bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lung Abscess Caused by <i>Paecilomyces lilacinus</i>
Authors: Ono Nobuhiro , Sato Kiyoshi , Yokomise Hiroyasu , Tamura Koichi 
Published: April 2003

We report the case of a 57-year-old man who was referred to our department for further investigation of an abnormal chest shadow. Radiography on admission demonstrated a coin lesion in the right hilum. To make a final diagnosis, right middle lobectomy was performed and the mass was revealed to be a fungal abscess. Further examination confirmed that the fungus was Paecilomyces lilacinus. This is the first reported case of lung abscess caused by P. lilacinus in an otherwise healthy person.
The Number of Interleukin 1 Receptors on Lung Fibroblasts in Patients with Idiopathic Pulmonary Fibrosis
Authors: Takeuchi M. , Nagai S. , Tsutumi T. , Mio T. , Izumi T. 
Published: April 2003

<i>Background:</i> We investigated the expression of the IL-1 receptor on lung fibroblasts in patients with idiopathic pulmonary fibrosis (IPF) the histology of which was diagnosed as usual interstitial pneumonia. <i>Methods:</i> <sup>125</sup>I-labeled IL-1α bound to lung fibroblasts in a specific and saturable manner in lung fibroblasts obtained from both IPF patients and control subjects. <i>Results:</i> Scatchard plot analysis revealed a single type of binding site in both groups. In total, 8,600 ± 1,450 (mean ±SD) sites/cell with a dissociation constant (K<sub>d</sub>) of 1.83 ± 0.28 (mean ±SD) n<i>M</i> in patients with IPF and 7,920 ± 1,470 sites/cell with a K<sub>d</sub> of 2.43 ± 0.49 n<i>M</i> in control subjects were counted. Furthermore, affinity cross-linking experiments revealed that the IL-1 receptor on lung fibroblasts in patients with IPF and control subjects had a molecular size of 80 kD. <i>Conclusion:</i> In conclusion, type I receptor was present on human lung fibroblasts, but there were no differences in number or affinity between IPF patients and controls.
In Long-Term Smokers and Former Smokers the Bronchodilator Response Is Not Related to the Fall in FEV<sub>1</sub>
Authors: Stănescu Dan , Veriter Claude , Sanna Antonio 
Published: April 2003

<i>Background: </i>Cigarette smoking is the cardinal cause of chronic obstructive pulmonary disease (COPD), but only a relatively small percentage of smokers are developing clinically overt disease, suggesting, therefore, that other risk factors than smoking are involved. Several studies have shown that the bronchodilator response (BR) is related to the progress of COPD, as assessed by the fall in forced expiratory volume in 1 s (FEV<sub>1</sub>). However, the relationship between BR and fall in FEV<sub>1</sub>, is a disputed one. <i>Objective: </i>To assess the relationship between BR and fall in FEV<sub>1</sub> in a group of long-term smokers and ex-smokers who were 60 years old on the average. <i>Methods:</i> Questionnaire, spirographic tests and BR were assessed in 56 smokers and ex-smokers of mean age 62.5 ± (SD) 2.7 years at the end of a 13-year follow-up period. BR was expressed as a percentage change of the prebronchodilator value (‘% initial’) and as a percentage change of predicted value (‘% predicted’). <i>Results:</i> The FEV<sub>1</sub>/VC vital capacity was 68.9 ± 7.6% at the start and 64.5 ± 11.3% at the end of the study. The average fall in FEV<sub>1</sub> over 13 years was 26 ± 25 ml/year. The FEV<sub>1</sub> increased after albuterol on the average with 5.9 ± 6.6%, 4.5 ± 3.9% of predicted, and the vital capacity with 2.5 ± 6.5%, 2.3 ± 6.4% of predicted. BR and fall in FEV<sub>1</sub> were correlated: the greater the BR, the more rapid the fall in FEV<sub>1</sub> (r = 0.4 and p < 0.01 for FEV<sub>1</sub>% and r = 0.3 and p < 0.05 for FEV<sub>1</sub> predicted). However, when adjusting for prebronchodilator FEV<sub>1</sub>, the BR was no more related to the fall in FEV<sub>1</sub> (r = 0.15, p > 0.05). <i>Conclusions: </i>In long-term smokers and ex-smokers, the BR measured at the end of the follow-up period was correlated with the fall in FEV<sub>1</sub>. However, after adjusting for prebronchodilator FEV<sub>1</sub> values, BR was no more related to the decline in FEV<sub>1</sub>. The BR appears not to be associated with the development of COPD.
Serum Concentrations of Lignocaine before, during and after Fiberoptic Bronchoscopy
Authors: Loukides S. , Katsoulis K. , Tsarpalis K. , Panagou P. , Kalogeropoulos N. 
Published: April 2003

