bluuebunny/crossref_metadata_2025_split huggingface dataset:
Single Breath Analysis of Endogenous Nitric Oxide in the Newborn
Authors: Artlich Andreas , Jónsson Baldvin , Bhiladvala Maneck , Lönnqvist Per Arne , Gustafsson Lars E. 
Published: April 2003

Nitric oxide (NO) is found in the exhaled gas of humans immediately after birth. However, variations of endogenous NO concentration during the breathing cycle have not been studied in newborns. We examined 24 newborns without acute respiratory compromise during spontaneous nasal breathing. Gas was sampled from the tip of a thin nasal catheter placed in the hypopharynx. Endogenous NO concentrations measured by chemiluminescence were assigned to the breathing cycle using synchronized CO<sub>2</sub> recording. Exhaled NO could reproducibly be measured at 1.9 ± 0.2 parts per billion (ppb, mean ± SEM). Autoinhaled nasal NO peaks during regular breathing were 12.0 ± 1.7 ppb and reached intermittent maxima of 52.2 ± 5.8 ppb. During regular breathing 6 infants exhibited sudden decreases of nasal NO peaks to periods with <50% amplitude suggesting transient shortage of autoinhaled nasal NO. We conclude that tidal NO analysis can be used to assess upper and lower airway NO production noninvasively during spontaneous breathing in the newborn.
Generation of Periventricular Leukomalacia by Repeated Umbilical Cord Occlusion in Near-Term Fetal Sheep and Its Possible Pathogenetical Mechanisms
Authors: Marumo G. , Kozuma S. , Ohyu J. , Hamai Y. , Machida Y. , Kobayashi K. , Ryo E. , Unno N. , Fujii T. , Baba K. , Okai T. , Takashima S. , Taketani Y. 
Published: April 2003

Periventricular leukomalacia (PVL) is a major cause of cerebral palsy. However, pathogenetic mechanisms of PVL have not been fully understood. Although it has been postulated that umbilical cord compression is related to the development of PVL, no animal experiments clearly demonstrated an association of umbilical cord occlusion with ‘periventricular’ white matter lesions. The purpose of this study is to determine whether umbilical cord occlusions could produce periventricular white matter lesions in fetal sheep and to examine how changes in fetal cardiovascular and metabolic variables are related to the induction of brain damage. Fourteen near-term fetal sheep underwent umbilical cord occlusion (3-min total cord occlusions 5 times at 5-min intervals). Dissections performed 24 h after cord occlusion revealed that periventricular white matter lesions were produced in 7 out of 14 sheep fetuses. According to the pattern of brain damage, we classified the fetal sheep into three groups: 5 fetuses with dominant lesions in the periventricular white matter (group I), 4 fetuses with brain lesions in the cerebral cortex and thalamus (group II) and 5 fetuses with no or minimal brain lesions (group III). Group I showed higher blood pressure and higher plasma lipid peroxide levels before cord occlusion compared to the other groups, while group II showed systemic hypotension during cord occlusion. No significant differences in changes in pH, PaCO<sub>2</sub>, PaO<sub>2</sub> and heart rate were found between the three groups. It is speculated that PVL might be produced by an association of preexisting chronic circulatory instability with an acute episode of severe repetitive cord occlusion.
Perinatal Expression of Heat-Shock Protein 90 in Different Regions of the Brain and in Non-Neural Tissues of the Piglet
Authors: David Jean Claude , Grongnet Jean François 
Published: April 2003

Important stressful events occur at birth or within the few hours that follow. To establish a possible involvement of stress proteins, expression of heat-shock protein 90 was determined by Western blotting in several regions of the brain and in non-neural tissues of the developing piglet (fetal to 10 days and adult). Expression was found in all the tissues studied. While comparable values were found in the whole brain during development, decreased expressions were observed from 4 to 8 h to 2 days after birth in cerebellum, cortex, hypothalamus and striatum. In hippocampus, low expression was observed from 4 h postnatally onward. In non-neural tissues, low expression was observed after birth and in the adult for heart, liver and lungs. In kidney, low values were found from birth to 1 day of age. Changes in environmental parameters like temperature and/or hypoxia can be related to differential expressions of heat-shock proteins and they possibly result in severe developmental outcomes. The results are discussed in terms of using the newborn piglet as a model for the study of different forms of stress on the heat-shock protein expression during postnatal development.
Prenatal Influence of Ischemia-Hypoxia-Induced Intrauterine Growth Retardation on Brain Development and Behavioral Activity in Rats
Authors: Tashima Lena , Nakata Masahiko , Anno Kikue , Sugino Norihiro , Kato Hiroshi 
Published: April 2003

