bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pulmonary dysfunction after primary closure of an abdominal wall defect and its improvement with bronchodilators
Authors: Nakayama Don K. , Mutich Rebecca , Motoyama Etsuro K. 
Published: March 2007

AbstractTo determine the extent of pulmonary dysfunction following primary closure of an abdominal wall defect, we obtained pulmonary function tests (PFT) in 11 newborn infants with gastroschisis and 6 with large omphaloceles admitted to a newborn ICU in a children's hospital. Patients were 1 to 30 days of age at the time of the PFT; all required endotracheal intubation and mechanical ventilation for operative procedures or for postoperative ventilatory support. Full‐term infants (n = 21) undergoing minor surgical procedures provided comparative measurements. Flow‐volume curves were obtained with manual inflation of the lungs followed by forced deflation using negative pressure, or by passive expiration, under sedation and pharmacologic paralysis. Deflation flow‐volume curves gave measurements of forced vital capacity (FVC) and maximal expiratory flow at 25% of vital capacity from residual volume (MEF25). Modified passive mechanics technique gave passive expiratory curves that provided measurements of respiratory system compliance (Crs) and resistance (Rrs). Tests were done: within 48 h (period A), 3–7 days (period B), and 8–30 days after surgical repair (period C). Pulmonary function testing after nebulized 0.1% isoetharine (a bronchodilator), to test for bronchial reactivity, began midway during the study period in 15 patients. Preoperative and postoperative tests were obtained in 5 patients. Closure of an abdominal wall defect decreased FVC, Crs, and MEF25 by up to 50% of normal, reference values after surgery (P < 0.05). FVC and MEF25 approached values of normal infants' by 4 weeks, whereas Crs remained 50% lower. Bronchodilators improved FVC by 21% and MEF25 by up to 48% during the first week of life (both, P < 0.05), but MEF25/FVC was not significantly altered, reflecting the opening of new lung units with no effect on upstream conductance. Bronchodilators may benefit babies who have respiratory difficulties following closure of abdominal wall defects.
Changes in the CA 19‐9 antigen and lewis blood group with pulmonary disease severity in cystic fibrosis
Authors: Kane Robert E. , Penny June , Walker Kay , Rubin Bruce K. , Wu James 
Published: March 2007

AbstractThe altered carbohydrate structure of sputum from patients with cystic fibrosis (CF) has been thought to be due to the inflammatory airway response. Carcinoembryonic antigen (CEA) and CA 19‐9 detect sialosylated carbohydrates in mucus. The epitope of CA 19‐9 is part of the Lewis A (Lea) blood group antigen. Serum concentrations of CEA and CA 19‐9 were determined by radioimmunoassay in 41 CF patients, aged 6–34 years; 16 were asymptomatic Outpatients, and 25 had been admitted for pulmonary exacerbations. There was no difference in CEA between groups. The CA 19‐9 serum concentration was elevated in 90% of patients who had at least one of the two Lewis antigens. The CA 19‐9 concentration of Inpatients with exacerbations was 2.7 times that of stable Outpatients (263 ± 44 versus 99 ± 13 U/mL P < 0.02). CA 19‐9 correlated significantly with age (r = 0.35, P < 0.05), Brasfield score (r = 0.39, P < 0.015), pulmonary function tests, cough severity (r = 0.50, P < 0.001) and NIH clinical score (r = 0.57, P < 0.001). CA 19‐9 concentration of Inpatients decreased by 44% from admission to discharge (302 ± 45 to 169 ± 39, P < 0.02).Fourteen of 25 (56%) of the Inpatients were Lea positive versus only 3/15 (20%) of Outpatients who had milder lung disease (P < 0.002). Of the Inpatients, 25% with more advanced lung disease were Le (a+b+), a rare blood group in the normal population, and one not observed in the Outpatients with milder disease.The results suggested that the serum CA 19‐9 concentration is an index of pulmonary disease severity in 94–95% of patients with CF who express the Lewis antigens, and it can be used to monitor response to therapy.
Effect of posture on regional ventilation in children
Authors: Davies H. , Helms P. , Gordon I. 
Published: March 2007

