bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gas‐exchange impairment: its correlation to lung mechanics in acute airway obstruction (studies on a rabbit asthma model)
Authors: Lagerstrand L. , Hedenstierna G. 
Published: April 2008

Summary. A rabbit model was developed for the studies of ventilation/perfusion relationships (V̇/Q̇) and thorax mechanics during bronchial provocation tests. Baseline data from 14 anaesthetized rabbits show a V̇A/Q̇ distribution that is broader (less efficientV̇A/Q̇match) than that of lung‐healthy humans, dogs and horses.Airway provocation was created by inhalation of ammonia, prostaglandin (PGE1) and methacholine bromide. Methacholine bromide was the only substance that triggered measurable V̇A/Q̇ changes. Measurements 5 min after methacholine provocation showed markedly increased thorax resistance, widened V̇A/Q̇ distribution and in some rabbits an increased shunt. Fifteen minutes after provocation that was still a broad V̇A/Q̇ distribution and in several rabbits a further increase of shunt. Both thorax resistance and perfusion of regions with low V̇A/Q̇ were reduced. Our results suggest a correlation between thorax resistance and perfusion of regions with low V̇A/Q̇. However, the slower normalization in V̇A/Q̇ disturbance and the remaining or increased shunt suggests that factors other than airway resistance contribute to the gas‐exchange impairment. These factors might be alveolar oedema, or mucus and oedema in the smallest airways.
Estimation of pulmonary vascular resistance in patients with ventricular septal defects by echo‐Doppler cardiography
Authors: Teien D. 
Published: April 2008

Summary. The pulmonary vascular resistance is one of the parameters considered in the evaluation of patients with ventricular septal defects. We describe a new method to estimate resistance. The method estimates the systolic resistance in the pulmonary circulation and we assume that there is a linear relation between this resistance and the traditional resistance in which a continuous flow in systole and diastole is assumed.The systolic resistance was compared to the traditional resistance index in a group of patients whose invasive data were evaluated retrospectively. A close correlation between the two estimates of resistance was found and when the results were applied to another group of patients examined non‐invasively and invasively there was no significant difference between the invasive resistance index and the non‐invasive estimate arrived at by the new method.
Autonomic nerve function in children and adolescents with insulin‐dependent diabetes mellitus
Authors: Åman J. , Eriksson E. , Lideen J. 
Published: April 2008

SUMMARYAutonomic nerve function was assessed in 67 insulin‐dependent diabetic children and adolescents and in 30 control subjects of the same age. The heart rate and blood pressure reactions to a deep breathing test (E/I ratio) and a tilt table test (acceleration and brake indices) were used. The E/I ratio, 1·54 +0·21, and the acceleration index, 25 ± 7·7, in the diabetic children were not significantly different from those of the control children, 1·51 ± 0·16 and 24 ± 7·5, respectively. Neither was any difference observed between the mean brake index values; 24·3 ± 14·6 vs 23·5 ± 7·5. However, the variance of the brake index in diabetic children was significantly higher than in control children (P< 0·005).The brake index was negatively correlated to age in the healthy control children (r= ‐0·48, P <0·1). The acceleration index, but not the E/I ratio, also tended to be age related (r= ‐0·32, P<0·01 NS).No correlation was observed between sex, glycaemic control or duration of diabetes and the autonomic nerve function. Neither were severe hypoglycaemic episodes in diabetic children related to the autonomic nerve function.It is concluded that autonomic neuropathy is uncommon in diabetic children and adolescents and that age‐related index values should be used when autonomic nerve function is evaluated in children of different ages.
Central haemodynamics in patients with severe postural hypotension
Authors: Mehlsen J. , Haedersdal C. , Trap‐Jensen J. 
Published: April 2008

SUMMARYCentral haemodynamics in the supine and head‐up tilted positions were studied in 24 patients with severe postural hypotension with and without supine hypertension. Results were compared with those obtained in eight normotensive and eight untreated hypertensive controls.In the supine position the patients had higher vascular resistances, lower stroke volumes and longer left ventricular ejection time indexes compared to controls, whereas left ventricular ejection fractions did not differ significantly. The patients with supine hypertension had significantly higher vascular resistance compared to those with supine normotension. The highest supine blood pressure levels were found in patients with multiple system atrophy.During tilt, vascular resistance and heart rates were increased and stroke volumes and left ventricular ejection time indexes were decreased in the controls. The patients were unable to increase their vascular resistance, but increased their heart rate and decreased their left ventricular ejection time indexes to a degree similar to the controls. The reductions in stroke volume were smaller in the patients compared to the controls. Changes in haemodynamics in response to head‐up tilting did not differ significantly between patients with supine hypertension and supine normotension.It is concluded that patients with postural hypotension have higher supine vascular resistance and are unable to contract peripheral arteries and arterioles during head‐up tilting. Contractility of the left ventricle is preserved and the baroreceptors are partially intact. Postural hypotensive patients with supine hypertension differ from those with supine normotension only with respect to supine vascular resistances.
Assessment of blood pressures and gradients by automated blood pressure device compared to invasive measurements in patients previously operated on for coarctation of the aorta
Authors: Wendel H. , Teien D. , Human D. G. , Nanton M. A. 
Published: April 2008