The effects of intrauterine growth retardation (IUGR) on brain histological or functional development were examined in rats. IUGR was induced by ligating the bilateral uterine arteries at day 17 of pregnancy. On day 22 of pregnancy, cesarean section was performed, and pups with a birth weight of <2 SD of the mean birth weight of control pups were regarded as IUGR rats. Morphological changes of the brain were studied by Nissl’s staining at different timepoints during prenatal and postnatal periods. For behavioral study, an open-field test was performed at 5, 7 and 10 weeks after birth. Histological studies showed the migration disorder of the neurons in the cerebral cortex from embryonic day 17 to postnatal day (PD) 49. The open-field test revealed locomotor disturbance at PD49 in male IUGR rats, but not in female IUGR rats or control rats. It is concluded that IUGR due to antenatal ischemia-hypoxia causes morphological changes in the central nervous system, and induces behavioral impairment, particularly in male rats.
Prediction of the Final Infarct Volume within 6 h of Stroke Using Single Photon Emission Computed Tomography with Technetium-99m Hexamethylpropylene Amine Oxime
Authors: Hirano T. , Read S.J. , Abbott D.F. , Baird A.E. , Yasaka M. , Infeld B. , Barber P.A. , Davis S.M. , McKay W.J. , Donnan G.A. 
Published: April 2003

<i>Background:</i> A simple method to predict the final infarct volume within 6 h of onset of hemispheric ischemic stroke based on the measurement of cerebral blood flow (CBF) using single photon emission computed tomography (SPECT) with techneticum-99m hexamethylpropylene amine oxime (<sup>99m</sup>Tc-HMPAO) was investigated in a clinical model involving patients without definite early reperfusion or clinical recovery. <i>Methods:</i> A group of 16 patients (group 1) was used to establish the methodology, which was then validated in a second group of 14 patients (group 2). The final infarct volume was defined using computed tomography (CT) performed at least 7 days after stroke. The relative CBF threshold value, expressed as a percentage of the mean contralateral hemispheric value, which most closely estimated the final infarct size on coregistered CT was established for each patient. <i>Results:</i> The mean threshold CBF value for group 1 was 63.7%. When this value was used to predict infarct size in group 2, a close correlation was observed between the actual and the estimated sizes (r = 0.973, p < 0.0001). This value was not time dependent. <i>Conclusions:</i> If no significant early reperfusion or clinical recovery occurs, a CBF threshold value of 63.7% on <sup>99m</sup>Tc-HMPAO SPECT performed within 6 h of stroke onset will reliably predict the final infarct size.
Potentially Reversible Factors during the Very Acute Phase of Stroke and Their Impact on the Prognosis: Is There a Large Therapeutic Potential to Be Explored?
Authors: Jørgensen Henrik Stig , Reith Jakob , Nakayama Hirofumi , Kammersgaard Lars Peter , Houth Jakob Gynthelberg , Raaschou Hans Otto , Olsen Tom Skyhøj 
Published: April 2003

In the Copenhagen Stroke Study, we evaluated the combined impact on stroke outcome of potentially treatable factors such as acute body temperature, blood glucose, and stroke in progression. The patients were stratified into two groups: (1) patients with ‘good’ prognostic parameters (body temperature on admission ≤37.0°C <i>and</i> plasma glucose on admission ≤6.5 mmol/l <i>and</i> who did not develop stroke in progression) and (2) patients with correspondingly ‘poor’ prognostic parameters. A poor outcome was observed in 4% of the patients with good prognostic parameters versus in 49% of the patients with poor prognostic parameters (p < 0.01). In the multivariate analysis which also included stroke severity, blood glucose contributed significantly to poor outcome with an odds ratio (OR) of 1.2/1.0 mmol/l increase, body temperature with an OR of 2.2/1°C increase, and stroke in progression with an OR of 2.9. However, the combined effect of all three factors was more than additive with an OR of 10.0 (95% CI 1.5–56; p < 0.01). We have shown that in human stroke a strong and more than additive association exists between potentially reversible parameters and outcome. Intervention trials can prove whether these marked relations are causal.
Gamma Knife Radiosurgery as a Primary Surgical Treatment for Hypersecreting Pituitary Adenomas
Authors: Zhang Nan , Pan Li , Dai Jiazhong , Wang Binjiang , Wang Enmin , Zhang Weijun , Cai Peiwu 
Published: April 2003

