to have the most adapted and most specialized flower characteristics in the Annonaceae. Some small‐flowered Annonaceae are pollinated by thrips and, for a few species, pollination by flies is suspected. Some genera, such as Guatteria, are uniform with respect to flower biology and seem to have adapted principally to nitidulids as pollinators. In contrast, the genus Annona, basically a group pollinated by dynastid beetles, is diversified with respect to flower morphology and pollination. The neotropical Annonaceae as a whole may have started as a group pollinated by sucking and pollen‐eating Thysanoptera and non‐destructive beetle groups. Species pollinated by such Thysanoptera and/or rove beetles (Staphylinidae) still show the laminar, plesiomorphic stamen type of Annonaceae with a tongue‐shaped connective prolongation. The disc‐like sclerified connective shield of the majority of Annonaceae is apparently a secondary and modified structure, especially prominent in the beetle‐pollinated species. The densely aggregated stamens with their connective shield appear to be a kind of antipredator structure in Annonaceae adapted to pollination by beetles.
Differentiation of the timing of flower abortion in Tilia japonica
Authors: Ito Eriko , Kikuzawa Kihachiro
Published: March 2003

The sex expression of Tilia japonica is functional andromonoecy (an andromonoecious system with abortion of perfect flowers). Some of protandrous flowers are aborted after shedding pollen grains and thus are functionally male flowers (FMF). When both male and female organs are retained in a flower, the plants can more flexibly regulate sex allocation, or resource allocation to male and female functions than true andromonoecious plants, which is considered as an adaptive significance of functional andromonoecy. However, the plants have to pay some costs of female organ in FMF. For functional andromonoecious plants, there is a conflict between flexibility and cost in determining the timing of flower abortion, or arrest investing in female functions in a flower. We clarified that (i) differentiation of the timing of flower abortion caused two types of FMF: short‐style (SS) and normal‐style (NS) flowers; (ii) SS can be produced at a lower cost than NS, and (iii) plants having NS can flexibly regulate sex allocation following a sudden change in conditions. Hence, we concluded that differentiation of the timing of flower abortion makes a compromise of the conflict. We also found that NS is more frequent than SS, and we discuss the adaptive significance of keeping potential fertility.
Variation in fruit‐ and seed set among and within inflorescences of Melampyrum roseum var. japonicum (Scrophulariaceae)
Authors: Hiei Kayako , Ohara Masashi
Published: March 2003

Abstract Variations in fruit set and seed set among and within inflorescences of the annual herb, Melampyrum roseum var. japonicum, were studied. Under natural conditions, although the mean fruit set was slightly different among inflorescences, the mean seedset was not significantly different among inflorescences within the plants. In constrast, within the inflorescences, the flowers located at a lower position of the inflorescence and which opened earlier showed higher fruit set than those at a higher position and which opened later. However, the seed set of matured capsules were not significantly different from each other, regardless of the position of flowers within the inflorescences. Patterns of the fruit‐ and seed set under open pollination indicated that variation in seed reproduction of M. roseum is due to variation in fruit production. The results of clipping experiments of flowers revealed that there was no functional limitation in seed production among flowers located at various positions within the inflorescence. It seemed that the variation in the fruit set within the inflorescences of M. roseum was not attributable to ‘architectural effects’. Reduction of the number of flowers within the inflorescences resulted in an increase of fruit set and seed weight, indicating that the flowers in an inflorescence compete for resources. This phenomenon supports the ‘resource competition hypothesis’, and variation in fruit set within the inflorescence is attributable to competition among flowers within the inflorescence for limited resources. Consequently, it was concluded that, under natural conditions, the early blooming flowers located at lower positions of the inflorescences obtain more resources and produce more fruits than the late blooming flowers located at higher positions in M. roseum.
Long‐term ventilator support in patients with Werdnig–Hoffmann disease
Authors: Sakakihara Yoichi , Kubota Masaya , Kim Shoei , Oka Akira
Published: March 2003

Abstract Background: Withholding and withdrawing life‐sustaining treatment for patients with Werdnig–Hoffmann disease (WHD) have been accepted as standard medical practice in most Western countries. However, a number of Japanese pediatricians are providing ventilator care for patients with this otherwise fatal disorder. We investigated the attitude of physicians in Japan who are providing ventilator care for patients with WHD.

Methods
: A postal questionnaire was sent to 40 hospitals where pediatricians were taking care of 55 ventilator‐assisted patients with WHD. Their views were sought on aspects of the care of these patients.

