bluuebunny/crossref_metadata_2025 huggingface dataset:
Reduction of phase error ghosting artifacts in thin slice fast spin‐echo imaging
Authors: Wan Xin , Parker Dennis L. , Lee James N. , Buswell Henry R. , Gullberg Grant T.
Published: March 2007

Fast spin‐echo (FSE) imaging techniques are very sensitive to the relative phase between the 90° (excitation) RF pulse and the 180° (refocusing) RF pulses. In this paper, it is demonstrated that a phase shift can be created between the excitation and refocusing pulses in such a manner that the received signal is divided into two components of distinctly different phase shifts. The nature of these two components is reviewed. It is demonstrated that ghosting artifacts will occur when images are reconstructed from this received signal. The ghosting is shown to be object dependent. A correction technique is presented which calculates the phase errors among different echoes based on measurements from a single echo train acquired without phase encoding gradients. The results in both phantom and human studies show that this method is capable of reducing the ghosting artifact in thin slice FSE images.
Estimation of average flow in ungated 3D phase contrast angiograms
Authors: Maier Stephan E. , Cline Harvey E. , Jolesz Ferenc A.
Published: March 2007

Three dimensional (3D) phase contrast angiograms contain velocity data, which is discarded after the reconstruction of the projections. In extension to earlier work on velocity quantification with ungated 2D phase data, this paper shows that a useful estimate of the average velocity and flow rate can be extracted from ungated 3D phase contrast angiograms. Simulations and experiments in a phantom and in vivo were performed. For pulsatile flow and strong spin saturation, an over‐estimation of the flow rate at the net in‐flow end of the imaging volume and underestimation at the net out‐flow end was observed. Imaging at lower RF tip angles yielded flow rates close to the correct value within the entire imaging volume. In contrast to ungated 2D experiments, the flow rates determined by repeated 3D experiments showed no variation.
In vivo measurement of partial oxygen pressure in large vessels and in the reticuloendothelial system using fast 19F‐MRI
Authors: Nöth Ulrike , Morrissey Sean P. , Deichmann Ralf , Adolf Holger , Schwarzbauer Christian , Lutz Joachim , Haase Axel
Published: March 2007

Quantitative in vivo 19F‐MRI was performed in a rat model to monitor partial oxygen pressure (pO2) using a perfluorocarbon (PFC) emulsion as contrast agent. On Days 1, 4, and 8 postin‐jection of the PFC emulsion, transaxial T1 and pO2 maps were acquired of the abdomen of rats that were consecutively ventilated with pure oxygen, air, and a mixture of 10% oxygen and 90% nitrogen. The images had a resolution of 0.75 mm x 0.75 mm x 2 mm and a total acquisition time of 24 min. In these images it was possible to distinguish between different vessels and hepatic and splenic tissue in the selected imaging plane. Serial 19F‐MRI measurements on the different days postinjection of the PFC allowed to determine separately the pO2 of arterial and venous blood and the intracellular pO2 in macrophages of the liver and spleen.
Continuous radial data acquisition for dynamic MRI
Authors: Rasche Volker , Boer Ruud W. De , Holz Dietrich , Proksa Roland
Published: March 2007

Since image acquisition times in MRI have been reduced considerably over recent years, several new important application areas of MRI have appeared. In addition to pure static anatomic information, the evolution of a dynamic process may be visualized by a sequence of temporal snapshots of the process acquired within a short time period. This makes applications like interactive or interventional MRI as well as the acquisition of additional functional information feasible. For high temporal resolution, all these applications require a quasi real‐time image acquisition during the time the interaction or dynamic process evolves. We present an approach to realtime imaging using a continuous radial acquisition scheme. The intrinsic advantages of radial or projection reconstruction (PR) techniques are used to minimize motion‐related image distortions. Modifications of the acquisition scheme as well as dedicated reconstruction techniques are used to further reduce the temporal blurring due to the finite acquisition time of one entire data set in our approach. So far we have used this technique for the visualization of active joint motion.
Shielded gradient coils on hyperbolic surfaces of revolution
Authors: Carlson Joseph W. , Roos Mark S.
Published: March 2007

A formalism for the calculation of fields generated by current distributions on hyperbolic surfaces of revolution is presented and used to generate designs for shielded gradient coils. One application is the development of small, insertable coils suitable for head imaging while allowing clearance for shoulders. This technique demonstrates that efficient designs that offer substantial advantages over conventional cylindrical designs are possible.
A Methodology for co‐registering abdominal MR images over multiple breath‐holds
Authors: Feinberg David A. , Johnson G.
Published: March 2007

Previous studies have demonstrated that the SNR of abdominal MR images can be increased by averaging images obtained in different breath‐hold acquisitions. In this note, the authors present a simple new methodology for ensuring that images acquired in multiple breath‐hold periods are accurately co‐registered. Within each breath‐hold, a quick coronal scout scan is followed by a longer axial scan. The scout is used to position the axial slices in a fixed position relative to the organ under examination. This MR technique can, in principle, be automated so as to add less than 1 s to the imaging time of the axial scan. The method can be used to increase SNR by signal averaging or to co‐register images acquired during, for example, uptake of contrast agents. SNR improvement with negligible blurring is demonstrated in liver images acquired by this method from healthy volunteers.
Increased noe enhancement in 1h decoupled 31p mrs
Authors: Sluis Robert Van , Payne Geoffrey S. , Leach Martin O.
Published: March 2007

