bluuebunny/crossref_metadata_2025_split huggingface dataset:
Usefulness of serum fibrinogen degradation product‐E in sporadic cases of classical hemolytic uremic syndrome
Authors: Aihara Yukoh , Nakamura Tomoko , Unayama Takao , Yoshida Yoshiyuki , Yokota Shumpei 
Published: March 2003

Abstract Background: Hemolytic uremic syndrome (HUS) associated with Shiga toxin (Stx)‐producing Escherichia coli O157:H7 infection is one of the diseases causing acute renal failure in young children. Although HUS is still a serious disease in children, no reliable predictive markers for HUS nor markers of disease severity are available so far. Recently, we experienced a sporadic case of typical HUS caused by Stx‐producing E. coli O157:H7 and detected, at the prodromal stage, a high level of serum fibrin/fibrinogen degradation product‐E (FDP‐E) fraction.
Methods
: To assess the usefulness of FDP‐E for the treatment of HUS in clinical practice, we retrospectively examined serum levels of FDP‐E in 22 patients with bloody diarrhea with or without HUS.
Results
: There were significantly increased levels of serum FDP‐E in patients with HUS, but not in those without HUS. Furthermore, serum levels of FDP‐E may correlate with disease severity in patients with HUS.
Conclusions
: These results suggest that serum levels of FDP‐E may be a useful marker of HUS in clinical practice.
Uroguanylin level in umbilical cord blood
Authors: Tsukahara Hirokazu , Sekine Kyoichi , Uchiyama Mayumi , Miura Masakazu , Nakazato Masamitsu , Date Yukari , Tsunezawa Wataru , Kotsuji Fumikazu , Nishida Koichi , Hiraoka Masahiro , Mayumi Mitsufumi 
Published: March 2003

Abstract

Background
: Uroguanylin is a novel natriuretic and diuretic peptide originally isolated from urine.
Methods
: To determine whether uroguanylin has a physiologic role during the perinatal period, uroguanylin levels in umbilical cord plasma obtained at the time of delivery were measured by radioimmunoassay and compared with cord serum osmolality.
Results
: Mean (±SD) cord plasma uroguanylin concentrations (8.8±2.1 fmol/mL) were higher compared with normal adult values. The extent of maturity, mode of delivery and gender did not appear to influence cord uroguanylin levels. The uroguanylin concentration had a significant positive correlation with cord serum osmolality.
Conclusion
: These findings support some regulatory role of this peptide in perinatal renal and cardiovascular adaptation.
Cyclobilirubin formation by in vitro photoirradiation with neonatal phototherapy light
Authors: Yasuda Saneyuki , Itoh Susumu , Imai Tadashi , Isobe Kenichi , Onishi Shoju 
Published: March 2003

Abstract

Background
: The main mechanism of phototherapy for neonatal hyperbilirubinemia is the production and excretion of (EZ)‐ and (EE)‐cyclobilirubin (4E,15Z‐ and 4E,15E‐cyclobilirubin). Thus, the clinical efficacy of the light source for phototherapy must be evaluated by cyclobilirubin formation from (ZZ)‐bilirubin in in vitro photoirradiation.
Methods
: In the present study, we investigated the in vitro production pattern of bilirubin photoisomers by phototherapy light from the bilirubin–human serum albumin complex.
Results
: No clear difference was found in the curves relative to (ZZ)‐bilirubin and its photoisomers under aerobic and anaerobic conditions. The ratio of (EZ)‐cyclobilirubin to (ZZ)‐bilirubin increased proportionately to the dose of irradiating light and no photoequilibrium state was observed analogous to that found in configurational photoisomerization. The concentration of (EZ)‐ and (EE)‐cyclobilirubin increased proportionately with the grade of the percentage decrease in A460 nm from 0 to 23%. With a percentage decrease in A460 nm of 23% or more, the cyclobilirubin concentrations reached a steady state. The reason for this appears to be that the concentration of (ZZ)‐bilirubin, a substrate for photoisomers, dropped below 1 mg/100 mL. Biliverdin was produced only in trace amounts. However, the absorption at 520–700 nm increased after a percentage decrease in A460 nm of more than 23%.
Conclusions
: The results of the present study show that little bilirubin photooxidation occurred with in vitro aerobic photoirradiation. Before the concentration of cyclobilirubin reaches a steady state, it is theoretically valid to use the percentage decrease in A460 nm for the evaluation of the clinical efficacy of the light source.
End‐tidal carbon monoxide is predictive for neonatal non‐hemolytic hyperbilirubinemia
Authors: Okuyama Hiroko , Yonetani Masahiko , Uetani Yoshiyuki , Nakamura Hajime 
Published: March 2003