Results
: Thirty‐three pediatricians from 31 hospitals responded to the questionnaire. Mechanical ventilation was initiated as an emergency measure in one‐third (12/32) of the patients before obtaining full informed consent from the parents. Two‐thirds (19/32) of parents asked the physicians to start ventilator care for the patients, while only three parents asked for the life‐sustaining treatment to be withheld. Although 80% (24/30) of the physicians thought that the quality of life of the ventilator‐dependent patients with WHD was inadequate, about half (17/30) answered that they would start ventilator assistance if they had a new patient with WHD.

Discussion
: Strong familial endorsement for the prolongation of a patient’s life, the secure national insurance and general pro‐life beliefs could have affected physicians’ decisions in favor of providing life‐sustaining treatments for patients with WHD.
Serum C‐reactive protein in the differential diagnosis of childhood meningitis
Authors: Tatara Ryohei , Imai Hiroyuki
Published: March 2003

Abstract Background: Although determination of serum C‐reactive protein (CRP) is considered one of the most useful tests for differentiating between bacterial and aseptic meningitis, its diagnostic accuracy in comparison with other laboratory parameters is yet to be further evaluated.

Methods
: A total of 192 pediatric cases, aged between 2 months and 14 years, comprising patients with bacterial meningitis (n=66) and aseptic meningitis (n=126), were retrospectively analyzed on the basis of data from the initial examination. The area under the best fit binormal curve of the receiver operating characteristics (Az) for CRP was determined and compared with that for several other analytic parameters, including white blood cell count and erythrocyte sedimentation rate of peripheral blood, standard cerebrospinal fluid analysis variables and the combination test (probability of acute bacterial meningitis (pABM)) derived from Hoen’s model.

Results
: Compared with each of the other variables, the Az for serum CRP (0.97~0.02) was found to be significantly greater (P<0.01) for all except pABM (0.99~0.01; P>0.05). False‐negative cases among the CRP test results were found to have been examined too early.

Conclusions
: The diagnostic accuracy of a single CRP determination was found to be equivalent to that of the most effective combination test. Patients with meningitis in whom serum CRP values are determined at least 12 h after the onset of fever and are <2 mg/dL are far less likely to have bacterial meningitis.
Immunoglobulin subgroups in children with febrile seizures
Authors: Çaksen Hüseyİn , Öner Ahmet Faİk , Arslan Şükrü , Kan Muhİttİn Cengİz , Cesur Yaşar , Üner Abdurrahman
Published: March 2003

Background
: The aim of the present study was to determine whether or not there was a role for immunoglobulin (Ig) or IgG subgroups in the pathogenesis of febrile seizures (FS).

Methods
: Serum levels of IgA, total IgG, IgM, IgE, IgG1, IgG2, IgG3 and IgG4 were measured in 34 children with FS and in 37 healthy children used as a control group. Both patients and controls were divided into two groups according to age (group I, 6–24 months; group II, 25–72 months).

Results
: Compared with controls, mean IgG4 levels in patients were found to be decreased in both groups I and II (group I: 95~14 vs 57~5, respectively, P=0.01; group II: 178.5~38.5 vs 65.1~24.5, respectively, P<0.01), while mean IgG2 levels were found to be decreased only in group II patients (170~16 vs 103~22; P<0.05).

Conclusions
: The results of the present study suggest that Ig subclass deficiencies may be responsible for the infections connected with FS or that they may be related to the pathogenesis of FS in some children.
Effects of albumin infusion therapy on total and unbound bilirubin values in term infants with intensive phototherapy
Authors: Hosono Shigeharu , Ohno Tsutomu , Kimoto Hirofumi , Nagoshi Ren , Shimizu Masaki , Nozawa Masayo
Published: March 2003

Background
: The purpose of the present study was to evaluate the effect of intravenous albumin administration on the serum total and unbound bilirubin values in term non‐hemolytic hyperbilirubinemic neonates during intensive phototherapy.

Methods
: Fifty‐eight infants (gestational age 39.4~1.4 weeks; birth weight 3245~435 g) were given phototherapy with similar light energy. Twenty infants (control group) received only phototherapy, while 38 others (albumin‐treated group) were also given human albumin at 1 g/kg bodyweight, i.v., during the first 2 h of phototherapy.

