bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tularaemia
Authors: Tärnvik A. , Berglund L. 
Published: April 2003

Tularaemia is a zoonotic bacterial disease of the Northern hemisphere. The causative agent,Francisella tularensis, is spread to humans by direct contact with infected rodents or lagomorphs, aerogenic exposure, ingestion of contaminated food or water, or by arthropod bites. The prevalence of tularaemia shows a wide geographic variation. In some endemic regions, outbreaks occur frequently, whereas nearby rural parts of a country may be completely free.F. tularensisis a facultative intracellular pathogen and its primary mammalian target cell is the mononuclear phagocyte. When tularaemia is acquiredviathe skin, a primary ulcer is often detected and in general, regional lymph nodes become prominently enlarged. When contracted by inhalation, the disease may present with pneumonia. Nearly as frequent, however, is the development of fever and general illness with no respiratory symptoms and no pulmonary radiological changes. When present, the changes vary widely and may sometimes include hilar enlargement indistinguishable from that of lymphoma.Within an outbreak, the first case of tularaemia is not always readily diagnosed. A decade may have lapsed since the disease was encountered and its existence may be more or less forgotten. The difficulty refers especially to the respiratory form, in which symptoms are less specific. In cases of atypical pneumonia or acute febrile disease with no local symptoms, a history of exposure to hares or rodents or merely living in an endemic region should be sufficient to include tularaemia among differential diagnoses.The microbiological diagnosis of tularaemia relies mainly on serology, and the treatment on broad-spectrum antibiotics. For decades, a live vaccine has been successfully used in risk groups but is presently not available due to difficulties in standardisation.
Mould exposure at home relates to inflammatory markers in blood
Authors: Beijer L. , Thorn J. , Rylander R. 
Published: April 2003

Living in damp buildings has been associated with airway symptoms, suspected to be due to inflammatory reactions. The relationship between home exposure to mould and signs of inflammation was, therefore, studied.Nonsmoking subjects with a high (G-high, >4.0 ng·m−3, n=17) or low (G-low, <2.0 ng·m−3, n=18) amount of airborne β(1→3)-d-glucan, an indicator of mould biomass, in the home were recruited. Blood samples were analysed for granulocytic enzymes, T-cell subsets and the secretion of cytokines fromin vitroincubated peripheral blood mononuclear cells (PBMCs).In the G-high group, the proportion of cytotoxic T-cells (CD8+S6F1+) was lower and secretion of tumour necrosis factor-α from PBMCs higher than in the G-low group. There were no significant differences in secretion of interferon gamma and interleukin (IL)-4 from PBMCs between the two groups. Among nonatopic subjects, the ratio between interferon gamma and IL-4 was significantly higher in the G-high group than in the G-low group and was related to the amount of β(1→3)-d-glucan in the home. No significant differences were found regarding secretion of IL-10 or IL-1β from PBMCs, eosinophil cationic protein or myeloperoxidase in serum, or differential cell counts in blood.The effects found on inflammatory markers in relation to β(1→3)-d-glucan in the home suggest upregulation of some parts of the inflammatory/immunological system due to mould exposure.
Apoptosis of bronchoalveolar lavage lymphocytes in hypersensitivity pneumonitis
Authors: Laflamme C. , Israël-Assayag E. , Cormier Y. 
Published: April 2003

The aim of this study was to look at the apoptosis of alveolar lymphocytes in hypersensitivity pneumonitis (HP). HP patients and normal unexposed controls were studied.The percentage of apoptotic lymphocytes was significantly lower in HP patients than in normal patients (37.4±3.4versus56.5±5.5% for Annexin V and propidium iodine detection methods and 0.4±0.1versus1.0±0.2% for dUTP nick end-labelling technique (TUNEL)). The proportion of bronchoalveolar lavage (BAL) lymphocytes positive for Fas antigen was significantly higher in HP patients than in normal subjects (71.7±5.4versus50.4±9.0%). However, no significant difference was found in the proportion of BAL lymphocytes positive for Fas ligand (FasL) between the two groups. Soluble Fas (sFas) levels in the BAL fluid of the patients and normals were 80.5±8.5 pg·mL−1and 23.2±3.1 pg·mL−1, respectively. A positive correlation was found between the percentage of BAL lymphocytes and the levels of sFas for the total subjects but not within the separate study groups. The intracellular quantity of the inducible anti-apoptotic gene Bcl-xL product was significantly higher in the pulmonary lymphocytes of HP patients than in lymphocytes of the control, while no difference was found for constitutive anti-apoptotic protein (Bcl–2).In conclusion, the apoptosis of pulmonary lymphocytes is lower in hypersensitivity pneumonitis than in normal subjects. This could be explained, at least in part, by an increase of soluble Fas, the anti-apoptic gene, and Bcl-xL.
Hypertonic saline increases secretory and exudative responsiveness of human nasal airwayin vivo
Authors: Greiff L. , Andersson M. , Wollmer P. , Persson C.G.A. 
Published: April 2003

