bluuebunny/crossref_metadata_2025 huggingface dataset:
Brooke–Spiegler syndrome – report of four families: treatment with CO2 laser
Authors: Retamar Roberto Adrián , Stengel F. , Saadi M. E. , Kien M. C. , Della Giovana P. , Cabrera H. , Chouela E. N.
Published: June 2007

Background  Brooke–Spiegler syndrome is a well known but rare cutaneous disorder characterized by the presence of multiple trichoepitheliomas and cylindromas.

Methods  Four families with Brooke–Spiegler syndrome are described.

Results  Spiradenomas developed on the back in two patients. A CO2 laser was used to treat facial trichoepitheliomas in two patients with good results.

Conclusions  The large number of facial lesions in this syndrome often produce a significant emotional impact. We believe that it is important to provide patients with a good therapeutic option. CO2 laser therapy may fill this role.
Patient education and regular surveillance results in earlier diagnosis of second primary melanoma
Authors: Uliasz Annemarie , Lebwohl Mark
Published: June 2007

Background  As the incidence of cutaneous melanoma continues to rise, more individuals will be at risk for developing second primary melanomas. We hypothesize that patient education and follow‐up surveillance will lead to the early detection of subsequent primary melanomas as demonstrated by a decrease in Breslow thickness at diagnosis.

Methods  A computer‐based investigation was performed to identify patients who had developed a second primary melanoma following treatment of in situ and American Joint Commission on Cancer (AJCC) Stage I or II melanoma. Patients are routinely educated on the increased risk of developing a second primary lesion and characteristic clinical features of melanoma. Patient surveillance was performed on a regular basis. Differences in Breslow thickness between the initial and subsequent primary melanomas were analyzed by a paired t‐test.

Results  Among 877 individuals identified in the Mount Sinai School of Medicine Department of Dermatopathology database with in situ or AJCC Stage I or II melanoma, 111 developed a second primary melanoma. The mean thickness was 0.239 ± 0.661 mm for the initial melanoma and 0.1135 ± 0.319 mm for the subsequent melanoma. By paired t‐test, the difference in tumor thickness was statistically significant (P = 0.019).

Conclusions  Upon analysis of our data, subsequent primary cutaneous melanomas were found to be significantly thinner than initial primary melanomas at the time of diagnosis. This suggests that earlier diagnosis may be the result of patient education and careful follow up. Counselling on the risk of developing a second primary melanoma, education regarding clinical characteristics of melanoma, and routine lifelong follow up should be provided to all patients diagnosed with a cutaneous melanoma.
Cutaneous phaeohyphomycosis caused by Veronaea botryosa observed as sclerotic cells in tissue
Authors: Kondo Yukiko , Hiruma Masataro , Matsushita Akiko , Matsuba Shoichi , Nishimura Kazuko , Takamori Kenji
Published: June 2007

A 65‐year‐old Japanese female farmer had an erythematous, slightly scaly, indurated plaque on the dorsum of the left wrist of more than 3 years’ duration. She had a history of hepatitis C. Her medical history and family history were otherwise unremarkable. The lesion had begun as a small region of erythema on the dorsum of the left wrist 3 years previously and had gradually enlarged. The patient had seen a local physician and had been treated with topical steroids, topical antifungals, and topical vitamin D3 agents without improvement.

Initial laboratory studies revealed slightly decreased numbers of white blood cells and thrombocytes, decreased albumin levels, and elevated liver enzymes, reflecting chronic hepatitis C. Clinical examination of the lesion revealed a well‐demarcated, erythematous, slightly scaly, indurated plaque of 22 mm × 28 mm in size on the dorsum of the left wrist (Fig. 1). Superficial lymph nodes were nonpalpable. Direct microscopy revealed aggregates of thick‐walled spores, considered to be sclerotic cells, from which budding brown hyphae emanated (Fig. 2a).

A well‐demarcated, erythematous, slightly scaly, indurated plaque of 22 mm × 28 mm in size on the dorsum of the left wrist

image

(a) Microphotograph of scales in KOH reveals aggregates of thick‐walled, brown sclerotic cells and budding brown hyphae (×400). (b) Conidia are bicellular, gourd‐shaped at maturity and pale brown. They are sympodially produced by darker conidiogenous cells (slide culture, ×400)

image

Cutaneous biopsy specimens revealed a chronic granulomatous inflammation infiltrated with lymphocytes, histiocytes, neutrophils, and multinucleated giant cells. Within the microabscess and within one of the giant cells were large, brown, thick‐walled cells, which were identified as sclerotic cells, and brown septate hyphae.

Culture on a Sabouraud dextrose agar slant at 26 °C yielded villous, green‐tinged, black–gray colonies, with a central button‐like protuberance. By 28 days, these colonies had reached 4.8 cm in diameter. A slide culture showed pale brown septate hyphae bearing lateral and terminal conidiophores. Conidiophores were erect, straight, or flexuous, unbranched or occasionally loosely branched, smooth‐walled, septate, and brown. Conidiogenous cells were terminal or lateral and cylindrical in the apical part with numerous dark brown scars fading away to the apex. Conidia were sympodial and bicellular, with rounded apices and truncated bases (Fig. 2b). On the basis of these morphologic features, we identified the mold as Veronaea botryosa. Surgical excision of the lesion was performed, resulting in complete healing.
Urachal duct remnant‐like umbilical clear cell acanthoma in an infant: An unusual presentation and pitfall in clinical practice
Authors: Hsu Hsiu‐cheng , Yang Chih‐Hsun , Kuo Tseng‐tong , Shih I‐Hsin , Hong Hong‐Shang
Published: June 2007

Background  Although an umbilical nodule is common in neonates and young infants, an umbilical nodule of poor therapeutic response will increase the likelihood of other uncommon etiology. Clear cell acanthoma (CCA) has never been described as an oozing umbilical nodule on infants.