Results
: When comparing changes in total and unbound bilirubin values 0, 2, 6 and 24 h after entering the study between the albumin‐treated group and the control group, there was a significant reduction in the serum unbound bilirubin values at the end of albumin treatment and at 6 and 24 h. However, there was no significant reduction in total serum bilirubin values during the study period. In the albumin‐treated group, the mean serum unbound bilirubin reduction from the baseline level at the end of albumin treatment and at 6 and 24 h was 0.40~0.19, 0.41~0.20 and 0.43~0.20 μg/dL, respectively.

Conclusions
: The results suggest that albumin priming may be effective for an immediate reduction in serum unbound bilirubin values, the fraction that is potentially neurotoxic.
Low‐dose doxapram therapy for idiopathic apnea of prematurity
Authors: Yamazaki Toshio , Kajiwara Masato , Itahashi Kazuo , Fujimura Masanori
Published: March 2003

Abstract

Background
: Doxapram is contraindicated for newborn infants in Japan because of its serious side effects. However, because of encouraging results of recent studies regarding the efficacy and safety of therapy for apnea of prematurity (AOP) with lower doses of doxapram than those previously proposed, approximately 60% of Japanese neonatologists continue to use doxapram at small doses. Caution is warranted because the sample sizes of the former studies are inadequate to evaluate doxapram for both its beneficial and harmful effects. Therefore, we conducted the present study in order to investigate the efficacy and harmful events of low‐dose doxapram therapy for idiopathic AOP in very low‐birth weight (VLBW) infants in a larger population.

Methods
: One hundred and six VLBW infants with idiopathic AOP were treated with doxapram at a dose of 0.2–1.0 mg/kg per h in combination with methylxanthines and the frequency of apnea and secondary outcomes were compared with a group of control infants.

Results
: An approximate 80% reduction in the frequency of apnea was found with only minimal side effects following low‐dose doxapram. Although there were no significant differences in secondary outcomes between the doxapram‐treated and control groups, mortality in doxapram‐treated infants was significantly lower than that in control infants.

Conclusions
: Patients with AOP unresponsive to treatment with methylxanthines may benefit from the addition of low‐dose doxapram.
Measles seroprevalence in Izmir with special emphasis on measles vaccination policy for Turkey
Authors: Egemen Ayten , Aksit Sadik , Ozacar Tijen , Kurugol Zafer , Keskinoglu Pembe , Pehlivan Tamer , Mutlu Sefika
Published: March 2003

Abstract

Background
: Measles outbreaks seem to occur every 2‐ to 3‐year intervals in Turkey. However, sero‐epidemiological studies are limited. Knowing the prevalence of measles susceptibility as measured either by serologic markers of immunity or surveys of vaccination coverage is an important tool to assess the risk for measles outbreaks.

Methods
: In order to determine the seroprevalence of measles antibodies among a 1 to 29‐year‐old population in İzmir (Turkey) and to develop the best vaccination policy for measles, a total of 600 people aged from 1 to 29 were selected for the study with cluster sampling. The information on sociodemographic characteristics, vaccination status and measles history was gathered for each participant. Measles‐specific IgG antibodies were screened qualitatively by using microenzyme immune assay for 595 subjects.

Results
: Of the 595 participants screened for the measles antibodies, 56 (9.4%) were seronegative. The proportion of the susceptible individuals in the age groups of 1–4, 5–9, 10–14, 15–19 and 20–29 was 20.0, 10.4, 6.0, 10.3 and 3.0%, respectively. The logistic regression analysis showed that none of the independent characteristics (sex, socioeconomic status, past measles history, vaccination status) with the exception of age group, was significantly associated with measles seronegativity.

Conclusion
: The optimal measles vaccination policy for Turkey may be to increase vaccination coverage above 90%, to conduct a catch‐up campaign covering persons aged 1–19, regardless of previous vaccination status. Another factor to consider is to adopt a routine two‐dose vaccination, giving the first dose at 12_15 months of age and the second dose at school entry.
Serum levels and differential expression of CD44 in childhood leukemia and malignant lymphoma: Correlation with prognostic criteria and survival
Authors: Taçyildiz Nurdan , Çavdar Ayhan O. , Yavuz Gülsan , Gözdaşoglu Sevgi , Ünal Emel , Ertem Ulya , Duru Feride , Ikinciogullari Aydan , Babacan Emel , Kuzu Isinsu , Cin Şükrü
Published: March 2003

Abstract

Background
: The CD44, a cell surface proteoglycan, participates in a variety of function including tumor dissemination and metastasis. However, there are no available data on the prognostic significance of CD44 expression of tumor tissue correlated with serum sCD44 level in childhood leukemias and lymphomas.

