bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nonlinear Measures of Respiration: Respiratory Irregularity and Increased Chaos of Respiration in Patients with Panic Disorder
Authors: Yeragani Vikram Kumar , Radhakrishna Rao K.A. , Tancer Manuel , Uhde Thomas 
Published: April 2003

<i>Background:</i> Respiratory irregularity has been previously reported in patients with panic disorder using time domain measures. However, the respiratory signal is not entirely linear and a few previous studies used approximate entropy (APEN), a measure of regularity of time series. We have been studying APEN and other nonlinear measures including a measure of chaos, the largest Lyapunov exponent (LLE) of heart rate time series, in some detail. In this study, we used these measures of respiration to compare normal controls (n = 18) and patients with panic disorder (n = 22) in addition to the traditional time domain measures of respiratory rate and tidal volume. <i>Methods:</i> Respiratory signal was obtained by the Respitrace system using a thoracic and an abdominal belt, which was digitized at 500 Hz. Later, the time series were constructed at 4 Hz, as the highest frequency in this signal is limited to 0.5 Hz. We used 256 s of data (1,024 points) during supine and standing postures under normal breathing and controlled breathing at 12 breaths/min. <i>Results:</i> APEN was significantly higher in patients in standing posture during normal as well as controlled breathing (p = 0.002 and 0.02, respectively). LLE was also significantly higher in standing posture during normal breathing (p = 0.009). Similarly, the time domain measures of standard deviations and the coefficient of variation (COV) of tidal volume (TV) were significantly higher in the patient group (p = 0.02 and 0.004, respectively). The frequency of sighs was also higher in the patient group in standing posture (p = 0.02). In standing posture, LLE (p < 0.05) as well as APEN (p < 0.01) contributed significantly toward the separation of the two groups over and beyond the linear measure, i.e. the COV of TV. <i>Conclusion:</i> These findings support the previously described respiratory irregularity in patients with panic disorder and also illustrate the utility of nonlinear measures such as APEN and LLE as additional measures toward a better understanding of the abnormalities of respiratory physiology in similar patient populations as the correlation between LLE, APEN and some of the time domain measures only explained up to 50–60% of the variation.
Handwashing Patterns in Two Dermatology Clinics
Authors: Cohen H.A. , Kitai E. , Levy I. , Ben-Amitai D. 
Published: April 2003

<i>Background:</i> The hands of health care workers are a major source of nosocomial infection. Studies conducted mainly in intensive-care units and emergency departments have shown low compliance with hand hygiene recommendation. <i>Objective:</i> To study hand hygiene practices in outpatient dermatology clinics in Israel. <i>Methods:</i> The fingers of 13 dermatologist physicians were sampled for bacterial cultures and their hand hygiene practices were monitored by two observers. In addition, 51 dermatologists attending a professional conference completed a questionnaire on hand hygiene practice. <i>Results:</i> All the physicians’ hands were found to be contaminated. <i>Staphylococcus aureus</i> was isolated in 9 cases (69.2%), a methicillin-resistant <i>S. aureus </i>in 1 (7.7%). Monitoring revealed 555 opportunities for handwashing; the average compliance was 31.4%. In the questionnaire, the main reasons given for poor hand hygiene were excessive work schedule (58%), lack of awareness (35.3%), reaction to disinfectants (17.7%) and lack of readily available facilities (15.7%). <i>Conclusion:</i> The hands of dermatologists are frequently colonized with microbial pathogens, but compliance with hand hygiene practice recommendations is low, despite a fairly high awareness of the importance. An active educational infection control program should be introduced in dermatology clinics.
In vitro Acid Resistance of CO<sub>2</sub>and Nd-YAG Laser-Treated Human Tooth Enamel
Authors: Tsai Chia-Ling , Lin Yng-Tzer , Huang Shun-Te , Chang Hseuh-Wen 
Published: April 2003

