bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of sevoflurane on cognitive deficit, motor function, and histopathology after cerebral ischemia in rats
Authors: EBERSPÄCHER E. , ECKEL B. , ENGELHARD K. , MÜLLER K. , HOFFMAN W. E. , BLOBNER M. , WERNER C. 
Published: April 2009

Background: The volatile anesthetic sevoflurane exhibits neuroprotective properties when assessed for motor function and histopathology after cerebral ischemia in rats. Damage of hippocampal neurons after ischemia relates to a number of cognitive deficits that are not revealed by testing animals for motor function. Therefore, the present study evaluates cognitive and behavioral function as well as hippocampal damage in rats subjected to cerebral ischemia under sevoflurane compared with fentanyl/nitrous oxide (N2O)/O2 anesthesia.Methods: Thirty‐four rats were trained for 10 days using a hole‐board test to detect changes in cognitive and behavioral function. Rats were randomly assigned to the following groups: (A) sham/fentanyl/N2O/O2 (n=7); (B) ischemia/fentanyl/N2O/O2 (n=10); (C) sham/2.0 vol% sevoflurane in O2/air (n=7); and (D) ischemia/2.0 vol% sevoflurane in O2/air (n=10). Cerebral ischemia was produced by unilateral common carotid artery occlusion combined with hemorrhagic hypotension (mean arterial blood pressure 40 mmHg for 45 min). Temperature, arterial blood gases, and pH were maintained constant. Cerebral blood flow was measured using laser‐Doppler flowmetry. After surgery, cognitive and behavioral function was re‐evaluated for 10 days. On day 11, the brains were removed for histopathologic evaluation (hematoxylin/eosin‐staining).Results: Cognitive testing revealed deficits in declarative and working memory in ischemic rats anesthetized with fentanyl/N2O. Rats anesthetized with sevoflurane during ischemia showed a significantly better outcome. Hippocampal damage was significantly worse with fentanyl/N2O.Conclusion: The present data add to previous investigations showing that sevoflurane prevents a deficit in cognitive function and histopathological damage induced by cerebral ischemia in rats.
A Scandinavian survey of drug administration through inhalation, suctioning and recruitment maneuvers in mechanically ventilated patients
Authors: GRIVANS C. , LINDGREN S. , ÅNEMAN A. , STENQVIST O. , LUNDIN S. 
Published: April 2009

Background: The aim was to describe current practices for drug administration through inhalation, endotracheal suctioning and lung recruitment maneuvers in mechanically ventilated patients in Scandinavian intensive care units (ICUs).Methods: We invited 161 ICUs to participate in a web‐based survey regarding (1) their routine standards and (2) current treatment of ventilated patients during the past 24 h. In order to characterize the patients, the lowest PaO2 with the corresponding highest FiO2, and the highest PaO2 with the corresponding lowest FiO2 during the 24‐h study period were recorded.Results: Eighty‐seven ICUs answered and reported 186 patients. Positive end‐expiratory pressure (PEEP) levels (cmH2O) were 5–9 in 65% and >10 in 31% of the patients. Forty percent of the patients had heated humidification and 50% received inhalation of drugs. Endotracheal suctioning was performed >7 times during the study period in 40% of the patients, of which 23% had closed suction systems. Twenty percent of the patients underwent recruitment maneuvers. The most common recruitment maneuver was to increase PEEP and gradually increase the inspiratory pressure. Twenty‐six percent of the calculated PaO2/FiO2 ratios varied >13 kPa for the same patient.Conclusion: Frequent use of drug administration through inhalation and endotracheal suctioning predispose to derecruitment of the lungs, possibly resulting in the large variations in PaO2/FiO2 ratios observed during the 24‐h study period. Recruitment maneuvers were performed only in one‐fifth of the patients during the day of the survey.
Isoflurane attenuates pulmonary interleukin‐1β and systemic tumor necrosis factor‐α following mechanical ventilation in healthy mice
Authors: VANEKER M. , SANTOSA J. P. , HEUNKS L. M. , HALBERTSMA F. J. , SNIJDELAAR D. G. , VAN EGMOND J. , VAN DEN BRINK I. A. , VAN DE POL F. M. , VAN DER HOEVEN J. G. , SCHEFFER G. J. 
Published: April 2009