Methods  To present a case of CCA which occurred on an 8‐month‐old female infant presenting with one weeping nodule on the umbilicus since early neonate. The lesion underwent skin biopsy and subsequent hematoxylin‐eosin and periodic acid‐Schiff staining.

Result  Three courses of liquid nitrogen cryosurgery were performed after the diagnosis of CCA was confirmed. The lesion resolved rapidly.

Conclusion  This report presents the first and youngest case of umbilical CCA in the English literature. This case supports the inflammatory dermatosic nature of CCA.
Thiazolidinediones in dermatology
Authors: Boyd Alan S.
Published: June 2007

Thiazolidinediones, also known as glitazones, represent a relatively new class of medication used for glycemic control in patients with type II diabetes mellitus. These drugs interact with the peroxisome proliferator‐activated receptor γ, a member of the nuclear receptor superfamily, which in turn heterodimerizes with retinoid X receptors to stimulate gene transcription. At a physiologic level, glitazones stimulate adipocyte differentiation, enhance insulin‐sensitive glucose uptake by muscle and fat cells, suppress angiogenesis, inhibit tumor cell growth, and normalize keratinocyte differentiation. They have also demonstrated the capacity to diminish inflammatory cytokine production, most notably, that of tumor necrosis factor α. Patients with such disparate conditions as psoriasis, hirsutism, melanoma, angiosarcoma, lipodystrophy, and necrobiosis lipoidica have benefited from the administration of thiazolidinediones. Clinicians should become familiar with glitazones as they are experiencing a burgeoning use among patients with non‐insulin‐dependent diabetes mellitus and have demonstrated clinical efficacy in treating certain skin conditions.
Identification of a novel HLA‐A*24 allele, HLA‐A*2467
Authors: Witter K. , Zahn R. , Albert T. , Volgger A. , Kauke T.
Published: June 2007

In this report, we describe the identification of a novel human leukocyte antigen‐A*24 (HLA‐A*24) allele, designated HLA‐A*2467. The new allele differs from the most closely related allele HLA‐A*2408 at five nucleotide positions all located in exon 2. Four of the five nucleotide changes result in amino acid substitution.
Adaptation in a spider mite population after long‐term evolution on a single host plant
Authors: MAGALHÃES S. , FAYARD J. , JANSSEN A. , CARBONELL D. , OLIVIERI I.
Published: June 2007

Evolution in a single environment is expected to erode genetic variability, thereby precluding adaptation to novel environments. To test this, a large population of spider mites kept on cucumber for approximately 300 generations was used to establish populations on novel host plants (tomato or pepper), and changes in traits associated to adaptation were measured after 15 generations. Using a half‐sib design, we investigated whether trait changes were related to genetic variation in the base population. Juvenile survival and fecundity exhibited genetic variation and increased in experimental populations on novel hosts. Conversely, no variation was detected for host choice and developmental time and these traits did not evolve. Longevity remained unchanged on novel hosts despite the presence of genetic variation, suggesting weak selection for this trait. Hence, patterns of evolutionary changes generally matched those of genetic variation, and changes in some traits were not hindered by long‐term evolution in a constant environment.
Ability of chromosome 4H to compensate for 4D in response to drought stress in a newly developed and identified wheat–barley 4H(4D) disomic substitution line
Authors: Molnár I. , Linc G. , Dulai S. , Nagy E. D. , Molnár‐Láng M.
Published: June 2007

A spontaneously developed wheat–barley 4H(4D) disomic substitution line was identified cytogenetically using genomic in situ hybridization (GISH), multicolour fluorescent in situ hybridization (FISH) and microsatellite markers. The ability of the barley 4H chromosome to compensate for wheat 4D in response to mild drought stress was also investigated. In the barley cv. ‘Betzes’ and the 4H(4D) substitution line, mild osmotic stress induced intensive stomatal closure, resulting in reduced water loss through transpiration and unchanged relative water content in the leaves. As the CO2 assimilation rate remained relatively high, the water use efficiency, which is an important factor associated with drought tolerance, increased extensively under mild osmotic stress in these lines. In the case of the parental wheat genotypes, however, mild drought stress induced less intense stomatal closure and a greater decrease in the CO2 assimilation rate than in barley or in the substitution line, resulting in unaugmented or reduced water use efficiency. The results demonstrate that genes localised on the 4H chromosome of barley were able to increase the water use efficiency of the wheat substitution line, which is suitable for improving wheat drought tolerance through intergeneric crossing.
Discovery and genotyping of high‐throughput SNP markers for crown rust resistance gene Pc94 in cultivated oat
Authors: Chen G. , Chong J. , Prashar S. , Procunier J. D.
Published: June 2007

