bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of alveolar epithelial ICAM-1 in lipopolysaccharide-induced lung inflammation
Authors: Beck-Schimmer B. , Madjdpour C. , Kneller S. , Ziegler U. , Pasch T. , Wüthrich R.P. , Ward P.A. , Schimmer R.C. 
Published: October 2002

Intercellular adhesion molecule-1 (ICAM-1) is known to play a central role in lung inflammation. Limited information, however, is available regarding the expression and biological function of ICAM-1 in the alveolar epithelial compartment. The current report analyses the expression pattern of ICAM-1 in primary cultures of rat alveolar epithelial cells (AECs) and in the rat lung following instillation of bacterial endotoxin (lipopolysaccharide (LPS)) in order to better define the role of alveolar epithelial ICAM-1.AECs stimulatedin vitrowith LPS were evaluated for ICAM-1 and ICAM-1 messenger ribonucleic acid content. Adherence assays with neutrophils and macrophages were performed. Endotoxin-induced ICAM-1 upregulation on AECs was demonstratedin vivoby immunofluorescence staining. In addition, the effect of intratracheally-instilled anti-ICAM-1 was assessed.Significant upregulation of ICAM-1 occurredin vitroandin vivoon AECs after LPS stimulation. Adherence assays showed a 114% increase in adhesion of neutrophils to AECs. Antibody directed against ICAM-1 reduced this adhesion by 40%. A significant reduction in the number of neutrophils in bronchoalveolar lavage fluid and whole lung was seen under airway ICAM-1 blockade.These data indicate that intercellular adhesion molecule-1 participates in the inflammatory response to lipopolysaccharide-induced lung injury in the distal airways by interacting mainly with neutrophils.
Bronchoscopic administration of bovine natural surfactant in ARDS and septic shock: impact on gas exchange and haemodynamics
Authors: Walmrath D. , Grimminger F. , Pappert D. , Knothe C. , Obertacke U. , Benzing A. , Günther A. , Schmehl T. , Leuchte H. , Seeger W. 
Published: October 2002

The aim of the present study was to investigate the feasibility and efficacy of bronchoscopic surfactant administration in a noncontrolled multicentre study in five university centres.A total number of 27 patients, suffering from severe acute respiratory distress syndrome (mean±sem lung injury score: 3.15±0.06) and septic shock (Acute Physiology and Chronic Health Evaluation (APACHE) II score at study entry 33.2±1.3, lactate 4.3±0.6 mmol·L−1) were studied. The patients were ventilated with a mean tidal volume of 11.0±0.5 mL·kg−1body weight (bw), either volume or pressure controlled, with 16.3±2.8 cmH2O positive end-expiratory pressure, for an average of 3.5±0.3 days at study entry. A natural bovine surfactant extract (300 mg·kg−1bw Alveofact®; mean total volume 378 mL) was delivered in divided doses to each segment of the lungsviaflexible bronchoscope within ∼45 min.No untoward effects on gas exchange, lung mechanics and haemodynamics were noted during the procedure of surfactant administration. Within 12 h the oxygen tension in arterial blood/inspiratory oxygen fraction increased from a mean of 109±8 mmHg to 210±20 mmHg (p<0.001). In seven patients, in whom gas exchange again deteriorated with further progression of the disease, a second surfactant dose of 200 mg·kg−1was administered 18–24 h after the first application, again improving arterial oxygenation. A total of 15 patients survived the 28-day study period (mortality rate 44.4%, compared to a calculated risk of death for the given APACHE II scores of 74.0±3.5%), with all causes of death being nonrespiratory. The bronchoscopic application of a high dose of natural surfactant in patients with severe acute respiratory distress syndrome and septic shock is both feasible and safe, resulting in a pronounced improvement in gas exchange.
Lung emptying in patients with acute respiratory distress syndrome: effects of positive end-expiratory pressure
Authors: Kondili E. , Prinianakis G. , Athanasakis H. , Georgopoulos D. 
Published: October 2002