<i>Background:</i> Lignocaine is commonly used for local anesthesia during fiberoptic bronchoscopy (FOB). Several studies have reported the peak serum concentration of lignocaine in relation to time, but most of them did not specify the administered dose of lignocaine gel and its possible correlation with peak serum concentration. <i>Objective:</i> The aim of our study was to record the plasma concentrations of lignocaine before, during and after FOB and to evaluate whether the doses for nasal and tracheobronchial anesthesia have any correlation with the peak serum concentrations of the drug. <i>Methods:</i> Twelve patients with no comorbid conditions undergoing FOB were studied. Lignocaine was administered as a 2% solution using a larynx syringe, 2% gel (mean dose 182.5 ± 15 mg) and finally 2% solution through the bronchoscope (mean dose 339 ± 12 mg). Total dose was 622 ± 20 mg. Venous blood samples were taken before the beginning of local anesthesia and then at 5, 10, 20, 60, 90 and 120 min thereafter. <i>Results:</i> Our results showed that peak plasma concentrations of lignocaine were observed in 8 patients 20 min after the beginning of local anesthesia, in 3 patients 30 min afterwards and in 1 patient 60 min afterwards (2.15 ± 0.4 μg/ml, 1.9 ± 0.3 μg/ml, 1.81 μg/ml, respectively). None of our patients exceeded the critical level of toxicity (5 μg/ml). Both the total and tracheobronchial doses of lignocaine were significantly correlated with peak serum concentration (r = 0.63, p = 0.05 and r = 0.64, p = 0.02, respectively). No correlation was found between the dose for nasal anesthesia and peak serum concentration. No adverse reactions were observed. <i>Conclusions:</i> In conclusion our data show that although the amount of lignocaine used in this study exceeded the recommended highest dose (400 mg) in all patients, no toxic levels were observed. Peak plasma concentrations were found within 20–30 min from the beginning of local anesthesia. The dose for the anesthesia of nasal mucosa represented a significant percentage of the total dose, but did not correlate with the peak serum concentration of the drug.
Respimat<sup>®</sup> (a New Soft Mist Inhaler) Delivering Fenoterol plus Ipratropium Bromide Provides Equivalent Bronchodilation at Half the Cumulative Dose Compared with a Conventional Metered Dose Inhaler in Asthmatic Patients
Authors: Kunkel G. , Magnussen H. , Bergmann K.-C. , Juergens U.R. , de Mey C. , Freund E. , Hinzmann R. , Beckers B. 
Published: April 2003

<i>Background:</i> Respimat<sup>®</sup>, a possible alternative to the conventional metered dose inhaler (MDI), is a novel, reusable, propellant-free, multidose soft mist inhaler. Respimat slowly releases a metered dose of active substance as a soft mist with a high proportion of the dose in the fine particle fraction, leading to improved lung deposition following inhalation when compared with the conventional MDI. <i>Objectives and Methods:</i> The equipotent bronchodilating efficacy and safety of a combination of fenoterol hydrobromide and ipratropium bromide (F/I) in cumulative doses delivered by either Respimat or pressurised MDI was assessed in a randomised, controlled, double-blind (within device) 4-way crossover study. Forty-three patients with stable asthma (mean FEV<sub>1</sub> 62% predicted) responsive to F/I inhaled cumulatively 16 puffs on each of 4 test days (1 + 1 + 2 + 4 + 8 puffs at 50-min intervals) via Respimat delivering 50/20, 25/20 or 25/10 µg F/I per puff or via MDI delivering 50/20 µg F/I per puff. <i>Results:</i> Cumulative doses of 400/160 and 400/320 µg F/I via Respimat produced bronchodilation (evaluated by average increase in FEV<sub>1</sub> 45–245 min after first inhalation) equivalent to that achieved with a cumulative 800/320 µg F/I via MDI (mean increase in FEV<sub>1</sub> above baseline 0.76, 0.73 and 0.71 litres, respectively). The tolerability of the F/I combination via Respimat was also comparable to that of twice the dose delivered via MDI. <i>Conclusion:</i> Therefore, a fenoterol hydrobromide/ipratropium bromide combination delivered by Respimat is as safe and effective as the MDI at half the cumulative dose, on acute administration to patients with asthma.
Diagnostic Accuracy of Pleural Fluid Polymorphonuclear Elastase in the Differentiation between Pyogenic Bacterial Infectious and Non-Infectious Pleural Effusions
Authors: Alegre José , Suriñach José Maria , Varela Encarna , Armadans Lluis , Marti Ramón , Segura Rosa , Aleman Carmen , Falcó Vicente , Fernandez de Sevilla Tomás 
Published: April 2003