1H decoupling using the WALTZ‐4 decoupling scheme is a popular means of improving spectral resolution in 31P NMR spectroscopy. At the same time, sensitivity in the proton decoupled 31P spectra is enhanced by the nuclear Overhauser effect. The authors show that when using WALTZ‐4 decoupling in a uniform decoupler RF field, the degree of sensitivity enhancement is critically dependent on whether the decoupling interval contains an odd or an even number of WALTZ decoupling elements. This effect is demonstrated both in phantoms and in vivo.
The rician distribution of noisy mri data
Authors: Gudbjartsson HáKon , Patz Samuel
Published: March 2007

The image intensity in magnetic resonance magnitude images in the presence of noise is shown to be governed by a Rician distribution. Low signal intensities (SNR < 2) are therefore biased due to the noise. it is shown how the underlying noise can be estimated from the images and a simple correction scheme is provided to reduce the bias. the noise characteristics in phase images are also studied and shown to be very different from those of the magnitude images. Common to both, however, is that the noise distributions are nearly Gaussian for SNR larger than two.
Embedded strong discontinuity finite elements for fractured geomaterials with variable friction
Authors: Foster C. D. , Borja R. I. , Regueiro R. A.
Published: March 2007

The strong discontinuity approach to modelling strain localization, combined with an enhanced strain element, has been used for more than a decade to model strain localization in materials including geomaterials. Most implementations of enhanced strain elements in the post‐localization regime use very simple constitutive formulations along the discontinuity, such as linear softening or a constant friction coefficient. However, the softening relations can be much more complex for geomaterials. For rocks this softening is induced by micro‐fractures coalescing into macroscopic cracks during a narrow time interval called ‘slip weakening.’ During this interval the cohesive resistance on the nucleating crack decays to zero while the frictional resistance increases. Furthermore, research has shown that the coefficient of friction for these materials is not constant, but in fact is a function both of the slip speed and the state of the material, including wear, temperature, and other factors. In this paper we augment the modelling capabilities of an enhanced strain element by incorporating a cohesive softening law and a popular rate‐ and state‐dependent friction model commonly used for describing the constitutive properties of rocks and rock‐like materials sliding along the fractured surface. Copyright © 2007 John Wiley & Sons, Ltd.
Correlation between prenatal ultrasound and fetal autopsy findings in fetal anomalies terminated in the second trimester
Authors: Akgun Hulya , Basbug Mustafa , Ozgun Mahmut Tuncay , Canoz Ozlem , Tokat Fatma , Murat Nurcan , Ozturk Figen
Published: March 2007

Objective

The aim of the study was to compare the consistency of major/minor fetal anomalies detected by second trimester prenatal ultrasound examination with the findings in fetal autopsies following the termination of pregnancy (TOP) in the second trimester.

Design

In a 4‐year long prospective study, 107 second‐trimester TOP was performed due to fetal malformation diagnosed by second trimester‐ultrasound examination at a tertiary referral center. Ultrasound findings were compared with fetal autopsy findings.

Result

Of the 107 cases with major fetal anomalies diagnosed by prenatal ultrasound, 49% had central nervous system anomalies, 23% had kidney and urinary tract anomalies, 11% had congenital heart disease. All of these major anomalies leading to TOP were confirmed by fetal autopsy (100% success rate in major anomalies). Overall success rate in prenatal ultrasound for major and minor anomalies was 77%. The percentage of additional minor anomalies detected in fetal autopsies was 20%. Three percent of the minor anomalies detected by prenatal ultrasonography could not be confirmed during autopsy. Chromosomal anomalies were detected in 9 (16%) out of 57 cases.

Conclusion

Evaluation of fetal autopsies following TOP enables diagnosis of pathologies undetected by prenatal ultrasound alone, leading to better preconceptional counseling for subsequent pregnancies. Copyright © 2007 John Wiley & Sons, Ltd.
Misleading capillary glucose measurements
Authors: Sandler M , Low‐Beer T
Published: March 2007

Glucose reagent strips are routinely used to monitor capillary glucose concentrations in patients in whom there is a risk of significant fluctuation of blood glucose. This method is regarded as being safe, rapid and accurate especially at the lower limits of glucose measurement. We report on three cases which highlight a particular clinical situation in which this form of glucose monitoring may be inaccurate, and may lead to inappropriate administration of glucose.
Comprehensive care programme for young adults with IDDM
Authors: Dunning Patricia , Best J D , Alford F P
Published: March 2007

In 1985 St Vincent's Hospital, Melbourne developed a diabetes service tailored to the special needs of young adults in the 18‐35 year age range with insulin‐dependent diabetes. The service comprises a weekly outpatient clinic, social‐educative evening meetings and a telephone/drop‐in service. The three aspects of the scheme are inter‐related, have common goals and are serviced by the same team members (diabetes specialists, diabetes educators, dietitian and social worker). The total clinic population is 150, of these 45 are referrals from the paediatric hospital. The clinics are small (8–12) and patients see the same doctor at each visit. Analysis of clinic attendance records indicates that people keep their appointments and are more likely to telephone if unable to attend, since the inception of the scheme. Four people have not continued attendance after transfer from the paediatric hospital. Each evening meeting is attended by 30–40 people, depending on individual interest in the topic, and other personal commitments. A core group of 16 regular attenders has emerged. Individual telephone consultations average 12 patient contacts per month. Drop‐in consultations average eight patient contacts each month of > 30 minutes duration, and six contacts of < 30 minutes duration per month. There were two hospital admissions from the group who regularly attend the clinic and evening meetings compared with 12 from the non attenders.
Does the quality of the diet sheet matter?
Authors: Frost G , Heavens Patricia , Masters Karon
Published: March 2007

The aim of the study was to investigate whether the type of dietary advice sheets make a significant difference to metabolic control and/or knowledge of newly diagnosed non‐insulin‐dependent diabetics (NIDDM). Thirty four subjects were randomly assigned to one of two groups. Group A (n = 17) were given “attractive” diabetic dietary advice sheets (incorporating colourful cover and illustrations), and Group B (n = 17) were given “unattractive” dietary advice sheets (the same text but without illustrations). There was no significant difference in age, body mass index, fasting blood glucose, fructosamine or type of drug treatment between the two groups.

