bluuebunny/crossref_metadata_2025_split huggingface dataset:
Successful treatment of hepatic sarcoidosis with hormone replacement in a postmenopausal woman
Authors: Chida Kingo , Shirai Masahiro , Sato Masaki , Sato Jun , Nakamura Hirotoshi 
Published: March 2003

AbstractA possible supplementary effect of sex hormone replacement therapy (HRT) for the postmenopausal woman with sarcoidosis is described. A 53‐year‐old woman presented with a 12‐year history of sarcoidosis in the eyes, in the submandibular lymph nodes and in the lungs. In the course of follow up without any medication, her liver function tests were abnormal, and she was diagnosed as having hepatic sarcoidosis. Daily administration of 0.625 mg conjugated oestrogen and 2.5 mg medroxyprogesterone improved her liver function. The results suggest that HRT may help to prevent the progression of sarcoidosis in postmenopausal patients.
Idiopathic bronchiolitis obliterans with organizing pneumonia presenting with spontaneous hydropneumothorax and solitary pulmonary nodule
Authors: Yang Dong Gyoo , Kim Kil Dong , Shin Dong Hwan , Choe Kyu Ok , Kim Sung Kyu , Lee Won Young 
Published: March 2003

AbstractThe first case of idiopathic bronchiolitis obliterans with organizing pneumonia (BOOP) presenting as solitary pulmonary nodule with spontaneous hydropneumothorax is reported in a 54‐year‐old man. A wedge resection of the right lower lobe was performed to show typical histological features of BOOP. This case report demonstrates that BOOP has a very diverse clinical manifestation and stresses the need to include solitary pulmonary nodule with hydropneumothorax in the spectrum of BOOP.
Asthma is more prevalent in rural New South Wales than metropolitan Victoria, Australia
Authors: Woods Rosalie K. , Burton Deborah L. , Wharton Cathryn , McKenzie Geoffrey H. , Walters E. Haydn , Comino Elizabeth J. , Abramson Michael J. 
Published: March 2003

Objective:The aim of this study was to compare the prevalence of adult respiratory symptoms and conditions in a rural setting with a metropolitan setting.Methodology:We used cross‐sectional population surveys of respiratory health using the European Respiratory Health Survey screening questionnaire. A random sample of 4455 eligible young adults aged 20–44 years, from electoral rolls in south‐eastern metropolitan Melbourne, Victoria, and 4521 from rural south‐western New South Wales were surveyed.Results:Response rates of 72% (n = 3194) and 69% (n = 3121) were achieved in Melbourne and the Riverina, respectively. Respondents from the Riverina reported significantly higher prevalences of nocturnal dyspnoea (P < 0.01), chronic bronchitis (P = 0.03), an asthma attack in the previous 12 months (P < 0.001), ever having had asthma (P < 0.001) and doctor‐diagnosed asthma (P < 0.001) compared to those from Melbourne. However, among those with ‘asthma attacks in the last 12 months’, Melbourne respondents experienced a higher frequency of attacks (P < 0.05). Riverina respondents reported a higher prevalence of smoking (P < 0.05) and smoked more cigarettes on average (P < 0.001) than Melbourne respondents. However, annoyance from air pollution was higher in Melbourne than in the Riverina.Conclusions:These results suggest that asthma is more prevalent in rural southern New South Wales than in Melbourne but follows a different pattern of exacerbations.
Primary spontaneous pneumothorax: Treatment practices in Australia
Authors: Sutherland Michael , Burdon Jonathan , Hart David 
Published: March 2003

Objective:The aim of the present study was to determine treatment practices for spontaneous pneumothorax (PTX) in Australia.Methodology:A questionnaire regarding treatment of PTX was posted to all medically qualified members of the Thoracic Society of Australia and New Zealand resident in Australia.Results:Fifty‐three per cent (n = 226) of questionnaires were returned. Twenty‐one responses were judged to be informal and rejected from analysis. The results indicate a general agreement in the treatment of small and large PTX but a wide variation in PTX of intermediate size.Conclusion:Opinion regarding the optimal treatment for PTX of intermediate size was found to vary considerably. There is a need for evidence‐based development and publication of best practice guidelines for PTX.
Optimization of sputum‐processing methods for the measurement of interleukin‐5: Effects of protease inhibition
Authors: SIMPSON JODIE L. , GIBSON PETER G. , WARK PETER A. B. 
Published: March 2003

