bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of N -methyl-d-aspartate Receptor ε1Subunit Gene Disruption of the Action of General Anesthetic Drugs in Mice
Authors: Sato Yuki , Kobayashi Eiji , Murayama Takanori , Mishina Masayoshi , Seo Norimasa 
Published: February 2005

Background
Recent molecular strategies demonstrated that the N-methyl-d-aspartate (NMDA) receptor is a major target site of anesthetic agents. In a previous article, the authors showed that knocking out the NMDA receptor epsilon1 subunit gene markedly reduced the hypnotic effect of ketamine in mice. In the current study, the authors examined the in vivo contribution of the NMDA receptor epsilon1 subunit to the action of other anesthetic drugs.

Methods
The authors determined the anesthetic effects of nitrous oxide on sevoflurane potency in NMDA receptor epsilon1 subunit knockout mice compared with those in wild-type mice. They then tested the hypnotic effect of gamma-aminobutyric acid-mediated agents, such as propofol, pentobarbital, diazepam, and midazolam, in knockout mice and wild-type mice.

Results
The anesthetic action of sevoflurane itself was unaffected by the abrogation of the NMDA receptor epsilon1 subunit. Adding nitrous oxide reduced the required concentration of sevoflurane to induce anesthesia in wild-type mice, whereas this sparing effect was diminished in knockout mice. Furthermore, propofol, pentobarbital, diazepam, and midazolam also had markedly attenuated effects in knockout mice.

Conclusions
Although it has been demonstrated that knocking out the expression of receptors may induce changes in the composition of the subunits, the network circuitry, or both, the current findings show consistently that the NMDA receptor epsilon1 subunit mediates nitrous oxide but not sevoflurane anesthesia. Furthermore, the attenuated anesthetic impact of propofol, pentobarbital, diazepam, and midazolam as well as ketamine in knockout mice suggests that the NMDA receptor epsilon1 subunit could be indirectly involved in the hypnotic action of these drugs in vivo.
Increased Pulmonary Venous Resistance Contributes to Increased Pulmonary Artery Diastolic–Pulmonary Wedge Pressure Gradient in Acute Respiratory Distress Syndrome
Authors: Her Charles , Mandy Szabolcs , Bairamian Mosses 
Published: February 2005

Background
Pulmonary artery diastolic (PAD)-pulmonary wedge pressure (PWP) gradient has been shown to be increased in sepsis and acute respiratory distress syndrome (ARDS). Because pulmonary venous vasoconstriction induced by endotoxemia in sepsis or postcapillary leukocyte aggregation in ARDS or both can increase pulmonary venous resistance (Rpv), it is possible that the elevated Rpv increases PAD-PWP. The authors examined this possibility by assessing the correlation between Rpv and PAD-PWP gradient in patients with ARDS.

Methods
Included were 20 patients with ARDS who required surgical procedures during general anesthesia. Rpv was calculated as the difference between mean pulmonary artery (PA) output pressure and PWP divided by cardiac index. Mean PA output pressure was computed from harmonic form of the recorded PA pressure by applying an attenuating factor to its phasic components, for which Fourier analysis was used. Total pulmonary vascular resistance (TPVR) was calculated as the difference between mean PA input pressure and PWP divided by cardiac index. To avoid the effect of PA resistance on TPVR and Rpv, the relative pulmonary venous resistance (Rpv/TPVR) was used.

Results
There was a good correlation between Rpv/TPVR and PAD-PWP gradient (R = 0.698, P < 0.0001). When patients were classified into two groups based on PAD-PWP gradient, the Rpv/TPVR was 0.66 +/- 0.06 in the group with a PAD-PWP gradient of 6 mmHg or greater and 0.46 +/- 0.08 in the other group (P < 0.0001).

Conclusion
A strong correlation between Rpv/TPVR and PAD-PWP gradient suggests that the increased Rpv contributes to increased PAD-PWP gradient in patients with ARDS.
Inhibitory Effects of Lidocaine and Mexiletine on Vasorelaxation Mediated by Adenosine Triphosphate–sensitive K+Channels and the Role of Kinases in the Porcine Coronary Artery
Authors: Kimoto Yoshiki , Kinoshita Hiroyuki , Nakahata Katsutoshi , Dojo Mayuko , Hatano Yoshio 
Published: February 2005

Background
Effects of antiarrhythmic drugs on coronary vasodilation mediated by K channels have not been studied. Modulator roles of protein kinase C and tyrosine kinase in the activity of K channels have also been unclear in the coronary artery. The current study examined whether lidocaine and mexiletine in the porcine coronary artery modify the vasorelaxation mediated by adenosine triphosphate-sensitive K channels via activation of protein kinase C and tyrosine kinase.

