bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictive and prognostic markers for invasive breast cancer
Authors: Mori Ichiro , Yang Qifeng , Kakudo Kennichi
Published: March 2003

Breast cancer is one of the most serious carcinomas among women worldwide, yet there are now encouraging signs that improvements in the mortality rate may be possible. The use of hormone therapy and chemotherapy has been widely accepted as treatment for breast cancer. Predictive factors can be used to predict response or lack of response to a particular therapy, and prognostic factors can be useful in making decisions about which patients should receive adjuvant therapy. Histopathology remains the universal basis of diagnosis, with the identification of new surrogate markers for potential new treatments. These are aimed at blocking tumor cell proliferation, neutralizing growth factors, stimulating apoptosis and blocking metastasis, and represent an integral part of new approaches for improving clinical management of patients with breast cancer. We review the standard predictive and prognostic factors that are routinely available today, and also describe some of the new, potential markers that are currently under investigation.
Matrix metalloproteinases in tumor invasion: Role for cell migration
Authors: Nabeshima Kazuki , Inoue Teruhiko , Shimao Yoshiya , Sameshima Tetsuro
Published: March 2003

Matrix metalloproteinases (MMP) play a role in a wide range of tumorigenesis, including early carcinogenesis events, tumor growth and tumor invasion and metastasis. Given that the ability of tumor cells to infiltrate and disseminate widely is what makes the tumors malignant, a role of MMP in cell migration during this invasive and metastatic process is important. There are two types of cancer cell migration: single cell locomotion and cohort migration (cell movement en mass keeping cell–cell contact, which is frequently seen in better differentiated carcinomas). Cell surface localization and activation of MMP is essential for cells to migrate, through rearrangement of extracellular matrix (ECM) to suit cell migration. Certain MMP, such as gelatinases and membrane ‐type 1 MMP, have special mechanisms to localize at leading edges in both types of cell migration. Moreover, in cohort migration, expression of these MMP is regulated via cell–cell contact within migrating cell sheets and confined to the foremost pathfinder cells of the migrating cell sheets. New roles of cell surface MMP, such as cleavage of cell surface receptors or cofactors involved in cell–ECM interactions during cell migration, are also discussed.
Detection of c‐erbB‐2 (HER‐2/neu) amplification in breast carcinoma by fluorescence in situ hybridization on tissue sections and imprinted cells
Authors: Kunitomo KazuyoshI , Takehana Takuo , Inoue Shingo , Fujii Hideki , Suzuki Shioto , Matsumoto Yoshiro , Ooi Akishi
Published: March 2003

Abnormalities in c‐erbB‐2 have attracted a great deal of attention. Treatment using an antibody against the c‐erbB‐2 gene product is effective against breast cancers with amplification and/or overexpression of c‐erbB‐2. There is an urgent need to establish methodology for selecting patients who would benefit from this therapy. A total of 235 breast carcinomas were examined for c‐erbB‐2 protein overexpression by immunohistochemistry. Tissue sections with discernible immunostaining from 52 tumors, 70 negative tumors and smear imprints from 35 patients were examined by dual‐color fluorescence in situ hybridization (FISH) using probes specific for c‐erbB‐2 and the centromeric region of chromosome 17. The concordance between gene amplification and protein overexpression was 95.7%. When the findings of the two FISH preparation techniques were compared, no discrepancies were found in 24 of the tumors. However, differences were seen in eight cases. In six of these cases the differences did not affect the presence or absence of amplification, but in the other two cases, considered to show low‐level amplification on paraffin sections, polysomy 17 was detected instead. It was concluded that FISH is an excellent tool to detect gene amplification in particular, and FISH on touch imprints is a useful adjunct to differentiate between low‐level amplification and polysomy 17.
Malignant mesothelioma of the pericardium: Case reports and immunohistochemical studies including Ki‐67 expression
Authors: Hirano Hiroshi , Maeda Tamaki , Tsuji Motomu , Ito Yasuhiro , Kizaki Tomohiko , Yoshii Yasuyosi , Sashikata Terumasa
Published: March 2003

Pericardial malignant mesothelioma (PMM) is extremely rare compared with pleural cases of mesothelioma. We present the clinical and pathological features of three autopsy cases with PMM. All three cases showed rapid progress and died of heart failure. Detailed examination was obtained from the autopsy. Macroscopic appearances of each case showed a thickened pericardium due to tumor invasion. Microscopic observations of all cases led to a diagnosis of epithelial‐type malignant mesothelioma (MM). The results of immunohistochemical examinations were similar to the previous published work on pleural mesothelioma. To disclose the pathological characteristics of PMM, we analyzed Ki‐67 labeling index (LI) of three cases of PMM and five cases of pleural MM that died within 2 years. The difference of Ki‐67 LI between PMM and pleural MM was not significant (P > 0.05). The poor prognosis of patients with PMM must be caused by restricted cardiac wall motion due to tumor involvement, in addition to the tumor proliferation itself.
Pleomorphic adenoma with extensive adenoid cystic carcinoma‐like cribriform areas of parotid gland
Authors: Ogawa Ikuko , Miyauchi Mutsumi , Matsuura Hiroo , Takata Takashi
Published: March 2003

