bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and Safety of Weight-Adapted Nadroparin Calcium vs. Heparin Sodium in Prevention of Clinically Evident Thromboembolic Complications in 1,190 General Surgical Patients
Authors: Egger Bernhard , Schmid Stefan W. , Naef Markus , Wildi Stephan , Büchler Markus W. 
Published: April 2003

<i>Aims:</i> In a prospective, randomized, single, general surgery center trial, comparison of the safety and efficacy of two low molecular weight heparin (LMWH; anti-Xa heparin sodium and weight-adapted nadroparin calcium) regimens was made. <i>Patients and Methods:</i> Eleven hundred and ninety patients undergoing various elective and emergency operations were randomized to receive daily either a fixed dose of 3,000 IU anti-Xa heparin sodium or a variable body weight-dependent dose of nadroparin calcium (weight <50 kg, 2,050 IU anti-Xa (WHO); 51–80 kg, 3,075 UI; 81–100 kg, 4,100 UI, and >100 kg, 6,150 UI) once until discharge. The first injection was administered 2.5–6 h before elective and emergency operations, respectively. Patients with clinical suspicion of deep venous thrombosis (DVT) underwent phlebography. Patients with signs of pulmonary embolism (PE) were further investigated by a ventilation-perfusion scan. <i>Results:</i> Statistically, there were no significant differences in the incidence of clinically evident DVT, PE or LMWH-related complications between both prophylactic regimens. Only 4 of the total of 15 hemorrhagic complications (4 wound hematomas in the nadroparin calcium group) were not classified as clearly surgically related, Two DVTs were confirmed by phlebography (both in the nadroparin calcium group). PE was confirmed by ventilation-perfusion scans (1 fatal, 1 on autopsy) in 1 patient with heparin sodium and in 6 patients with nadroparin calcium. <i>Conclusions:</i> Both regimens were equally safe and the risk of clinically evident DVT and PE was similar.
Cost of Pelvic Floor Repair for Faecal Incontinence
Authors: Buttafuoco A. , Keighley M.R.B. 
Published: April 2003

<i>Background:</i> Pelvic floor repair is often unsuccessful for the treatment of incontinence. Some patients undergo repeated operations, and a few may require a stoma that can result in further operations. <i>Method:</i> We have examined the cost of two forms of pelvic floor repair: post-anal repair (PAR; n = 47) and total pelvic floor repair (TPFR; n = 32). <i>Results:</i> Persistent incontinence, which had an impact on the quality of life, occurred in 23 patients (29%); this was more common after PAR (21 patients; 45%) than after TPFR (2 patients; 6%), but the follow-up period was longer (9.7 years) after PAR than after TPFR (6.6 years), and incontinence tended to deteriorate with time. Twenty-two patients required repeat operations for incontinence (20 patients having 56 re-operations after PAR, and 2 patients who had repeated operation after TPFR). The average number of admissions was 1.92 (PAR 2.42, TPFR 1.18). The total number of operations was 141 (average 1.78), being greater after PAR (104; average 2.12) than after TPFR (37; average 1.15). The total hospital stay was 1,631 days; average 20.64, being longer following PAR (994 days; average 21.1) than after TPFR (637; average 19.9). The total hospital cost based on hospital stay, number of operations, operating time, complexity of surgery and out-patient visits was C∈ 294,216 (average C∈ 3,724), being higher after PAR (C∈ 190,062; average C∈ 4,043) as compared with TPFR (C∈ 104,154; average C∈ 3,254). The extra financial burden was largely borne by 9 individuals, all requiring a stoma, having repeated procedures (more than 2 operations) in whom the average cost was twice that of the index operation. <i>Conclusion:</i> We conclude that end-stage faecal incontinence is a huge burden on hospital budgets, since over time many patients require repeated operations.
Perception of Lateral Misarticulation and Its Physical Correlates
Authors: Akagi Masato , Suzuki Noriko , Hayashi Katsumi , Saito Hiroto , Michi Ken-ichi 
Published: April 2003