AbstractLittle information has been published concerning the pattern of regional ventilation in children, yet many differences in lung and chest wall mechanics in childhood, supported by clinical observation, have led to the hypothesis that the pattern of regional ventilation seen in children may not be the same as in adults.Forty‐three children and 16 adult volunteers underwent Krypton (Kr) 81m radionuclide ventilation lung scans in the supine and right and left decubitus postures.In children aged 2–10 years mean fractional ventilation to the right lung (VfR) was 46.1%. This fell to 36% when dependent and rose to 56.1% in the uppermost position. Redistribution of ventilation away from the dependent towards the uppermost lung was seen in all children. In children aged 10–18 years VfR was 57.2% (supine), 48.0% (dependent), and 62.9% (uppermost). An identical pattern was seen in children with normal or abnormal pulmonary function tests (peak expiratory flow rate, and FEV1: FVC ratio). In subjects over 18 years of age a different pattern was seen: mean VfR was 52.4% (supine), rising to 53.4% (dependent), and falling to 48.9% (uppermost).Postural redistribution of ventilation, as assessed by Kr81m ventilation imaging, changes late in the second decade of life. This will have clinical consequences in the management of children with unilateral lung disease.
Technique and use of transbronchial biopsy in children and adolescents
Authors: Whitehead B. , Scott P. J. , Helms P. , Malone M. , Macrae D. , Higenbottam T. W. , Smyth R. L. , Wallwork J. , Elliott M. , De Leval M. 
Published: March 2007

AbstractSince July 1988, a total of 92 transbronchial biopsies (TBB) have been performed in 18 patients (aged 3–16 years). Twelve patients (67%) were heart‐lung transplant (HLT) recipients undergoing surveillance for pulmonary graft rejection and infection. The remainder included immunocompromised patients at risk of opportunistic infections (n = 4), patients with fibrosing alveolitis (n = 1) and a collagen vascular disorder with suspected lung involvement (n = 1). TBB was performed through either a fiberoptic (n = 50) or a rigid (n = 41) bronchoscope, all under general anesthesia. On one occasion a cardiac bioptome was used through an endotracheal stent. The sensitivity of TBB for diagnosing acute and chronic rejection in HLT patients was 88% and 60%, respectively (specificity, 91% and 100%). Definitive diagnoses were made in 4 (67%) of the non‐HLT group. Bronchoalveolar lavage (BAL) was performed during each procedure for microbiological and cytological examination. Thirty‐four pathogenic organisms including Pseudomonas aeruginosa (16/34), Staphylococcus aureus (8/34), and Candida albicans (5/34) were isolated from BAL culture. Complications included pneumothorax (8%), transient pyrexia (7%), and dyspnea (2%).
Ultrathin fiberoptic bronchoscopy for airway toilet in neonatal pulmonary atelectasis
Authors: Shinwell Eric S. 
Published: March 2007

AbstractPulmonary atelectasis is often seen in young infants with respiratory disease and it may contribute to increased ventilatory requirements and the development of chronic lung disease such as bronchopulmonary dysplasia. Standard management consists of postural drainage (chest physiotherapy and suction) and selective intubation with suction of a major bronchus. This report describes a new approach consisting of removal of bronchial secretions under direct vision via ultrathin fiberoptic bronchoscopy, without interruption of mechanical ventilation. The procedure was performed safely in ten cases and resulted in significant rapid improvement in the infants' respiratory condition and in complete resolution of the atelectasis in eight cases. In two infants, partial improvement was seen. No adverse effects of the procedure were encountered. It is concluded that this approach is a safe and potentially valuable therapeutic maneuver in the management of pulmonary atelectasis in sick intubated neonates. © 1992 Wiley‐Liss, Inc.
High‐frequency jet ventilation and surfactant treatment of newborns with severe respiratory failure
Authors: Davis Jonathan M. , Richter Susan E. , Kendig James W. , Notter Robert H. 
Published: March 2007

AbstractTwenty‐eight newborn infants (birthweight, 2.4 ± 1.1 kg; gestational age, 34.6 ± 6.1 weeks) with respiratory distress syndrome (RDS), meconium aspiration syndrome, or pneumonia who deteriorated in spite of optimal conventional mechanical ventilation (CMV) and exogenous surfactant therapy were treated with high‐frequency jet ventilation (HFJV) and continued surfactant therapy. For enrollment, infants had to have a limited response to surfactant therapy and conventional ventilation, and meet clinical criteria that confirmed clinical deterioration and severity of illness. Study infants had received exogenous calf lung surfactant extract (CLSE) and conventional ventilation prior to the start of HFJV at 46.3 ± 8.2 hours of age. Patients initially responded to HFJV alone with significant improvement in several respiratory variables, but deteriorated subsequently and received additional doses of exogenous surfactant on HFJV. Exogenous surfactant and HFJV resulted in significant and sustained improvement in several respiratory variables. Only ten patients deteriorated to meet criteria for a second surfactant dose on HFJV, and two patients received a third dose. Twenty‐five of the 28 patients studied survived (89%). No patients received extracorporeal membrane oxygenation or were discharged home on oxygen. The results of this pilot study suggest that the combination of HFJV and exogenous surfactant replacement may be effective in treating infants with more severe respiratory failure, and indicate the need for more extensive controlled investigations. © 1992 Wiley‐Liss, Inc.
Intensive care course and outcome of patients infected with respiratory syncytial virus
Authors: Stretton Mark , Ajizian Samuel J. , Mitchell Ian , Newth Christopher J. L. 
Published: March 2007