Hypertonic saline (HS) is used in sputum induction studies. However, little is known about the physiological effects of HS on human airwaysin vivo. The present study takes advantage of the fact that the airway effects of topical challenges may be accurately examined in the readily accessible nasal airway. The present study specifically examines whether exposure to HS affects histamine challenge-induced exudation of plasma (α2-macroglobulin) and methacholine-induced secretion of mucin (fucose).Isotonic saline and HS (27 and 45 g·L−1), with and without concomitant histamine challenges, and with and without preceding methacholine challenges, were administered onto the nasal mucosa in 16 healthy subjects. Lavage fluid levels of α2-macroglobulin and fucose were analysed.Histamine produced a significant mucosal output of plasma (α2-macroglobulin). HS itself did not evoke exudation of α2-macroglobulin, but it significantly increased the plasma exudation effect of histamine. Methacholine produced a significant nasal mucosal output of fucose. HS also increased the mucin secretion (fucose), and it enhanced the secretory effect of methacholine.The authors concluded that hypertonic saline alone evokes mucinous secretion in human nasal airwaysin vivoand that it also enhances the exudative and secretory effects of histamine and methacholine, respectively. Through different mechanisms the HS exposure may also improve the recovery of soluble indices in human nasal airways. Whether or not the present findings are translatable to human bronchial airways remains to be examined.
High Mallampati score and nasal obstruction are associated risk factors for obstructive sleep apnoea
Authors: Liistro G. , Rombaux Ph. , Belge C. , Dury M. , Aubert G. , Rodenstein D.O. 
Published: April 2003

Induced nasal obstruction can cause obstructive apnoeas in healthy subjects during sleep, but the relationship between nasal resistance measured during wakefulness and obstructive sleep apnoea syndrome (OSAS) is weak. It was postulated that if the subjects could not breathe through the nose, the oral airway must be used, but if this airway is narrowed as well, then it could precipitate sleep-disordered breathing (SDB).Nasal patency, Mallampati score (MS), neck circumference and body mass index were measured in 202 subjects referred to the authors' hospital to undergo a full-night polysomnography for suspicion of SDB.A significant correlation was found between the MS and apnoea/hypopnoea index measured during sleep. However, the relationship between these parameters was only significant in patients with nasal obstruction. The relative risk of having OSAS with a MS of III or IV was 1.95 for the whole group and 2.45 in patients with nasal obstruction.In conclusion, a high Mallampati score represents a predisposing factor for obstructive sleep apnoea syndrome, especially if it is associated with nasal obstruction. These patients merit special attention from both the sleep physician and the anaesthetist.
Evaluation of a portable device for diagnosing the sleep apnoea/hypopnoea syndrome
Authors: Dingli K. , Coleman E.L. , Vennelle M. , Finch S.P. , Wraith P.K. , Mackay T.W. , Douglas N.J. 
Published: April 2003

Waiting times for hospital-based monitoring of the obstructive sleep apnoea/hypopnoea syndrome (OSAHS) are rising. This study tested whether Embletta, a new portable device, may accurately diagnose OSAHS at home.A synchronous comparison to polysomnography was performed in 40 patients and a comparison of home Embletta studies with in-laboratory polysomnography was performed in 61 patients.In the synchronous study, the mean difference (polysomnography–Embletta) in apnoeas+hypopnoeas (A+H)·h−1in bed was 2·h−1. In comparison to the apnoea/hypopnoea index (AHI)·h−1slept, the Embletta (A+H)·h−1in bed differed by 8·h−1. These data were used to construct diagnostic categories in symptomatic patients from their Embletta results: “OSAHS” (≥20 (A+H)·h−1in bed), “possible OSAHS” (10–20 (A+H)·h−1in bed) or “not OSAHS” (<10 (A+H)·h−1in bed). In the home study, the mean difference in (A+H)·h−1in bed was 3·h−1. In comparison to the polysomnographic AHI·h−1slept, the Embletta (A+H)·h−1in bed differed by 6±14·h−1. Using the above classification, all nine patients categorised as not OSAHS had AHI <15·h−1slept on polysomnography and all 23 with OSAHS on Embletta had an AHI ≥15 on polysomnography, but 18 patients fell into the possible OSAHS category potentially requiring further investigation and 11 home studies failed.Most patients were satisfactorily classified by home Embletta studies but 29 out of 61 required further investigation. The study suggested a 42% saving in diagnostic costs over polysomnography if this approach were adopted.
Systemic effects of chronic obstructive pulmonary disease
Authors: Agustí A.G.N. , Noguera A. , Sauleda J. , Sala E. , Pons J. , Busquets X. 
Published: April 2003