In order to clarify the relationship between perceptual diagnosis of lateral misarticulation (LM) by sophisticated listeners and the physical correlates of LM, three experiments using sustained speech /∫/ were conducted. Experiment 1 was designed to compare the spectral envelopes of normal speech (NS) /∫/ with those of LM /∫/. Experiment 2 was designed to collect the auditory impressions of sophisticated listeners listening to LM and NS /∫/ with specific spectral envelope bands replaced by LM. These two experiments showed that: (1) the spectral envelopes of LM are flat or decrease along the frequency axis in the frequency band above approximately 4 kHz, and there is a substantial peak at around 3.2 kHz in LM, which varies peculiarly with time; (2) the replacement of the spectral envelope between 2.5 and 4.5 kHz of NS with that of LM resulted in a remarkable increase in auditory impressions of LM. The facts suggest that the spectral envelope characteristic of LM has a peculiar variation at around 3.2 kHz. Additionally, experiment 3 estimated the spectrum of sustained speech /∫/ using vocal tract area functions. The results suggest that typical peaks of LM are related to the length and position of the vocal tract constriction region.
Diminished Reserve for Cerebral Vasomotor Response to <i>L</i>-Arginine in the Elderly: Evaluation by Transcranial Doppler Sonography
Authors: Okamoto Masaya , Etani Hideki , Yagita Yoshiki , Kinoshita Naokazu , Nukada Tada-atsu 
Published: April 2003

<i>Background:</i> Nitric oxide is pivotal in endothelially dependent vasodilatory regulation. An association of endothelial dysfunction with aging has been documented in the forearm and coronary vascular beds. However, the influence of aging in the human cerebral circulation, where regulation is particularly complex, is incompletely understood. <i>Objective:</i> We systematically administered <i>L-</i>arginine, a precursor of nitric oxide, to evaluate the influence of aging on nitric oxide-mediated cerebral vasomotor regulation. <i>Methods:</i> Among healthy volunteers, 20 older subjects (10 men, 10 women; age: 70.2 ± 2.8 years) and 22 younger subjects (10 men, 12 women; age: 28.8 ± 1.9 years) received intravenous infusions of <i>L</i>-arginine monochloride (500 mg/kg) over 30 min. Hemodynamic parameters were monitored continuously during and after infusion. The cerebral vasomotor response was estimated by transcranial Doppler sonography of the right middle cerebral artery. <i>Results:</i> Infusion of saline as a control brought little change in the mean blood pressure, heart rate or cerebral blood flow velocity in either group. On administration of <i>L</i>-arginine, cerebral blood flow velocity increased and mean blood pressure decreased. After completion of infusion, both parameters rapidly normalized. While reduction of mean blood pressure did not differ between older and younger groups, the cerebral circulation in the older group showed a blunted, smaller, and more easily saturated vasomotor response compared to the younger group, though both groups had similar baseline values. <i>Conclusion:</i> Our results indicate a diminished nitric oxide-mediated cerebral vasomotor response in aging subjects. Additionally, transcranial Doppler sonography can be used to reliably evaluate age-related changes in the physiologic responses of the human cerebral circulation.
Creatinine Clearance, Cockcroft-Gault Formula and Cystatin C: Estimators of True Glomerular Filtration Rate in the Elderly?
Authors: Burkhardt H. , Bojarsky G. , Gretz N. , Gladisch R. 
Published: April 2003

<i>Background:</i> The aim of this study was to assess the accuracy and precision of estimators of true glomerular filtration rate (GFR) (Cockcroft formula, measured creatinine clearance (CCR) and a cystatin-C-based estimation) in elderly patients attending a geriatric department. Additionally, parameters influencing GFR in the elderly were evaluated. <i>Methods:</i> 30 patients aged 57–90 years treated in the Geriatric Department for pulmonary or cerebral diseases were included in the study. Nine patients were diabetic and 16 hypertensive. Exclusion criteria were advanced dementia, acute heart failure and primary renal disease. Inulin clearance (CINU), CCR and estimation by Cockcroft-Gault equation (CG) were performed on the same day. For comparison of the methods an analysis according to Bland and Altman was used, depicting the mean difference between the methods and the limits of agreement of the differences, representing their 95% interval of confidence. Furthermore, the influence of confounding variables on GFR estimation was analyzed by multiple regression. <i>Results:</i> Baseline characteristics showed a median age of 74.5 years and a median body weight of 66.7 kg. Median values for serum creatinine 88.4 µmol/l, 5.74 mmol/l for urea and 1.57 mg/l for cystatin C. CCR (median: 51.6 ml/min) and CG (median: 63.0 ml/min) underestimated CINU (median: 83.3 ml/min). Both methods showed poor precision compared with CINU. The upper limit of agreement of the difference was 101.3 ml/min for CCR and 81.4 ml/min for CG, the lower limit was –33.8 ml/min for CCR and –24.6 ml/min for CG. Among frequently used variables to predict GFR, the reciprocal of serum creatinine and body weight revealed a significant influence but not age or gender. A cystatin-C-based estimation of GFR, derived from regression analysis, did not improve the precision of the estimation of GFR compared to CG. Additionally, the occurrence of diabetes mellitus disclosed a borderline influence on the estimation of GFR. <i>Conclusion:</i> CCR is not only inconvenient and time consuming, but also imprecise and inaccurate in the elderly, mainly due to reduced muscle mass and erroneous urine sampling. CG and a cystatin-C-based estimation are slightly more adequate, but overall there is no sufficiently precise formula for GFR estimation in the elderly.
Intrapartum Prediction of Macrosomia: Accuracy of Abdominal Circumference Estimation
Authors: Al-Inany Hesham , Alaa Nadin , Momtaz Mohamed , Abdel Badii Mona 
Published: April 2003

