bluuebunny/crossref_metadata_2025_split huggingface dataset:
Formulating Knowledge Management Infrastructure Based on Strategic Management and Total Quality Management
Authors: Lin Cheng Ming , Wei Chiu-Chi 
Published: March 2004

Due to the rapid change in technology environments, creating value through Knowledge Management (KM) has become a new research area. The organization must continuously learn, share, expand and apply knowledge in order to maintain business advantage in this highly competitive age. This study first investigates the evolution and practical application of the Strategic Management (SM) and Total Quality Management (TQM), and then constructs an adequate framework for establishing the KM system. The objective of this study is to address the importance of SM and TQM on KM from the methodological viewpoint. A few points are discussed to explore the key factors for establishing the most effective management structure to optimize the KM value.
Antioxidant properties ofN‐acetylcysteine: their relevance in relation to chronic obstructive pulmonary disease
Authors: Dekhuijzen P.N.R. 
Published: March 2004

Oxidative stress has been implicated in the pathogenesis and progression of chronic obstructive pulmonary disease.Both reactive oxidant species from inhaled cigarette smoke and those endogenously formed by inflammatory cells constitute an increased intrapulmonary oxidant burden. Structural changes to essential components of the lung are caused by oxidative stress, contributing to irreversible damage of both parenchyma and airway walls. In addition, oxidative stress results in alterations in the local immune response, increasing the risk of infections and exacerbations, which, in turn, may accelerate lung function decline.The antioxidantN‐acetylcysteine, a glutathione precursor, has been applied in these patients in order to reduce symptoms, exacerbations and the accelerated lung function decline. This article reviews the presently available experimental and clinical data on the antioxidative effects ofN‐acetylcysteine in chronic obstructive pulmonary disease.
Glutathione and glutamate levels in the diaphragm of patients with chronic obstructive pulmonary disease
Authors: Engelen M.P.K.J. , Orozco-Levi M. , Deutz N.E.P. , Barreiro E. , Hernández N. , Wouters E.F.M. , Gea J. , Schols A.M.W.J. 
Published: March 2004

Recently, decreased glutamate (Glu) and reduced glutathione (GSH) levels were reported in the quadriceps femoris of patients with chronic obstructive pulmonary disease (COPD). The aim of the present study was to investigate whether Glu and GSH levels are also modified in the diaphragm of these patients.Nine male COPD patients (forced expiratory volume in one second (FEV1) range 28–68% of the predicted value) and seven male patients with normal pulmonary function (mean±sd FEV186±3% pred) submitted to thoracotomy were included. Biopsy specimens were taken from the diaphragm (both groups) and the quadriceps femoris (COPD group alone) in order to assess fibre size, myosin heavy chain expression, GSH levels and amino acid profile.The COPD group was characterised by preserved fibre size, a higher proportion of type I fibres (mean±sem 70±3versus26±4%), and higher Glu and GSH content in the diaphragm compared to the quadriceps muscle. However, Glu and GSH levels were similar in diaphragm from the COPD and control groups. Glu level correlated with GSH level in both muscles. No significant correlation was found between Glu or GSH level and fibre size or proportions.This study shows that glutamate and reduced glutathione levels are preserved in the diaphragm of chronic obstructive pulmonary disease patients. Alterations in glutamate and reduced glutathione metabolism are muscle-specific in chronic obstructive pulmonary disease, affecting the quadriceps femoris but not the diaphragm. Glutamate and reduced glutathione levels are strongly interrelated in both muscles, independent of fibre type distribution and fibre size.
Remission of respiratory symptoms by smoking and occupational exposure in a cohort study
Authors: Eagan T.M.L. , Gulsvik A. , Eide G.E. , Bakke P.S. 
Published: March 2004

Few studies have estimated the remission rates of respiratory symptoms in general populations. No community cohort studies have examined the impact of smoking cessation and previous dust or fumes exposure on the remission of respiratory symptoms.In the Hordaland County Study, an 11‐yr community cohort (1985–1996/1997) from Western Norway, data from 2,819 subjects were used to examine the remission of six respiratory symptoms.The measured cumulative remission varied from 42.3% for morning cough to 58.4% for chronic cough. Smoking cessation was a significant predictor of remission of the cough symptoms and wheezing, with odds ratios (OR) (95% confidence intervals (CI)) varying from 2.2 (1.3–3.7) for wheezing to 6.2 (3.5–11.2) for morning cough, after adjustment for sex, age, pack-years smoked, previous dust or fumes exposure, and educational level. In those not previously exposed to dust or fumes, the adjusted OR (95% CI) for the remission of morning cough, phlegm cough, dyspnoea grade 2, attacks of dyspnoea and wheezing varied from 1.5 (0.9–2.5) for attacks of dyspnoea to 2.1 (1.1–3.9) for dyspnoea grade 2, as compared to those previously exposed to dust or fumes.This study suggests a beneficial effect of smoking cessation and an adverse effect of occupational exposure on the remission of respiratory symptoms.
Duration of effect of single-dose inhaled fluticasone propionate on AMP‐induced bronchoconstriction
Authors: Luijk B. , Kempsford R.D. , Wright A.M. , Zanen P. , Lammers J-W.J. 
Published: March 2004