The purposes of this study were to test the effectiveness of laser treatment (pulsed CO<sub>2</sub> and pulsed Nd-YAG) on in vitro acid resistance of human enamel. Thirty enamel surfaces were prepared from 10 extracted permanent premolars (3 surfaces per tooth). Two experimental surfaces on each tooth were irradiated with either CO<sub>2</sub> or Nd-YAG lasers. All specimens were demineralized in 10 ml lactate buffer for 24 or 72 h after laser treatment. After 24-hour acid treatment the mean concentration of calcium that dissolved into the lactate buffer in the CO<sub>2</sub> laser group was significantly less than in the control group, while the dissolved calcium concentration in the Nd-YAG laser group did not differ from the control group (p > 0.05). The erosion depth in the CO<sub>2</sub> laser group was significantly shallower than in the Nd-YAG laser group (p < 0.001). After 72-hour acid treatment, the acid resistances of neither group of laser-treated surfaces differed significantly from the controls. By scanning electron microscopy, the acid-eroded laser-treated enamel surfaces had type I and type II etching patterns, fissures, and disordered rough surfaces compared to control enamel, with a regular type II etching pattern. CO<sub>2</sub> laser-treated tooth enamel was more resistant to acid challenge than was Nd-YAG laser-treated enamel, given the same fluence, but neither type of laser increased acid resistance of subsurface enamel.
An Economic Evaluation of Donepezil in Mild to Moderate Alzheimer’s Disease: Results of a 1-Year, Double-Blind, Randomized Trial
Authors: Wimo Anders , Winblad Bengt , Engedal Knut , Soininen Hilkka , Verhey Frans , Waldemar Gunhild , Wetterholm Anna-Lena , Mastey Vera , Haglund Anders , Zhang Richard , Miceli Robert , Chin Warren , Subbiah Ponni 
Published: April 2003

The costs and consequences of donepezil versus placebo treatment in patients with mild to moderate Alzheimer’s disease (AD) were evaluated as part of a 1-year prospective, double-blind, randomized, multinational clinical trial. Patients received either donepezil (n = 142; 5 mg/day for 28 days followed by 10 mg/day according to the clinician’s judgement) or placebo (n = 144). Unit costs were assessed in 1999 Swedish kronas (SEK) and converted to US dollars (USD). Donepezil-treated patients gained functional benefits relative to placebo on the Progressive Deterioration Scale (p = 0.042) and Instrumental Activities of Daily Living scale (p = 0.025) at week 52. Caregivers of donepezil-treated patients spent an average of 400 h less annually providing care than caregivers of placebo-treated patients. Mean annual healthcare costs were SEK 137,752 (USD 16,438) per patient for the donepezil group and SEK 135,314 (USD 16,147) in the placebo group. With the average annual cost of donepezil at SEK 10,723 (USD 1,280) per patient, the SEK 2,438 (USD 291) cost difference represented a 77% cost offset. When caregiver time and healthcare costs were included, mean annual costs were SEK 209,244 (USD 24,969) per patient in the donepezil group and SEK 218,434 (USD 26,066) in the placebo group, a total saving associated with donepezil treatment of SEK 9,190 (USD 1,097) per patient [95% CI of SEK –43,959 (USD –5,246), SEK 25,581 (USD 3,053); p = 0.6]. The positive effects on the efficacy outcome measures combined with no additional costs from a societal perspective indicate that donepezil is a cost-effective treatment, representing an improved strategy for the management of patients with AD.
A Method for Incorporating Ages at Onset in Affected Sibpair Linkage Studies
Authors: Hsu L. , Li H. , Houwing-Duistermaat J.J. 
Published: April 2003

Data with varying age at disease onset arise frequently in studies of mapping disease associated genes. Naively combining affected subjects with different ages at onset may result in a much reduced power in detecting the disease genes. In this paper we present a weighted score test statistic to detect the linkage between marker and latent disease loci using affected sibpairs, where the weight is used for assigning differential contribution due to the varying age at onset of each affected sibpair to the test statistic. We show that the weighted test has a correct type I error rate asymptotically. For an illustrative purpose, we analyze a data set from the 12th Genetic Analysis Workshop. The result shows that the weighted tests appear to be able to pinpoint the location of latent disease genes better than the mean IBD test with equal weight with respect to the age at onset. To avoid the potential power loss due to the improper weight, we propose to use a combined test statistic, taking the maximum of two tests, one that is weighted by the age-dependent penetrance function and the other that may be invariant to the age. We conduct an analytical study, comparing the combined test with weighted and equal weight with respect to age test. It shows that the combined test retains the most power of the better one of the two tests being combined.
Mechanism of the Antihypertensive Effect of Stevioside in Anesthetized Dogs
Authors: Liu Ju-Chi , Kao Pai-Keng , Chan Paul , Hsu Yung-Ho , Hou Chun-Cheng , Lien Gi-Shih , Hsieh Min-Hsiung , Chen Yi-Jen , Cheng Juei-Tang 
Published: April 2003

