bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nitric oxide‐related compounds in patients with congenital heart defects and pulmonary hypertension
Authors: Kotake Fumiaki , Kobayashi Jun , Sonoda Masaru 
Published: March 2003

Abstract Background: The relationship between blood levels of nitric oxide (NO)‐related compounds in patients with congenital heart defects (CHD) and degree of pulmonary hypertension (PH) has not yet been described.
Methods
: Thirty‐six patients (aged 6 months to 19 years) with CHD were divided into three groups on the basis of their hemodynamic characteristics: group 1 (control, n=5), left‐to‐right shunt (–) without PH (pulmonary to systemic artery peak pressure ratio, Pp/Ps<0.4); group 2 (n=14), left‐to‐right shunt (+) without PH; group 3 (n=17), left‐to‐right shunt (+) with PH (Pp/Ps>0.4). Blood samples were obtained from the right atrium, pulmonary artery, left atrium or pulmonary capillary wedge and aorta during cardiac catheterization. All NO‐related compounds in whole blood were measured by chemiluminescent assay using Sievers NO analyzer.
Results
: The sampling site had no significant impact on NO‐related compound levels. However, the patients with PH (group 3) had significantly higher (P<0.01) blood levels of NO‐related compounds (117.3~14.7 μmol/L) than the patients without PH (groups 1 and 2, 23.9~3.2 and 38.4~4.8 μmol/L, respectively). In addition, pulmonary artery resistance (Rp) values of less than 6 Wood U/m
2 were directly correlated with levels of NO‐related compounds, whereas Rp values greater than 6 Wood U/m
2 were inversely correlated with blood levels of NO‐related compounds.
Conclusion
: The present results suggest that the hemodynamic status of the pulmonary circulation in CHD affects, at least partly, blood levels of NO‐related compounds.
Psychosocial factors affecting psychosomatic symptoms in Japanese schoolchildren
Authors: Tanaka Hidetaka , Tamai Hiroshi , Terashima Shigenori , Takenaka Yoshito , Tanaka Toshitaka 
Published: March 2003

Abstract Background: In a previous study we reported the prevalence of psychosomatic symptoms in 1619 Osaka elementary schoolchildren using our original general health questionnaire assessed by their parents. We found that psychosomatic symptoms were increasing with age. This study was designed to investigate psychosocial factors responsible for increasing psychosomatic symptoms with age.
Methods
: We calculated a correlation coefficient between the physical complaints score (PCS) and these psychosocial variables using quantitation I of multiple regression analysis separately in the older (10–12 years, n=860) and the younger age group (7–9 years, n=759).
Results
: A stronger relationship between PCS and psychosocial problems was found in the older (r=0.719, P<0.0001) than in the younger age group (r=0.570, P<0.0001). Further analysis demonstrated that difficulties in school performance and increasing psychological conflicts with human relationships were major causes of somatic complaints in the older age group. In the younger age group, however, immaturity of social skills seems to be a primary problem. In addition, poor parental interaction and the playing of computer games were found to increase somatic complaints in children.
Conclusion
: Children in the older age reflect the closer bio–psycho–socio interaction compared with their younger counterparts. This may give rise to a high incidence of psychosomatic disorders and school refusal in Japanese children. We emphasize that psychological support by parents in daily life is necessary to reduce psychosomatic symptoms in children.
Investigation of the relationship between low Apgar scores and early neonatal thyroid function
Authors: Sak Erbil , Akin Mehmet , Aktürk Zekeriya , Akin Fulya , Atay Enver , Aydoğdu Cavit , Yüzkollar Erdoğan 
Published: March 2003

Abstract Background: The aim of the present study was to assess the effects of low Apgar scores on perinatal thyroid function.
Methods
: Forty full‐term infants delivered by the normal spontaneous vaginal route were enrolled into the study. All babies had 1 and 5 min Apgar scores below 4. The control group consisted of 26 full‐term healthy neonates. Cord blood and serum tri‐iodothyronine (T3), thyroxine (T4), reverse tri‐iodothyronine (rT3), free thyroxine (FT4), thyroid‐stimulating hormone (TSH) and thyroid‐binding globulin (TBG) determinations were performed by an enzyme immunoassay method.
Results
: The mean values of FT4 and T4 observed in the cord blood of the study group were significantly lower compared with matched controls, whereas the mean TSH values were significantly higher. There were no differences in concentrations of T3, rT3 and TBG between the two groups.
Conclusions
: These results demonstrate the existence of transient hypothyroidism at birth in babies with Apgar scores below 4 delivered by the spontaneous vaginal route.
Transient hypogammaglobulinemia of infancy: Clinical and immunologic features of 40 new cases
Authors: Kiliç S Şebnem , Tezcan İlhan , Sanal Özden , Metin Ayşe , Ersoy Fügen 
Published: March 2003