Crown rust caused by Puccinia coronata f. sp. avenae Eriks is a serious problem for oat production worldwide and pyramiding multiple resistance genes into new cultivars is a key objective of breeders. Many race specific resistance genes have been mapped and markers that are closely linked to them have been identified. However, the use of these markers in oat breeding practice has been limited due to the economics of marker assisted selection (MAS) deployment. Single nucleotide polymorphism (SNP) markers have been demonstrated to have a high‐throughput capability with relatively low cost and numerous semi‐automated SNP scoring platforms exist. Gene Pc94 has remained highly effective since it was first tested on the Canadian crown rust populations in 1993 and is one of the few effective genes available in Western Canada. In the present study, PCR products were amplified using primers derived from sequences of amplified fragment length polymorphism bands which have been shown to be linked to Pc94. Genomic DNA from genotypes, with and without the Pc94 gene, were used as the PCR templates. By comparative sequence alignment amongst the PCR fragments, many putative SNP sites were identified. From these sites, four SNP sites were selected and validated by the single base extension method. One SNP site, Pc94‐SNP1a, was tested on two F2:3 populations segregating for the resistance gene. The map distances between the SNP marker and Pc94 were 2.1 and 5.4 cM in the two different populations. Various oat cultivars and germplasm lines were also tested for a wider application of the SNP marker. Fluorescent technology and capillary electrophoresis allowed for the semi‐automated, fairly high‐throughput scoring of the SNP markers.
Development of the male gametophyte of an infertile plant Armoracia rusticana Gaertn.
Authors: Winiarczyk K. , Tchórzewska D. , Bednara J.
Published: June 2007

Horseradish, Armoracia rusticana, is propagated vegetatively through root cuttings. It is described as a male‐sterile plant as it does not form seeds or only develops them in small quantities. This study discusses the anatomical structure of anthers and the events throughout meiosis up to the formation of a male gametophyte. Microscopic observations have shown that the anatomical structure of the anther wall of A. rusticana is typical of the whole family of Brassicaceae, and all its layers are properly developed and fully functional. Meiosis in the sporogenous tissue proceeds correctly and leads to the formation of microspores. Also the configurations of the cytoplasmic skeleton are typical of plants with simultaneous cytokinesis. Further development, however, exhibits many abnormalities. A majority of the cells formed in the sample studied were dysfunctional uninucleate microspores with apparent symptoms of degeneration of the cytoplasm and organelles. Binucleate pollen grains, in which mitosis did occur, constituted only 10% of the cells analysed. Anatomical and cytological observations of male sterility in A. rusticana indicated inhibition of development at the microspore, stage which was manifested by cytoplasm degeneration with a low number of membranes and a scarce amount of starch in proplastids. Usually, in the prolonged microspore stage and in the young pollen no mitosis occurs at the time of anthesis. Cytological disorders may, to a great extent, limit the number of functional bicellular male gametophytes. Both in microspores and in pollen grains, there is exceptionally little starch in plastids.
Relationship between molecular marker heterozygosity and hybrid performance in intra‐ and interspecific hybrids of cotton
Authors: Zhang X. Q. , Wang X. D. , Jiang P. D. , Hua S. J. , Zhang H. P. , Dutt Y.
Published: June 2007

The present study was conducted to investigate the relationship between parental molecular marker diversity and hybrid performance in both intra‐ and interspecific hybrids of cotton to evaluate the feasibility of predicting hybrid performance using molecular markers. Three cytoplasmic male sterile (CMS) lines were crossed with 10 restorer lines to produce 22 F1 hybrids during 2003. Of 22 F1s, 14 hybrids were intraspecific (Gossypium hirsutum × G. hirsutum) and eight interspecific (G. hirsutum × G. barbadense). These 22 F1 hybrids and their parents were evaluated for yield and fibre quality traits at Zhejiang University, Hangzhou, China during 2004 and 2005. Genetic distances (GD) among the parents were calculated from 56 random‐amplified polymorphic DNAs (RAPD) and 66 simple sequence repeat (SSR) marker data, and their correlation with hybrid performance and heterosis were analysed. The parents could be discriminated into G. hirsutum and G. barbadense clusters by cluster analysis based on both RAPD and SSR markers data. The correlation (r = 0.503, P ≤ 0.05) was calculated between GDrapd (GD based on RAPD markers) and GDssr (GD based on SSR markers). Correlation of GD with hybrid performance and heterosis differed considerably between intra‐ and interspecific hybrids. The correlation between GD and hybrid performance was non‐significant for most of traits within the hybrids of G. hirsutum species. However, it was significantly and positively correlated for fibre length, fibre strength and elongation in interspecific hybrids. The relationship between GD and heterosis was observed to be positively significant for boll weight within hybrids of G. hirsutum with significant and negative correlations for fibre length and elongation. In conclusion, the power of predicting hybrid performance using molecular markers in cotton is low. But, the relationship between SSR marker heterozygosity and hybrid performance can be used to predict fibre length during interspecific hybrid cotton breeding.
Mapping of EST‐derived CAPS markers in Italian ryegrass (Lolium multiflorum Lam.)
Authors: Miura Y. , Hirata M. , Fujimori M.
Published: June 2007

New molecular markers derived from expressed sequence tag (EST) sequences were mapped on linkage maps of Italian ryegrass by a two‐way pseudo‐testcross strategy. cDNA sequences were obtained from various tissues of Italian ryegrass (Lolium multiflorum) and converted into cleaved amplified polymorphic sequence (CAPS) markers. Of 260 EST primer pairs that amplified a single band, 74 generated bands that showed clear polymorphisms among individuals of an F1 mapping family. Of the 74 polymorphic marker loci, 69 were mapped on an Italian ryegrass linkage map previously constructed using amplified fragment length polymorphism (AFLP), restriction fragment length polymorphism (RFLP), and simple sequence repeat (SSR) markers. The newly‐developed EST‐CAPS markers would be useful as an efficient tool to identify genetic markers and to identify candidate genes for quantitative trait loci (QTLs) associated with important traits in Italian ryegrass.
Structural and Functional Events on the Porcine Zona Pellucida During Maturation, Fertilization and Embryonic Development: a Scanning Electron Microscopy Analysis
Authors: Michelmann HW , Rath D , Töpfer‐Petersen E , Schwartz P
Published: June 2007

