bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of terbutaline in combination with mannitol on mucociliary clearance
Authors: Daviskas E. , Anderson S.D. , Eberl S. , Chan H-K. , Young I.H. , Seale J.P. 
Published: January 2003

β2-agonists and osmotic agents stimulate mucociliary clearance (MCC)viadifferent mechanisms which could potentially interact.The effects of inhaling terbutaline in combination with mannitol on MCC were investigated in nine healthy (aged 19±1 yrs) and 11 mild (aged 21±4 yrs) asthmatic subjects. Using99mTc-sulphur colloid radioaerosol and a gamma camera, MCC was studied on four separate days with each of the following interventions: 1) terbutaline or its placebo inhaled 10 min before mannitol (in random, double blind); 2) terbutaline inhaled 5 min after mannitol; and 3) terbutaline inhaled 10 min before the control for mannitol. Lung images were collected over a period of 120 min postintervention and over 150 min in total.The mannitol-induced increase in clearance was transiently inhibited by terbutaline pretreatment and transiently enhanced when terbutaline was administered after mannitol both in asthmatic and healthy subjects. The order of administration of mannitol and terbutaline did not affect the total clearance of radioactive mucus over 140 min from the start of intervention in both groups.The pathways through which terbutaline and mannitol increase mucociliary clearance may transiently interact in an inhibitory or synergistic way, depending on the order of administration. However, this did not affect the overall increase in mucociliary clearance over 140 min.
Effects of salmeterol on mucosal inflammation in asthma: a placebo-controlled study
Authors: Jeffery P.K. , Venge P. , Gizycki M.J. , Egerod I. , Dahl R. , Faurschou P. 
Published: January 2003

Although the anti-inflammatory effects of inhaled corticosteroids in the treatment of asthma are established, the effects of long-acting β2-adrenergic receptor agonists on inflammation are the subject of debate. The aim of the present study was to determine the effect of salmeterol on the numbers of inflammatory cells in biopsy samples of distinct immunophenotype and those expressing the genes for interleukin-4 and -5, regulatory cytokines particularly relevant to asthma.Twenty patients (aged 18–55 yrs) with mild stable asthma were randomised in a three-way crossover study to 6 weeks of treatment with: 1) salmeterol (50 µgb.d.; SM50); 2) fluticasone propionate (250 µgb.d.; FP250), or 3) placebo.Compared with placebo, SM50significantly reduced the numbers of neutrophils in bronchial biopsy samples and the concentrations of myeloperoxidase and soluble E-selectin in serum, each of which reflect neutrophil involvement. Compared with FP250, SM50reduced neutrophil number and human neutrophil lipocalin level in bronchial lavage fluid and intercellular adhesion molecule-1 level in bronchoalveolar lavage fluid. Compared with placebo, FP250significantly reduced the numbers of (CD3+) T-lymphocytes, (CD4+) T-helper cells, (CD45RO+) activated T-helper cells and eosinophils in the biopsy samples; it also reduced the percentage of eosinophils and soluble intercellular adhesion molecule-1 in serum. The percentage of symptom-free days and nights and airways hyperresponsiveness improved significantly after SM50compared to both placebo and FP250.In conclusion, a novel antineutrophilic effect of the inhaled long-acting β2-adrenergic receptor agonist, salmeterol, in mild asthma is reported.
Mometasone furoate is a less specific glucocorticoid than fluticasone propionate
Authors: Austin R.J.H. , Maschera B. , Walker A. , Fairbairn L. , Meldrum E. , Farrow S.N. , Uings I.J. 
Published: January 2003

Fluticasone propionate (FP) and mometasone furoate (MF) are potent synthetic corticosteroids that are widely used as anti-inflammatory agents to treat respiratory diseases. As part of the assessment of the potential for side-effects associated with their use, their activities, not only at the glucocorticoid receptor (GR) but also at the other members of the steroid nuclear receptor family, have been compared.Cell-based functional systems were established to measure different aspects of GR function, as well as the activity at all the other steroid nuclear receptors.The effects of MF and FP on the GR were potent and indistinguishable. Neither corticosteroid showed any activity at the oestrogen receptor, while both were weak antagonists of the androgen receptor. FP was a relatively weak agonist of the progesterone receptor but MF was a very potent agonist of the progesterone receptor, giving activity at similar concentrations to those that stimulate the GR (concentration generating 50% maximal effect (EC50)=50 pM). Moreover, while FP was a weak antagonist of the mineralocorticoid receptor (concentration generating 50% maximal inhibitory effect=80 nM), MF displayed potent partial agonist activity (EC50=3 nM, 30%).Mometasone furoate is considerably less specific for the glucocorticoid receptor than fluticasone propionate, showing significant activity at other nuclear steroid receptors.
Influence of heat island phenomenon on building heat load
Authors: Akasaka H , Nimiya H , Soga K 
Published: January 2003