We report an interesting case of pleomorphic adenoma (PA) with extensive adenoid cystic carcinoma (ACC)‐like cribriform areas of parotid gland along with a discussion of the differential diagnosis. The patient was a 62‐year‐old‐female who presented with a 5‐month history of a slow‐growing painless mass in the left preauricular region. Pathological examination of the excised mass revealed a well‐encapsulated tumor consisting of typical PA areas and extensive ACC‐like cribriform areas. The transition between both areas was frequently observed. There was no clinical or histological evidence of a longstanding PA, such as prominent hyalinization with dystrophic calcification. Immunohistochemically, the neoplastic myoepithelial cells of the PA areas showed frequent expression of vimentin and S‐100 protein, along with occasional positivity for glial fibrillary acidic protein and α‐smooth muscle actin. The immunoreactivity of the neoplastic myoepithelial/basal cells forming cribriform nests was essentially identical to that of the PA areas. The difference of immunoreactivity of the basal/myoepithelial cells between PA and ACC may have some discriminatory advantage. In addition, the low proliferative activity observed in the entire tumor suggested that the cribriform nests resembling ACC are also the component of PA.
NDP‐sugars, floridoside and floridean starch levels in relation to activities of UDP‐glucose pyrophosphorylase and UDP‐glucose‐4‐epimerase in Solieria chorda l is (Rhodophyceae) under experimental conditions
Authors: Goulard Fabienne , Le Corre Géraldine , Diouris Marcel , Deslandes Eric , Floc'h Jean‐Yves
Published: March 2003

Under limited nutrient availability (i.e. unenriched sea‐water) and under 75 mol photons m–2 s–1 irradiance 12:12 LD, thalli of Solieria chordalis J. Agardh accumulated floridean starch and floridoside. When they were transferred into nutrient‐enriched seawater (150 umol L−1 NO31‐ and 7 umol L−1 P043i at 35 umol photons m−2 s−1 in irradiance 12:12 LD, starch and floridoside levels decreased. The main nucleotide diphosphate (NDP) sugars (i.e. UDP‐glucose, UDP‐galactose and ADP‐glucose) and the activities of UDP‐glucose pyrophosphorylase [Enzyme Code (EC) 2.7.7.9] and UDP‐glucose‐4‐epimerase (EC 5.1.3.2) were measured under these controlled culture conditions. Both UDP‐glucose and UDP‐galactose in the thal l i increased under conditions known to favor the accumulation of floridean starch and floridoside, whereas they decreased under conditions leading to floridean starch and floridoside breakdown. On the other hand, ADP‐glucose level only varied slightly. Although UDP‐glucose pyrophosphorylase activity rose under conditions of floridean starch synthesis, little variation was observed in UDP‐glucose‐4‐epimerase activity. These results suggest a possible enzymatic regulation of the NDP‐sugar and carbohydrate pool in which UDP‐glucose pyrophosphorylase would play a major role.
Research note: Identification of a cDNA homologous to the cell‐cycle‐controlling cdc2 gene in Acroslphonia duriuscula (Acrosiphoniales, Chlorophyta)
Authors: Kato Atsushi , Aruga Hirofumi , Mototnura Taizo
Published: March 2003

Cyclin‐dependent kinases, the most notable of which is cdc2, are key regulators of the cell cycle and are highly conserved in evolution. We have cloned and analyzed one cDNA containing an open reading frame of 337 amino acids from a multinucleate, multicellular green alga, Acrosiphonia duriuscula (Ruprecht) Collins. The deduced protein, named Adcdc2‐1, showed 51% and 54% amino acid sequence identity to yeast cdc2/cdc28 and human cdc2, respectively. Several domains that characterize the cdc2‐related kinases were identified from this sequence, although the PSTAIRE motif was replaced with PPTTIRE. Furthermore, this protein has conserved Tyr and Thr residues that are sites of phosphorylation in cdc2‐related kinases and are important for regulating kinase activity. The present results suggest that the universal cdc2 is conserved in algae with unique structural characteristics.
Endobronchial metastasis from stomach cancer
Authors: Park Yong Beom , Byun Young Sup , Kim Se Kyu , Yang Dong Gyu , Chang Joon , Kim Joo Hang , Shin Dong Hwan , Kim Sung Kyu , Lee Won Young
Published: March 2003

A young woman presented with a dry cough present during the previous 4 weeks. A chest radiograph demonstrated diffuse interstitial infiltration in both lower lung fields. Fibreoptic bronchoscopic examination revealed multiple 2–3 mm elevated nodules on the bronchial surface and a mucosal biopsy showed extensive subepithelial infiltration of poorly differentiated adenocarcinoma without definite precancerous alteration in the overlying epithelium. Studies for the evaluation of primary tumour focus were performed. Oesophagogastroduodenoscopy showed advanced gastric cancer of Borrmann type III, and mucosal biopsy of the stomach showed poorly differentiated adenocarcinoma. The patient was treated three times with systemic chemotherapy, but her condition deteriorated. Three months after diagnosis, she died of complicated pneumonia. This is a rare case of endobronchial metastasis from stomach cancer. The stomach is an unusual site of endobronchial metastasis from extrathoracic primary malignancy.
Acute myopathy after status asthmaticus: Steroids, myorelaxants or carbon dioxide?
Authors: Goh Adrian , Chan Patrick
Published: March 2003

Acute myopathy complicating treatment of status asthmaticus has been increasingly recognized since its original description in 1977. We report a case of an 11‐year‐old boy with severe asthma requiring mechanical ventilation. He was given high doses of parenteral steroids and neuromuscular blockade with non‐depolarizing agents in order to achieve controlled hypoventilation with an ensuing hypercapnoea. He developed rhabdomyolysis with elevated creatinine kinase and renal impairment secondary to myoglobinuria. Electrophysiological studies revealed myopathic abnormalities. The aetiology for this myopathy appears to be related to therapy with parenteral steroids, muscle‐relaxant agents and respiratory acidosis. Patients treated with steroids and neuromuscular blocking agents should be regularly monitored for development of myopathy.
The breathing route dependence of ventilatory responses to hypercapnia and exercise is modulated by upper airway resistance
Authors: Shi Yong‐Xin , Seto‐Poon Margaret , Wheatley John R
Published: March 2003

Objective:

The ventilatory response to hypercapnia is greater breathing orally than nasally.

