bluuebunny/crossref_metadata_2025_split huggingface dataset:
Leptin induces hypertrophy through activating the peroxisome proliferator‐activated receptor α pathway in cultured neonatal rat cardiomyocytes
Authors: Hou Ning , Luo Miao‐Shan , Liu Shi‐Ming , Zhang Hai‐Ning , Xiao Qing , Sun Pu , Zhang Gen‐Shui , Luo Jian‐Dong , Chen Min‐Sheng 
Published: August 2010

Summary1. Our previous study has shown that leptin induces cardiomyocyte hypertrophy; however, the mechanisms are poorly understood. Recent studies have shown that peroxisome proliferator‐activated receptor α (PPARα) activation might be responsible for pathological remodeling and severe cardiomyopathy. Leptin, as an endogenous activator of PPARα, regulates energy metabolism through activating PPARα in many cells. Therefore, we hypothesized that leptin induces cardiomyocyte hypertrophy through activating the cardiac PPARα pathway.2. Cultured neonatal rat cardiomyocytes were used to evaluate the effects of PPARα on hypertrophy. The selective PPARα antagonist GW6471 concentration‐dependently decreased atrial natriuretic factor mRNA expression by 23%, 36%, 44% and 59%, and significantly decreased total RNA levels, protein synthesis and cell surface areas, all of which were elevated by 72 h of leptin treatment. The augmentation of reactive oxygen species levels in leptin treated cardiomyocytes was reversed by 0.1–10 μmol/L GW6471 (40%, 52% and 58%). After 24 h of treatment, leptin concentration‐dependently enhanced mRNA expression by 7%, 93%, 100% and 256%, and protein expression by 31.2%, 64.2%, 143% and 199%, and the activity of PPARα. Meanwhile, cardiomycytes receiving 72 h of treatment with the PPARα agonist, fenofibrate, concentration‐dependently increased total RNA levels, atrial natriuretic factor mRNA expression, protein synthesis and cell surface area. Treatment of fenofibrate for 4 h also elevated oxygen species levels in a concentration‐dependent manner.3. In conclusion, these findings show that leptin induces hypertrophy through the activation of the PPARα pathway in cultured neonatal rat cardiomyocytes.
Increased intestinal permeability as a predictor of bacterial infections in patients with decompensated liver cirrhosis and hemorrhage
Authors: Kim Byung Ik , Kim Hong Joo , Park Jung Ho , Park Dong Il , Cho Yong Kyun , Sohn Chong Il , Jeon Woo Kyu , Kim Hong Soo , Kim Dong Joon 
Published: August 2010

AbstractBackground and Aim:  There have been no trials comparing the prophylactic effect of oral quinolone and intravenous cephalosporin antibiotics and elucidating the predictive factors for the occurrence of bacterial infections in cirrhotic patients with gastrointestinal bleeding in Asian‐Pacific region.Methods:  One hundred and thirteen patients with advanced liver cirrhosis and active gastrointestinal hemorrhage were enrolled in our study. The patients were randomly allocated into either the oral ciprofloxacin group (n = 50, 500 mg every 12 h) or the intravenous ceftriaxone group (n = 63, 2.0 g per day for 7 days).Results:  Proven or possible infections were significantly more frequent in the patients in the oral ciprofloxacin group (34.0%) than the intravenous ceftriaxone group (14.3%, P = 0.002). The intestinal permeability index (IPI, mean [SD]) measured the day after admission was significantly higher in the patients with proven or possible infections (1.45 [0.96]) compared with the no infection group (0.46 [0.48], P < 0.01). By multivariate analysis, oral ciprofloxacin prophylaxis and higher IPI at the time of inclusion were independent and significant predictors for proven or possible infections. By receiver operating characteristic curve analysis, the best cutoff value of IPI for the prediction of the occurrence of bacterial infection was 0.62%.Conclusions:  The frequency of proven or possible infections was significantly lower in the intravenous ceftriaxone group compared with the oral ciprofloxacin group. The IPI measured the day after admission is a good clinical parameter predicting the occurrence of infection in these patients.
Ubiquitin‐proteasome profiling for enhanced detection of hepatocellular carcinoma in patients with chronic liver disease
Authors: Qu Kevin Z , Zhang Ke , Ma Wanlong , Li Hairong , Wang Xiuqiang , Zhang Xi , Giles Francis , Lai Michelle , Afdhal Nezam H , Albitar Maher 
Published: August 2010

