bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of Helicobacter pylori stool antigen test before and after eradication therapy
Authors: TANAKA AKIFUMI , WATANABE KAZUHIRO , TOKUNAGA KENGO , HOSHIYA SATOSHI , IMASE KIYOTO , SUGANO HAJIME , SHINGAKI MASAO , KAI AKEMI , ITOH TAKESHI , ISHIDA HITOSHI , TAKAHASHI SHIN’ICHI 
Published: May 2003

AbstractBackground and Aim: The Helicobacter pylori stool antigen (HpSA) test is useful for initial diagnosis of H. pylori infection, but there is disagreement regarding its diagnostic accuracy after eradication therapy. The aim of the present study was to evaluate the diagnostic accuracy of the HpSA test before and after eradication therapy.Methods: One hundred and thirty‐six patients underwent upper gastrointestinal endoscopy with biopsies for the diagnosis of H. pylori infection using culture, histology and the rapid urease test. Fifty‐four H. pylori‐positive patients were treated with 1‐week triple therapy. Six to 10 weeks after the end of therapy, the patients underwent re‐endoscopy and received the same biopsy‐based methods. In addition, the 13C‐urea breath test was performed. The HpSA test was performed before and 6–10 weeks after the end of therapy. In 23 patients, the HpSA test was also performed at the end of therapy.Results: Before therapy, the sensitivity and specificity of the HpSA test was 98.3% (95% confidence interval (CI): 95.9–100%) and 95.0% (95% CI: 75.1–99.9%), respectively. At the end of therapy, the HpSA tests were all negative both for eradication and non‐eradication patients. The sensitivity and specificity of the HpSA test after eradication therapy were 90% (95% CI: 55.5–99.7%) and 97.7% (95% CI: 93.3–100%), respectively.Conclusions: The HpSA test is a useful method for the diagnosis of H. pylori infection before and after eradication therapy.
Prescribing and administration of nebulized bronchodilators: A prospective audit in a university hospital
Authors: KHOO See Meng , LIM T. K. 
Published: May 2003

Objective:  Inaccurate and incomplete prescribing of nebulized bronchodilators can result in uncertainty and suboptimal treatment. A prospective study was carried out to assess the completeness of prescription and the quality of bronchodilator drug administration via nebulizers.Methodology:  A total of 121 consecutive inpatient nebulized bronchodilator prescriptions and treatments administered to 93 adult medical inpatients in a university hospital were studied prospectively. Five different aspects of the prescriptions were examined to assess their accuracy and completeness. The administration of each nebulizer treatment was studied using audit of medication charts and interview with ward nurses.Results:  No prescription was correct and complete in all five aspects assessed. The most common mistake was failure to state the type and flow rate of driving gas (100%). This was followed by failure to prescribe recommended doses of bronchodilators (46%) and failure to give unambiguous instruction on frequency of treatment (39%). It was found that in only 21.5% of instances was the administration of nebulized bronchodilator drugs optimal.Conclusion:  This prospective audit has demonstrated major deficiencies in the prescribing and administration of nebulized bronchodilators and it has highlighted the need for a local protocol and continuing staff education. The alternative method of administering bronchodilator via metered dose inhaler with large volume spacer should be evaluated in the treatment of acute airflow obstruction in hospitalized patients.
The significance of tumour markers as an indication for mediastinoscopy in non‐small cell lung cancer
Authors: ANDO Soichiro , KIMURA Hideki , IWAI Naomichi , KAKIZAWA Kimitaka , SHIMA Masayuki , ANDO Michiko 
Published: May 2003

Objective:  The purpose of this study was to verify the significance of tumour markers as indicators for mediastinoscopy in non‐small cell lung cancer.Methodology:  In the past 4 years, 205 patients with non‐small cell lung carcinoma (NSCLC) underwent surgical resection at Chiba Cancer Center, Chiba, Japan. The correlation between the serum levels of eight tumour markers (CEA, AFP, CA19‐9, SCC, NSE, CA125, CYFRA, ProGRP) and the presence of N2 disease was analysed. Univariate and multivariate analyses were performed to determine the relationship between both marker levels and clinical findings and N2 disease.Results:  In multivariate analysis, positive CEA was significantly associated with the diagnosis of N2 disease. We also demonstrated that when CA125, CYFRA and ProGRP were positive, they were individually significantly associated with N2 disease. However, CEA was superior to the other markers and equivalent to a combination of various tumour markers.Conclusion:  It was concluded that evaluation of CEA in addition to CT is of use in the diagnosis of N2 disease in NSCLC patients and should be used as an indication for mediastinoscopy.
Bronchoalveolar lavage fluid cells in mixed connective tissue disease
Authors: ENOMOTO Katsumi , TAKADA Toshinori , SUZUKI Eiichi , ISHIDA Takashi , MORIYAMA Hiroshi , OOI Hidemi , HASEGAWA Takashi , TSUKADA Hiroki , NAKANO Masaaki , GEJYO Fumitake 
Published: May 2003