The pattern of lung emptying was studied in 10 mechanically-ventilated patients with acute respiratory distress syndrome.At four levels of positive end-expiratory pressure (PEEP) (0, 5, 10 and 15 cmH2O) tracheal (Ptr) and airway pressures (Paw), flow (V′) and volume (V) were continuously recorded. Tidal volume was set between 0.5–0.6 L andV′/Vcurves during passive expiration were obtained. Expired volume was divided into five equal volume slices and the time constant (τe) and effective deflation compliance (Crseff) of each slice was calculated by regression analysis ofV/V′ and postocclusionV/Ptrrelationships, respectively. In each slice, the presence or absence of flow limitation was examined by comparingV′/Vcurves with and without decreasingPaw. For a given slice, total expiratory resistance (Rtot) (consisting of the respiratory system (Rrs), endotracheal tube (Rtube) and ventilator circuit (Rvent)) was calculated as the τe/Crseffratio. In the absence of flow limitationRrswas obtained by subtractingRtubeandRventfromRtot, while in the presence of flow limitationRrsequaledRtot. The τe of the pure respiratory system (τers) was calculated as the product ofRrsandCrseff.At zero PEEP, τersincreased significantly towards the end of expiration (52±31%) due to a significant increase inRrs(46±36%). Application of PEEP significantly decreasedRrsat the end of expiration and resulted in a faster and relatively constant rate of lung emptying.In conclusion, without positive end-expiratory pressure the respiratory system in patients with acute respiratory distress syndrome deflates with a rate that progressively decreases, due to a considerable increase in expiratory resistance at low lung volumes. Application of positive end-expiratory pressure decreases the expiratory resistance, probably by preventing airway closure, and as a result modifies the pattern of lung emptying.
Bone mineral density in patients with chronic obstructive pulmonary disease treated with budesonide Turbuhaler®
Authors: Johnell O. , Pauwels R. , Löfdahl C-G. , Laitinen L.A. , Postma D.S. , Pride N.B. , Ohlsson S.V. 
Published: October 2002

There is a need for studying the effects of long-term inhaled corticosteroid therapy on bone mineral density (BMD) and vertebral fracture rates in patients with mild chronic obstructive pulmonary disease (COPD).Patients (n=912, mean age 52 yrs) with mild COPD (mean forced expiratory volume in one second (FEV1) 77% of predicted; mean FEV1/slow vital capacity ratio 62%) were randomized to receive budesonide 400 µg, or placebo twice dailyviaTurbuhaler®. BMD was measured at the L2–L4 vertebrae and the femoral neck, trochanter and Ward's triangle by dual-energy X-ray absorptiometry at baseline and after 6, 12, 24 and 36 months (n=161). Radiographs of the thoracic and lumbar spine were obtained at the beginning and end of treatment (n=653).Previous fractures were present at baseline in 43 budesonide-treated patients (13.4%) and 38 placebo-treated patients (11.5%). New fractures occurred in five budesonide-treated patients, compared with three in the placebo group (p=0.50). There were no significant changes in BMD at any site in budesonide-treated patients, compared with the placebo group, during the course of the study. Budesonide treatment was associated with a slight but statistically significant decrease in the area under the concentration-time curve for serum osteocalcin.In the present study, involving a large group of patients with chronic obstructive pulmonary disease, long-term treatment with budesonide 800 µg·day−1viaTurbuhaler® had no clinically significant effects on bone mineral density or fracture rates.
Role of biomarkers for early detection of lung cancer and chemoprevention
Authors: Hirsch F.R. , Merrick D.T. , Franklin W.A. 
Published: October 2002