Airway hyperresponsiveness induced by adenosine‐5'‐monophosphate (AMP) is regarded as a reliable model for allergic asthma and for the evaluation of anti-asthmatic drugs. Single-dose inhaled corticosteroids (ICS) are known to be protective in this model, but the duration of action of these drugs in this model has never been studied.The duration of ICS protection was determined by administration of single-dose fluticasone propionate (FP; 1,000 µg) up to 26 h before AMP challenge. A randomised, double-blind, placebo-controlled, four-way crossover study was performed in 13 mild asthmatics (mean±sd predicted forced expiratory volume in one second (FEV1) 98±7%). Each subject received placebo and FP (at 26, 14 or 2 h prior to the AMP challenge). Furthermore, the marker exhaled nitric oxide (eNO) was studied after administration at these time points to investigate whether eNO also demonstrates the duration of action of ICS.The doubling concentrations difference (DCD) of AMP causing a 20% fall in FEV1, when FP was administered 26, 14 or 2 h prior to challenge, was significantly increased as compared with placebo: DCD (95% confidence interval) at 26 h, 0.73 (0.20–1.26), p=0.008; 14 h, 1.50 (0.99–2.01), p<0.001; and 2 h, 2.89 (2.37–3.40), p<0.001. However, eNO was not significantly affected at these time points.In conclusion, a single dose of 1,000 µg inhaled fluticasone propionate protects against adenosine‐5'‐monophosphate airway hyperresponsiveness up to 26 h after dosing. This study suggests that adenosine‐5'‐monophosphate challenge can be used as a sensitive marker to study the duration of action of inhaled corticosteroids.
Nasalversusfull face mask for noninvasive ventilation in chronic respiratory failure
Authors: Willson G.N. , Piper A.J. , Norman M. , Chaseling W.G. , Milross M.A. , Collins E.R. , Grunstein R.R. 
Published: March 2004

This study was undertaken to determine the efficacy of nasal mask (NM)versusfull face mask (FFM) for the delivery of noninvasive ventilation (NIV) in subjects with nocturnal hypoventilation.A total of 16 patients (11 males) were enrolled, all with nocturnal hypoventilation currently treated at home with NIVviapressure preset devices. Subjects underwent full polysomnography on three occasions; on the first night current therapy on NM was reviewed, followed by two experimental studies in randomised order using either NM or FFM. NIV settings and oxygen flow rate were the same under both conditions. Notably, 14 of the 16 subjects required the use of a chinstrap to minimise oral leak.Apnoea-hypopnoea indices were within normal limits under both conditions (1.7±3.4 NMversus1.6±2.4 h FFM). The type of interface did not significantly affect gas exchange during sleep (minimum average arterial oxyhaemoglobin saturation total sleep time 93.4±2.1 NMversus92.8±2.5% FFM, Delta transcutaneous carbon dioxide nonrapid eye movement sleep to rapid eye movement sleep (0.58±0.36 NMversus0.50±0.40 kPa FFM). Sleep efficiency was significantly reduced on the FFM (78±9 NMversus70±14% FFM), although arousal indices were comparable under both conditions (15.6±9.8 NMversus15.8±8.8 h FFM).Full face masks appear to be as effective as nasal masks in the delivery of noninvasive ventilation to patients with nocturnal hypoventilation. However, a chinstrap was required to reduce oral leak in the majority of subjects using the nasal mask.
G‐CSF enables completion of tuberculosis therapy associated with iatrogenic neutropenia: Fig. 1.—
Authors: Cormican L.J. , Schey S. , Milburn H.J. 
Published: March 2004