<i>Object: </i>To estimate the efficacy of Gamma Knife radiosurgery (GKR) especially as a primary surgical treatment for hypersecreting pituitary adenomas. <i>Methods:</i> 274 patients were treated with GKR. The mean tumor volume was 1.86 cm<sup>3</sup>. The mean peripheral dose was 28.7 Gy. <i>Results:</i> 223 patients were followed up for an average of 31.6 months. The dose related to the tumor growth control and endocrinological normalization was detailed and statistical analysis of the data was performed. <i>Conclusion:</i> GKR as a primary surgical treatment for hypersecreting pituitary adenomas may be safe and effective.
Prostate-Specific Antigen Levels and Prognosis in Patients with Hormone-Refractory Prostate Cancer Treated with Low-Dose Dexamethasone
Authors: Morioka Masaaki , Kobayashi Tatsuya , Furukawa Yoji , Jo Yoshimasa , Shinkai Masanori , Matsuki Takakazu , Yamamoto Tokunori , Tanaka Hiroyoshi 
Published: April 2003

<i>Objective:</i> The efficacy of low-dose dexamethasone (DXM) therapy in patients with hormone-refractory prostate cancer (HRPC) was evaluated. <i>Patients and Methods: </i>Prostate-specific antigen (PSA) response and survival following DXM therapy were analyzed in 27 Japanese patients exhibiting HRPC. Concurrent therapies and antiandrogen withdrawal syndrome, which may affect PSA levels and palliative effects, were excluded from the study. A dose of 1.5 mg of DXM was administered, and androgen deprivation therapy was maintained during DXM therapy. A decline in PSA levels of at least 50% from baseline was considered a significant PSA response. Prognostic factors for PSA response and survival were examined by univariate and multivariate analyses. <i>Results:</i> A significant PSA response was observed in 16 of the 27 cases (59.3%). Median survival period of patients exhibiting significant PSA response was 15.9 months and was significantly longer than that of patients demonstrating a decline in PSA of less than 50% (median 7.7 months, p < 0.0001). Effect on pain control also correlated with the significant PSA response. No meaningful prognostic factors for PSA response were detected; however, a PSA decline of greater than 50% was the prognostic factor for survival. <i>Conclusion:</i> DXM therapy remains one of the most beneficial treatment modalities in patients with HRPC.
Surgery for Renovascular Diseases: A Single-Center Experience in Revascularizing Renal Artery Stenosis and Aneurysm
Authors: Koyanagi Tomohiko , Nonomura Katsuya , Takeuchi Ichiro , Watarai Yoshihiko , Seki Toshimori , Kakizaki Hidehiro 
Published: April 2003

<i>Objective:</i> Diagnosis and management of renovascular diseases (RVD) at Hokkaido University Hospital was reviewed with particular emphasis on surgical revascularization (SR). <i>Patients and Methods:</i> We studied a total of 33 patients with RVD [16 patients with renal artery stenosis (RAS): group 1, and 17 patients with renal artery aneurysm (RAA): group 2, 10 males, 23 females, aged 9–69 years (median 46), unilateral 24, bilateral 9]. Functional diagnosis of RVD with regard to renovascular hypertension (RVH) was done with the captopril test (CP-T) and captopril-enhanced <sup>99m</sup>Tc-DTPA (diethylenetriamine-pentaacetic acid) renal scintigraphy (CER). All were subjected to SR. Number, length, size and site of RVD with involvement of branch arteries dictated the choice of operative method but basically in situ repair for main trunk disease (11 kidneys) and ex vivo bench repair with autotransplantation for those beyond the first bifurcation intrarenally involving branched arteries (24 kidneys) were employed. The outcome was analyzed as to blood pressure control, split renal function, and branch renal artery patency. <i>Results:</i> (1) Sensitivity of CP-T and CER was 79 and 77% respectively in group 1, while it was 40 and 38% respectively in group 2. (2) Blood pressure was cured in 66.7% (group 1, 68.8% and group 2, 63.6%) and improved in 22.2% (group 1, 18.8% and group 2, 27.3%) with an overall success rate of 88.9%. (3) Renal function was good in 81.3% (group 1, 83.3% and group 2, 78.6%) and fair in 9.4% (group 1, 0% and group 2, 21.4%) with overall success in 90.7%. (4) Patency was preserved in 90.5% of branch anastomoses. <i>Conclusions:</i> Despite challenging complexities, SR of RVD is feasible with a reasonable amount of morbidity and effective in controlling blood pressure and preserving renal function in the majority of cases.
Effect of ‘Drug Holiday’ on Blood Pressure Control: A Randomized Double-Blind Comparative Trial of Amlodipine versus Felodipine Extended Release in Chinese Patients with Mild to Moderate Essential Hypertension
Authors: Hu Dayi , Zhao Xiuli , He Xin , Tao Daning , Wang Shoulan , Wei Guojing , Qiu Zhiyong , Li Wanyi , Liu Yin , Li Zhaoxia , Zhang Giulan 
Published: April 2003