There was a significant improvement (p<0.01) in the knowledge score of Group A and an improvement in fructosamine and fasting blood glucose levels (p<0.05).

“Attractive” dietary advice literature, therefore, may improve theoretical knowledge of the diet and also, possibly, glycaemic control.
Compliance with glibenclamide treatment in non‐insulin‐dependent diabetic patients
Authors: Babiker I E , Jerrom D W A , McInerney D , Hartog M
Published: March 2007

Compliance with glibenclamide therapy was tested in a group of 18 non‐insulin‐dependent diabetic patients. A considerable degree of non‐compliance was found – only nine (50%) achieved a compliance score of 95‐105% at an unscheduled home visit. Five (28%) were found to be taking more than the prescribed amount.

A significant relationship was found between taking less than the prescribed amount and somatic symptoms and indices of social dysfunction.
Introducing reflectance meters to hospital wards
Authors: Weedon L M , Wills P D
Published: March 2007

The introduction of Reflolux S blood glucose meters (BM UK Ltd) onto all wards of a District General Hospital is described. We established a continuing, structured education programme and a laboratory‐based quality assurance scheme (QA) and issued guidelines regarding safety and correct usage of the meter. A formal hospital policy on blood glucose monitoring together with certification of user competence recorded on a database has enabled evaluation of nurse training and audit. The introduction of a QA scheme has allowed assessment of meter results, identified areas where more education was needed and provided data to feed back to ward staff. Poor performers have benefited from positive liaison with diabetic nurse specialists at an early stage.
Detailed investigation of the cause of impotence in 20 diabetic men
Authors: Ryder R E J , Facey P , Hayward M W J , Evans W D , Bowsher W G , Peters J R , Owens D R , Hayes T M , Robinson L Q , Watkins S E , Williams P A
Published: March 2007

To clarify the cause of their impotence, 20 diabetic patients underwent detailed assessments of: diabetic autonomic neuropathy (acetylcholine sweatspot test, pupil test‐PD%, five cardiovascular tests); vascular disease (radioisotope phallogram, response to intracorporeal papaverine); nocturnal penile rigidity; psychiatric disturbance (General Health Questionnaire). Results suggested cause as: vascular 7/20 (35%), vascular and autonomic neuropathy 7/20 (35%), autonomic neuropathy 3/20 (15%), psychiatric disturbance 2/20 (10%), beta‐blockers 1/20 (5%). The sweatspot test appeared to be the most sensitive assessment of autonomic neuropathy. Investigations suggested an alternative aetiology in all cases with a normal sweatspot test. In one patient with autonomic neuropathy, high deep‐artery velocity on Doppler but loss of papaverine‐induced erection, dynamic cavernosography revealed venous leakage; impotence was improved by surgical venous ligation. The results suggest that most impotence in diabetics has an organic basis. The sweatspot test (ideally in conjunction with cardiovascular tests and pupil test) and response to intracorporeal papaverine may identify and categorise most of these patients. Those with normal tests are unlikely to have organic disease and could be referred for psychosexual/psychiatric counselling. Doppler studies may identify those who need investigating for venous leakage. The others could then, in the first instance, be offered one of the recently described non‐invasive devices for overcoming diabetic impotence. Self‐administered intracorporeal papaverine may also be considered, but only a minority of diabetic patients seem to respond.
Awareness of foot problems
Authors: Barker R A , Macleod A F , Till A S , Lowy C , Sönksen P H
Published: March 2007

Two hundred and nine diabetic patients, randomly selected from the diabetic clinic, were questioned about foot problems and care of the feet. The feet were then examined for ulcers, amputations, pulses, presence or absence of ankle jerks and vibration perception threshold measured.

The prevalence of neuropathy was 22% (45/207). To direct questioning, 30% of the patients admitted to having problems with their feet and had significantly higher vibration perception threshold (p<0.005 for the great toes) than those with no problems. Although 81% of patients realised that diabetic subjects may have problems with their feet, only 54% took any precautions; those who did not had significantly higher vibration perception thresholds than those who did.

In patients with evidence of peripheral neuropathy, about half (51%) were asymptomatic and over half (56%) took no precautions in terms of looking after their feet. This latter group, who are most in need of education about care of the feet, would have to be identified by a comprehensive screening programme if prophylactic foot care is to be effective in preventing disability.
Quality of life assessment in diabetes: A preliminary study of young adults in Liverpool
Authors: Wallymahmed M E , Baker G A , MacFarlane I A
Published: March 2007

A quality of life questionnaire was completed by 38 young adults with insulin‐dependent diabetes (IDDM) from Liverpool. Ages ranged from 15‐26 years and 18 were male. The questionnaire explored three domains: The impact of diabetes, concerns about the effects of diabetes, and personal satisfaction. Thirty‐eight non‐diabetic subjects aged 15‐27 years, 12 male, also completed non‐diabetic related questions on personal satisfaction, health and social/vocational worries.

