bluuebunny/crossref_metadata_2025_split huggingface dataset:
Standard dose of inhaled albuterol significantly increases QT dispersion compared to low dose of albuterol plus ipratropium bromide therapy in moderate to severe acute asthma attacks in children
Authors: Coskun Senol , Yuksel Hasan , Tikiz Hakan , Danahaliloğlu Selahattin 
Published: March 2003

Abstract

Background
: Beta‐2 agonist therapy has previously shown to increase the QT dispersion (QTd) in asthmatic patients and increased QTd has been well documented in association with cardiac arrhythmias and sudden death. However, the data concerning the effect of low doses of beta‐2 agonist therapy in combination with the anticholinergic agents to potentiate bronchodilatation on QTd in asthmatic children are limited. The objectives of this study was to investigate the changes on QTd during both the standard dose of nebulized albuterol therapy and low dose nebulized albuterol plus inhaled ipratropium therapyn to assess the potential arrhytmogenic risk of these two treatment strategies in children with acute asthmatic attacks.
Methods
: Forty‐three children with the diagnosis of moderate to severe acute asthma were enrolled in the study. Standard dose of nebulized albuterol therapy (0.15 mg/kg) were administered to 20 patients (group 1) and low dose of nebulized albuterol (0.075 mg/kg) plus nebulized ipratropium bromide therapy (250 μg/dose) were given to the remaining 23 patients (group 2). Respiratory distress score, peak expiratory flow rate, arterial blood pressure, O2 saturation, serum potassium and urea nitrogen levels were studied and QT interval parameters were measured from the standard 12‐lead electrocardiograms at baseline and after treatment.
Results
: Significant improvement was achieved in respiratory distress score and peak expiratory flow rate after three dose inhalation. No significant difference was observed between the pre and post‐treatment values of serum potassium, blood urea nitrogen, O2 saturation and arterial blood pressure values. The evaluation of the corrected QTd (QTcd) showed that while there was no statistical difference in the pre and post‐treatment values in group 2 (30.4±3.1 msn vs 32.1±3.9 msn), QTcd was found to be significantly increased in group 1 after treatment (29.0±3 msn vs 40.6±5.1 msn, P<0.0001).
Conclusion
: The data of the present study suggest that the increase of the QTd is more prominent with the use of a standard dose of albuterol compared to low dose albuterol plus ipratropium therapy. Therefore, it may be concluded that a low dose of albuterol plus ipratropium bromide therapy may be preferred to avoid rhythm disturbances in asthmatic children.
Sotalol in treatment of pediatric cardiac arrhythmias
Authors: Çeliker Alpay , Ayabakan Canan , Özer Sema , Özme Sencan 
Published: March 2003

Abstract

Background
: There is limited experience on sotalol use in the management of childhood arrhythmias. This study reviews the results of our experience with oral sotalol for treatment and prevention of tachyarrhythmias in children.
Methods
: The records of 62 patients (27 female, 35 male, mean age: 8.5±5.3 years) treated with sotalol for supraventricular or ventricular arrhythmias from 1994 to 1999 at our institution were reviewed. Demographic, clinical, echocardiographic, electrocardiographic (ECG), ambulatory ECG and electrophysiologic variables were collected.
Results
: Forty‐two (63.6%) patients had re‐entrant supraventricular tachycardia, eight patients (12.9%) had atrial tachycardia, one patient (1.6%) had junctional ectopic tachycardia, four patients (6.5%) had ventricular tachycardia, and seven patients (11.3%) had complex ventricular arrhythmias, as evidenced by surface or ambulatory ECG records; or revealed during the electrophysiological study. The mean sotalol dose was 3.9±1.2 mg/kg per day. In 15.5±13.9 months of sotalol use 50% (n=31) had complete relief of symptoms and/or arrhythmia and 29% (n=18) had partial relief. Sotalol was ineffective in 20% (n=13). Sotalol was more effective in re‐entrant type supraventricular tachycardias (P=0.012). Sotalol was the first choice in 35.5% of patients. The sotalol therapy was initiated in inpatient settings in 40.3% (25 patients). Complications due to sotalol were seen in six patients (five patients developed bradycardia/pauses, and one patient had torsades de pointes) for which the sotalol dose was modified. In patients with sick sinus syndrome, a pacemaker was implanted and in another patient sotalol was stopped.
Conclusion
: Sotalol, being an effective and safe drug particularly in children, is a good therapeutic alternative for the preventive treatment of childhood tachyarrhythmias.
Comparative pharmacokinetics of oral 6‐mercaptopurine and intravenous 6‐mercaptopurine riboside in children
Authors: Mawatari Hideo , Unei Kazuhiko , Nishimura Shin‐Ichiro , Sakura Nobuo , Ueda Kazuhiro 
Published: March 2003