Summary. The aim of the study was to compare invasive and non‐invasive blood pressure measurements and gradients. Twenty‐two children and 16 adults previously operated for coarctation of the aorta were included. Invasive blood pressures were recorded proximally and distally close to the former operation site and non‐invasive systolic blood pressures were recorded by an automated sphygmomanometer on right arm and leg. The adults were investigated at rest and during supine exercise. The correlation between invasive and non‐invasive measurements of proximal blood pressures in adults at rest and children were the following, r= 0.92, SD 7.6 mmHg (n= 16) and r= 0.85, SD 11 mmHg (n= 22) respectively. The corresponding correlation for the distal blood pressures were the following for adults at rest 0.64, SD 11.9 mmHg and in children /‐ = 0.82, SD 9.2 mmHg.During exercise in adults we found a low correlation when comparing invasive and non‐invasive proximal and distal blood pressures and a poor correlation regarding the gradients, r= 0.50, SD 16 mmHg, r= 0.45, SD 15.9 mmHg and r= 0.30, SD 22.9 mmHg respectively (n= 16).We also measured the time interval between cessation of exercise and completion of the blood pressure recordings, which gave a mean interval of 73 sec (range 45–115 sec). During that interval the mean fall in the proximal blood pressure was 37 mmHg (range 20–80 mmHg), and the mean fall of the gradient was from 41 mmHg (range 20–76 mmHg) to 23 mmHg (range 6–56 mmHg).We conclude that the non‐invasive estimation of proximal blood pressures gave fair results but that the estimation of gradients are unsatisfactory. The use of this method to predict exercise induced blood pressures changes and gradients seems highly unreliable.
Ineffective ventilation during exercise in patients with chronic congestive heart failure
Authors: Sovijärvi A. R. A. , Näveri H. , Leinonen H. 
Published: April 2008

Summary The pathophysiologic mechanisms causing exertional breathlessness in patients with chronic congestive heart failure (CHF) are not fully understood. Therefore, we have studied whether the ventilation in such patients is ineffective during exercise. Thirteen patients with treated chronic CHF (New York Heart Association class II‐IV) and eight healthy controls underwent a maximal bicycle ergometer test with continuous analysis of expired air and frequent arterial blood sampling for gas and lactate analysis. All subjects were non‐smokers and none had any signs of a pulmonary disease. Peak O2 consumption of the patients was 14.9 ±5.3 ml min‐1 kg‐1 and that of controls 33.6 ±7.5 ml min‐1 kg‐1. In patients with CHF the ratio of pulmonary dead space to tidal volume was significantly elevated at peak exercise compared with that of the controls (0.36±0.08 vs. 0.20±0.07, P<0.05). The ventilatory equivalent for CO2 (VE:VCO2) was also significantly higher in patients than in controls during exercise (P<0.05). Furthermore, both the ventilatory equivalents for CO2 and O2 (VE:VD2) had a significant inverse correlation with peak O2 consumption (P<0.001 for VE:VT:O2 and P<0.05 for VE:VO2), O2 consumption at anaerobic threshold (P<0.01) and O2‐pulse (P<0.001) among the patients. During exercise the arterial PO2 and PCO2 remained normal in patients and controls.These data indicate that in patients with chronic CHF wasted ventilation is pathologically increased during exercise, and this is related to the severity of the disease. Chronic CHF is not associated with decreased ventilatory reserve, hypoxaemia or alveolar hyperventilation. The ineffectiveness of ventilation is probably an important cause of exertional breathlessness in patients with CHF.
Myocardial reperfusion in thrombolysis A 99Tcm‐Sestamibi SPECT study in patients with acute myocardial infarction
Authors: Boström P.‐Å. , Diemer H. , Freitag M. , Juhlin P. , Lilja B. , Erhardt L. 
Published: April 2008