Methodology: We hypothesize that this is due to higher nasal resistance to airflow compared with oral resistance. Seven normal male subjects were studied during both progressive hyperoxic hypercapnia (HC) and exercise (EX) until ventilation exceeded 40 L/min. Under each condition, subjects breathed via the nose only or the mouth only. For each breathing route, ventilation and pathway resistance were calculated simultaneously at the highest common exercise workload (140 ± 20 watt; mean ± SE) or the same end‐tidal CO2 level (8.0 ± 0.5%).

Results: The ventilatory response breathing nasally was decreased by a similar amount for both EX and HC when compared with the oral route. The difference between nasal and oral ventilation was highly correlated with the difference between nasal resistance and oral resistance for both EX and HC (linear regression analysis; r = 0.91 for EX and r = 0.86 for HC; both P < 0.01).

Conclusion: We conclude that the breathing route dependence of ventilatory responses to respiratory stimuli in normal subjects is independent of the method of stimulation and is substantially determined by the added resistance of nasal breathing.
Biased T cell receptor Vβ gene expression in bronchoalveolar lavage fluid from Japanese patients with sarcoidosis
Authors: Yoshitomi Atsushi , Sato Atsuhiko , Hayakawa Hiroshi , Chida Kingo , Toyoshima Mikio , Uchijima Masato , Yoshida Atsushi , Koide Yukio
Published: March 2003

Objective:

Sarcoidosis is believed to be one of the T cell‐mediated granulomatous diseases with unknown aetiology. We attempt to search for the causative T cell clones of sarcoidosis.

Methods: We study T cell receptor β‐chain variable region (Vβ) repertoire in peripheral blood (PB) and bronchoalveolar lavage fluid (BALF) from patients with sarcoidosis, using semi‐quantitative reverse transcriptase–polymerase chain reaction method. The expression of 22 kinds of Vβ genes is examined in 17 patients with sarcoidosis and nine normal subjects.

Results: Compared with control subjects, the group with sarcoidosis exhibits significantly high expressions of the Vβ2 (P < 0.005, Wilcoxon’s test) and Vβ6 (P = 0.005) genes in BALF. In each BALF sample, the Vβ2 (P < 0.01, χ2 test) and Vβ6 (P < 0.01) genes were overexpressed (> 2 SD above the mean value for each Vβ observed in control subjects) in 11 and 10 of 17 patients with sarcoidosis, respectively. Furthermore, the amino acid sequences of Vβ6+ complementarity determining region 3 were conserved in one of three patients. There is, however, no disposition of Vβ gene usage in PB from patients with sarcoidosis compared with control subjects.

Conclusions: The T lymphocytes with Vβ2 and/or Vβ6 are associated with the pathogenesis of sarcoidosis. The possibility exists that these T lymphocytes might be capable of recognizing the restricted antigens, thereby inducing oligoclonal expansion.
Flow–volume curve changes in patients with obstructive sleep apnoea and brief upper airway dysfunction
Authors: Campbell Alastair H , Guy Paul A , Rochford Peter D , Worsnop Christopher J , Pierce Robert J
Published: March 2003

Objective:

Patients with obstructive sleep apnoea (OSA) and those with brief upper airway dysfunction (BUAD) have been reported to have abnormalities of maximal flow–volume curves. This study was designed to assess the ability of flow–volume curves to predict the presence of OSA or BUAD.

Methodology: Four maximal flow–volume manoeuvres performed by 33 OSA patients and 16 BUAD patients were compared with those of 36 normal subjects. Flow–volume indices, their variability, saw‐toothing in the curve and an algorithm based on the flow ratios and shape of the curves were assessed.

Results: When the confounding factors, body mass index (BMI), age, gender and smoking status were taken into account, there was no significant difference in a variety of indices derived from the flow–volume curves between OSA and normal subjects. No BUAD patient had normal flow–volume curves as determined with the algorithm. After BMI, age, gender and smoking status were accounted for, decreased forced expiratory volume in 1 s (FEV1), and increased variability of peak expiratory flow (PEF)/peak inspiratory flow (PIF) and FEV1/PEF remained significantly associated with BUAD.

Conclusions: These findings suggest that flow–volume curve indices have no value in predicting OSA. Some abnormalities are found in patients with BUAD; a normal flow–volume curve makes the diagnosis of BUAD unlikely.
The effect of intratracheal pulmonary ventilation on the decrease of dead space in rabbits with acute respiratory failure
Authors: Lee Kook Hyun , Kim Jie Ae , Cho Hyun Sung
Published: March 2003

Objective:

A technique that improves the efficiency of alveolar ventilation should decrease the pressure required and reduce the potential for lung injury during mechanical ventilation. High partial pressure of carbon dioxide (PaCO2) can be tolerated if associated with a lower airway pressure as in permissive hypercapnia (PH). Intratracheal pulmonary ventilation (ITPV) was developed to allow a decrease in physiological dead space during mechanical ventilation. We compared the effect of hybrid ventilation (HV) as a modification of ITPV with PH on the decrease of tidal volume and airway pressures in rabbits with acute respiratory failure.

Methodology: Tracheostomy was performed in seven rabbits ventilated under volume‐controlled mode in the supine position. Arterial blood gas analysis, airway pressures, and dead space ventilation were measured at respiratory rates of 20/min as control values. Oleic acid (OA) of 0.06 mL/kg was injected to induce acute respiratory failure. Tidal volume (VT) was elevated to maintain PaCO2 in the normal range. These same parameters were measured as OA values. Then VT was reduced to the control level to allow PH. Hybrid ventilation was initiated by inserting a reverse thrust catheter (RTC) into the endotracheal tube. Hybrid ventilation consists of a pressure‐controlled mode of mechanical ventilation and ITPV while flushing fresh gas continuously via the RTC. Respiratory parameters were compared under control, OA, PH and HV conditions.