Abstract

Background
: The aim of the present study was to evaluate the value of an end‐tidal carbon monoxide corrected for inhaled carbon monoxide concentration (ETCOc) at the early neonatal period. The value would be useful for predicting subsequent hyperbilirubinemia in non‐hemolytic full‐term infants.
Methods
: The ETCOc levels were measured every 6 h during the first 72 h of life in healthy, full‐term, non‐hemolytic, newborn Japanese infants using a breath carbon monoxide analyzer. The ETCOc levels in hyperbilirubinemic infants were compared with those in non‐hyperbilirubinemic infants. Hyperbilirubinemia was defined as the level of the peak total serum bilirubin concentration (TBC) greater than or equal to 257 μmol/L (15.0 mg/dL). The ETCOc measurement for predicting subsequent hyperbilirubinemia was evaluated with a receiver–operating characteristic (ROC) curve.
Results
: Fifty‐one infants were enrolled in the study. Seven of the 51 infants developed hyperbilirubinemia. The ETCOc levels in non‐hyperbilirubinemic infants were decreased in the first 72 h after birth. However, those in the hyperbilirubinemic infants were not decreased significantly, and were higher than those in non‐hyperbilirubinemic infants at 42, 48, 54 and 66 h of age. The ETCOc level at 42 h of age was the most predictive of subsequent hyperbilirubinemia by ROC analysis. At the cut‐off level of 1.8 μL/L (p.p.m.), the sensitivity, the specificity, the positive predictive value and negative predictive value were 86, 80, 40 and 97%, respectively.
Conclusion
: Increased ETCOc level in the early neonatal period is associated with subsequent hyperbilirubinemia, even in infants without hemolytic disease. The ETCOc measurement may be useful as a screening test for predicting hyperbilirubinemia without hemolytic diseases.
Functional immaturity of cord blood monocytes as detected by impaired response to hepatocyte growth factor
Authors: Jiang Qi , Azuma Eiichi , Hirayama Masahiro , Iwamoto Shotaro , Kumamoto Tadashi , Kobayashi Michihiro , Yamamoto Hatsumi , Sakurai Minoru , Komada Yoshihiro 
Published: March 2003

Abstract

Background
: Monocytes as antigen‐presenting cells play an important role in host defense and transplantation. However, there are little reports on cord blood monocytes, and the role of monocytes in cord blood transplantation is largely unknown.
Methods and Results
: There are several cytokines affecting monocyte function. These include interferon‐γ, interleukin‐4, interleukin‐10, granulocyte macrophage‐colony stimulating factor and hepatocyte growth factor (HGF). We investigated the effect of these cytokines on antigen‐presenting capacity (APC) of cord and adult blood monocytes. Using either mononuclear cells or purified CD4+ T cells as responder cells, HGF enhanced APC of adult monocytes most effectively among these cytokines. In contrast, cord blood monocytes failed to respond to HGF. As HLA, costimulatory and adhesion molecules may affect APC function, we examined these antigens of monocytes following HGF stimulation. The HGF upregulated integrin α5 subunit (CD49e) and intercellular adhesion molecule‐1 (CD54) was expressed in adult blood monocytes, but not in cord blood. In kinetic studies, HGF downregulated c‐met protein/HGF receptor expression of adult monocytes in lower concentrations and at shorter incubation time as compared with that of cord blood.
Conclusions
: The results suggest that impaired response of cord blood monocytes to HGF may be responsible, in large part, for their functional immaturity.
Risk of irregular menstrual cycles and low peak bone mass during early adulthood associated with age at menarche
Authors: Anai Takanobu , Miyazaki Fumiko , Tomiyasu Toshiko , Matsuo Toshiko 
Published: March 2003