Background: Mechanical ventilation (MV) induces an inflammatory response in healthy lungs. The resulting pro‐inflammatory state is a risk factor for ventilator‐induced lung injury and peripheral organ dysfunction. Isoflurane is known to have protective immunological effects on different organ systems. We tested the hypothesis that the MV‐induced inflammatory response in healthy lungs is reduced by isoflurane.Methods: Healthy C57BL6 mice (n=34) were mechanically ventilated (tidal volume, 8 ml/kg; positive end‐expiratory pressure, 4 cmH2O; and fraction of inspired oxygen, 0.4) for 4 h under general anesthesia using a mix of ketamine, medetomidine and atropine (KMA). Animals were divided into four groups: (1) Unventilated control group; (2) MV group using KMA anesthesia; (3) MV group using KMA with 0.25 MAC isoflurane; (4) MV group using KMA with 0.75 MAC isoflurane. Cytokine levels were measured in lung homogenate and plasma. Leukocytes were counted in lung tissue.Results: Lung homogenates: MV increased pro‐inflammatory cytokines. In mice receiving KMA+ isoflurane 0.75 MAC, no significant increase in interleukin (IL)‐1β was found compared with non‐ventilated control mice.Plasma: MV induced a systemic pro‐inflammatory response. In mice anesthetized with KMA+ isoflurane (both 0.25 and 0.75 MAC), no significant increase in tumor necrosis factor (TNF)‐α was found compared with non‐ventilated control mice.Conclusions: The present study is the first to show that isoflurane attenuates the pulmonary IL‐1β and systemic TNF‐α response following MV in healthy mice.
Quality of cardiopulmonary resuscitation on manikins: on the floor and in the bed
Authors: JÄNTTI H. , SILFVAST T. , TURPEINEN A. , KIVINIEMI V. , UUSARO A. 
Published: April 2009

Background: In general, in‐hospital resuscitation is performed in a bed and out‐of‐hospital resuscitation on the floor. The surface under the patient may affect the cardiopulmonary resuscitation (CPR) quality; therefore, we evaluated CPR quality (the percentage of chest compressions of correct depth) and rescuer's fatigue (the mean compression depth minute by minute) when CPR is performed on a manikin on the floor or in the bed.Methods: Forty‐four simulated cardiac arrest scenarios of 10 min were treated by intensive care unit (ICU) nurses in pairs using a 30 : 2 chest compression‐to‐ventilation ratio. The rescuer who performed the compressions was changed every 2 min. CPR was randomly performed either on the floor or in the bed without a backboard; in both settings, participants kneeled beside the manikin.Results: A total number of 1060 chest compressions, 44% with correct depth, were performed on the floor; 1068 chest compressions were performed in the bed, and 58% of these were the correct depth. These differences were not significant between groups. The mean compression depth during the scenario was 44.9±6.2 mm (mean±SD) on the floor and 43.0±5.9 mm in the bed (P=0.3). The mean chest compression depth decreased over time on both surfaces (P<0.001), indicating rescuer fatigue, but this change was not different between the groups (P=0.305).Conclusions: ICU nurses perform chest compression as effectively on the floor as in the bed. The mean chest compression depth decreases over time, but the surface had no significant effect.
The combined neuroprotective effects of lidocaine and dexmedetomidine after transient forebrain ischemia in rats
Authors: GOYAGI T. , NISHIKAWA T. , TOBE Y. , MASAKI Y. 
Published: April 2009

Background: We investigated whether coadministration of lidocaine and dexmedetomidine would reduce brain injury following transient forebrain ischemia in rats to a greater extent than either drug alone.Methods: Adult male Sprague–Dawleyrats were anesthetized with halothane to maintain normocapnia and normoxia. Rats received subcutaneous injection of saline 1 ml/kg, lidocaine 10 mg/kg, dexmedetomidine 3 μg/kg, or lidocaine 10 mg/kg plus dexmedetomidine 3 μg/kg. Thirty minutes after the drug injection, forebrain ischemia was induced by hemorrhagic hypotension and occlusion of the bilateral carotid arteries, and was confirmed by isoelectric EEG. At the end of 10‐min ischemia, rats were reperfused. The same dose of drugs was administered 3, 24, and 48 h after ischemia. Neurological examination was done at 1, 2, and 7 days after ischemia. Seven days after ischemia, the brain was stained with hematoxylin and eosin. We counted ischemic cells in the CA1 hippocampal region, striatum, and cerebral cortex. We also measured extracellular glutamate and norepinephrine concentration in hippocampal CA1 in the four groups.Results: As compared with saline‐treated rats, rats receiving dexmedetomidine plus lidocaine showed less than neurological deficit scores at 2 and 7 days after ischemia, and had less ischemic cells in the CA1 region. However, administration of dexmedetomidine plus lidocaine did not alter the area under the glutamate concentration curve and norepinephrine concentration during ischemia in the CA1 region, compared with saline‐treated rats.Conclusions: Our results suggest coadministration of lidocaine and dexmedetomidine improves the neurological outcome without alteration of glutamate and norepinephrine concentrations during forebrain ischemia in rats.
An inquiry into the relationship between ABO blood group and thrombotic thrombocytopenic purpura
Authors: Staropoli J. F. , Stowell C. P. , Tuncer H. H. , Marques M. B. 
Published: April 2009