Objective:  Patients with mixed connective tissue disease (MCTD) exhibit clinical features of systemic lupus erythematosus (SLE), systemic sclerosis (SSc), and polymyositis and dermatomyositis (PM–DM). The objective of this study was to clarify differences in BAL findings and immunophenotypes of BAL fluid (BALF) cells of patients with interstitial lung disease associated with these diseases.Methodology:  We were unable to recruit a sufficient number of SLE patients with lung disease. We compared immunophenotypes of lymphocytes and alveolar macrophages (AM) in BALF of 20 MCTD patients with those of 21 SSc and 27 PM–DM patients and tested the relationships between immunophenotypes and pulmonary function in MCTD.Results:  MCTD patients had a significantly higher CD4/CD8 ratio with more CD4 positive lymphocytes than PM–DM patients (P = 0.025). In AM phenotypes, MCTD patients had a significantly lower percentage of CD71 positive AM compared with SSc patients (P = 0.023). DLCO was negatively related to absolute numbers of CD8 positive lymphocytes (R = −0.517, P= 0.033).Conclusions:  CD4 positive lymphocytes in BALF were increased in MCTD compared to PM–DM patients, while CD71 positive AM were decreased in MCTD compared to SSc patients. CD8 positive lymphocytes correlated negatively with DLCO measurements in MCTD patients.
Sputum eosinophilia and bronchial responsiveness in patients with chronic non‐productive cough responsive to anti‐asthma therapy
Authors: FUJIMOTO Keisaku , YAMAGUCHI Shinji , URUSHIBATA Kazuhisa , KOIZUMI Tomonobu , KUBO Keishi 
Published: May 2003

Objective:  We aimed to examine airway inflammation and bronchial responsiveness in patients with chronic non‐productive cough responsive to anti‐asthma therapy.Methodology:  Bronchial responsiveness to methacholine as well as the number of inflammatory cells and concentration of eosinophil cationic protein (ECP) in induced sputum were measured in 42 patients with chronic non‐productive cough of unknown origin. Their response to bronchodilator, antiallergic and inhaled or oral glucocorticoid therapy was subsequently assessed.Results:  Complete remission of coughing was attained with anti‐asthma therapies in 34 patients (responder group), while eight patients did not respond (non‐responder group). Twenty patients in the responder group and three in the non‐responder group showed bronchial hyperresponsiveness (BHR). The number of eosinophils and ECP levels in the sputum from responders with BHR were significantly increased when compared with those from non‐responders and healthy subjects. These sputum measures were also significantly increased in responders without BHR when compared with healthy subjects. However, there were no significant differences in these inflammatory markers between the responders with and without BHR. The neutrophil numbers in the sputum from non‐responders and responders both with and without BHR were also significantly higher than in control subjects, but there were no significant differences.Conclusions:  These findings suggest that patients with chronic non‐productive cough responsive to anti‐asthma therapy characteristically have eosinophilic airway inflammation, which may play an important role in the development of chronic cough. Furthermore, the evaluation of not only bronchial responsiveness but also airway inflammation by examination of induced sputum may be useful for diagnosis and deciding on therapeutic strategies.
Effect of osmolality on mucociliary transportability and rheology of cystic fibrosis and bronchiectasis sputum
Authors:   Yasuhiro SHIBUYA, WILLS Peter J. , COLE Peter J. 
Published: May 2003