AbstractBackground and Aim:  A reliable test for the detection of hepatocellular carcinoma (HCC) could improve disease management. Recent reports suggested a link between abnormalities in the ubiquitin‐proteasome system (UPS) and HCC. We investigated the potential of using UPS markers, along with HCC markers, to differentiate HCC from chronic liver disease (CLD).Methods:  Sera from 135 HCC and 262 CLD patients were retrospectively analyzed for levels of UPS markers (proteasome, ubiquitin, and proteasome enzymatic activities) and the conventional HCC markers alpha fetoprotein (AFP), AFP‐L3, and des‐gamma‐carboxyprothrombin (DCP). Multivariate logistic regression analysis was used to develop a model for differentiating HCC from CLD. The model was developed using a subset of 98 HCC patients and 104 CLD patients with advanced fibrosis or cirrhosis (Metavir F3‐4) and then validated using an independent set (37 HCC and 44 CLD (F3‐4)).Results:  A UPS signature model incorporating six markers (trypsin‐like, caspase‐like, chymotrypsin‐like, and normalized chymotrypsin‐like activities of proteasomes; AFP; and DCP) accurately differentiated HCC from CLD (area under the curve = 0.938 [95% confidence interval, 0.884–0.991]). When analysis was restricted to patients with tumors ≤ 3 cm, the UPS model exhibited higher sensitivity (83.1% vs 51.8%) and specificity (90.2% vs 83.7%) than the three conventional markers, with good positive predictive values (34.2% vs 15.1%). These results were confirmed in the independent validation set.Conclusion:  The UPS signature in combination with AFP and DCP provides sensitive and specific differentiation of HCC in patients with CLD. The importance of the UPS in HCC suggests that therapeutic approaches targeting the UPS should be explored.
Six‐minute walk test in pulmonary rehabilitation: Do all patients need a practice test?
Authors: JENKINS Sue , CECINS Nola M. 
Published: August 2010

ABSTRACTBackground and objective:  The six‐minute walk test (6MWT) is widely used as an outcome measure in pulmonary rehabilitation programs (PRP). A learning effect for the test has been reported in COPD; however, limited data exist in patients with other respiratory diagnoses. The objectives of this study were to: (i) report the magnitude of change in 6MWD with test repetition in patients referred to an outpatient PRP, and (ii) compare the magnitude of change in 6MWD with test repetition in patients with COPD, interstitial lung disease (ILD), bronchiectasis and asthma.Methods:  Retrospective study of 349 patients with stable COPD (n = 245), ILD (n = 21), bronchiectasis (n = 33) or asthma (n = 50) who performed two 6MWT at enrolment into a PRP.Results:  6MWD increased in all groups on the second test (all P < 0.001). At least 80% of patients in each diagnostic group walked further on their second 6MWT. The magnitude of change (mean, 95% CI) was greater (P < 0.05) in the COPD (37 m, 95% CI: 33–41 m) and ILD (41 m, 95% CI: 27–55 m) cohorts compared with the bronchiectasis (22 m, 95% CI: 14–31 m) and asthma (19 m, 95% CI: 11–27 m) cohorts.Conclusions:  Respiratory diagnosis influences the magnitude of the learning effect for the 6MWT. The findings support the recommendation of a practice 6MWT at baseline assessment in order to provide an accurate measure of the effects of rehabilitation on 6MWD.
The debate on CXR utilization and interpretation is only just beginning: A Pro/Con Debate
Authors: MEHTA Atul C. , CHUA Ai‐Ping , GLEESON Fergus , MEZIANE Moulay 
Published: August 2010

ABSTRACTThe CXR is the most commonly performed radiographic examination worldwide. Its ease of performance, apparent ease of interpretation and low radiation dose, alongside its great spatial resolution would suggest that it should be the first investigation performed in all patients presenting with thoracic disease. But, the advent of ever‐improving multislice CT and increasing scanner availability has resulted in some patients being referred directly for scanning, bypassing the CXR. This has resulted in an inexorable rise in the number of scans performed, with an increase in patient radiation exposure and concerns among legislators and physicians that the number of scans needs to be regulated. A key role in the reduction of unnecessary scanning in patients with thoracic disease is the understanding of the place of the CXR, its ability to help in disease detection and monitoring, and its limitations.
Respiratory health issues in the Asia–Pacific region: An overview
Authors: JAMROZIK Euzebiusz , MUSK Arthur William 
Published: August 2010