Urbanization causes the so-called heat island phenomenon that raises urban atmospheric temperature higher than that in the suburbs. The phenomenon leads to a decrease in heating load and an increase in cooling load in the urban buildings. In this paper, the effect of the heat island phenomenon on the heat load of buildings was analysed by year-to-year changes in the heat load both in the urban and suburban areas. Tokyo was selected as the target urban area and Choshi, as a less urbanized city, among 30 stations located in a range of about 100 km both east-west and north-south centering on Tokyo. Investigation on the relationship between the changes in heat load during the past 100 years confirmed that • The heating load of Choshi has decreased about 20% since 1900, whereas the heating load of Tokyo has decreased about 40% in the same period of time. Also • The cooling load of Tokyo has increased about 20% since 1900, but the similar increase can be seen in that of Choshi.
Improved oxygenation with reduced recirculation during venovenous ECMO: comparison of two catheters
Authors: Rais-Bahrami Khodayar , Walton Dawn M , Sell Jeffrey E , Rivera Oswaldo , Mikesell Gerald T , Short Billie L 
Published: January 2003

Objectives: To determine whether the new double-lumen catheter made by OriGen Biomedical (Austin, TX) for venovenous (VV) extracorporeal membrane oxygenation (ECMO) would reduce recirculation and improve oxygenation during VV ECMO when compared with the Kendall double-lumen catheter (Kendall Healthcare Products, Mansfield, MA). Design: Prospective intervention study. Setting: The animal research laboratory at Children’s National Medical Center, Washington, DC. Subjects: Nine newborn lambs one to seven days old and weighing 4.4± 0.8 kg. Intervention: Animals were anesthetized, intubated, and ventilated. The ductus arteriosus was ligated. Femoral arterial and venous, cephalic jugular vein, and pulmonary artery catheters were placed. After systemic heparinization, the catheter to be tested, an OriGen catheter, was placed in the right internal jugular vein and advanced into the right atrium. The animal was placed on ECMO and stabilized, with the ventilator settings decreased to a peak inspiratory pressure of 15-20 cmH2O, peak end-expira-tory pressure of 5 cmH2O, rate of 15-25 breaths/min, and a fractional inspired oxygen concentration of 0.21-0.30. ECMO flows were increased in 100-ml increments from 200 to 600 ml/min with measurements taken 15 min after each change. The OriGen catheter was removed, the Kendall catheter was placed, and the studies were repeated. Measurements and Main Results: Heart rate, mean blood pressure, paO2, jugular cerebral oxygen saturation, pulmonary artery oxygen saturation, pump venous oxygen saturation, and postmembrane circuit pressures were measured at each study period. The OriGen catheter improved oxygenation, with higher systemic paO2, higher pulmonary artery and cerebral oxygen saturations, and lower pump venous oxygen saturations (indicating less recirculation). With the OriGen catheter, paO2 levels ranged from 69± 18 mmHg [9.2± 2.4 kPa] to 114 ± 45 mmHg [15.2± 6.0 kPa], compared range from 61± 15 mmHg [8.1± 2.0 kPa] to 87± 34 mmHg [11.5± 4.5 kPa] for the Kendall catheter. These findings indicate that, at all flow rates studied, less recirculation occurred with the OriGen catheter than with the Kendall catheter. The postmembrane pressures were significantly lower for the OriGen catheter at any given flow (from 30 ± 5 to 122 ± 18 mmHg) when compared with the Kendall catheter (from 77± 16 to 330 ± 78 mmHg). Conclusions: These findings indicate that the OriGen catheter resulted in a reduction of recirculation, thereby resulting in an improvement in oxygenation while on VV ECMO. The lower postmembrane pressure potentially could reduce the risk of ECMO circuit complications such as tubing rupture, bleeding complications, as well as hemolysis. This new catheter makes VV ECMO more effective and represents a design that could be used for neonatal and/or pediatric ECMO.
Impact of cardiopulmonary bypass management on postcardiac surgery renal function
Authors: Fischer Uwe M , Weissenberger Wilko K , Warters R David , Geissler Hans J , Allen Steven J , Mehlhorn Uwe 
Published: January 2003