Background and Objectives  ABO blood group accounts for up to 40% of the variability in plasma von Willebrand factor (VWF) levels, which vary in the rank order AB > B > A > O > Bombay. This may be due in part to the influence of ABO‐associated oligosaccharides on the proteolysis of VWF by the metalloprotease ADAMTS13, which is markedly deficient in thrombotic thrombocytopenic purpura (TTP). Using ABO blood group as a surrogate for baseline VWF levels as well as susceptibility to proteolysis by ADAMST13, we set out to determine whether ABO blood group influences the clinical course of TTP.Methods  We conducted a retrospective analysis of the clinical course of 76 patients with primary, sporadic TTP treated at two institutions over the past 10 years.Results  We found no significant differences between group O and non‐O patients with respect to presenting platelet count and lactate dehydrogenase concentration, maximum serum creatinine concentration, and total number of therapeutic plasma exchanges per episode.Conclusions  Substrate‐related contributors to the highly variable phenotype and clinical course of TTP warrant further investigation.
The preliminary experimental and clinical study of the relationship between the pigment gallstone and intestinal mucosal barrier
Authors: Su Yang , Wu Shuodong , Fan Ying , Jin Junzhe , Zhang Zhenhai 
Published: April 2009

AbstractAims:  To investigate the relations between the formation of pigment gallstone and the function of the intestinal mucosal barrier, as well as the underlying mechanism.Methods:  Eighty guinea pigs were randomly divided into three groups in which they were respectively given normal diet, gallstone‐causing diet, and gallstone‐formation diet with a supplementary intestinal mucosal protection compound known as glutamine. The model of pigment gallstone was established after 8 weeks of dietary administration. Indices about the function of the intestinal mucosal barrier and bacterial translocation were measured. Clinical cases were divided into three groups: control, cholesterol gallstone, and pigment gallstone, where the levels of plasma diamine oxidase (DAO), plasma endotoxin and the excretion rates of technetium 99m‐diethylene triamine pentaacetic acid (99mTC‐DTPA) in the urine of each group were measured.Results:  In the pigment gallstone group, the level of plasma DAO and endotoxin, the excretory ratio of lactulose and mannitol in urine, the bacterial translocation ratio in the celiac lymph nodes and the activities of β‐glucuronidase increased comparing to the control group. The gallstone‐formation rate for the intestinal mucosal protection group (GLN) decreased, and other indices, except the activity of β‐glucuronidase, were all lower than that of gallstone‐formation group. In the clinical experiment, the levels of plasma DAO and endotoxin, as well as the excretory rate of 99mTC‐DTPA in urine were higher in the patients with gallstones than that in the control group.Conclusions:  The formation of pigment gallstone was related to the abnormal function of the intestinal mucosal barrier. The abnormality in the function of the intestinal mucosal barrier probably induced the formation of gallstone by a bacterial translocation mechanism.
Predictors of microscopic portal vein invasion by hepatocellular carcinoma: Measurement of portal perfusion defect area ratio
Authors: Shirabe Ken , Kajiyama Kiyoshi , Abe Tomoyuki , Sakamoto Shigeru , Fukuya Tatsuro , Akazawa Kohei , Morita Kazutoyo , Maehara Yoshihiko 
Published: April 2009

AbstractObjective:  Microscopic portal vein invasion (PVI) by cancer cells is a poor prognostic factor after hepatic resection for hepatocellular carcinoma (HCC). The aim of this study is to predict PVI preoperatively in patients with HCC.Methods:  We studied 46 hepatectomized patients who had HCC without any portal venous invasion detected during preoperative radiographic evaluation. We defined the portal perfusion defect area ratio (PPDAR) as the following: the quotient of the maximal portal perfusion defect area, on computed tomography during arterio‐portography (CTAP) is divided by the maximal tumor area on magnetic resonance imaging (MRI) or CT.Results:  The median PPDAR was 1.3 (mean 1.4 ± 1.1; ranged from 0.7 to 5.8). The incidence of PVI was 4.5% in patients with a PPDAR <1.3, 35.7% in those with a PPDAR of 1.3–1.6, 70% in those with a PPDAR ≥1.6 (P = 0.0005). When analyzing the preoperative value of different cut‐off points for the PPDAR, the lowest P‐value by Fisher's exact test was achieved when the PPDAR threshold was 1.6 (P = 0.0012). The sensitivity was 58%, and specificity was 91% with this cut‐off value. On univariate analyses, factors that significantly correlated with PVI were PPDAR (P = 0.0012), serum levels of des‐gamma‐carboxy prothrombin (P = 0.033), and tumor size (P = 0.0126). On multivariate analysis, PPDAR was the only significant independent predictor of PVI.Conclusion:  Our study shows that PPDAR is a new concept, which is useful in predicting PVI and that a value ≥1.6 is predictive of PVI.
Antidepressant effect detected on proton magnetic resonance spectroscopy in drug‐naïve female patients with first‐episode major depression
Authors: Kaymak Semra Ulusoy , Demir Başaran , Oğuz Kader Karlı , Şentürk Senem , Uluğ Berna 
Published: April 2009