Lung cancer is the leading cause of cancer deaths in developed countries. The poor prognosis associated with this disease is closely related to the fact that most lung cancer patients are not identified until their malignancy has reached an advanced stage.Recent advances have added to the understanding of the morphological and molecular characteristics of preinvasive bronchial lesions and early lung cancers. Such information is being used to provide new tests for the detection of lung cancer at early or preinvasive stages, and for identifying targets for therapeutic intervention that can prevent progression to advanced disease. Laser induced fluorescence endoscope bronchoscopy has improved the sensitivity with which preinvasive dysplastic bronchial lesions and early invasive malignancies can be detected. Morphological features of such lesions have been described and can be monitored by follow-up bronchoscopies in order to validate potential chemoprevention treatments.Distinct morphological characteristics such as angiogenic squamous dysplasia also suggest that processes like angiogenesis are present early in the development of lung cancer. Furthermore, tissue obtained from these early lesions has been used to describe alterations in the expression of a number of factors that distinguish these early lesions from normal bronchial epithelium. This could provide molecular markers and targets for the detection and treatment of early lung cancer. Studies to detect these alterations by polymerase chain reaction and/or immunhistochemical analyses of easily obtained specimens such as sputa are helping identifing molecular markers that could be utilized in effective screening programmes.The current article reviews new findings regarding the molecular biology of preinvasive bronchial lesions and early lung cancers, and describes new developments regarding their application in the early detection and chemoprevention of lung cancer.
Development and implementation of the Rehabilitation Activities Pro” le for children: impact on the rehabilitation team
Authors: Roelofsen Eline E , Anne-Mei B , Beckerman Heleen , Lankhorst Gustaaf J , Bouter Lex M 
Published: October 2002

Objective: To describe the changes in functioning of the rehabilitation team induced by the Rehabilitation Activities Pro”le for children (Children’s RAP), an instrument designed to improve interdisciplinary communication in paediatric rehabilitation. Design: Multiple case-study design. Subjects: Seven paediatric rehabilitation teams. Intervention: A two-year project to develop and implement the Children’s RAP. Data collection: During the project, data were gathered from observations, documents and informal interviews. After the project, formal interviews were held with team members and parents, and a focus group meeting with representatives of the teams was organized. Data analysis: Data were analysed by the method of analytic induction. The analysis was checked by an independent researcher. The preliminary results and conclusions were discussed in detail with participating teams. Results: Development and implementation, as well as the changes induced by the project, varied between teams. Changes were observed for individual team members, for the team as a whole and for the children and their parents. However, changes for individual team members occurred relatively quickly, in comparison with the other changes. To achieve an optimal interdisciplinary team approach all changes are necessary. Therefore, we postulated four hierarchical steps in the development of an interdisciplinary team approach: (1) process-oriented approach, (2) result-oriented approach, (3) problem-oriented approach, and (4) interdisciplinary team approach.
Evaluation of a home-based exercise and training programme to improve sit-to-stand in patients with chronic stroke
Authors: Monger Claire , Carr Janet H , Fowler Virginia 
Published: October 2002

Objective: To investigate the feasibility and efficacy of a task-specific homebased exercise protocol for improving sit-to-stand (STS), with additional exercises to strengthen lower limb extensor muscles in patients with chronic stroke. Design: A pre-test, post-test design was used. Subjects: Six subjects at least one year post stroke and discharged from all rehabilitation services for at least six months participated in the study. Outcome measures: Functional performance of sit-to-stand was evaluated using the Standing Up item of the Motor Assessment Scale (MAS). Peak vertical ground reaction force, walking speed over 10 m and grip strength were also measured. Results: Group MAS score was significantly higher at post-test than at pretest with two subjects reaching the highest point on the scale and three subjects reaching the second highest point. Time-to-peak vertical ground reaction force occurred significantly closer to thighs-off, the critical time when the body mass is propelled into standing. Walking speed increased significantly over 10 m from a mean of 0.86 m/s to 1.10 m/s. Grip strength, which was not trained, did not change. Conclusions: This study demonstrates that a home-based task-specific exercise and training protocol for STS can induce improved performance of STS and increase walking speed more than one year after stroke.
Cancer patients' interpretations of verbal expressions when given information about ending cancer treatment
Authors: Friedrichsen Maria J , Strang Peter M , Carlsson Maria E 
Published: October 2002

Background: Cancer patients’ interpretations of the meaning of words used when given bad news are not well studied in medical settings. The aim of this study was to ascertain what significance verbal expressions had for cancer patients when they were given information about ending active tumour treatment, and what message they felt they received. Methods: Tape-recorded semi-structured interviews were performed and analysed using a qualitative phenomenographical approach. Results: Thirty patients with incurable cancer admitted to hospital-based home care unit in Sweden participated. Three main categories about the significance of words emerged: 1) words could indicate indirect warnings as being forewarnings, evasive or ambiguous; 2) words could also be perceived as emotionally trying, as threats or abandoning; 3) other words were fortifying and strengthened the patient in this situation. The overall message given during the information could be interpreted differently: either focused on treatment, on quality of life, or on threat and death. Conclusion: The understanding of the significance of words to tailor the information to patients helps the physician to use forewarnings and fortifying words and to identify and avoid the use of threatening words.
Clinical and immunogenetic characterization of Mexican patients with ‘Rhupus’
Authors: Simón J A , Granados J , Cabiedes J , Morales J Rúz , Varela J Alcocer 
Published: October 2002