Background:Interleukin (IL)‐5 measurement in sputum samples has produced variable results that appear to be due to methodological problems. The aim of the present study was to investigate the effects of dithiothreitol (DTT), sputum protease inhibition and sample storage on IL‐5 recovery in order to develop a method to accurately measure IL‐5 in dispersed sputum supernatant.Methodology:Measurement of IL‐5 in sputum was performed in 22 subjects with airway disease. Interleukin‐5 recovery was measured in samples spiked with recombinant human IL‐5 using a commercial ELISA. A mix of four protease inhibitors (PI) was added to sputum processed using the selection method with dispersion using DTT and stored with and without inhibitors.Results:The addition of PI to sputum resulted in a 24% increase in IL‐5 recovery. Recovery was not further increased with the addition of a blocking protein. Storage of IL‐5‐spiked sputum gave significantly less recovery. The addition of PI to sputum processed with DTT had no effect on total cell count, viability or cell differential.Conclusion:Interleukin‐5 recovery is increased by the addition of PI to samples processed using the selected portion method with DTT dispersion. A protease inhibitor cocktail should be added to sputum for IL‐5 assay.
Long‐term observations of the clinical course after step down of corticosteroid inhalation therapy in adult chronic asthmatics: Correlation with serum levels of eosinophil cationic protein
Authors: BABA Kenji , SAKAKIBARA Ayako , YAGI Takeo , NIWA Sayaka , WAKAYAMA Hideo , TAKAGI Kenzo 
Published: March 2003

Background: Symptoms often deteriorate in well‐controlled asthmatics after a step down in inhaled beclomethasone dipropionate (iBDP) therapy if the serum concentration of eosinophil cationic protein (sECP) is high. This deterioration is significantly abrogated by pranlukast, a leukotriene receptor antagonist, or by seratrodast, a thromboxane A2 receptor antagonist. However, these results were based on short‐term (less than 6 months) observations.Methods: We studied 35 well‐controlled adult asthmatics. We assigned the patients into different groups according to their sECP levels before the step down: (i) group A, sECP < 25 μg/L; (ii) group B, sECP ≥ 25 μg/L; and (iii) group C, sECP ≥ 25 μg/L but patients treated with pranlukast or seratrodast. We began the study with a step down in iBDP therapy (initial step down), then followed the clinical course of the asthma for 2 years. During the study period, we decreased, increased or maintained the iBDP dose on the basis of the stepwise approach described in the National Institutes of Health guidelines. We monitored the time and frequency of exacerbation and evaluated the iBDP dose required to control the asthma symptoms.Results: The rates of exacerbation after the step down were high in groups A and B. In group A, the conditions were again qualified for the step down in all patients, but this was not the case for most group B patients. From 15 to 21 months after the initial step down, the average dose of iBDP required to control symptoms was significantly higher in group B than in group A patients (P = 0.0127–0.0373). The exacerbation rate in group C after 12 months tended to be lower than in the other two patient groups (P = 0.0743). In group C, the average dose of iBDP from 9 to 24 months after the initial step down was significantly lower than before the step down (P < 0.0001) and was not significantly different from the mean dose of iBDP in groups A or B.Conclusions: High sECP in well‐controlled asthma may indicate the necessity for a higher iBDP dose over a long period than when the sECP concentration is not high. Even if sECP is high, pranlukast or seratrodast help to prevent exacerbation of asthma and enable successful step down in iBDP therapy for at least 2 years thereafter.
CD4+ T cells in lung tissue predict responsiveness to cyclosporin A in interstitial pneumonia
Authors: YOSHIOKA YASUKO , OHWADA AKIHIKO , DAMBARA TAKASHI , FUKUCHI YOSHINOSUKE 
Published: March 2003

Objective: A limited number of case studies have demonstrated the steroid‐sparing and disease stabilization effects of cyclosporin A (CsA) combined with corticosteroid in patients with chronic interstitial pneumonia (IP). Although CsA is known to inhibit the proliferation and function of CD4+ T cells, it is not clear what type of IP is responsive to CsA administration.Methodology: In order to evaluate whether any lymphocyte subsets in alveolar tissue predict the responsiveness to CsA, morphometric analysis was performed on lung tissue obtained from six IP patients who were treated with a combination of CsA and steroid because the therapeutic effect of steroid alone had been limited.Results: Cell densities of CD4+ T cells were significantly decreased in the alveolar tissues obtained from CsA responders (n = 3) compared to non‐responders (n = 3) (120 ± 86/mm2vs 503 ± 172/mm2, P=0.0495). CD4/CD8 ratios of CsA responders were also significantly lower than those of non‐responders (0.315 ± 0.070 vs 1.975 ± 0.965, P=0.0463). However, cell densities of CD8+ T cell and areas of B cells aggregates were similar in both groups.Conclusions: The present observations, contrary to expectation, reveal that lower cell densities of CD4+ T cells and lower CD4/CD8 ratios are associated with responsiveness to CsA in combination therapy, suggesting that pharmacological actions other than suppression of CD4+ T cells explain the efficacy of CsA in patients with chronic IP.
Addition of a 2‐month low‐dose course of levofloxacin to long‐term erythromycin therapy in sinobronchial syndrome
Authors: FUJIMURA MASAKI , MIZUGUCHI MASAYUKI , NAKATSUMI YASUTO , MIZUHASHI KEIICHI , SASAKI SHIGEKI , YASUI MASAHIDE 
Published: March 2003