Contents

Porcine oocytes and pre‐implantation embryos from the same, as well as from different animals, have an extremely heterogeneous morphology of the zona pellucida (ZP) surface, as shown by scanning electron microscopy. For years, it has been believed that this heterogeneous morphology plays an important role in the sperm–oocyte interaction. The aim of this study was to analyse the zona morphology and sperm‐binding patterns on the porcine ZP. Oocytes were divided into four categories: immature, matured in vivo, or matured in vitro over a time period of 24 or 48 h. The zona morphology of early embryos grown in vivo or in vitro was also investigated. Four different types of zona morphology were detectable. They ranged from a porous, net‐like structure to a nearly smooth and compact surface. No correlation could be established between the different kinds of maturation in terms of these zona types. All oocytes exhibited extremely heterogeneous zona morphologies, with no clear trend. During subsequent in vivo embryo development, the zona surface changes from a porous structure to one with a compact surface, while the morphology of in vitro embryos remained compact at all stages of development. The analysis of the number and distribution patterns of spermatozoa trapped in the ZP revealed extremely variable patterns, regardless of the zona morphology. Differences were only present if sorted or unsorted spermatozoa were used for insemination. Regardless of the number of inseminated spermatozoa after sorting, only a few (1–2) could be detected on the ZP. Whether oocytes were matured in vivo or in vitro was not a relevant factor. Unsorted spermatozoa bound in higher numbers than sorted ones. The number was directly dependent on the number of spermatozoa used for insemination.
Description of a multidimensional classification system for patients with expiratory central airway collapse
Authors: MURGU Septimiu D. , COLT Henri G.
Published: June 2007

Background and objective:  Patients with expiratory central airway collapse present with various symptoms, aetiologies, morphologies, extent and severity of airway collapse. The aim of this study was to delineate a multidimensional classification system and common language for evaluating patients with expiratory central airway collapse.

Methods:  The classification system was based on the morphology and origin of the airway abnormality as well as stratification parameters such as functional status, extent and severity of airway collapse. Patients with expiratory central airway collapse who underwent clinical and bronchoscopic examination before and after treatment were identified from a bronchoscopy database. The classification was applied to the study patients before and after treatment to assess the utility of this stratification approach.

Results:  Eighteen patients were studied. Four had excessive dynamic airway collapse and 14 had tracheobronchomalacia. Post‐treatment, functional status improved by one class in 12 patients, by two classes in four patients and remained unchanged in two. Severity of airway collapse improved in 15 and remained unchanged in three patients. The extent of abnormality diminished in 14 patients and did not change in four.

Conclusions:  Using this classification, the morphologies and aetiologies of expiratory central airway collapse are identified, and an objective stratification of patients according to degree of functional impairment, extent of disease and severity of airway collapse is possible.
Pleurodesis: A novel experimental model
Authors: MARCHI Evaldo , VARGAS Francisco S. , ACENCIO Milena M.P. , TEIXEIRA Lisete R. , ANTONANGELO Leila , LEE Y.C. Gary , LIGHT Richard W.
Published: June 2007

Background and objective:  The experimental model of pleurodesis in rabbits has been useful in understanding the pathophysiology of the pleural inflammatory injury induced by several sclerosing agents. However, restrictions on the use of rabbits in laboratory investigation are making this model less accessible. The aim of this study was to present a new experimental model of pleurodesis in mice using talc or silver nitrate.

Methods:  Four groups of 10 C57BL/6 mice received talc 2 or 4 mg/g in 0.5 mL saline, or 0.025% or 0.05% silver nitrate in 0.5 mL H2O. After 28 days the animals were sacrificed, and the pleural cavity was opened and evaluated for evidence of macroscopic pleural adhesions and haemothorax (scores 0–4), atelectasis (scores 0–2), and microscopic pleural and alveolar inflammation and fibrosis (scores 0–4). Statistical analysis used anova.

Results:  Silver nitrate 0.05% produced a more effective pleurodesis in mice than did 0.025% silver nitrate or talc 4 mg/g, with significant higher scores for pleural adhesions, microscopic pleural inflammation and fibrosis. Haemothorax, atelectasis, and microscopic alveolar inflammation and fibrosis were negligible in both groups.

Conclusions:  Both talc 4 mg/g and 0.05% silver nitrate produced an efficient pleurodesis in this experimental model in mice. This new model may overcome the restrictions on the use of large‐ and medium‐sized animals in laboratory investigation and may open new fields of investigation with knockout mice.
Induced sputum analysis in asymptomatic young adults with bronchial hyperresponsiveness to methacholine
Authors: NOMURA Naho , YOSHIKAWA Takahiro , KAMOI Hiroshi , KANAZAWA Hiroshi , HIRATA Kazuto , FUJIMOTO Shigeo
Published: June 2007

Background and objectives:  BHR is a clinical feature of asthma and factors crucial to the development of BHR remain to be elucidated. Asymptomatic BHR also occurs in the general population. This study examined the prevalence of asymptomatic BHR in a population of young Japanese atopic individuals to identify whether airway inflammation is present in asthmatic patients but not in asymptomatic subjects with BHR.

Methods:  Fifty atopic volunteers (aged 18–23 years) without lower respiratory symptoms were recruited and their bronchial responsiveness to methacholine was measured in order to categorize them into two groups, those with BHR (PC20 below 8 mg/mL) and those without BHR. We evaluated the inflammatory cell profiles and measured IL‐5 and IL‐13 levels in sputum from subjects of each group by ELISA. Results were compared with those for young adult asthmatic patients.

