bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of bronchial hyperresponsiveness in chronic rhinosinusitis with nasal polyp
Authors: Han D. H. , Kim S. W. , Cho S. H. , Kim D. Y. , Lee C. H. , Kim S. S. , Rhee C. S. 
Published: December 2008

Background:  Chronic rhinosinusitis with nasal polyposis (CRSNP) and asthma are inflammatory lesions of the respiratory epithelium. This study was conducted to evaluate predictive factors of bronchial hyperresponsiveness (BHR) in patients with CRSNP.Methods:  BHR was evaluated using a methacholine bronchoprovocation test (MBPT) in 122 consecutive patients newly diagnosed with CRSNP at Seoul National University Hospital from January 2004 to June 2006. The following parameters were analyzed and compared between the BHR and non‐BHR groups: symptoms, atopic status, current smoking, disease severity of CRSNP based on the Lund–Mackay scoring system of sinus CT, and counts of eosinophils in the serum and nasal tissues.Results:  Thirty‐five percent of the patients were found to have BHR, and BHR was found to occur more frequently in patients that were currently suffering from sneezing (P = 0.007). In addition, the mean eosinophil counts of the serum and nasal tissues were higher in the BHR group than in the non‐BHR group (P = 0.001 for the serum, P = 0.045 for the nasal tissues), and the eosinophil counts of the serum correlated to those of the nasal tissues (r = 0.334, P = 0.013). The disease severity, as determined by the Lund–Mackay scoring system, was not different between the two groups (P > 0.05). The best cutoff serum eosinophil count for predicting BHR in CRSNP patients was determined to be 300 cells/μl (sensitivity 70%, specificity 70%).Conclusion:  Taken together, these results indicate that moderate to severe sneezing and a serum eosinophil count ≥ 300 cells/μl may be predictive factors for BHR in patients with CRSNP.
Cigarette smoke facilitates allergen penetration across respiratory epithelium
Authors: Gangl K. , Reininger R. , Bernhard D. , Campana R. , Pree I. , Reisinger J. , Kneidinger M. , Kundi M. , Dolznig H. , Thurnher D. , Valent P. , Chen K.‐W. , Vrtala S. , Spitzauer S. , Valenta R. , Niederberger V. 
Published: December 2008

Background:  The association between cigarette smoke exposure and allergic airway disease is a matter for debate. We sought to investigate in an in vitro system whether active smoking reduces the integrity and barrier function of the respiratory epithelium and thus facilitates allergen penetration.Methods:  We cultured the human bronchial epithelial cell line 16HBE14o− in a transwell culture system as a surrogate for the intact respiratory epithelium. The cell monolayer was exposed to standardized cigarette smoke extract (CSE). The extent and effects of trans‐epithelial allergen penetration were measured using 125I‐labelled purified major respiratory allergens (rBet v 1, rPhl p 5 and rDer p 2) and histamine release experiments.Results:  Exposure of cells to concentrations of CSE similar to those found in smokers induced the development of para‐cellular gaps and a decrease in trans‐epithelial resistance. CSE exposure induced a more than threefold increase in allergen penetration. Increased subepithelial allergen concentrations provoked a substantial augmentation of histamine release from sensitized basophils.Conclusions:  Our results indicate that cigarette smoke is a potent factor capable of reducing the barrier function of the respiratory epithelium for allergens and may contribute to increased allergic inflammation, exacerbation of allergic disease and boosting of IgE memory.
Development of a recombinant antigen‐based ELISA for the sero‐detection of porcine lymphotropic herpesviruses
Authors: Brema Susanne , Lindner Iris , Goltz Michael , Ehlers Bernhard 
Published: December 2008