Results: Oleic acid injection decreased partial pressure of oxygen (PaO2) from 401 ± 35 mmHg to 129 ± 39 mmHg, increased VT from 42 ± 5 mL to 52 ± 10 mL, and increased dead space (VD)/VT ratio from 0.65 ± 0.07 to 0.71 ± 0.07. During PH, the increase in PaCO2 was accompanied by an increase in VD/VT ratio from 0.71 ± 0.07 to 0.79 ± 0.03 and by a decrease of peak inspiratory pressure (PIP) from 19.4 ± 4.0 cmH2O to 16.8 ± 3.1 cmH2O. PaCO2 was lowered from 50 ± 5 mmHg in PH to 39 ± 5 mmHg in HV with a lower VT. VD/VT ratio in HV which was as low as that in control.

Conclusions: Hybrid ventilation is an effective and easy‐to‐use ventilatory modality to reduce PaCO2 and airway pressures by the reduction in VD/VT ratio in acute respiratory failure model.
Bronchial responsiveness to beta‐adrenergic stimulation and enhanced beta‐blockade in asthma
Authors: Boskabady Mohammad Hossen , Snashall Phyllip Duglas
Published: March 2003

Objective:

Beta‐adrenergic blocking drugs have no effect on the airways of normal subjects but in asthma even small doses may cause severe deterioration. A seemingly obvious explanation for this abnormal sensitivity is that asthmatic airways, but not normal airways, are tonically dilated by the sympatho‐adrenal system. However, studies suggest that sympatho‐adrenal activity is normal in asthma, as is bronchial sensitivity to β‐agonists. The present study re‐examines bronchial β‐adrenergic sensitivity in asthma and also measures antagonism produced in normal and asthmatic bronchi by a beta‐blocking drug.

Methodology: The threshold bronchodilator doses of inhaled isoprenaline (dose required for a 35% increase in specific airway conductance ‘PD35’) was measured in 11 normal and 14 asthmatic adults on two separate occasions. After administering propranolol (inhaled or intravenously) PD35 was remeasured.

Results: Sensitivity to isoprenaline was greater in symptomatic asthmatics (PD35 = 0.003 μmol) than in asymptomatic asthmatics (PD35 = 0.021 μmol) and in non‐asthmatics (PD35 = 0.123 μmol; P < 0.001 in each case). Symptomatic asthmatics also showed 66‐fold more antagonism than non‐asthmatics when they were given propranolol by inhalation (P < 0.001) and sixfold more with intravenous propranolol (P = 0.005).

Conclusions: The increased sensitivity of asthmatics to inhaled isoprenaline suggests that they may also be more sensitive to their endogenous adrenaline, which may thus dilate and stabilize their airways. Taken with enhanced antagonism by propranolol, this provides insight into the aggravation of asthma by beta‐blocking drugs.
Seasonal variation in asthma hospitalizations and death rates in New Zealand
Authors: Kimbell‐Dunn Mona , Pearce Neil , Beasley Richard
Published: March 2003

Objective:

The aim of this study was to determine if there is a seasonal pattern to asthma hospitalizations and mortality in New Zealand.

Methodology:

Data for an 18–20 year period were obtained for the whole of New Zealand regarding the number of asthma deaths and hospital discharges in each month, as well as annual population totals (1978–1995 for asthma hospitalizations, 1976–1995 for asthma deaths). Monthly mortality and hospital discharge rates were calculated for the age groups 5–14, 15–44, and those aged 45 years and older. Variation about the mean monthly rates was plotted along a linear timescale to observe the seasonal trend.

Results:

In the oldest age group (45+), asthma mortality and hospitalization rates peaked in the winter months (July/August). Among the younger age groups, however, mortality and hospitalizations showed different seasonal patterns; peak hospitalization occurred in the early winter months, with peak mortality in the early summer months.

Conclusions:

Seasonal variations in the asthma hospitalization and death rates in New Zealand are similar to those from the Northern Hemisphere. The peak mortality in summer for the younger age groups is paralleled by a reduction in hospitalizations in this period, indicating that the increase in mortality may be due to problems of access to medical care.
Budesonide reduces sensitivity and reactivity to inhaled mannitol in asthmatic subjects
Authors: BRANNAN JOHN D. , KOSKELA HEIKKI , ANDERSON SANDRA D. , CHAN H. KIM
Published: March 2003

Objective: The aim of the study was to investigate whether treatment using inhaled corticosteroids decreases airway responsiveness to inhaled mannitol in asthmatic subjects.

Methodology: Before treatment or a change in treatment with inhaled corticosteroids, 18 asthmatic subjects had measurements of lung function and airway sensitivity to mannitol taken and they completed a self‐administered questionnaire on asthma symptoms. The procedure was repeated 6–9 weeks after taking 800–2400 μg/day of budesonide.

Results: There were significant reductions in airway sensitivity (provoking dose to induce
a 15% fall in FEV1 (PD15)) and airway reactivity measured
by the response dose ratio (RDR; final percentage fall FEV1/total dose
of mannitol administered). The PD15 (Gmean (95%CI)) increased
from 78 mg (51, 117) before treatment to 289 mg (202, 414) following treatment (P
< 0.001). All subjects had a significant increase beyond the repeatability of
0.9 doubling doses with seven subjects becoming unresponsive. There was a 4.2 (3.4,
4.9)‐fold improvement in the RDR with the value before the treatment period 0.18
(0.12, 0.28) decreasing to 0.04 (0.03, 0.08) following treatment (P < 0.001). These improvements were associated with significant improvements in lung function and symptom severity.