Objective: Cardiac surgery on cardiopulmonary bypass (CPB) is associated with postoperative renal dysfunction and up to 4% of patients with normal preoperative renal function develop acute renal failure (ARF) requiring dialysis. According to recent investigations, CPB management is not evidence-based and, thus, current clinical CPB practice may favor renal dysfunction. The purpose of our study was to investigate if postcardiac surgery renal dysfunction is influenced by CPB management. Methods: We selected three groups of patients with normal preoperative renal function who had been subjected to cardiac surgical procedures on CPB: 44 patients with postoperative ARF requiring hemofiltration/dialysis (ARF group), 51 patients with postoperative renal dysfunction not requiring hemofiltration/dialysis (serum creatinine increase > 0.5 mg/dl within 48 h postsurgery: CREAgroup), and 48 patients with normal postoperative renal function (Control group). The patients’ on-line CPB records were analyzed for CPB duration, CPB perfusion pressure, CPB flow, and periods on CPB at a perfusion pressure < 60 mmHg. On-CPB diuretic and vasoconstrictor medication was recorded. Results: Patient demographics were similar for the three groups. In the ARF group, CPB duration was longer (166± 77 [standard deviation, SD] min) compared to CREA (115± 41 min; p < 0.001) and to Control groups (107± 40 min; p < 0.001), and mean CPB flow was lower (2.35± 0.36 l/min/m2) compared to CREA (2.61± 0.35 l/min/m2; p=0.0015) and to Control groups (2.51± 0.33 l/min/m2; p= 0.09). Mean arterial pressure on CPB (ARF: 61± 10; CREA: 60± 7; Control: 63± 9 mmHg; p= 0.19) as well as furosemide and norepinephrine medication on CPB were similar for the groups. Compared to Control (46± 26 min), CPB duration at arterial pressures < 60 mmHg was longer in ARF (78± 60 min; p= 0.034) and in CREA (62± 36 min; p=0.048). Conclusions: Our data suggest that current clinical CPB management impacts postoperative renal function. We found that patients with normal preoperative renal function who developed postoperative ARF had longer CPB duration, lower CPB perfusion flow, and longer periods on CPB at pressures < 60 mmHg compared to patients with no post CPB ARF. However, our data do not allow us to separate these CPB-related factors from the potential influence of perioperative low cardiac output syndrome as a cause for postoperative ARF. Thus, future clinical studies are required to elucidate CPB-induced ARF and to optimize CPB management for ARF prevention.
Differential regulation of MMP-2, TIMP-2 and IL-6 in valve replacement versus CABG patients
Authors: Watanabe Masazumi , Hasegawa Satoru , Ohshima Nagahisa , Tanaka Hiroyuki , Sakamoto Tohru , Sunamori Makoto 
Published: January 2003

Background: Extracellular matrix degradation may play an important role in left ventricular (LV) remodeling. It has been reported that matrix metalloproteinase-2 (MMP-2) is activated under mechanical stress conditions. Therefore, we examined the release of MMP-2, its inhibitor and interleukin-6 (IL-6), which affects MMPs, in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Methods: Arterial blood samples were obtained from 20 patients undergoing cardiac surgery and six patients with descending aortic replacement (as noncardiac control) with CPB. Samples were assayed for plasma MMP-2, tissue inhibitors of matrix metalloproteinase-2 (TIMP-2) and IL-6 concentration. Results: Plasma MMP-2 concentrations in the valvular disease patients were greater than in other patients ( p < 0.05) and correlated with the LV mass (r= 0.810, p < 0.0001) prior to the operation. Plasma MMP-2 concentrations decreased during CPB and gradually recovered to the baseline levels after CPB. Plasma TIMP-2 concentrations increased significantly during and after CPB in a biphasic manner. Plasma IL-6 concentrations also increased significantly during CPB ( p < 0.05 versus baseline levels). Conclusion: Plasma MMP-2 concentrations reflect the state of the left ventricle, and changes in plasma MMP-2 and TIMP-2 concentrations during CPB may play an important role in LV remodeling after cardiac surgery.
Is there any impact of the shape of aortic end-hole cannula on stroke occurrence? Clinical evaluation of straight and bent-tip aortic cannulae
Authors: Albert A A , Beller C J , Arnrich B , Walter J A , Rosendahl U P , Hetzel A , Priss H , Ennker J 
Published: January 2003