AbstractPICU admissions of 97 children positive for respiratory syncytial virus on fluorescent antibody screening were reviewed; 68% of 44 patients without history of preceding disease (Group I) and 79% of 53 patients with preceding pulmonary, cardiac, or other disease (Group II) required ventilation. In Group I ventilated children weighed significantly less (P = 0.001) and were of lower chronological (P = 0.02) and post‐conceptional ages (P = 0.02) than those not ventilated. Eighteen infants ventilated for apnea weighed significantly less (P = 0.003), were more often born at ≦37 weeks gestation (P = 0.001) and were at lower post‐conceptional age than 11 infants ventilated for progressive respiratory deterioration. There was no significant difference in mean weight, chronological age, post‐conceptional age, CO2, or pH between 12 admissions with BPD who required ventilation for RSV infection and 5 who did not require ventilation. Ribavirin administration to five ventilated patients with BPD did not significantly alter the duration of intubation or PICU stay. Six patients with cardiac disease required longer periods of ventilation than others (Group I, P = 0.001; all others in Group II, P = 0.04). No deaths occurred in Group I, while 6 of 53 (11%) patients in Group II died. In this series immuno compromise placed patients at greatest risk of dying. Mechanical ventilation can be safely managed in previously healthy, RSV infected infants and should be initiated before significant cardiorespiratory compromise arises. © 1992 Wiley‐Liss, Inc.
Comparison of helium dilution and nitrogen washout measurements of functional residual capacity in infants and very young children
Authors: Tepper Robert S. , Asdell Steve 
Published: March 2007

AbstractIn infants and very young children, functional residual capacity (FRC) is the lung volume most frequently measured and gas dilution techniques are most frequently used to measure FRC. We compared measurements of FRC by helium dilution (FRCHe) and nitrogen washout (FRC) in a lung model of known volumes (20,40,60,80 mL), in 8 normal infants (NL), 8 infants with acute respiratory illness (ARI), and 7 infants with chronic lung disease (CLD). In the model lung, measurements of FRCHe had a significantly greater coefficient of variation compared to FRC (6.5 vs 1.5%, P < 0.02), but there was no such difference in the results from all infants combined (6.5 vs 6.2%). In the model lung, the difference between known volumes and the measured values was significantly different from zero only for FRCHe at 20 mL (−4.4 mL, P 0.02). For both FRCHe and FRC, the slopes of the regression equations were 0.99 and the intercepts not significantly different from zero. We conclude that techniques for measuring FRCHe and FRC yield accurate, reproducible, and comparable results in normal, healthy infants and very young children, and in those with respiratory disease. © 1992 Wiley‐Liss, Inc.
Aplasia of respiratory tract cilia
Authors: DeBoeck K. , Jorissen M. , Wouters K. , Van der Schueren B. , Eyssen M. , Casteels‐VanDaele M. , Corbeel L. 
Published: March 2007

AbstractWe report on ciliary aplasia of the respiratory tract, a rare disorder of the mucociliary apparatus, that is insufficiently recognized as a distinct entity. A culture method for ciliogenesis was developed by our laboratory and offers the advantage of studying cilia free of secondary changes associated with infection. Three cases of primary ciliary aplasia were documented histologically in direct biopsy specimens and also in biopsy specimens cultured specifically for ciliogenesis. Primary ciliary aplasia should be differentiated from secondary ciliary aplasia in which basal bodies are present and ciliogenesis takes place in specific culture. Only hereditary ciliary abnormalities are expressed in cell cultures. We critically review the cases of ciliary aplasia reported to date. © 1992 Wiley‐Liss, Inc.
Spirometric and endoscopic evaluation of airway collapse in infants with bronchopulmonary dysplasia
Authors: McCoy Karen S. , Bagwell Charles E. , Wagner Mary , Sallent Jorge , O'Keefe Michael , Kosch Phillip C. 
Published: March 2007