Background
: Transient hypogammaglobulinemia of infancy (THI) results from a delay in the maturation of immunoglobulin production.
Methods
: The clinical and immunologic data of 40 patients with THI are presented. Clinically, the majority of patients presented with recurrent respiratory infections and otitis media, bronchitis and/or bronchial asthma and recurrent gastroenteritis.
Results
: Ten of 40 children had isolated low IgG; isolated low IgA and isolated low IgM were detected in one and three patients, respectively. At initial evaluation, levels of all three immunoglobluins were low in nine patients. Ten patients had diminished IgG and IgA levels, six had diminished IgA and IgM levels and one had low IgG and IgM levels. Two patients were given intravenous immunoglobulin replacement therapy for 1 year. None of the patients has experienced serious infections during their follow‐up period.
Conclusions
: Prospective evaluation of patients (age range 5–60 months) revealed that immunoglobulin levels in 33 patients recovered before 36 months of age. Seven patients still had low immunoglobluin levels at 40–57 months of age. Three of these patients had low levels of both IgG and IgA, while two patients had low IgM levels and a further two patients had low IgA levels.
Correlation between neuroimaging and neurological outcome in periventricular leukomalacia: Diagnostic criteria
Authors: Hashimoto Kazuhiro , Hasegawa Hisaya , Kida Yoshikazu , Takeuchi Yutaka 
Published: March 2003

Abstract

Background
: Periventricular leukomalacia (PVL) is the most important factor in cerebral palsy in preterm infants.
Methods
: In the present study, we investigated 747 preterm infants of less than 36 weeks gestation who were repeatedly examined by cranial ultrasonography and computed tomography (CT) scanning at around 40 weeks of corrected post‐menstrual age. The clinical course of these infants was followed for more than 3 years and they were examined by magnetic resonance imaging (MRI) between 12 and 18 months of age.
Results
: Single examinations in early infancy were not sufficient to diagnose PVL, but the combination of ultrasonography, CT and MRI examinations allowed the clinical diagnosis of PVL. In preterm infants, clinical PVL could be predicted from cystic PVL and periventricular echogenicity (PVE) 3 or PVE 2 prolonged over 3 weeks on ultrasonography and confirmed by MRI after 11 months of corrected age.
Conclusions
: We tried to determine diagnostic criteria for PVL by neuroimaging. Such criteria from neuroimaging for PVL may be useful for determining the exact occurence rate of and clinical risk factors for PVL.
Contingent negative variation in children with orthostatic dysregulation
Authors: Torigoe Katsumi , Numata Osamu , Ogawa Youhei , Kaneko Utako , Usuda Touhei , Imamura Masaru , Takeuchi Kazuo , Suzuki Hiroshi , Endo Hikosato 
Published: March 2003

Abstract

Background
: Children with orthostatic dysregulation (OD) appear to have hypodynamia, as well as the symptoms described in the OD criteira. Hypodynamia, which is greatly influenced by motivation, volition and concentration, is unexceptionally recognized in their everyday life. It has been suggested that the symptoms and hypodynamia aggravate considerably the quality of life (QOL) of children with OD. The purpose of this study was to distinguish the characteristics of contingent negative variation (CNV) and post imperative negative variation, which may reflect the level of attention and motivation in children with OD.
Methods
: Twelve patients with OD aged 10–15 years and 23 age‐matched healthy children were included. The CNV was recorded from Fz, Cz and Pz linked to earlobes during 30 trials consisting of a warning stimulus and an imperative stimulus with an interstimulus interval (ISI) of 2 s and an intertrial interval (ITI) of 10 s. The imperative stimulus of each trial required a button to be pressed.
Results
: The untreated children with OD did not have a significantly smaller CNV amplitude than healthy children. Children with OD treated with midodrine and autonomic training had a significantly larger CNV amplitude than the untreated children, in the area of early, late and total CNV at the three sites.
Conclusion
: The present study confirms that children with OD have diminished motivation and deterioration of concentration, which cause hypodynamia in everyday life. Treatment for OD improves the symptoms, diminished motivation and deterioration of concentration, consequently restoring dynamia. Treatment for OD should be recommended to ameliorate QOL of children with OD.
Child behavior problems: Prevalence and correlates in rural minority areas of China
Authors: Li Yan , Shi Anping , Wan Ying , Hotta Masanaka , Ushijima Hiroshi 
Published: March 2003