Objective: To compare the impact of straight and bent-tip aortic cannulae on stroke occurrence, location, and severity. Methods: Prospective data were collected on 8129 patients (coronary artery bypass grafting (CABG) and/or valvular surgery). ‘Bent-tip’ aortic cannulae were used in 15.6% of cases and ‘straight’ end-hole cannulae in 84.4% of cases. Results: There were a total of 137 strokes: right anterior 52, left anterior 39, bilateral 23, posterior 18, and location not established5. With the use of bent-tip cannulae, the incidence of strokes was 0.9% versus 1.8% with straight cannulae (c2, p=0.026). Bilateral and posterior strokes occurred more often with the use of straight cannulae (c2, p= 0.015). Straight cannulae also related to the severity of strokes (c2, p= 0.003). Conclusions: There is an influence of the type of cannula on the occurrence, location, and severity of strokes. Straight cannulae cause significantly more often and more severe bilateral and posterior strokes than bent-tip cannulae.
Has aphasia therapy been swallowed up?
Authors: Enderby Pam , Petheram Brian 
Published: January 2003

Objective: To review the change in number of referrals to speech and language therapy for dysphasia and dysphagia over one decade. Design: This retrospective study analyses data collected on an information system developed speci cally for the use of speech and language therapists in the management of their services. Setting: Eleven health care providers used the system between 1985 and 1995 and recorded details of 73 758 patients referred to speech and language therapy during that period. Results: Whilst there were 12 times as many dysphasic patients as dysphagic patients referred to speech and language therapy in 1987, the position was reversed by 1995 with twice as many dysphagic as dysphasic patients being referred to these services. Dysphagia in 1987 accounted for less than 1% of the referrals to speech and language therapy. This percentage increased, until in 1995 20% of referrals were for dysphagia. Conclusion: No causal relationship between the changes in referral to speech and language therapy for these two groups has been established in this study. However, there has been a signi cant increase in referral to speech and language therapy of people with dysphagia. Whilst referrals for dysphasia have increased, they represent a lower percentage increase and now receive less treatment per case than in 1987.
The timed ‘Up & Go’ is dependent on chair type
Authors: Siggeirsdóttir K , Jónsson B Y , Jónsson H , Iwarsson S 
Published: January 2003

Introduction: The timed ‘Up & Go’ (TUG) is a performance test identifying problems in functional mobility. More knowledge on how the type of chair used in uences test results is needed. Objective: To investigate inter-rater agreement on the time score and to assess if chair type used in uenced the performance of the test. Setting: (1) Inter-rater agreement investigation on the time score was carried out with elderly individuals living in a retirement home (n = 31). (2) Four types of chairs were tested on elderly individuals in three different health care centres (n = 100). Results: The two observers were close in timing (mean difference = 0.04 s). From a reference chair the median time for TUG was 15.7 s compared with 16.9 s from a chair with a low seat (p < 0.001). It was signi cantly more dif cult to stand up from a chair without armrests (p < 0.001), and from the lowest chair (p < 0.001), which was also the only chair dif cult to sit down on (p = 0.02). Conclusion: The inter-rater agreement of the time scoring of the TUG has been con rmed. Test performance is dependent on chair type; chairs with armrests and a seating height of 44-47 cm should be used. Clinicians must follow standard procedures and equipment when using the test or else risk invalidating test findings.
Responsiveness of two upper extremity function instruments for stroke inpatients receiving rehabilitation
Authors: Hsueh I-Ping , Hsieh Ching-Lin 
Published: January 2003

Objective: To compare the responsiveness of the Action Research Arm test (ARAT) and the upper extremity section of the Motor Assessment Scale (UE-MAS) in assessing the recovery of upper extremity function in stroke inpatients receiving rehabilitation. Subjects: Forty-eight stroke inpatients. Setting: The physical medicine and rehabilitation department of a medical centre. Design: The patients were tested at admission and at discharge from the department. Methods: Various indices, including effect size d, Wilcoxon test and Spearman's rho, were used to assess responsiveness. The change in score of the upper extremity subscale of the Fugl-Meyer scale was used as the external criterion. Results: The responsiveness indices of both total scores of the ARAT and UE-MAS are generally moderate and similar ( d = 0.52, Wilcoxon Z = 5.03, p < 0.001 and rho = 0.66 for the ARAT; d = 0.45, Z = 4.54, p < 0.001 and rho = 0.7 for the UE-MAS). Responsiveness indices are small to moderate and similar in each of the subscales of both instruments. Conclusion: The results of this study support the value of the ARAT and UE-MAS for measuring recovery of upper extremity function in stroke patients.
Development and validation of two new sensory tests of the hand for patients with stroke
Authors: Dannenbaum Ruth M , Michaelsen Stella M , Desrosiers Johanne , Levin Mindy F 
Published: January 2003

