bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fetal growth and the timing of exposure to maternal smoking
Authors: Ohmi Hiroki , Hirooka Kenzou , Mochizuki Yoshikatsu 
Published: March 2003

Abstract
Background
: Maternal smoking during the third trimester reduces the birthweight of the full‐term neonate. We assessed the relationship between the timing of exposure to maternal smoking, gestational period, weight and body length for both full‐term and preterm neonates.
Methods
: A retrospective study with a questionnaire was conducted in 1194 infants who participated in the official medical examination for 3‐year‐old infants.
Results
: The risk of preterm birth from mothers who smoked during any trimesters was significantly increased. The body length of neonates whose mothers smoked during the third trimester was shorter than that of neonates whose mothers did not smoke during the third trimester. The weight of full‐term neonates whose mothers smoked during the third trimester was lighter than that of neonates whose mothers did not smoke during the third trimester.
Conclusions
: Maternal smoking during any trimesters increased the risk of preterm birth. Maternal smoking during the third trimester reduced the body length of both full‐term and preterm neonates, and the birthweight of the full‐term neonate in a somewhat dose‐dependent manner.
Effects of child seats on the cardiorespiratory function of newborns
Authors: Nagase Hiroaki , Yonetani Masahiko , Uetani Yoshiyuki , Nakamura Hajime 
Published: March 2003

Abstract
Background
: This study aims to determine the effect of differently positioned infant car seats on cardio­respiratory parameters in healthy full‐term newborns.
Methods
: We examined 15 healthy term newborns for respiratory compromise due to normal restraint in a recommended infant car seat. There are currently two types of car seats available in Japan: a chair‐shaped car seat and a bed‐shaped car seat. Using a sleep apnea recorder, we simultaneously monitored heart rate, percutaneous oxygen saturation, chest impedance and nasal airflow in infants placed in each of the car seats and also placed in the supine position on a nursery cot. Episodes of oxygen desaturation below 95% and longer than 10 s (mild desaturation) and below 90% longer and than 10 s (moderate desaturation) were evaluated over 30 min observation period.
Results
: The amount of time infants spent in a sleep state was significantly longer in the car seats than it was on the cot (P = 0.0015 for bed‐shaped, P = 0.0012 for chair‐shaped) and there was no difference in this measure between the two types of car safety seats. Mean of oxygen saturation with the chair‐shaped car seat (95.8%) was significantly lower than that with the bed‐shaped car seat (98.8%) (P = 0.0008). Newborn infants laid on the cot showed no episodes of desaturation. Newborn infants placed in the chair‐shaped car seat had significantly more episodes of mild desaturation (mean, 7.33 times in nine of 15 infants), whereas in the bed‐shaped seat observed only once each in two infants (P = 0.008). Moderate desaturation was observed in four of 15 infants in the chair‐shaped car seat, whereas not observed in the bed‐shaped car seat (P = 0.068).
Conclusion
: The results suggest that prior to discharge the degree of oxygen desaturation that occurs when an infant is placed in a chair‐style car seat should be checked.
Helicobacter pylori infection in patients with idiopathic short stature
Authors: Takahashi Masahisa , Kimura Hiroshi , Watanabe Kazuyoshi 
Published: March 2003

Abstract
Background
: Some investigators have recently described

an association between Helicobacter pylori infection and children with short stature. In the present study, we aimed to evaluate children with short stature with different etiologies.
Methods
: This study evaluated short patients aged

from 1 to 16 years. These patients were divided into a growth

hormone deficient short stature group (n = 27)

and an idiopathic short stature group (n = 14).