AbstractWe evaluated eight infants with bronchopulmonary dysplasia (BPD) at ages from 2 to 13 months who had repeated episodes of clinical respiratory deterioration associated with agitation. These episodes limited further weaning from ventilation or necessitated recurrent intubation and reinstitution of ventilation. All infants underwent spirometric evaluation and six also had endoscopic examination during simulated agitation episodes (elicited by toe pinching). All babies were found to have a very prolonged near zero expiratory airflow pattern, accompanied by vigorous diaphragmatic and abdominal muscle activity and rapid development of hypoxia. Six patients had endoscopically documented tracheal collapse under the same simulated circumstances. The episodes ceased with calming or sedation of the infants. © 1992 Wiley‐Liss, Inc.
Response to inhaled bronchodilators and nonspecific airway hyperreactivity in children with cystic fibrosis
Authors: Sanchez Ignacio , Powell Richard E. , Chernick Victor 
Published: March 2007

AbstractWe tested the hypothesis that children with CF who have a significant response to bronchodilator (ED) would respond positively to standard methacholine (Mch) challenge. Our objective was to correlate the response to BD with the concentration that produced a 20% fall (PC20) in forced expiratory volume in 1 second (FEV1). We studied 22 patients (12 males), aged 10.5 ± 0.7 years (mean ± SE), with a Shwachman‐Kulczycki score 82 ± 2.6 and baseline FEV11 of 80 ± 4.5% predicted. Baseline expiratory flows, static lung volumes, and airway resistance were measured before and 30 min after inhaled salbutamol. On a separate day, within 2 weeks, a Mch challenge was given, with doubling concentrations from 0.03 to 8.0 mg/mL. A positive challenge was defined as a PC20≦ 2.0 mg/mL, and a positive response to BD as a >6%0 of FEV1 increase. Mch challenge yielded 17 responders (R) with a PC20 of 0.5 ± 0.1 mg/mL, and 5 nonresponders (NR) with a PC20 of 8.8 of 2.9 mg/mL. Baseline FEV11 was 77 ± 5.3% predicted in R compared to 89 ± 6.3% in NR (P = < 0.001). History of springtime rhinitis was positive in 9/17 R and 2/5 NR. No significant correlation was found between baseline FEV1 1 and PC20 or between change in FEV1 1 post‐BD and PC20 A >6% increase in FEV1 1 was seen in 14/17 R (83% sensitivity) and in none of the 5 NR (100% specificity). In R, 8/17 patients had baseline FEV1 1 < 80% predicted, compared to 1/5 in NR. We conclude that a change in FEV11 > 6% from baseline after bronchodilator in children with CF suggests nonspecific airway hyperreactivity. © 1992 Wiley‐Liss, Inc.
Soluble interleukin‐2 receptor levels in infants with bronchopulmonary dysplasia
Authors: Stefano John L. , Spear Michael L. , Pearlman Stephen A. , Fawcett Paul , Proujansky Roy 
Published: March 2007

AbstractSoluble interleukin‐2 receptors (sIL2R) in plasma have been identified as a marker of lymphocyte activation. Lymphocyte activation as a manifestation of inflammation may be important in the pathogenesis of bronchopulmonary dysplasia (BPD). To test the hypothesis that infants with BPD have higher slL2R levels, 12 infants with or at risk of developing BPD (GA ± SD, 27 ± 5 weeks; BW ± SD 1,053 ± 733 g) had plasma slL2R levels determined and were compared to 20 infants being ventilated for respiratory distress syndrome (RDS) (GA 2 SD, 28 ± 3.5 weeks; BW ± SD, 1,133 ± 390 g: P=NS for both GA and BW, t test). Tracheal aspirates in both groups were also analyzed for slL2R levels. To control for the effects of postnatal age (PNA) and study weight (SW) on the slL2R levels, another group of 16 nonventilated babies (NVB) had plasma analyzed for slL2R (PNA t SD: 39 ± 40 days NVB vs. 48 ± 36 days BPD; P =NS); (SW ± SD: 1391 ± 250 g NVB vs. 1212 ± 700 g BPD; P =NS). The following data were obtained for the plasma slL2R levels (mean 2 SEM U/mL): RDS controls, 1,231 ± 80; BPD infants, 1,790 ± 120; NVB controls, 1,319 ± 76; P =0.0005 RDS vs. BPD and P =0.002 BPD vs. NVB. There was no significant difference in the sIL2R levels for the infants at risk of developing BPD vs. the infants with established BPD. Also, when analyzed separately, infants at risk of BPD and the infants with established BPD had higher slL2R levels than the RDS and NVB controls. No differences were noted in the tracheal slL2R levels in the BPD vs. RDS groups. These data indicate that infants with BPD had significantly higher slL2R levels in plasma than either RDS or NVB controls. Therefore, lymphocyte activation may play a role in the pathogenesis of BPD. © 1992 Wiley‐Liss, Inc.
The relationship of nasal disorders to lower respiratory tract symptoms and illness in a random sample of children
Authors: Barr Marisa B. , Weiss Scott T. , Segal Mark R. , Tager Ira B. , Speizer Frank E. 
Published: March 2007