Objective:  Water is the main constituent of mucus, and its concentration is likely to be important in all aspects of mucus function, including ciliary clearance. The objective of this study was to investigate the effect of water content and osmolality of the mucus on mucociliary transportability.Methodology:  Rheology and ciliary transportability of 10 sputum samples that had been subjected to various manipulations were measured using a mucus‐depleted bovine trachea model.Results:  It was shown that addition of sodium chloride 0.2 Osmoles/kg (0.585% weight for weight) increased the transportability by 41% (P < 0.01). Evaporation of the sputum to 50% of its original weight caused a 118% increase in transportability (P < 0.0006), but iso‐osmolal removal of 50% of the liquid with filter cards led to a non‐significant, 25% increase in transportability. Parallel plate viscoelasticity was approximately doubled in both the evaporated and liquid‐depleted samples, but was not changed by the addition of 0.2 Osmoles/kg of sodium chloride. The correlation between the osmolality of sputum and ciliary transportability (r = 0.54, P= 0.005) was better than the correlations between the viscosity (r = 0.21, P= 0.27) or elasticity (r = 0.23, P= 0.23) and ciliary transportability.Conclusions:  These results suggest that the osmolality of sputum exerts a greater influence on mucociliary clearance than its viscoelastic properties.
The effects of air pollution on acute respiratory conditions
Authors:   Mohammad Reza MASJEDI, JAMAATI Hamid Reza , DOKOUHAKI Pouneh , AHMADZADEH Zarrin , TAHERI Sima Alinezhad , BIGDELI Masoud , IZADI Shirin , ROSTAMIAN Abdorrahman , AAGIN Khosro , GHAVAM Seyed Masoud 
Published: May 2003

Objective:  Air pollution and its potential health effects are very important worldwide. It is particularly problematic in densely populated cities of developing countries that suffer from a lack of both short‐ and long‐term programmes for air pollution control. We decided to study the short‐term effects of air pollution on lung health by assessing the relationship between the levels of six air pollutants and emergency visits for asthma and COPD exacerbations in Tehran, Iran.Methodology:  We monitored the daily attendances for acute respiratory conditions (asthma attacks and COPD exacerbations) to the emergency departments of five major hospitals together with the daily concentrations of six major pollutants during a 5‐month period in Tehran. The association between these acute respiratory conditions and the levels of air pollutants was determined by multiple stepwise regression.Results:  A correlation was observed between the number of hospital admissions for asthma and the weekly mean concentration of nitrogen dioxide (P < 0.05). The 3‐day and 10‐day mean concentrations of sulphur dioxide were also found to be directly associated with the number of asthma admissions during this period (P < 0.05). No direct correlation was observed for other variables.Conclusion:  This study further emphasizes the deleterious effects of air pollution on respiratory health in major populated cities such as Tehran and suggests that increased attention needs to be given to urgent control of air pollution problems.
Influence of stressful life events on the onset of sarcoidosis
Authors: YAMADA Yoshihito , TATSUMI Koichiro , YAMAGUCHI Tetsuo , TANABE Nobuhiro , TAKIGUCHI Yuichi , KURIYAMA Takayuki , MIKAMI Riichiro 
Published: May 2003

Objective:  The onset of sarcoidosis may be triggered by any hereditary and/or environmental factor. Among these factors, psychosocial stress may play a critical role in the onset of sarcoidosis. The aim of the present study was to evaluate the influence of stressful life events on the onset of sarcoidosis.Methodology:  The social and/or life events experienced prior to diagnosis in 55 patients with sarcoidosis, were evaluated quantitatively using the Social Readjustment Rating Scale (SRRS), the most authoritative method to quantify the magnitude of the events requiring changes in lifestyle. In addition, personality with respect to stress‐reactivity was simultaneously evaluated using the Minnesota Multiphasic Personality Inventory (MMPI) alexithymia scale. Both the degree of stress, evaluated by SRRS, and stress‐reactivity, evaluated by MMPI scale, of sarcoidosis patients were compared with those of 92 healthy controls.Results:  The magnitude of stressful life events was significantly higher in patients with sarcoidosis compared with healthy controls. In addition, capacity for coping with stress was found to be inferior in sarcoidosis patients compared with that in the control groups.Conclusion:  These results indicated that psychosocial stress assessed on the basis of alexithymic characteristics of the self perception of stress may be partly implicated in the development of sarcoidosis.
Differences in clinical features between influenza A H1N1, A H3N2, and B in adult patients
Authors: KAJI Masahide , WATANABE Aya , AIZAWA Hisamichi 
Published: May 2003