Abstract

Background
: The risk of irregular menstrual cycles and low peak bone mass of the lumbar spine in young adult women, associated with age at menarche, has not been clearly defined. The aim of this study was to investigate this further.
Methods
: A total of 180 college females aged 20–23 years were surveyed about menstruation, exercise, and calcium intake by means of a questionnaire. We also measured vertebral bone mineral density in these women by dual energy X‐ray absorptiometry. The subjects were divided into six groups according to their age at menarche. Comparisons were made of the mean body mass index (BMI) and T‐scores (the ratio to the mean bone mineral density of young adult Japanese women) among those groups, and odds ratios of irregular menstrual cycles and low peak bone mass less than 87% (– 1 standard deviation (SD) of T‐scores were calculated using the mean menarcheal age (12 years) group as a control.
Results
: The mean BMI and T‐scores were significantly lower in delayed menarche groups (equal to or more than 13 years) compared with early menarche groups (equal to or less than 12 years). The odds ratios of irregular menstrual cycles were 5.9 (95% confidence intervals (CI) 1.7–20.6), 13.7 (95% CI 3.6–51.6), and 73 (95% CI 6.5–813.9) in the 13‐, 14‐, and more than 14 years menarcheal age groups, respectively. The odds ratio of low peak bone mass less than 87% (– 1SD) was 3.4 (95% CI 1.1–10.3) in the 14 years menarcheal age group.
Conclusions
: Young adult women with delayed menarche may be at high risk for irregular menstrual cycles and low peak bone mass.
Cerebral metabolism and regional cerebral blood flow during moderate systemic cooling in newborn piglets
Authors: Okubo Kensuke , Itoh Susumu , Isobe Kenichi , Kusaka Takashi , Nagano Keiko , Kondo Masatoshi , Onishi Shoju 
Published: March 2003

Abstract

Background
: Clinical trials of hypothermic therapy in asphyxiated infants have started recently. However, clinical studies have been delayed by the difficulty in selecting infants with a bad neurological prognosis and by the concern regarding adverse effects of hypothermia. The purpose of this study is to examine the effects of systemic cooling on cerebral metabolism (CMR) and the regional cerebral blood flow (rCBF) in newborn piglets.
Methods
: The rCBF in the seven parts of the brain were measured with colored microspheres. The blood samples for the measurement of cerebral oxygen consumption (CMRO2) and cerebral glucose consumption (CMRglc) was collected from the umbilical artery and the superior sagittal sinus.
Results
: Reductions of cerebral cortex temperature to 32°C decreased blood flow in all brain regions. In particular, blood flow in the brainstem decreased more significantly than in any other region. The total cerebral blood flow (CBF), CMRO2 and CMRglc, respectively, decreased to 32.3~3.9 mL/100 g per min, 2.8~1.0 mLO2/100 g per min and 22~12 mmol/100 g per min at 32°C (41, 53 and 46% of the initial value). The CBF decreased in parallel with CMRO2 and CMRglc down to 35°C, but CBF decreased to a greater extent than CMRO2 and CMRglc at below 35°C.
Conclusions
: The indication of hypothermic therapy and the degree of cooling have to be performed very carefully. Systemic cooling is especially dangerous for the total asphyxiated infants who might have damage to the brainstem because the blood flow in the brainstem has significantly decreased during hypothermia.
Effect of insulin on transport kinetics of alpha‐aminoisobutyric acid in the perfused human placental lobule in vitro
Authors: Nandakumaran Moorkath , Makhseed Ma’Asoumah , Al‐Rayyes Samer , Akanji Abayomi O , Sugathan Thattaruparambil N 
Published: March 2003

Abstract

Background
: The limited data available on the role of insulin on maternal‐fetal transport of amino acids prompted us to undertake this study.
Methods
: Transport kinetics of a model amino acid, alpha‐aminoisobutyric acid (AIB) was investigated in perfusion of isolated human placental lobules in vitro in non steady‐state conditions and the effect of therapeutic dose of insulin was assessed in parallel series of perfusions. National Culture and Tissue Collection medium diluted with Earle’s buffered salt solution was used as the perfusate and tritiated water was used as the reference marker for comparison.
Results
: In five successful perfusions with insulin, differential transport rate indices of AIB for 10, 25, 50, 75 and 90% of efflux fractions in the fetal venous outflow averaged 0.76, 1.03, 1.02, 1.09, 1.04 and 1.03 times those of reference values, respectively. The indices differed significantly than in controls for 10, 25 and 50% efflux fractions, but not in the case of 75 and 90% efflux values. The AIB transport fraction (TF), expressed as percentage of injected maternal dose, averaged 29.4 ± 5.4% and 38.7 ± 6.2% of the corresponding reference marker value in control and insulin series, respectively. With regards to the pharmacokinetic transport parameters, the absorption and elimination rates of the amino acid were significantly higher in the study group than in the control.
Conclusion
: We conclude that insulin, in physiological and therapeutic doses, stimulates maternal‐fetal AIB transport in vitro, in the perfused human placental lobule.
Crush syndrome of children in the Marmara Earthquake, Turkey
Authors: Dönmez Osman , Meral Adalet , Yavuz Mahmut , Durmaz Oguzhan 
Published: March 2003