Neutropenia is a rare complication of anti-tuberculous therapy and is usually due to a single agent, most frequently isoniazid. The current case describes a previously healthy immunocompetent patient with tuberculosis of the lymph nodes who developed neutropenia due to a number of first line antibiotics (rifampicin, isoniazid and ethambutol) and streptomycin when introduced in combination and individually thus resulting in repeated treatment disruption.The introduction of twice-weekly subcutaneous granulocyte-colony stimulating factor to correct iatrogenic neutropenia facilitated the continuation and eventual completion of therapy without adverse effect.This is the first description of the use of granulocyte-colony stimulating factor to correct iatrogenic neutropenia due to anti-tuberculous antibiotics and the second description of the occurrence of iatrogenic neutropenia to more than anti-tuberculous antibiotic in an individual.
Additive blockade of β2‐integrin adhesion of eosinophils by salmeterol and fluticasone propionate
Authors: Myo S. , Zhu X. , Myou S. , Meliton A.Y. , Liu J. , Boetticher E. , Lambertino A.T. , Xu C. , Muñoz N.M. , Leff A.R. 
Published: March 2004

Migration of human eosinophils is regulated by integrin expression, conformational change, and activation of cytosolic phospholipase A2(cPLA2). Corticosteroids have been shown to inhibit cPLA2hydrolysis in human eosinophils. The objective of this study was to determine the mechanisms of fluticasone propionate (FP) alone or in combination with salmeterol (SM) in blocking adhesion mediated by β2‐integrin in human eosinophils.Human eosinophils were isolated by negative magnetic selection. β2‐integrin-mediated eosinophil adhesion was measured by residual eosinophil peroxidase activity. Eosinophils were pretreated for 12 h to 24 h with FP and with or without SM for 30 min.Both SM alone and FP alone inhibited eosinophil adhesion in concentration- and time-dependent manner. SM alone modestly (∼30%) inhibited interleukin (IL)‐5‐induced eosinophil adhesion. Blockade of IL‐5‐induced eosinophil adhesion caused by 10−7 M FP at 24 h was augmented by 10−7 M SM from 41.5% to 72.5%. Similar blockade was also observed for eotaxin-induced eosinophil adhesion. Neither SM, FP, nor FP+SM blocked either: 1) upregulation of CD11b surface expression; or 2) phosphorylation of cPLA2.Blockade of β2‐integrin-mediated eosinophil adhesion by fluticasone propionate is augmented by salmeterol. Decreased adhesion results from augmented blockade of nuclear translocation of cytosolic phospholipase A2caused by addition of salmeterol to fluticasone.
Influence of treatment on leptin levels in patients with obstructive sleep apnoea
Authors: Sanner B.M. , Kollhosser P. , Buechner N. , Zidek W. , Tepel M. 
Published: March 2004

Obstructive sleep apnoea syndrome (OSAS) is a common disorder in obesity. Leptin, an adipocyte-derived signalling factor, plays an important role in metabolic control. There is growing evidence that leptin regulation is altered in OSAS. Therefore, the aim of this study was to test the hypothesis that effective treatment will influence leptin levels in OSAS patients.Serum leptin levels were determined in 86 consecutive patients (aged 57.5±11.0 yrs) with polysomnographically verified OSAS. In addition, leptin levels were reassessed and treatment efficacy was evaluated by polysomnography after 6 months of therapy.Patients were treated with continuous or bilevel positive airway pressure, a mandibular advancement device or conservatively, depending on the clinical symptoms. Mean serum leptin levels did not change with treatment in the whole study group (7.3±5.0versus7.5±4.8 ng·mL−1), however, leptin levels decreased in effectively treated patients (8.5±5.0versus7.4±5.1 ng·mL−1) while they increased in ineffectively treated patients (5.0±4.0versus7.7±4.1 ng·mL−1). Furthermore, not only was there a significant and independent correlation between the change in leptin levels with treatment and the change in body mass index, but also with the change in apnoea/hypopnoea index.Effective treatment of sleep-disordered breathing may have significant effects on leptin levels in obstructive sleep apnoea syndrome patients. Changes in leptin levels are related to changes in apnoea/hypopnoea index in obstructive sleep apnoea syndrome patients.
Food and fatty acid intake and atopic disease in adults
Authors: Trak-Fellermeier M.A. , Brasche S. , Winkler G. , Koletzko B. , Heinrich J. 
Published: March 2004

