bluuebunny/crossref_metadata_2025_split huggingface dataset:
Beneficial effects of hydrocortisone and papaverine on a model of pulmonary embolism induced by autologous blood clots in isolated and perfused rabbit lungs
Authors: TREJO Humberto E. , URICH Daniela , PEZZULO Alejandro A. , CARABALLO Juan C. , GUTIÉRREZ Jeydith , CASTRO Ignacio J. , CENTENO Greenmy R. , SÁNCHEZ DE LEÓN Roberto 
Published: November 2007

Background and objective:  Mechanical obstruction has been considered the prime determinant of haemodynamic changes after pulmonary embolism (PE); however, the function of vasoconstrictive and inflammatory mediators in the physiopathology of this disease is unclear. The aim of this investigation was to study the effect of an anti‐inflammatory and a vasodilator in a setting of induced PE.Methods:  A prospective, laboratory study was undertaken using 30 New Zealand white rabbits. A model of isolated and perfused rabbit lungs was used; PE was induced using autologous blood clots. Six study groups were established (each n = 5): PE without any drug (PG); PE + papaverine (PpG); PE + hydrocortisone (HG); PE in West's Zone III (ZIIIG); PE using acellular perfusate (AG) and PE using acellular perfusate + papaverine (APpG). The pulmonary artery pressure (PAP) and fluid filtration rate (FFR) were continuously measured during the experiments.Results:  Increases in PAP and oedema formation were observed in the PG after embolization. The PpG and the APpG showed neither oedema nor significant PAP increases. The HG group developed less oedema and less increase in PAP compared with the PG. The ZIIIG developed oedema the fastest. The AG developed less oedema and increases in PAP compared with the PG.Conclusion:  These findings suggest that vasoconstriction and inflammatory mediators play an important role in the physiopathology of PE, as neither PAP increases nor oedema were observed in the PpG and a reduction of oedema and PAP was seen in the HG group. The decrease in oedema and PAP in the acellular group strongly suggests a key role of circulating blood cells.
Surfactant degradation activity in bronchoalveolar lavage fluid from guinea pigs challenged with antigen
Authors: ABO Miki , KURASHIMA Kazuyoshi , FUJIMURA Masaki , MYOU Shigeharu , NAKAO Shinji , TASHIRO Katsumi , KOBAYASHI Tsutomu 
Published: November 2007

Background and objective:  Surfactant dysfunction is a characteristic of bronchial asthma, but mechanisms of dysfunction following antigen exposure are not understood. The aim of this study was to examine whether bronchoalveolar lavage fluid (BALF) has surfactant degradation activity after antigen challenge, using an animal model of asthma.Methods:  BALF was collected 24 h after a challenge with aerosolized antigen solution in actively sensitized guinea pigs and from non‐sensitized control guinea pigs. The surface tension of BALF was measured by pulsating bubble surfactometer. Surfactant activity was expressed as the minimum surface tension of BALF after 5 min of pulsation. BALF was separated into a cellular phospholipid fraction and supernatant, and reconstituted into ‘pellet + supernatant’ and ‘pellet + saline’ fractions.Results:  Surfactant activity of BALF from sensitized antigen‐challenged animals was reduced after 4 h of incubation at 37°C but a decrease was not observed in BALF from non‐sensitized control animals. The decrease of surfactant activity in BALF from challenged animals was prevented by incubation at 4°C. Disappearance of surfactant activity after incubation at 37°C was observed in the ‘pellet + supernatant’, but not in the ‘pellet + saline’ fraction. The decrease of surfactant activity in BALF was also partially suppressed by the secretory phospholipase A2 inhibitor, indoxam, and by a cocktail of protease inhibitors.Conclusion:  Surfactant‐degrading activity was present in the supernatant of BALF from antigen‐challenged guinea pigs. This activity may be attributed to secretory phospholipase A2 and to proteases present in the antigen‐challenged airway.
Design and validation of an interpretative strategy for cardiopulmonary exercise tests
Authors: SCHMID Andreas , SCHILTER Daniel , FENGELS Ingo , CHHAJED Prashant N. , STROBEL Werner , TAMM Michael , BRUTSCHE Martin H. 
Published: November 2007