<i>Background and Objectives: </i>To establish the diagnostic accuracy of the markers of neutrophil activity (elastase and lysozyme) determined in pleural fluid, for differentiating between pyogenic bacterial infectious and non-infectious pleural effusions. <i>Patients and Methods: </i>At our tertiary referral teaching hospital, 160 patients over 14 years with pleural effusion (PE), classified as pyogenic bacterial infectious (41 parapneumonic complicated, 32 parapneumonic non-complicated) and non-infectious (32 neoplasm and 55 undiagnosed pleural exudates) were examined in a prospective study. Polymorphonuclear elastase (PMN-E) was determined by an immunoactivation method and lysozyme by a turbidimetric method. Receiver operating characteristic (ROC) curves were used to evaluate diagnostic accuracy. <i>Results: </i>Pleural fluid PMN-E was the biochemical marker that best differentiated between pyogenic bacterial infectious and non-infectious PE. The ROC area under the curve (AUC) for PMN-E was 0.8276. A PMN-E value over 230 µg/l diagnosed infectious PE with a specificity of 0.81 and a sensitivity of 0.74. The ROC AUC for proteins plus lactate dehydrogenase was 0.7430. Differences between the two ROC curves were significant (p = 0.032). After excluding purulent parapneumonic complicated PE, the sensitivity of a pleural fluid PMN-E value equal to or greater than 230 µg/l was 0.64 and the specificity 0.81. <i>Conclusions: </i>Pleural fluid PMN-E was the marker that best differentiated infectious from non-infectious PE, and PMN-E values lower than 230 µg/l suggest non-infectious PE.
Effect of the Airway Epithelium on the Contraction of Rat Isolated Trachea under Conditions of Low Temperature
Authors: González O. , Santacana G.E. 
Published: April 2003

<i>Background:</i> The exposure of the airways to low temperature (LT) is a well-known trigger of bronchoconstriction and asthma. However, the mechanisms involved in this response are not well understood. In particular, the specific role of the airway epithelium in the response to LT has not been well established. <i>Objective:</i> The purpose of this work is to study the regulatory role of the airway epithelium in the contractile response of the rat trachea under conditions of LT. <i>Methods:</i> Isolated rat tracheas were stimulated with acetylcholine (ACH) at 37 and 18°C, and dose-response curves were generated in epithelium-intact or epithelium-denuded conditions. EC<sub>50</sub> and E<sub>max</sub> were determined under these conditions. <i>Results:</i> Epithelium denudation at 37°C, increases the tracheal sensitivity to ACH, (EC<sub>50</sub> from 5.9 to 2.6 µ<i>M</i>, p = 0.003). The effects of denudation were even more pronounced at 18°C. E<sub>max</sub> was significantly decreased under these conditions. Exposure of intact tracheas to 18°C also produced a significant increase in tracheal sensitivity (EC<sub>50</sub> from 5.9 to 1.5 µ<i>M</i>, p = 0.0004), although no changes in E<sub>max</sub> were noted. <i>Conclusions:</i> These results strongly suggest that the airway epithelium diminishes the sensitivity of the airway smooth muscle to ACH at 37 and 18°C, and that it is also needed to observe the maximal contractile response under LT conditions. Therefore, the spasmogenic effect of low temperature is significantly potentiated by the absence of airway epithelium.
Immediate Motor Effects of Stimulation through Electrodes Implanted in the Human Globus Pallidus
Authors: Ashby P. , Strafella A. , Dostrovsky J.O. , Lozano A. , Lang A.E. 
Published: April 2003

