bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accurate continuous drug delivery at low infusion rate with a novel microvolumetric infusion pump (MVIP): pump design, evaluation and comparison to the current standard
Authors: Weiss M. , Gerber S. , Füchslin R. M. , Neff T. A. 
Published: October 2004

SummaryInfusion devices for continuous and precise drug administration are indispensable tools in anaesthesia and critical care medicine. Problems such as start‐up delays, non‐continuous flow and susceptibility to hydrostatic pressure changes at low infusion rates resulting in accidental bolus release or prolonged flow interruption are inherent to current infusion technology. In order to improve precise drug delivery, an innovative technical concept has been realised in a novel microvolumetric infusion pump (MVIP) device. The MVIP principle includes repeated filling and emptying of a non‐compliant microsyringe without the use of valves. The performance of the MVIP prototype has been evaluated and compared with standard syringe infusion pump assemblies. The novel MVIP concept has thereby proven to eliminate most problems during infusion start‐up, steady state flow and vertical pump displacement, and has the potential of revolutionising infusion technology and setting a new dimension in patient safety.
Changes of serum chloride and metabolic acid‐base state in critical illness
Authors: Funk G.‐C. , Doberer D. , Heinze G. , Madl C. , Holzinger U. , Schneeweiss B. 
Published: October 2004

SummaryAlterations of electrolytes and albumin cause metabolic acid‐base disorders. It is unclear, however, to what degree these plasma components affect the overall metabolic acid‐base state in the course of critical illness. We performed serial analyses of the metabolic acid‐base state in 30 critically ill patients over the course of 1 week. We applied a physical–chemical acid‐base model and used a linear regression model to determine the influence of sodium, chloride, unmeasured anions and albumin on the net metabolic acid‐base state. Progressive hypochloraemia was identified as the main cause of developing metabolic alkalosis. Changes in serum chloride and unmeasured anions were responsible for changes of 41% and 22% in the metabolic acid‐base state, respectively. Sodium and albumin played a minor role. In conclusion, chloride is the major determinant of metabolic acid‐base state in critical illness.
Ultrasound for central venous cannulation: economic evaluation of cost‐effectiveness
Authors: Calvert N. , Hind D. , McWilliams R. , Davidson A. , Beverley C. A. , Thomas S. M. 
Published: October 2004

SummaryWe compared the economics of using two‐dimensional ultrasound locating devices and more traditional landmark methods for central venous cannulation in the National Health Service (NHS). The evaluation consisted of a systematic review of randomised controlled trials and an economic evaluation using decision analytic cost‐effectiveness modelling. Incremental costs per complication avoided associated with landmark and ultrasound central venous cannulation were modelled for patients scheduled for central venous cannulation. The marginal economic cost of using ultrasound for central venous cannulation was less than £10 per procedure, assuming that a machine is used for 15 procedures each week. The base case scenario implied that £2000 worth of resource savings result for every 1000 procedures undertaken and 90 avoided complications. Sensitivity analysis indicated that the results of modelling appear robust to the central assumptions used. Ultrasound guidance used in central venous cannulation procedures saves NHS resources even with conservative modelling assumptions.
Effectiveness of bupropion as an aid to stopping smoking before elective surgery: a randomised controlled trial
Authors: Myles P. S. , Leslie K. , Angliss M. , Mezzavia P. , Lee L. 
Published: October 2004

SummarySmoking is a risk factor for complications during and after surgery, but most smokers are unable to quit before elective surgery. We tested the efficacy of bupropion in improving smoking cessation rates in this setting by enrolling 47 patients from the elective surgery waiting list in a double‐blind randomised controlled trial. Patients receiving bupropion had a lower daily cigarette consumption at the time of hospital admission, median (IQR) cigarettes per day: 6 (2–7) vs. 15 (9–20), p = 0.046. They also had a reduction in end‐expired carbon monoxide (p = 0.004), a known contaminant of cigarette smoke, and increased arterial oxygen saturation on pulse oximetry (p = 0.011). They were more likely to have stopped smoking at the 3‐week visit (p = 0.036), but not at the 6‐week visit (p = 0.25) or at the time of hospital admission for surgery (p > 0.99). This study found that smokers waiting for elective surgery are more likely to reduce or stop smoking when treated with bupropion.
Postoperative 12‐lead ECG predicts peri‐operative myocardial ischaemia associated with myocardial cell damage
Authors: Böttiger B. W. , Motsch J. , Teschendorf P. , Rehmert G. C. , Gust R. , Zorn M. , Schweizer M. , Layug E. L. , Snyder‐Ramos S. A. , Mangano D. T. , Martin E. 
Published: October 2004