Background and objective:  Cardiopulmonary exercise testing (CPET) is a common investigation for the evaluation of exertional dyspnoea. At present, there is no consensus on the best interpretative strategy and none of the available algorithms have been validated. The aim of this study was to develop and validate a standardized strategy for the interpretation of CPET.Methods:  This study analysed 199 CPETs from patients with exertional dyspnoea. Using a set of 100 CPETs a standardized interpretation using a four‐step approach was developed that scored: examination quality, performance, exercise limitation and cofactors. A second set of 99 CPETs was interpreted by two experts in the field, initially independently and then in a consensus conference. The standardized interpretation was compared with each expert, the expert's consensus and the original clinical reports.Results:  Matching between the standardized interpretation strategy and the expert consensus was 82%, 82% with one expert and 86% with a second expert and 64% with the original clinical reports. From one to four exercise‐relevant cofactors were found in 77% of the patients.Conclusion:  The standardized interpretation showed a precision comparable to the opinion of a single expert and significantly improved the consistency in CPET reports in a pulmonary centre with different physicians and varying degrees of expertise.
Latent tuberculosis infection in a military setting diagnosed by whole‐blood interferon‐γ assay
Authors: CHOI Chang‐Min , HWANG Seung Sik , LEE Chang‐Hoon , LEE Hye Won , KANG Cheol‐In , KIM Chang‐Hoon , HAN Sung Koo , SHIM Young‐Soo , YIM Jae‐Joon 
Published: November 2007

Background and objectives:  Rapid and accurate diagnosis of latent tuberculosis infection (LTBI) is crucial in military settings. This study aimed to detect the prevalence of LTBI using a whole‐blood interferon‐γ assay based on Mycobacterium tuberculosis‐specific antigens, and to identify risk factors for LTBI among military personnel in contact with patients with active pulmonary TB.Methods:  This prospective study investigated contacts in military camps in South Korea of soldiers with active pulmonary TB. The whole‐blood interferon‐γ assay was performed using QuantiFERON TB‐Gold.Results:  Among the 175 contacts, 25 (14.3%) showed positive results to the assay. Long duration of exposure (OR 2.83; 95% CI: 1.63–4.91), laryngeal TB (OR 6.04; 95% CI: 1.54–23.67) and intensive exposure (OR 5.13; 95% CI: 1.63–16.12) were associated with a positive result.Conclusions:  A relatively small number of TB contacts in a military setting had LTBI.
13C‐phenylalanine breath test correlates with liver fibrosis in postoperative biliary atresia
Authors: WADA MASAKI , WADA YUKO , UCHIYAMA MAKOTO , KAJIWARA MASAHIRO , TAKATORI KAZUHIKO 
Published: November 2007

AbstractBackground: Values derived from the 13C‐phenylalanine breath test (PBT) may serve as an index for liver fibrosis and clinically predictive readings for liver diseases in adults. In the present study the PBT was conducted in postoperative biliary atresia (BA) children to evaluate phenylalanine metabolism in the liver, and the results based on biochemical data, especially the index on liver fibrosis, were compared with PBT findings.Methods: Hepatofunctional evaluations were conducted in 10 postoperative BA children with moderate (group B; n = 4) and severe (group A; n = 6) liver dysfunction, and the PBT results were compared with those of 13 normal healthy children (group C). Subjects were orally given single‐bolus 13C‐phenylalanine at 3.5 mg/kg (maximum dosing: 100 mg) in the morning. Time‐related exhaled gas was periodically collected until 120 min after dosing. The 13CO2 levels were monitored with gas chromatography–mass spectrometry before and after administration, and the 13C excretion rate, 13C cumulative excretion and time of maximum 13C excretion rate were monitored accordingly.Results: Total bile acid, hyaluronic acid, type IV collagen 7S, total bilirubin or albumin and the PBT findings were significantly correlated. The PBT findings in group A were significantly lower those of group B, indicating that phenylalanine metabolism was markedly attenuated in the former.Conclusion: The PBT values correlated well with liver fibrosis in postoperative BA children. Because PBT is a non‐invasive approach, results from this method may serve as a useful and reliable index for post‐surgical monitoring of children operated on for liver fibrosis.
Correlation between white blood cell count and metabolic syndrome in adolescence
Authors: HSIEH CHANG‐HSUN , PEI DEE , KUO SHI‐WEN , CHEN CHENG‐YU , TSAI SHIH‐LI , LAI CHUN‐LUNG , LEE CHIEN‐HSING , WU CHUNG‐ZE , HUNG YI‐JEN , HSIEH MING‐CHEN 
Published: November 2007

