bluuebunny/crossref_metadata_2025_split huggingface dataset:
Immediate Posttraumatic Seizures: Is Routine Hospitalization Necessary?
Authors: Dias Mark S. , Carnevale Frank , Li Veetai 
Published: April 2003

<i>Objective:</i> A recent Internet survey of pediatric neurosurgeons showed that 86% routinely admitted children with immediate posttraumatic seizures (PTS) for a brief period of observation. We wished to determine whether certain children meeting predefined criteria could instead be safely discharged from the emergency room. <i>Methods:</i> We reviewed the records of children admitted during the past 5 years with a diagnosis of seizure and head injury. Children with a minor head injury, a PTS occurring within 24 h of injury and no intracranial abnormalities on admission CT scan were included. Children with previous neurological conditions, a history of prior seizures (other than PTS or febrile seizures), a prior history of anticonvulsant use, or intracranial abnormalities on the admission CT scan were excluded. Records were abstracted for child’s age, gender, length of admission, previous history of PTS or febrile seizures, mechanism of injury, location of impact, time between impact and PTS, the number, length and type of PTS, Glasgow Coma Score (GCS) on admission, subsequent complications and hospital costs. <i>Results:</i> Seventy-one children met the inclusion criteria. Eleven children presented to the emergency room with prolonged seizures, transient apnea or persistently low GCS and required admission to the intensive care unit (ICU). Among the 60 remaining children with simple PTS, none had further seizures during the follow-up period, and none had significant complications. The average cost of hospitalization was known for 58 children; after excluding the costs for 5 patients who were admitted to the ICU, the average hospital cost amounted to USD 1,615 per patient. <i>Conclusions:</i> Our data suggest that children with isolated minor head injuries and simple PTS who recover fully in the emergency room, whose CT scans show no intracranial abnormalities and who have no prior history of neurological disease, epilepsy or anticonvulsant use are at low risk for recurrent seizures or neurological complications, and could potentially be sent home to a reliable caretaker and a stable home situation. However, because of the limited sample size in this study, the statistical risk of a bad outcome may be as high as 9%; we therefore suggest that much larger studies are potentially needed before this becomes a standard policy.
Effect of Dietary Supplementation with Polyunsaturated Fatty Acids on Bronchial Hyperreactivity in Subjects with Seasonal Asthma
Authors: Villani F. , Comazzi R. , De Maria P. , Galimberti M. 
Published: April 2003

Dietary supplementation with omega-3 essential fatty acids results in the production of uniqe 5-lipoxygenase and cyclooxygenase products which are biologically less active and may inhibit the production, or actions, of the eicosanoids produced when arachidonic acid is the substrate for 5-lipoxygenase and cyclooxygenase, rather than omega-3 essential fatty acids. Since airway inflammation may play a central role in the pathophysiology of asthma, we studied the effect of omega-3 essential fatty acids on bronchial responsiveness in 7 atopic patients suffering from seasonal asthma due to airborne allergens, and positive to intracutaneous skin reaction to two or more allergens. Bronchial responsiveness to ultrasonically nebulized distilled water (UNDW) was determined 30 days from the initial ingestion of 3 g/day of omega-3 essential fatty acids and 30 days after stopping dietary supplementation. Flow volume curves and R<sub>aw</sub> were recorded before the provocation test, at the end of inhalation, and at 10-, 20-, 30- and 60-min intervals. The maximum fall in forced expiratory volume in 1 s (FEV<sub>1</sub>) and the maximum increase in airway resistance (R<sub>aw</sub>) were chosen as the main outcome parameters. After 30 days of dietary supplementation, bronchial responsiveness to UNDW was significantly improved (in fact maximum fall in FEV<sub>1</sub> was –11% vs. –28% before treatment, and maximum increase in R<sub>aw</sub> was +37% vs. +265% before treatment). The challenge test repeated 30 days after stopping dietary supplementation was the same as that recorded before treatment. The present data strongly suggest the hypothesis that dietary supplementation with omega-3 essential fatty acids could decrease bronchial hyperreactivity in atopic patients.
Is Asthma in the Elderly Really Different?
Authors: Quadrelli Silvia A. , Roncoroni Aquiles J. 
Published: April 2003