Methods
Porcine coronary arteries without endothelium were suspended for isometric force recording, and vasorelaxation to levcromakalim (10 to 10 m) was obtained. Changes in membrane potentials produced by levcromakalim (10 m) were also recorded.

Results
Glibenclamide completely abolished vasorelaxation as well as hyperpolarization in response to levcromakalim. Lidocaine and mexiletine significantly reduced these responses. Calphostin C, Go 6976, genistein, and erbstatin A partly restored vasorelaxation or hyperpolarization in response to levcromakalim in arteries treated with mexiletine but not in those with lidocaine, whereas these inhibitors did not alter the vasorelaxation to levcromakalim. Phorbol 12-myristate 13-acetate produced reduction of vasorelaxation in response to levcromakalim, which is recovered by calphostin C or Go 6976.

Conclusions
Therefore, lidocaine and mexiletine inhibit vasorelaxation mediated by the activation of adenosine triphosphate-sensitive K channels in the coronary artery. Protein kinase C and tyrosine kinase seem to have roles in the inhibitory effect of mexiletine but not in that of lidocaine. Class Ib antiarrhythmic drugs may reduce coronary vasodilation mediated by adenosine triphosphate-sensitive K channels via the differential modulator effects on these kinases.
Isoflurane Neuroprotection in Hypoxic Hippocampal Slice Cultures Involves Increases in Intracellular Ca2+and Mitogen-activated Protein Kinases
Authors: Gray Jonathan J. , Bickler Philip E. , Fahlman Christian S. , Zhan Xinhua , Schuyler Jennifer A. 
Published: February 2005

Background
The volatile anesthetic isoflurane reduces acute and delayed neuron death in vitro models of brain ischemia, an action that the authors hypothesize is related to moderate increases in intracellular calcium concentration ([Ca2+]i). Specifically, the authors propose that during hypoxia, moderate increases in [Ca2+]i in the presence of isoflurane stimulates the Ca2+-dependent phosphorylation of members of the mitogen-activated protein kinase (MAP) kinase Ras-Raf-MEK-ERK pathway that are critical for neuroprotective signaling and suppression of apoptosis.

Methods
Death of CA1, CA3, and dentate neurons in rat hippocampal slice cultures was assessed by propidium iodide fluorescence 48-72 h after 60-75 min of hypoxia. [Ca2+]i in CA1 neurons was measured with fura-2 and fura-2 FF. Concentrations of the survival-signaling proteins Ras, MEK, MAP kinase p42/44, and protein kinase B (Akt) were assessed by immunostaining, and specific inhibitors were used to ascertain the role of Ca2+ and MAP kinases in mediating survival.

Results
Isoflurane, 1%, decreased neuron death in CA1, CA3, and dentate gyrus neurons after 60 but not 75 min of hypoxia. Survival of CA1 neurons required an inositol triphosphate receptor-dependent increase in [Ca2+]i of 30-100 nm that activated the Ras-Raf-MEK-ERK (p44/42) signaling pathway. Isoflurane also increased the phosphorylation of Akt during hypoxia.

Conclusions
Isoflurane stimulates the phosphorylation of survival signaling proteins in hypoxic neurons. The mechanism involves a moderate increase in [Ca2+]i from release of Ca from inositol triphosphate receptor-dependent intracellular stores. The increase in [Ca2+]i sets in motion signaling via Ras and the MAP kinase p42/44 pathway and the antiapoptotic factor Akt. Isoflurane neuroprotection thus involves intracellular signaling well known to suppress both excitotoxic and apoptotic/delayed cell death.
A Comparison of Median Effective Doses of Intrathecal Levobupivacaine and Ropivacaine for Labor Analgesia
Authors: Sia Alex T. , Goy Raymond W. , Lim Yvonne , Ocampo Cecilia E. 
Published: February 2005

Background
The study was designed to determine and compare the median effective doses (MEDs) of intrathecal ropivacaine with levobupivacaine for labor analgesia.