AbstractBackground: Metabolic syndrome (MetS) is associated with increased risk for diabetes and coronary heart disease. Data suggest that MetS starts even in children. Thus, it is important to understand the role of MetS and the risks related to it. Furthermore, white blood cell count (WBCC) is available in routine examination and it has been proved to be related to risks of MetS.Methods: A total of 1657 subjects aged 14–19 years were enrolled, with normal WBCC (≤10 × 109 cells/L). The subjects were divided into four quartiles according to WBCC (WBCC1–4, from the lowest to highest WBCC) in both genders.Results: The female subjects had significantly lower systolic blood pressure, fasting plasma glucose (FPG), triglyceride (TG), body mass index (BMI) and higher high‐density lipoprotein‐cholesterol (HDL‐C) than the male subjects. When comparing the risks of the quartiles of WBCC, WBCC4 had significant higher BMI than WBCC1 and WBCC2 in both genders; and lower HDL‐C than WBCC3 in male subjects. On multiple regression WBCC was positively related with BMI and TG and negatively related to HDL‐C in male subjects. In female subjects only BMI was positively correlated with WBCC. Subjects with MetS did not have significant higher WBCC than those without MetS.Conclusions: In adolescents with normal WBCC, BMI is significantly related to the levels of WBCC and is the earliest component of MetS to be noted in adolescents. Elevated TG and decreased HDL‐C could also be important markers for future risk factors only in male subjects.
Immunoadsorbent apheresis eliminates pathogenic IgG in childhood lupus nephritis
Authors: TAKAHASHI SHORI , WADA NAOHIRO , HARADA KENSUKE 
Published: November 2007

AbstractBackground: It is suggested that the highly cation‐charged fraction of the IgG and IgG3 subclasses may play a pathogenic role in lupus nephritis. In contrast, immunoadsorbent therapy using a sodium dextransulfate fixed cellulose gel column–low invasive selective immunoadsorbent apheresis therapy (SDSC‐IAT) has been applied to lupus nephritis with favorable results. However, elimination using pathogenic IgG by SDSC‐IAT has never been investigated.Method: Two patients with diffuse proliferative lupus nephritis were treated using SDSC‐IAT concomitant with immunosuppressive therapy. The eluates from the SDSC, and the patients’ serum obtained before and just after SDSC‐IAT were subjected to an IgG charge analysis using isoelectric focusing and immunoblotting, and also to laser nephelometry assay, which is used for measuring IgG subclass concentration. Indirect immunofluorescence staining was performed to detect IgG subclass deposition in the glomerulus.Results: Both of the patients had an immediate decrease in anti‐double‐strand DNA antibody and in the circulating immune complex with a following clinical improvement. Repeated biopsies demonstrated improvement of glomerular lesions with a marked reduction of IgG and C3 deposition. The IgG of the SDSC eluates consisted of highly cation charged (isoelectric points: 9–10) fractions. In addition, IgG3 was specifically removed from the patients’ serum using an SDSC among the IgG subclasses. The subclass of deposited IgG in the glomeruli showed IgG3 predominance.Conclusion: SDSC‐IAT specifically removed the highly cation charged fractions of IgG and IgG3 from the patients’ serum and the elimination of these fractions may have resulted in clinical improvement.
Home mechanical ventilation in children: Retrospective survey of a pediatric population
Authors: OTTONELLO GIANCARLO , FERRARI ILARIA , PIRRODDI INES MARIA GRAZIA , DIANA MARIA CRISTINA , VILLA GIOVANNA , NAHUM LAURA , TUO PIETRO , MOSCATELLI ANDREA , SILVESTRI GILBERTO 
Published: November 2007

AbstractBackground: Home care support is beneficial for children needing mechanical ventilation, when clinically stable.Methods: A retrospective analysis was carried out of the long‐term home ventilation management of a pediatric population with chronic respiratory failure composed of 20 ventilator‐dependent children categorized according to age, diagnosis and ventilation support. Age groups consisted of 10% under 1 year, 30% between 2 and 5 years, 30% between 6 and 12 years, and 30% older than 12 years. Diagnostic categories included myopathic disorder, n = 5; congenital central hypoventilation syndrome, n = 6; chest wall disorder, n = 5; cystic fibrosis, n = 1; pulmonary hypertension, n = 1; and diaphragmatic paralysis, n = 2.Results: Sixty‐five percent were ventilated using non‐invasive mode (NIMV): eight with nasal mask, five with full‐face mask, and two children in NIMV also used negative pressure mode; 35% were ventilated using tracheostomy, one of them also used a diaphragmatic pacer. Seventy percent needed nocturnal ventilatory support, (20% 12–18 h, 10% full‐day). A total of 18 children were included in the home care and follow‐up program. Two children died: one because of worsening of his chronic disease and one because of septic shock.Conclusion: Although home care ventilation is not yet widely diffused, it represents a valid alternative to long hospitalization for children with stable chronic respiratory failure.
Quantitative measurements of Hemophilus influenzae type b capsular polysaccharide antibodies in Japanese children
Authors: ISHIWADA NARUHIKO , FUKASAWA CHIE , INAMI YUKIKO , HISHIKI HARUKA , TAKEDA NOBUE , SUGITA KATSUO , KOHNO YOICHI 
Published: November 2007