Methods
: Serum levels and leukemic cell tumor tissue expression of CD44 were detected in 54 children with acute leukemia and malignant lymphoma. Serum samples were obtained from all patients before treatment and during remission. Twelve age‐matched healthy children were included as a control group.

Results
: The serum CD44 levels were significantly higher in patients with Hodgkin’s disease (HD), non‐Hodgkin’s lymphoma (NHL), Burkitt’s lymphoma (BL) and acute lymphoblastic leukemia (ALL) than those in the control group. The median values were 1627.0, 1336.0, 1318.5, 1730.4, 902.7 ng/mL, respectively, and P<0.001, P<0.01, P<0.01, P<0.05 in comparisons, respectively. However, there was no significant difference between acute myeloid leukemia (AML) and the control group (median values: 900.3 and 902.7 ng/mL, respectively, P>0.05). Serum sCD44 levels significantly declined in HD, NHL and ALL patients who were in complete remission (median values: 684.0, 573.8 and 1101.1 ng/mL, respectively, P<0.05 in each comparison). Patients with HD had higher levels of serum sCD44 and correlated well with higher erythrocyte sedimentation rate (ESR), B‐symptoms and advanced‐stage disease (P<0.05, P<0.05 and P<0.01, respectively). Expression of CD44 was significantly high in patients with HD and NHL who were in advanced stages of disease. High serum CD44 level was also associated with high tumor tissue expression of CD44 in patients with HD and BL. In addition, patients with higher levels of serum sCD44, had a poorer outcome and survival than those with lower sCD44 levels in HD and NHL groups.

Conclusions
: A high serum sCD44 level and/or tumor tissue expression at diagnosis is associated with poor prognostic criteria and/or unfavorable outcome in childhood leukemias and lymphomas.
Management of childhood diseases in the Byzantine period: I − Analgesia
Authors: Ramoutsaki Ioanna A. , Dimitriou Helen , Kalmanti Maria
Published: March 2003

Evidence on the use of pain relievers for medical purposes in childhood was traced in medical treatises during Byzantine times(4th to 15th century ad). The texts of Aetius, Paulus Aeginitis, Orivasios and others strongly reveal influences fromancient Greek medicine. Greek physicians of the times, who helped the medical thinking of antiquity to stay alive, used opium withmandragoras, hyoscyamos and other sedative herbs to produce a kind of anesthetic state and to relieve pain. However, in children’scases they chose to selectively use substances in more standardized quantities, mainly in mixtures. Less aggressive methods such aswarm baths, or appropriate food were highly respected by them and recommended for the treatment of sick children.
Prevention of respiratory syncytial virus infections in high‐risk infantsby monoclonal antibody (palivizumab)
Authors: Groothuis Jessie R. , Nishida Hiroshi
Published: March 2003

Respiratory syncytial virus (RSV) is a major viral pathogen whichcauses serious respiratory illness in infants and children worldwide.Palivizumab (Synagis) is an anti‐RSV monoclonal antibody administeredintramuscularly for the prevention of severe RSV respiratory diseasein high‐risk infants and young children. The IMpact‐RSV trial, thepivotal multicenter, randomized, placebo‐controlled trial performedin the USA, Canada and the United Kingdom demonstrated an overall55% reduction in hospitalization rate due to RSV infection inpreterm infants (≤ 35 weeks gestation)with and without chronic lung disease (CLD). Subgroup analysis in prematureinfants without CLD revealed an even greater reduction in RSV hospitalizationrates (78%). Adverse events were infrequent and did notdiffer between placebo and palivizumab groups. Injection site reactionswere infrequent and mild; no differences were observed between palivizumaband placebo subjects. Palivizumab does not interfere with administrationof other pediatric vaccines. Comprehensive parent education programsregarding prevention of infection, avoidance of risk factors forinfection, careful adherence to infection control policies, andrecognition of early symptoms of RSV infection remain important componentsof RSV prevention strategies. In light of the lack of effectivevaccines for this serious health risk, palivizumab offers the onlyoption for prophylaxis against RSV disease in high‐risk infants.
Relationship between erythropoietin levels both in cord serum and amniotic fluid at birth and abnormal fetal heart rate records
Authors: Kakuya Fujio , Shirai Masaru , Takase Masashi , Ishii Noriyuki , Ishioka Tooru , Hayashi Tokitsugi , Kasamo Mitsunori , Kawamura Mitsuhiro , Sasaki Kiminori
Published: March 2003

Background
: Our data in rats suggest that an elevated amniotic fluid erythropoietin (EPO) level at birth indicates antepartum fetal hypoxia. However, the short gestation period in rats does not permit a direct comparision of our data with humans.