Stevioside is a sweet-tasting glycoside isolated from the leaves of <i>Stevia rebaudiana</i>. It has been used as a noncaloric sugar substitute in Japan and Brazil for decades. Previous studies have shown that it lowered blood pressure in spontaneously hypertensive rats by intravenous injection. This study was designed to evaluate the hypotensive effect of stevioside in dogs and to define the underlying mechanism. After nasogastric administration of stevioside powder (200 mg/kg), the blood pressure of healthy mongrel dogs began to significantly decrease at 60 min and returned to baseline level at 180 min. The reduction of blood pressure was more rapid (at 5–10 min) and effective after intravenous injection. However, no significant change of blood pressure was noted after injection through left vertebral artery, implicating that the hypotensive effect is not related to the central nervous system. Stevioside also showed significant hypotensive effects in renal hypertensive dogs, in a dose-dependent manner. In cultured rat aortic smooth muscle cells (A7r5 cell line), stevioside can dose-dependently inhibit the stimulatory effects of vasopressin and phenylephrine on intracellular Ca<sup>2+</sup> in a calcium-containing medium. However, no intracellular Ca<sup>2+</sup> inhibitory effect was observed in calcium-free medium, implicating that stevioside may inhibit the Ca<sup>2+</sup> influx from extracellular fluid. Our present data show that stevioside did not influence the calcium ionophore (A23187) induced Ca<sup>2+</sup> influx, indicating that the antagonistic effect was through Ca<sup>2+</sup> channels. This study confirmed that stevioside is an effective antihypertensive natural product, and its hypotensive mechanism may be probably due to inhibition of the Ca<sup>2+</sup> influx.
Evaluation of a Netilmicin-Loading Dose in Very Low Birthweight Infants
Authors: Berger A. , Kretzer V. , Gludovatz P. , Rohrmeister K. , Prusa A.R. , Kohlhauser C. 
Published: April 2003

<i>Background:</i> The bactericidal efficacy of aminoglycosides is directly related to maximum serum concentrations, particularly the initial one. Therefore, several groups have recommended an aminoglycoside loading dose. Our goal was to develop a simplified dosage regimen for preterm infants which would result in therapeutic maximum serum concentrations early in the course of therapy. <i>Methods:</i> Open, noncomparative study during November 2000 to April 2001. The modified netilmicin-dosing protocol included a loading dose of 5 mg/kg in the first week of life, followed by a maintenance regimen of 3.5 mg/kg every 24 h. After the first week of life the corresponding doses were 6 (loading) and 5 mg/kg (maintenance). A peak level was measured 30 min after the second dose, and a trough level immediately before the third dose. <i>Results:</i> Thirty-five very low birthweight infants (mean birthweight 876 ± 170, range 536–1,385 g; mean gestational age 26 ± 1.8, range 23–30 weeks) who had 46 episodes of netilmicin treatment were included in the analysis. Mean netilmicin peak and trough values were 15.9 ± 3.7 (range 8.9–28.9) and 3.4 ± 1.3 (range 1.0–7.8) µmol/l, respectively. Ninety-one percent of all peak levels were within the targeted range of ≧10 µmol/l. Eleven trough values (24%) were ≧4 µmol/l: in 7 instances netilmicin was administered within the first week of life, 5 of these patients had concomitant indomethacin treatment. Only 1 of the 35 neonates had a rise in serum creatinine of ≧0.5 mg/dl during netilmicin therapy. Hearing evaluations were performed in 25 of the 29 surviving infants at discharge home, all of which gave normal results. <i>Conclusions:</i> The new netilmicin-dosing protocol yielded therapeutic maximum serum concentrations in 91% of cases after the second dose. However, a significant number of very low birthweight infants had elevated trough levels, particularly when netilmicin was administered in the first week of life with concomitant indomethacin treatment. We speculate that a longer interval between the loading dose and the first maintenance dose would result in fewer elevated trough levels with a similarly high number of therapeutic peak levels.
Grief Hallucinations: True or Pseudo? Serious or Not?
Authors: Baethge Christopher 
Published: April 2003