The perceived quality of life in these young adults with IDDM was not related to glycaemic control (HbA1), or gender. The Liverpool patients with diabetes reported significantly more personal satisfaction than the non‐diabetic males. Comparing the questionnaire scores with published data on IDDM patients from the USA, young adults have a similar perceived quality of life to adolescents in the USA with a trend towards a better perceived quality of life than older adults in the USA. These preliminary findings merit further investigation.
Photography of the peripheral retina: Assessment of its value in screening for diabetic retinopathy
Authors: Smith S A , Shilling J S , Sonksen P H
Published: March 2007

The diagnostic value of peripheral retinal photography in screening for retinopathy was assessed in 100 eyes from 95 diabetic patients following pharmacological mydriasis. Polaroid prints of the central 45° field and of 4 peripheral fields were assessed by a consultant ophthalmologist. There were 45 eyes judged to have no retinopathy centrally. Of the 55 eyes with retinopathy, 21 were referred: 3 for pre‐proliferative retinopathy and 18 for maculopathy. The 4 Polaroids of the peripheral retina were assessed at a second reviewing session. There was significant agreement in diagnosing the presence or absence of retinopathy from the central versus the peripheral review. No proliferative retinopathy was identified from any of the photographs. There were 7 eyes judged to have clear central fields in which the peripheral photographs revealed retinopathy, though none of these required referral. It is concluded that additional peripheral photographs are not essential for routine screening.
The economics of setting up a diabetic foot clinic
Authors: Moriarty K T , Slater N , Welsh C , Hardisty C
Published: March 2007

Though the combined diabetic foot clinies have been shown to be beneficial, very little is known of either their workload or the costs of running them. The foot clinic at this hospital has been established for five years and referral patterns and workload are now relatively constant.

Information was collected about all the patients who attended clinic in a one‐year period. Data about each outpatient and inpatient attendance was recorded to enable estimation of the costs involved in running such a clinic as a guide to those who may wish to set up a similar service.
Abnormal gastric scintigraphy is not a reliable sign of diabetic autonomic neuropathy
Authors: Nilsson H , Lilja B , Rosén I , Ekberg O , Sundkvist G
Published: March 2007

To evaluate whether gastric scintigraphy could be considered a reliable test of autonomic neuropathy in diabetic patients, two patients, with vomiting and abnormal gastric scintigraphy are reported. Although the clinical presentations were similar, extensive investigation revealed that one patient suffered from autonomic neuropathy as part of a generalized neuropathy while the second patient showed a reversible gastroparesis without objective signs of neuropathy. Accordingly, before gastric scintigraphy can be considered to reflect autonomic neuropathy, other tests have to be carried out.
An evaluation in the diabetes clinic of the Cholestech L‐D‐X analyser
Authors: Cummings MH , Watts GF , Mazurkiewicz JC , Slavin BM
Published: March 2007

The Cholestech L‐D‐X lipid analyser (LDX) is one of the first fully automated desktop analysers to determine serum high‐density‐lipoprotein cholesterol (HDL‐C) concentration, an important measurement for assessing dyslipidaemia, particularly in patients with non‐insulin‐dependent diabetes mellitus. We compared results of total cholesterol (TC), triglyceride (TG) and HDL‐C concentrations measured by the LDX and by a standard (DAX) laboratory analyser from serum obtained from 40 patients in our diabetic clinic. The mean differences between the concentrations measured were not statistically significant, there being a very close correlation between methods (TC: LDX = 0.98. DAX + 0.06, r = 0.98, p<0.01; TG: LDX = 1.01. DAX + 0.05, r = 0.99, p<0.01 and HDL ‐C: LDX = DAX + 0.03, r = 0.97, p<0.01). Random error assessed by analysis of variance was minimal. We conclude that the Cholestech L‐D‐X analyser may be useful for providing rapid and accurate measurements of serum lipid profiles, particularly in patients in whom measuring HDL‐C concentration is important. The small size, speed of analysis and simplicity of use of the LDX make it an ideal instrument for utilisation in the diabetes clinic and lipid out‐patient clinic.
General practitioner Clinical Assistant rotation in the diabetes clinic increases confidence in the care of patients with diabetes
Authors: O'Mullane NM
Published: March 2007

A Clinical Assistant rotation in the diabetes clinic lasting four months was offered to general practitioners, with a view to giving “hands‐on” experience in diabetes care.

Six general practitioners have completed the scheme so far. The general practitioners spent time with the diabetes physician, dietitian, chiropodlst, specialist nurse and also saw the patients themselves. A visual analogue scale was used to assess their confidence before and after the course.

Confidence scores before: after, and range of mean () were: neuropathic assessment 3.5 (2−4): 7.5 (5−9), assessment of retinopathy 2.5 (1−3): 6.1 (5−8), relevance of blochemical tests 4.3 (2−7): 7.8 (7−8), advice on diet 4.6 (4−5): 7.3 (4−8), use of oralhypoglycaemics 3.8 (3−5): 7.3 (6−8), knowledge of insulins 2.8 (1−4): 6.3 (5−8). Patient educational topics included action of insulins 4.5 (2−6): 7.5 (5−10), action of tablets 4.6 (3−6): 7.8 (6−10), blood glucose monitoring 5.1 (4−6): 8.1 (5−10) and foot care 4.6 (1−8): 7.8 (4−10).