Methods
In this double-blind study, 100 parturients in early labor were randomized to receive either intrathecal ropivacaine or levobupivacaine. For each drug, the patients were assigned to receive one of the five doses studied, namely 1, 1.5, 2, 2.5, or 3 mg. Effective analgesia was defined as a pain score (0-100 visual analog scale) of less than 10 within 15 min of injection, lasting for 45 min or more after the induction of analgesia. MEDs were derived from probit analysis. The duration of analgesia rendered by the two drugs at 2.5 and 3 mg was also compared.

Results
The MED for levobupivacaine was 1.07 mg (95% confidence interval, 0.88-1.25 mg), and the MED for ropivacaine was 1.40 mg (95% confidence interval, 1.20-1.61 mg). Levobupivacaine was found to be 1.31 (95% confidence interval, 1.04-2.01) times more potent than ropivacaine. At doses of 2.5 mg or greater, there was no significant difference in duration of analgesia between levobupivacaine (median, 63.5 min; range, 46-123 min) and ropivacaine (median, 59.0 min; range, 47-93 min; P = 0.18). We detected no difference in the incidence of hypotension, nausea and vomiting, motor block, or abnormal fetal heart tracing between the two drugs.

Conclusions
The MED of intrathecal ropivacaine for labor analgesia was significantly greater than levobupivacaine experimentally, but this significance was reduced when the comparison was based on molar potency. There was no difference in the duration of analgesia or adverse effects between the two drugs at higher doses (2.5 mg or greater).
α2-Adrenoceptor Activation by Clonidine Enhances Stimulation-evoked Acetylcholine Release from Spinal Cord Tissue after Nerve Ligation in Rats
Authors: Obata Hideaki , Li Xinhui , Eisenach James C. 
Published: February 2005

Background
Spinally administered clonidine produces analgesia via alpha2-adrenergic receptors. The analgesic potency of clonidine and its dependency on muscarinic acetylcholine receptors increase in rats after nerve injury. The authors hypothesized that these changes reflect greater acetylcholine release from the spinal cord by clonidine, either through direct or indirect effects.

Methods
Male Sprague-Dawley rats were divided into two groups: no surgery or left L5 and L6 spinal nerve ligation (SNL). All experiments were performed 3 weeks after SNL. Crude synaptosomes were prepared from the spinal enlargement and loaded with [H]choline. Samples were incubated with clonidine in the absence or presence of KCl depolarization. The authors also examined the effect of clonidine on KCl evoked acetylcholine release using perfusion of spinal cord slices, in which some spinal circuitry is maintained.

Results
In synaptosomes, clonidine alone induced minimal acetylcholine release, which was actually greater in tissue from normal rats than in tissue from SNL rats. In the presence of KCl depolarization, however, clonidine enhanced acetylcholine release in tissue from SNL rats but inhibited release in tissue from normal rats. Similarly, in spinal cord slices, clonidine enhanced KCl evoked acetylcholine release in tissue from SNL animals but inhibited such release in tissue from normal animals. The alpha2-adrenoceptor antagonist idazoxan inhibited the effects of clonidine in slices from SNL rats.

Conclusion
These results suggest that clonidine enhances depolarization-induced acetylcholine release in neuropathic but not in normal spinal cord tissue. Interestingly, this enhanced acetylcholine release by clonidine occurs in a synaptosomal preparation, consistent with a direct effect on alpha2 adrenoceptors on cholinergic terminals. Enhanced release of acetylcholine by clonidine could contribute to increased analgesia of clonidine in neuropathic pain.
Postpartum hemorrhage: a prospective, comparative study in Angola using a new disposable device for oxytocin administration
Authors: Strand Roland T. , Da Silva Florinda , Jangsten Elisabeth , Bergström Staffan 
Published: February 2005