Chronic obstructive pulmonary disease (COPD) is characterised by an inappropriate/excessive inflammatory response of the lungs to respiratory pollutants, mainly tobacco smoking.Recently, besides the typical pulmonary pathology of COPD (i.e.chronic bronchitis and emphysema), several effects occurring outside the lungs have been described, the so-called systemic effects of COPD. These effects are clinically relevant because they modify and can help in the classification and management of the disease.The present review discusses the following systemic effects of chronic obstructive pulmonary disease: 1) systemic inflammation; 2) nutritional abnormalities and weight loss; 3) skeletal muscle dysfunction; and 4) other potential systemic effects. For each of these, the potential mechanisms and clinical implications are discussed and areas requiring further research are highlighted.
Predictors of poor renal outcome in patients with lupus nephritis treated with combined pulses of cyclophosphamide and methylprednisolone
Authors: Cortés-Herández J , Ordi-Ros J , Labrador M , Segarra A , Tovar J L , Balada E , Vilardell-Tarres M 
Published: April 2003

Lupus nephritis remains a major cause of morbidity and mortality in patients with systemic lupus erythematosus. Although the renal prognosis has improved, the optimal therapeutic regime has not been definitively established, and significant challenges remain in the management of disease progression and recurrent renal relapse. We performed a prospective study to evaluate the outcome of 38 patients with severe lupus nephritis treated with standard cyclophosphamide and methylprednisolone pulse therapy, and to determine the variables associated with poor outcome. Five patients developed end-stage renal disease (ESRD) (13%), 10 (26%) developed persistent proteinuria (>1 g=24 h) and 15 (39%) suffered at least one relapse after 8 years of follow-up. A high chronicity index, interstitial fibrosis (P = 0.04), persistent hypertension (P < 0.0001) and hypocomplementaemia(P = 0.002) after treatment were the major variables associated with ESRD. Tubular atrophy (P = 0.01), persistent hypertension (P = 0.0001) and hypocomplementaemia after treatment (P = 0.0281) were associated with persistent proteinuria. Persistence of anti-dsDNA antibodies and hypocomplementaemia after treatment (P = 0.0118) were associated with renal relapse. Our data suggest that the group of patients with persistence of hypocomplementaemiaand raised anti-dsDNA antibodies titres are at high risk of renal relapse and may be candidatesfor continuation of immunosuppressive treatment. Patients with persistent proteinuria alone or a high chronicity index are less likely to respond to immunosuppression, and strict control of the hypertension may be the best approach.
Ethical Issues After the Disclosure of a Terminal Illness: Danish and Norwegian hospice nurses’ reflections
Authors: Lorensen Margarethe , Davis Anne J , Konishi Emiko , Bunch Eli H 
Published: April 2003

This research explored the ethical issues that nurses reported in the process of elaboration and further disclosure after an initial diagnosis of a terminal illness had been given. One hundred and six hospice nurses in Norway and Denmark completed a questionnaire containing 45 items of forced-choice and open-ended questions. This questionnaire was tested and used in three countries prior to this study; for this research it was tested on Danish and Norwegian nurses. All respondents supported the ethics of ongoing disclosure to terminally ill patients based on ethical principles embedded in their country’s Patients’ Rights Acts. Truth, as an intrinsic value, proved foundational to patient autonomy, the most frequent ethical principle these nurses reported to justify their ethical position on information disclosure to terminally ill people. Telling the truth about a diagnosis was not the end of ethics in hospice care, but rather the beginning because what occurs ethically in dealing with prognosis issues became central to these hospice nurses, the patients and their families. Coupled with truth-telling, compassionate interaction and care become extensions of patients’ rights.
Disseminated Neuroblastoma in Children Older Than One Year at Diagnosis: Comparable Results With Three Consecutive High-Dose Protocols Adopted by the Italian Co-Operative Group for Neuroblastoma
Authors: De Bernardi Bruno , Nicolas Brigitte , Boni Luca , Indolfi Paolo , Carli Modesto , Cordero di Montezemolo Luca , Donfrancesco Alberto , Pession Andrea , Provenzi Massimo , di Cataldo Andrea , Rizzo Antonino , Tonini Gian Paolo , Dallorso Sandro , Conte Massimo , Gambini Claudio , Garaventa Alberto , Bonetti Federico , Zanazzo Andrea , D’Angelo Paolo , Bruzzi Paolo 
Published: April 2003

