bluuebunny/crossref_metadata_2025_split huggingface dataset:
Immunological role of indoleamine 2,3‐dioxygenase in rat liver allograft rejection and tolerance
Authors: Lin Yu‐Chun , Chen Chao‐Long , Nakano Toshiaki , Goto Shigeru , Kao Ying‐Hsien , Hsu Li‐Wen , Lai Chia‐Yun , Jawan Bruno , Cheng Yu‐Fan , Tateno Chise , Yoshizato Katsutoshi 
Published: July 2007

AbstractBackground and Aim:  Indoleamine 2,3‐dioxygenase (IDO) is expressed in the placenta and plays an essential role in maternal tolerance. Recent data showed that giving IDO inhibitor blocked liver allograft tolerance. However, the immunological role of IDO in rat liver allograft models has not been characterized. In the present study, the time‐course of IDO expression and the localization of IDO were analyzed to address the role of IDO in the induction of tolerance.Methods:  Rat orthotopic liver transplantations (OLT) were performed and IDO gene expression of OLT livers was analyzed. Immunohistochemistry was used to evaluate the localization of IDO‐expressed cells in the liver.Results:  The IDO gene was detected in the allogeneic liver graft at the acute phase but the signal could not be detected when these OLT rats were treated with cyclosporinee A. The time‐course of IDO gene expression in liver grafts of the spontaneous tolerant OLT model revealed that the IDO mRNA was expressed in both the rejection phase and the induction phase of tolerance, but the signal was gradually lowered during the maintenance phase of tolerance. Immunohistochemistry confirmed that the IDO protein was detected in antigen‐presenting cells but not in hepatocytes.Conclusion:  Our results demonstrated that IDO is induced in antigen‐presenting cells of rat liver allografts under drug‐free status, suggesting that indirect or direct recognition of donor antigen and further T‐cell activation may be inhibited. IDO may act as a local immunosuppressive molecule to protect transplanted cells, tissues and organs from immune attack.
Inhaled mannitol changes the sputum properties in asthmatics with mucus hypersecretion*
Authors: DAVISKAS Evangelia , ANDERSON Sandra D. , YOUNG Iven H. 
Published: July 2007

Background and objectives:  Most asthmatics with mucus hypersecretion have difficulty in clearing their secretions so that mucus plugs and airway obstruction are commonly present. Inhaled mannitol facilitates clearance of mucus. This study investigated the changes in the physical properties of sputum in response to mannitol in asthmatics with chronic cough and sputum production.Method:  Sputum was collected from 12 asthmatics (26–73 year), lifelong non‐smokers, at baseline, after eformoterol (24 μg) and after mannitol on each of four visits. Inhaled mannitol doses were: 635 mg (Visit 1), 240 mg (Visit 2), 360 mg (Visit 3) and 360 mg in the presence of montelukast (Visit 4). Eformoterol was inhaled before mannitol on each visit to prevent bronchoconstiction. Sputum measurements included viscosity, elasticity, surface tension, contact angle‐glass and percentage solids.Results:  There were no significant differences between the sputum properties at baseline and after eformoterol. Mannitol (360 mg) reduced the baseline (mean ± SEM) elasticity from 29.9 ± 4.5 to 15.1 ± 1.4 Pa (P < 0.0001), viscosity from 18.4 ± 3.2 to 8.1 ± 1.2 Pa (P < 0.0001) at 1 rad/ s, surface tension from 92.1 ± 2.2 to 81.9 ± 2.5 mN/m (P < 0.0001), contact angle‐glass from 57.5 ± 3.2 to 49.6 ± 2.0 degrees (P < 0.0001), and percentage solids from 6.9 ± 0.7 to 5.7 ± 0.4% (P < 0.0001). All doses of mannitol reduced the sputum properties similarly and no property was further reduced by montelukast (P > 0.4).Conclusion:  Inhaled mannitol reduced the viscoelasticity, surface tension, contact angle and the solids content of sputum in asthmatics with chronic cough and sputum production, consistent with the osmotic effect of mannitol causing water efflux in the airway lumen.
Comparing serum and pleural fluid pro‐brain natriuretic peptide (NT‐proBNP) levels with pleural‐to‐serum albumin gradient for the identification of cardiac effusions misclassified by Light's criteria
Authors: PORCEL José M. , CHORDA José , CAO Gonzalo , ESQUERDA Aureli , RUIZ‐GONZÁLEZ Agustin , VIVES Manuel 
Published: July 2007