Conclusion: Treatment with the inhaled corticosteroid budesonide caused a decrease in airway sensitivity and reactivity to inhaled mannitol and this was associated with expected improvements in lung function and symptoms.
Two patients with microscopic polyangiitis and unusual pulmonary manifestation
Authors: BAIK JAE JOONG , JEON YONG DUK , CHUNG YEONTAE
Published: March 2003

Abstract: We encountered two patients with microscopic polyangiitis (MPA) associated with unusual pulmonary manifestations. The first patient was a 45‐year‐old man who had worked in a mine for 3 years when he was young. On admission, chest X‐rays showed long‐standing silicosis and a new patchy infiltration. The second patient was a 52‐year‐old female. On admission, chest X‐rays showed bilateral patchy infiltrations. Since then, variable patterns of patchy infiltration have waxed and waned repeatedly. The renal biopsy revealed that both patients had glomerulonephritis associated with small vessel vasculitis but with few or no immune deposits. There was neither granulomatous inflammation nor eosinophilic infiltration. Myeloperoxidase‐antineutrophil cytoplasmic antibody (ANCA) was positive in both patients. After treatment with glucocorticoids and cyclophosphamide, radiological findings were minimal and stable. These two cases show that patients with MPA have a wide spectrum of radiological findings.
Pulmonary hypertension in patients with chronic obstructive pulmonary disease: Recent advances in pathophysiology and management
Authors: HIDA WATARU , TUN YE , KIKUCHI YOSHIHIRO , OKABE SHINICHI , SHIRATO KUNIO
Published: March 2003

Abstract: In patients with chronic obstructive pulmonary disease (COPD), pulmonary hypertension (PH) is associated with a worse prognosis. Recently, information has been increasing concerning the cellular and molecular aspects of the pathophysiology of PH in COPD. The most striking finding is the role of vascular endothelial cells and endogenous mediators released by these cells. Endothelial cell‐dependent relaxation is impaired in COPD patients with PH. Moreover, vascular remodelling in these patients is mainly responsible for irreversible PH in advanced COPD. Smoking cessation will slow down the progression of the disease process and may prevent the development of PH in COPD. The timing of initiation of long‐term oxygen therapy is important for the effective management of PH in COPD. Research on therapeutic agents for the effective treatment of PH is still needed in the management aspect of patients with COPD. This review focuses on the recent advances in our understanding of the pathophysiology and treatment of PH in COPD.
Prevalence of asthma symptoms among the adult population in the city of Mashhad (north‐east of Iran)
Authors: BOSKABADY Mohammad Hossein , KOLAHDOZ Gholam Hassan
Published: March 2003

Objective: Although there is evidence of worldwide variation in the prevalence of asthma, the prevalence of asthma in adult populations in Iran is not known.

Methods: We studied the prevalence of asthma symptoms among the adult population (aged 20 years and over) in the city of Mashhad using a questionnaire. A total of 5579 subjects, comprising 2835 males and 2744 females, were interviewed by trained medical students. The following were used as asthma symptoms in the questionnaire: recurrent wheeze, recurrent cough or tightness at rest, night cough and wheeze or cough during exercise. Subjects with two symptoms or who had been previously diagnosed with asthma were considered as having asthma.

Results: The results showed that 158 subjects (2.8%), comprising 69 males (2.4%) and 89 females (3.2%), had asthma. The proportion of subjects with a family history of asthma (40.5%), a history of allergy (43.7%) and a smoking habit (24.5%) was significantly higher than in normal subjects. Of the subjects determined to have asthma, 120 (76%) had been previously diagnosed as having asthma and were under treatment. However, only 65 subjects (41.1%) were currently under treatment.

Conclusion: These results suggested a 2.8% prevalence of asthma among the adult population in the city of Mashhad, most of whom had been previously diagnosed and were under treatment.
New Perspectives in Pollination Biology: Floral Fragrances. A day in the life of a linalool molecule: Chemical communication in a plant‐pollinator system. Part 1: Linalool biosynthesis in flowering plants
Authors: Raguso Robert A. , Pichersky Eran
Published: March 2003

The monoterpene alcohol, linalool, is present in the floral fragrance of diverse plant families and is attractive to a broad spectrum of pollinators, herbivores and parasitoids. Floral emission of linalool has evolved de novo in the fragrant, moth‐pollinated annual Clarkia breweri (Gray) Greene (Onagraceae) through a combination of up‐regulation and ectopic expression of its biosynthetic enzyme, linalool synthase (LIS), in conjunction with allometric size increases in all floral organs. Linalool synthase activity and linalool emissions are 1000‐fold lower in a sibling species, C. concinna (Fischer & Meyer) Greene, that is diurnally pollinated. Linalool synthase expression is spatially and temporally regulated during C. breweri flower development, immediately precedes free linalool emission and is absent from nonfloral tissues. Its activity is highest in the style, but most of the linalool product appears to be converted to the pyranoid and furanoid linalool oxides. The LIS structural gene is a member of the terpene synthase gene family, sharing sequence identity with two discrete classes, represented by limonene synthase (LMS) and copalyl pyrophosphate synthase (CPS). Genetic crosses between C. breweri and C. concinna indicate that strong linalool emission segregates as a dominant mendelian trait, whereas the inheritance of linalool oxide formation is more complex, suggesting epistatic biosynthetic pathway interactions. We discuss areas for future research, including comparative studies of linalool biosynthesis in different plant families, entrainment of linalool emission to nocturnal circadian rhythms and the induction of vegetative linalool as an indirect herbivore defense.
Regulation of CD31 expression and interleukin‐4 production by human cord blood CD4+ T cells with interleukin‐4 and interleukin‐7
Authors: Katamura, Kenji , Fukui, Tetsuya , Kiyomasu, Takahiro , Ohmura, Kayo , Iio Jun , Ueno Hideki
Published: March 2003

Abstract

Background
: T helper 2 cell type cytokines, such as interleukin (IL)‐4 and IL‐5, play pivotal roles in the development of allergic diseases. However, the mechanism by which naive CD4+ T cells acquire the ability to produce these cytokines remains unclear. Recently, it was reported that IL‐7 induces the ability to produce IL‐4 as well as interferon (IFN)‐γ and IL‐5 in naive CD4+ T cells without TCR stimulation. To further analyze the mechanism of acquiring IL‐4‐producing ability by naive CD4+ T cells, the effects of IL‐7 on human cord blood CD4+ T cells were compared with those of IL‐4, which induced the ability to produce IFN‐γ but not IL‐4.

