bluuebunny/crossref_metadata_2025_split huggingface dataset:
Celiac disease in Turkish children: Presentation of 104 cases
Authors: Demir Hülya , Yüce Aysel , Koçak Nurten , Özen Hasan , Gürakan Figen 
Published: March 2003

Abstract Background: Celiac disease is characterized by life‐long gluten intolerance. Clinical features of patients with celiac disease are variable. In the present study, clinical, laboratory and histologic features of 104 patients with celiac disease were evaluated.
Methods
: Intestinal biopsy and serum antigliadin and anti‐endomysium antibodies were used for the diagnosis of patients. Mucosal lesions were classified according to the criteria of Marsh. Antigliadin antibodies were measured with a commercial enzyme‐linked immunosorbent assay. Anti‐endomysium antibodies were analyzed by indirect immunoflourescence with the use of a section of monkey esophagus. Routine hematological and biochemical analyses and measurement of immunoglobulin levels were undertaken.
Results
: The mean (± SD) patient age was 5.9~4.1 years (range 10 months–16 years) and the most common symptom was diarrhea (81.7%) followed by abdominal distention, weight loss, anorexia and failure to thrive. Abdominal distention (60.6%), short stature (45.2%) and iron‐deficiency anemia were the most common findings. High serum alanine aminotransferase levels were found in 38.3% of patients and these levels became normal after adoption of a gluten‐free diet in all but two patients with cirrhosis. Immunoglobulin A, IgG antigliadin antibodies and IgA anti‐endomysium antibodies were found in 76, 94 and 90% of patients, respectively. Biopsy of the small intestine revealed that 95, two and seven patients had type 3, type 2, and type 1 lesions, respectively, according to the Marsh classification. There was no statistically significant difference between patients and control groups with regard to antinuclear antibody, antismooth muscle antibody, anti‐DNA and anticardiolipin antibodies (IgG and IgM).
Conclusions
: Although classical celiac disease was seen in most patients in the present study, clinical variability of the condition should be kept in mind. In particular, patients with uncommon findings, such as short stature, cryptogenic liver disease and iron‐deficiency anemia, should also be screened for celiac disease.
Killing of human Herpes virus 6‐infected cells by lymphocytes cultured with interleukin‐2 or ‐12
Authors: Kida Kazunori , Isozumi Rie , Ito Masahiro 
Published: March 2003

Abstract

Background
: Human Herpes virus 6 (HHV‐6) is a causative agent of exanthema subitum and replicates mainly in lymphocytes. The aim of present study was to investigate cytotoxicity against HHV‐6‐infected cells by cord blood mononuclear cells (CBMC) and adult peripheral blood mononuclear cells (PBMC).
Methods
: Human herpes virus 6‐infected and ‐uninfected lymphocytes were used as target cells. Killing of target cells by CBMC and PBMC was investigated by the chromium release cytotoxicity assay.
Results
: Freshly isolated CBMC and PBMC did not lyse HHV‐6‐infected and ‐uninfected cells. When CBMC and PBMC were cultured with interleukin (IL)‐2, HHV‐6‐infected cells were significantly lysed compared with uninfected cells. Deletion of CD16+ cells by treatment of effector cells with anti‐ Leu‐11b (CD16) antibody with complement reduced cytotoxicity against HHV‐6‐infected cells and T lymphocyte‐rich cells did not lyse HHV‐6‐infected cells. Treatment of effector cells with anti‐Fas ligand antibody and treatment of HHV‐6‐infected cells with anti‐Fas antibody reduced cytotoxicity against HHV‐6‐infected cells. DNA fragmentation was detected in the supernatant from HHV‐6‐infected cells cultured with IL‐2‐activated lymphocytes. Culture of CBMC and PBMC with IL‐12 also enhanced cytotoxicity against HHV‐6‐infected cells.
Conclusions
: These data suggest that lymphocytes cultured with IL‐2 or IL‐12 mediate killing against HHV‐6‐infected cells and killing of HHV‐6‐infected cells was through apoptosis. Fas–Fas ligand interaction is one pathway by which HHV‐6‐infected cells are killed. Killing of HHV‐6‐infected cells by NK cells activated by cytokines may play a role in the recovery from HHV‐6 infection in vitro.
Effect of high‐frequency oscillatory ventilation on the upper airways of kittens
Authors: Liu Dongmei , Miyasaka Katsuyuki , Nakagawa Satoshi , Hashizume Kohei 
Published: March 2003