To examine the nature of asthma in the elderly, we compared older (group 1: 65 years or older, n = 50) with younger patients (group 2: <40 years, n = 99) and to determine the influence of long-standing disease, elderly asthmatics with early onset (group A: onset before 40, n = 22) were compared with patients developing symptoms later in their lives (group B: onset after 40, n = 22). Blood eosinophilia and IgE value ≥100 IU/l were more frequent in younger patients. Short symptom-free periods were more frequent among older asthmatics (78.5 vs. 45.4%, p < 0.001). Only 31.2% of older patients had only mild symptoms. Requirement of systemic steroids was higher in the elderly population. The worst FEV<sub>1</sub> was lower in older patients (54.4 ± 17.3 vs. 71.8 ± 18.5%, p {FC96}& 0.001). Patients with early-onset asthma showed more frequently shorter symptom-free periods (93.3 vs. 53.3%, p <0.05), higher emergency admissions/year, and hospitalizations/year. Best FEV<sub>1</sub> (group 1: 66.7 ± 13.7% vs. group 2: 90.3 ± 15.1%, p < 0.005) and worst FEV<sub>1</sub> (46.2 ± 13.1 vs. 61.0 ± 13.2%, p < 0.01) were lower in early-onset patients. A higher systemic steroid requirement, a lower best and worst FEV<sub>1</sub>, shorter symptom-free periods and a lesser proportion of patients with only mild symptoms were observed in patients older than 65 with early-onset asthma compared with those younger than 40 years. Elderly patients with a shorter duration of asthma were not different from young patients. Our study strongly suggests that severity of asthma and development of irreversible airflow obstruction depend on the duration of disease.
Lactate Dehydrogenase in Bronchoalveolar Lavage Fluid of Patients with Active Pulmonary Tuberculosis
Authors: Emad Ali , Reza Rezaian Gholam 
Published: April 2003

<i>Background:</i> Serum lactate dehydrogenase (LDH) concentration is an indicator of tissue injury. It may be increased in a variety of interstitial diseases and in pulmonary tuberculosis (PTB). <i>Objective:</i> To investigate the value of LDH levels in bronchoalveolar lavage fluid (BALF) for the diagnosis of active PTB and to assess its relationship with serum LDH levels. <i>Methods:</i> The study was a prospective clinical study. It included 25 consecutive patients with documented active PTB and 20 healthy adults who underwent bronchoscopy with bronchoalveolar lavage (BAL). Both total serum and LDH levels were measured. <i>Results:</i> BALF LDH level was increased in all patients with active PTB. The mean BALF LDH level was significantly higher in patients with PTB (198.84 ± 88.31 mIU/ml) as compared to controls (14.01 ± 8.69 mIU/ml) (p = 0.0001). There was a significant correlation between BALF LDH and serum LDH levels in patients with PTB (r = 0.55, p = 0.006). <i>Conclusion:</i> BALF LDH levels are not specific and may be increased in many diseases. A very low value (possibly less than 60 mIU/ml) may, on the other hand, be useful to exclude the diagnosis of active PTB.
A Chest Wall Restrictor to Study Effects on Pulmonary Function and Exercise
Authors: Cline CamalaC. , Coast J.Richard , Arnall DavidA. 
Published: April 2003

Chest wall-restrictive loading reduces a person’s ability to expand the chest wall during inhalation and results in decrements in lung capacities, resting pulmonary function, and ultimately, exercise performance. Chest wall restriction is observed in some forms of skeletal and pulmonary diseases (e.g., scoliosis) as well as in occupational situations (e.g., bulletproof vests). We have designed a constant-pressure chest wall-restrictive device that provides a quantifiable and reproducible load on the chest. This paper describes the device and the initial pulmonary function tests conducted. Ten subjects participated in this study. Subjects wore the restrictive device while performing pulmonary function tests at four externally added restrictive loads on three separate occasions. A two-way repeated-measures multivariate analysis of variance revealed significant decreases in forced expiratory vital capacity (FVC) and forced expiratory volume in 1 s (FEV<sub>1.0</sub>) at each load while the ratio of FEV<sub>1.0</sub> to FVC (FEV<sub>1.0</sub>%) was maintained. No significant differences in any variable were found across time or between the seated and standing position. These results indicate that this chest wall-restrictive device provides a quantifiable added inspiratory load in the breathing cycle that results in reproducible decrements in pulmonary function representative of those seen in some restrictive pulmonary disease and occupational situations.
Equivalence of Two Steroid-Containing Inhalers: Easyhaler Multidose Powder Inhaler Compared with Conventional Aerosol with Large-Volume Spacer
Authors: Koskela T. , Hedman J. , Ekroos H. , Kauppinen R. , Leinonen M. , Silvasti M. , Tukiainen H. 
Published: April 2003