Results:  In the young atopic group, 17 subjects (34.0%) exhibited BHR. Compared with asthmatic patients sputum from asymptomatic subjects with BHR contained significantly lower numbers of eosinophils (P < 0.001) and had significantly lower levels of IL‐5 (P = 0.088) and IL‐13 (P = 0.032). There were no significant differences in each inflammatory parameter between the two asymptomatic groups.

Conclusions:  In young adult atopic subjects with asymptomatic BHR, airway inflammation does not necessarily play a determining role in the development of BHR to methacholine itself, though it might be an important factor in the onset of asthma.
A human model of the pathophysiology of chronic obstructive pulmonary disease
Authors: ALIVERTI Andrea , KAYSER Bengt , MACKLEM Peter T.
Published: June 2007

Abstract:  This short review summarizes a series of studies on the effects of expiratory flow limitation (EFL) at ∼1 L/s during incremental exercise to maximal workload (Wmax) in normal subjects on exercise performance, respiratory muscle dynamics and control, and CO2 elimination. Each subject served as his or her own control by performing the same protocol without EFL. Additionally, an index of cardiac output was measured before and after imposing EFL while the subjects exercised at Wmax, Wmax was reduced to 65% of control by severe dyspnoea. EFL forced a decrease in the shortening velocity of expiratory muscles, resulting in increased expiratory pressures which accounted for 66% of the variance in Borg scale ratings of dyspnoea. In spite of an increase in the shortening velocity of inspiratory muscles, inspiratory pressures and power increased, because EFL exercise induced hypercapnia, which increased the chemical drive to breathe. This was in part due to an increased alveolar dead space presumably resulting from a reduction in pulmonary capillary blood volume secondary to the high expiratory pressures. A vicious circle was established in which expiratory muscle pressures induced hypercapnia, which resulted in an even stronger expiratory muscle contraction. The imposition of EFL reduced cardiac output by 10% and decreased arterial O2 saturation, reducing energy supplies to working locomotor and respiratory muscles. This model reproduces the most important clinical features of COPD, and these arise from ventilatory pump dysfunction rather than from the lung. It also leads to hypotheses that can be tested in patients with COPD.
Atelectatic children treated with intrapulmonary percussive ventilation via a face mask: Clinical trial and literature overview
Authors: YEN HA THI KIM , BUI THI DUNG , TRAN ANH TUAN , BADIN PHILIPPE , TOUSSAINT MICHEL , NGUYEN ANH TUAN
Published: June 2007

Background: Persistent atelectasis in children is lacking a gold standard treatment. Intrapulmonary percussive ventilation (IPV) is presented as a promising chest physiotherapy technique in the treatment of atelectasis. This study aimed to follow the evolution of atelectasis resolution with noninvasive IPV in young children and to detect eventual adverse effects.

Methods: Six children were hospitalized for respiratory distress with suspicion of atelectasis. A 15 min IPV treatment was immediately started at D1 twice a day for 5 days. Children were free of any other treatment. Chest X‐Ray (CXR) was performed on the second day (D2) and was repeated 3 days later (D5). After the study, CXR were retrospectively reviewed by three specialists who had no knowledge of the clinical observations of the patients. They were asked to assess atelectasis by a score between 4 (complete collapse) and 0 (complete resolution). A clinical score on a maximum of 4 points was assessed by appetite deterioration, dyspnoea, mucus production and cough presence at D1 and D5 (1 point per symptom present). Paired t‐test compared D1 and D5 results.

Results: All patients returned home after 5 days IPV. SpO2 normalized (93.2 ± 0.8 to 95.3 ± 0.8; P = 0.002) and patients all improved clinically (score, 2.8 ± 0.9 to 0.8 ± 0.6; P < 0.05). Out of four patients with radiographic evidence of atelectasis, three improved their atelectasis score.

Conclusions: No side‐effect or adverse effect was observed during IPV treatments. IPV was safe and effective in atelectasis resolution in 3/4 of the cases. Patients all recovered a stable clinical state. CXR improved in 4/5 children. They were all discharged home after 5 days of IPV treatment.
Utility of a new transcutaneous jaundice device with two optical paths in premature infants
Authors: NAMBA FUMIHIKO , KITAJIMA HIROYUKI
Published: June 2007

Background: Hyperbilirubinemia may cause dysfunction of the central nervous system of newborn infants. Recently, a new transcutaneous bilirubin device has been developed, which is not limited by maturity or melanin concentration of the skin. However, there have been few reports limiting the subjects to preterm and very low‐birthweight (VLBW) infants.

Methods: Transcutaneous bilirubin (TcB) and total serum bilirubin (TSB) were measured within 1 h of time lag in 50 premature infants. TcB was measured with the new jaundice device on the forehead. TSB samples were measured by direct colorimetry. The correlation coefficient and regression line were calculated.

Results: The results showed a good correlation between TcB and TSB. However, the correlation tended to be worse with infants whose birthweights were lower than 1000 g, or whose gestational ages at birth were shorter than 28 weeks.