The coexistence of systemic lupus erythematosus and rheumatoid arthritis (rhupus), is a rare clinical condition. To date, 50 cases of rhupus have been described worldwide; however, the lack of clinical criteria for this rheumatic condition has created confusion in the characterization of this disorder. Nevertheless, in this paper we describe a comprehensive clinical and serological characterization of a cohort of 22 Mexican patients with rhupus, supported by generic HLA-DR phenotyping. We found that rhupus patients have a special clinical behavior. In this setting, the signs and symptoms of rheumatoid arthritis prevail, little organic damage associated with systemic lupus erythematosus (SLE) exists and none of the cases present thrombosis or morbidity during pregnancy in spite of presenting a high frequency of anticardiolipin antibodies. We also found an increased frequency of HLA-DR1 and HLA-DR2 alleles compared to healthy ethnically matched controls, systemic lupus erythematosus and rheumatoid arthritis patients.
Expansion of marginal zone B cells is not sufficient for the development of renal disease in NZB×NZW F1 mice
Authors: Schuster H , Martin T , Marcellin L , Garaud J-C , Pasquali J-L , Korganow A S 
Published: October 2002

The mechanisms which govern the production of autoantibodies and of tissue damage during systemic lupus (SLE) are still unclear. In the NZB£NZW F1 (BW) model of SLE glomerulonephritis, the activation and commitment of B cells are thought to play a major role in disease progression. Previous analysis has suggested that these mice have a substantial increase of marginal zone (MZ) B cells before the occurrence of the disease. Owing to the probable role of this B cell subset in autoantibody production, it was important to define the possible link between this abnormality and the occurrence of kidney damage. Using cytofluorometry analysis, we followed the splenic MZ B cell phenotype in different series of mice with shared autoimmune genetic background and histologically defined renal status. By comparing BW females and BW males, NZB and NZW mice, we confirm that BW mice have an increase in MZ B cells but this MZ B cells expansion is not directly linked to tissue lesions. Genetically modified BW female mice with a restricted repertoire of B and T cell antigen receptors, and which do not develop nephritis, exhibit the same increase of MZ B cells, suggesting that this increase does not depend on a specific set of antigens. Moreover, our analysis brings to light a predisease state in BW males, with autoantibody production and mesangial deposits.
Celecoxib for systemic lupus erythematosus: case series and literature review of the use of NSAIDs in SLE
Authors: Lander S A , Wallace D J , Weisman M H 
Published: October 2002

The primary objectives of this study were to evaluate the safety and efficacy of the cyclooxygenase-2 inhibitor celecoxib in systemic lupus erythematosus (SLE) patients both with and without a self-reported sulfa drug allergy and to review the literature on the use of nonsteroidal agents in SLE subjects. A retrospective review of medical records was performed for 50 SLE patients seen by a community-based rheumatologist and treated with open label celecoxib in doses of 200–400 mg/day for a period of 1–9 months. A MEDLINE search of all articles pertaining to the use of NSAIDs in patients with SLE since 1966 was undertaken. We noted that, in this cohort of celecoxib-treated SLE patients from an office rheumatology practice, the majority demonstrated some improvement, and little toxicity was observed. SLE patients with self-reported sulfa allergies were not more likely to have adverse reactions to celecoxib than non-sulfa allergic patients. The literature review performed herein reveals that, although NSAID toxicity should be a continuing concern in an SLE population, structural dissimilarities between celecoxib and the sulfonamide antimicrobials may make true crossallergenicity less likely to be a clinical problem. These results suggest that patients with SLE can be safely and effectively treated with celecoxib; however, further studies are needed to assess the effectiveness and safety of all NSAIDs in SLE.
Spearheading clinical intervention documentation into the future: an Alberta Cancer Board study
Authors: Moosa Ashraf , Nyrose Judith 
Published: October 2002