Abstract

Background
: High‐frequency oscillatory ventilation (HFOV) has become the preferred method of ventilation for the fragile lungs of neonates and infants because its beneficial effects on lungs are well known; however, its benefits on upper airways are not yet known. We investigated the effects of HFOV and conventional mechanical ventilation (CMV) on the airways of kittens with normal lungs.
Methods
: Ten healthy cross‐bred kittens, 2–3‐months‐old, with a mean bodyweight of 0.98 kg, were randomly divided into two groups: HFOV and CMV. Kittens were intubated and ventilated for 24 h. A semiquantitative scoring system was used to grade histopathological tissue changes in the cricoid, mid‐trachea, carina and left bonchus. The injury scores of the two groups were ranked and compared using a two‐tailed Mann–Whitney rank test.
Results
: Histopathologic changes were similar and mild in both groups under light microscopic examination. There was no significant difference in airway injury between the two groups.
Conclusions
: We conclude that, in this animal model, HFOV results in minimal airway damage when properly managed and causes no greater tracheobronchial injury than CMV.
Serum levels of neutrophil activation cytokines in Kawasaki disease
Authors: Suzuki Hiroyuki , Noda Eisaku , Miyawaki Masakazu , Takeuchi Takashi , Uemura Shigeru , Koike Michio 
Published: March 2003

Abstract

Background
: The aim of the present study was to investigate whether neutrophils are early effector cells for vascular endothelial damage in the acute phase of Kawasaki disease (KD) by examining serial changes in neutrophil counts and serum levels of neutrophil activation cytokines, such as granulocyte colony stimulating factor (G‐CSF) and interleukin (IL)‐8.
Methods
: From October 1994 to June 1998, a total of 52 patients with KD were included in the study. Thirty‐three patients had some infectious diseases, while 20 healthy children served as control subjects. Serial changes in neutrophils were counted by the optimal Wright–Giemsa staining method and serum levels of IL‐8 and G‐CSF in patients with KD were measured by an enzyme‐linked immunosorbent assay system.
Results
: Serum G‐CSF levels both before and after intravenous immunoglobulin therapy (IVIG; P<0.05) and neutrophil counts after IVIG (P<0.005) were higher in KD patients with coronary arterial lesions (CAL) than those without CAL. However, serum IL‐8 levels before and after IVIG showed no significant differences in these two groups.
Conclusions
: These data suggest that neutrophils may be important as early effector cells for vascular endothelial damage and that G‐CSF may play a more important role than IL‐8 in KD.
Risk factors for severe respiratory syncytial virus‐associated lower respiratory tract infection in children
Authors: Kaneko Mitsunobu , Watanabe Jun , Ueno Etsushi , Hida Mariko , Sone Tomofumi 
Published: March 2003

Abstract

Background
: Respiratory syncytial virus (RSV) is the most important cause of viral lower respiratory tract infection that can be a life‐threatening disease in infants and children. This study was conducted to look for independent risk factors for severe respiratory syncytial virus‐associated lower respiratory tract infection (RSV‐LRI) that required oxygen supplementation or mechanical ventilation.
Methods
: Medical records of patients younger than 4 years hospitalized with RSV‐LRI at Shizuoka Red Cross Hospital from July 1, 1995 to June 30, 1999 were reviewed. The patients were compared using univariate and multivariate logistic regression analysis.
Results
: A total of 157 patients were hospitalized with RSV‐LRI at Shizuoka Red Cross Hospital from the study time period. Of these, 20 patients (12.7%) were diagnosed with severe RSV‐LRI. Subjects younger than 3 months of age had an odds ratio (OR) of 59.9 (95% confidence interval (CI) 14.7_244.0) for the dependent variable of severe RSV‐LRI (P<0.0001). Subjects with a history of congenital heart disease also had an OR of 99.2 (95% C1 8.5–1160.1) (P<0.0005).
Conclusions
: Infants younger than 3 months without any underlying diseases may be at high risk for severe RSV‐LRI. Respiratory syncytial virus prophylaxis is needed not only for high‐risk patients, but for healthy early infants.
Cardiovascular effects of a phosphodiesterase III inhibitor, amrinone, in infants: Non‐invasive echocardiographic evaluation
Authors: Teshima Hidetaka , Tobita Kimimasa , Yamamura Hideshi , Takeda Atsuhito , Motomura Hideki , Nakazawa Makoto 
Published: March 2003