AbstractBackground: Hemophilus influenzae type b (Hib) infection has a high morbidity and mortality rate in children. The frequency of natural immunity against Hib in Japanese children is not known, and Hib vaccine has not yet been introduced in Japan.Methods: Anti‐capsular polysaccharide‐specific IgG (anti‐CP) antibody titers were examined in serum samples from 100 children and 107 young adults who were not vaccinated against Hib, in serum samples from eight patients with Hib systemic infection and in 10 commercially available human immune globulin preparations on enzyme‐linked immunosorbent assay.Results: A total of 44% (44/100) of Japanese children and all patients with Hib systemic infection in the acute phase did not have the minimum protective level of anti‐CP antibodies (>0.15 μg/mL). The rate of natural Hib immunity was lowest in children under 1 year of age and gradually increased with age. Only 3.74% (4/107) of Japanese young adults did not have the minimum protective level of anti‐CP antibodies. Analysis of 10 commercially available human immune globulin preparations indicated an average level of 28.25 μg anti‐CP antibody/mL immune globulin (range 14.96–44.17 μg/mL).Conclusions: Approximately half of Japanese children are not protected against Hib infection. Therefore, Hib vaccine should immediately be included as part of the routine immunization program in Japan. It was also found that all tested commercially available immune globulin preparations had high anti‐CP titers. Well‐controlled clinical trials of i.v. immune globulin administration for prevention and treatment of Hib systemic infection are needed in Japan.
Post‐mortem analysis for two prevalent β‐oxidation mutations in sudden infant death
Authors: YANG ZI , LANTZ PATRICK E , IBDAH JAMAL A 
Published: November 2007

AbstractBackground: Fatty acid oxidation disorders may cause sudden and unexpected infant death and are associated with the histological hallmark of hepatic steatosis. The goal of the present study was to assess the value of post‐mortem molecular analysis for medium‐chain acyl‐coenzyme A dehydrogenase (MCAD) and mitochondrial trifunctional protein (MTP) defects in unexplained sudden infant death (SID) associated with fatty infiltration of the liver. MCAD catalyzes the first step of medium‐chain fatty acid oxidation while MTP catalyzes the last three steps of long‐chain fatty acid oxidation.Methods: In a retrospective study, 220 consecutive cases of sudden and unexplained infant death certified by medical examiners at Wake Forest University Medical Center were assessed for hepatic steatosis. Subjects with evidence of hepatic steatosis were screened for mutations in MCAD and MTPα‐subunit using DNA isolated from paraffin‐embedded liver tissue, single‐strand conformation variance, and nucleotide sequence analyses.Results: Sixteen cases (7.3%) were associated with diffuse micro‐vesicular or mixed micro‐ and macro‐vesicular hepatic steatosis. Two of these 16 cases (12.5%) had disease‐causing mutations. One was homozygous for the prevalent MCAD A985G mutation. The second was a compound heterozygous for the prevalent MTP G1528C mutation and a novel 1 bp deletion in exon 18 of the MTPα‐subunit gene.Conclusions: A significant proportion (7.3%) of SID is associated with hepatic steatosis. The present data support post‐mortem molecular analysis for the MCAD A985G and MTP G1528C prevalent mutations in cases of sudden and unexplained infant death associated with hepatic steatosis.
Impaired transient elevation of blood hemoglobin in response to acute hypoxia in neonates with asplenia
Authors: OKA TATSUJIRO , ITOI TOSHIYUKI , HAMAOKA KENJI 
Published: November 2007