Conclusion: TcB and TSB have a close correlation, and TcB tends to be higher than TSB. The Minolta transcutaneous jaundice device could be used as a screening instrument, leading to the avoidance of invasive blood samplings for preterm and VLBW infants. However, in patients whose birthweights are lower than 1000 g or whose gestational ages are shorter than 28 weeks, care must be taken when using the transcutaneous jaundice device because of low reliability in these patients.
Re‐treatment regimens for acute stage of Kawasaki disease patients who failed to respond to initial intravenous immunoglobulin therapy: Analysis from the 17th nationwide survey
Authors: UEHARA RITEI , YASHIRO MAYUMI , OKI IZUMI , NAKAMURA YOSIKAZU , YANAGAWA HIROSHI
Published: June 2007

Background: Current regimens for re‐treatment of patients with Kawasaki disease who failed to respond to the initial intravenous immunoglobulin (IVIG) therapy are still uncertain. The purpose of this study is to reveal what regimens were used as the initial therapy and re‐treatment for acute stage of Kawasaki disease in the current Japanese medical setting.

Methods: The 17th nationwide survey on Kawasaki disease covered patients whose onset was in 2001 and 2002. In questionnaires sent to all hospitals with a bed capacity of 100 or more and a pediatric department, several questions related to therapeutic regimens for Kawasaki disease were posed. The authors observed the proportions of hospitals that had regimens for patients who failed to respond to the initial therapy.

Results: Among those hospitals that responded to the survey, 1052 (64.1%) reported that at least one patient with Kawasaki disease visited the hospital. Among these 1052 hospitals, 73.3% had a regimen to administer 30–39 mg/kg per day of oral aspirin with initial IVIG. The proportion of hospitals that used 1 g/kg per day of IVIG for 2 days was the largest among the options for the initial treatment. For those patients who fail to respond to the initial therapy, 464 hospitals (44.1%) reported that their pediatricians would use additional IVIG only. The number of hospitals that planned to administer high‐dose IVIG and ulinastatin was 185 (17.6%). The number of hospitals having regimens of additional IVIG and steroids was 54 (5.1%).

Conclusions: The current status of the treatment for patients with Kawasaki disease not responding to the initial IVIG therapy in Japan was revealed. A randomized trial of a large sample is needed to ascertain the effectiveness of several options for re‐treating Kawasaki disease.
Serum free T4 and thyroid stimulating hormone levels in preterm infants and relationship between these levels and respiratory distress syndrome
Authors: TANAKA KYOKO , SHIMIZU TOSHIAKI , HOSAKA ATSUTO , TOKITA AKIFUMI , SHIGA SEIGO , YAMASHIRO YUICHIRO
Published: June 2007

Background: There have been few studies of the thyroid stimulating hormone (TSH) surge in extremely low‐birthweight (ELBW) infants, and the relationship between thyroid hormones and respiratory distress syndrome (RDS) has yet to be clarified. The present study sought to determine the serum levels of free T4 (fT4) and TSH in ELBW infants and to examine the relationship between these levels and the development of RDS.

Methods: The authors measured serum fT4 and TSH levels soon after birth in 449 preterm infants, who were born at 22–36 weeks of gestation, and determined the associations between these levels, the incidence of RDS, and the recognized clinical factors associated with RDS.

Results: Serum fT4 and TSH levels, and the fT4/TSH ratio, in the group at 22–24 weeks of gestation were significantly lower than those in the group at 28–36 weeks. The levels and ratio increased significantly with increasing gestational age. There were significant correlations between the serum fT4 level and the birthweight, Apgar score, and gender, and between the serum TSH level and the gestational age, mode of delivery, and birthweight. No significant relationship between the incidence of RDS and the serum levels of fT4 and TSH was observed.

Conclusion: The authors’ results suggest that the serum levels of fT4 and TSH in ELBW infants are very low, and that these levels are not correlated with the occurrence of RDS.
Certain type of chronic lung disease of newborns is associated with Ureaplasma urealyticum infection in utero
Authors: HONMA YOKO , YADA YUKARI , TAKAHASHI NAOTO , MOMOI MARIKO Y , NAKAMURA YOSHIKAZU
Published: June 2007

Background: Recent studies of chronic lung disease (CLD) of newborns emphasize the contribution of antenatal infection. However, the association of Ureaplasma urealyticum infection and CLD has been controversial. The purpose of the present paper was to determine whether U. urealyticum is associated with chorioamnionitis (CAM) and a certain type of CLD.

Methods: One hundred and five infants <32 weeks of gestation who were admitted to the neonatal intensive care unit at Jichi Medical School Hospital, who underwent both histological and microbiological examinations and who survived to discharge were included. CAM was determined by histological examination. Placenta, gastric and tracheal aspirates, and nasopharyngeal swabs were cultured for Mycoplasma and other microorganisms. CLD was defined as oxygen needed at 28 days of age with symptoms of persistent respiratory distress and hazy or emphysematous and fibrous appearance upon X‐ray. CLD was further divided into two subtypes according to the presence of antenatal infection.

Results: CAM was associated with premature rupture of membrane (odds ratio [OR], 10.19; 95% confidence interval [CI]: 3.10–33.56), placental colonization of U. urealyticum (OR 6.73, 95%CI: 1.89–23.91), neonatal colonization of other microorganisms (OR 7.33, 95%CI: 1.22–44.13) and level of IgM (OR 1.06, 95%CI: 1.01–1.11). Comparisons between CLD and non‐CLD patients showed that gestational age (OR 0.43, 95%CI: 0.30–0.61) and white blood cell count (WBC) at birth (OR 1.06, 95%CI: 1.01–1.11) were risk factors for CLD, while gestational age (OR 0.38, 95%CI: 0.23–0.64), neonatal colonization of U. urealyticum (OR 5.98, 95%CI: 1.17–30.6) and WBC (OR 1.08, 95%CI: 1.01–1.15) were independent risk factors for infection‐related CLD compared with non‐CLD. Within CLD, infection‐related CLD was associated with neonatal colonization of U. urealyticum (OR 43.7, 95%CI: 2.84–673.8) and WBC (OR 1.27, 95%CI: 1.07–1.50).