Background: We previously reported that a 6‐month low‐dose course of ofloxacin combined with long‐term low‐dose erythromycin therapy (EM therapy) was superior to EM therapy alone for sinobronchial syndrome (SBS), especially during the initial 2 months of treatment. However, there was no data as to whether discontinuation of low‐dose ofloxacin after 2 months results in symptom relapse. This study was designed to clarify this issue.Methodology: Twenty‐three patients with SBS received a 2‐month course of levofloxacin (LVFX) therapy (100 mg once a day) concurrent with a 6‐month course of EM therapy (200 mg three times a day) (group A). Eighteen other patients were given the EM therapy alone (group B). Clinical parameters, including quantity of morning sputum, were recorded in a daily symptom diary, and reviewed by each doctor in charge at 2–4 week intervals.Results: The quantity of morning sputum decreased more rapidly in group A than in group B. No relapse of symptoms was recognized after discontinuation of LVFX in group A.Conclusions: A 2‐month low‐dose course of LVFX in conjunction with long‐term EM therapy may be efficacious for the treatment of SBS, as evidenced by rapid improvement of expectoration without any relapse after LVFX discontinuation.
Molecular systematics in the genusClintoniaand related taxa based onrbcLandmatKgene sequence data
Authors: Hayashi Kazuhiko , Yoshida Seiji , Utech Frederick H. , Kawano Shoichi 
Published: March 2003

AbstractIn an attempt to elucidate the affinity and phylogeny of the disjunct North American–eastern Asian genusClintonia, two chloroplast genes,rbcLandmatK, were sequenced for all five species (Clintonia andrewsiana, Clintonia borealis, Clintonia umbellulata, Clintonia unifloraandClintonia udensis). Similar sequence data sets for both genes supported the idea that a monophyly ofClintoniaconsists of two clades, one in eastern Asia and one in North America. The North American lineage resolves into an eastern group and a western group. There are surprisingly few site substitutions within these two genes, notwithstanding the wide morphological diversity of the genus. To root theClintoniatrees,Cardiocrinum(=Lilium)cordatum,Medeola virginiana,Scoliopus bigeloviiandScoliopus halliiwere used as outgroup taxa. Similar topologies forClintoniaresulted when both therbcLandmatKgene sequences were combined. However, when an amino acid tree was generated for thematKsequence, all differences between the North American species were reduced to similarities due to synonymous codon sequences. Differentiation patterns of some selected morphological, karyological and embryological characters inClintoniawere also reviewed in comparison to the resulting molecular topologies. The unique,Clintonia‐type megasporogenesis that produced identical, maternally derived, diploid zygotes and endosperm coupled to polyploid buffering provides a considerable constraint on variability. A search of possible sister genera toClintoniawas also attempted based on the molecular analyses and outgroup analysis, andMedeola virginianafrom eastern North America turned out to be the closest relative found.
Stepwise multimodal approach in the treatment of Kasabach–Merritt syndrome
Authors: Shin Hee Young , Ryu Kyung Ha , Ahn Hyo Seop 
Published: March 2003