A control group included children with normal growth and no abdominal

pain (n = 47). Anti‐H. pylori antibodies were measured in each group (total of 88).
Results
: The antibody positivity rates for each

group were as follows: growth hormone deficient short stature group,

7.4%; idiopathic short stature group, 28.6%; and

control group, 6.4%. The H. pylori antibody positivity rate in the idiopathic short stature group was significantly higher than in the control group.
Conclusion
: Our findings suggest an association

between H. pylori infection and idiopathic short stature.
Metabolic alkalosis with hypoelectrolytemia in infants with cystic fibrosis
Authors: Fustik Stojka , Pop‐Jordanova Nada , Slaveska Nevenka , Koceva Svetlana , Efremov Gorgi 
Published: March 2003

Abstract
Background
: Infants with cystic fibrosis (CF) can develop episodes of hyponatremic hypochloremic dehydration with metabolic alkalosis when they sweat excessively, which is not caused by sweating in normal infants. We investigated the incidence of the metabolic alkalosis with hypoelectrolytemia in CF infants, the possible risk factors for its occurrence and the importance of the manifestation in the diagnosis of CF.
Methods
: In order to evaluate the incidence and the risk factors for the development of this sweat‐related metabolic disorder in CF, we reviewed the records of all children diagnosed as having CF before the age of 12 months in a 10‐year period. Data analysis included medical history data, clinical features, biochemical parameters (blood pH, serum bicarbonate, sodium, chloride and potassium levels), sweat chloride test values, as well as genetic analysis data.
Results
: The prevalence of metabolic alkalosis in association with low serum electrolyte concentrations (hyponatremia, hypochloremia, and hypokalemia) in infant CF population in our region was 16.5%. We found no season predilection in its occurrence. Early infant age, breast‐feeding, delayed CF diagnosis, heat exhaustion and the presence of severe CF transmembrane conductance regulator mutations are predisposed factors for the development of metabolic alkalosis with hypoelectrolytemia.
Conclusions
: The results from our study suggest that metabolic alkalosis with hypoelectrolytemia is a relatively common manifestation of CF in infancy. The possibility of CF should be seriously considered in any infant with this metabolic disorder.
Cross‐cultural menopausal experience: Comparison of Australian and Taiwanese women
Authors: Fu Shiu‐Yun , Anderson Debra , Courtney Mary 
Published: March 2003

Abstract A more universal approach to the understanding of menopause can offer health professionals a broader view of the phenomenon. The present study's objectives were to describe and explain the menopausal experiences of Asian and Occidental women, and to examine the relationship between social/cultural factors and women's menopausal symptoms. Questionnaires were used to investigate psychosocial and cultural factors and menopausal symptoms in 45–55 years old Taiwanese (n = 105) and Australian (n = 450) women. The variables investigated included: social demography; menopause status; attitudes toward menopause; mental health; vitality; social functioning; and menopausal symptoms. Significant differences were found between Taiwanese and Australian women in their attitude towards menopause, menopausal symptoms and vitality scores. No significant differences were seen in the areas of social functioning, mental health and menopause status. The results suggest that cultural factors may influence the experience of menopause for women. These findings may improve health professionals’ understanding of cultural beliefs relating to menopause so that culturally appropriate care can be provided.
Results of conservative treatment of upper urinary tract transitional cell carcinoma
Authors: Fujimoto Naohiro , Sato Hideki , Mizokami Atsushi , Inatomi Hisato , Matsumoto Tetsuro 
Published: March 2003

Abstract
Background
: The treatment preserving the kidney for upper urinary tract tumor is still controversial. The indications and results of conservative treatment remain to be elucidated. Experiences of this type of treatment are reported.
Methods
: Between April 1981 and March 1998, 14 patients with upper urinary tract transitional cell carcinoma were treated with renal preserving methods. Five were elective and nine were imperative cases. Treatments performed were partial nephrectomy, partial ureterctomy with or without adjuvant chemotherapy, endoscopic tumor resection and topical bacillus Calmette‐Guerin instillation in one, 10, two and one patient, respectively.
Results
: Crude and cause‐specific 5 year‐survival rates were 91.7 and 100%, respectively. Of 14 patients, five had bladder recurrences, but ipsilateral local recurrence developed in only one patient. Two patients died from metastasis of transitional cell carcinoma 61 and 89 months after initial treatment. The lesions of carcinoma in situ were well controlled with topical bacillus Calmette‐Guerin therapy.
Conclusion
: The results of conservative treatment for upper urinary tract tumor were satisfactory and local excision can be indicated for low grade, solitary tumors located in the distal ureter.
Mechanisms of drug resistance in chemotherapy for urogenital carcinoma
Authors: Naito Seiji , Yokomizo Akira , Koga Hirofumi 
Published: March 2003