Abstract

Background
: Crush syndrome is defined as traumatic rhabdomyolysis with systemic and local complications.
Methods
: Crush syndrome and its related complications were diagnosed on the basis of clinical and biochemical data. In this study, we evaluated 20 children with crush syndrome transferred to our center in Bursa during the Marmara earthquake, 1999. We investigated the clinical and laboratory findings of these children.
Results
: Serum creatine kinase, aspartate aminotransferase, and alanine aminotransferase levels were high in all patients. Fifty‐five percent of the patients (n=11) had one extremity injury and 45% (n=9) had multiple extremity injuries. Fasciotomy was required in 15 children. Serum muscle enzymes and D‐dimer levels were high in children with multiple extremity injuries. Acute renal failure developed in 35% (n: 7/20) of them. Peak serum creatine kinase level was positively correlated with aspartate aminotransferase, alanine aminotransferase, hospitalization time, serum urea and creatinine (P<0.05).
Conclusions
: Crush syndrome was more severe in children with multiple extremity injuries and acute renal failure frequently developed in these children. Peak serum creatine kinase level as well as potassium, urea, uric acid, creatinine, lactic dehydrogenase, aspartate aminotransferase, alanine aminotransferase, and calcium levels were the helpful biochemical parameters in estimating the severity of crush syndrome.
Morphological differences between glomerular epithelial cells (GEC) excreted during chemotherapy with antineoplastic drugs and GEC excreted in renal diseases
Authors: Watanabe Akihiro , Kakihara Toshio , Hara Masanori , Tanaka Atsushi , Kanno Katsue , Imai Chihaya , Ikarashi Yukie , Okubo Soichiro , Yanagihara Toshio , Uchiyama Makoto 
Published: March 2003

Abstract

Background
: To better understand the mechanisms of glomerular epithelial cell (GEC) injuries in various diseases, we compared GEC excreted during chemotherapy (antineoplastic drugs) and GEC excreted in renal diseases.
Methods
: For 19 patients undergoing chemotherapy (85 courses), 69 patients with IgA nephropathy and 16 patients with Henoch‐Schölein purpura nephritis, the number of excreted GEC and GEC casts were counted by an immunofluorescent study. The morphological features of GEC were also studied in an immunofluorescent study combined with Hoechst stain.
Results
: Glomerular epithelial cells were detected in 78% of the chemotherapy courses and in 94% of the patients with renal diseases. The GEC casts were observed in 2% of chemotherapy courses, while in renal diseases GEC casts were observed in 60% of the patients. Proteinuria (>30 mg/dL) and hematuria were not identified in any of the chemotherapy courses. The morphology and size of GEC were more variable than that in patients with nephropathy. Furthermore, GEC in patients undergoing chemotherapy often showed small nuclei and fragmented nuclei, which were rarely observed in patients with nephropathy.
Conclusions
: These results showed that the detachment of podocytes was not directly associated with proteinuria or hematuria. The findings also suggest that GEC are damaged via an apoptotic process by chemotherapy. On the contrary, GEC may be detached through a non‐apoptotic process in renal diseases.
Low plasma levels of hemostatic proteins during the induction phase in children with acute lymphoblastic leukemia: A retrospective study by the JACLS
Authors: Hongo Teruaki , Okada Shuichi , Ohzeki Takehiko , Ohta Hideaki , Nishimura Shin‐Ichiro , Hamamoto Kazuko , Yagi Keiko , Misu Hideo , Eguchi Naohiro , Suzuki Nobuhiro , Horibe Keizo , Ueda Kazuhiro ,   The Japan Association of Childhood Leukemia Study (JACLS)
Published: March 2003