The aim of the study was to assess the relationship between dietary intake of selected foods and fatty acids with atopic disease prevalence in adults.Data from the European Community Respiratory Health Survey in Erfurt, combined with a 3‐day weighed records dietary survey, was used. Complete data was available from 469 males and 333 females aged 20–64 yrs. Multiple logistic regression was applied comparing the highest with the lowest quartile of dietary exposures and linear trends were tested stratified by sex.In males, margarine intake and a high ratio of omega‐6 to omega‐3 fatty acids were positively associated with hay fever. In females, a high intake of total fat, palmitoleic and oleic acids were positively associated with sensitisation. A high total fat, high monounsaturated fatty acid and high oleic acid consumption were positively associated with hay fever.Whilst an excessive intake of fat or imbalance in fat intake, particular of monounsaturated fatty acids, increased the risk for hay fever and allergic sensitisation in females, mostly no significant associations were found for males. Dietary factors were mostly not related with prevalence rates of bronchial hyperresponsiveness and atopic eczema either in males or in females.
A population-based study of the costs of care for community-acquired pneumonia
Authors: Bartolomé M. , Almirall J. , Morera J. , Pera G. , Ortún V. , Bassa J. , Bolíbar I. , Balanzó X. , Verdaguer A. ,   the Maresme Community-Acquired Pneumonia Study Group (GEMPAC)
Published: March 2004

In a population-based study, the consumption of resources for treating adult patients with community-acquired pneumonia was determined.During a 2‐yr period, all cases with a clinical and radiological suspicion of community-acquired pneumonia that occurred in patients aged >14 yrs in a community of 74,610 inhabitants were investigated prospectively.Of 292 cases with a suspicion of community-acquired pneumonia, 224 were included (18.5% misdiagnoses). The mean number of visits per patient was 4.5 (72% in the primary care setting). Inpatient care was recommended in 59.8% of cases; after discharge, 44% of patients were managed in outpatient clinics. The mean direct cost of pneumonia treated in the hospital setting was (euros)1,553, whereas the mean cost of cases treated as outpatients was 196. A total of 15.7% of admissions were considered inappropriate and the length of stay could have been reduced by 3.5 days in the most severe cases. A reduction in inappropriate admissions and lengths of hospital stay would result in a decrease in cost of 17.4%.Community-acquired pneumonia in Maresme, Spain, occurs at a low incidence, although with a high percentage of hospitalisations (in part inappropriate), resulting in considerable costs.
Respiratory changes during defecation in patients with chronic respiratory failure
Authors: Delmastro M. , Santoro C. , Nava S. 
Published: March 2004

Oxygen (O2) desaturation may occur in patients affected by respiratory diseases during daily activities, although most of these activities,e.g.walking, washing and cooking, can be avoided or eventually performed with an external aid.In this prospective study, the respiratory changes induced by the mandatory effort of defecation were assessed in patients with chronic respiratory insufficiency. Twenty-four consecutive patients with chronic respiratory failure due to obstructive or restrictive pulmonary disorders, showing a marked O2desaturation during the 6-min walk test, were enrolled. Thirteen of them were already established on long-term O2therapy (LTOT), while 11 were not. O2saturation (Sa,O2), respiratory rate (RR), cardiac frequency (fc) and dyspnoea were measured at rest, and during and after defecation.Sa,O2decreased significantly during defecation, while RR,fc and dyspnoea increased, both in the subgroup of patients without significant resting hypoxaemia and in the subgroup of patients receiving their usual resting flow of LTOT, as compared to resting values.In conclusion, the respiratory system of patients with chronic respiratory failure may be significantly strained by defecation.
Amino acids and asthma: a case-control study
Authors: Fogarty A. , Broadfield E. , Lewis S. , Lawson N. , Britton J. 
Published: March 2004

Amino acids contribute to various anti-oxidant and immunological activities relevant to asthma pathogenesis, raising the possibility that differences in amino acids may be involved in asthma aetiology. The authors hypothesised that cystine reduces the risk of asthmaviaglutathione metabolism. Methionine, glutamine, glutamic acid and glycine may have potential protective effects, whilst arginine, phenylalanine and tryptophan may have adverse effects in asthma.Fasting plasma levels of amino acids were compared in a case-control study. A total of 89 adults, aged 18–65 yrs, with asthma controlled by inhaled corticosteroids, were recruited from a volunteer database and local primary care registers, and compared with 89 controls individually matched for age, sex and primary care centre.Contrary to the primary hypothesis, cases had higher fasting plasma cystine levels than controls, and there was no difference between cases and controls in any of the other amino acids tested, with the exception of plasma glycine, which was associated with a strongly reduced risk of asthma (odds ratio for the highest tertile compared to lowest 0.30 (95% confidence interval (0.11–0.82)).This study negates the hypothesis that higher fasting plasma cystine levels have a protective effect on the risk of asthma, although the inverse correlation with plasma glycine deserves further investigation.
Phagocytes transmitChlamydia pneumoniaefrom the lungs to the vasculature
Authors: Gieffers J. , van Zandbergen G. , Rupp J. , Sayk F. , Krüger S. , Ehlers S. , Solbach W. , Maass M. 
Published: March 2004