Objective:  The differences in clinical features between influenza A H1N1, A H3N2, and B in the past three influenza seasons were examined.Methodology:  Patients with respiratory symptoms who consulted Kurume University Medical Center, Department of Internal Medicine, Kurume, Fukuoka, Japan, from January to March in 1999, 2000, and 2001 were included. Based on virological and serological findings, the influenza patients were divided into the above three groups for comparison of symptoms and laboratory data.Results: Patients (n = 196) included 54 with influenza A H1N1, 98 with A H3N2, and 44 with B. Mean ages in the groups were 33 ± 8.4 years, 41 ± 15.2 years, and 29 ± 9.8 years (influenza B patients tended to be younger). Fever was much greater in the A H3N2 group (38.6 ± 0.46°C) than in the A H1N1 or B groups. This was also true for laboratory indices of viral infection. Gastrointestinal symptoms such as nausea, epigastralgia, and diarrhoea were prominent in influenza B. Myalgia was common in all groups.Conclusions:  Influenza A H3N2 infection was more severe than A H1N1 or B in terms of fever, leukopenia, and C‐reactive protein. Myalgia and other symptoms such as fever, headache, general malaise and sore throat were equally frequent in influenza A H3N2, A H1N1, and B infections. Gastrointestinal symptoms were more common in influenza B.
COPD prevalence in 12 Asia–Pacific countries and regions: Projections based on the COPD prevalence estimation model
Authors: Regional COPD Working Group  
Published: May 2003

Objective:  COPD is a leading cause of mortality and morbidity worldwide. Despite the high rates of cigarette smoking, and the wide use of biomass fuels, there is very little objective data on the prevalence of COPD in Asia.Methodology:  We used a COPD prevalence model to estimate the prevalence of COPD in 12 Asian countries. This model is a validated, computerized tool that uses epidemiological relationships and risk factor prevalence to project the prevalence of COPD within a given population aged 30 years and older.Results:  The total number of moderate to severe COPD cases in the 12 countries of this region, as projected by the model, is 56.6 million with an overall prevalence rate of 6.3%. The COPD prevalence rates for the individual countries range from 3.5% (Hong Kong and Singapore) to 6.7% (Vietnam).Conclusions:  The COPD prevalence rates projected by the model reflect the high prevalence of the risk factors for the disease in Asia. The combined prevalence of 6.3% for these countries is considerably higher than the overall rate of 3.8% as extrapolated from WHO data for this region. These estimates highlight the need for further epidemiological studies to support appropriate allocation of resources for the prevention and management of COPD.
Rhinovirus is not detectable in peripheral lung tissue after asthma death
Authors: WATSON Mark W. , BEASLEY Richard , HOLGATE Stephen T. , BARDIN Philip G. 
Published: May 2003

Objective:  Viral infections are associated with both mild and severe exacerbations of asthma and may therefore be associated with asthma death. As such we hypothesized that it might be possible to detect rhinovirus (RV), the virus most frequently implicated in acute asthma, in lung tissue from patients who died from asthma.Methodology:  We studied archival, wax‐embedded lung tissue obtained postmortem from: (i) patients who died from asthma (n = 12), (ii) asthma patients with non‐asthma‐related death (n = 3), and (iii) non‐asthmatic individuals who died from unrelated causes (n = 3). A validated reverse transcription‐polymerase chain reaction (RT‐PCR) assay was used to detect RV. To confirm RNA preservation, RT‐PCR was used to detect expression of the constitutive gene adenine‐phosphoribosyl‐transferase (APRT). Sensitivity of the assay was assessed using wax‐embedded RV‐infected cells.Results:  Sensitivity of RT‐PCR for RV in wax‐embedded sections was similar to previous studies (approximately 100 viral copies). Specimens used for study were predominantly of alveolar and small airway origin (< 2 mm). All tissues examined were negative for the presence of RV mRNA and positive for APRT mRNA.Conclusions:  RV infection of the lower airway may be an uncommon cause of fatal asthma. Alternatively, RV may not extend to peripheral airways and more proximal tissue sampling or PCR assays for other viruses may be required to determine an association between viral respiratory tract infection and fatal asthma.
Secretory leukocyte proteinase inhibitor, alpha‐1‐antitrypsin deficiency and emphysema: Preliminary study, speculation and an hypothesis
Authors: AYAD Monna S. , KNIGHT Kenneth R. , BURDON Jonathan G. W. , BRENTON Sue 
Published: May 2003