AbstractCancer chemotherapy is the principal approach for urogenital cancers. However, the acquisition of resistance to anticancer agents is a critical factor that limits the successful treatment of malignancies. The multidrug resistant (MDR) phenotype has been widely recognized in cancer chemotherapy in urogenital tumors and the mechanisms underlying MDR have also been extensively studied. One of the principle mechanisms in MDR is caused by the overexpression of P‐glycoprotein (P‐gp), encoded by the multidrug resistance gene (MDR1). It functions as an ATP‐dependent active efflux pump of chemotherapeutic agents in human cancer cells. Recently, other drug resistance proteins, including multidrug resistance‐associated protein (MRP1) and cMOAT (or MRP2), were also identified from multidrug resistant cells. A functional analysis of MRP1 has shown that MRP1 may have the potential to act as a transporter of glutathione conjugates, which has been known as a central detoxification pathway in anticancer agents. Furthermore, several other resistance‐related proteins (e.g. glutathione S‐transferase, metallothionein, thioredoxin, topoisomerase I, II, O
6‐alkylguanine‐DNA methyltransferase, etc.) have been found to be up‐ or down‐regulated in resistant cells and these molecules are believed to contribute to the resistant phenotype as well. Based on the molecular characteristics identified in MDR, several experimental and clinical approaches have been studied to overcome MDR. One of these strategies is to reverse MDR by using such P‐gp inhibitors as verapamil and cyclosporine A. In this review, we summarize the recent advances in MDR‐related molecules and clinical trials to circumvent MDR in urogenital carcinomas.
Comparative study of long‐term stone recurrence after extracorporeal shock wave lithotripsy and open stone surgery for kidney stones
Authors: KOŞAR ALIM , SARICA KEMAL , AYDOS KAGˇAN , KÜPELI SADETTIN , TÜRKÖLMEZ KADIR , GÖGˇÜS ORHAN 
Published: March 2003

Background: Extracorporeal shock wave lithotripsy (ESWL) has become the treatment of choice for most calculi of upper urinary tract and the need for open stone surgery (OSS) have considerably reduced. However, stone recurrence is often encountered as a long‐term problem requiring re‐treatment.Methods: In the present retrospective study, the recurrence rates of ESWL and OSS were compared in the treatment of kidney calculi. During the 1 year period of the present study, 43 patients were treated by OSS and 400 underwent ESWL (the Dornier MPL 9000 lithotriptor). The recurrence of stone was defined as reappearance of the stone on plain abdominal radiography during the follow‐up period.Results: Complete removal of all stone fragments was achieved in 51.2% of patients (n = 22) treated with OSS. In the ESWL group, the stone free rate was 56.7% (n = 237). The recurrence rate was 31.8% within a mean of 40 months (range 32–48 months) in the OSS group, whereas this figure was 13.9%, with a mean period of 46 months (range 42–48 months) in the ESWL group (P &lt; 0.05). The mean periods of recurrence in ESWL and OSS groups were 20 (range 6–42 months) and 11 months (range 8–44 months), respectively (P &lt; 0.05). However, the mean stone burdens of both groups were different (2.9 ± 0.8 vs 1.4 ± 1.1 cm). For comparable stone burdens, the recurrence rate was similar. In the ESWL group, stones in the lower calyx, multiple stones and larger stones showed a higher recurrence rate. The recurrence after OSS was also influenced by stone burden.Conclusions: The results of the present study demonstrate that stone burden may be the primary risk factor for stone recurrence after ESWL and OSS.
Fate of residual fragments after successful extracorporeal shock wave lithotripsy
Authors: Shigeta Masanobu , Kasaoka Yoshinobu , Yasumoto Hiroaki , Inoue Katsumi , Usui Tsuguru , Hayashi Mutsuo , Tazuma Susumu 
Published: March 2003