Abstract

Background
: The poor absorption of orally administered 6‐mercaptopurine (6MP) causes a wide variation in its cytotoxic efficacy. An i.v. dosage form would eliminate this problem. Our objective was to compare the pharmacokinetics of 6MP administered orally with those of an i.v. dosage form 6‐mercaptopurine riboside (6MPR), in children with acute lymphoblastic leukemia or malignant lymphoma.
Methods
: A total of 10 children were treated with oral 6MP, 50 mg/m2 per day, while five children were treated with 6MPR, 50 mg/m2 per day, administered by rapid i.v. injection. The plasma concentrations of 6MP and of 6MPR were measured on day 0, while the concentrations of 6‐thioguanine nucleotides (6TGN) in red blood cells (RBC) were measured on day 2. The area under the plasma concentration‐time curve (AUC1–5) was calculated from 1 to 5 h after drug administration.
Results
: With the intravenously administered 6MPR, the AUC1–5 ranged from 124 to 186 (1.5‐fold range, median 145) μM min; only two samples were obtained for the RBC concentration of 6TGN, and were 121 and 273 pmol per 25 mg hemoglobin. With the orally administered 6MP, the AUC1–5 ranged from 23 to 65 μM min (2.8‐fold range, median 56); the RBC concentration of 6TGN ranged from 18 to 152 pmol per 25 mg hemoglobin (median 75).
Conclusion
: The i.v. administration of 6MPR showed less interindividual variation in the AUC1–5 coupled with a higher RBC level of 6TGN as compared with those by oral 6MP. We conclude that the i.v. administration of 6MPR achieves stable blood levels of active drug in children undergoing cancer chemotherapy.
Prophylactic effect of inactivated influenza vaccine on young children
Authors: Maeda Taro , Shintani Yukihiro , Miyamoto Hajime , Kawagoe Hiroyuki , Nakano Kanako , Nishiyama Atsusi , Yamada Yoshiyasu 
Published: March 2003

Abstract
Background
: The effectiveness of inactivated influenza vaccine in healthy infants and young children has been controversial. The aim of this study was to determine the prophylactic effect of inactivated influenza vaccine in young children.
Methods
: Eighty‐six healthy infants and children younger than 7‐years‐old were immunized by a subcuta­neous injection of inactivated influenza vaccine before the 1999/2000 influenza season. Ninety‐four age‐matched children were randomly assigned as the control. These children were followed‐up from January to April, 2000. A diagnosis of influenza A virus infection was made rapidly by a positive result of the the enzyme immunoassay membrane test using enzyme‐conjugated monoclonal antibodies specific for a conserved epitope of influenza A nucleoprotein. The incidence of influenza A infection was compared and statistically assessed.
Results
: The prevalence of influenza A
virus infection, diagnosed by the influenza A rapid detection test,
was 5.8% in the vaccine group and 17.0% in the
control group, that is significantly lower in the vaccine receiving group
than the non‐receiving group (P = 0.016). However, four out of five infected children in the vaccine group were younger than 2‐years‐old.
Conclusion
: We conclude that inactivated influenza vaccine reduces the incidence of influenza A virus infection in 2–6‐year‐old children.
Attenuated nitrergic inhibitory neurotransmission to interstitial cells of Cajal in the lower esophageal sphincter with esophageal achalasia in children
Authors: Watanabe Yoshio , Ando Hisami , Seo Takahiko , Katsuno Shinsuke , Marui Yuji , Ono Yasuyuki , Torihashi Shigeko 
Published: March 2003