Abstract:  Background:  Xenotransplantation using pigs as donor species carries a risk for the activation of latent porcine herpesviruses and potential transmission to the human recipient. The porcine lymphotropic herpesviruses (PLHV‐1, ‐2, ‐3) are widespread in domestic pigs and closely related to the human gammaherpesviruses, Epstein–Barr virus and Kaposi sarcoma herpesvirus, causing lymphoproliferative disorders. PLHV‐1 has been associated with a porcine post‐transplantation lymphoproliferative disorder (PTLD), affecting miniature swine after experimental transplantation. In human xenotransplantation, PLHV might be transferred to the transplant recipient and cause PTLD or related diseases. The elimination of PLHV from donor pigs is therefore necessary, and requires the availability of nucleic‐acid‐ and antibody‐based detection methods.Methods:  The N‐ and C‐terminal parts (gB1 and gB2) of the glycoprotein B gene of PLHV‐1, ‐2 and ‐3 were cloned and expressed in Escherichia coli. Antisera were raised in mice. PLHV PCR was performed as published earlier.Results:  An ELISA was developed, using recombinant glycoprotein B of PLHV‐1 as the antigen, and used for the analysis of groups of pigs, differing by age and origin. Seropositivity ranged from 38% (piglets) to 90% (gilts) and 100% (breeding sows, miniature pigs and pigs for slaughter). In comparison, PCR products of PLHV were found in the blood of 0 to 80% of the pig groups. Additionally, a group of 12 piglets was tested repeatedly after birth until the age of 156 days. A decline of antibodies was found during the first 3 weeks after birth, followed by a rise in most pigs during the weeks thereafter. PLHV PCR products in the blood were only observed later than 3 weeks after birth.Conclusion:  Newborn pigs may be passively protected by maternal antibodies against PLHV infection during the first 3 weeks post partum. The rise of antibody titers thereafter and the appearance of PLHV sequences in the blood possibly indicates de novo infection by contact to the infected mother sow. The PLHV–ELISA may aid in breeding PLHV‐free pigs.
Experimental application of xenogenous antlerogenic cells in replacement of auricular cartilage in rabbits
Authors: Cegielski Marek , Dziewiszek Wojciech , Zabel Maciej , Dzięgiel Piotr , Iżycki Dariusz , Zatoński Maciej , Bochnia Marek 
Published: December 2008

Abstract:  Background:  Regenerative medicine in the recent years aims at explaining involvement of stem cells in regenerative processes and applying this knowledge in fulfilling human needs to find new, more efficient therapeutic methods. Growing antlers constitute a model organ for examining regeneration processes of tissues because they are the only mammalian appendages capable of regeneration. The rate of growth of deer antlers makes them one of the quickest growing structures in mammals. The cells taking part in this process have a considerable proliferating potential. The aim of the study was to analyze the possibility of using xenogenous antlerogenic cells (AC) in regeneration of cartilaginous tissues in non‐immunosuppressed animals.Methods:  We undertook to use a xenogenous implant consisting of cultured antlerogenic mesenchymal cells suspended in hemostatic sponge in the reconstruction of lesions of ear cartilage in nine rabbits. A surgical site was prepared half‐way up the outer, dorsal part of the right ear. About 1 cm from the free edge of the ear, a centrally peduncled flap of skin and perichondrium was prepared, measuring 1.5 cm × 1.5 cm. The exposed cartilage was excised in an area of about 1 cm × 1 cm. In the operated rabbits, in the prepared perichondrial pocket, we placed a flake of Spongostan® saturated with the suspension of AC. Xenogenous cell survival and regeneration abilities were determined by histologic, immunohistochemical, and electron microscopy analysis of the grafts.Results:  In each case, healing occurred properly and neither local inflammation, necrosis nor implant rejection was observed. The hyaline cartilage lesion was replaced by new fibrous cartilage. This is similar to the histologic process occurring in growing deer antlers. The histologic, immunohistochemical, and electron microscopy analysis demonstrated the presence (and thus possible participation) of exogenous cells in the reconstructive process. At the same time, the immune response was very weak, which was confirmed by immunohistochemical reactions.Conclusion:  Implanted antlerogenic cells were not rejected and possibly took part in the reconstruction of missing sections of the scaffolding of the rabbits’ ear cartilages (although the mechanism is yet unknown). Low immunogenicity of AC, simplicity, efficiency, and low costs of production of implant material are the benefits of this method. Further research should unequivocally answer the question whether the MIC‐1 cells are or are not the long‐sought‐after ideal material for the reconstruction of cartilaginous tissue lesions in various species, including human.
Chitosan/gelatin hydrogel as immunoisolative matrix for injectable bioartificial pancreas
Authors: Yang Kai‐Chiang , Wu Chang‐Chin , Lin Feng‐Huei , Qi Zhi , Kuo Tzong‐Fu , Cheng Yung‐Hsin , Chen Moon‐Pei , Sumi Shoichiro 
Published: December 2008