<i>Objective:</i> To compare the antihypertensive effect and safety of amlodipine and felodipine extended release (ER). <i>Methods:</i> Seventy-six patients with mild to moderate hypertension were randomized to two groups in a double-blind manner. One group was treated with amlodipine 5.0–10.0 mg/day (group 1), and the other group with felodipine ER 5.0–10.0 mg/day (group 2), for 12 weeks. Twenty-four-hour ambulatory blood pressure (ABP) monitoring at baseline and after treatment was used to evaluate drug efficacy and blood pressure (BP) changes during a ‘drug holiday’ (48 h). <i>Results:</i> Diastolic BP was reduced in the amlodipine group by 15.1 mm Hg (to a final BP of 84.8 mm Hg) and in the felodipine ER group by 15.3 mm Hg (to a final BP of 85.0 mm Hg). Efficacy was considered to be achieved in 83.8% of patients in group 1 and in 87.9% of patients in group 2 (not significant). The number of patients controlled at the starting dose was 28 in group 1 and 19 in group 2 (p < 0.01). In group 1, BP remained below 140/90 mm Hg 24–48 h after the missed dose, and 24-hour ABP was not significantly different from that before the missed doses. In group 2, BP was above 140/90 mm Hg after the missed dose, and both BP and 24-hour ABP were statistically significantly higher than those before the missed doses. Adverse reactions were infrequent in both groups. <i>Conclusions:</i> Both amlodipine and felodipine ER are effective, safe, reliable and well tolerated in the treatment of mild to moderate essential hypertension. BP was well controlled in group 1 24–48 h after the missed dose. The fluctuation of BP in group 2, however, was significantly worse than that in group 1.
A Diminished Intrapartum Amniotic Fluid Index Is a Predictive Marker of Possible Adverse Neonatal Outcome when Associated with Prolonged Labor
Authors: Kawasaki Noriyoshi , Nishimura Hiroshi , Yoshimura Toshihiro , Okamura Hitoshi 
Published: April 2003

<i>Objective:</i> To determine whether a diminished intrapartum amniotic fluid volume represents a risk of adverse neonatal outcome when it occurs in conjunction with prolonged labor. <i>Methods:</i> The intrapartum amniotic fluid index (iAFI) was measured in 242 parturients over 35 weeks of gestation during 1st-stage labor, and the umbilical artery blood gas was analyzed at delivery. The subjects were divided into group A (n = 99), having a diminished amniotic fluid volume (iAFI ≤8.0 cm) and group B (n = 143), having a normal amniotic fluid volume (iAFI 8.1–20.0 cm), and selected antenatal, delivery, and neonatal variables were compared. In addition, the two groups were subdivided according to the duration of labor. Statistical analysis was performed using independent Student’s t test, Mann-Whitney U test, chi-square analysis, and Fisher’s exact test where appropriate. p < 0.05 was considered significant. <i>Results:</i> The patient characteristics and pregnancy outcomes were similar in groups A and B, as were the incidences of an umbilical artery blood pH <7.20 and/or an Apgar score <7 (group A 9.5%, group B 10.1%). In group A, however, the incidence of an adverse neonatal outcome was 23.5% in cases in whom the duration of labor was longer than 8 h which was significantly higher than in cases in whom the duration of labor was 8 h or less (2.8%; p < 0.01). In group B, the incidence of an adverse neonatal outcome was similar in the two subgroups. <i>Conclusions:</i> The risk of an adverse neonatal outcome is higher in patients with diminished amniotic fluid volume if labor is prolonged. Consequently, determination of the iAFI could be a useful admission test.
Physical Characteristics of Vivostat<sup>®</sup> Patient-Derived Sealant
Authors: Velada J.L. , Hollingsbee D.A. 
Published: April 2003