Abstract
Background
: Thromboembolic and bleeding events are serious complications associated with the administration of L‐asparaginase (ASP) during the induction phase in children with acute lymphoblastic leukemia (ALL). Prophylactic supplementation of plasma‐derived coagulation products remains controversial. The purposes of this study were to examine the plasma levels of hemostatic proteins during the induction phase and the efficacy of prophylactic replacement of plasma‐derived products.
Methods
: A multicenter retrospective survey on the incidence of hemostatic complications and the frequency of prophylactic replacement of plasma‐derived products among children with ALL who underwent ASP therapy was conducted. All patients were treated according to the Japan Association of Childhood Leukemia Study (JACLS) ALL‐97 protocol.
Results
: Thirty‐six (67%) of the 54 JACLS‐treatment centers responded and provided information on 127 patients. Clinically
relevant hemostatic complications occurred in two patients (1.6%;
2/127); one patient suffered intracranial bleeding 5 days
after beginning the protocol, and the second patient suffered an ischemic attack during an ASP treatment. The administration of ASP
(10 000 u/m2 × six doses) led to significant reductions in the plasma fibrinogen (180 ± 74 to 105 ± 57 mg/dL), antithrombin III (AT III) (126 ± 21 to 73 ± 18%), and plasminogen levels (97 ± 17 to 52 ± 18%). These laboratory parameters returned to normal levels 2 weeks after completion of the ASP treatment. Forty‐eight patients (38%) received AT III concentrate (AT III‐supplement group). The AT III level of the AT III‐supplement group was significantly lower than that of the AT III non‐supplement group, not only during the ASP therapy, but also prior to the ASP therapy. A greater percentage of patients in the AT III‐supplement group received fresh‐frozen plasma and in greater amounts than those in the AT III non‐supplement group.
Conclusions
: Severe hemorrhage and thrombosis were uncommon in the ALL patients who underwent ASP therapy in comparison with the degree of coagulation changes. Prophylactic administration of AT III concentrate or fresh‐frozen plasma did not demonstrate clear beneficial effects in the treatment of ALL in preventing thromboembolic events.
Communication effectiveness of nurses working in a variety of settings within one large university teaching hospital in western Japan
Authors: Ito Misae , Lambert Vickie A. 
Published: March 2003

AbstractThis survey study measured the communication effectiveness of 176 nurses working on a variety of clinical units within one large university hospital in western Japan. The vast majority of the nurses demonstrated fair effectiveness in their communication skills. Although some of the nurses did demonstrate slightly higher communication effectiveness scores, few of the nurses’ demographic characteristics appeared to influence how well they communicated. The major limitations of the present study were the use of one hospital for data gathering, and the possible lack of cultural sensitivity of the communication questionnaire.
Reflective practise in clinical teaching
Authors: Lau Annie Kit Ling , Chuk Kai Cheung , Wei So Winnie Kwok 
Published: March 2003

AbstractThe present paper describes the process of reflective practise in clinical teaching through a workshop entitled ‘Effective Clinical Teaching’. The clinical teachers were invited to analyze the content of a videotape in which various clinical teaching scenarios were presented. Following this, they discussed a series of questions designed to promote reflective activities and evaluated the interaction among the student, the client and the clinical teachers in each scenario. The teachers also identified the positive and negative aspects of the teaching approaches portrayed on the tape. Finally, the participants made recommendations that would improve the interaction and suggested alternate teaching strategies to enhance the learning outcome. In addition, there was sharing of clinical teaching experiences among the clinical teachers. Through this process of reflection on action, the clinical teachers were able to understand various teaching approaches as perceived by students, and to address the issues that might hinder student learning in clinical settings. Different reflective activities have also been proposed to enhance student's reflective learning skills.
Illness Behavior by the Elderly in a Korean Clan: Focus on Health‐Care Seeking Behavior
Authors: Cho Myoung Ok 
Published: March 2003

Purpose:  In an aging society such as in Korea, developing an efficient health delivery system for the elderly has become an emergent social problem because of the increasing elderly population and the complexity of degenerative diseases. Therefore, nurses, as deliverers of health care, must, more deeply, understand the health behavior of the elderly. An answer to the question, ‘How do the elderly choose a health‐care system, and why do they do this?’ was sought.Method:  This ethnographic study was conducted over three sessions. In January 1990, data on socio‐cultural context were gathered. Information on health and illness behaviors was collected from June 1994 to November 1994. From July 1995 to February 2001, the previously collected data were compared and confirmed. The subjects of this study, initially, were 10 women, aged 60 years or more. Five more women were added to the study in February 2001. The role of the researcher was that of cultural learner in the position of participant–observer. The data analysis procedure involved reflective thinking, comparison, and creativity.Results:  The findings revealed that the elderly managed their health problems through all available types of health care (i.e. professional, traditional, and folk system). The conditions for their choice of a health‐care system were found to be their affinity to the resource person in everyday life, the characteristics of the health problem, their confidence in the particular system and their available economic resources. It was concluded that the elderly must maintain favorable interactions with her/his neighbors in order to gain needed health management.