Summary. This study presents the outcome of myocardial scintigraphy performed before and after thrombolytic treatment in 16 patients with acute myocardial infarction using 99Tcm‐Sestamibi (Cardiolite®, Du Pont Scandinavia AB, Kista, Sweden).The patients were given 99Tcm‐Sestamibi intravenously as soon as possible after the decision to give thrombolytic treatment. When the patients were in a clinically stable state after the thrombolytic treatment, myocardial perfusion was analysed with the gamma camera using single photon emission computerized tomography (SPECT). A second 99Tcm‐Sestamibi tomography was carried out on the second to fourth day after the myocardial infarction. Data reconstruction was done with the ‘Bull's eye technique’.Nine patients received thrombolysis < 3 h from the onset of pain. In this group six patients (66%) improved their myocardial perfusion by > 10% after treatment, while all seven patients who received treatment ≥ 3 h after the onset of pain improved their myocardial perfusion by < 10%.This study emphasises the importance of early diagnosis and treatment of patients with acute myocardial infarction in order to salvage myocardium.
Volume blood flow measurements with a transit time flowmeter: an in vivo and in vitro variability and validation study
Authors: Lundell A. , Bergqvist D. , Mattsson E. , Nilsson B. 
Published: April 2008

Summary. A transit time flowmeter, Transonic TC101 (Transonic Inc., USA) has been evaluated to study volume flow. Two flow probes, 4 and 6 mm, were used. The experiments were carried out in vivo on the carotid arteries (n= 16) in sheep and in vitro against a pre calibrated rotational pump. Exsanguination measurements, n= 32, were used for the calculation of the error of measurement in vivo. The error of measurement in vitro was calculated on 11 different flow rates from 0 to 150 ml min‐1.The variability in vivo was evaluated using data from 10, 30 s measurement periods with a 30 s pause between measurements. The variability in vitro was evaluated at three flow rates (46, 78, and 113 ml min‐1). Five 1‐min measurements with a 1‐min pause between measurements were made.The error of measurement in vivo was 12.05% and in vitro 5.50% (4 mm probe) and 14.90% (6 mm probe). In vivo the variability was between 1.1 and 4.4% and in vitro between 1.5 and 11.2%. The correlation coefficients between the flowmeter on the one hand and exsanguination and the rotational pump on the other were 0.99, 0.99 (4 mm probe) and 0.98 (6 mm probe).It is concluded that the flowmeter has a small variability and error of measurement both in vivo and in vitro.,
Magnesium sulphate infusion decreases circulating calcitonin gene‐related peptide (CGRP) in women with primary Raynaud's phenomenon
Authors: Myrdal U. , Leppert J. , Edvinsson L. , Ekman R. , Hedner T. , Nilsson H. , Ringqvist I. 
Published: April 2008

Summary. The effects of two different vasodilating agents (MgSO4 infusion and the calcium antagonist nifedipine) on circulating levels of calcitonin gene‐related peptide (CGRP) were studied in 12 women with pronounced primary Raynaud's phenomenon (PRP) and in 12 healthy females. There were no significant differences with regard to basal levels of circulating CGRP between women with PRP and the control group; median 15–5 (range 10–48) vs. 14 (range 10–69) pmol 1‐1, respectively. However, treatment with MgSO4 infusion significantly decreased circulating CGRP in women with PRP only from median 15–5 (range 10–48) to 10 (range 10–110) pmol l‐1) (P<0–05). On the other hand 14 days of treatment with nifedipine did not affect circulating CGRP in either of the investigated groups.Erythrocyte magnesium (ery‐Mg) levels increased significantly after MgSO4 infusion in women with PRP (2–43± 0–13 vs. 2–52 ± 0–15mmol 1‐1, P<0–05) but not in the controls (2–51 ± 0–24 vs. 2–57 ± 0–28 mmol l‐1, ns).In conclusion, the decrease of circulating CGRP after MgSO4 infusion in women with PRP provides further evidence that magnesium plays a significant role in the pathophysiology of PRP.
Human gallbladder pressure and volume: validation of a new direct method for measurements of gallbladder pressure in patients with acute cholecystitis
Authors: Body Lars , Højgaard Liselotte , Grønvall Svend , Stage Jens G. 
Published: April 2008