Objective: To establish validity and reliability of two new sensory tests evaluating moving (MTP) and sustained (STP) touch-pressure and their relationship to hand function for patients with stroke. The STP had four components in which a light or heavy ball was applied passively or held actively. Participants: Twenty-eight participants with hemiparesis (1–109 months) from rehabilitation hospitals or outpatient programmes. Design: Content validity was established. Then reliability and concurrent and construct validity were determined. Sensation was compared with hand functional ability using the Modified Moberg recognition task, the Box and Block test and one task of the TEMPA test. Results: Reliability: Both types of reliability were significant for MTP (ICC = 0.92) and all components of STP (ICC = 0.62 to 0.92). Concurrent validity:MTP and STP correlated significantly ( r = -0.39 to -0.83) with the Semmes–Weinstein Monofilament test used as a ‘gold standard' comparison. Construct validity: MTP was significantly related to Moberg ( r = 0.49). Three of four components of STP correlated with TEMPA ( r = 0.49–0.53) and Moberg (0.45–0.71). Only STP (heavy ball) correlated with Box and Block (0.42–0.48). Of the four components of STP, only the passive STP (light ball) was not related to hand function. Conclusion: The new sensory tests of moving, and three components of sustained touch-pressure were reliable. The passive STP (light ball) was discarded. All but this test were relevant to the two functional roles of sensation: exploration for MTP and dexterity during holding for STP.
Measurement of sitting balance using the Manchester Active Position Seat (MAPS): a feasibility study
Authors: Powell E S , Pyburn R E , Hill E , Smith K S , Ribbands M S , Mickelborough J , Pomeroy V M 
Published: January 2003

Background: Evaluation of the effectiveness of therapy to improve sitting balance has been hampered by the limited number of sensitive objective clinical measures. We developed the Manchester Active Position Seat (MAPS) to provide a portable system to track change in the position of centre of force over time. Objectives: (1) To investigate whether there is correspondence between the measurement of position change by a forceplate and by MAPS. (2) To explore whether and how MAPS measures changes in position when seated healthy adults change posture. Design: A feasibility study. Methods: (1) An adult subject sat on MAPS placed on top of a forceplate. The x and y coordinates of the centre of pressure recorded from the forceplate and centre of force from MAPS during movement were compared graphically. (2) Four adults sat on MAPS using a standardized starting position and moving into six sets of six standardized target postures in a predetermined randomized order. The absolute shift in centre of force from the starting position was calculated. Results: (1) The pattern of change of position over time was similar for the forceplate and for MAPS although there was a measurement difference, which increased with distance from the centre. (2) The direction of change of position corresponded to the direction of movement to the target postures but the amount of change varied between subjects. Conclusions: MAPS shows promise as an objective clinical measure of sitting balance, but peripheral accuracy of measurement needs to be improved.
Comparative effect of positive and negative static magnetic fields on heart rate and blood pressure in healthy adults
Authors: Hinman Martha R 
Published: January 2003

Objective: To compare changes in heart rate (HR) and blood pressure (BP) associated with short-term exposure to static magnetic fields (SMFs) of positive versus negative polarity. Design: A double-blind, randomized controlled trial using a time series design. Setting: Physical therapy laboratory in a university setting. Subjects: Seventy-five adults with a mean age of 30.6 years were assigned to one of three treatment groups. No subjects had any symptoms of cardiovascular disease or cardiac irregularity. Interventions: Fifteen-minute exposure to an SMF by lying on a mattress pad containing magnets of positive polarity, negative polarity, or none (placebo). Main outcome measures: HR and BP were monitored prior to exposure, at 1-minute, 5-minute, 10-minute and 15-minute intervals following exposure, and again 5 minutes after exposure. Results: Subjects in all groups demonstrated slight decreases in HR and BP, but none of these changes were associated with the intervention ( p = 0.170). Conclusions: Short-term exposure to an SMF of either positive or negative polarity does not appear to cause any clinically meaningful changes in HR or BP among asymptomatic subjects. This finding supports the safe use of unipolar SMFs that contain low-intensity magnets (<1000 gauss) relative to the cardiovascular system.