Background
: The purpose of the present study was to evalutate the various treatment modalities for Kasabach–Merritt syndrome (KMS) and to identify the most reliable treatment modalities.
Methods
: A retrospective analysis was performed on 37 KMS patients who were admitted to Seoul National University Hospital between January 1979 and June 1999. Age, sex, locations of the hemangiomas, clinical symptoms and hematologic data were analyzed by multivariate logistical regression analysis to determine the response to various treatment modalities.
Results
: Twenty‐four of 37 patients (20 boys and 17 girls) were diagnosed during infancy. The locations of hemangioma were superficial skin in 31 patients, combined skin and visceral organs in four patients and visceral organs only in two patients. Tumor size was more than 5 cm in diameter in all cases, except for one. The treatment principle of KMS in our center involves a stepwise multimodal approach. Of the 37 cases, surgical resection was performed in two. Steroids were tried initially in 35 patients over a 1 week period, with an initial response rate of 11.4% (4/35). Combined steroid/radiation treatment was given in 28 cases, with a response rate of 75.0% (21/28). Four of five patients with additional interferon (IFN)‐α therapy improved. No significant correlations were found between the prognostic factors, such as age, sex, size and locations of the hemangioma, hematologic data and the treatment modalities.
Conclusions
: Based on the experiences in a single center over a period of 20 years, we recommend a stepwise multimodal approach for the treatment of KMS; for example, steroid, radiation therapy and IFN‐α in this order. However, surgical treatment is helpful if total resection is possible.
Severe upper airway obstruction in the tropics requiring intensive care
Authors: Chan Pwk , Goh Ayt , Lum Lcs 
Published: March 2003

Background
: The clinical profile of severe upper airway obstruction, a challenging acute pediatric emergency, has not been extensively documented in the developing nations of the tropics.
Methods
: The diagnostic categories, severity of illness and outcome from 63 episodes of severe upper airway obstruction in 56 children admitted to the Pediatric Intensive Care Unit between January 1994 and December 1999 were reviewed. Outcome variables studied included requirement for ventilation, mortality and complications. Severity of illness was determined with the Pediatric Risk of Mortality (PRISM) II score.
Results
: Viral croup (29%) was the most common diagnosis, followed by mediastinal malignancy (13%), bacterial tracheitis (11%) and Pierre Robin syndrome (11%). There were no admissions for acute epiglottitis. Thirty episodes (48%) required ventilation for a median duration of 4.0 days. Bacterial tracheitis (100%) and subglottic stenosis (100%) were the most likely diagnoses requiring ventilation. Difficulty in intubation was encountered in 13 episodes (43%) involving, in particular, patients with bacterial tracheitis (83%; P=0.006). Only two patients required a tracheostomy. The overall mortality was 11%. The PRISM score for all categories was generally low (mean 10.3~1.0; median 9.0). Non‐survivors had a significantly higher PRISM II score than survivors (27.4~9.7 vs 8.1~4.9, respectively; P=0.002) and were more likely to include children with bacterial tracheitis and mediastinal malignancy.
Conclusions
: There is marked heterogeneity in the causes of upper airway obstruction in the tropics with viral croup remaining the most common. A significant proportion required ventilation, but outcome is generally favorable, except in those with bacterial tracheitis and mediastinal malignancy.
Anti‐interleukin‐8 autoantibody in the tracheobronchial aspirate of infants with chronic lung disease
Authors: Takasaki Jiro , Ogawa Yunosuke 
Published: March 2003

Background
: A high concentration of interleukin (IL)‐8 has been observed in the tracheobronchial aspirate of infants with chronic lung disease (CLD), although the pattern varies depending on the type of CLD. Alveolar fluid from patients with adult respiratory distress syndrome (ARDS) also contains an elevated level of IL‐8. Recently, the presence of anti‐IL‐8 autoantibody was demonstrated in the alveolar fluid from patients with ARDS.
Methods and Results
: The concentration of anti‐IL‐8 autoantibody in the tracheobronchial aspirate of infants with CLD was measured in order to discover whether there was any correlation with the concentration of IL‐8. Similar to IL‐8 concentration, the anti‐IL‐8 IgM antibody concentration in all infants with CLD following intrauterine infection was already high during the first 48 h. However, the concentration in infants with CLD following respiratory distress syndrome began to increase after 11 days of life, in contrast with the rise in IL‐8 between 48 h after birth and day 5.
Conclusions
: The presence of anti‐IL‐8 autoantibody may provide a mechanism that limits the bioavailability of free IL‐8 in the lungs. In addition, the time lag between the increase in IL‐8 and anti‐IL‐8 IgM autoantibody demonstrated in the present study could be used to estimate the time when the inflammation begins, even if the IL‐8 concentration is already high.
Infant abuse in Osaka: Health center activities from 1988 to 1999
Authors: Kobayashi Michiko 
Published: March 2003