Background and objectives:  To assess the diagnostic performance of the amino‐terminal fragment of pro‐brain natriuretic peptide (NT‐proBNP) in pleural fluid and serum for the identification of pleural effusions owing to heart failure, and to determine if these measurements allow better categorization of cardiac effusions that have been misclassified by Light's criteria, than do serum‐pleural fluid albumin and protein gradients.Methods:  The study prospectively evaluated NT‐proBNP in serum and pleural fluid from patients with effusions owing to heart failure (n = 53) and other causes (n = 40). Measurements were made of levels of NT‐proBNP by an electrochemiluminiscence immunoassay, and serum‐pleural fluid protein and albumin gradients.Results:  Using a cut‐off value of 1500 pg/mL for serum and pleural samples, the accuracy of NT‐proBNP for identifying pleural effusions from cardiac causes was 89% and 90%, respectively. The area under the receiver operating characteristic curve for the diagnosis of pleural effusions from heart failure was similar for pleural fluid (0.931, 95% CI: 0.871–0.991) and serum (0.919, 95% CI: 0.855–0.984) NT‐proBNP. Six (75%) of eight patients with cardiac effusions that were misclassified as exudates by Light's criteria would have been correctly categorized by either NT‐proBNP or the albumin gradient, whereas only four (50%) would have been correctly classified by the protein gradient.Conclusions:  NT‐proBNP is a useful marker for the diagnosis of pleural effusions from heart failure when measured in either serum or pleural fluid. At a cut‐off of 1500 pg/mL, NT‐proBNP is at least as accurate as the albumin gradient to correctly identify cardiac effusions misclassified as exudates by standard criteria, but at much higher cost.
The new ATS/ERS guidelines for assessing the spirometric severity of restrictive lung disease differ from previous standards
Authors: AGGARWAL Ashutosh N. , AGARWAL Ritesh 
Published: July 2007

Background and objectives:  The ATS/ERS Task Force on Lung Function Testing recently proposed guidelines for the interpretation of pulmonary function tests and suggested that a reduction in FEV1 be used for categorizing both obstructive and restrictive abnormalities. This changes the severity stratification algorithm of restrictive patterns diagnosed by spirometry, that are currently categorized based on reduction in VC. This study examined the level of agreement between these two categorization schemes.Methods:  Spirometry records of 2527 adult patients evaluated over 1 year were retrieved; 361 of these patients showed a restrictive pattern. Severity of airway restriction was separately assessed in these patients using the indicative schemes provided in the new ATS/ERS and the earlier ATS guidelines.Results:  There were 212 (58.7%) patients with a restrictive pattern who had identical severity categorization using both guidelines. In most instances of discordance, the severity categorization differed only by a single stratum. Of 149 discordant results, 91 (60.1%) were placed in a better category, and 58 (39.9%) in a worse category, when using the new ATS/ERS recommendations. Overall weighted kappa estimate for agreement between the two schemes of categorization was 0.649.Conclusion:  Based on spirometry results, the level of severity of restriction cannot be described interchangeably between the old and new guidelines for all patients. The new guidelines tend to give lower severity scores for restrictive lung diseases in up to 25% of patients.
Acute exacerbation of idiopathic pulmonary fibrosis: Role of Chlamydophila pneumoniae infection
Authors: TOMIOKA Hiromi , SAKURAI Toshiyasu , HASHIMOTO Kimio , IWASAKI Hironobu 
Published: July 2007