Aim:  Recent neuroimaging studies support functional and structural alterations in the dorsolateral prefrontal cortex (DLPFC), particularly on the left side in patients with major depressive disorders (MDD). The aim of the present study was to examine the biochemical characteristics of left DLPFC as measured on proton (1H) magnetic resonance spectroscopy (MRS) in patients with drug‐naïve first‐episode MDD and a healthy control group. A second aim was to assess the effect of antidepressant treatment on the metabolites of DLPFC.Methods:  Short‐echo single‐voxel 1H‐MRS was done for the left DLPFC in 17 female drug‐free MDD patients (mean age ± SD, 30.9 ± 6.9 years) and 13 matched control subjects (mean age ± SD, 29.1 ± 6.2 years) and was repeated at 8 weeks following antidepressant treatment.Results:  Comparison of baseline values indicated that there were no significant differences in any of the metabolite ratios (N‐acetyl aspartate/creatine [NAA/Cr], myoinositol [Ino]/Cr, and choline [Cho]/Cr) between patients and controls. Significant differences were detected between pre‐ and post‐treatment Ino/Cr ratios (0.67 ± 0.13, 0.58 ± 0.22, P = 0.032, respectively), although there was no difference in NAA/Cr and Cho/Cr ratios.Conclusion:  Although no significant metabolic alterations exist in female patients with drug‐naïve first‐episode MDD as evaluated on 1H‐MRS, an increase in Ino/Cr was observed following 8‐week antidepressant treatment. These findings give rise to the possibility that non‐neuronal cells, particularly glial cells that are probably damaged, play a role in the action of antidepressant treatment.
A two‐year follow‐up study of chronic fatigue syndrome comorbid with psychiatric disorders
Authors: Matsuda Yasunori , Matsui Tokuzo , Kataoka Kouhei , Fukada Ryosuke , Fukuda Sanae , Kuratsune Hirohiko , Tajima Seiki , Yamaguti Kouzi , Kato Yukiko Hakariya , Kiriike Nobuo 
Published: April 2009

Aims:  Chronic fatigue syndrome patients often have comorbid psychiatric disorders such as major depressive disorders and anxiety disorders. However, the outcomes of chronic fatigue syndrome and the comorbid psychiatric disorders and the interactions between them are unknown. Therefore, a two‐year prospective follow‐up study was carried out on chronic fatigue syndrome patients with comorbid psychiatric disorders.Methods:  A total of 155 patients who met the Japanese case definition of chronic fatigue syndrome were enrolled in this study. Comorbid psychiatric disorders were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders 4th edition criteria. Patients with comorbid psychiatric disorders received psychiatric treatment in addition to medical therapy for chronic fatigue syndrome. Seventy patients participated in a follow‐up interview approximately 24 months later.Results:  Of the 70 patients with chronic fatigue syndrome, 33 patients were diagnosed as having comorbid psychiatric disorders including 18 major depressive disorders. Sixteen patients with psychiatric disorders and eight patients with major depressive disorders did not fulfill the criteria of any psychiatric disorders at the follow up. As for chronic fatigue syndrome, nine out of the 70 patients had recovered at the follow up. There is no significant influence of comorbid psychiatric disorders on the outcome of chronic fatigue syndrome.Conclusions:  Chronic fatigue syndrome patients have a relatively high prevalence of comorbid psychiatric disorders, especially major depressive disorders. The outcomes of chronic fatigue syndrome and psychiatric disorders are independent. Therefore treatment of comorbid psychiatric disorders is necessary in addition to the medical treatment given for chronic fatigue syndrome.
Sacral nerve stimulation in faecal incontinence: position statement based on a collective experience
Authors: Leroi A. M. , Damon H. , Faucheron J. L. , Lehur P. A. , Siproudhis L. , Slim K. , Barbieux J. P. , Barth X. , Borie F. , Bresler L. , Desfourneaux V. , Goudet P. , Huten N. , Lebreton G. , Mathieu P. , Meurette G. , Mathonnet M. , Mion F. , Orsoni P. , Parc Y. , Portier G. , Rullier E. , Sielezneff I. , Zerbib F. , Michot F. ,   Club NEMO
Published: April 2009