Abstract

Background
: In 1988, the first survey of child abuse in Japan was conducted in Osaka Prefecture as a joint effort between medical, health and welfare agencies. Ensuing surveys in 1988 revealed that infant abuse had a death rate of 10% in Health Center.
Methods
: In 1996 and 1999, surveys were performed on 130 and 215 abused children under 18 years of age. They were studied in terms of their activity of Health Center, including help, means of involvement by health visitors.
Results
: Fifty‐five percent of children were detected via health centers. In 69% of cases, health visitors listened to parents and promptly contacted other agencies. Ninety‐five percent of cases had home visits. The concerted effort of the health centers with allied disciplines in Osaka Prefecture yielded the following changes: the mortality rate decreased from 9.8% in 1988 to 2.3% in 1996, and institutionalized cases tripled from 13.7% in 1988 to 39.5% in 1999. The rate of admission to day care centers increased from 22.4% in 1988 to 58.7% in 1999. Along with the constant support of health visitors, day care centers provided secure support and protection for parents and infants.
Conclusions
: Effective prevention and treatment become possible only when treatment of the child’s physical and psychological health, mental care for parents and tangible support for childrearing and daily life were undertaken in a concerted way. To this end, a systematic commitment of all child agencies, child guidance centers, as well as medical, health educational, welfare and other allied disciplines is required.
Impact of glycemic control on serum lipoprotein (a) in Arab children with type 1 diabetes
Authors: Alsaeid Mayra , Qabazard Maryam , Shaltout Azza , Sharma Prem N 
Published: March 2003

Abstract

Background
: Lipoprotein (a) (Lp (a)) is an independent risk factor for coronary artery disease (CAD), a major cause of death in patients with type 1 diabetes mellitus. Both type 1 diabetes and CAD represent major problems in Kuwait. Data on the effect of metabolic control on Lp (a) in diabetic children are limited and this is particularly true for Arab children. The objectives of the present study were to analyze serum Lp (a) levels in patients with type 1 diabetes compared with non‐diabetic children, taking into account the effect of glycemic control.
Methods
: Circulating lipids, including Lp (a), were measured in serum samples from 60 prepubertal non‐diabetic children and 58 prepubertal children with type 1 diabetes. Comparisons of Lp (a) concentrations were made between the non‐diabetic and diabetic children with good to fair control (glycosylated hemoglobin (GHb) <11%) and a group of diabetic children with poor control (GHb ≥ 11%).
Results
: The mean serum Lp (a) level in all diabetic children was 187.62+160.43 mg/L, compared with 162.88+156.06 mg/L in the control group. The group of children with poor glycemic control had higher median Lp (a) levels (147.50 mg/L) than either the group of diabetic children with good to fair control (95 mg/L; P<0.028) or the group of non‐diabetic children (125 mg/L; P<0.04). Moreover, 38.3% of poorly controlled diabetic children had elevated Lp (a) levels ≥ 250 mg/L, compared with 12.5% of diabetic children with good to fair control and 16.7% of non‐diabetic children (P<0.025 and P<0.039, respectively). No association was found between Lp (a), diabetes duration and insulin dose.
Conclusions
: In Arab children, highest Lp (a) levels are associated with poorest metabolic control. The prevalence of Lp (a) levels associated with cardiovascular risk is higher in poorly controlled diabetic children. Increased levels of Lp (a) may be another contributing factor to the high risk for CAD in diabetic patients.
Ala/Thr60 variant of the Leydig insulin‐like hormone is not associated with cryptorchidism in the Japanese population
Authors: Takahashi Ikuko , Takahashi Tsutomu , Komatsu Masaki , Matsuda Jun , Takada Goro 
Published: March 2003

Abstract

Background
: Leydig insulin‐like hormone (Insl3), a member of the insulin‐like superfamily, is specifically expressed in Leydig cells of fetal and postnatal murine testis. Recently, the absence of the Insl3 gene has been reported to result in bilateral cryptorchidism in male mice and it has been suggested that mutations of the INSL3 gene may cause cryptorchidism in humans.
Methods
: We sequenced the INSL3 gene from five Japanese patients with sporadic bilateral cryptorchidism. Patients’ genome DNA was prepared from blood leukocytes. Two exons of the INSL3 gene were amplified by polymerase chain reaction and were sequenced directly. A restriction fragment length polymorphism assay was performed on 70 control samples for analysis of polymorphism.
Results
: Three of five cases had a heterozygous single‐base change, a G to A transition at position 178 of the INSL3 gene, which predicts an alanine (GCC) to threonine (ACC) change at codon 60 (designated A60T). However, the A60T mutation was also found in the normal Japanese population at an allele frequency of 26%, which suggests that this mutation is a common polymorphism and is not associated with the occurence of cryptorchidism.
Conclusions
: No mutation has been found in the INSL3 gene from Japanese patients with idiopathic cryptorchidism. We did find the A60T polymorphism, which was not associated with the occurence of cryptorchidism.