Objective. The Alberta Cancer Board (ACB) Pharmacy recognizing the significance and merits of intervention documentation examined the reporting methods at the ACB’s two major tertiary cancer treatment centres, the Cross Cancer Institute (CCI) and the Tom Baker Cancer Centre (TBCC). The goal of the project was to identify interventions and actions performed by pharmacists and the resulting outcomes. This information would then be forwarded to the pharmacy computer team to implement electronic documentation of clinical interventions utilizing the pharmacy software program (RxTFC). Data Sources. The student collected information through focus groups, literature reviews, shadowing and interviewing pharmacists, manual/paper documentation review and checking the ‘notes’ section of the computer software program (RxTFC). Study Selection. Published literature on intervention documentation was researched and those relevant to clinical documentation in ambulatory care settings were selected. Data Extraction. There was an extensive data collection process, a student researcher was able to define, identify and develop the types of interventions and actions that ACB pharmacists perform daily and the outcomes of the provision of these clinical services. Mosby’s definitions for intervention, action and outcome were adopted in order to aid when sorting and classifying data collected. Data Synthesis. The types of documentation and a list of interventions and actions are summarized in tables. The results indicate that manual forms that are currently in ACB pharmacies are not being used to their full capacity and/or are not being used as they were originally intended. Possible reasons are a lack of self-reporting, differing reporting styles among pharmacists, a lack of time and/or inconvenient manual documentation systems currently in place. Also, pharmacists differ in their perceptions on what constitutes an intervention. Advantages and disadvantages of both manual and electronic reporting practices are outlined. Conclusions. Clinical intervention documentation is an important tool for pharmacists to ensure that patients are provided with the best pharmaceutical care available in oncology settings. J Oncol Pharm Practice (2001) 7, 35-46
DNA hypomethylation and methyltransferase expression in atherosclerotic lesions
Authors: Hiltunen Mikko O , Turunen Mikko P , Häkkinen Tomi P , Rutanen Juha , Hedman Marja , Mäkinen Kimmo , Turunen Anna-Mari , Aalto-Setalä Katriina , Ylä-Herttuala Seppo 
Published: October 2002

Arterial smooth muscle cell (SMC) migration and proliferation are central features in atherogenesis. Altered gene expression and cell proliferation in atherosclerotic lesions have some similar characteristics with certain solid tumors and thus might have similar mechanisms that lead to SMC proliferation. Among cancer cells common features are genome-wide hypomethylation which correlates with transformation and tumor progression, and coincident over-expression of methyltransferase (MTase). The purpose of the present study was to analyze whether alterations in DNA methylation and MTase expression are present in atherosclerotic lesions. A significant reduction in genomic 5-methylcytosine content was detected in advanced human atherosclerotic lesions and in lesions of ApoE knock-out mice. SMC were shown to develop hypomethylation in vitro during transformation from a contractile to synthetic pheno-type. Balloon denudation of New Zealand White rabbit aorta caused proliferation of intimal SMC with concomitant genomic hypomethylation in the thickened intima. By using in situ hybridization the overall transcriptional activity was found to be increased in clusters of lesion SMC. Marked heterogeneity was seen in MTase mRNA expression in various types of atherosclerotic lesions among intimal and medial SMC. These findings show that (1) genomic hypomethylation occurs during atherogenesis in human, mouse and rabbit lesions and that it correlates with increased transcriptional activity; (2) MTase is expressed in atherosclerotic lesions; and (3) hypomethylation is present in advanced lesions at the same level as in malignant tumors and may affect cellular proliferation and gene expression in atherosclerotic lesions.
Vascular trauma
Authors: Strong DP , Edwards AT 
Published: October 2002

Last century saw a marked increase in vascular injuries and their treatment has been improved from the experience gained in the major conflicts in the latter half of the last century. This trend of increasing numbers of vascular injuries has been perpetuated by a rise in civilian violence. This article reviews the mechanisms, diagnosis and treatment of vascular injury and outlines some of the advances in endovascular techniques for treating vascular trauma.