Background.  Postpartum hemorrhage (PPH) is the single most common cause of maternal death in the world, and oxytocin is known to be effective for its prevention and treatment. The use of syringes can be problematic in areas affected by HIV. The aim of this study was to introduce Uniject™ (a new disposable device for administration of 10 IU oxytocin) as part of active management of the third stage of labor (AMTL) and try to reduce PPH.Methods.  A prospective, comparative study was performed between March 1998 and May 2000 in Luanda. Seven hundred and eighty‐two parturient women with physiological management were compared to 814 with AMTL. Postpartum lost blood was collected using a plastic sheet during labor and a bucket placed under a cholera bed for 2 h postpartum. Student's t‐test and χ2 test were used.Result.  PPH was reduced from 40·4 to 8·2% and severe PPH (≥1000 ml) from 7·5 to 1% in the AMTL group (P < 0·001).Conclusions.  Uniject™ was well tolerated and offers an alternative for oxytocin administration. AMTL should be implemented also in resource‐poor settings as a routine management to reduce PPH.
Number of antenatal visits and women's opinion
Authors: Hildingsson Ingegerd , Rådestad Ingela , Waldenström Ulla 
Published: February 2005

Background.  The national recommendation in Sweden regarding number of antenatal care visits was reduced in 1996. The aim of this study was to explore the factors associated with number of visits made and with women's own opinions about these visits. Another aim was to study associations between the number of visits and satisfaction with antenatal care overall.Methods.  All Swedish‐speaking women who came for their first visit to the midwife in 593 participating clinics during 3 weeks evenly spread over 1 year in 1999–2000 were invited to participate in the study. Information was collected by postal questionnaires after the booking visit and 2 months after childbirth. Cases of preterm delivery and intrauterine death were excluded.Results.  After excluding miscarriages, non‐Swedish‐speaking women, and women booked at non‐participating clinics, about 69% of all women booked in antenatal care were recruited. Of these, 2421 (83%) completed the two questionnaires. About 25% followed the standard visiting schedule for a normal pregnancy, 57% made more visits, and 17% fewer visits. The number of visits made was associated with parity, medical diagnosis, depressive symptoms, level of education, and women's preferences in early pregnancy. Women's own opinion that they made too few visits was associated with a preference for more visits in early pregnancy and actually receiving fewer visits than the standard schedule. The view that they made too many visits was associated with a previous negative birth experience, a wish for fewer visits, having a medical diagnosis, many children, and major worries. The vast majority of women (87.6%) were satisfied with antenatal care overall but less with emotional (76.9%) than with medical (82.3%) aspects. No association was found between number of visits made and satisfaction, but women's own opinion that they had too few visits was associated with dissatisfaction with medical as well as emotional aspects of care and the opinion that they made too many visits with the emotional aspects of care.Conclusion.  Two‐thirds of the women did not follow the standard visiting schedule, the majority of women made more visits. The number of antenatal visits seemed to be fairly well adapted to women's individual needs and, to some extent, to their own wishes. Very few women were dissatisfied with the number of visits made as well as the antenatal care overall.
Surgery for pelvic organ prolapse in women of 80 years of age and older
Authors: Schweitzer Karlijn J. , Vierhout Mark E. , Milani Alfredo L. 
Published: February 2005

Background.  To investigate the long‐term results of women over 80 years of age following surgery for pelvic organ prolapse.Design.  Retrospective, descriptive study.Methods.  We reviewed all records of women of 80 years and older operated for pelvic organ prolapse; all patients alive were contacted through a postal questionnaire.Results.  A total of 2058 operations for pelvic organ prolapse were performed in the study period. One hundred and twenty‐eight patients were 80 years and older with the mean age of 83 years (range 80–92 years). In three cases, serious complications occurred, and one of them died shortly after the operation. Follow‐up was done with a postal questionnaire. Eighty‐eight percent of patients who were alive at the time of data analysis returned the questionnaire.The mean duration of follow‐up was 28 months (range 1–80 months). There were no patients who reported a relapse of prolapse. Urinary incontinence, urge, stress, or mixed incontinence, was present in almost half of the cases. The time to full recovery after the operation was experienced to be less than 3 months for 48%. General satisfaction with the procedure was high with 88% being (very) satisfied.Conclusion.  The operative correction of a pelvic organ prolapse in a group of women 80 years and older is a successful operation, with an acceptable morbidity and a high satisfaction of the patients.
Child Health Assessment at School Entry (CHASE) project: evaluation in 10 London primary schools
Authors: Edmunds S. , Garratt A. , Haines L. , Blair M. 
Published: February 2005