Summary. Increased gallbladder (GB) pressure is probably a part of the pathogenesis of acute cholecystitis, and measurements of GB pressure might therefore be of interest. The aim of this study was to validate a microtip pressure transducer for intraluminal GB pressure measurements.In vitro precision and accuracy was within 0.2 mmHg, (SD) and 0.6±0.1 mmHg (mean±SD), respectively. Pressure rise rate was 24.8±5.5 mmHgs‐1. Zero drift was in the range 0.3±0.4 to 0.8±0.9 mmHg (mean±SD). GB pressure was investigated in 16 patients with acute cholecystitis treated with percutaneous ultrasonically guided cholecystostomy.Basal intraluminal GB pressure was 8.9 mmHg (2.1–12.2 mmHg; n =9, open cystic duct) and 1.8 and 5.8 mmHg (n =2, closed cystic duct). There was no significant difference between two different measurements in the same patients (n =5). The pressure was significantly influenced by respiration (n =8) and the pressure seems to be higher in the sitting position than in the supine position (n =5). Cystic duct opening pressure was 10.4,11.2 and 16.8 mmHg (n =3). Pressure‐volume responses showed that the GB up to a certain volume could accommodate increases in intraluminal volume with only slight changes in intraluminal pressure (n =4).Except for the zero drift, this piece of equipment seemed to fulfil the requirements of being able to measure pressure in the GB. In vivo measurements showed a good clinical reproducibility of the method, and also that respiration and patient posture influenced the pressure measurements. Further, a GB pressure‐volume relationship was demonstrated, and the possibility of a cystic duct opening pressure was described.
Electrical restitution in diseased human ventricular myocardium
Authors: Nánási Péter P. , Varró András , Pankucsi Csaba , Homolay Péter , Knilans Timothy K. , Kovács László , Papp Gyula J. , Lathrop David A. 
Published: April 2008

SUMMARY. Action potential configuration and electrical restitution were studied in diseased human ventricular muscle by comparing the characteristics of hypertrophic (HYP) and dilated (DIL) human ventricular preparations. Conventional microelectrode techniques were used to evaluate action potentials evoked at increasingly longer diastolic intervals. The steady‐state action potential duration (APD90) was significantly longer in DIL than in HYP preparations (393±5 ms, n = 4 and 296 ± 11 ms, n = 4, respectively; P < 0–001, mean ± SEM). In the dilated preparations studied at long diastolic intervals, the initial period of rapid repolarization (phase 1) was absent, and the rate of final repolarization (phase 3) was reduced. Electrical restitution relations in these preparations were fitted as the sum of two exponentials. The time constant of the fast component was significantly longer in DIL than in HYP preparations (242 ± 9 ms and 121 ± 4 ms, respectively; P < 0–001). No difference was observed in the time constants for the slow component of restitution in the two groups.Electrical restitution was also studied in single human ventricular myocytes by using patch clamp techniques. The initial 600 ms period of restitution was fitted in these cells to a monoexponential function. The time constant for this period of the restitution relation was significantly longer, while the estimated amplitude of this early rising phase was significantly lower in human cells obtained from DIL hearts than the respective parameters obtained in the healthy canine and guinea pig cells also examined.The observed changes in the restitution kinetics of the dilated human heart are, likely, the consequence of alterations in the ionic currents that underlie the cardiac action potential.
Explaining National Border Effects in the QUAD Food Trade
Authors: Olper Alessandro , Raimondi Valentina 
Published: April 2008

AbstractUsing a ‘structural’ gravity‐like model, this paper first provides estimates of bilateral ‘border effects’ in food trade among the QUAD countries (the US, Canada, Japan and the EU) at the ISIC (International Standard Industrial Classification) four‐digit level (18 food sectors). It then investigates the underlying reasons for border effect, assessing the role played by policy barriers (tariffs, non‐tariff barriers to trade (NTBs) and domestic support) with respect to barriers unrelated to trade policy, such as information‐related costs, cultural proximity and preferences. In contrast to several previous findings, our results show that policy trade barriers, especially in the form of NTBs, are part of the story in explaining national border effects. Interestingly, in all country pair combinations, NTBs significantly dominate the trade reduction effect induced by tariffs. However, results show that elements linked to information‐related costs and consumer preferences matter a great deal in explaining the magnitude of border effects. These findings have implications for the economic and welfare‐related significance of national borders.
Reticular erythema with focal mid‐dermal elastophagocytosis (REMDE)
Authors: Hillen Uwe 
Published: April 2008