Abstract:  Background:  The feasibility of using chitosan/gelatin hydrogel as immunoisolative matrix to provide an additional protection to the microencapsulated islet cells was demonstrated in this study. We hope that the use of hydrogel can extend the functional longevity of microencapsulated islet cells during xenotransplantation.Methods:  Chitosan/gelatin solution with glycerol 2‐phosphate disodium salt hydrate was prepared and utilized as a cell carrier. The biocompatibility of the chitosan/gelatin hydrogel was first established by using a mouse insulinoma cell line, NIT‐1. Insulinoma cells were encapsulated in agarose as microspheres and then macroencapsulated in chitosan/gelatin hydrogel. In vitro cell activity, material‐mediated cytotoxicity, cytokine‐mediated cytotoxicity assay, and insulin secreting profiles of insulinoma/agarose microspheres macroencapsulated in chitosan/gelatin hydrogel were analyzed. For in vivo study, insulinoma/agarose microspheres with chitosan/gelatin solution was applied as an injectable bioartificial pancreas (BAPs). Insulinoma/agarose microspheres suspended in phosphate‐buffered saline or in chitosan/gelatin solution was injected into the subcutaneous layer of diabetic rats. Non‐fasting blood glucose (NFBG) concentration of rat was measured perioperatively. After pre‐determined intervals, the chitosan/gelatin hydrogel containing insulinoma/agarose microspheres was retrieved for histologic examinations.Results: Insulinoma/agarose microspheres macroencapsulated in hydrogel revealed functional activity and secreted insulin continually for 60 days in vitro. Chitosan/gelatin hydrogel was not cytotoxic to islet cells, and in contrast, the hydrogel showed cytoprotective effects against cytokine‐mediated cytotoxicity. The NFBG of diabetic rats transplanted with free insulinoma/agarose microspheres was decreased to euglycemia but restored to hyperglycemia in 15 days. Contrarily, the NFBG of rats transplanted with insulinoma/agarose microspheres with hydrogel remained euglycemic for 42 days. Histologic sections revealed that the fibrous tissue envelopment and the infiltrated immune‐related cells contributed to the dysfunction of BAPs.Conclusions:  This study indicates that using chitosan/gelatin hydrogel as a cell carrier is feasible and can provide an additional protection for the microencapsulated islet cells during xenotransplantation.
Topographic electroencephalogram in children during mask induction of anaesthesia with sevoflurane
Authors: SONKAJÄRVI E. , ALAHUHTA S. , SUOMINEN K. , HAKALAX N. , VAKKURI A. , LÖPPÖNEN H. , OHTONEN P. , JÄNTTI V. 
Published: December 2008

Background: Epileptiform patterns, spikes, polyspikes and periodic epileptiform discharges (PED) have been reported in electroencephalograms (EEGs) during anaesthesia induction with sevoflurane in healthy adults and children. Published recordings have been performed with a limited number of channels, and therefore the topographic distributions of these patterns are not known.Methods: Twenty ASA I children aged 4–10 years undergoing routine operations were anaesthetized with 8% sevoflurane in 50%/50% oxygen and nitrous oxide using mask induction with controlled normoventilation. An EEG was recorded with a full 10–20 electrode system including orbitofrontal and ear electrodes, and a recording band of 0.016–70 Hz. Beat‐to‐beat heart rate (HR) was calculated off‐line.Results: Nineteen out of 20 children developed multifocal spikes and polyspikes with a maximum over the frontal lobes. Four patients developed suppression, which was almost continuous and lasted several minutes, and thereafter a continuous EEG resumed, a few spikes were seen and then a nonepileptiform pattern. In three children a couple of PED waves were seen at the onset of a continuous EEG. HR increased maximally before the onset of spikes. No motor phenomena were seen.Conclusion: These recordings confirm the epileptogenic property of sevoflurane in mask induction. The spikes and polyspikes had frontal multifocal maxima and may be missed in recordings from frontopolar electrodes used by depth‐of‐anaesthesia monitors. PED and burst suppression were synchronous over the whole cortex. Epileptiform activity was indiscernible from epileptiform waveforms without anaesthesia, such as the patterns seen in status epilepticus.
Can video mobile phones improve CPR quality when used for dispatcher assistance during simulated cardiac arrest?
Authors: BOLLE S. R. , SCHOLL J. , GILBERT M. 
Published: December 2008