Purpose: The aim of the present study was to investigate the reason residual fragments from upper urinary tract calculi failed to clear after successful extracorporeal shock wave lithotripsy (ESWL).Methods: Risk factors were analyzed in 161 patients with residual fragments (≤ 4 mm) that had remained for more than 3 months after ESWL. The factors examined in the present study were gender, a history of urolithiasis, the number, location and size of stones, hydronephrosis 3 months after ESWL and bacteriuria before ESWL. The mean follow‐up period was 20.0 months (range 6–69 months).Results: The overall stone‐free rate was 14.3%. The stone‐free rate in patients with multiple stones or hydronephrosis 3 months after ESWL was significantly lower than that in patients without these conditions (P &lt; 0.05 and P &lt; 0.01, respectively). The cumulative non‐clearance rate in patients with hydronephrosis was significantly higher than in patients without this condition (P < 0.05). Results of Cox’s proportional hazards model indicated that hydronephrosis was the most important and only significant factor for failure to clear of the seven factors investigated (P < 0.05).Conclusion: Hydronephrosis was most highly correlated with the fate of residual fragments after ESWL.
A case of neuroleptic malignant syndrome in a patient with hemodialysis
Authors: Kunishima Yasuharu , Masumori Naoya , Kadono Masao , Tsukamoto Taiji 
Published: March 2003

AbstractA 63‐year‐old man with chronic renal failure who had received hemodialysis three times per week for 4 years developed neuroleptic malignant syndrome 10 days after taking amoxapine. His condition was characterized by muscle rigidity, elevation of body temperature and altered consciousness. Although he was treated with dantrolen and supportive care as well as discontinuation of amoxapine, his condition rapidly deteriorated, resulting in death. Because the pharmacokinetics of drugs, especially those such as antidepressants, in patients with chronic renal failure has not been fully clarified, one should be careful about giving such patients these drugs.
Histology of the fetal prune belly syndrome with reference to the efficacy of prenatal decompression
Authors: Shimada Kenji , Hosokawa Shyozo , Tohda Akira , Matsumoto Fumi , Johnin Kazuyosi 
Published: March 2003

Abstract
Background
: Deficient abdominal musculature, complex abnormalities of urinary tracts and bilateral abdominal cryptorchidism represent the basic characteristics of prune belly syndrome (PBS). Although prenatal diagnosis of PBS is rarely made, because of the wide variety of ultrasonographic images, reported cases have gradually increased. Once a fetus suspected of having PBS is found, it is sometimes difficult for the pediatric urologists to decide how to treat them. The histology of the kidney and urinary tracts in fetuses with PBS was reviewed in order to give suggestions on the management of prenatal cases.
Methods
: Autopsy records of nine fetuses (5 males, 2 females and 2 undetermined) with characteristically distended and deficient abdominal wall were reviewed. Gestational age (GA) at detection ranged from 12 to 25 weeks and at delivery from 13 to 32 weeks.
Results
: Renal histology in two fetuses showed earlier than normal disappearance of cortical nephrogenic zone replaced by cortical cysts and dysplastic structures. The nephrogenic zone was retained in five fetuses which were younger than GA 20 weeks. While the number of glomeruli along the medullary ray was normal for the age in three fetuses younger than GA 20 weeks, it was decreased in all others. Bladder histology was variable showing both increased musculature and defective or dysplastic muscles. There was a tendency for connective tissues in the bladder wall to increase in proportion to GA, The ureter revealed scarcity of muscle bundles among dense connective tissue. The urethra was atretic in eight fetuses.
Conclusion
: The clinical implication from the renal histology is that decompression of the urinary tract should be done before GA 20 weeks. However, the early fetal treatment appears to have no effect on the urodynamics in this disorder with deficient musculature.
What is the optimal treatment for lower ureteral stones larger than 1cm?
Authors: KÜpeli Bora , Alkībay Turgut , Sinik Zafer , KaraoĞlan ÜstÜnol , Bozkirli ībrahim 
Published: March 2003