A structured rotation for general practitioners for four months through the diabetes clinic improved their confidence in education, treating and screening patinets with diabetes.
An unusual case of relapsing brittle diabetes
Authors: Gill G , Kent L , Williams G , Walford S , Alberti G
Published: March 2007

A case is presented of a young female insulin‐dependent diabetic (IDDM) patient who required continuous hospitalisation over a two year period for factitiously produced ketoacidosis (DKA). Her instability resolved after implantation of an insulin infusion pump as well as psychiatric therapy. Eighteen months later, however, she presented with recurrent severe hypoglycaemia, also shown to be factitious. She again resolved, and over nine years of subsequent follow‐up she remains well with non‐problematic glycaemic control.
What happens in the long‐term to the intensively treated IDDM patient? A four year follow‐up
Authors: Haakens K , Dahl‐Jørgensen K , Vaaler S , Aagenaes Ø , Mosand R , Hanssen KF
Published: March 2007

A four year follow‐up of treatment with continuous subcutaneous insulin infusion (CSII) or multiple injections (MI) in not‐highly selected insulin‐dependent diabetic patients is presented. Forty patients (CSII 25; MI 15) were followed for 51.0 months from the start of intensified insulin therapy. Eleven patients (44%) changed from CSII to MI; none changed in the reverse direction or to any other regimen. The initial improvement in HbA1c was lost both in the CSII, MI and change‐over groups. On CSII three patients experienced five subcutaneous abscesses at infusion sites, and two were hospitalised with diabetic ketoacidosis. Hypoglycaemia requiring assistance was equally common on the two treatment modalities. The initial weight gain tended to continue.

We conclude that insulin‐dependent diabetic patients clearly prefer Intensified Insulin therapy, especially MI, for long‐term treatment. How ever, the initial improvement in glycaemic control was not maintained in the long‐term in these patients who were not highly selected. Subcutaneous abscesses at infusion sites and diabetic ketoacidosis requiring hospitalisation occurred exclusively on CSII. These results have important implications for the long‐term treatment of those with insulin‐dependent diabetes.
Over‐estimating glycated haemoglobin
Authors: Connolly VM , Kesson C
Published: March 2007

Glycated haemoglobin measurement has become increasingly important in the management of diabetes and is often used for diagnostic purposes. Several assays are available for measuring glycated haemoglobin, some of which do not differentiate glycated haemoglobin from fetal haemoglobin. We report a case where this led to an erroneous diagnosis of diabetes.
The effects of an integrated education programme on the management of diabetic ketoacidosis
Authors: Thompson C J , Cummings F , Jung R T , Newton R W
Published: March 2007

A twelve month retrospective case note audit of the management of 35 episodes of diabetic ketoacidosis revealed deficiencies in the delivery of intravenous fluid and potassium chloride administration and in the rate of nasogastric intubation. These defects were addressed in a structured education programme for junior medical staff. A subsequent twelve month case note audit of 30 cases of diabetic ketoacidosis was conducted to evaluate changes in practice. Following introduction of the treatment protocol and education programme, patients were treated with larger volumes of intravenous fluid (median 5.8 v 3.6 litres, p=0.0001) and potassium chloride (150 v 60 mmol, p=0.0001), were more likely to have nasogastric intubation where clinically indicated (68% v 0%, p<0.001) and were less likely to become hypokalaemic (13% v 63%, p=0.001). Patients were returned more rapidly to subcutaneous insulin (20 v 29 hours, p=0.0005), though duration of hospital stay and complication rates were unchanged. Management of diabetic ketoacidosis can be successfully changed after introduction of an integrated postgraduate education programme.
Case history notes designed as an aid to professional education. Metabolic cataract causing loss of vision in newly diagnosed insulin‐dependent diabetes mellitus
Authors: Chalmers J , Herlihy OH , Macdonald M , Campbell W
Published: March 2007

Loss of vision is a worrying symptom for any diabetic patient, particularly in young diabetic subjects with poor control. Once osmotic lens change has been excluded, patients presenting with recent changes in their vision should have careful ophthalmological assessment. In this case, a recently diagnosed insulin‐dependent diabetic patient was found to have bilateral metabolic cataracts. Following their surgical removal satisfactory vision was restored. Metabolic cataracts are unusual but should be kept in mind as a cause of visual loss in young people with diabetes.
Diabetic gastroparesis
Authors: Goddard WP , Youde JY , Davies MJ , Rathbone BJ , McNally PG
Published: March 2007

We describe the case of a man with chronic poor glycaemic control who developed multiple complications. Gastroparesis was proven on radio‐nucleotide scanning and failed to respond to therapeutic interventions. Despite his glycaemic control being optimised he was admitted frequently with intractable vomiting and abdominal pain and did not respond to conventional treatment. A percutaneous endoscopic feeding gastro‐jejunos‐tomy was inserted under local anaesthesia. The double lumen system allowed easy drainage of retained gastric content while facilitating jejunal feeding via a soft biliary tube. The technique we have described may be of benefit in the management of severe diabetic gastroparesis.
Proteomic and transcriptomic analysis of rice mature seed‐derived callus differentiation
Authors: Yin Lan , Tao Yong , Zhao Kang , Shao Jianmin , Li Xiaobing , Liu Guozhen , Liu Siqi , Zhu Lihuang
Published: March 2007