An inquiry into the psychopathology and the clinical significance of grief hallucinations is presented and two cases with severe grief hallucinations are described. Unlike many cases in the literature, the two female patients were young (aged 43 and 45, respectively) and both suffered from the loss of a daughter. The heterogeneous concept of grief hallucinations is described and discussed, focusing particularly on the difficulties of reaching a differentiation between hallucination and pseudohallucination. Basic theses of the article are: (1) Contrary to a widely held view, grief hallucinations can display all the characteristics of ‘true’ hallucinations. (2) The concept of grief hallucinations probably comprises a heterogeneous group of disturbances of perception and of thought processes. They can be experienced as comforting but can also cause considerable distress. (3) There are essentially two definitions of pseudohallucinations and they contradict each other. The extremely vague concept of pseudohallucinations appears to be of questionable value and should be abandoned.
The Wireless Capsule: New Light in the Darkness
Authors: Fritscher-Ravens Annette , Swain C. Paul 
Published: April 2003

The development of wireless capsule endoscopy offers the potential to examine the whole small intestine, with its 5-meter length, and has the advantage of being painless. Using a miniature CMOS camera and a short focal length lens, images are obtained, as the optical window of the capsule sweeps past the gut wall, without requiring air inflation of the gut lumen. The capsule endoscope is propelled by peristalsis through the gastrointestinal tract. The video images are transmitted using radiotelemetry to an array of aerials attached to the body which allows image capture. The images are stored on a small portable recorder carried on a belt and subsequently downloaded for analysis. The system allows more than 7 h of continuous recording of images of the gastrointestinal tract. The patients are free to continue their daily routine during the examination. The capsule endoscope has performed well in trials in patients with difficult gastrointestinal bleeding and in comparative studies with push enteroscopy. It has received both a CE mark and FDA approval for use in patients. It has been used to date in about 4,000 patients. The current clinical data are reviewed.
Airway Responsiveness and Airway Remodeling after Chronic Exposure to Procaterol and Fenoterol in Guinea Pigs in vivo
Authors: Nishimura Hideko , Tokuyama Kenichi , Arakawa Hirokazu , Ohki Yasushi , Sato Akira , Kato Masahiko , Mochizuki Hiroyuki , Morikawa Akihiro 
Published: April 2003

<i>Background:</i> Chronic exposure to fenoterol (FEN), a β<sub>2</sub>-adrenergic receptor (β<sub>2</sub>-AR) agonist, was shown to induce both airway hyperresponsiveness and airway remodeling in experimental animals. <i>Objective:</i> We wanted to know the effects of chronic exposure to procaterol (PRO), a β<sub>2</sub>-AR agonist, on airway function and structure, because this agent is widely used as a bronchodilator in Japan. For comparison, the effects of FEN were also examined. <i>Methods:</i> Aerosolized PRO (0.1 or 1 mg/ml), FEN (1 mg/ml) or vehicle (0.9% NaCl) was given to guinea pigs 3 times a day for 6 weeks. Sublaryngeal deposition of these agents was calculated using radioisotopes. At 72 h after the last inhalation of PRO, FEN or vehicle, the dose-response relationship between lung resistance (R<sub>L</sub>) and intravenously administered acetylcholine (ACh) was measured. After measuring R<sub>L</sub>, histological changes in noncartilaginous airway dimensions were evaluated. <i>Results:</i> The amount of sublaryngeal deposition of 0.1 mg/ml PRO in the present study was speculated to be 100 times larger than that of therapeutic dose. ACh concentrations causing 2-fold, 10-fold and maximal increases in R<sub>L</sub> were not different in 4 groups tested. In the smaller membranous airways (<0.4 mm in diameter), but not the larger ones, thickening of adventitial areas was significantly greater in animals treated with β<sub>2</sub>-AR agonists than in control animals (23 and 25, and 96% higher in animals treated with 0.1 and 1 mg/ml PRO or 1 mg/ml FEN, respectively). The degree of the increase was significantly less in PRO-treated animals than in FEN-treated animals (p < 0.01). <i>Conclusion:</i> Our results did not provide any evidence that regular inhalation of PRO at the therapeutic dose might induce bronchial hyperresponsiveness. In addition, huge amounts of PRO only caused a mild thickening of the adventitial areas, suggesting that PRO may be a weak inducer of airway remodeling compared with FEN.
Endogenous Nitric Oxide Production in the Airways of Preterm and Term Infants
Authors: Condò Valentina , Pugni Lorenza , Fumagalli Monica , Mosca Fabio 
Published: April 2003