Background: Because mobile telephones may support video calls, emergency medical dispatchers may now connect visually with bystanders during pre‐hospital cardio‐pulmonary resuscitation (CPR). We studied the quality of simulated dispatcher‐assisted CPR when guidance was delivered to rescuers by video calls or audio calls from mobile phones.Methods: One hundred and eighty high school students were randomly assigned in groups of three to communicate via video calls or audio calls with experienced nurse dispatchers at a Hospital Emergency Medical Dispatch Center. CPR was performed on a recording resuscitation manikin during simulated cardiac arrest. Quality of CPR and time factors were compared depending on the type of communication used.Results: The median CPR time without chest compression (‘hands‐off time’) was shorter in the video‐call group vs. the audio‐call group (303 vs. 331 s; P=0.048), but the median time to first compression was not shorter (104 vs. 102 s; P=0.29). The median time to first ventilation was insignificantly shorter in the video‐call group (176 vs. 205 s; P=0.16). This group also had a slightly higher proportion of ventiliations without error (0.11 vs. 0.06; P=0.30).Conclusion: Video communication is unlikely to improve telephone CPR (t‐CPR) significantly without proper training of dispatchers and when using dispatch protocols written for audio‐only calls. Improved dispatch procedures and training for handling video calls require further investigation.
Stroke volume averaging for individualized goal‐directed fluid therapy with oesophageal Doppler
Authors: JØRGENSEN C. C. , BUNDGAARD‐NIELSEN M. , SKOVGAARD L. T. , SECHER N. H. , KEHLET H. 
Published: December 2008

Background: An individualized fluid optimization strategy, based on maximization of cardiac stroke volume (SV) with colloid boluses (goal‐directed therapy), improves outcome after surgery. Oesophageal Doppler (OD) is used for SV maximization in most randomized studies, but evidence‐based guidelines for the SV maximization procedure are lacking and variation in SV may influence the indication for fluid administration. We measured beat‐to‐beat OD SV before and after fluid optimization in order to estimate the number of heartbeats for which SV needs to be averaged to provide an acceptable accuracy for goal‐directed therapy with this technology.Methods: Twenty patients scheduled for surgery were anaesthetized, followed by OD SV assessment. Thirty seconds of beat‐to‐beat data were recorded before and after volume optimization performed by successive boluses of 200 ml colloid until SV did not increase ≥10%. SV variability was assessed before and after the volume optimization when SV was measured beat to beat and when it was averaged over 2–10 heartbeats.Results: Nineteen (95%) and 17 (85%) patients demonstrated an SV variability ≥10% before and after volume optimization, respectively, when SV was measured beat to beat. However, when SV was averaged over 10 heartbeats, only two (10%) and one (5%) of the patients demonstrated an SV variability ≥10% before and after optimization, respectively (P<0.0001).Conclusion: OD SV variability is significantly reduced and reaches an acceptable level when SV is averaged over 10 heartbeats. The use of a shorter averaging period for SV may lead to incorrect volume administration in goal‐directed fluid management.
Severe hypoglycemia during intensive insulin therapy
Authors: KAUKONEN K.‐M. , RANTALA M. , PETTILÄ V. , HYNNINEN M. 
Published: December 2008

Background: Tight glycemic control reduces mortality in surgical intensive care patients and in long‐term medical intensive care patients. A large study on intensive insulin therapy was prematurely discontinued due to safety issues. As the safety of intensive insulin therapy has been questioned, we screened all patients during a 17‐month period to reveal the incidence of hypoglycemia and its effects on the outcome of the patients.Methods: All patients treated between February 2005 and June 2006 in two intensive care units (ICUs) of a tertiary care teaching hospital were included in the study. A nurse‐driven intensive insulin therapy with a target blood glucose level of 4–6 mmol/l had been introduced earlier. The patients were divided into two groups according to the presence of severe hypoglycemia (≤2.2 mmol/l).Results: One thousand two hundred and twenty‐four patients (1124 treatment periods) were included. During the study period, 61,203 blood glucose measurements were performed, 2.6% of which were below and 52.6% above the target range. Severe hypoglycemia (glucose ≤2.2 mmol/l) occurred in 25 patients (36 measurements). The incidence was 0.06% of the measurements and 2.3% of the patients. The median age, sex, Acute Physiology And Chronic Health Evaluation II, Simplified Acute Physiology Score II, diagnosis category, ICU or hospital length of stay did not differ between the groups. The hospital mortalities were 25% and 15% in patients with or without severe hypoglycemia, respectively (P=0.16).Conclusion: Severe hypoglycemia during intensive insulin therapy is rare in clinical practice compared with previous clinical trials.
Accuracy and reliability of continuous blood glucose monitor in post‐surgical patients
Authors: YAMASHITA K. , OKABAYASHI T. , YOKOYAMA T. , YATABE T. , MAEDA H. , MANABE M. , HANAZAKI K. 
Published: December 2008