Conclusions: Placental colonization of U. urealyticum was significantly related to CAM; and neonatal colonization of U. urealyticum and leukocytosis at birth were risk factors for infection‐related CLD.
Extracorporeal leukocyte removal therapy for patients with ulcerative colitis
Authors: KUMAGAI MASAMI , YAMATO YASUHIKO , MAEDA KOHJI , NAKASHIMA EISUKE , USHIJIMA KOSUKE , KIMURA AKIHIKO
Published: June 2007

Background: The purpose of the present paper was to investigate efficacy of leukocytapheresis (LCAP) or granulocytapheresis (GCAP) in pediatric patients with ulcerative colitis (UC), including reduction of the total dose and side‐effects of corticosteroids.

Methods: Courses of five Japanese adolescents with UC were analyzed. Four patients had recurrent UC with repeated remissions and exacerbations despite therapy including 5‐aminosalicylic acid in combination with a corticosteroid. The other patient had a first attack. Effectiveness of adding LCAP or GCAP was assessed with regard to short‐term changes in clinical activity, complications, and longer‐term outcome.

Results: Clinical improvement was attained in three patients, while the other two did not improve and underwent colectomy. One of the two patients had moderately severe complications from LCAP and showed increased clinical activity during LCAP. The other, who began therapy with LCAP alone, had moderate improvement only after addition of a corticosteroid.

Conclusion: Additional studies are needed to determine optimum timing of LCAP or GCAP and initiation of remission‐maintenance therapy.
Characteristics of obese children with low content of arachidonic acid in plasma lipids
Authors: OKADA TOMOO , SATO NORIKO F , KUROMORI YUKI , MIYASHITA MICHIO , TANIGUTCHI KAZUO , IWATA FUJIHIKO , HARA MITSUHIKO , AYUSAWA MAMORU , HARADA KENSUKE , SAITO EMIKO
Published: June 2007

Background: Although there have been many studies on the relationship between obesity and long‐chain polyunsaturated fatty acid (LCPUFA), the results and their interpretation are controversial, especially in children. Arachidonic acid (AA), the product of n‐6 LCPUFA, is reported to be related to insulin resistance. The purpose of the present paper was to investigate the LCPUFA profile in obese children and mechanisms that contribute to reduced AA content.

Method: An age‐ and sex‐matched control study was performed. The study subjects were 59 obese children (mean age, 11.8 years) and 53 healthy non‐obese children (mean age, 12.5 years). The study parameters included anthropometric measurements, serum lipids, leptin and fatty acid composition in plasma.

Results: Plasma fatty acids in obese children had lower linoleic acid (P < 0.0001) and higher dihomo‐γ‐linolenic acid (P = 0.0004) than those in non‐obese children. In all subjects combined, δ‐6 desaturase (D6D) index (ratios of [C 18:3n‐6+C 20:2n‐6]/C 20:4n‐6 or C 20:4n‐6/C 18: 2n‐6) correlated with leptin (P < 0.0001). There was no significant difference in AA content between obese and non‐obese. However, the AA content was low (<mean − 1SD in controls) in 27.1% of obese children, in whom D6D index was not elevated in spite of high insulin concentration.

Conclusion: Obese children had changes in plasma LCPUFA profile that indicate upregulation of n‐6 LCPUFA metabolism, probably caused by activated D6D activity to compensate AA demand. Heterogeneity of AA content in obese children depends on D6D and δ‐5‐desaturase activity, which may reflect insulin sensitivity.
Natural course of lower urinary tract symptoms following discontinuation of alpha‐1‐adrenergic blockers in patients with benign prostatic hyperplasia
Authors: Yokoyama Teruhiko , Watanabe Toyohiko , Saika Takashi , Nasu Yasutomo , Kumon Hiromi , Miyaji Yoshiyuki , Nagai Atsushi
Published: June 2007

Objective:  α1‐adrenergic blockers (αb) remain the first‐line therapy in men with lower urinary tract symptoms (LUTS). The current published work advocates continued use of αb for their effect to be maintained. However, some patients decide to discontinue use of the medication after their symptoms are relieved and can keep good conditions. In this study, we investigated the natural course of LUTS after the discontinuation of successful treatment of αb.

Methods:  Among 75 patients with LUTS who stopped αb medication once their symptoms improved, 60 patients (age, 50–87 years; median, 70) who could be followed for at least 12 months after discontinuation of αb were analyzed in this study. Evaluations included a clinical determination of the International Prostate Symptom Score (IPSS), peak flow rate (Qmax) and postvoid residual urine volume (PVR). Upon patient request or in cases of PVR more than 100 mL, administration of αb was resumed.

Results:  Eighteen out of the 60 patients (30%) asked for re‐treatment within 12 months after discontinuation (re‐treatment group). The other 42 patents were able to maintain good condition without medication (discontinuation group). The IPSS was 15.9, 8.7, 10.1, 10.2, 9.7, 8.8 and 9.0, on the first visit, just before discontinuation, and 1, 3, 6, 9 and 12 months after stopping treatment among the discontinuation group, respectively. Similarly, Qmax was 10.6, 14.8, 14.2, 14.3, 14.7, 13.2 and 13.6 mL/ s, respectively. Treatment periods, prostatic volume and peak flow rates just before discontinuation of medication differed significantly between the re‐treatment and discontinuation group.