ABSTRACTThe Asia–Pacific region is home to a large heterogeneous population whose respiratory health is influenced by diverse social, economic and environmental factors. Despite this variability, the most prevalent causes of respiratory morbidity and mortality are tobacco smoking, infection, and air pollution. This review aims to summarize current respiratory health issues in the region including smoking‐related diseases especially COPD, lung cancer and infectious problems such as pandemic influenza, the severe acute respiratory syndrome coronavirus, bacterial pneumonia and tuberculosis, as well as the contribution of air pollution to respiratory disease. Published data on trends in the epidemiology and management of respiratory diseases and are summarized; finally, the limitations of available data and projections for the future of respiratory health in the region are discussed.
Acute fibrinous and organizing pneumonia in a patient with HIV infection and Pneumocystis jiroveci pneumonia
Authors: HEO Jung Yeon , SONG Joon Young , NOH Ji Yun , YONG Hwan Seok , CHEONG Hee Jin , KIM Woo Joo 
Published: August 2010

ABSTRACTAcute fibrinous and organizing pneumonia (AFOP) is a disease of the small airways that is characterized by deposition of fibrin within the alveolar spaces. The histological pattern is described as a variant of cryptogenic organizing pneumonia (COP). Although COP has been occasionally described in patients with HIV infection, the variant form, AFOP, has not been previously reported in such patients. This report describes an intriguing case of AFOP in a patient with HIV infection and Pneumocystis jiroveci pneumonia. AFOP was diagnosed after tapering of corticosteroid therapy. This case illustrates that non‐infectious pulmonary infiltrates should be considered in the differential diagnosis of lung disease in patients with HIV infection.
Haemodynamic effects of proportional assist ventilation during high‐intensity exercise in patients with chronic obstructive pulmonary disease
Authors: CARRASCOSSA Cláudia R. , OLIVEIRA Cristino C. , BORGHI‐SILVA Audrey , FERREIRA Eloara M.V. , MAYA Joyce , QUEIROGA Fernando , BERTON Danilo C. , NERY Luiz E. , NEDER J. Alberto 
Published: August 2010

ABSTRACTBackground and objective:  Proportional assist ventilation (PAV) has been proposed as a more physiological modality of non‐invasive ventilation, thereby reducing the potential for deleterious cardio‐circulatory effects during exercise, in patients with COPD. We therefore evaluated whether PAV modulates the kinetic and ‘steady‐state’ haemodynamic responses to exercise in patients with moderate‐to‐severe COPD.Methods:  Twenty patients underwent constant‐load (75–80% peak work rate) cycle ergometer exercise testing to the limit of tolerance (Tlim), while receiving PAV or breathing spontaneously. Stroke volume (SV), heart rate (HR) and cardiac output (CO) were monitored by impedance cardiography.Results:  Compared with unassisted breathing, PAV increased Tlim in 8/20 patients (median improvement 113% (range 8 to 212) vs −20% (range −40 to −9)). PAV had no significant effects on ‘steady‐state’ haemodynamic responses either in patients with or those without increased Tlim (P > 0.05). However, at the onset of exercise, SV kinetics were slowed with PAV, in 13/15 patients with analysable data. HR dynamics remained unaltered or failed to accelerate sufficiently in nine of these patients, thereby slowing CO kinetics (T1/2 61 s (range 81–30) vs 89 s (range 100–47)). These deleterious effects were not, however, associated with PAV‐induced changes in Tlim (P > 0.05).Conclusions:  PAV slowed the SV and CO kinetics at the onset of high‐intensity exercise in selected patients with moderate‐to‐severe COPD. However, these adverse effects of PAV disappeared during the stable phase of exercise, and were not related to the ergogenic potential of PAV in this patient population.
Measurement of exhaled nitric oxide: Comparison of different analysers
Authors: KORN Stephanie , TELKE Ina , KORNMANN Oliver , BUHL Roland 
Published: August 2010