Abstract
Background
: Esophageal achalasia (EA) is a rare disease in children, the etiology and pathogenesis of which remain controversial. Previous studies have suggested that a specific class of interstitial cells of Cajal (ICC) act as mediators in nitrergic inhibitory neurotransmission in the lower esophageal sphincter (LES). The aim of this investigation is to clarify the status of ICC and nitrergic inhibitory neurons in the LES of EA using immunohistochemistry.
Methods
: Specimens were obtained from two patients with EA (aged 6 and 10 years) and two patients with esophageal carcinoma (aged 56 and 63 years) not involving the lower esophagus as controls. Immunohistochemistry was used to study the distribution of ICC and nitrergic inhibitory neuron.
Results
: The LES contains the c‐kit positive ICC in the muscle layers, which form close relationships with nitric oxide synthase (NOS)‐containing nerve fibers in the controls. The distribution of ICC was almost the same between samples with EA and controls. However, such nerve fibers were absent in EA with a longer duration of the symptoms, but were reduced in a shorter duration.
Conclusions
: Decreased nitrergic inhibitory neurotransmission to ICC in LES is a possible cause of sphincter achalasia in pediatric patients with EA. The decrease in NOS‐positive neurons of patients with achalasia may be gradual, which may account for the long duration of symptoms prior to treatments. Further advancement of esophageal motility damage was suspected in pediatric EA.
IgG and IgG subclasses deficiency in children undergoing continuous ambulatory peritoneal dialysis and its provocative factors
Authors: Akman Sema , Güven Ayfer Gür , Ince Selma , YeĞin Olcay 
Published: March 2003

Abstract
Background
: Low levels of serum IgG or IgG subclasses may be responsible for the defective peritoneal defense and for peritonitis attacks in continuous ambulatory peritoneal dialysis (CAPD) children. Malnutrition, peritoneal loss or frequent peritonitis may lead to IgG or IgG subclasses deficiency.
Methods
: Levels of IgG subclasses were determined

in 12 children undergoing CAPD treatment. Radial immunodiffusion

technique was used for determination. Patients were aged from 6

to 16 years (mean age 12.3 years) and had been

on CAPD for 11−26 months (mean duration 19.4 months).

We evaluated whether IgG and IgG subclasses deficiency are related

to malnutrition, the peritonitis rate and the duration of CAPD using

the spss program.
Results
: Serum total IgG levels were found to be low in eight out of 12 patients. Eight patients showed low levels of IgG1, four patients IgG2, one patient IgG3 and three patients IgG4. Total IgG values were found to be positively correlated to malnutrition status, peritonitis rate and duration of CAPD. The IgG2 values were found to be related to the duration of CAPD. The IgG4 values were found to be correlated to the peritonitis rates.
Conclusions
: The IgG and IgG subclasses deficiency may develop in children while on CAPD treatment. Periodical determinations of either serum IgG or the subclasses may be useful in the follow‐up of these patients.
Dyslipidemia in young Japanese children: its relation to familial hypercholesterolemiaand familial combined hyperlipidemia
Authors: Ohta Takao , Kiwaki Kohji , Endo Fumio , Umehashi Hozo , Matsuda Ichiro 
Published: March 2003

Abstract
Background
: Most cases of dyslipidemia found inadults are non‐familial. However, in children, especially youngchildren, dyslipidemias other than familial hypercholesterolemia(FH) have not yet been characterized.
Methods
: From April 1990 to March 1999, 56 181children were screened, and 1380 showed abnormal levels of apolipoproteinB (more than 2.5 standard deviations above the mean). Among these,1198 were re‐examined and further characterized by measuring lipidsand apolipoproteins, and by their familial histories.
Results
: Seventy‐seven percent of the children(928 of 1198) recalled were diagnosed as being dyslipidemic. Ninety‐onechildren were FH, 423 were type IIa, 128 were type IIb, 98 weretype IV, and 188 were hypoalphalipoproteinemia. The presumed incidenceof FH was 0.19%, IIa 0.87%, IIb 0.26%,IV 0.20%, and hypoalphalipoproteinemia 0.39%,taking into account the percentage of subjects who refused recall.At regular follow‐ups, in many children with type IIb, the phenotypicexpression changes from type IIb to IIa or IV. Thus, lipid and apolipoproteinlevels were determined in 77 family members in 34 families of childrenwith type IIb. Forty‐five family members were dyslipidemic (typeIIa 18, type IIb 11, type IV 16). As a result, 27 children(79%) with type IIb met the criteria for familial combinedhyperlipidemia.
Conclusion
: Children with dyslipidemia had morefamily or genetic background than adults. Unexpectedly, childrenwith type IIb were mostly familial combined hyperlipidemia. Thus,setting appropriate eating patterns during childhood might be importantfor normalizing risk factors for atherosclerotic coronary heartdisease, especially in children with FH or type IIb.
Non‐traumatic renal arteriopelvic fistula
Authors: Shinojima Hirokazu , Seki Toshimori , Kumagai Akira , Sakurai Yasuo , Shinno YUICHIRO 
Published: March 2003