Abstract
Objective
: The inotropic effect of amrinone is still controversial in management of congestive heart failure in pediatric patients, especially in infants. In order to determine the cardiovascular effect of amrinone in pediatric patients, we performed echocardiographic evaluation in 11 infants (mean age of 2 months) after intracardiac surgery.
Methods
: Amrinone was loaded with a dose of 1.0 mg/kg, followed by continuous infusion with 10 µg/kg per min. We performed echocardiographic measurements before and immediately after loading of amrinone, and evaluated its cardiovascular effect.
Results
: After loading of amrinone, the heart rate increased by 5% in average, but there was no change in blood
pressure. Left ventricular (LV) fractional shortening and mean velocity of circumferential fiber shortening corrected for heart rate increased
significantly (0.25 ± 0.09 to 0.28 ± 0.08 and 0.94 ± 0.35 to 1.10 ± 0.34, respectively).
Left ventricular end‐systolic wall stress decreased from 36.6 ± 18.5 to 29.1 ± 14.4 g/cm2, indicating
the reduction of LV afterload. Stress‐velocity index, a sensitive index of left ventricular contractility, was elevated significantly
(Z‐score: −1.45 ± 4.21 to 0.04 ± 4.11).
Conclusion
: Amrinone has not only vasodilative effects, but definite positive inotropic effects in infants with heart failure.
Human herpesvirus‐6 infection in neonates: Not protected by only humoral immunity
Authors: Sugimoto Tomoko , Tanaka‐Taya Keiko , Ono Jiro , Miyoshi Hiroko , Okada Shintaro , Yamanishi Koichi 
Published: March 2003

Abstract
Background
: Infants are usually protected from various viral infections, including human herpesvirus‐6 (HHV‐6) and human herpesvirus‐7 (HHV‐7) infections, during the early infantile period by antibodies transferred from their mothers. However, rare cases of exanthem subitum (ES) in neonates have been described in published reports.
Methods
: From the infantile patients of febrile illness, HHV‐6 and HHV‐7 DNA were examined by the polymerase chain reaction method. Antibodies to HHV‐6 and HHV‐7 were detected by indirect immuno­fluorescence assay and neutralization test. Viral isolation was attempted from the patient’s peripheral blood mononuclear cells (PBMC) during the acute phase of febrile illness.
Results
: Human herpesvirus‐6 was verified virologically in two neonates who were clinically diagnosed as ES within the first month of life. Although high copies of HHV‐6 DNA were detected in their PBMC during the acute phase, the isolation of HHV‐6 from their PBMC was not successful. Neutralizing antibodies to HHV‐6 were detected in sera of the acute phase, and those antibodies were considered to be transferred from their mothers. Antibody titers showed fourfold elevation in sera of the convalescent phase. The HHV‐6 infection occurred despite the presence of pre‐existing maternal antibody. Human herpesvirus‐7 and HHV‐7 DNA were not detected from their clinical samples.
Conclusions
: This observation suggests that HHV‐6 infection could not be protected by only humoral immunity.
Participation in change: Self‐reflection of staff in a psychiatric admission unit
Authors: Lepola Irja , Blom‐Lange Marja 
Published: March 2003

AbstractThis paper reports on a comprehensive nursing research and development project carried out in the psychiatric admission unit of The Mental Hospital, Keropudas, Finland. The purpose of the project was to plan, implement and evaluate the functioning of the ward in order to orient it more towards patient‐centered practices. This study was an action research project, the methodological foundations of which were based on the action theory and dialectics. This article reports on the staff’s written essays based on self‐reflection concerning the orientation of action towards change. The essays were analyzed using the method of continuous comparison. This analysis yielded a conceptual outline of how the orientation of action towards change manifested itself in the internal regulation of the ward staff. The main category of data to result from selective coding was participation in change. Participation was enthusiastic, hesitant or withdrawn.
Integrated quality improvement program in patient care
Authors: Navuluri Ramesh B. 
Published: March 2003

AbstractQuality improvement in nursing is paramount among the factors contributing to an institution’s survival and growth. The demand by patients, families, insurance payers, and health professionals for quality in patient care is ever increasing. A review of the literature revealed that existing programs that ensure and monitor quality of care are group‐specific based on diagnosis‐related groups, time‐specific as in care maps and critical pathways, focused on outcomes only, or are not comprehensive by ignoring ‘little things’. Hence, there is a need for a comprehensive, continuous, individual patient‐specific, multidisciplinary quality improvement program. To fulfill the need, an integrated quality improvement program (IQIP) is formulated, and a quality monitor format (QMF) is devised. The QMF is planned by the staff nurses for each patient, and includes patient care standards, patient care by other departments, and ‘little things’ like ice water and noise control which have a significance to patients and families. The QMF is maintained from admission to discharge of each patient, non‐conformances are analyzed, and problem solving to improve quality is made continually at unit and institution levels. Committed implementation of IQIP ensures delivery of quality care, enhances satisfaction of patients and families, satisfies government regulations, and provides meaning to the efforts of nurses, education, management, and research.
Experience of Postmenopausal Women of Hormone Replacement Therapy
Authors: Lee Hea‐Sook , Choi Kyung‐Sook 
Published: March 2003