<i>Background and Objectives:</i> An equivalence study was conducted in which the efficacy and safety of a daily dose of 800 μg of beclomethasone diproprionate administered via a multidose powder inhaler, Easyhaler, and via a metered-dose inhaler (MDI) with a large-volume spacer were compared in adult, newly diagnosed, steroid-naive asthmatic patients. Acceptability of the medications was also compared. <i>Methods:</i> One hundred and forty-four patients were recruited into the double-blind, double-dummy, randomised, parallel-group multicentre study. The study treatment period was 8 weeks. It was preceded by a 2-week run-in period. Morning and evening peak expiratory flow (PEF), numbers of inhalations of a sympathomimetic and asthma symptoms were recorded daily. Spirometry and histamine challenge were performed, and health-related quality of life and morning serum cortisol levels measured during control visits. <i>Results:</i> Criteria indicating treatment equivalence were met. The mean of the primary outcome variable, morning PEF, increased significantly, from 426 to 461 litres/min in the Easyhaler group and from 436 to 467 litres/min in the MDI+spacer group. Similar improvements between groups were also seen in relation to all secondary variables. Changes in serum cortisol levels were minor. In 6 out of 10 questions about device acceptability, the majority of patients rated Easyhaler as better than the MDI+spacer combination. <i>Conclusion:</i> It was concluded that the devices tested were equivalent in terms of efficacy and safety.
Feedback-Controlled Negative Pressure Ventilation in Patients with Stable Severe Hypercapnic Chronic Obstructive Pulmonary Disease
Authors: Kössler W. , Lahrmann H. , Brath H. , Wei T. , Frank W. , Wild M. , Zwick H. , Wanke T. 
Published: April 2003

<i>Background:</i> In recent studies, the efficacy of intermittent rest of the inspiratory muscles as an option of treating patients with severe chronic obstructive pulmonary disease (COPD) has become questionable. <i>Objective:</i> The aim of our study was to analyze the effects of feedback-controlled intermittent negative pressure ventilation (INPV) on stable, but severely hypercapnic COPD patients. <i>Methods:</i> 21 clinically stable, hypercapnic patients with severe COPD underwent INPV with chest shells for 3 weeks, 6 h a day. The INPV sessions were optimized by a visual biofeedback system, which enabled control over the decrease in diaphragmatic activity. Respiratory muscle (RM) function parameters, lung function parameters, blood gases and exercise capacity were analyzed. <i>Results:</i> In the end, 19 patients concluded INPV treatment. They had PaO<sub>2</sub> of 56.5 ± 11.8 mm Hg, PaCO<sub>2</sub> of 50.2±2.7 mm Hg (mean ± SD) and FEV<sub>1</sub> of 27.8 ± 4.3% predicted before treatment. There was no statistically significant change in lung function parameters, RM function parameters, physical performance and level of dyspnea after 3 weeks of INPV. <i>Conclusion:</i> We conclude that intermittent RM rest induced by INPV can relax inspiratory muscles in most patients with stable severe COPD, but fails to improve RM function and exercise capacity.
Interstitial Laser Coagulation in Benign Prostatic Hyperplasia: A Critical Evaluation after 2 Years of Follow-Up
Authors: Krautschick A.W. , Köhrmann K.U. , Henkel T.O. , Michel M.S. , Alken P. 
Published: April 2003

Since 1993 we have prospectively followed a cumulative cohort of males with benign prostatic hyperplasia and symptomatic bladder outlet obstruction who underwent interstitial laser coagulation (ILC) of the prostate. We evaluated the safety and efficacy of ILC with respect to relief of symptoms and bladder outlet obstruction. In addition to the critical evaluation of our clinical results, the perineal and transurethral approaches were investigated as they may make a substantial impact on the overall success rate, including prostate size, number of sticks per prostate volume and type of application. A total of 59 patients were treated with the Nd-YAG laser (mediLas fibertom) between April 1993 and December 1996. At the time of reevaluation, 47 patients had completed a follow-up of up to 24 months. A perineal approach was used in 34%, transurethral in 23%, and a combined approach in 43% of the patients, depending on the preoperative volume of the prostate. 75% were high-risk patients in accordance with the ASA score (ASA III). The efficacy of treatment was assessed 6, 12, 24 and 52 weeks postoperatively in accordance with the International Prostate Symptom Score (IPS/quality of life), cystomanometric studies, peak urinary flow rate, residual volume and volume reduction of the prostate. Reduction of prostatic volume and sticks used per prostate volume were correlated to the overall success rate. A significant improvement in all voiding parameters (flow rate, residual volume), including the symptom score, was observed. P<sub>det</sub> decreased from an average of 90 cm H<sub>2</sub>O preoperatively to 42 cm H<sub>2</sub>O postoperatively after 24 weeks and the mean reduction in prostate volume was 14 cm<sup>3</sup>. Interestingly, it was noted that the overall success rate was not size-related. A distinct positive correlation was found in the number of sticks performed and the improvement in objective and subjective parameters. In view of the low morbidity outcome, especially in high-risk patients, we proclaim Nd-YAG interstitial laser coagulation of the prostate to be an effective and safe alternative method of treatment for symptomatic benign prostatic hyperplasia.
Malignant Fibrous Histiocytoma of the Epididymis
Authors: Ikinger Uwe , Westrich Martin , Bersch Wolf , Böttinger Klaus 
Published: April 2003