AbstractWe examined the relationship of nasal disorders, defined as frequent colds and sinus trouble, to lower respiratory tract symptoms in a random population of 718 children aged 4 to 11 years in East Boston, Massachusetts. Frequent colds were significantly associated with maternal smoking (odds ratio (OR) = 3.00; 95% confidence interval (Cl) = 1.97, 4.58), and so was sinus trouble (OR = 4.73; 95% Cl = 1.78, 12.51). After adjustment for maternal smoking, age and sex, frequent colds (OR = 2.88; 95% Cl = 1.87, 4.42) and sinus trouble (OR = 4.95, 95% CI = 1.83, 13.39) remained significant predictors of lower respiratory tract symptoms in separate logistic regressions. If one restricted the cohort to the 513 children who also had personal smoking information and adjusted for this variable as well, the results for colds were unchanged (OR = 2.94; 95% Cl = 1.78, 4.84) but the results for sinus trouble were now not statistically significant (OR = 2.30, 95% Cl = 0.67, 7.94). We conclude that nasal disorders are associated with lower respiratory tract symptoms in children. © 1992 Wiley‐Liss, Inc.
Respiratory compliance in infants—a preliminary evaluation of the multiple interrupter technique
Authors: Fletcher M. E. , Dezateux C. A. , Stocks J. 
Published: March 2007

AbstractMeasurements of total respiratory system compliance (Crs) using the multiple occlusion technique (MOT) in spontaneously breathing infants can be difficult to interpret in the presence of an unstable end‐expiratory level. Similarly, measurements using the passive flow volume technique (PFV) are invalidated if there is a linearity of the expiratory time constant (Trs), irrespective of respiratory effort. For possibly overcoming these problems, we assessed the feasibility of a technique using multiple interruptions of of a single expiration (MIT), obtaining several pairs of volume‐pressure data, from one expiration, which relate to a single end‐expiratory level.Crs was measured in 16 infants aged 0.5 to 20 months using the MOT, MIT, and PFV technique. The MOT and the MIT each failed in one (different) infant, both succeeding where the other failed. The PFV technique failed in five infants in whom no acceptable plateau of airway pressure during occlusion and no Trs could be obtained from a single breath. Failure to obtain a linear Trs was accompanied by failure of the MIT in only one infant. Individual differences between the MIT and the MOT were less than 9%. However, the PFV measurements varied from −16.3% to +25.7% of the values from MIT or MOT. The greatest differences between Crs values coincided with the greatest differences between volume intercepts of the extrapolated volume‐pressure (MOT, MIT) and flow‐volume (PFV) data.From this preliminary study, the MIT proved as successful as the MOT, requiring fewer occluded breaths to measure Crs. In infants with a rapid respiratory rate, the data from several expirations can be merged and analyzed as for the MOT. © 1992 Wiley‐Liss, Inc.
A scoring system for lung function tests in infants
Authors: Hampton F. , Beardsrnore C. S. , Morgan W. , Williams A. , Taussig L. , Thompson J. R. 
Published: March 2007

AbstractMeasurements of thoracic gas volume (TGV), airway resistance (Raw), and airway conductance (Gaw) were calculated in a group of 42 normal infants using a whole‐body plethysmograph. Maximum expiratory flow at functional residual capacity was measured in a separate group of 108 normal infants. Using data obtained from these infants the following regression equations were calculated:

The standard errors of prediction are a measure of the scatter of individual results from the normal population about the true regression line. They were used to define limits of the normal ranges for these tests of lung function, and to develop a scoring system. This approach is preferable to expressing results as percent predicted, which gives no indication of how likely a measurement is to be within normal limits. © 1992 Wiley‐Liss, Inc.