Purpose: In the present paper, we report on a 34‐year‐old female with macroscopic hematuria due to a non‐traumatic renal arteriopelvic fistula (APF). The patient initially presented at another hospital with asymptomatic macroscopic hematuria. Following abdominal ultrasonography, computed tomography (CT) and laboratory data, no abnormal findings were seen. Therefore, the patient was referred to Teine Keijinkai Hospital for a more precise evaluation of the urinary tract and vascular abnormality. Methods/Results: Endoscopically, there was bleeding from the right ureteral orifice, so the patient was admitted for further examination. No abnormal findings were seen on urinary cytology and following an intravenous pyelogram. A selective right lower polar renal arteriogram revealed arterial extravasation directly into the pelvis before the venous phase, so APF of the kidney was diagnosed. The patient had no history of urinary tract trauma, so the APF was thought to be idiopathic. After transcatheter arterial embolization (TAE) with a gelatine sponge, macroscopic and microscopic hematuria disappeared and a low‐density area was seen in the middle pole of the right kidney in an abdominal CT scan 4 days after TAE. This was thought to be renal infarction due to TAE. Conclusions: After discharge, the patient had no further hematuria.
Seminoma associated with bilateral cryptorchidism in Down’s syndrome: A case report
Authors: Miki Masaya , Ohtake Nobuaki , Hasumi Masaru , Ohi Masaru , Moriyama Shin’ichi 
Published: March 2003

Backgound: A case of testicular typical seminoma associated with bilateral undescended testes in Down’s syndrome is reported. A 42‐year‐old institutionalized male patient developed left testicular seminoma with retroperitoneal metastasis. Methods/Results: Neither adjuvant chemotherapy nor radiotherapy were performed due to his severe mental retardation. He died as a result of the cancer 2 years after a left radical orchiectomy and an autopsy was carried out. Discussion: Recently an increase in the incidence of the association of testicular tumors and Down’s syndrome has been repeatedly documented. Thirty‐six cases of testicular tumors associated with Down’s syndrome have been reported and of these 17.1% had cryptorchidism. This is a much lower percentage considering the high risk of cryptorchidism in males with Down’s syndrome. The relationship between testicular germ cell tumors associated with cryptorchidism and Down’s syndrome is discussed.
Orthotopic ileal neobladder in male patients: Functional outcomes of 66 cases
Authors: Arai Yoichi , Taki Yoji , Kawase Norio , Terachi Toshiro , Kakehi Yoshiyuki , Okada Takuya , Okabe Tatsushiro , Kanba Tomomi , Konami Teruo , Kin Sojun , Oishi Kenji , Miyakawa Mieko , Takeuchi Hideo , Ueda Tomohiro , Hamaguchi Akikazu , Okada Yusaku 
Published: March 2003

Abstract
Background
: Orthotopic urinary diversion has become the preferred form of bladder reconstruction after cystectomy. We report on our experience with 66 male patients undergoing this procedure from November 1990 to February 1998.
Methods
: A neobladder was constructed using an ileal segment with a Hautmann type bladder. Complications were assessed and subdivided into early and late types. Voiding function was evaluated in terms of voiding pattern and continence. Median follow up was 19.5 (range 3.5–87.7) months.
Results
: There was one (1.5%) perioperative death. The most frequent pouch‐related and unrelated early complications were persistent urine leak (7.6%) and prolonged ileus (16.7%), respectively, the majority of cases of which were managed conservatively. Analysis of late complications revealed 6.2% ureteroileal stenosis and 1.5% urethrointestinal stenosis rates, but no case of bladder stone formation. Of the 61 patients in whom voiding function was evaluable, 95.1% achieved excellent daytime continence, while only 67.2% had night‐time continence. With regard to posture at voiding, 23 (37.7%) voided in a sitting position. Three of the patients (4.9%) were unable to void and required regular intermittent catheterization.
Conclusions
: An orthotopic neobladder can be constructed with acceptable morbidity and excellent functional results. We believe that orthotopic urinary diversion offers an attractive alternative to a bladder substitute when cystectomy is required.
A case of female large urethral diverticulum treated by electrofulguration
Authors: Fujikawa Keita , Matsui Yoshiyuki , Fukuzawa Shigeki , Soeda Asaki , Takeuchi Hideo 
Published: March 2003