SummaryA 57‐year‐old man presented with a persistent arcuate partly reticular erythema of the upper chest. Histopathological examination revealed an upper and mid‐dermal perivascular and interstitial dermatitis with macrophages which had engulfed elastic fibers. Additionally a focal dermal elastolysis was observed. The characteristic clinicopathological constellation has hitherto been reported in only 3 cases, including our case. Presumably, the disease belongs to a spectrum of clinical manifestation of mid‐dermal elastolysis. It is suggested to gather future cases under the provisional diagnosis ‘‘reticular erythema with focal mid‐dermal elastophagocytosis” (REMDE) to gain more insights into this rare disease.
Neonatal hyperbilirubinemia increases intestinal protein permeability and the prevalence of cow's milk protein intolerance
Authors: Raimondi Francesco , Indrio Flavia , Crivaro Valeria , Araimo Gabriella , Capasso Letizia , Paludetto Roberto 
Published: April 2008

AbstractAims: Bilirubin is a newly discovered modulator of the gut barrier in vitro and in vivo. We studied the effect of bilirubin on the serosal to mucosal intestinal permeability in vivo. We also investigated the prevalence of cow's milk protein intolerance (CMPI) in infants with moderate hyperbilirubinemia versus matched controls.Methods: Faecal alpha 1 antitrypsin (a1AT) was used to monitor intestinal protein loss; a large cohort was prospectively followed for 12 months for sign and symptoms of CMPI.Results: Neonates with hyperbilirubinemia had higher stool excretion of a1AT than controls (0.68 ± 0.28 mg/g vs. 0.25 ± 0.11 mg/g; p < 0.01). Faecal a1AT correlates with total serum bilirubin (TSB) (r = 0.85; p < 0.01). Also, in the first 12 months of life, formerly hyperbilirubinemic infants had an higher prevalence of CMPI (14/353 vs. 4/339; χ2= 4.018, p = 0.045).Conclusions: Neonatal hyperbilirubinemia increases stool protein loss and is also a mild risk factor for CMPI.
Predictive value of Apgar score in infants with very low birth weight
Authors: Mori Rintaro , Shiraishi Jun , Negishi Hirokuni , Fujimura Masanori 
Published: April 2008

AbstractBackground: Accurate prediction of the prognosis of infants with very low birth weight is beneficial both for their parents and for healthcare professionals.Methods: This was a population‐based study of all low‐birth‐weight infants admitted to neonatal units in one region in Japan. The Apgar score at 1 and 5 min and neonatal mortality were retrospectively analyzed to obtain the predictive values of the scores. The results were stratified into two categories by birth weight and three time periods (1980–1986, 1987–1993 and 1994–2000).Results: The predictive values improved in the later years, and therefore only the data obtained in the period 1994–2000 were used. A score of less than 5 at 5 min appears to be a good predictor of neonatal mortality in infants with a birth weight between 1500 g and 2499 g (positive likelihood ratio, 17.59 [95% confidence interval (CI) 12.68–24.40]); however, there is no evidence that the score is a good predictor of neonatal mortality in infants with very low birth weight.Conclusion: In infants with a low birth weight between 1500 g and 2499 g, an Apgar score at 5 min of less than 5 is a good predictor of neonatal mortality. The score is not useful in predicting the short‐term prognosis of very low‐birth‐weight infants.
Paediatric poisonings treated in one Finnish main university hospital between 2002 and 2006
Authors: Kivistö Juho E , Arvola Taina , Parkkari Jari , Mattila Ville M 
Published: April 2008

AbstractAim: Acute poisonings are a major cause of morbidity among children. This study aims to describe the incidence and nature of emergency visits for acute paediatric poisoning among Finnish children.Methods: All patients younger than 16 years admitted to the Tampere University Hospital's emergency department with a diagnosis of poisoning during 2002–2006 were identified from the Hospital Information System using the International Classification of Diseases (ICD‐10).Results: Altogether 369 emergency visits were diagnosed with poisoning, the overall incidence being 8.1 per 10 000 person–years (95% CI 7.3–9.0). A majority of patients were adolescents aged 10–15 years (48%) and children under 5 years (45%). Boys represented 55% of the cases. Nonpharmaceutical agents were suspected to be the cause in 60.4% and pharmaceuticals in 30.6% of the intoxications. Multiple agents were involved in 8.4% of the cases. Ethanol was the agent in 30.9% of the poisonings. Most patients (78.9%) were hospitalized (median length of stay 1 day). Overall mortality was 0.3%.Conclusion: Acute paediatric poisonings represent a relatively frequent problem in Finland, and remain a life‐threatening problem. The high proportion of alcohol poisonings highlights the necessity to develop more effective primary prevention programs.