Background: The STG‐22™ is the only continuous blood glucose monitoring system currently available. The aim of this study is to determine the accuracy and reliability of the STG‐22™ for continuously monitoring blood glucose level in post‐surgical patients.Methods: Fifty patients scheduled for routine surgery were studied in surgical intensive care unit (ICU) of a university hospital. After admission to the ICU, the STG‐22™ was connected to the patients. An attending physician obtained blood samples from a radial arterial catheter. Blood glucose level was measured using the ABL™800FLEX immediately after blood collection at 0, 4, 8, and 16 h post‐admission to the ICU (total of 200 blood glucose values).Results: The correlation coefficient (R2) was 0.96. In the Clarke error grid, 100% of the paired measurements were in the clinically acceptable zone A and B. The Bland and Altman analysis showed that bias±limits of agreement (percent error) were 0.04(0.7)±0.35(6.3) mmol (mg/dl) (7%), −0.11(−2)±1.22(22) (15%) and −0.33(−6)±1.28(23) (10%) in hypoglycemia (<70(3.89) mmol (mg/dl), normoglycemia (3.89(70)–10(180) mmol (mg/dl), and hyperglycemia (>10(180) mmol (mg/dl), respectively.Conclusions: The STG‐22™ can be used for measuring blood glucose level continuously and measurement results are consistent with intermittent measurement (percentage error within 15%). Therefore, the STG‐22™ is a useful device for monitoring in blood glucose level in the ICU for 16 h.
Midazolam dose for loss of response to verbal stimulation during the unilateral or bilateral spinal anesthesia
Authors: YUN M. J. , KIM Y. H. , OH A. Y. , JEON Y. T. , KIM Y. C. 
Published: December 2008

Background: We have conducted this study to investigate whether unilateral or bilateral spinal anesthesia with bupivacaine induces different sensitivity to intravenous (i.v.) midazolam for sedation.Methods: Forty‐two patients undergoing various elective unilateral lower extremity surgeries were allocated into two groups: (1) unilateral spinal anesthesia group (Group US, n=21; heavy bupivacaine 5 mg/ml, 9 mg) and (2) bilateral spinal anesthesia group (Group BS, n=21; heavy bupivacaine 5 mg/ml, 9 mg). One milligram of midazolam was injected i.v. at 30‐s intervals until the patients did not respond to the hand grasp test beginning 15 min after spinal anesthesia. The concentration of plasma bupivacaine was evaluated every 15 min for the first 75 min after the start of the spinal anesthesia, and the bispectral index was monitored continuously.Results: The mean venous plasma concentration of bupivacaine was not significantly different between Group US and BS. The dose of midazolam required to abolish responses to verbal commands was significantly lower in Group BS (mean 5.9±1.2 mg) vs. Group US (mean 9.0±1.4 mg).Conclusions: A higher dosage of midazolam is required for loss of response to verbal stimulation during unilateral spinal anesthesia than during bilateral spinal anesthesia.
Comparison of effects and plasma concentrations of opioids between elderly and middle‐aged patients after cardiac surgery
Authors: PESONEN A. , SUOJARANTA‐YLINEN R. , HAMMARÉN E. , TARKKILA P. , SEPPÄLÄ T. , ROSENBERG P. H. 
Published: December 2008

Background:In elderly patients, opioids may cause prominent postoperative sedation and respiratory depression. We evaluated the influence of age on the effects of opioids and plasma concentrations of fentanyl and oxycodone in cardiac surgery patients.Methods:Thirty (≥75 years, gender M9/F21) and 20 (≤60 years, gender M20/F0) patients scheduled to undergo cardiac surgery. A standard anesthesia with fentanyl as an opioid was used. Fentanyl plasma concentrations were measured at the end of surgery and 2 h later. After tracheal extubation, when the pain intensity was at least moderate, blood samples for fentanyl and oxycodone plasma concentration measurements were taken. Thereafter, oxycodone hydrochloride 0.05 mg/kg i.v. was administered. After 15 and 45 min, pain intensity, sedation and oxycodone plasma concentration were determined. This test protocol was repeated twice.Results:The elderly had a higher plasma concentration of fentanyl at the end of surgery than younger patients (5.7±2.2 vs. 3.8±1.2 ng/ml,P=0.001). The plasma concentrations of oxycodone were comparable between the groups. The interval between the second and the third oxycodone dose was longer in the elderly patients (P=0.036). Pain intensity on the verbal rating scale was lower at the 45‐min assessment point after all three oxycodone test doses (P=0.008) and sedation scores were significantly higher after the third dose in the elderly patients (P=0.035).Conclusions:In elderly patients, the plasma concentration of fentanyl was higher but plasma levels of oxycodone were at a similar level compared with middle‐aged patients. However, the elderly patients had less pain and were more sedated after doses of oxycodone.