Few studies have measured endogenous nitric oxide exhaled from the respiratory system of newborn infants. We measured exhaled nitric oxide (eNO) in the first 48 h of life in 24 (13 preterm, 11 term) spontaneously breathing (online method) newborns using a chemoluminescence analyzer. There was a significant difference in the eNO concentration between term and preterm healthy infants in the first 2 days of life (repeated measures analysis of variance, p < 0.05). In term infants there is a peak eNO production in the first hours of life, suggesting a potential role in postnatal adaptation, while in preterm infants eNO production is almost absent at birth, and then gradually increases.
Evaluation of Cerebral Hemodynamics with Perfusion MRI in Childhood Moyamoya Disease
Authors: Kim Seung-Ki , Wang Kyu-Chang , Oh Chang-Wan , Kim In-One , Lee Dong Soo , Song In Chan , Cho Byung-Kyu 
Published: April 2003

The purpose of our study was to evaluate the role of perfusion MRI and to compare the findings with those of conventional imaging in childhood moyamoya disease (MMD). Perfusion MRI was performed preoperatively on 13 cases of childhood MMD. Based on the perfusion MRI findings, patients were classified into four groups: those with normal regional cerebral blood volume (rCBV) and time to peak (TTP) (group 1, n = 2); those with normal rCBV and delayed TTP (group 2, n = 1); those with increased rCBV and delayed TTP (group 3, n = 5), and those with decreased rCBV and delayed TTP (group 4, n = 5). Lesion volume as determined using the rCBV map was compared with that on MRI and single photon emission computerized tomography (SPECT). The characteristics of groups 1, 2 and 3 were a high frequency of transient ischemic attacks, normal finding on MRI, early angiographic stages, decreased reserve on SPECT and favorable operative outcome. In group 3, angiography revealed abundant collateral channels. In group 4, all cases had infarction on MRI and abnormal perfusion on SPECT. Angiographic stages tended to have progressed, and operative outcome was less favorable. Perfusion MRI documented hemodynamic asymmetries in the five cases with normal MRI. Perfusion MRI is suggested to have a sensitivity intermediate between rest and acetazolamide SPECTs. We conclude that perfusion MRI may be a valuable tool for characterizing and monitoring ischemia in MMD. Perfusion MRI provides additional functional information not available from conventional MRI and has a potential role comparable to SPECT in the evaluation of MMD.
Experimental Dispase-Induced Retinopathy Causes Up-Regulation of P2Y Receptor-Mediated Calcium Responses in Müller Glial Cells
Authors: Francke Mike , Uhlmann Susann , Pannicke Thomas , Goczalik Iwona , Uckermann Ortrud , Weick Michael , Härtig Wolfgang , Wiedemann Peter , Reichenbach Andreas , Bringmann Andreas 
Published: April 2003

During proliferative vitreoretinopathy (PVR) Müller glial cells show an up-regulation of their responsiveness to extracellular adenosine 5′-triphosphate (ATP). In the present study, we investigated if such a glial cell response is also a feature for other retinopathies besides PVR. To this aim, the proteolytic enzyme, dispase (0.1 U), was injected into the vitreous of rabbit eyes. After 3 weeks, a distinct retinopathy had developed which showed no signs of PVR. The retinopathy was characterized by strong alterations of the retinal vasculature in the medullary rays, by photoreceptor degeneration, retinal atrophy, and activation of microglial cells. Müller cells became reactive, as indicated by up-regulation of glial fibrillary acidic protein immunoreactivity and by hypertrophy involving subretinal fibrosis. Müller cell reactivity was also evidenced electrophysiologically by a down-regulation of their inwardly rectifying potassium currents and by an up-regulation of their responsiveness to extracellular ATP. Significantly more Müller cells from dispase-treated eyes showed ATP-evoked calcium (83%) and current responses (69%) when compared with cells from control eyes (13 and 9%, respectively). The results indicate that increased responsiveness to extracellular ATP may be a more general feature of Müller cell gliosis, and is also observed in retinopathies besides PVR.