Abstract

Background
: Ethnicity may possibly associate with different maternal child‐rearing practices and child developmental problems. The aim of this study was to better understand epidemiological features and correlates of child behavior problems in a large sample of children in economically disadvantaged rural minority areas of China and to provide reference data for subsequent intervention of child developmental problems.
Methods
: A total of 1222 rural mother‐child pairs belonging to Hani, Yi, Hui, Miao and Han were drawn from four economically disadvantaged minority counties in Yunnan Province of China. Well‐trained investigators completed child physical examination and measurements (height and weight) in village clinics and interviews of mothers at respondents’ homes using a structured questionnaire.
Results
: Child behavior problems were prevalent in children aged 2–6 years: 71.4% for temper tantrums; 48.2% for swearing; 36.0% for nocturnal bed‐wetting; 29.9% for disobedience; 29.5% for difficulty initiating sleep; and 17.0% for picky eating. Child behavior problems significantly differed across Hani, Yi, Hui, Miao and Han ethnic groups. Logistic regression indicated that ethnicity of Hui compared with Han, younger children, prenatal risk factors, being a twin, ineffective child‐rearing behaviors, such as pampering, corporal punishment, swaddling, family disagreement among child‐rearing contributed independently to the risk for child behavior problems.
Conclusions
: The child behavior problems were prevalent in children aged 2–6 years in rural minority children of China. Ineffective family child‐rearing practices increase risk for child behavior problems.
Betaine and homocysteine concentrations in infant formulae and breast milk
Authors: Sakamoto Akiko , Ono Hiroaki , Mizoguchi Nobuyuki , Sakura Nobou 
Published: March 2003

Abstract

Background
: Early diagnosis and treatment of homocystinuria with methionine‐free or low methionine formulae significantly improve prognosis in children found by newborn screening and treated soon after birth. Betaine (Bet) supplementation is also an effective strategy for dietary treatment of homocystinuria. However, previous reports on diet therapy have only examined methionine and cysteine concentrations but not those of Bet and homocysteine (Hcy) in infant diets.
Methods
: We measured Bet and Hcy concentrations in three methionine‐free formulae, five infant starter formulae, and 33 samples of human breast milk from 10 mothers.
Results
: In methionine‐free formulae, Hcy but not Bet was isolated. However, in human breast milk and infant starter formulae, both Bet and Hcy were detected. However, the Bet concentration was not sufficient for the treatment.
Conclusions
: Our study suggests that methionine‐free formulae should have Hcy eliminated and be fortified with Bet to the concentration of 150 mg/dL for the treatment of homocystinuria.
Association between birthweight and body mass index at 3 years of age
Authors: Tanaka Tamami , Matsuzaki Akinobu , Kuromaru Ryuichi , Kinukawa Naoko , Nose Yoshiaki , Matsumoto Toshimichi , Hara Toshiro 
Published: March 2003

Abstract

Background
: Obesity in children is one of the risk factors for adulthood obesity, which then leads to the development of chronic diseases such as hypertension, hyperlipidemia and diabetes. In this study, we identified significant factors associating with the body mass index (BMI) at 3 years of age from the perinatal characteristics of children.
Methods
: A total of 588 children were included in the study. The BMI at 3 years of age was examined in conjuction with the possible variables such as parents’ smoking status during pregnancy, parents’ age at birth, gestational age, sibling number and live birth order, sex, birthweight, BMI at 1 month of age, weight gain during the first month of life and feeding method at 1 month of age.
Results
: Univariate analysis showed that birthweight (P<0.0001), weight gain during the first month of life (P=0.0012) and BMI at 1 month of age (P<0.0001) were significantly associated with the BMI at 3 years of age. Of these factors, birthweight and weight gain during the first month of life were the independent factors correlating with the BMI at 3 years by multivariate analysis (P<0.0001 and P=0.0095, respectively).
Conclusions
: Infants with higher birthweight and/or greater weight gain during the first month of life may have a risk of being overweight at 3 years of age.
Natural coagulation inhibitors (protein C, protein S, antithrombin) in patients with sickle cell anemia in a steady state
Authors: Bayazit Aysun Karabay , Kilinç Yurdanur 
Published: March 2003