Purpose: To compare the outcomes associated with modifications in three consecutive protocols employed by the Italian Co-Operative Group for Neuroblastoma (ICGNB) in disseminated neuroblastoma. Patients and Methods: Between January 1985 and November 1997, a total of 359 children aged 1 to 15 years with newly diagnosed stage 4 neuroblastoma were enrolled in three consecutive protocols. Compared with ICGNB-85, the ICGNB-89 protocol contained two more chemotherapy cycles, and some drugs were given at greater doses, whereas in the ICGNB-92 protocol, the induction phase included a chelating agent, and individual cycles contained four drugs instead of two. Results: A total of 330 of 359 evaluable children were included in this analysis; 106 children were treated with ICGNB-85, 65 children were treated with ICGNB-89, and 159 children were treated with ICGNB-92 protocols. Radical resection of primary tumor was carried out in 59.4%, 50.8%, and 57.9% of the patients, respectively. Major tumor response after induction therapy was achieved in 66.7%, 69.2%, and 68.6% of the patients, respectively. A total of 218 of 232 patients received consolidation therapy consisting of conventional chemotherapy in 65 patients and of high-dose chemotherapy in 153 patients. Disease recurrence or progression occurred in 82.1%, 69.2%, and 74.8% of the patients, respectively. Therapy-related deaths occurred in 1.9%, 12.3%, and 6.9% of the patients, respectively. Five-year overall survival (OS) for the three studies was 26%, 23%, and 28%, and event-free survival (EFS) was 19%, 17%, and 17%, respectively. Conclusion: The therapeutic modifications adopted in the ICGNB-89 and ICGNB-92 protocols were not associated with a significant improvement in response rate or in the 5-year OS and EFS as compared with the ICGNB-85 protocol. Attempts at intensifying chemotherapy were associated with greater toxicity.
Leptin Distribution and Metabolism in the Pregnant Rat: Transplacental Leptin Passage Increases in Late Gestation but Is Reduced by Excess Glucocorticoids
Authors: Smith Jeremy T. , Waddell Brendan J. 
Published: April 2003

Abstract
Leptin is essential for the establishment of pregnancy and appears to promote fetal growth, but the mechanisms regulating fetal leptin exposure remain unclear. In rodents, indirect evidence suggests that fetal leptin is partly derived from the maternal circulation via transplacental passage. Indeed, the placenta expresses mRNA for Ob-Ra, one of the short forms of the leptin receptor (Ob-RS) important in leptin transport, and this expression increases markedly in late pregnancy. Therefore, we determined the transplacental passage of maternal leptin to the fetus in the rat and whether this transport increases near term in association with a rise in placental expression of Ob-RS protein. Because of the proposed role of leptin in promoting fetal growth, we also assessed the effect of glucocorticoid-induced fetal growth retardation on placental leptin transport. Anesthetized rats received a constant infusion of 125I-leptin via a jugular cannula before and at d 16 and 22 of pregnancy (term = d 23); plasma samples were obtained at 10, 20, 40, 60, 80, and 100 min, and fetuses and placentas were collected at the time of the final sample. The metabolic clearance rate of leptin fell (P &lt; 0.01) from 3.08 ± 0.23 ml/min per kg in nonpregnant rats to 2.36 ± 0.13 ml/min per kg by d 22. Transplacental passage of 125I-leptin, estimated from its concentration in the whole fetus relative to maternal plasma, increased 10-fold (P &lt; 0.005) between d 16 and d 22 of pregnancy. Over this same period, Ob-RS protein expression in the placental labyrinth zone increased by almost 2-fold. Transplacental leptin passage was reduced (P &lt; 0.05) by 77% after maternal dexamethasone treatment, whereas suppression of endogenous glucocorticoid synthesis (by metyrapone) increased (P &lt; 0.05) the transfer of maternal leptin to the fetus by 55%. These data show that transplacental passage of maternal leptin is a significant source of fetal leptin and increases markedly during late pregnancy. Consistent with the proposed role of leptin as a fetal growth factor, transplacental leptin passage is reduced in association with glucocorticoid-induced fetal growth retardation.
Structural Analysis of Yoked Chorionic Gonadotropin-Luteinizing Hormone Receptor Ectodomain Complexes by Circular Dichroic Spectroscopy
Authors: Fralish Gregory B. , Dattilo Brian , Puett David 
Published: April 2003