Background and objectives:  Patients with idiopathic pulmonary fibrosis (IPF) may experience acute exacerbations of their illness. The actual trigger(s) of such exacerbations is unknown. Chlamydophila pneumoniae infection can cause exacerbation of asthma and COPD. A prospective study was conducted to investigate the possible role of C. pneumoniae infection in triggering acute exacerbations of IPF.Methods:  A prospective observational study over 5 years of consecutive IPF patients who fulfilled the criteria for acute exacerbation. Sputum, blood cultures and acute and convalescent serology for C. pneumoniae IgG and IgA (ELISA) were performed.Results:  Previous infection with C. pneumoniae is common. Of the 27 study patients, 15 had a C. pneumoniae IgG index of 1.10–2.99 (positive) and 3 had a C. pneumoniae IgG index of >2.99 (strongly positive) at the time of presentation with an acute exacerbation. In addition, 15 subjects had a C. pneumoniae IgA index of 1.10–2.99 (positive) and 6 subjects had a C. pneumoniae IgA index of >2.99 (strongly positive). However, only two of the 15 subjects (13%) for whom paired sera were tested exhibited a significant rise in antibody response (change in index of 1.90 for C. pneumoniae IgG and 1.54 for IgA, respectively) indicating either acute or reactivated infection with C. pneumoniae. There were 15 deaths (56%) despite supportive care that included high‐dose corticosteroid therapy and oxygen supplementation.Conclusions:  Mortality is high with acute exacerbation of IPF. Acute infection with C. pneumoniae is uncommon at the time of presentation with acute exacerbation of IPF.
A teaching hospital's experience applying the Pneumonia Severity Index and antibiotic guidelines in the management of community‐acquired pneumonia
Authors: LEE Richard Wai Wing , LINDSTROM Steven Terence 
Published: July 2007

Background and objectives:  The Pneumonia Severity Index (PSI) was developed to predict mortality in community‐acquired pneumonia (CAP). It has been prospectively validated to identify patients who are at low risk of death and thereby aid in the selection of patients for outpatient management. This study assessed the compliance of medical staff at a university teaching hospital with the use of the PSI and the PSI‐based local antibiotic guidelines in admitted patients.Methods:  This was a retrospective study of 137 consecutive adults admitted with a primary diagnosis of CAP between July and December 2003. Implementation of the PSI and local antibiotic guidelines occurred 4 months prior to the study period. The data collected included patient demographics, PSI parameters, patient outcomes, adherence and compliance with the PSI scoring process and local antibiotic guidelines.Results:  Forty per cent of all CAP admissions were patients in PSI Class I to III. The compliance with scoring the PSI was low (45 out of 137 patients; 33%), as was the accuracy of the PSI scoring (26 out of 45 patients; 58%). Compliance with the local antibiotic guidelines was 87% in patients in whom the PSI was performed.Conclusions:  In admitted patients, non‐adherence with the PSI admission guidelines was common. Compliance with scoring the PSI and its scoring accuracy was low. This may be due to a lack of awareness and its relative complexity. Further studies to identify potential barriers to compliance are warranted.
Association between asthma, asthma symptoms and C‐reactive protein in US adults: Data from the national health and nutrition examination survey, 1999–2002
Authors: ARIF Ahmed A. , DELCLOS George L. , COLMER‐HAMOOD Jane 
Published: July 2007