The immediate motor effects of stimulation through electrodes chronically implanted in the globus pallidus internus (GPI) were studied in 9 subjects with Parkinson’s disease. Single stimuli (at ≫0.4 Hz) produced short latency facilitation of voluntarily activated contralateral muscles in all subjects. The latency and distribution of the facilitation, its probably monosynaptic nature, and the short chronaxie and refractory period of the activated neural elements suggest that the facilitation results from the direct excitation of the fast conducting corticospinal pathway. The facilitation of motoneurons followed high frequency (e.g. 200 Hz) stimulation without decrement and occurred at stimulus intensities well below those required to produce a visible muscle contraction. We conclude that, while there may be other effects, GPI stimulation through electrodes may activate the corticospinal tract, even when the stimuli are below the threshold for a visible muscle contraction, and that continuous stimulation may do so continuously. This may be an unwanted side effect, but possible therapeutic actions are considered. The reproducible short latency facilitation enabled us to estimate current spread from the quadripolar electrodes used for deep brain stimulation. When the current is sufficient to excite large myelinated fibers near one of the quadripolar electrodes, an additional 1-mA current will activate similar fibers at an additional distance of 1.8 mm with bipolar stimulation and at a distance of 5.7 mm with monopolar stimulation.
Comparison between Stereotactic CT and MRI Coordinates of Pallidal and Thalamic Targets using the Laitinen Noninvasive Stereoadapter
Authors: Hirabayashi Hidehiro , Hariz Marwan I. , Fagerlund Markku 
Published: April 2003

The coordinates of one and the same target were compared between stereotactic CT and MRI studies, using the original Laitinen noninvasive Stereoadapter, and a slightly modified stereoadapter in 34 patients scheduled for pallidotomy or thalamotomy. The differences between CT and MRI coordinates were significant for the anteroposterior y (p < 0.001) and the vertical z (p < 0.01) coordinates. When the targets were analyzed separately for the coordinates in the right and left hemispheres, only those of the left-sided targets were significantly different between CT and MRI measurements. In patients where a vertex support was added to the Stereoadapter, there were no differences between CT and MRI target coordinates, regardless of the side of the target. However, in all patient groups, the three-dimensional vectorial difference between CT and MRI coordinates showed that the MRI-defined targets lay anterior and dorsal, that is, rostral, to the CT-defined targets, with a 95% confidence interval of the differences ranging from 1.8 to 2.4 mm. This rostral shift in target coordinates on MRI versus CT happens to coincide with the usual approach of the probe towards the target during surgery. It is concluded that the differences in target coordinates in our study are due partly to MRI distortion and partly to repositioning error of the Stereoadapter on the head. The relatively low magnitude of these differences does not preclude the use of the Stereoadapter for MRI-guided functional stereotactic surgery, provided careful impedance monitoring and macrostimulation of the target area prior to lesioning.
Effects of a Stereotactic Headframe Assembly on Proton Magnetic Resonance Spectroscopy
Authors: Campeau Norbert G. , Wood Christopher P. , Erickson Bradley J. , Jack Jr. Clifford R. , Felmlee Joel P. 
Published: April 2003

The effects of a magnetic resonance-compatible stereotactic headframe assembly on single voxel proton magnetic resonance spectroscopy (MRS) were investigated. Multiple stimulated echo acquisition mode (STEAM) spectra were obtained within a commercially available brain metabolite phantom placed within the headframe assembly (Leksell, Model G). All acquisition parameters were kept constant, except voxel location. Maximal distortion occurred for voxels acquired in the immediate vicinity of a headframe fixation pin, manifested by spectral broadening, changes in peak area and height and distortion of the baseline, rendering these acquisitions nondiagnostic. The range of this interaction was short, and a voxel acquired with nearest edge located 2.0 cm or greater from the fixation pin tip produced NAA/Cr, Cho/Cr and mI/Cr ratios differing by less than 7.5% from a spectrum obtained at the phantom center. The feasibility of performing single voxel MRS with a stereotactic headframe in place is demonstrated.
Stereotactic Posterioventral Pallidotomy Improves Balance Control as Assessed by Computerized Posturography
Authors: Mandybur George , King W. Michael , Moore Kenneth 
Published: April 2003