This study compared the physical characteristics of Vivostat<sup>®</sup> patient-derived sealant with two conventional fibrin sealants, Tissucol<sup>®</sup> and Beriplast<sup>®</sup>. Vivostat sealant exhibited greater elasticity without compromising tensile strength. Vivostat sealant polymerised at low temperatures (4 and 25°C) or at high temperature (70°C) exhibited similar viscoelastic properties as when polymerised at normal physiological temperature (37°C). Vivostat fibrin I solution can be stored at room temperature for up to 8 h without affecting the mechanical properties of the derived sealant. These physical characteristics of Vivostat patient-derived sealant suggest that it may have suitable stability and performance characteristics for use in a wide range of surgical procedures.
The Significance of Radiopharmaceutical Choice on the Estimation of the Absolute Renal Function in Different Stages of Renal Failure
Authors: Ilic S. , Vlajkovic M. , Bogicevic M. , Rajic M. , Stefanovic V. 
Published: April 2003

<i>Objective:</i> An abnormal filtration fraction due to divergence between glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) may lead to different estimations of absolute renal function, depending on the radiopharmaceutical administered. The purpose of this study was to estimate GFR and ERPF by measuring the clearances of technetium-99m diethylenetriamine pen- taacetic acid (<sup>99m</sup>Tc-DTPA) and iodine-131 sodium <i>o</i>-iodo- hippurate (<sup>131</sup>I-OIH) in patients with renal failure and evaluate the significance of these radiopharmaceuticals in the prognosis of the disease. <i>Methods:</i> This study included 25 patients who were followed up during different phases of acute renal failure (ARF) as well as 46 patients with incipient and advanced chronic renal failure (CRF). Results were compared with those obtained in 20 healthy volunteers. Clearance of <sup>99m</sup>Tc-DTPA and <sup>131</sup>I-OIH was measured by the technique of a single blood sample taken 180 and 44 min after administration of the radiotracer, respectively. <i>Results:</i> In the patients with ARF, absolute values of GFR and ERPF decreased during oligoanuric and diuretic phases, but the lower filtration fraction suggested a greater reduction of GFR. In the recovery phase of ARF, both GFR and ERPF improved and an almost normal filtration fraction suggested a more prominent GFR increase. The recovery of ARF patients was in accordance with <sup>131</sup>I-OIH clearance values recorded in the oligoanuric phase. The GFR and ERPF decreased concordantly in patients in the incipient stage while in advanced CRF, a slightly greater decrease in GFR was recorded. <i>Conclusions:</i> In ARF, the degree of the initial fall in GFR does not serve as a prognostic indicator whereas the degree of the initial fall of ERPF does have prognostic significance. The decrease in GFR parallels the decrease in ERPF in CRF and a measurement of either parameter should give a comparable estimate of renal function.
Present Status of Antimicrobial Susceptibility of <i>Haemophilus influenzae</i> Isolates in Kuwait as Determined by E-Test
Authors: Dhar Rita , Wilson Sunita , Ghafoor Mahboob , Rotimi Vincent O. , Chugh Tulsi D. 
Published: April 2003

<i>Objective:</i> To study antimicrobial susceptibility pattern of clinical isolates of <i>Haemophilus influenzae</i> using E-test and compare the results with those of a study done in 1983. <i>Methods:</i> The antimicrobial susceptibility of 196 isolates of <i>H. influenzae</i> against nine antimicrobial agents (amoxicillin-clavulanic acid, ampicillin, cefaclor, cefotaxime, ceftriaxone, chloramphenicol, ciprofloxacin, clarithromycin, and trimethoprim-sulfamethoxazole) was performed by E-test on <i>Haemophilus</i> test medium. The results obtained were compared with those from an earlier study conducted here on 108 strains collected between October and December 1983. <i>Results:</i> Except for cefotaxime, which consistently showed an excellent in vitro activity (MIC<sub>90</sub> = 0.047 mg/l), other antimicrobial agents presented a decline in their effectiveness. Among the newer antibiotics tested, all the strains were found to be sensitive to ciprofloxacin (MIC range = 0.004–0.0094 mg/l) whereas clarithromycin showed high MIC of 12 mg/l for 90% of the strains. There was a marked increase in the number of beta-lactamase-producing isolates from 4.6% in 1983 to 31.6% in the present study. Amongst 62 beta-lactamase-producing strains 14.5% exhibited resistance to amoxicillin-clavulanic acid (MIC >8 mg/l). Only 3.1% isolates were found to be of capsular type b in 1998 compared to 9.2% in 1983. No beta-lactamase-negative ampicillin-resistant (BLNAR) strain was isolated during the present study whereas only one strain (0.9%) was isolated in 1983. <i>Conclusion:</i> This study shows that despite a decrease in the number of type b and BLNAR <i>H. influenzae</i> isolates, there is an apparent increase in the trend to acquire resistance to several antimicrobial agents.