Background and objectives:  CRP is elevated in several inflammatory diseases; however, little is known about its association with asthma.Methods:  The study evaluated the associations between CRP, asthma and asthma symptoms using data on 8020 adults ≥20 years of age from the latest US National Health and Nutrition Examination Survey.Results:  The prevalence estimates of current asthma, wheezing and nocturnal cough were 3.6% (95% CI: 2.9–4.4), 14.7% (95% CI: 13.7–15.8) and 4.6% (95% CI: 3.8–5.3), respectively. Geometric mean of CRP was 0.20 mg/dL (95% CI: 0.19–0.21). The majority of female (69.5%) respondents were in the fourth (highest) quartile of CRP. Mean CRP levels were significantly higher in non‐Hispanic blacks as compared with non‐Hispanic whites. The adjusted odds of current asthma and past asthma (as compared with no asthma) were 1.60 (95% CI: 1.02–2.53) and 1.43 (95% CI: 1.07–1.91), respectively, greater in the fourth quartile of CRP. The adjusted odds of presence of both wheezing and nocturnal cough were 2.18 and 3.40 in the third and fourth quartile of CRP, respectively.Conclusions:  This study shows that adults with asthma and asthma symptoms have higher levels of CRP. The potential use of CRP as a clinically useful marker for asthma severity and control should be further explored.
Comparison of Indian reference equations for spirometry interpretation
Authors: AGGARWAL Ashutosh N. , GUPTA Dheeraj , JINDAL Surinder K. 
Published: July 2007

Background and objectives:  It would be desirable in a large country such as India that a single set of reference equations be used to interpret lung function tests performed across the entire country. This study compared north, west and south reference equations in interpreting spirometry results in north Indian patients.Methods:  Spirometric records of 27383 patients aged 16–65 years were assessed. Spirometric values for FVC, FEV1 and FEV1%FVC values derived from north, west and south Indian reference equations were compared. Differences in the lower limit of normal (LLN) were studied across the age and height range of the study group to determine if there was any clinically significant difference in the three derived values.Results:  The north and west Indian equations was discordant in 22.1% instances, and the north and south Indian equations in 12.9% instances, with kappa estimates of agreement being 0.626 and 0.781, respectively. Most of the patients with abnormal spirometry using north Indian equations were erroneously interpreted to have normal spirometry using west or south Indian equations. The south Indian equations underpredicted LLN for FVC and FEV1 for most men and women. The west Indian equations underpredicted LLN for FVC and FEV1 in all men, and in younger and short statured women.Conclusions:  North, west and south Indian reference equations do not yield equivalent results for spirometry interpretation in north Indian patients.
Improved lung function after thoracocentesis in patients with paradoxical movement of a hemidiaphragm secondary to a large pleural effusion
Authors: WANG Lee‐Min , CHERNG Jaw‐Ming , WANG Jeng‐Shing 
Published: July 2007

Background and objectives:  Previous studies have shown little or no improvement in pulmonary function and arterial blood oxygenation after therapeutic thoracocentesis. This study investigated changes in pulmonary function, arterial blood gases and dyspnoea after therapeutic thoracocentesis in patients with paradoxical movement (PM) of a hemidiaphragm due to pleural effusion.Methods:  Twenty‐one patients with pleural effusion and PM of a hemidiaphragm and 41 patients with pleural effusion but without paradoxical movement (NPM) were studied before and 24 h after thoracocentesis. Lung function measurements included lung mechanics, blood gas exchange and the Borg dyspnoea scale.Results:  At thoracocentesis a mean of 1220 mL of pleural fluid was removed from the PM group and 1110 mL from the NPM group. Post‐thoracocentesis the PM group showed small but significant improvement (P < 0.05) in FEV1 (63% vs 73%), FVC (67% vs 77%), PaO2 (66 mm Hg vs 73 mm Hg), A‐a O2 gradient (38 mm Hg vs 30 mm Hg), and the Borg scale (5.1 vs 2.1). The NPM group showed no significant change in any parameter.Conclusions:  Statistically significant improvement in pulmonary function following thoracocentesis was observed in patients with pleural effusion and PM of the hemidiaphragm. Patient selection may therefore explain the different outcomes of thoracocentesis reported in previous studies.
Effects of inflammatory cytokines on the recurrence of liver cancer after an apparently curative operation
Authors: BAI Li , MAO Gao Ping , CAO Chuan Ping 
Published: July 2007