Objectives:  This study investigated (i) whether adequate concentrations of secretory leukocyte proteinase inhibitor (SLPI) in the lungs of alpha‐1‐antitrypsin (A1AT) deficient patients can explain the variability in the development of emphysema in these individuals, and (ii) whether cigarette smoking jeopardises the protective screen provided by functional SLPI.Methodology:  Four subjects [two normal proteinase inhibitor M (PiM), two abnormal PiZ] were selected from patients presenting for diagnostic bronchoscopy and lung function testing (spirometry, DLco). Each subject underwent BAL and had blood taken for A1AT and SLPI estimation.Results:  As expected serum and BAL A1AT concentrations were within the normal range in the normal PiM subjects. In normal subjects, SLPI concentrations in serum and BAL were within the normal range. A1AT‐deficient subjects had reduced serum and BAL levels of A1AT reflecting their genetic disorder but showed increased concentrations of SLPI in BAL and serum. Percentage neutrophil elastase (NE) inhibitory capacity of BAL fluid was low in both A1AT‐deficient subjects and a cigarette‐smoking normal subject. In contrast, the NE inhibitory capacity for the normal subject who had never smoked was normal.Conclusions:  These findings suggest that in A1AT deficiency there may be a compensatory increase in SLPI. This may protect the lung against the development of emphysema in A1AT‐deficient individuals. Cigarette smokers may have a lower SLPI concentration than non‐smokers. This provides an explanation for at least some of the observed variation in the development of emphysema in A1AT deficient subjects.
A step‐wise application of methylprednisolone versus dexamethasone in the treatment of acute exacerbations of COPD
Authors: LI Huiping , HE Guojun , CHU Haiqing , ZHAO Lan , YU Hui 
Published: May 2003

Objective:  The aim of the study was to explore the clinical value of a step‐wise application of methylprednisolone (MP) compared to dexamethasone (DXM) in acute exacerbations of COPD.Methodology:  One hundred and forty‐two patients with an acute exacerbation of COPD were divided randomly into two groups: 71 patients were treated with MP and the other 71 patients were treated with DXM. Otherwise each group was given the same basic treatments: antibiotics, bronchodilators, oxygen therapy as well as standard hospital care. The patients in the MP group were given a tapering dose of MP for 7–14 days, and the patients in the DXM group were given a corresponding tapering dose of DXM for 7–14 days. Then both groups were given a gradually reducing dose of oral prednisone for 2–3 weeks. Two weeks before the prednisone was tapered off, inhaled corticosteroid was introduced. The patients’ symptom scores, physical signs, per cent predicted FEV1%, and arterial blood gases were monitored before treatment and after the seventh day of treatment.Results:  There was an obvious improvement in symptoms after 1–3 days in all 71 patients in the MP group, with their wheezing being distinctly reduced or disappearing entirely. The maximum benefit that occurred in the MP group (90.14%) was considerably higher than that of the DXM group (25.35%), P < 0.05. The predicted FEV1% in the MP group increased from 46.7 ± 10.6 to 67.5 ± 12.4, compared with an increase in the DXM group from 50.1 ± 7.6 to 58.9 ± 10.8. The difference between the two groups was significant (P < 0.05).Conclusions:  An adequate and tapering dose of MP used in acute exacerbations of COPD can relieve the inflammatory reaction in airways and reduce airway spasm more promptly than DXM.
Choice Reaction Time and Adequacy of Dialysis: A New Application of an Old Method
Authors: Ahmad Suhail 
Published: May 2003

Background:  Choice Reaction Time (CRT) is the time it takes for a subject to accurately respond to a flashing panel of lights. The CRT has been used to assess the quality of dialysis in hemodialysis patients and to assess the neurological impairments in patients with Parkinson's disease.Methods:  Three groups of end‐stage renal disease (ESRD) patients on three different renal replacement therapies were tested using CRT: intermittent peritoneal dialysis (IPD, n = 11), thrice weekly hemodialysis (HD, n = 22), and well‐functioning kidney transplant (Tx, n = 6). A group of volunteers with normal renal function (NL, n = 12) was also tested.Results:  The CRT was significantly longer in IPD patients (618 ± 89 ms) than observed in the other three groups (p < 0.0001). CRT in HD patients was 461 ± 50 ms, which was significantly longer than in Tx patients (396 ± 25 ms, p = 0.05). However, the CRT in the Tx patients was no different from the NL (382 ± 22, p = 0.32). There was a strong negative correlation between CRT and weekly creatinine clearance in the IPD group (r =− .96) and between the dialysis index and CRT in HD (r =− 0.79).Conclusions:  CRT may be a useful tool in assessing the adequacy of dialysis.