Methods
: We conducted a retrospective study of the relationship between EPO levels at birth and abnormal fetal heart rate (FHR) records in 113 infants.

Results
: Among the cesarean section group, the cord serum and amniotic fluid EPO levels in the infants with antepartum abnormal FHR records were significantly higher than those in the control infants. Among the vaginal delivery group, the cord serum EPO levels in the infants with intrapartum abnormal FHR records was significantly higher than that in the control infants. The EPO levels in either cord serum and amniotic fluid discriminated between infants with antepartum abnormal FHR records. The control infants had a sensitivity of 83% and a specificity of 96%. Six of the seven infants with abnormal EPO levels in both cord serum and amniotic fluid had symptoms of prolonged fetal hypoxia. Five infants with abnormal EPO levels in only cord serum had symptoms of acute fetal hypoxia before birth. Four of the 14 infants with abnormal EPO levels at birth had poor outcomes in the neonatal period.

Conclusions
: We concluded that EPO levels in both cord serum and amniotic fluid at birth are valuable for determining the timing of fetal hypoxia and may predict the outcome in the neonatal period.
Serodiagnosis of Helicobacter pylori infection is not accurate for children aged below 10
Authors: Okuda Masumi , Miyashiro Eikichi , Koike Michio , Tanaka Tomoyuki , Bouoka Mina , Okuda Syuuji , Yoshikawa Norishige
Published: March 2003

Background
: In order to investigate the immune response to Helicobacter pylori in childhood, we compared anti‐H. pylori IgG and IgA antibodies with H. pylori antigen in the stool and examined the clinical usefulness of the anti‐H. pylori IgG and IgA antibodies.

Methods
: This study included 157 children who were seen at our hospital. Serum and stool samples were obtained for these children. Antibodies to H. pylori were examined using an H. pylori IgG enzyme‐linked immunosorbent assays (ELISA) and an H. pylori IgA ELISA. Analysis of stool samples was carried out by the H. pylori stool antigen (HpSA) enzyme immunoassay.

Results
: Of the 157 children, 45 children were HpSA positive, 110 were negative and two were undetermined. Out of 45 HpSA positive patients, 25 children were both IgG and IgA positive and seven were negative for both IgG and IgA antibodies. Of the 110 patients who were HpSA negative, 97 were negative for both antibodies. All HpSA positive children older than 10 years were positive for IgG and IgA antibodies, but of the HpSA positive children under the age of 10, only 18 out of 35 (51.4%) were positive for IgG antibodies or IgA antibody.

Conclusion
: These facts suggested that an immature immune response or tolerance to H. pylori exists in childhood and serodiagnosis of H. pylori infection is less useful in children aged below 10.
Clinical experiences of microsurgical side‐to‐end epididymovasostomy for epididymal obstruction
Authors: Eguchi Jiro , Nomata Koichiro , Hirose Takeshi , Nishimura Naoki , Igawa Tsukasa , Kanetake Hiroshi , Saito Yutaka , Higami Yoshikazu
Published: March 2003

Background: Some surgical treatments are performed for obstructive azoospermia in urology and good results have been reported. Of 61 azoospermic patients who visited our department of urology, nine were diagnosed as having epididymal obstruction of unknown etiology.

Methods: We describe nine consecutive side‐to‐end epididymovasostomy procedures performed on these patients. These procedures are microsurgical two‐layer anastomosis.

Results: Of the nine men, five (55.6%) had sperm in the ejaculate postoperatively and, up until publication, the pregnancy rate was 33.3% (three of nine).

Conclusions: These results suggest that reconstruction of the seminal tract should be considered first for obstructive azoospermia.
Psoas abscess associated with iliac vein thrombosis and piriformis and gluteal abscesses
Authors: Arai Yutaka , Kawakami Takahiro , Soga Hiroki , Okada Yusaku
Published: March 2003

Background: A 14‐year‐old boy was admitted because of lumbago and high fever.

Methods/Results: Computed tomography scans revealed psoas, piriformis and gluteal abscesses as well as right iliac vein thrombus. A right femoral venogram demonstrated compression from the psoas abscess and thrombosis of the common iliac vein. Appropriate surgical drainage, administration of antibiotics and anticoagulant therapy were effective in the present case.

Conclusions: This is the first report of primary psoas abscess associated with vein thrombosis and is also unique in that abscesses were multiple without predisposing diseases or trauma.