OBJECTIVE:  To investigate the effects of inflammatory cytokines, tumor necrosis factor‐alpha (TNF‐α), interleukin‐1beta (IL‐1β), interleukin‐6 (IL‐6) and vascular cell adhesion molecule (VCAM‐1), on the recurrence of liver cancer after apparently curative surgical resection of the tumor.METHODS:  An experimental mouse model of liver cancer metastasis was designed using hepatoma 22(H22) inoculated into the subserous layer of spleen of 615 mice. Partial hepatectomy (PH) or sham operation (SH) was performed at various periods of spleen inoculation and metastasic effects were recorded. The expression of inflammatory cytokines as TNF‐α, IL‐1β, IL‐6 and VCAM‐1 were analyzed by reverse transcriptase‐polymerase chain reaction (RT‐PCR).RESULTS:  Compared with SH, a significant augmented metastatic effect was observed in the mice with PH (P < 0.01), and higher mRNA expressions of TNF‐α, IL‐1β, IL‐6 and VCAM‐1 were also observed. The peak expressions of IL‐1β, IL‐6 and VCAM‐1 were found at 48 and 72 h, respectively. Among them, TNF‐α expression was found immediately increasing after 4 h and kept at a high level till 96 h after PH. The expression of VCAM‐1 was found to have two peaks at 4 and 72 h after PH, 3–6 times higher than its level prior to the operation. The expression of TNF‐α, IL‐1β, IL‐6 and VCAM‐1 showed a significantly positive correlation with the augmenting effect of liver metastasis in the mice model.CONCLUSION:  The results indicate that pro‐inflammatory cytokines, TNF‐α, IL‐1β, IL‐6 and VCAM‐1 might be involved in promoting the enhanced metastasis of liver cancer after surgical operation, especially the PH.
HUITAI rapid urease test: A new ultra‐rapid biopsy urease test for the diagnosis of Helicobacter pylori infection
Authors: GOH Khean‐Lee , CHEAH Phaik‐Leng , NAVARATNAM Parasakthi , CHIN Sow‐Chan , XIAO Shu‐Dong 
Published: July 2007

BACKGROUND:  The gastric biopsy urease test is an accurate and robust diagnostic test for Helicobacter pylori infection. Large endoscopy units use their own homemade unbuffered ultra‐rapid urease test for diagnosis of H. pylori infection but several commercial rapid urease tests are available.OBJECTIVE:  To compare the accuracy and reaction time of a new biopsy urease test, HUITAI rapid urease test, in the diagnosis of H. pylori infection.METHODS:  Consecutive patients presenting with dyspepsia to the endoscopy unit, University of Malaya Medical Center were recruited for the study. Patients who were previously treated for H. pylori infection or who had received antibiotics, proton pump inhibitors or bismuth compounds in the preceding 4 weeks were excluded. The H. pylori diagnosis was made based on the homemade rapid urease test, histology and culture of gastric biopsies. Biopsies from the antrum and corpus of the stomach were taken for this purpose. In addition, two antral and corpus biopsies were taken for the HUITAI rapid urease test. A positive diagnosis of H. pylori infection was made when the culture was positive or if both histology and the rapid urease test were positive. A negative diagnosis was made when all tests were negative. The positive reaction time of the HUITAI rapid urease test was carefully timed up to 60 min.RESULTS:  Two hundred and six patients were recruited in the study. One hundred and twelve were diagnosed as having an H. pylori infection while the other 94 patients were regarded as negative. There were no spoiled tests and no indeterminate results. The sensitivity of the HUITAI rapid urease test was 98.2% (95% confidence interval (CI): 93.7%, 99.8%), specificity, 99.0% (95% CI: 94.2%, 100%), positive predictive value, 99.0% (95% CI: 95.1%, 100%), negative predictive value, 97.9% (95% CI: 92.6%, 99.7%). The overall diagnostic accuracy for the HUITAI rapid urease test was 98.5% (95% CI: 96.6, 99.9). The median positive reaction time was 1.0 min (25–75% inter‐quartile range [IQR]: 1.0–3.0 min).CONCLUSIONS:  The HUITAI rapid urease test is highly accurate for the diagnosis of an H. pylori infection and showed a very rapid positive reaction time.
Experimental radiotherapy‐induced enteritis: A probiotic interventional study
Authors: Seal MG , Naito Y , Barreto R , Lorenzetti A , Safran P , Marotta F 
Published: July 2007