A 54-year-old patient was found to have a painless ca. 1.5 cm diameter tumor in the region of the right epipidymis. The right testis was exposed from a scrotal incision. The final pathology surprisingly showed malignant fibrous histiocytoma (MFH) of the epipidymis and the patient subsequently underwent radical inguinal orchiectomy. Complete metastatic screening was normal. Postoperatively, 60 Gy external beam radiation was administered. At the least follow-up (6 years), there were no recurrences or metastases. MFH is an extremely rare, highly malignant connective tissue tumor, which may, occasionally, affect the male genital tract. There are no agreed treatment principles. The overall prognosis is poor.
Profile of Placental Alkaline Phosphatase Expression in Human Malignancies: Effect of Tumour Cell Activation on Alkaline Phosphatase Expression
Authors: Dabare A.A.N.P.M. , Nouri A.M.E. , Cannell H. , Moss T. , Nigam A.K. , Oliver R.T.D. 
Published: April 2003

Cellular alkaline phosphatases (ALP) are increasingly recognised as important markers for monitoring tumour cell behaviour in human malignancies. Colorimetric, flow-cytometric, and immunocytochemical assays were employed to assess the influence of activation on expression of cellular ALP in human tumour cell lines. The results showed the following: (1) Testis tumour biopsies (16/16) unlike bladder (0/14) and head and neck (0/16) tumours showed positive staining for ALP, particularly the placental type, i.e. PLAP, although this was not always present on all the cells of non-seminoma biopsies. (2) The intensity of ALP expression differed widely in tumour cell lines. Based on biochemical analysis, the profile of ALP fell into two categories: (a) low expressing (MW 70 kD, placental type ALP) like Hep2 and KB lines, and (b) those expressing both low and high molecular (MW 95 kD) bands like testis lines Tera II and Ep2102. In all cases treatment of tumour cell lysates with heat prior to biochemical analysis showed the disappearance of the higher and sharpening of the lower molecular weight ALP band. (3) Exposure of tumour cells to epidermal growth factor (EGF) expressing EGF receptor led to a decreased ALP expression by as much as 54% as assessed by biochemical or flow-cytometric techniques. These data demonstrated that testis tumour tissues and cell lines expressed ALP which were different from others. The data also showed that exposure of tumour cell lines expressing EGFr to EGF resulted in suppression of ALP expression. These observations are consistent with the notion that EGFr and PLAP expression may be taken as a marker of proliferation and differentiation in human malignancies, respectively.
Outcome of Augmentation Sigmoidocystoplasty in Children with Neurogenic Bladder
Authors: Arikan Nihat , Türkölmez Kadir , Budak Mehmet , Gogus Orhan 
Published: April 2003

<i>Purpose:</i> The role of augmentation cystoplasty in the neuropathic bladder has been well determined since clean intermittent self-catheterization (CISC) has been accepted as a treatment modality in voiding dysfunction. We present our clinical experience with sigmoid augmentation cystoplasty in children with neurogenic bladder disorder. <i>Material and Methods:</i> From 1991 to 1997 sigmoid augmentation cystoplasty with modified clam technique was performed in 18 cases with neuropathic bladder pathologies. In 4 cases, ureteroneocystostomy was performed, 2 of whom were bilateral. Age range of these patients was 5–17 years (mean 10.3 years) and follow-up period was from 16 to 70 months (mean 41 months). <i>Results:</i> Pyuria was detected in 10 cases and 2 of them were symptomatic. Clinical acidosis was detected in only 1 case. Fifteen cases (83%) were continent by using CISC with 4–6 hourly and detrusor pressure lower than 30 cm water at maximal bladder capacity. <i>Conclusion:</i> In children with neurogenic bladder pathologies refractory to conservative management, augmentation cystoplasty with CISC is an effective treatment modality in protecting the upper urinary tract and preventing incontinence.
Heme Arginate Therapy forBeta Thalassemia:In vitro versus in vivo Effects
Authors: Rund Deborah , Fibach Eitan , Goldfarb Ada , Friedberg Aviva , Rachmilewitz Eliezer 
Published: April 2003