Conclusions:  In spite of the short follow‐up periods, these results suggest that selected patients with relatively small prostatic volume and good flow rates after therapy can discontinue αb medication after their symptoms improve.
Adrenocortical carcinoma: Retrospective study of 14 patients experienced at a single institution over 34 years
Authors: Nishida Sachiyo , Itoh Naoki , Sasao Takumi , Masumori Naoya , Taguchi Keisuke , Tsukamoto Taiji
Published: June 2007

Objective:  To review clinical outcome of patients with adrenocortical carcinoma experienced at a single institute over 34 years.

Methods:  The study included 14 patients who were diagnosed as having the disease and were treated at the Department of Urology, Sapporo Medical University Hospital between 1973 and 2006. Their clinical features and outcomes were reviewed.

Results:  Of the 14 patients, there were nine men and five women. The median follow‐up period was 13.0 months (range, 1–213). Two patients were classified as having stage II disease, seven as stage III and five as stage IV. The disease was completely removed in eight patients and incompletely in three. Two other patients received exploratory laparotomy only. The remaining one patient had no indication for surgery. The median survival periods were 2 months in patients with stage IV and 108 months in those with stages II and III (P = 0.136). Mitotane treatment in the adjuvant setting did not clearly affect the clinical courses of patients without metastasis. However, the treatment was effective for metastasis that was repeatedly developed as late recurrence in one patient. Three patients with metastasis at diagnosis received combination chemotherapy with etoposide, doxorubicin and cisplatin (EDP) with or without mitotane treatment, to which lung metastasis completely responded in one patient.

Conclusions:  Adrenocortical carcinoma is a rare disease but frequently recurs. The best chance of survival may be achieved by early detection and complete surgical removal. There may be patients who possibly benefit from mitotane treatment with or without EDP, although this remains to be conclusively determined.
Sickle‐shaped crack in a round bar under complex Mode I loading
Authors: CARPINTERI A. , BRIGHENTI R. , VANTADORI S. , VIAPPIANI D.
Published: June 2007

A sickle‐shaped surface crack in a round bar under complex Mode I loading is considered. First, the stress‐intensity factor (SIF) along the front of the flaw is numerically determined for five elementary Mode I stress distributions (constant, linear, quadratic, cubic and quartic) directly applied on the crack faces. The finite element method and linear elastic fracture mechanics concepts are employed. Then, a numerical procedure to calculate approximate values of SIF for a complex Mode I stress distribution on the crack faces is proposed based on both the power series expansion of the function describing such a stress distribution and the superposition principle. In order to validate the results obtained through the above procedure, a comparison with numerical data available in the literature is made.
The effect of gentamicin sulphate on the fracture properties of a manually mixed bone cement
Authors: BALEANI M. , PERSSON C. , GUANDALINI L. , PIAZZA E. , ERANI P. , SQUARZONI S. , VICECONTI M.
Published: June 2007

This work investigates the effect of adding gentamicin, an antibiotic, on the fracture properties of bone cement.

Endurance limit, fatigue crack propagation and fracture toughness were determined for a polymethylmethacrylate‐based cement, containing 10% w/w of barium sulphate as radiopacifying agent, and the same formulation modified by the addition of 4.22% w/w of gentamicin sulphate.

The antibiotic does not affect the endurance limit nor the fracture toughness of the material. There are significant differences in the parameters of the Paris' law fitting the crack growth data: once the main crack is nucleated, it initially propagates at a lower rate but thereafter accelerates faster in gentamicin loaded bone cement. Despite this difference, the growth rate for the same stress intensity factor remains of the same order of magnitude in both formulations.

The addition of 4.22% w/w of gentamicin sulphate to radiopaque bone cement has a negligible total effect on the fracture properties of the material.
Avoiding unnecessary iteration in fracture mechanics calculations
Authors: STANLEY P.
Published: June 2007

A recent publication includes a number of design calculations which incorporate iterative procedures. It is demonstrated that these are unnecessary and non‐iterative techniques are described for use in their place.
Casein kinase I epsilon gene transfer into the suprachiasmatic nucleus via electroporation lengthens circadian periods of tau mutant hamsters
Authors: Wang Haoran , Ko Caroline H. , Koletar Margaret M. , Ralph Martin R. , Yeomans John
Published: June 2007

Circadian activity rhythms in mammals are controlled by the expression and transcriptional regulation of clock genes in the suprachiasmatic nucleus (SCN). The circadian cycle length in hamsters is regulated in part by casein kinase I epsilon (CKIε). A semidominant mutation (C→T, R178C, CKIεtau) appears to act as a dominant‐negative allele to shorten the period of circadian rhythms. We tested this hypothesis in vivo by expressing wild‐type CKIε gene in homozygous tau mutant hamsters. High‐level CKIε+/+ gene transfer and expression (as indicated by green fluorescent protein) were obtained by injecting CKIε‐containing plasmids bilaterally near the SCN, followed by in vivo electroporation. Rhythmicity reappeared 5–7 days after electroporation, with a gradual increase in circadian period over the next 10 days. The circadian period returned to the baseline over the next 20 days. For the five hamsters with clearest gene expression in the SCN, the mean lengthening time was 39.6 min. Period change was not observed in either control tau mutant hamsters electroporated with plasmids lacking the CKIε gene or in wild‐type hamsters with plasmids containing the wild‐type CKIε gene. Therefore, normal periodicity in homozygous CKIεtau hamsters was partially rescued by expression of the wild‐type CKIε gene in the SCN, supporting a competitive and dominant‐negative action of the mutant allele. This study shows that electroporation of wild‐type CKIε gene into the SCN is sufficient for lengthening the shorter circadian period of tau mutant hamsters in a time‐dependent way and supports the conclusion that CKIεtau is the cause of the shorter period.