ABSTRACTBackground and objective:  Exhaled nitric oxide (NO) is used as a surrogate marker to monitor eosinophilic airway inflammation, assist in diagnosis, and support treatment decisions for asthma patients. The aim of this study was to compare five NO analysers: Medisoft (M), Aerocrine Niox (N), Aerocrine Niox flex (NF), Aerocrino Niox mino (NM) and EcoMedics (E).Methods:  In 85 subjects (25 asthma patients, 25 COPD patients, 35 healthy volunteers; median age 36.5 years, range 23–79, 47% female), three NO measurements per individual were performed, using each analyser according to the American Thoracic Society/European Respiratory Society guidelines. Subjects evaluated the devices on the basis of comfort and ease of performing the measurement.Results:  Median NO concentrations were 24.8 parts per billion (ppb) (range 6.3–262.7) for M, 14.5 ppb (0.0–196.6) for N, 15.2 ppb (5.6–67.7) for NF, 16.3 ppb (5.0–208.3) for NM, and 13.1 ppb (4.0–103.0) for E. There was significant correlation among the absolute NO values measured with all the devices (0.743 for M vs NF < r < 0.979 for N vs NF). Bland–Altman plots suggested an acceptable degree of agreement among the results obtained with the three Niox analysers. Measurements obtained with the Medisoft and Ecomedics analysers were not directly comparable with those obtained with the other devices. The greatest differences in absolute NO levels for individual patients were between measurements with the M and E analysers (8.3 ppb, range 27.4–159.7, P < 0.001). Acceptance of the measurements by patients was high, independent of the device used.Conclusions:  Exhaled NO values obtained with different devices were not directly comparable and may differ to a clinically relevant extent, depending on which device is used.
Alveolar proteinosis with hypersensitivity pneumonitis: A new clinical phenotype
Authors: VERMA Hema , NICHOLSON Andrew G. , KERR Keith M. , DEMPSEY Owen J. , GIBBS Allen R. , CAMPBELL Ian , BLACK Fiona , RASSL Doris , RICE Alexandra J. , RENZONI Elizabeth A. , WELLS Athol U. , HANSELL David M. 
Published: August 2010

ABSTRACTBackground and objective:  The aim of the present study was to report the features of five patients with concurrent histopathological features of pulmonary alveolar proteinosis (PAP) and hypersensitivity pneumonitis (HP) and their high‐resolution CT (HRCT) appearances.Methods:  Patients with histopathological features of both HP and PAP on surgical lung biopsy referred for tertiary review were retrospectively identified. The pathology and HRCT images were semi‐quantitatively scored to evaluate the relative contribution to HP and PAP.Results:  Five patients had histopathological features of HP and PAP but had varied HRCT appearances. All had imaging features of PAP to a varying degree with two patients also showing characteristics of HP but three patients had ill‐defined thickened interlobular septa, not typical of either disease.Conclusions:  We describe the coexistence of PAP and HP in five patients and discuss possible linkages between these two distinct pathologies.
State of the art: How to set up a pulmonary rehabilitation program
Authors: JENKINS Sue , HILL Kylie , CECINS Nola M. 
Published: August 2010

ABSTRACTPulmonary rehabilitation plays an essential role in the management of symptomatic patients with COPD. The benefits of rehabilitation include a decrease in dyspnoea and fatigue, and improvements in exercise tolerance and health‐related quality of life. Importantly, rehabilitation reduces hospitalization for acute exacerbations and is cost‐effective. Although most of the evidence for pulmonary rehabilitation has been obtained in patients with COPD, symptomatic individuals with other respiratory diseases have been shown to benefit. In this review we outline a stepwise approach to establish, deliver and evaluate a pulmonary rehabilitation program (PRP) that would be feasible in most settings. Throughout the review we have specified the minimum requirements for a PRP to facilitate the establishment of programs using limited resources. Recommendations for staffing and other resources required for a PRP are presented in the first section. Exercise training is a focus of the section on program delivery as this is the component of rehabilitation that has the strongest level of evidence for benefit. Program considerations for patients with respiratory conditions other than COPD are described. Different approaches for delivering the education component of a PRP are outlined and recommendations are made regarding topics for group and individual sessions. The problems commonly encountered in pulmonary rehabilitation, together with recommendations to avoid these problems and strategies to assist in their resolution, are discussed. The review concludes with recommendations for evaluating a PRP.
Lung function testing in health and disease: Issues pertaining to Asia–Pacific populations
Authors: IP Mary S.M. 
Published: August 2010

ABSTRACTThe Asia–Pacific region comprise of diverse ethnic populations and healthcare systems of highly variable developmental stages. We face challenges in lung function testing, many of which are different from the issues encountered in the west. In some places, access to proper lung function testing facilities is very limited due to resource constraints or geographic inconvenience. It is important to note the potential differences of normative values in Asia–Pacific populations, compared with established values derived from populations of Caucasian ethnicity, hence the need to choose from available prediction formulae the ones that most closely approximate the subjects being tested. The criteria for defining abnormality is a hot topic globally. In the Asia–Pacific region, the trade‐off between simplicity and thus ease of application and the pitfall of under‐ or over‐diagnosis based on fixed cut‐off values has to be recognized. The promotion of wider availability and proper utilization of lung function testing will go a long way in the enhancement of respiratory health and disease management in the region.
Lecithinized superoxide dismutase treatment improves steroid‐refractory interstitial pneumonia
Authors: KAWASHIMA Tatsuo , WAKABAYASHI Toru , KURODA Toshihisa , NISHIDE Toshio , MATSUZAWA Yasuo , SHIRAI Kohji 
Published: August 2010