SummaryPeri‐operative myocardial ischaemia is the single most important risk factor for an adverse cardiac outcome after non‐cardiac surgery. The present study examines whether intermittent 12‐lead ECG recordings can be used as an early warning tool to identify patients suffering from peri‐operative myocardial ischaemia and subsequent myocardial cell damage. Fifty‐five vascular surgery patients at risk for or with a history of coronary artery disease were monitored for peri‐operative myocardial ischaemia using intermittent 12‐lead ECG recordings taken pre‐operatively and at 15 min, 20 h, 48 h, 72 h and 84 h postoperatively. The effectiveness of the 12‐lead ECG was gauged by examining concordance with continuous 3‐channel Holter monitoring and capturing peri‐operative myocardial ischaemia by serial analyses of creatine kinase myocardial band isoenzyme and cardiac troponin T and I. The incidence of peri‐operative myocardial ischaemia detected by 12‐lead ECG was 44% and was identifiable in most patients (88%) 15 min after surgery. The incidence of peri‐operative myocardial ischaemia detected by continuous monitoring was 53%, with the most severe episodes occurring intra‐operatively and during emergence from anaesthesia. The concordance of the 12‐lead method with continuous monitoring was 72%. The concordance of creatine kinase myocardial band isoenzyme activity with the 12‐lead method was 71% and with Holter monitoring 57%. The concordance of mass concentration of creatine kinase myocardial band with 12‐lead ECG recordings was 75%, and the corresponding value for Holter monitoring was 68%. The concordance of cardiac troponin T and I levels with the 12‐lead method was 85% and 87%, respectively, and concordance with Holter monitoring was 72% and 66%, respectively. The postoperative 12‐lead ECG identified peri‐operative myocardial ischaemia associated with subsequent myocardial cell damage in most patients undergoing vascular surgery.
Effect of head posture on tracheal tube position in children*
Authors: Olufolabi A. J. , Charlton G. A. , Spargo P. M. 
Published: October 2004

SummaryChanges in the tracheal tube tip to carina distance were measured by radiographic screening following various head postures in 45 children undergoing cardiac catheterisation under general anaesthesia who were intubated via nasal and oral routes. Extension of the head moved the tracheal tube away from the carina and flexion moved it towards the carina in both routes. Endobronchial intubation was noted during neck flexion in a significant proportion of children intubated orally but none occurred during nasal intubation. Extension produced greater upward movement of the tracheal tube tip in the oral route than the nasal route. In contrast, flexion produced greater downward movement in the nasal route in some patients. The direction of movement with lateral rotation and use of a shoulder roll was inconsistent.
Phagocytosis of apoptotic eosinophils but not neutrophils by bronchial epithelial cells
Authors: Sexton D. W. , Al‐Rabia M. , Blaylock M. G. , Walsh G. M. 
Published: October 2004

SummaryBackground
We have previously demonstrated that human bronchial epithelial cells engulf apoptotic eosinophils.Objectives
To compare and contrast the phagocytic capabilities of monocyte‐derived macrophage and primary airway epithelial cells for apoptotic granulocytes.Results
Here we compared phagocytosis of human apoptotic eosinophils and neutrophils by small and large airway epithelial cells (SAEC and LAEC) and monocyte‐derived macrophages. Confocal microscopy of F‐actin staining and scanning and transmission electron microscopy revealed phagocytic cup formation around apoptotic eosinophils by airway epithelial cells (AEC) membranes with evidence of their digestion. Resting and cytokine‐stimulated AEC did not recognize and ingest apoptotic neutrophils. The latter were phagocytosed by macrophages that exhibited greater ingestion of and higher capacity for, apoptotic eosinophils over apoptotic neutrophils. Cytochalasin D completely abolished uptake of apoptotic eosinophils by SAEC, LAEC or macrophage monolayers. Ligation of epithelial cell CD44 receptors for 24 h increased phagocytosis of apoptotic eosinophils by SAEC and LAEC with a potency comparable with that of IL‐1. Phagocytosis was a specific receptor‐mediated process involving integrin‐ (αvβ3, αvβ5, CD36), phosphatidylserine receptor‐ and lectin‐dependent mechanisms. No significant differences were observed in avarice for apoptotic eosinophils by SAEC or LAEC either resting, CD44 monoclonal antibodies‐ or cytokine‐ stimulated, or in their usage and expression of recognition receptors.Conclusion
These findings further suggest and define an important role for the bronchial epithelium in the selective removal of apoptotic eosinophils from the airways in asthma.
Desloratadine partially inhibits the augmented bacterial responses in the sinuses of allergic and infected mice
Authors: Kirtsreesakul V. , Blair C. , Yu X. , Thompson K. , Naclerio R. M. 
Published: October 2004