<i>Objective:</i> To evaluate the accuracy of abdominal circumference (AC) estimation of macrosomia early in labor and whether a cutoff value could be detected. <i>Design:</i> A prospective clinical trial. <i>Setting:</i> The Department of Obstetrics and Gynecology, Cairo University. <i>Participants:</i> One hundred pregnant females presenting in early labor with clinical impression of macrosomia were examined by ultrasound, and those babies with abdominal circumference more or equal to 35 cm were recruited for the study. <i>Interventions:</i> Every woman was considered as her own control, and fetal weight was calculated using the formula of Shepard et al. The accuracy of abdominal circumference in prediction of macrosomia was evaluated using the Receiver operating characteristic curve. <i>Results:</i> A cutoff value of AC ≧37 cm was found to have a sensitivity of 77%, a specificity of 75%, a positive likelihood ratio of 3.1 and a negative likelihood ratio of 0.3. <i>Conclusion:</i> Intrapartum ultrasonographic evaluation of abdominal circumference for suspected macrosomic babies in early labor is an easy, practical method that should be adopted in decision making.
Linkage Analysis of Alpha 1-Antitrypsin Deficiency: Lessons for Complex Diseases
Authors: Silverman Edwin K. , Mosley Jonathan D. , Rao D.C. , Palmer Lyle J. , Province Michael A. , Elston Robert C. , Weiss Scott T. , Campbell Edward J. 
Published: April 2003

<i>Objectives:</i> Severe alpha 1-antitrypsin (A1AT) deficiency is the one proven genetic risk factor for chronic obstructive pulmonary disease (COPD). Familial aggregation has been demonstrated for COPD among individuals who do not have A1AT deficiency, but linkage analysis of COPD has not been reported. To investigate the optimal phenotype definitions and analytical methods for the linkage analysis of COPD, we examined a set of 28 A1AT- deficient families containing 155 individuals. We have used the protease inhibitor (PI) type as a genetic marker rather than a disease gene, and we have performed linkage analysis between PI type and serum A1AT level and spirometry-related phenotypes. <i>Methods:</i> Linkage analysis was performed on the quantitative phenotypes forced expiratory volume at 1 s (FEV<sub>1</sub> as % predicted), the ratio of FEV<sub>1</sub> to forced vital capacity (FEV<sub>1</sub>/FVC as % predicted), and serum A1AT level using the variance component approach in SOLAR, the generalized estimating equation approach in RELPAL, and the model-based classical lod score method in LINKAGE. Linkage analysis with qualitative A1AT and spirometry phenotypes was performed using a model-based method (LINKAGE) and a model-free method (GENEHUNTER). Adjustments for smoking effects were investigated under each method. <i>Results:</i> All of the methods demonstrated linkage of PI type to serum A1AT level. Interestingly, however, the other quantitative phenotypes provided only weak evidence for linkage of PI type to lung disease. Better evidence for linkage of lung disease to PI type was found using a moderate or a mild threshold for the definition of airflow obstruction. <i>Conclusions:</i> For linkage analysis of spirometry phenotypes in A1AT deficiency, qualitative phenotypes provided stronger evidence for linkage than quantitative phenotypes. Possible contributors to the stronger evidence for linkage to qualitative spirometry phenotypes include the ascertainment scheme and the nonnormality of the pulmonary function data in PI Z subjects. This study provides guidelines for studies of the genetics of COPD unrelated to A1AT deficiency.
A Rapid and Simple Photometric Assay for Quantification of Eosinophil Chemotaxis
Authors: Nagase Hiroyuki , Yamaguchi Masao , Jibiki Sayaka , Yamada Hirokazu , Ohta Ken , Kawasaki Hiroshi , Yoshie Osamu , Yamamoto Kazuhiko , Morita Yutaka , Hirai Koichi 
Published: April 2003