Callus differentiation is a key developmental process for rice regeneration from cells. To better understand this complex developmental process, we used a 2‐D gel electrophoresis approach to explore the temporal patterns of protein expression at the early stages during rice callus differentiation. This global analysis detected 60 known proteins out of 79 gel spots identified by MS/MS, of which many had been shown to play a role in plant development. Two new proteins were revealed to be associated with the callus differentiation and have been confirmed by Western blot analysis. The results of proteomics experiments were further verified at the mRNA level using microarray and real‐time PCR. Comparison of the differentially expressed protein levels with their corresponding mRNA levels at the two callus early differentiation stages showed a good correlation between them, indicating that a substantial proportion of protein changes is a consequence of changed mRNA levels, rather than post‐transcriptional effects during callus differentiation, though microarray revealed more expression changes on RNA levels. These findings may contribute to further understanding of the mechanisms that lead to callus differentiation of rice and other plants as well.
Call for 2008 Reviews Issue
Authors: Dunn Michael J.
Published: March 2007

No abstracts.
Two‐dimensional gel electrophoresis as tool for proteomics studies in combination with protein identification by mass spectrometry
Authors: Wittmann‐Liebold Brigitte , Graack Hanns‐Rüdiger , Pohl Thomas
Published: March 2007

No abstracts.
Distribution of ventilation in young children with cystic fibrosis
Authors: Couriel J. M. , Schier M. , Sc B App , Hutchison A. A. , Phelan P. D. , Landau L. I.
Published: March 2007

We attempted to measure the distribution of ventilation in 24 children who had cystic fibrosis (CF) and 58 control subjects (ages 3.9–6.8 years) using the multiple breath the nitrogen washout (MBNW) test. Moment analysis was performed on the MBNW curve, and the first and second moment ratios were derived. Only 40 (49%) of the children were able to complete the test satisfactorily and success was related to age (P< 0.01). Children who had CF had higher moment ratios, both first and second, than did controls (P< 0.001); also, CF subjects who had more severe symptoms had higher moment ratios than did those who had minimal symptoms (P< 0.005). The first moment ratio had a lower coefficient of variation than did the second (14% vs 31%) and, in 8 children who performed the test in duplicate, it also had a lower index of intrasubject variability (6.4% vs 15.1%). Both ratios were lower than those described in older children and in adults, which is consistent with the more rapid washout seen in this age group. Although moment analysis of the MBNW curve can be performed in approximately 50% of children 4 to 6‐years‐old, the complexity of the test, the apparatus, and the analysis and the high failure rate in children under the age of 6 are likely to restrict its use to research studies in specialized pediatric respiratory laboratories.
Respiratory syncytial virus infections in SR croatia, Yugoslavia
Authors: Mlinarić‐Galinović Gordana , Ugrčić Irena , Božikov Jadranka
Published: March 2007

The prevalence of respiratory syncytial virus (RSV) infection was studied during three consecutive annual outbreaks (1983–1986) in SR Croatia, Yugoslavia. A total of 1,238 subjects were examined, using RSV isolation and immunofluorescent (DTFA) methods, with 1,042 showing the signs of respiratory infection and 207 of these having a positive RSV finding. Generally, the prevalence of mild upper respiratory infection (URTI) was 18%, reaching a peak of 30% at 1 year of age. The prevalence of severe lower respiratory tract infections with bronchiolitis, pneumonia, and croup accounted for 51, 34.4, and 28.3% respectively. The highest incidence of RSV infection among respiratory cases was observed in the first 6 months of life (49.4%), being particularly high at the second month among those with URTI, bronchiolitis, pneumonia, and croup (76.2%). Both sexes were equally susceptible to RSV infection (20.51% females, 19.03% males). RSV infections, seasonal incidence ranged from 25.55 to 30.31% in 1983/84 and 1984/85 respectively and dropped sharply to 8.93% in 1985/86. Pediatr Pulmonol 1987; 3:304–308.
Histamine‐induced airway obstruction in infancy: Changes in oxygenation
Authors: Prendiville Anne , Maxwell David L. , Rose Alison , Silverman Michael
Published: March 2007

In seven recurrently wheezy infants who were found to be histamine‐responsive during bronchial challenge, changes in oxygenation (by oximeter and transcutaneous Po2 electrode) and carbon dioxide tension (by transcutaneous Pco2 electrode) were concurrently measured. The histamine challenge consisted of doubling concentrations administered by nebulizer for 1 min at 5‐min intervals, up to a maximum concentration of 8 g/L. The response was determined from maximum expiratory flow using a squeeze technique. Significant mean reductions in transcutaneous oxygen tension of 0.9 ± 0.7 kPa and 1.5 ± 0.9 kPa were seen respectively at half the provoking concentration and at the provoking concentration of histamine that caused a significant reduction in maximum expiratory flow rates. The reduction in oxygen saturation of 4.8 ± 3% was also significant at the provoking concentration. No significant change in transcutaneous carbon dioxide tension was seen. These results suggest that acute histamine‐induced airway obstruction causes significant ventilation/perfusion disturbance in wheezy infants. Oxygen monitoring should be performed during bronchial challenge tests in infancy.
Infants with cystic fibrosis: Pulmonary function at diagnosis
Authors: Tepper Robert S. , Hiatt Peter , Eigen Howard , Scott Peter , Grosfeld Jay , Cohen Mervin
Published: March 2007

Meconium ileus (MEC), failure to thrive (FTT), and a combination of FTT and pulmonary symptoms (COMB) are the most frequent symptoms of cystic fibrosis (CF) at the time of diagnosis. The purpose of this study was to compare to normal controls (NC) the pulmonary function of CF infants at the time of diagnosis, when grouped by these symptoms. The measurements of pulmonary function included oxygen saturation (SaO2), functional residual capacity (FRC), mixing index (MI), total respiratory system compliance (Crs), and maximal flow at FRC (VmaxFRC).