AbstractAims  To assess the feasibility of implementing the Child Health Assessment at School Entry (CHASE) questionnaire, developed to capture the multiple dimensions of the health of children in their first year at school, and to evaluate data quality, reliability and validity.Methods  Parents of 278 year‐1 children, from 10 primary schools in two London boroughs, received a parent questionnaire and school nurses completed a separate questionnaire from health and education records for children whose parents consented. Additional data on free school meal eligibility and ethnicity were obtained from the two Local Education Authorities. The parent questionnaire included the Strengths and Difficulties Questionnaire (SDQ) and four dimensions of the Child Health Questionnaire Parent Form‐28 (CHQ‐PF28).Results  Response rate was 61%. The association between school free school meals eligibility and response rate in each school approached significance (r = –0.62, P = 0.05). Data completeness of the parent questionnaire was high (mean 98%). Data completeness of the school nurse questionnaire was more variable (mean 82%). Cronbach's Alpha was greater than 0.6 for four of the five SDQ scales and greater than 0.7 for the two CHQ‐PF28 multi‐item scales. Relative to parents with qualifications, parents with no qualifications rated their children as having significantly more conduct problems, peer problems, and overall mental health problems (P < 0.01) as assessed by the SDQ, and significantly lower global health (P < 0.01) as assessed by the CHQ‐PF28. Children with special educational needs and children with long‐standing illness or disability were rated as having significantly lower global health (P < 0.05) than children without these. Sample tables of inter‐school and inter‐borough comparison of key findings demonstrate considerable differences in physical and mental health status.Discussion  The questionnaire was acceptable to parents and school nurses, and feasible to implement within existing school resources. Initial tests of internal reliability and validity are satisfactory. These data have the potential to inform interventions and service provision at school and borough level, and public health trends over time.
How do carers of disabled children cope? The Ugandan perspective
Authors: Hartley S. , Ojwang P. , Baguwemu A. , Ddamulira M. , Chavuta A. 
Published: February 2005

AbstractBackground Community‐based rehabilitation (CBR) was recommended by the World Health Organization in 1989 as the strategy for improving the quality of life of disabled people and their families, which should be built on local knowledge and practices. In Uganda, there is no documentation on how services relate to local knowledge. There is a need for increased knowledge and understanding of how family members cope with their disabled children to provide the basis for future service development.Methods A qualitative phenomenological design was used to develop an in‐depth understanding of how Ugandan families cope with their disabled children in their own communities. Data were collected from 52 families with children with disabilities from five impairment groups, through interviews and observations in three districts of Uganda, one urban, two rural.Results There are many children with disabilities who are included, loved and cared for by their families. A lot of time and money is spent on seeking a cure. The extended family systems are breaking down and the main burden of caring for a disabled family member generally falls on one, sometimes two, female carers. Male members act as gatekeepers, controlling the key decisions concerning the child and the associated resources.Conclusions CBR should move the focus of their services away from the disabled individual towards the whole family. It is important to provide accurate information about causes and prevention of impairments, the realities of a cure, support and respite for the female carers, and opportunities for the involvement of fathers. This methodology is a practical mechanism for collecting data that have the potential to positively influence and guide the development of CBR practice in the locality. At a conceptual level the data support the philosophy of inclusion, social integration, the importance of trust and respect, and utilizing a holistic approach. These are eminently transferable to other settings.
Children's perceptions of attending a residential weight‐loss camp in the UK
Authors: Holt N. L. , Bewick B. M. , Gately P. J. 
Published: February 2005

AbstractBackground and aim  Residential camps have been used to deliver weight‐loss interventions to paediatric populations, but very little is known about how children perceive and evaluate attending such camps. Therefore, this study examined children's perceptions of attending a residential paediatric weight‐loss camp.Methods  Fifteen attendees (mean age = 13.56) of the 2002 Carnegie International Camp‐UK (CIC‐UK) were engaged in semi‐structured interviews, which were transcribed verbatim and subjected to an inductive analysis procedure.Results  Results reflected pre‐camp issues including worries (boot camp fears, being bullied) and goals and aspirations (weight loss goals, reducing bullying, increasing self‐esteem and making friends). Negative elements pertaining to the camp experience were homesickness and dietary concerns. Positive elements of the camp experience were enjoyment, peer support, staff support and choice of activities.Conclusion  Enjoyment, support from peers and staff and choice over activities appear to be important aspects in the delivery of residential obesity treatments for children.