Chlamydia pneumoniae, a major cause of community-acquired pneumonia, primarily infects the respiratory tract. Chronic infection of nonrespiratory sites, such as the vascular wall, the brain or blood monocytes, requires evasion from the lungs and spreadingviathe bloodstream. The cell types involved in dissemination are insufficiently characterised.In this study, New Zealand White rabbits were infected intratracheally withC. pneumoniae, and lung manifestation and systemic dissemination were monitored by polymerase chain reaction and immunohistochemistry. Infection of the lungs was characterised by an early phase dominated by granulocytes and a late phase dominated by alveolar macrophages (AM).Granulocytes, AM and alveolar epithelial cells acted as host cells for chlamydiae, which remained detectable for up to 8 weeks. AM transported the pathogen to the peribronchiolar lymphatic tissue, and subsequentlyC. pneumoniaeentered the spleen and the aortaviadissemination by peripheral blood monocytes.In conclusion,Chlamydia pneumoniae-infected alveolar macrophages transmigrate through the mucosal barrier, and give the pathogen access to the lymphatic system and the systemic circulation. Infected peripheral blood monocytes are the vector system within the bloodstream and transmit the infection to the vascular wall. This is the first description of granulocytes acting as a reservoir forChlamydia pneumoniaeearly in infection.
Lysosomal cysteine proteases in the lung: role in protein processing and immunoregulation
Authors: Bühling F. , Waldburg N. , Reisenauer A. , Heimburg A. , Golpon H. , Welte T. 
Published: March 2004

Lysosomal cysteine proteases are a family comprising >10 enzymes. For many years it was believed that these enzymes catalyse protein breakdown unselectively, are highly redundant in their substrate specificity and are also expressed ubiquitously.This view has changed dramatically since a number of new lysosomal cysteine proteases with restricted expression and outstanding enzymatic activity have been described. In addition, knockout mice and selective protease inhibitors have been used to characterise specific functions of single proteases.In this review, some of these functions are discussed in relation to the lungs, especially the role of lysosomal cysteine proteases in matrix remodelling, immunoregulation and surfactant protein processing.
Pulmonary gas exchange and educational level: a community study
Authors: Welle I. , Eide G.E. , Gulsvik A. , Bakke P.S. 
Published: March 2004

Socio-economic status (SES) is related to increased risk of airway disease in terms of forced expiratory volume in one second (FEV1) and forced vital capacity. No data are available as to what extent SES predicts alveolar function in a general population.In this cross-sectional study, 1,275 subjects aged 18–73 yrs underwent pulmonary testing, including the single-breath carbon monoxide transfer capacity of the lungs (TL,CO). Educational level was used as an index for SES.Mean±sdTL,CO% predicted was 97% among those with primary school education, 99% among those with secondary school education and 104% among those with a university degree. In a multiple linear regression analysis, adjusting for age, height, haemoglobin, carboxyhaemoglobin, smoking habits, occupational exposure, FEV1and body mass index,TL,COwas significantly related to educational level in males but not in females. Occupational exposure was not significant.In this study, socio-economic status was found to be an independent determinant ofTL,CO. Even in an affluent country such as Norway, socio-environmental risk factors may differ based on individuals' SES. Such risk factors may, for instance, be higher exposure to airborne pollutants, poorer housing conditions, or lower consumption of fruit and vegetables. Further exploration is called for.
Fabrication of Single Crystalline Neodymium Oxide Nanowires under Mild Conditions
Authors: Murata Yusuke , Adachi Motonari 
Published: March 2004

Abstract
Nanowires of single crystalline neodymium oxide have been successfully synthesized under mild conditions using surfactant-assisted assemblies composed of laurylamine hydrochloride and neodymium alkoxide modified with acetylacetone. The nanowire structure was characterized by XRD, TEM, SEM, and nitrogen adsorption isotherms. Nd2O3 nanowires have a single crystalline structure with diameters ranging from 10 to 50 nm and lengths of several hundred nanometers. This newly developed synthetic method can be easily extended to other rare earth metal oxides.