Results
: Interleukin‐7 preserved the population of CD4+CD31– T cells in cord blood and induced their IL‐4‐producing ability without T cell receptor (TCR) stimulation, while IL‐4 induced CD31 on CD31– T cells and could not induce their IL‐4‐producing ability. Both the CD31‐inducing effect and the inhibitory priming effect for IL‐4‐production by IL‐4 were also observed after cord blood CD4+ T cells had been primed with IL‐7 and acquired the IL‐4‐producing ability.

Conclusions
: Interleukin‐7 induced the IL‐4‐producing ability in naive CD4+CD31– T cells without TCR stimulation, suggesting that the signal transduction via CD31 may have an inhibitory effect on the acquisition of the IL‐4‐producing ability by cord blood CD4+ T cells in the absence of TCR stimulation.
Relationship between serum leptin and thyroid hormones in children
Authors: Asami Tadashi
Published: March 2003

Abstract Background: Because leptin decreases food intake and increases energy expenditure, the possible influence of thyroid status on the leptin system has been investigated mainly in adults and animals. However, the data available at present are very confusing. The aim of the present study was to assess the possible interaction of thyroid hormones with the leptin system.

Methods
: Serum free thyroxine (FT4), a biologically active thyroid hormone, and thyroid stimulating hormone (TSH), a sensitive and reliable index of thyroid status, were examined in 51 children (19 males, 32 females) with mass screening‐detected congenital hypothyroidism on continuous
L‐thyroxine (L‐T4) substitution therapy. The subjects were divided into younger (n=35, aged 1 month – 5 years) and older (n=16, 6 years – 11 years) children groups. Serum levels of leptin and thyroid hormones were measured in the subjects. Body mass index (BMI) was estimated by the formula bodyweight (kg)/height`height (m
2), which is known as the Kaup index in younger children and BMI in older children and adults.

Results
: In the younger children group, serum leptin levels showed no correlation with serum TSH, FT4 or T4. In the older children group, serum leptin concentrations significantly correlated with T4 (r=0.510, P<0.05) and BMI (n=16, r=0.647, P<0.01), but not with TSH or FT4.

Conclusion
: The role of thyroid hormones in modulating leptin synthesis and secretion seems to have little, if any, clinical or biological relevance.
Inhalation of nebulized nitroglycerin in dogs with experimental pulmonary hypertension induced by U46619
Authors: Gong Fangqi , Shiraishi Hirohiko , Kikuchi Yutaka , Hoshina Masaru , Ichihashi Kou , Momoi Yuko Sato and Mariko Y
Published: March 2003

Abstract Background: Pulmonary hypertension (PH) causes mortality in some congenital and acquired heart and lung diseases. However, inhalation of NO gas requires complicated and expensive instruments and elaborate preparations to avoid toxic gas administration. We tested the effectiveness and safety of inhaled nebulized nitroglycerin (Neb‐NTG) in dogs with experimental PH.

Methods
: Experimental PH was induced by continuous infusion of a thromboxane analog (U46619). The U46619 infusion rate was adjusted to maintain a systolic pulmonary artery pressure (PAP) at 40 mmHg in 10 anesthetized and mechanically ventilated dogs. Then, 20 μg/kg of NTG liquid nebulized by compressed air was inhaled.

Results
: After infusion of U46619, the systolic, diastolic and mean PAP increased by 119%, 228% and 169%, respectively, and the systolic, diastolic and mean systemic arterial pressures (SAP) increased by 19%, 29% and 23%, respectively. The systolic pulmonary to systemic pressure ratio (Pp/Ps) and mean Pp/Ps increased by 83% and 113%, respectively, and the pulmonary vascular resistance (PVR), systemic vascular resistance (SVR) and pulmonary to systemic resistance ratio (Rp/Rs) increased by 341%, 100% and 145%, respectively. After inhalation of Neb‐NTG in dogs with experimental PH, systolic, diastolic and mean PAP and PVR decreased by 25~4, 26~11, 25~9 and 31~21%, respectively. There were no significant changes in systolic, diastolic and mean SAP, SVR, cardiac output and plasma methemoglobin concentrations. The systolic and mean Pp/Ps decreased by 18~7 and 20~7%, respectively. The Rp/Rs decreased by 25~13%.