Abstract

Background
: Patients with sickle cell anemia (SCA) run the risk of having decreased levels of natural coagulation inhibitors. This may be due to either hemostatic abnormalities or hepatic dysfunction. This study is designed to evaluate coagulation profiles of patients with SCA in a steady state and to determine whether hypercoagulable state is present or not.
Methods
: Seventeen children with SCA in a steady state were included in this study. The routine hematological evaluation was done with a coulter‐counter. Reticulocyte percentage and blood coagulation tests were also determined. The coagulation inhibitors such as protein C (as activated partial thromboplastine time prolongation time), protein S (as Factor V inhibition) and antithrombin (colorimetric assay) were measured in all cases.
Results
: In the coagulation profile, mean euglobuline lysis time and mean fibrin degradation product levels were both significantly higher in the patient group than in the control group (P<0.05), although other parameters were within normal limits. The values for aspartate aminotransferase (AST), alanine aminotransferase (ALT) and indirect reacting bilirubin were significantly higher in the patient group than in the control group (P<0.001, P<0.005, P<0.0001, respectively). The serum protein levels were normal. Mean factor V level was significantly lower and mean factor VIII level was found significantly higher in the patient group than in the control group (P<0.05 and P<0.005, respectively). Protein C and AT levels were lower in patients with SCA than in control subjects (P<0.001). Protein S levels were also lower in the patient group than in the control group, but the difference between the two groups was not significant (P>0.05).
Conclusion
: It is indicated that antithrombotic functions of patients with SCA are handicapped even in a steady state; and both hemostatic abnormalities and hepatic dysfunction contribute to low levels of natural coagulation inhibitors.
Unexplained subdural hematoma in young children: Is it always child abuse?
Authors: Fung Eva Lai Wah , Sung Rita Yn Tz , Nelson Edmund Anthony Severn , Poon Wai Sang 
Published: March 2003

Abstract
Background
: In the published reports of the developed society, subdural hematoma and/or retinal hemorrhages, in the absence of documented history of major trauma, should be considered diagnostic of child abuse. Many people used the above criteria for diagnosis, but subsequently found that retinal hemorrhages were more common in non‐accidental injuries (NAI). To what extent is the proposed pathognomonic association between unexplained subdural hematoma/retinal hemorrhages and child abuse a self‐fulfilling prophecy?
Methods
: Clinical details of nine children under 2 years with unexplained subdural hematoma admitted to Prince of Wales Hospital between 1995 and 1998 were reviewed.
Results
: Four had no other physical signs
of injury, five had retinal hemorrhages and one had multiple bruises over
the body. Following multidisciplinary case conferences for seven
children, a diagnosis of NAI was concluded in four cases, but in
no case could the abuser be definitely identified. Clinical outcome
was poor with seven children showing either profound disability
(n = 5) or evidence of developmental
delay (n = 2).
Conclusion
: In this series, NAI were not established in three of the seven cases. Did we underdiagnose child abuse in these cases? Despite a magnitude of opinion to the contrary, the issue of whether ‘trivial’ head injury can cause subdural hemorrhages and/or retinal hemorrhages is yet unresolved. Clearly much more information on this very sensitive and serious issue is required and these data should be collected with an open mind.
Bone mineral status in ambulatory pediatric patients on long‐term anti‐epileptic drug therapy
Authors: Tsukahara Hirokazu , Kimura Kouki , Todoroki Yukiko , Ohshima Yusei , Hiraoka Masahiro , Shigematsu Yosuke , Tsukahara Yasuyo , Miura Masakazu , Mayumi Mitsufumi 
Published: March 2003