AbstractBackground: It has been shown that acute hypoxia induces the transient elevation of blood hemoglobin concentration ([Hb]) as a consequence of sympathetic‐mediated splenic contraction to maintain the supply of oxygen, and splenectomy abolishes this phenomenon. The purpose of the present paper was to determine, retrospectively, whether the ability of transient elevation of [Hb] against acute hypoxia would be impaired in neonates with asplenia.Method: Eleven neonates who underwent surgery from 1998 to 2003 were enrolled in this retrospective study. They were divided into two groups: (i) five patients with asplenia syndrome with cyanotic congenital heart disease (asplenia group); and (ii) six patients with hypoplastic left heart syndrome who needed nitrogen gas inhalation therapy (HLHS group). In the asplenia group simultaneous data of arterial oxygen saturation (Sao2) and [Hb] were obtained before and after the temporary unexpected decrease of percutaneous arterial oxygen saturation. In the HLHS group they were obtained before and after nitrogen gas administration therapy. The arterial oxygen content (Cao2) changes and the ratio of Cao2 change (Cao2 after hypoxia divided by Cao2 before hypoxia) were also calculated.Results: In the asplenia group [Hb] was unchanged (12.9 ± 1.6 g/dL to 12.8 ± 1.4, n.s.) and Cao2 was decreased (14.5 ± 1.6 mL/dL to 11.9 ± 1.1, P = 0.018). In the HLHS group [Hb] was increased (14.6 ± 1.3 g/dL to 15.4 ± 1.5, P = 0.028), but Cao2 was changed (18.2 ± 2.2 mL/dL to 16.7 ± 3.0, P = 0.043). The ratio of Cao2 change for the HLHS group was significantly different from that of the asplenia group (0.92 ± 0.10, 0.83 ± 0.10, respectively, P = 0.02).Conclusions: Patients with asplenia syndrome have some disadvantage regarding this protective mechanism against acute hypoxia.
Neonatal subgaleal hemorrhage: Clinical presentation, treatment, and predictors of poor prognosis
Authors: CHANG HUNG‐YANG , PENG CHUN‐CHIH , KAO HSIN‐AN , HSU CHYONG‐HSIN , HUNG HAN‐YANG , CHANG JUI‐HSING 
Published: November 2007

AbstractBackground: Neonatal subgaleal hemorrhage (SGH) is a rare but potentially lethal medical emergency. The objective of the present retrospective study was to clarify the clinical presentation, management, and factors associated with morbidity and mortality.Methods: The records of all newborns from January 1995 to December 2004 were reviewed for evidence of SGH, based on the presence of a fluctuating hemorrhagic mass that crossed suture lines and extended toward the neck. Characteristics were compared between those with a poor or a good outcome.Results: Forty‐two newborns with SGH were identified, 77% having had an instrumental delivery. The incidence was 0.6/1000 deliveries and 4.6/1000 vacuum‐assisted deliveries. Thirteen patients (31%) had a poor outcome (five died, four had epilepsy, three with severe auditory dysfunction, two with cerebral palsy, and one with renal vein thrombosis). The group with the poor outcome had significantly more patients who had been transferred from other hospitals (P < 0.001). Those with a poor outcome had significantly more hypotension (P < 0.001) and seizures (P < 0.05). Laboratory findings associated with a poor outcome included anemia, coagulopathy, metabolic acidosis, and renal impairment. Other predictors of a poor prognosis included skull bone fracture, the need for pressors, blood transfusion, ventilator support, intensive care unit admission, and a longer hospital stay.Conclusions: SGH may be associated with serious complications and death. The condition must be recognized promptly and monitored closely. Those with poor prognostic factors should be referred for intensive care, treated aggressively, and followed in the long term.
Prevalence and clinical findings of migraine and tension‐type headache in adolescents
Authors: UNALP AYCAN , DIRIK ERAY , KURUL SEMRA 
Published: November 2007

AbstractBackground: The majority of previous studies on headache in children and adolescents have focused mainly on migraine. There is a paucity of population‐based studies investigating the prevalence of tension‐type headache (TTH). The objectives of the present study were to estimate the prevalence of migraine and TTH in adolescents using the 2004 International Headache Society (IHS) criteria and to determine the sociodemographic and clinical differences between the migraine and TTH.Methods: Stratified group sampling was used in the present analytic, school‐based, cross‐sectional study. From the city of Izmir, 2384 students aged 14–18 years were invited to complete a questionnaire.Results: Migraine was found to be more common than TTH (21.3% vs 5.1%). The prevalence increased considerably to 29.9 and 15%, respectively, when the criteria defining the number and duration of headaches were excluded. All types of headaches were more frequent in female subjects but no significant difference was found in gender between the headache groups (P= 0.073). Headache in temples, number of siblings (more than one sibling), mother’s and father’s education (at least high school graduation) were more commonly seen in students with TTH. Absenteeism rate due to the headache was found to be higher in the migraine group than in the TTH group (P= 0.000).Conclusions: Migraine and TTH were found to be common types of headaches in adolescents. It was thought that, with the use of modified IHS criteria, the number of undiagnosed patients with headache will decrease.