Compared to NC (n = 33), the MEC group (n = 5) had a higher MI (54 vs. 42%) and no difference in SaO2, Crs or VmaxFRC. There were no significant differences between FTT (n = 8) and NC groups although there was a tendency for Crs to be lower in the FTT group (5.1 vs. 6.8 ml/cm H2O). When compared to all other groups, the COMB group (n=11) had significantly lower SaO2, MI, Crs, and VmaxFRC.

The normal lung function in the MEC group is consistent with the normal anatomy reported in CF infants dying secondary to meconium ileus. Longitudinal evaluation of the infants in this study, following initiation of care as patients with a diagnosis of CF, may allow us to determine whether symptoms at diagnosis remain an important determinant of lung function in infancy.
Pulmonary mechanics and energetics of normal, non‐ventilated low birthweight infants
Authors: Abbasi Soraya , Bhutani Vinod K.
Published: March 2007

Pulmonary mechanics and energetics were determined in 33 healthy low birthweight infants (< 1,500 g, 28–34 weeks gestation) who had never received ventilatory support. Tidal volume, dynamic pulmonary compliance, pulmonary resistance, pressure‐volume relationships, and tidal flow‐volume measurements were obtained by pneumotachography and the esophageal balloon technique. Standardized data collection and software data analysis by least mean squares technique yielded data at 0.5, 1, 2, and 4 weeks postnatally, as a function of gestational age (<30, 30–32, and >32 weeks gestation). Relatively stable values were obtained for tidal volume and minute ventilation (normalized for body weight); these were associated with values of peak‐to‐peak esophageal pressure significantly (P < 0.001) increasing from 4.4 ± 0.3 SEM cmH2O at 0.5 weeks to 8.1 ± 0.8 SEM cmH2O at 4 weeks of age. Dynamic pulmonary compliance ranged from 2.0 to 2.4 mL/cmH2O in the first 4 weeks of life. When normalized for weight, compliance decreased with age, which may suggest a slower pulmonary maturation as compared to increase of body weight. Mean pulmonary resistance decreased from 62.9 cmH2O/L/s at <30 weeks gestation to 32.5 cmH2O/L/s at >32 weeks gestation, 0.5 weeks postnatally. Pulmonary resistance peaked at 2 weeks postnatally (P < 0.05), at all gestational ages, then decreased. Changes in pulmonary mechanics resulted in increasing resistive work of breathing. Our findings suggest a postnatal retardation of pulmonary and airway growth, relative to gestation maturation. These data can provide an objective base of comparison for data in sick, low birthweight neonates. Pediatr Pulmonol 1990; 8:89‐95.
Infants with upper respiratory illnesses have significant reductions in maximal expiratory flow
Authors: Martinez Fernando D. , Taussig Lynn M. , Morgan Wayne J.
Published: March 2007

We studied maximal expiratory flows at functional residual capacity (V̇maxFRC) obtained by use of the chest compression technique in 9 infants who had signs of upper respiratory illness (URI) at the time of testing, and in 9 infants who were symptom‐free but whose parents reported they had a URI in the previous month. When compared to 109 infants with no URI, infants with current URI had 40% lower V̇maxFRC (mean±SD: 125.7 ± 54.5 mL/s vs. 73.6 ± 53.6 mL/s; P < 0.01). Infants with a past URI had mean values for V̇maxFRC (120.2 ± 50.2 mL/s) that were not significantly different from those of infants with no URI. Changes in the shape of the flow‐volume loop analogous to those reported in infants with lower airway obstruction were also noticed in infants with current URI. These findings suggest that, as in older children and adults, clinically unapparent alterations in lower airway function occur during URI in infants. Pediatr Pulmonal 1990; 9:91–95.
What are the mechanisms producing increased ventilation in dead space studies in neonates?
Authors: Upton C. J. , Milner A. D. , Stokes G. M. , Carman P. G. T.
Published: March 2007

In 21 studies on 15 infants an additional dead space tube produced a significant rise in end‐tidal P and fall in end‐tidal P, associated with a rise in minute ventilation (228 ± 77 mL/kg/min at zero, 348 ± 85 mL/kg/min at one, and 437 ± 128 mL/kg/min at two anatomical dead spaces). The differences between end‐inspiratory and end‐expiratory P and P did not change significantly, suggesting an increase in dead space, but not in alveolar ventilation. In a further 9 babies the rise in ventilation was unchanged when measurements were repeated in 30% oxygen (361 ± 65 vs. 340 ± 54 mL/kg/min at one anatomical dead space). Studies on 8 babies, with the added tube ventilated by a fan, showed that a mean 28% of the rise in minute ventilation was due to increased resistance. Although the response to tube breathing in neonates is complex, carbon dioxide appears to be the major factor producing increased ventilation. Pediatr Pulmonal 1990; 9:136–139.
Pulmonary function following positive pressure ventilation initiated immediately after birth in infants with respiratory distress syndrome
Authors: Bose Carl , Wood Brian , Bose Gennie , Donlon Deborah , Friedman Mitchell
Published: March 2007