AbstractFemale urethral diverticulum is not an uncommon disease. We report a case of female urethral diverticulum which caused severe urethral pain, but for which the diagnosis had not been obtained at many hospitals for many years. Transurethral electrocauterization of the diverticulum was very effective in this case.
Multidisciplinary treatment, including laser hyperthermia, for extensive regional metastasis of a penile tumor
Authors: Shirahama Tsutomu , Enokida Hideki , Yanase Ichirou , Nobori Takuo , Ohyama Masaru , Ohi Yoshitada 
Published: March 2003

Background: There is no reliable treatment for penile tumor with lymph node metastasis.Methods: We report on a patient with a penile tumor with extensive regional metastasis that was successfully managed with combined laser hyperthermia, radiation and chemotherapy.Results: The patient has survived more than 7 years without evidence of disease.Conclusions: Multidisciplinary treatment, including laser hyperthermia, may be useful for the treatment of regional metastasis of penile tumor.
Serous‐lined extramural tunnel technique for uretero‐ileal implantation in urinary diversion
Authors: KATO HARUAKI , IIZUKA KEIJI , IGAWA YASUHIKO , NISHIZAWA OSAMU 
Published: March 2003

Purpose: We present our initial experience of a serous‐lined extramural tunnel technique for anti‐refluxing uretero‐ileal anastomosis in five cases of orthotopic ileal bladder and four cases of continent ileal pouch.Methods/Results: Ureters were implanted into serous‐lined tunnels formed from a detubularized W‐configurated ileal segment. Neither upper tract dilatation nor reflux were observed in any patient postoperatively.Conclusion: The technique can provide an effective uretero‐ileal anastomosis for reflux prevention with minimal use of the ileal segment and without the use of any artificial materials.
Possible misinterpretation on computed tomography of left inferior vena cava as retroperitoneal lymph node metastasis: A report of two cases
Authors: Arisawa Chizuru , Kihara Kazunori , Fujii Yasuhisa , Ishizaka Kazuhiro , Masuda Hitoshi , Oshima Hiroyuki 
Published: March 2003

Purpose: We report on two cases of retroperitoneal lymph node metastasis of testicular cancer with left inferior vena cava.Methods/Results: A 25‐year‐old man with a left testicular cancer with pulmonary and retroperitoneal lymph node metastases received three courses of VIP (etoposide, ifosfamide and cisplatinum) chemotherapy. Subsequent abdominal computed tomography (CT) revealed round lesions enhanced with contrast agent on both sides of the aorta inside the degenerated lymphadenopathy. These lesions were regarded as a duplicated inferior vena cava (IVC) and this was confirmed at retroperitoneal lymph node dissection. The second case is of a 21‐year‐old man with a left testicular cancer with pulmonary, liver and widespread lymph node metastases. Subsequent to a course of VIP chemotherapy, super high‐dose chemotherapy was administered. Abdominal CT revealed a round mass enhanced with contrast agent on the left side of the aorta adjacent to the degenerated lymphadenopathy, which was regarded as the transposed left IVC and this was confirmed at lymph node dissection.Conclusions: In both cases, initial CT failed to detect the lesions as the left IVC and there was a possibility for the misinterpretation of such venous anomalies with residual lymphadenopathy.
Retroperitoneal hemorrhage due to spontaneous rupture of adrenal myelolipoma
Authors: Amano Toshiyasu , Takemae Katsuro , Niikura Susumu , Kouno Masanori , Amano Masako 
Published: March 2003

Background

: A very rare case of retroperitoneal bleeding due to spontaneous rupture of a large adrenal myelolipoma in a 62‐year‐old woman is reported.
Methods/Results

: She consulted the emergency room of the Nagano Red Cross Hospital with a complaint of sudden left flank pain. A computerized tomography (CT) scan revealed a tumor with areas of fat density and hematoma in the left retroperitoneal space. After her general condition improved, an operation was performed. The tumor strongly adhered to the left kidney and a left nephrectomy with the tumor was curative. Histologic diagnosis was adrenal myelolipoma. No blood transfusion was required.
Conclusions
: A CT scan is very useful in the pre‐operative diagnosis of adrenal myelolipoma with retroperitoneal hemorrhage. Watch and wait treatments before operation and nephrectomy with adhered tumor are safe and curative.