Goal:  The purpose of this study was to examine and describe women's physical and psychological changes after a trial of hormone replacement therapy (HRT), so as to be able to provide accurate information about HRT to women who are preparing to undergo HRT.Methods:  The study sample consisted of 10 women who were taking hormones for treatment of postmenopausal symptoms. Data were collected from September 2000 to March 2001. Interviews were recorded and transferred to written documents. The analysis of the data used the methodology described by Giogi.Results:  The subjects reported that taking HRT was an excellent choice for enhancing their quality of life during menopause because they felt younger and healthier, although they expressed concern about unexpected side‐effects, after their HRT. They felt that such effects could be prevented through regular check‐ups. The participants recommended that all postmenopausal women take HRT because they believed the benefit of HRT was greater than its harmfulness. The subjects also suggested that postmenopausal women need to be educated about the physical and psychological symptoms that they feel during menopause and about how to manage the symptoms. It was concluded that accurate information about the relationship between HRT and the quality of life should be provided to postmenopausal women, in addition to providing educational programs on postmenopausal management to postmenopausal women.
Vesicoureteral reflux in a boy presenting with difficulty in walking
Authors: Matsumoto Seiji , Hara Yasushi , Esa Atsunobu , Matsuura Takeshi , Kurita Takashi 
Published: March 2003

Background: We report an uncommon case who presented himself at our hospital with main complaints of high fever and difficulty in walking due to pain on extension of his right lower extremity. Methods: He was diagnosed, through investigation of his urinary tract, as having secondary psoas pyomyositis spread from acute pyelonephritis caused by vesicoureteral reflux. Results: He was successfully managed firstly by antibiotic therapy, followed by the correction of reflux by ureteroneovesicostomy.
Recurrent bladder adenocarcinoma in an ileal conduit stoma: A case report
Authors: Inobe Takuji , Kanda Kazuya , Murakami Yoshihide , Tsuji Masahito , Tamura Masato , Kagawa Susumu 
Published: March 2003

Abstract
Background
: The first case of a patient with recurrent adenocarcinoma in an ileal conduit stoma 7 months after radical cystectomy is reported.
Results/Discussion
: The most likely explanation of this case is hematogenous metastasis based on the clinical diagnosis and the pathological immunostaining examination of cytokeratin.
Common sheath reimplantation with ureteral plication: A useful technique for the management of ectopic ureterocele
Authors: Yamazaki Yuichiro , Setoguchi Kiyoshi , Yago Rie , Suzuki Mari , Toma Hiroshi 
Published: March 2003

Abstract
Background
: When salvaging the upper pole kidney in duplex ectopic ureterocele, primary bladder level surgery with common sheath ureteral reimplantation has the definite advantage of allowing the reconstruction of the entire collecting system through a single lower abdominal incision. However, there are several complications associated with a common sheath reimplantation in a child with a very dilated upper pole ureter, such as vesicoureteral reflux or ureterovesical stenosis.
Methods/Results
: To avoid these complications, ureteral plication over the common ureteral sheath in two children with duplex ectopic ureterocele was used. Postoperatively, neither child showed reflux or recurrent urinary tract infection and both showed a marked improvement of the upper pole collecting system.
Conclusion
: This technique allows for a simple and definitive reconstruction in cases of duplex ectopic ureterocele, particularly with dilated upper pole ureter.
Urinary undiversion for pelvic actinomycosis: A long‐term follow up
Authors: MAEDA HIROSHI , SHICHIRI YASUMASA , KINOSHITA HIDEHUMI , OKUBO KAZUTOSHI , OKADA TAKASHI , AOKI YOSHITAKA , MAEKAWA SHINYA , ARAI YOICHI 
Published: March 2003