ABSTRACTPulmonary fibrosis associated with amyopathic dermatomyositis is known to have a generally aggressive course and is ultimately fatal. We report the case of a 50‐year‐old patient with amyopathic dermatomyositis, who developed progressive interstitial pneumonia that was unresponsive to corticosteroids and multiple immunosuppressive agents, including cyclosporine and tacrolimus hydrate. Five courses of lecithinized superoxide dismutase were administered without adverse effects. Improvements in physiological parameters, such as pulmonary function and exercise tolerance, as well as the serum Krebs von den Lungen 6 level, were observed. This is the first report of a case of steroid‐refractory interstitial pneumonia treated with lecithinized superoxide dismutase.
Effect of the alveolar recruitment manoeuvre on haemodynamic parameters in patients with acute respiratory distress syndrome: Relationship with oxygenation
Authors: HUH Jin Won , HONG Sang‐Bum , LIM Chae‐Man , KOH Younsuck 
Published: August 2010

ABSTRACTBackground and objective:  Although the alveolar recruitment manoeuvre (ARM) is considered to be an optimal method of recruiting collapsed alveoli in a short period, the haemodynamic effects of the ARM have not been investigated. The aim of this study was to assess whether the ARM causes haemodynamic instability in patients with ARDS, and any relationship this might have with arterial oxygenation.Methods:  Twenty‐eight patients with ARDS (16 responders and 12 non‐responders), who were admitted to the medical intensive care unit of a university‐affiliated hospital, were enrolled in the study. ARM, using the extended sigh method, was performed within 48 h of the onset of ARDS. Haemodynamic parameters were measured at baseline, during the ARM, and at 2 min, 30 min and 1 h after the ARM.Results:  Responders and non‐responders showed no significant changes in blood pressure or cardiac index during or after ARM. Mean pulmonary artery pressure (MPAP), pulmonary vascular resistance index (PVRI) and right ventricular stroke work index (RVSWI) were transiently increased compared with baseline, in responders and non‐responders. During and after ARM, the systemic vascular resistance index was significantly higher in non‐responders than in responders.Conclusions:  Some haemodynamic parameters (MPAP, PVRI and RVSWI) changed significantly during ARM. However, these haemodynamic changes were minimal, transient and probably have no clinical significance.
Iodine‐123 metaiodobenzylguanidine scintigraphic assessment of pulmonary vascular status in patients with chronic obstructive pulmonary disease
Authors: KOIZUMI Tomonobu , URUSHIHATA Kazuhisa , HANAOKA Masayuki , TSUSHIMA Kenji , FUJIMOTO Keisaku , FUJII Tadashige , KUBO Keishi 
Published: August 2010

ABSTRACTBackground and objective:  Lung uptake of iodine‐123 metaiodobenzylguanidine (123I‐MIBG) is used as an indicator of pulmonary endothelial function. Decreased lung uptake of 123I‐MIBG has been demonstrated in patients with COPD as compared with normal subjects. The present study was performed to examine the relationship between lung uptake of 123I‐MIBG and pulmonary artery pressure (Ppa) at rest and during exercise, in patients with COPD.Methods:  123I‐MIBG scintigraphy was performed in 19 patients with COPD. Anterior planar images were acquired 15 min after the injection of 123I‐MIBG, and the total lung to upper mediastinum ratio (LMR) was calculated for both lungs. Right heart catheters were used to monitor Ppa continuously at rest and during exercise. Exercise was performed on an electrically braked bicycle ergometer at a constant workload of 25 W for 3 min.Results:  In COPD patients the LMR were not correlated with the pulmonary function parameters measured before exercise, including FEV1, PaO2, DLCO, or Ppa at rest. However, the percentage increase in Ppa during exercise was significantly correlated with LMR.Conclusions:  Evaluation of the kinetics of lung uptake of 123I‐MIBG may be a novel scintigraphic tool for the assessment of exercise‐induced pulmonary hypertension in patients with COPD.