Abstract
Purpose
: To compare the treatment options for lower ureteral stones larger than 1 cm.
Methods
: The records of 449 patients with lower ureteral calculi larger than 1 cm were reviewed retrospectively. Of these patients 342 (76.1%) were treated with extracorporeal shock wave lithotripsy (ESWL) (group 1), 66 (14.7%) with pneumatic lithotripsy (PL) (group 2) and 128 (28.5%) with ureterolithotomy (group 3). Eighty‐seven (19.5%) patients underwent any of the two treatment modalities because of unsuccessful primary treatment.
Results
: The overall stone‐free rates were 32.4, 90.9 and 95.3% for ESWL, PL and ureterolithotomy, respectively. These values were 84.4% for primary PL and 96.7% for primary ureterolithotomy. The re‐treatment rate (46.4%) and secondary procedures were much more frequent in the ESWL group. There was no difference in the complication rates of the three groups.
Conclusions
: Pneumatic lithotripsy with ureteroscopy seems to be an appropriate treatment for larger ureteral stones. While ESWL can be tried as a first treatment option because of its non‐invasive nature, lower success and higher re‐treatment rates limit its usefulness. Ureterolithotomy is still a reasonable alternative for these large or unfragmented stones.
Diagnosis and treatment of post‐herniorrhaphy vas deferens obstruction
Authors: Matsuda Tadashi 
Published: March 2003

AbstractChildhood inguinal herniorrhaphy (IH) is one of the most frequent causes of seminal tract obstruction. The incidence of vasal obstruction was found to be as high as 26.7% in subfertile patients with a history of childhood IH. The distal end of the vas deferens was found at the internal inguinal ring or in the pelvic cavity in 56.7% of cases, more than 3 cm of the vas deferens had been resected in 37.9% of cases, and sperm was found in vasal fluid in 45.5% of cases during corrective surgery. Microsurgical two‐layer vasovasostomy resulted in the postoperative appearance of sperm in 39% of patients. In patients with postoperative azoospermia, a secondary epididymal obstruction caused by a long‐term vasal obstruction is a highly probable cause. Ipsilateral epididymovasostomy following successful inguinal vasovasostomy results in the postoperative appearance of sperm in the ejaculate in 100% of the patients and a subsequent natural pregnancy rate of 50%. The overall pregnancy rate among couples, following surgery in 18 patients, was 43%, excluding pregnancies achieved by in vitro fertilization or intracytoplasmic sperm injection. Microsurgical reanastomosis of the seminal tract resulted in high impregnation rates among partners of patients with seminal tract obstruction caused by childhood IH. After receiving sufficient information on each treatment modality, patients can choose their preferred treatment, either reanastomosis of the seminal tract or assisted reproductive technology using epididymal or testicular sperm.
Urinary tract cancer screening through analysis of urinary red blood cell volume distribution
Authors: Wakui Mamoru , Shiigai Tatsuo 
Published: March 2003

Abstract
Background
: Hematuria is differentiated between glomerular and urinary tract origins on the basis of urinary red cell morphology. We used this distinction in a program of mass screening for urinary tract cancer to achieve cost‐effective and safe hematuria screening.
Methods
: Of a total of 21 372 adults (mean age 52.3 years; range 20–79 years) participating in a health screening, 912 (4.3%) had a positive dipstick for hematuria and were enrolled in the present study. Urinary red cell volume distribution curves (RDC), the simplest method of assessing urinary red cell morphology, were calculated and subjects were divided into two groups based on their RDC patterns. Group I subjects had a normocytic or mixed pattern and they were immediately investigated for urinary tract malignancy because of the associated risk for urological disease. Group II subjects had a microcytic pattern and, therefore, were judged to be at a low risk of urologic malignancy and were followed up 3 years later without urologic investigations.
Results
: Among the 38 subjects in group I (4% of all dipstick‐positive subjects), one case of bladder cancer was detected. In the remaining 37 patients, 15 cases of benign diseases were discovered. Group II was composed of 869 subjects (96%). The inquiry into their health status conducted 3 years later revealed that 831 (95.6%) were healthy and, of these, 13 had experienced gross hematuria during the period but urological malignancies were ruled out by their urologists, two (0.2%) had died of diseases other than urological cancer and 36 (4.1%) were lost to follow‐up. With our method, total costs have been reduced by 93.8% against a conventional setting of a full evaluation for all cases of hematuria.
Conclusions
: Microcytic hematuria, accounting for 96% of asymptomatic microhematuria cases in the present study, was not associated with a risk for urinary tract malignancy. Compared with conventional hematuria screening with a complete work‐up of all cases of hematuria, investigating only subjects with mixed or normocytic RDC patterns was safe and cost effective.