SummaryBackground
Allergic rhinitis (AR) is considered a major predisposing factor for the development of acute bacterial rhinosinusitis. How AR augments a bacterial infection is unknown.Objective
Our purpose in this study was to test whether an H1 receptor antagonist, desloratadine, could reduce the augmented effect of an ongoing allergic reaction on acute bacterial rhinosinusitis.Methods
Three groups of infected and ovalbumin (OVA)‐sensitized mice were studied: (1) infected and allergic mice treated with desloratadine, (2) infected and allergic mice treated with placebo, and (3) infected mice. A fourth group of uninfected, non‐sensitized mice served as a control for the cellular changes. BALB/c mice were sensitized by two intraperitoneal injections of OVA given 8 days apart. One day after the second injection, the mice were nasally exposed daily to 6% OVA (the groups treated with desloratadine or placebo) or phosphate‐buffered saline (PBS) (the infection‐only group) for 5 days. After the second OVA exposure, the mice were intranasally inoculated with Streptococcus pneumoniae. Desloratadine or placebo was given daily throughout the OVA exposure period. Nasal allergic symptoms were observed by counting of nasal rubbing and sneezing for 10 min after OVA or PBS nasal challenge. On day 5 post‐infection, nasal lavage culture was done, and the inflammatory cells in the sinuses were evaluated by flow cytometry.Results
Mice that were made allergic, infected, and treated with placebo showed more organisms and phagocytes than did only infect mice. They also manifested allergic nasal symptoms and eosinophil influx into the sinuses. Desloratadine treatment during allergen exposure reduced allergic symptoms and reduced sinonasal infection (P<0.05). There tended to be less myeloid cell and neutrophil influx (P=0.09 both), but not eosinophil influx (P=0.85) compared with that in the placebo‐treated group.Conclusion
Desloratadine treatment during nasal challenge inhibited allergic symptoms and reduced sinonasal infection, suggesting that histamine via an H1 receptor plays a role in the augmented infection in mice with an ongoing allergic reaction.
Allergen‐specific immunosuppression by ovalbumin fused with diphtheria toxin in mice sensitized with albumins of different origin
Authors: Lee B. K. , Yoo J. E. , Jang Y. S. , Kim J. Y. , Hong C. S. , Ro J. Y. 
Published: October 2004

SummaryBackground
We previously reported that ovalbumin–diphtheria toxin (OVA–DT) fusion protein eliminates mast cells bearing OVA‐specific IgE and protects OVA‐sensitized mice from fatal anaphylaxis induced by OVA challenge.Objective
To prove the specificity of therapeutic effect of OVA–DT to allergy induced by OVA only and not by other allergens such as human serum albumin (HSA), and to examine the cytotoxic effect of OVA–DT on B cells bearing OVA‐specific IgE.Methods
Mice were sensitized with two different antigens, OVA and HSA, and then treated with OVA–DT. The therapeutic effect of OVA–DT on the allergy response to each of allergen was evaluated by anaphylactic test. The effect of OVA–DT on the production of allergen‐specific Ig isotypes of the sensitized mice and the cytotoxic effect of OVA–DT on B cells expressing OVA‐specific IgE were examined.Results
OVA–DT suppressed only OVA‐induced allergy but not HSA‐induced allergy in mice sensitized with a mixture of OVA and HSA. The suppression was prolonged even to the mice boosted with the same allergen 14 days after last treatment of OVA–DT.In addition, when the sensitized mice were boosted with the same allergens 14 days after last treatment of OVA–DT, the mice showed to increase the production of OVA‐specific IgG2a/IgG3 and decreased that of OVA‐specific IgE. OVA–DT targeted B cells bearing OVA‐specific IgE, and killed them by DT‐mediated cytotoxicity.Conclusion
The therapeutic effect of OVA–DT was specific to OVA‐induced allergy and the suppression of OVA‐induced allergy was continuously shown in the mice boosted with the same allergens. This is considered to be caused by the increase of OVA‐specific IgG2a and IgG3, and because of the decrease of OVA‐specific IgE by killing of B cells bearing OVA‐specific IgE.
Anaphylaxis to excipient mannitol: evidence for an immunoglobulin E‐mediated mechanism
Authors: Hegde V. L. , Venkatesh Y. P. 
Published: October 2004