Postural instability is arguably the most debilitating symptom of Parkinson’s disease (PD). Recently, posterioventral pallidotomy/pallidoansotomy (PVP) has been advocated to improve a multitude of symptoms associated with PD. Dyskinesias, rigidity and bradykinesia are the most talked about improved symptoms, but posture and gait are also affected after PVP. To analyze the effect of PVP on postural control, 14 patients with PD were prospectively studied using a computerized dynamic posturography machine. Seven males and 7 females underwent a total of 18 procedures, 6 left PVP, 6 right PVP, 2 bilateral and 2 had Vim thalamotomies in addition to PVP. Data were collected pre- and postoperatively after a 12-hour drug-free interval (‘off’ period) and 1–2 h after medications (‘on’ period). Postoperative analyses were performed between 1 and 3 months postoperatively. As a group, patients’ balance, in the off period, improved after surgery in a dynamic setting. Prior to surgery, patients’ anterior-posterior sway exceeded their stability limits (patient fell) on 31% of the trials. After surgery, the fall rate
decreased to 23%. Anterior-posterior sway decreased significantly (p < 0.05) postoperatively when the platform was sway referenced. In comparing the effect of surgery in decreasing sway with that of medication preoperatively, improvement after surgery (off period) was better than the preoperative on period (p < 0.05). Patients also improved in ostoperative off state when compared to preoperative off state with the platform sway referenced (p < 0.05), controlling for improvement in dyskinesia-induced imbalance. In conclusion, PVP improves standing balance performance better than that achieved with medications preoperatively. Since central input parameters were improved, the mechanism of PVP may be centralized.
Analysis of Brain Tumours Suitable for Curability via Gene Therapy in North East Malaysia
Authors: Abdullah J. , Isa M.N. 
Published: April 2003

Two hundred primary brain tumours in both adults and children from the year 1990 to 1998 presenting for treatment to the Neurosurgical Division of the Hospital of the University of Sciences Malaysia were studied retrospectively. Volumes of tumours were taken from CT scans with contrast using two formulas and divided into 4 groups: (1) less than 20 cm<sup>3</sup>, (2) 20–50 cm<sup>3</sup>, (3) 50–100 cm<sup>3</sup> (4) larger than 100 cm<sup>3</sup>. The majority of the brain tumours were in the volume range of 50–100 cm<sup>3</sup>, and are thus potentially curable with retroviral gene therapy.
Dose-Volume Effect in Gamma Knife Radiosurgery of Meningiomas
Authors: Kang C.S. , Zheng L.G. , Xu D.S. 
Published: April 2003

<i>Objective:</i> To study the relationship between dose-volume effect and complication in gamma knife radiosurgery of intracranial meningiomas. <i>Method:</i> By using an integrated logistic formula to establish mathematical models, the authors analyzed the relationship between treatment volume and logistic probability for 15 Gy, and the relationship between prescribed dose and treatment volume in 3% logistic probability. Furthermore, 37 meningiomas treated by gamma knife radiosurgery were analyzed retrospectively to investigate how the 3% isoeffect curve impacted on complication. <i>Result:</i> There was a linear relation between treatment volume and logistic probability for 15 Gy. The regression formula was f(x) = 0.0042x + 0.0007. The 3% isoeffect curve indicated that the prescribed dose was inversely proportional to the treatment volume. During 16.3 months follow-up on average, 18 cases below the 3% isodose curve were without complication, but in 19 cases above the 3% isodose curve, 5 cases suffered complications, the difference being statistically significant. <i>Conclusion:</i> Dose selection in gamma knife radiosurgery is volume dependent. The 3% isodose curve may possibly be the guideline in gamma knife radiosurgery of meningiomas.
An Update on Vitamin D<sub>3</sub> Analogues in the Treatment of Psoriasis
Authors: van de Kerkhof P.C.M. 
Published: April 2003

Vitamin D<sub>3</sub> analogues have revolutionized the topical treatment of psoriasis during the last decade. The mode of action of this ligand for the vitamin D<sub>3</sub> receptor is via modulation of the transcription of genes with vitamin D<sub>3</sub> response elements in their promoter region. Vitamin D<sub>3</sub> analogues cause inhibition of various aspects of cutaneous inflammation and epidermal proliferation with enhancement of normal keratinization. In vivo, active vitamin D<sub>3</sub> analogues proved to have a substantial antipsoriatic effect. Calcipotriol (50 µg/g in ointment or cream), tacalcitol (4 µg/g in ointment) and calcitriol (3 µg/g in ointment) have been shown to have an antipsoriatic effect in placebo-controlled studies. The most extensive body of information on comparative studies and on combination therapies is available for the analogue calcipotriol. So far, calcipotriol is available as a routine treatment in most countries, whereas tacalcitol has been registered in Japan and some European countries. From the available data in the literature we may conclude that calcipotriol is a first-line treatment for psoriasis and is advantageous in the combination with several other antipsoriatic treatments suchs as topical corticosteroids, PUVA, cyclosporin and acitretin. Tacalcitol 4 µg/g as a once-daily principle is effective in psoriasis. Comparative studies will indicate the position of the existing and new vitamin D<sub>3</sub> analogues.