Hemin has a profound effect on erythroid cell maturation and promotes fetal hemoglobin synthesis in vitro. In β-thalassemia, increasing fetal hemoglobin levels can ameliorate the anemia. We administered heme arginate, a novel stable form of hemin, to 4 patients with thalassemia intermedia and studied the in vitro versus in vivo effects. In erythroid cultures, there was a marked rise in total hemoglobin and hemoglobin F. In vivo, 3 of 4 patients had a rise in hemoglobin levels (from 0.4 to 1.1 g%), which was statistically significant in 1 patient. There were no serious adverse effects. Heme arginate may be useful in the treatment of thalassemia intermedia.
Determination of Hematopoietic Stem Cells in Peripheral Blood by an Automated Hematology Analyzer (SE-9000)
Authors: Takekawa Katsuhiro , Yamane Takahisa , Hino Masayuki , Tatsumi Noriyuki 
Published: April 2003

We evaluated the usefulness of an automated hematology analyzer (SE-9000) for the identification and counting of peripheral blood stem cells (PBSCs). The samples tested were from 14 patients with hematological malignancies. Peripheral blood samples were collected from the subjects before and after a course of chemotherapy. From the leukapheresis sample, CD34+ cells, assumed to be hematopoietic stem cells, were obtained with an immunomagnetic cell separator. The CD34+ cells obtained accumulated in the gate corresponding to low recurrent frequencies of the automated hematology analyzer. This gate shows results of the ‘immature information’ (IMI) channel. Software for detection of only the cells that accumulated in this gate was therefore developed. With this trial program, the regression coefficient between the percentage of leukocytes from the blood samples that were CD34+ and the percentage of such leukocytes that appeared on the IMI channel was 0.79. With this analyzer, the number of PBSC could be counted in about 80 s. The identification and counting of cells picked up by the IMI channel should be clinically useful for the monitoring of changes in PBSC after chemotherapy for mobilization.
Some Aspects of Morphological and Dysplastic Changes of the Bone Marrow in Malignant Lymphoma
Authors: Jakovleva Kristina , Everaus Hele 
Published: April 2003

Cytological and histological study of the bone marrow of 33 patients with malignant lymphoma was performed to evaluate (1) the occurrence of secondary myelodysplastic changes, (2) the cell lines involved and (3) whether secondary myelodysplastic changes were similar or different for non-Hodgkin’s lymphoma (NHL) and Hodgkin’s disease (HD). Different changes in erythro-, granulo- and megakaryopoiesis were revealed. Granulo- and erythropoiesis were disturbed more frequently. Morphological changes of the erythroid series, megaloblastoid maturation of the nucleus and multinuclearity, were seen more often in NHL patients. Cells of the granulocytic series demonstrated different changes: hypogranulation and hypersegmentation in NHL, hypergranulation and Döhle’s bodies in HD. No remarkable dysplastic changes of megakaryopoiesis were demonstrated.
Response to Granulocyte Colony-Stimulating Factor in an Autoimmune Neutropenic Adult
Authors: Imoto Shion , Hashimoto Makoto , Miyamoto Mitsuko , Murayama Tohru , Murayama Mika , Nakamura Masanori , Matsui Toshimitsu , Chihara Kazuo , Ryo Ryukichi 
Published: April 2003

Clinical value of granulocyte colony-stimulating factor (G-CSF) for autoimmune neutropenia (AIN) has not been well established. We experienced an adult case of AIN which showed an excellent response to G-CSF. A 75-year-old female was admitted with high-grade fever. Her neutrophil count was remarkably low (neutrophil 0.09 × 10<sup>9</sup>/l). Antigranulocyte autoantibody was demonstrated in her serum by an immunofluorescence method and she was diagnosed as AIN. Administration of G-CSF (filgrastim 5 μg/kg) gave a rapid increase of neutrophils (from 0.11 × 10<sup>9</sup>/l to 2.10 × 10<sup>9</sup>/l on the second day), which has enabled us to preserve the use of G-CSF for emergency, that is, for overt serious infection.