AbstractObjective  Since the first paper published by Matzel et al., in 1995, on the efficacy of sacral nerve stimulation (SNS) in patients with faecal incontinence, the indications, the contraindications, the stimulation technique and follow up of implanted patients have changed. The aim of this article was to provide a consensus opinion on the management of patients with faecal incontinence treated with SNS.Method  Recommendations were based on a critical review of the literature when available and on expert opinions in areas with insufficient evidence.Results  We have reviewed the indications and contraindications, proposed an algorithm for patient management showing the place of SNS. The temporary test technique, the implantation technique, the patient follow up and the approach in case of treatment failure were discussed.Conclusion  We hope not only to provide a guide on patient management to clinical practitioners interested in SNS but also to harmonize our practices.
An exploratory study of the effect of using high‐mix biphasic insulin aspart in people with type 2 diabetes
Authors: Dashora U. , Ashwell S. G. , Home P. D. 
Published: April 2009

Objective:  To compare blood glucose control when using biphasic insulin aspart (BIAsp) three times a day (using 70/30 high‐mix before breakfast and lunch), with biphasic human insulin (BHI, 30/70) twice daily in adults with type 2 diabetes already treated with insulin.Research design and methods:  In a 60‐day, open‐label, crossover study, people with insulin‐treated type 2 diabetes [n = 38, baseline haemoglobin A1c 8.3 ± 0.9 (s.d.) %] were randomized to BIAsp three times a day before meals, as BIAsp 70 (70% insulin aspart and 30% protamine‐complexed insulin aspart) before breakfast and lunch and BIAsp 30 (30/70 free and protamine‐complexed insulin aspart) before dinner, or to human premix insulin (BHI) 30/70 twice a day before meals. A 24‐h in‐patient plasma glucose profile was performed at the end of each 30‐day treatment period. The total daily insulin dose of BIAsp regimen was 110% of BHI and the doses were not changed during the study.Results:  There was no difference between BIAsp and BHI in geometric weighted average serum glucose over 24 h [7.3 vs. 7.7 mmol/l, BIAsp/BHI ratio 0.95 (95% CI 0.88–1.02), not significant (NS)], but daytime geometric weighted average glucose concentration was significantly lower with the BIAsp regimen than with BHI [8.3 vs. 9.2 mmol/l, BIAsp/BHI ratio 0.90 (0.84–0.98), p = 0.014]. The mealtime serum glucose excursion was also lower with BIAsp than with BHI with statistically significant differences at lunchtime [difference −4.9 (−7.0 to −2.7) mmol/l, p = 0.000); the difference in glucose excursions above 7.0 mmol/l was also significant [−5.8 (−8.3 to −3.2) mmol/l, p = 0.000). The proportion of participants experiencing confirmed hypoglycaemic episodes was similar between regimens (42 vs. 43%, NS).Conclusions:  An insulin regimen using high‐mix BIAsp (BIAsp 70) before breakfast and lunch and BIAsp 30 before dinner can achieve lower blood glucose levels during the day through reduced mealtime glucose excursions in particular at lunchtime than a twice‐daily premix regimen.
The long‐term natural history of overactive bladder symptoms due to idiopathic detrusor overactivity in women
Authors: Garnett Stephen , Swithinbank Lucy , Ellis‐Jones Julie , Abrams Paul 
Published: April 2009

OBJECTIVESTo assess the long‐term natural history of overactive bladder (OAB) symptoms due to idiopathic detrusor overactivity (IDO) in women.PATIENTS AND METHODSOriginal urodynamic traces were reviewed and women who were referred with OAB symptoms and found to have IDO on investigation in our urodynamic unit ≥10 years previously were invited for a repeat urodynamic and symptomatic assessment.RESULTSIn all, 174 women were identified and invited to participate; 53 had repeat urodynamics, another 32 attended the unit for symptom assessment and a further 23 completed postal questionnaires. There were no significant symptomatic or urodynamic differences between these groups at baseline. Of the 53 who had repeat urodynamics, 46 (88%) had persistent symptomatic IDO.CONCLUSIONSOAB symptoms have a significant effect on the quality of life of those affected. OAB symptoms due to IDO in women are persistent, lasting for ≥10 years in 88% of this study population. This information might affect the treatment choices made by patients and their doctors in the management of this condition.