AbstractBinding of the heterodimeric glycoprotein hormone, chorionic gonadotropin (CG), occurs to the heptahelical LH receptor N-terminal ectodomain (ECD), a large portion of which has been modeled as a leucine-rich repeat protein. In this study, we expressed and purified three single chain N-CG-ECD-C complexes, one comprising the full-length ECD, 1–341 (encoded by exons 1–10 and a portion of 11), and two C-terminal ECD deletion fragments, 1–294 (encoded by exons 1–10) and 1–180 (encoded by exons 1–7). The fusion proteins, including yoked CG (N-β-α-C), were characterized by Western blot analysis and circular dichroism (CD). Analysis of the CD spectra obtained on the CG-ECD fusion proteins, and of the difference spectrum of each after subtracting the CG contribution, yielded secondary structures consistent with a repeating β-strand/α-helix fold as predicted in the homology model. A marked decrease in helicity was observed when the C-terminal 47 amino acid residues were removed from the ECD. Removal of an additional 114 residues, i.e. the region encoded by exons 8–10, results in the loss of fewer helical residues. These results suggest that the hinge region of the ECD, predicted to contain only limited secondary structure, interacts with and stabilizes the ligand-occupied N-terminal portion. Furthermore, the results support a repeating fold, consistent with the proposed model for the LHR ECD.
Collaborative development using EMProDS: The electromechanical product design system
Authors: Farr R , Gayretli A , Speller H , Gindy N 
Published: April 2003

Among manufactured products, electromechanical devices are something of a special case, requiring input at the earliest design stage of experts from two (or more) distinctly separate branches of engineering. This tends to promote a modular approach under which products are partitioned by function, with each module being either purely electrical or purely mechanical. However, customers' demands for smaller lighter, less expensive items with greater functionality force manufacturers to produce integrated systems. Furthermore, modules which function optimally in isolation may not produce an optimal assembly. This paper describes an alternative approach to the conceptual design of electromechanical products, in which a software tool promotes the communication of ideas and opinions. EMProDS provides an easy-to-use distributed design environment, meant to preserve as far as possible the intent of the design team—an aspect of design which can easily be lost once detailed computer aided design drawings are made. This makes any redesign activity which is required simpler and eliminates a common source of conflict between specialists with different technical backgrounds.
Rapid Synthesis of SnSe Nanowires via an Ethylenediamine-assisted Polyol Route
Authors: Shen Guozhen , Chen Di , Jiang Xuan , Tang Kaibin , Liu Yankuan , Qian Yitai 
Published: April 2003

Abstract
A rapid ethylenediamine-assisted polyol (ENAP) process has been proposed to synthesize SnSe nanowires with high aspect ratio for the first time. The product was characterized by X-ray powder diffraction and transmission electron microscope. It was found that ethylenediamine has a great influence on the morphology and purity of the final products.
An Acid–Base Controlled Molecular Switch. syn–anti Conformational Switching in a μ-oxo Bis(Iron Porphyrin)
Authors: Hembury Guy A , Borovkov Victor V , Lintuluoto Juha M , Inoue Yoshihisa 
Published: April 2003

Abstract
It was found that FeD adopted a stable syn conformation as a result of the inclusion of atomic oxygen in a μ-oxo fashion, but on exposure to acidic conditions converted into the extended anti form. When this was subsequently made basic the syn conformation was re-adopted, simply due to re-inclusion of atomic oxygen forming the μ-oxo species. It was found that the combination of these affects allowed FeD to undergo repeated conformational switching cycles that were reproducible and robust.
Preparation and Properties of Sterically Protected Diphosphene and Fluorenylidenephosphine Bearing the 2,6-Di-tert-butyl-4-methoxyphenyl Group
Authors: Toyota Kozo , Kawasaki Subaru , Nakamura Akitake , Yoshifuji Masaaki 
Published: April 2003

Abstract
A new bulky bromobenzene, 2-bromo-1,3-di-tert-butyl-5-methoxybenzene, was prepared and utilized to preparations of the corresponding diphosphene and fluorenylidenephosphine including low-coordinate phosphorus atom(s). An electronic perturbation of the p-methoxy group in the system was indicated by UV–vis spectra and 31P NMR chemical shifts.