SummaryBackground
Anaphylaxis to mannitol present naturally in pomegranate and cultivated mushroom in a sensitized subject has been described recently, and an IgE‐mediated mechanism to this sugar alcohol has been proposed. The same subject also experienced severe allergic reactions to a chewable pharmaceutical (cisapride drug).Objective
The purpose of the study was to identify allergenic component in the pharmaceutical preparation, and also, to understand the mechanism of immediate hypersensitivity to mannitol.Methods
Methodology involved skin prick tests (SPTs), high‐performance liquid chromatographic (HPLC) analysis of pharmaceutical preparations, separation of mannitol by Ca++‐ion‐moderated cation‐exchange chromatography, preparation of alditol–protein conjugates by reductive amination, SPT using the conjugates, hapten affinity purification of the allergic serum on d‐mannitol–keyhole limpet haemocyanin (KLH)–Sepharose CL‐6B, and detection of serum mannitol‐specific IgE by ELISA.Results
Component testing by SPT, and HPLC analysis of various pharmaceuticals indicated that the excipient mannitol is the causative allergen. Mannitol separated from Cisapid MPS showed allergenic activity by SPT. Among the several conjugates tested by SPT, d‐mannitol–bovine serum albumin and d‐mannitol–KLH showed positive weal/flare reaction, demonstrating the presence of cell‐bound mannitol‐specific IgE in vivo. Negative results with d‐glucitol, d‐galactitol, meso‐erythritol, and l‐mannitol protein conjugates clearly showed that the mannitol‐specific human IgE is very specific to the d‐isomer of mannitol. ELISA using the hapten affinity‐purified allergic serum was positive, demonstrating the presence of mannitol‐specific serum IgE in the allergic subject.Conclusion
Mannitol, which is widely used as a food and drug additive (excipient), can rarely cause IgE‐mediated anaphylaxis. This study is the first one to demonstrate the presence of mannitol‐specific human IgE in a sensitized allergic subject to validate an IgE‐mediated hypersensitivity mechanism for mannitol.
Self‐reported prevalence and risk factors of asthma among Korean adolescents: 5‐year follow‐up study, 1995–2000
Authors: Hong S.‐J. , Lee M.‐S. , Sohn M. H. , Shim J. Y. , Han Y. S. , Park K. S. , Ahn Y. M. , Son B. K. , Lee H. B. ,   the Korean ISAAC Study Group
Published: October 2004

SummaryObjectives
The International Study of Asthma and Allergies in Childhood (ISAAC) questionnaires have shown that the prevalence of childhood asthma is increasing worldwide. Although Asian countries used to have lower prevalence rates of allergic disease than Western countries, this prevalence is increasing in several Asian countries. To determine whether the prevalence of childhood asthma is changing in Korean adolescents, we compared findings from nationwide cross‐sectional surveys in 1995 and 2000 on populations of middle‐school children using the Korean version of the ISAAC questionnaire.Methods
We developed Korean versions of the ISAAC written (WQ) and video (AVQ) questionnaires for allergic diseases. In 1995, the enrolled population consisted of 15 481 children, ages 12–15, and encompassing all three grades in middle school, selected from 34 schools across the nation; the response rate was 97.3%. In 2000, 15 894 children were selected from 31 of the same schools, and the response rate was 96.4%. The SAS system version 8.0 was utilized for all statistical analyses.Results
The WQ showed that the lifetime and 12‐month prevalence of wheeze did not change from 1995 to 2000. While the 12‐month prevalence rates of sleep disturbed by wheezing and night cough increased, the rates of severe attack of wheezing and exercise‐induced wheeze did not change, over this period of time. The lifetime prevalence of asthma diagnosis, however, increased significantly, from 2.7% in 1995 to 5.3% in 2000, as did the 12‐month prevalence of asthma treatment, from 1.0% in 1995 to 1.9% in 2000. The AVQ also showed increases in the lifetime and 12‐month prevalence rates of wheeze at rest, exercise‐induced wheeze, nocturnal wheeze, nocturnal cough, and severe wheeze over this period of time. These were especially because of significant increases in the Provincial cities of Korea. Interestingly, the 12‐month prevalence of wheeze was consistently high in Cheju with low air pollution indices, whereas this rate was low in Ulsan and Ansan with very high air pollution indices. Risk factor analysis showed that body mass index (BMI), passive smoking, and living with a dog or cat, but not air pollution, were associated with higher risk of wheeze.Conclusions
In the 5‐year period from 1995 to 2000, the prevalence of asthma symptoms has increased in Korean adolescents, much of it because of increases in Provincial Centers. BMI, passive smoking, and living with a dog or cat are important risk factors. Environmental factors other than air pollution may be associated with increases in asthma, especially in Provincial Centers.
Effects of nutrient enrichment on the decomposition of wood and associated microbial activity in streams
Authors: Gulis Vladislav , Rosemond Amy D. , Suberkropp Keller , Weyers Holly S. , Benstead Jonathan P. 
Published: October 2004