Conclusions
: The results of this study demonstrate that Neb‐NTG is an effective and selective pulmonary vasodilator and may offer a new therapeutic option for PH.
Epidemiologic features of rotavirus infection in Taiwan: A review
Authors: Tsai Chang‐Hai , Chiu Hsiu‐Hui , Abe Toshiaki
Published: March 2003

Abstract Group A rotaviruses are a major cause of severe gastroenteritis in children under 4 years of age worldwide. Group A rotaviruses have been identified in many animal and bird species; they are antigenically complex, and multiple serotypes infect humans. Reassortant rotavirus vaccines are now available that confer protection against severe illness due to rotavirus serotypes G1–4. Before vaccines are introduced, it is necessary to establish their efficacy and to establish a baseline for future surveillance strategies. The purpose of the present review is to describe current knowledge of the diversity of rotavirus in Taiwan. The present review is based on the available published studies and data from China Medical College Hospital (Taiwan). In Taiwan, rotavirus has been detected year‐round, with the epidemic peak swinging from November–December in 1984 to January–March in 1988–95 and then back to December–March in 1996–99. Most affected patients are under 2 years of age. Only group A rotavirus has been found. Neither group B nor group C rotavirus have been identified. G1 strains have been the predominant strains except for the year 1992–93, when G2 strains were prevalent. There has been no G4 strain detected in published studies. The electropherotype ‘baba’ has been observed every year. Five other electropherotypes have been sporadically found. Half of the strains that have been studied were genotype P[8] and their VP7 serotype was G1 or G3. All genotype P[4] strains have shown serotype G2. It is expected that the reassortant rotavirus vaccine will be effective in prevention of severe illness caused by rotavirus in Taiwan.
Possible effects of antioxidant status on increased platelet aggregation in childhood iron‐deficiency anemia
Authors: Tekin Demet , Yavuzer Sema , Tekin Mustafa , Akar Nejat , Cin Şükrü
Published: March 2003

Background
: Alterations in platelet function and antioxidant status in children with iron‐deficiency anemia (IDA) have been reported previously. The present study was performed to better understand possible interactions between these two systems.

Methods
: Erythrocyte superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH‐Px) activity and platelet function were evaluated in 15 children (aged 11/2–15 years) with IDA. The antioxidant enzyme activity was determined spectrophotometrically. Platelet aggregation and secretion studies were performed using impedance and bioluminescence methods, respectively. Ten age‐matched healthy children were included as a control group.

Results
: There were no differences in SOD and CAT activities between patients and controls. However, GSH‐Px activity was significantly lower in the iron‐deficient children. Platelet aggregation responses to collagen and ADP were also significantly higher in iron‐deficient children than in controls.

Conclusions
: Decreased antioxidant defense in IDA may cause increased oxidant stress, which, in turn, may result in a tendency towards platelet aggregation.
Frequency of portal and systemic bacteremia in acute appendicitis
Authors: Jurić Ivo , Primorac Dragan , žagar živojin , Biocǐć Mihovil , Pavi̇ć Siniša , Furlan Dubravko , Budimir Drăzen , Janković Sti̇pan , Hodžić Petar Krešimir , Alfirević Darko , Alujević Antonio , Titlić Marina
Published: March 2003

Abstract

Background
: Acute appendicitis is the most common condition requiring an emergency abdominal operation in childhood. In the present study, we analyzed the frequency of portal and systemic bacteremia in 42 patients with acute appendicitis and determined the microbial agents responsible for an acute appendicitis and for portal and systemic bacteremia.

Methods
: Appendectomies were performed on 50 young patients (5–18 years of age), as well as clinical and bacteriological tests. Six independent samples from each patient isolated from the peripheral vein, superior mesenteric vein, appendix and peritoneum were obtained prior to surgery, during surgery and after surgery for biochemical, immunologic and bacteriologic examination.

Results
: Pathohistology confirmed the diagnosis of appendicitis in 42 patients, while in the other eight patients there were no obvious pathologic findings, so they served as a control group. Of 50 patients with a clinical appearance of acute appendicitis, in 19 patients (38%) we detected portal bacteremia in the mesenteric vein, while in only three cases (6%) did we find systemic bacteremia detected from the peripheral vein. Furthermore, bacteriologic analysis revealed that Bacteroides spp. and Escherichia coli were the predominant species isolated.

Conclusions
: The results presented in this paper suggests that portal bacteremia did not influence peripheral blood reactions. Furthermore, in the present study we have found a positive correlation between the smear and bacteremia of the superior mesenteric vein, but not with the bacteremia of systemic blood.
Tracheostomy in childhood: 20 years experience from a pediatric surgery clinic
Authors: İlçe Zekeriya , Celayir Sinan , Tekand Gonca Topuzlu , SarI Murat Nüvit , ErdoĞan Ergun , Yeker Daver
Published: March 2003

Background
: There is a limited indication for tracheostomy procedures in pediatric surgery. It is rarely applied to the pediatric patient because they can be kept intubated for a longer duration compared with adults. Problems and complications can occur after tracheostomy, even during the childhood period.

Purpose
: The purpose of this study is to evaluate our experience with tracheostomy procedure.

Methods
: Records of 17 children treated over a 20‐year period (1978−99) were reviewed retrospectively in the aspects of indication, complication and mortality.

Results
: There were 13 boys and four girls with

a mean age 30.3 months (range: 1 week−13 years).

Indications for tracheostomy were prolonged intubation (n = 5),

subglottic stenosis (n = 3), general

body trauma (n = 2), tracheomalasia

(n = 2), tracheoesophageal cleft

(n = 1), cervical tumor pressing

trachea and larynx (n = 1), congenital

myotonic dystrophy plus respiratory failure (n = 1),

burn injury of trachea and esophagus (n = 1), and

foreign body aspiration (n = 1). In the last decade the number of cases with tracheotomy increased due to the development of new intensive care units, the use of mechanical ventilation and the increasing number of patients needing prolonged ventilation support. In this group, tracheostomies were mainly performed electively. The overall complication rate was 29%. Mortality was 59% and there was one death related to the tracheostomy procedure.