OBJECTIVE:  Acute radiation of the small intestine causes an immediate and potentially reversible effect on the sensitive regenerative epithelium of the intestinal mucosa while markedly altering the overall intestinal ecosystem. The aim of the present study was test a novel probiotic mixture formulation (Microflorana‐F) in an experimental model of acute radiation enteritis with particular interest in endotoxinemia and bacterial translocation.MATERIALS AND METHODS:  Male Wistar rats allocated to three groups were fed for 7 days with: (A) a standard balanced diet; (B) a standard diet with the addition of 1 mL t.i.d. of Microflorana‐F and (C) the same probiotic but after heat inactivation. Under ketamine anesthesia, abdominal irradiation was performed at a single dose rate of 20 Gy. Sham‐radiated healthy rats served as a control (D). Standard food and active/inactive probiotic supplementation schedule was maintained throughout the study period. When they were killed 14 days later a midline laparotomy and a medium sternotomy was carried out. The mesenteric lymph nodes, whole spleen and liver samples as well as blood, the portal vein and bile samples were cultured. Endotoxinemia was also measured.RESULTS:  Early deaths (1 week) occurred mostly in rats fed standard food or inactivated probiotic. The endotoxin level significantly increased in irradiated rats fed standard food and inactivated probiotic while supplementation with the active form of the probiotic mixture significantly improved such parameters (P < 0.05). After radiation injury, mesenteric lymph nodes and portal blood were the samples most frequently yielding bacterial growth. Treatment with only the active form of probiotic significantly reduced the incidence of bacterial contamination in all samples.CONCLUSIONS:  These data suggest that the manipulation of gut ecosystem by biologically effective probiotic preparations might be a worthwhile therapeutic and preventive tool in radiation‐induced enteritis.
Effects of extracellular signal‐regulated kinase on rat cultured hepatic stellate cells stimulated by acetaldehyde
Authors: ZHENG Shu Mei , JIANG Ming De , ZENG Wei Zheng , XU Hui , WANG Yun Xia , MA Hong De , XIE Fang Wei , ZHANG Yong , QIN Jian Ping , WU Xiao Ling 
Published: July 2007

OBJECTIVE:  To investigate the effects of PD98059 on the cell cycle, cell proliferation, the secretion of type I collagen and expression of transforming growth factor‐β‐1 mRNA in rat hepatic stellate cells stimulated by acetaldehyde.METHODS:  Rat hepatic stellate cells stimulated by acetaldehyde were incubated with different concentrations of PD98059. The cell cycle was analyzed by flow cytometry. Cell proliferation was assessed by methyl thiazolyl tetrazolium colorimetric assay. The mRNA expression of transforming growth factor‐β‐1 was examined by reverse transcriptase polymerase chain reaction. Type I collagen of the culture medium was detected by enzyme‐linked immunoadsorbent assay.RESULTS:  Twenty, 50 and 100 µmol/L PD98059 could significantly inhibit the proliferation and provoke a G0/G1‐phase arrest of hepatic stellate cells stimulated by acetaldehyde in a dose‐dependent manner. The secretion of type I collagen and transforming growth factor‐β‐1 mRNA expression of acetaldehyde‐induced hepatic stellate cells were markedly inhibited by 50 and 100 µmol/L PD98059, respectively.CONCLUSION:  Extracellular signal‐regulated kinase signal transduction pathway could regulate cell proliferation, the secretion of type I collagen and transforming growth factor‐β‐1 mRNA expression of rat hepatic stellate cells stimulated by acetaldehyde. This is most likely related to its regulative effect on the cell cycle.