Summary1. We determined the effects of nutrient enrichment on wood decomposition rates and microbial activity during a 3‐year study in two headwater streams at Coweeta Hydrologic Laboratory, NC, U.S.A. After a 1‐year pretreatment period, one of the streams was continuously enriched with inorganic nutrients (nitrogen and phosphorus) for 2 years while the other stream served as a reference. We determined the effects of enrichment on both wood veneers and sticks, which have similar carbon quality but differ in physical characteristics (e.g. surface area to volume ratios, presence of bark) that potentially affect microbial colonisation and activity.2. Oak wood veneers (0.5 mm thick) were placed in streams monthly and allowed to decompose for approximately 90 days. Nutrient addition stimulated ash‐free dry mass loss and increased mean nitrogen content, fungal biomass and microbial respiration on veneers in the treatment stream compared with the reference. The magnitude of the response to enrichment was great, with mass loss 6.1 times, and per cent N, fungal biomass and microbial respiration approximately four times greater in the treatment versus reference stream.3. Decomposition rate and nitrogen content of maple sticks (ca. 1–2 cm diameter) also increased; however, the effect was less pronounced than for veneers. Wood response overall was greater than that determined for leaves in a comparable study, supporting the hypothesis that response to enrichment may be greater for lower quality organic matter (high C : N) than for higher quality (low C : N) substrates.4. Our results show that moderate nutrient enrichment can profoundly affect decomposition rate and microbial activity on wood in streams. Thus, the timing and availability of wood that provides retention, structure, attachment sites and food in stream ecosystems may be affected by nutrient concentrations raised by human activities.
Females from resting eggs and parthenogenetic eggs in the rotifer Brachionus calyciflorus: lipid droplets, starvation resistance and reproduction
Authors: Gilbert John J. 
Published: October 2004

Summary1. In the heterogonic life cycle of monogonont rotifers, amictic (female‐producing) females develop from two types of eggs: fertilised resting (diapausing) eggs and parthenogenetic subitaneous eggs. Females hatched from resting eggs initiate clonal populations by female parthenogenesis and are called stem females. This study compares females from resting and parthenogenetic eggs that were produced under identical culture conditions and were of similar birth order.2. Newborn stem females had many more lipid droplets in their tissues than similar‐sized, newborn females from parthenogenetic eggs. When neonates were stained with Nile Red and viewed under epifluorescent illumination, these droplets were shown to be sites of neutral‐lipid storage products.3. Stem females had no posterolateral spines and short anterior spines, while their mothers and offspring in subsequent, parthenogenetic generations typically had long posterolateral spines and elongated anterior spines.4. Newborn stem females survived starvation significantly longer than newborn females from parthenogenetic eggs.5. When females from resting and parthenogenetic eggs were cultured from birth to death at a high food concentration, the reproductive potential (r day−1) of the stem females was significantly higher (0.82–0.88 versus 0.70), primarily because of egg production at an earlier age. The mean lifetime fecundity (Ro) of stem females was significantly greater than that of females from parthenogenetic eggs.6. Extensive lipid reserves should increase the ability of stem females to colonise new habitats. Firstly, compared with females from parthenogenetic eggs, stem females are more likely to experience starvation or food limitation. Resting eggs hatch in response to physical and chemical factors that are not directly related to food availability, and from sediments that may be far from food‐rich surface waters. Secondly, when food is abundant, stem females have a greater reproductive potential.