Conclusion
: Tracheostomy is a life saving procedure when performed with an appropriate indication and surgical technique. Therefore, the pediatric surgeons dealing with this procedure should be aware of the tracheostomy care problems, fatal complications and the need for reconstructive surgery. With strict indications and experience of the procedure, this should be enough effort to minimize its complications and related care problems.
Incidences of nasopharyngeal colonization of respiratory bacterial pathogens in Japanese children attending day‐care centers
Authors: Masuda Kaori , Masuda Ryuji , Nishi Jun‐Ichiro , Tokuda Koichi , Yoshinaga Masao , Miyata Koichiro
Published: March 2003

Background
: In Japan, many younger children attending day‐care centers tend to frequently experience acute respiratory infections and prolonged otitis media.

Objectives

: To evaluate the carriage rate of respiratory bacterial pathogens in children attending day‐care centers in our district.

Methods
: Nasopharyngeal cultures of 156 healthy children between the ages of 1 month and 5 years were conducted at two day‐care centers in Japan, in April 1999. The carriage rates of four major pathogens (Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and Staphylococcus aureus) and the antibiotic susceptibilities of the isolates were examined.

Results
: Streptococcus pneumoniae, H. influenzae, M. catarrhalis and S. aureus were detected in 94 (60.3%), 83 (53.2%), 54 (34.6%) and 28 (17.9%) children, respectively. A total of 141 (90.4%) children carried at least one pathogen among these four pathogens and 87 (55.8%) children carried more than one pathogen. Fifty‐seven of the 94 (60.6%) S. pneumoniae isolates were penicillin‐intermediately or highly resistant strains of S. pneumoniae (PISP/PRSP). Beta‐lactamase producing H. influenzae was not detected. Twelve of the 28 (42.9%) S. aureus isolates were methicillin‐resistant. The incidence of colonization by PISP/PRSP in children younger than 3 years (43/69, 62.3%) was significantly higher than that in children aged 3−5 years (14/87, 16.1%) (P < 0.0001).

Conclusions
: We conclude that the rates of colonization by respiratory bacterial pathogens, especially by antibiotic‐resistant strains, were high in children attending day‐care centers in our district, suggesting their horizontal spread among children in day‐care centers. Considering that the majority of children attending day‐ care centers carried one or more of the bacterial pathogens, the judicious use of antimicrobials will be required to prevent the increase of antibiotic‐resistant rates among the colonizing pathogens.
Efficacy and safety of rectal thiopental, intramuscular cocktail and rectal midazolam for sedation in children undergoing neuroimaging
Authors: Alp Handan , Orbak Zerrin , Güler Ibrahim , Altinkaynak Sevin
Published: March 2003

Background
: This study was designed to investigate the overall usefulness of rectal thiopental, rectal midazolam and i.m. modified cocktail (meperidine‐chlorpromazine hydrochloride‐feniramin maleat) in 70 children undergoing computed tomography (CT) and magnetic resonance imaging (MRI).

Methods
: The dosage of thiopental was 50 mg per kg for infants under 6 months of age, 35 mg per kg between six and 12 months, and 25 mg per kg for older children. The maximal dose did not exceed 700 mg in this study. The dosage of midazolam was 1 mg per kg for all children. A modified cocktail was described as a formulation including 11 mg/mL of meperidine, 2.8 mg/mL of chlorpromazine and 2.8 mg/mL of pheniramine maleat. The dosage of modified cocktail was 0.1 mL per kg for all children.

Results
: The mean induction time for the i.m. cocktail was significantly longer than that for rectal thiopental (P < 0.001). The mean duration of deep sedation was 60.79 ± 27.00 min with rectal thiopental and 58.74 ± 39.70 min with i.m. cocktail (P > 0.05). Although the mean duration of sleep for rectal thiopental and i.m. cocktail was similar, the mean discharge duration for i.m. cocktail was significantly longer than that for rectal thiopental (P < 0.05). Children sedated with the cocktail therapy also required a longer period of observation in the department. Significant decreases in heart rate, systolic blood pressure and oxygen saturation occurred in three groups (P < 0.001). Significant decreases in body temperature occurred after rectal thiopental and i.m. cocktail therapy (P < 0.01). The effect of rectal midazolam was minimal.

Conclusions
: Rectal thiopental may be the drug of choice for pediatric sedation because it has a more rapid onset and offset of action. It is also safe and effective at the dosage studied in children undergoing MRI. Rectal midazolam also may be used in children undergoing CT imaging because of minimal side‐effects.
New criteria of normal serum lipid levels in Japanese children: The nationwide study
Authors: Okada Tomoo , Murata Mitsunori , Yamauchi Kuniaki , Harada Kensuke
Published: March 2003

Aim
: To make new criteria of serum lipid levels in current Japanese children using the large nationwide data provided from Japan Association of Health Service for the analysis.

Methods
: The subjects were schoolchildren who received screening and care programs for lifestyle related diseases since 1993−1999. Serum total cholesterol (TC), high‐density lipoprotein cholesterol (HDLC) and triglyceride (TG) levels were measured, and low‐density lipoprotein cholesterol (LDLC) levels were calculated. Serum lipid levels were analyzed by age and sex. For each serum lipid, we extracted age‐ and sex‐specific group which the mean value was not statistically different from that in 1999 by Student's t‐test analysis.

Results
: The level below the 75th percentile was defined to be acceptable, from the 75th to 95th to be borderline and over the 95th to be high in TC/LDLC. The level below the fifth percentile in HDLC was defined to be low and the level over the 95th percentile in TG to be high. Therefore, TC level was categorized as follows: acceptable < 190 mg/dL; borderline 190−219 mg/dL; and high > 220 mg/dL. The LDLC level was also categorized into: acceptable < 110 mg/dL; borderline 110−139 mg/dL; and high > 140 mg/dL. The cut‐off value in TG was determined to be 140 mg/dL and in HDLC was 40 mg/dL.

Conclusions
: This new criteria should prove valuable in health strategies for rational prevention and intervention in children. It should be emphasized to provide some intervention for Japanese children immediately.