Background: A 43‐year‐old woman who had been using intrauterine contraceptive devices for the past 10 years underwent an emergency operation for bowel and urinary obstruction.Methods/Results: Frozen section analysis showed undifferentiated adenocarcinoma. Incomplete tumorectomy, ileal resection, partial cystectomy, colostomy and bilateral ureterocutaneostomy were palliatively performed. Postoperatively, periodic acid‐Schiff and Grocott–Gomori methenamine tests revealed Actinomyces and the final diagnosis was pelvic actinomycosis. Treatment with penicillin G administered intravenously relieved her symptoms and the lesion was dramatically improved. The patient underwent colostomy closure and urinary undiversion.Conclusions: Five years after urinary undiversion, the patient’s renal function has been maintained and she can void without incontinence and dysuria.
Erectile function and nocturnal penile tumescence in patients with prostate cancer undergoing luteinizing hormone‐releasing hormone agonist therapy
Authors: Marumo Ken , Baba Shiro , Murai Masaru 
Published: March 2003

Background: Luteinizing hormone‐releasing hormone (LHRH) agonists have been widely used as effective agents in endocrine therapy for prostate cancer. Continuous administration of the drug results in profound suppression of testicular androgen production. However, the side effects on erectile function have not been fully investigated.Methods: We studied the influences of testosterone suppression on male sexual function and nocturnal penile tumescence in nine sexually active patients with prostate cancer who were treated with an LHRH agonist.Results: Following reduction of serum testosterone concentrations to a castration level by the administration of the LHRH agonist, sexual desire, sexual interest and sexual intercourse were totally annulled, with significant changes in frequency, magnitude, duration and rigidity of nocturnal erections observed in all patients.Conclusions: These results demonstrate that the LHRH agonist strongly suppresses erectile function and sexual activity. Taking into account the quality of sexual function for relatively young and sexually active patients and their partners, it is necessary to establish effective modalities that minimize the adverse effects on sexual function for the treatment of patients with prostate cancer.
Severe rhabdomyolysis as a complication of high‐dose chemotherapy in a patient with advanced testicular cancer
Authors: Hoshi Senji , Itoh Akihiro , Kato Shinnosuke , Suzuki Kenichi , Kawamura Sadafumi , Orikasa Seiichi 
Published: March 2003

Background: A 38‐year‐old man was diagnosed with choriocarcinoma in the left testis, a 9 cm retroperitoneal tumor, left hydronephrosis, multiple lung metastasis and gynecomastia. His serum hCG level decreased but was still above the normal range after four courses of standard chemotherapy.Methods: High‐dose chemotherapy was then given with ICE (ifosfamide, carboplatin, etoposide) from days −7 to −3.Results/Discussion: On day −2 the patient became confused and hallucinated, so the sedatives haloperidol and flunitrazepam were administrated. His creatinine phosphokinase levels increased to 6150 IU/L (reference range &lt;197 IU/L) on day 0. Myoglobinuria and myoglobinemia were noted and the renal dysfunction progressed. A peripheral blood stem cell transplantation was performed after hemodialysis on day 0. Although his bone marrow recovered, the patient died of respiratory failure on day 18. An autopsy revealed massive pulmonary bleeding. Pretreatment renal dysfunction, renal damage by high‐dose chemotherapy, ifosfamide‐induced hallucinations and the administration of sedatives, such as haloperidol and flunitrazepam, may have been causative factors for the rhabdomyolysis observed in this patient.
Outcome of precise vesicourethral anastomosis following retropubic radical prostatectomy using a Foley catheter
Authors: FUJISAWA MASATO , HIGUCHI AKIHIRO , GOTOH AKINOBU , MATSUI TAKASHI , HARA ISAO , GOHJI KAZUO , OKADA HIROSHI , ARAKAWA SOICHI , KAMIDONO SADAO 
Published: March 2003

Purpose: In order to evaluate precise anastomosis using a Foley catheter, complications following radical retropubic prostatectomy were examined.Methods: Twenty‐one patients underwent radical retropubic prostatectomy. Precise vesicourethral anastomosis was performed, visualizing the urethral stump by raising up the urogenital diaphragm using a Foley catheter. Complications, such as prolonged urinary extravasation and temporary urinary retention, were checked when the catheter was removed. Incontinence was evaluated both within 6 weeks and more than 6 weeks after operation. Anastomotic and urethral strictures were also checked during follow up.Results: The follow‐up period ranged from 4 to 47 months (mean (Â± SD) 22.0 Â± 12.1 months). Eighteen of 21 patients (85.7%) achieved continence after the operation. However, two patients still had stress incontinence and one patient had mild incontinence. Neither prolonged urinary extravasation nor temporally urinary retention were observed. Anastomotic and urethral stricture were not experienced during follow up.Conclusions: Precise anastomosis using a Foley catheter is technically easy and useful, even for relatively inexperienced urologists, to perform. Patients can often achieve continence following this procedure.