Cardiopulmonary function following positive pressure ventilation, initiated immediately after birth, was evaluated in 10 very low birthweight infants with respiratory distress syndrome (RDS; RDS infants). Multiple gas rebreathing methodology was used to measure functional residual capacity (FRC), diffusing capacity of the lung for carbon monoxide (DLCO) and effective pulmonary capillary blood flow (Q̇eff) at 2, 24, and 72 hr of age. Cardiopulmonary function variables were also measured at 2 hr of age in 10 infants of similar birthweight who did not have RDS (non‐RDS infants). In RDS infants, mean FRC at both 2 hr of age (15 mL/kg or 0.42 mL/cm) and 24 hours of age (20 mL/kg or 0.54 mL/cm) was less than published predicted values for healthy infants and significantly less than values in non‐RDS infants at 2 hours of age (29 mL/kg or 0.8 mL/cm). By 72 hr of age, mean FRC in RDS infants rose to predicted. At 2 and 24 hours of age, mean Q̇eff in RDS infants (41 and 38 mL/min/kg, respectively) was below predicted, as well as below the value observed in non‐RDS infants at 2 hr of age (62 mL/min kg). In RDS infants, DLCO remained well below published predicted values throughout the first three days of life. We conclude that early aggressive respiratory therapy does not result in the establishment of normal lung volumes during the first day of life, but it does so by 3 days of age. However, in spite of intubation immediately after birth and the application of continuous positive pressure ventilation during the first 3 days of life, very low birthweight infants with RDS continue to have significant alteration in lung function, evidenced by impaired diffusing capacity of the lung and low arterial‐alveolar oxygen tension ratios. Pediatr Pulmonal 1990; 9:244–250.
Occurrence of respiratory syncytial virus subtypes in hospitalized children in Cleveland, Ohio from 1985 to 1988
Authors: Stark James M. , Fatemi S. Hossein , Amini Saeid B. , Huang Yung T.
Published: March 2007

In order to determine the frequency of occurrence of the two respiratory syncytial virus (RSV) subtypes in hospitalized children in Cleveland, Ohio, we analyzed clinical isolates obtained during three consecutive winter epidemic seasons between 1985 and 1988. RSV was recovered from the frozen clinical specimens of 197 patients: 176 subtype A, and 21 subtype B. Subtype A predominated during all three epidemic seasons, ranging from 83 to 94% of isolates. We surveyed the clinical records of 16 children with subtype B, and 101 children with subtype A infections, hospitalized at the University Hospitals of Cleveland during these winter epidemics and found no differences in age, sex, race, or clinical spectrum of severity of disease caused by the two subtypes. In contrast to previously reported data, subtype A predominated in each of the winter seasons studied within this community. We conclude that both subtypes circulate concurrently within the community during the winter. In hospitalized children both subtypes appear to cause a similar spectrum of disease. Both the concurrent circulation of RSV subtypes and the similar spectrum of illness pose for important considerations in the development of effective vaccines against this common respiratory agent in children.
Influence of sedation on the hering‐breuer inflation reflex in healthy infants
Authors: Rabbette P. S. , Dezateux C. A. , Fletcher M. E. , Costeloe K. L. , Stocks J.
Published: March 2007

The airway occlusion technique for measuring passive respiratory mechanics in infants relies on an ability to evoke the Hering‐Breuer inflation reflex (HBR). However, the persistence of this reflex beyond the early newborn period remains controversial. We have recently demonstrated that there is no change in the strength of this reflex during the first two months of life in healthy infants during natural sleep. Measurements beyond this immediate newborn period are difficult without sedation, but it is unclear whether sedation itself may influence this reflex.

To investigate the influence of sedation, the HBR was measured in 66 healthy, full‐term infants aged 4‐8 weeks. Thirty‐three infants were measured during natural sleep, and 33 after triclofos sodium sedation (75 mg · kg−1). The strength of the HBR was assessed from the change in expiratory time (TE) following brief end‐inspiratory airway occlusion, as compared to TE during spontaneous breathing. The mean increase in TE following occlusion was 89.45% (SD, 29.8; range, 44‐175) in infants sleeping naturally, and 92.42% (SD, 31.2; range, 34‐179) in sedated infants. Using unpaired t tests, no statistically significant difference was found between groups (P = 0.7516). We conclude that the strength of the HBR in healthy infants is not influenced by sedation with triclofos sodium, in doses normally used for lung function testing.
High‐frequency oscillatory ventilation compared with conventional mechanical ventilation in newborn lambs: Effects of increasing airway pressure on intracranial pressures
Authors: Walker Adrian M. , Brodecky Vojta A. , de Preu Nicole D. , Ritchie Blair C.
Published: March 2007

We tested the hypothesis that intracranial pressures and cerebral perfusion pressure in the newborn are more seriously affected by increasing airway pressure during high‐frequency oscillatory ventilation (HFOV) than during conventional mechanical ventilation (CMV). Mean airway pressure was acutely elevated in stepwise fashion to 25 cm H2O in six anesthetized, paralyzed newborn lambs. Pressure (mean ± SE) increased similarly during HFOV and CMV in the jugular vein (7 ± 1 and 8 ± 1 cm H2O, respectively), the sagittal sinus (6 ± 1 and 7 ± 1 cm H2O), and the cerebrospinal fluid of the lateral ventricle (4 ± 1 and 6 ± 1 cm H2O). Decreases in arterial blood pressure (− 13 ± 2 and − 10 ± 2 cm H2O) and cerebral perfusion pressure (− 17 ± 2 and − 16 ± 2 cm H2O) were also similar during HFOV and CMV. Intracranial pressure−volume curves were generated by incrementing cerebrospinal fluid volume in eight lambs. Curves generated during HFOV and CMV were similar, reflecting a similar intracranial compliance during the two ventilatory modes. These data indicate that intracranial compliace and the effects of increasing airway pressure upon intracranial pressures are not significantly different between HFOV and CMV.