Abstract
Background
: For ambulatory pediatric outpatients, reports of abnormalities of bone metabolism associated with anti‐epileptic drugs are inconsistent and may be difficult to interpret.
Methods
: The effects of long‐term anti‐epileptic therapy (mainly valproic acid and/or carbamazepine) on bone mineral status were evaluated in ambulatory epileptic patients (seven males and 11 females) aged 5.5−15.9 years. Bone mineral density (BMD) at the lumbar spine was measured by dual‐energy X‐ray absorptiometry and markers of bone and mineral metabolism were determined.
Results
: The mean BMD was decreased by 9% in our patients relative to the control, and five patients (all males)
showed osteopenia, defined as BMD SD scores less than − 1.5. Serum levels of minerals, intact parathyroid hormone and 1α,25 (OH)2 vitamin D were within the normal ranges. In most patients, serum levels of intact osteocalcin, carboxyterminal propeptide of type I procollagen
and pyridinoline cross‐linked telopeptide of type I collagen were reduced relative to the corresponding mean control values. The BB genotype
by BsmI restriction fragment length polymorphism, associated with low BMD, was not found in our patients. The dietary calcium intake in the osteopenic patients was significantly lower than that of the non‐osteopenic patients.
Conclusions
: Our results indicate that long‐term anti‐epileptic treatment induces a state of decreased bone turnover in children, resulting in osteopenia preferentially in males. The alterations may be due, at least in part, to direct effects of the drugs on bone cells; and that low calcium intake could be an aggravating factor for anti‐epileptic‐associated osteopenia.
Most reliable indices in differentiation between thalassemia trait and iron deficiency anemia
Authors: Demir Aysin , Yarali Nese , Fisgin Tunc , Duru Feride , Kara Abdurrahman 
Published: March 2003

Abstract
Background
: Iron deficiency anemia (IDA) and thalassemia trait (TT) are the most common forms of microcytic anemia. Some discrimination indices calculated from red blood cell indices are defined and used for rapid discrimination between TT and IDA. However, there has been no study carried out in which the validity of all of the defined indices are compared in the same patient groups. Youden's index is the most reliable method by which to measure the validity of a particular technique, because it takes into account both sensitivity and specificity.
Methods
: We calculated eight discrimination indices (Mentzer Index, England and Fraser Index, Srivastava Index, Green and King Index, Shine and Lal Index, red blood cell (RBC) count, red blood cell distribution width and red blood cell blood distribution width index (RDWI)) in 26 patients with IDA and in 37 patients with beta TT (βTT). We determined the number of correctly identified patients by using each discrimination index. We also calculated sensitivity, specificity, positive and negative predictive value and Youden's index of each discrimination index.
Results
: None of the discrimination indices showed a sensitivity and specificity of 100%. Youden's indices of RBC count and RDWI were the highest with the value of 82 and 80%, respectively. Ninety percent and 92% of the patients were correctly identified with RBC and RDWI, respectively.
Conclusion
: Red blood cell count and RDWI are the most reliable discrimination indices in differentiation between βTT and IDA.
Challenges of the grounded theory approach to a novice researcher
Authors: Backman Kaisa , Kyngäs Helvi A. 
Published: March 2003

AbstractThe grounded theory approach has been used in nursing research since 1970. The latest methodological books describe the research process in detail. However, there are many problems involved in the grounded theory approach, which especially need to be considered by a novice researcher. One of these problems is the question of how deeply and widely the researcher should familiarize her‐ or himself with the research topic before the empirical study. The problems also include the need to focus the research problem and to choose the sampling method. Data analysis is a multistage process, which demands from the researcher both sensitivity and time to work out the findings which emerge from the data. In this paper, the grounded theory approach is described as a process undertaken by the novice researcher. The purpose of this paper is to discuss the challenges of the grounded theory approach and the problems encountered by a researcher using the method for the first time.
Thoughts and feelings of in‐patients with advanced terminal cancer: Implications for terminal care improvement
Authors: Tanaka Aiko , Iwamoto Teruyo , Kaneyasu Hisae , Petrini Marcia A. 
Published: March 2003

AbstractThe purpose of this study was to clarify how terminally ill patients think and feel while hospitalized, thereby providing some insight into improving the quality of terminal care. The subjects of the study were eight terminally ill patients with cancer. The researchers obtained the patients’ consent and their doctors’ permission prior to conducting the interviews. Individual, semi‐structured interviews were conducted. The patients’ thoughts and feelings were extracted and then categorized according to particular themes. As a result, we came up with four major categories: maintaining pain control, living an ordinary life, hoping for improvement of physical condition, and having family nearby. The desire to live life to its fullest given their situation, as well as to maintain a hopeful attitude about their future proved very important. The presence of family also played a crucial role. These factors must be taken into consideration in achieving better care for terminally ill patients.