Various methods have been devised to assay eosinophil chemotaxis. In this review, we introduced a rapid and sensitive eosinophil chemotactic assay system based on eosinophil peroxidase (EPO) determination. Eosinophils were semipurified by dextran sedimentation followed by Percoll gradient centrifugation. Eosinophil migration was measured by the Boyden blind-well chamber technique using a 96-well multiwell chamber and polycarbonate membrane filter. The number of migrated eosinophils was assessed by determination of the EPO activity of drop-off cells, and photometric measurement was performed with a microtiter plate reader. The contribution of neutrophil peroxidase to the assay is negligible, and the assay is sensitive enough to detect 200 eosinophils. The method is both less tedious and less laborious than conventional manual methods, and it allows a large number of samples to be analyzed within 4 h. When eosinophils were exposed to 15 chemokines and their migration was assayed using this method, we found that only CC chemokine receptor 3 ligands, such as eotaxin, induced significant eosinophil migration.
Autocrine Regulation of Eotaxin in Normal Human Bronchial Epithelial Cells
Authors: Saito Hiroshi , Shimizu Hisako , Akiyama Kazuo 
Published: April 2003

Normal human bronchial epithelial cells (NHBECs) spontaneously synthesize and store chemokines including eotaxin, RANTES, or MCP-3. We also observed the constitutive expression of mRNA specific for CC chemokine receptor-3 (CCR3) in these cells. The stimulation of these cells by eotaxin (1–100 ng/ml) dose-dependently increased eotaxin production. In addition, RANTES or eotaxin-2 but not MCP-3 at the higher concentrations (100 ng/ml), also induced slight eotaxin production. Eotaxin elicited the expression of eotaxin mRNA at 6 h after stimulation. Antibody against eotaxin or CCR3, and actinomycin D inhibited these effects of eotaxin. These antibodies also significantly inhibited the ability of eotaxin to produce further eotaxin. These findings strongly suggest that eotaxin which originates from inflammatory cells or cells resident in the airway of bronchial asthmatics can induce further production of eotaxin and participate in expansion of allergic inflammation.
Suppressive Effect of Topically Applied CX-659S, a Novel Diaminouracil Derivative, on the Contact Hypersensitivity Reaction in Various Animal Models
Authors: Goto Yuso , Inoue Yoshifumi , Tsuchiya Masami , Isobe Masakazu , Ueno Takamasa , Uchi Hiroshi , Furue Masutaka , Hayashi Hideya 
Published: April 2003

<i>Background:</i> The T-cell-mediated contact hypersensitivity reaction (CHR) is thought to be involved in the pathogenesis of clinical cutaneous disorders including atopic dermatitis. A novel diaminouracil derivative, CX-659S, has been reported to have an inhibitory activity against picryl chloride (PC)-induced CHR when administered either orally or percutaneously. The inhibitory effect of topical CX-659S was assessed in three CHR models in the present study. In addition, to elucidate the mechanism of action of this compound, we examined the effect of CX-659S on the expression of messenger RNAs for proinflammatory cytokines after elicitation in PC models. <i>Methods:</i> For the in vivo evaluation of the efficacy of CX-659S, we used PC- or oxazolone-induced CHR in mice and 2,4-dinitrochlorobenzene (DNCB)-induced CHR in guinea pigs. CX-659S was topically applied immediately after the hapten challenge in each model. To assess the effect on gene expression of cytokines, we used the reverse transcriptase-polymerase chain reaction (RT-PCR), a semiquantitative technique with specific primers. <i>Results:</i> Topical CX-659S dose-dependently inhibited ear swelling at 24 h after the challenge in the two mouse models. This inhibitory effect was histologically confirmed in the PC model. Topically applied CX-659S also inhibited erythema and edema formation 24 h after challenge in the guinea pig model. CX-659S inhibited the expression of mRNA for proinflammatory cytokines IL-1β and TNF-α in vivo. <i>Conclusions:</i> Topically applied CX-659S showed significant inhibitory activities against CHR models both in mice and in guinea pigs. Inhibition profiles of CX-659S toward mRNA expression for proinflammatory cytokines corroborated these findings. CX-659S thus could be a useful therapeutic agent for allergic cutaneous disorders such as allergic contact dermatitis and atopic dermatitis.
High-Level Expression in Mammalian Cells of Recombinant House Dust Mite Allergen ProDer p 1 with Optimized Codon Usage
Authors: Massaer Marc , Mazzu Pasqualina , Haumont Michèle , Magi Mauro , Daminet Véronique , Bollen Alex , Jacquet Alain 
Published: April 2003

<i>Background:</i> The major house dust mite allergen Der p 1 is associated with allergic diseases such as asthma. Production of recombinant Der p 1 was previously attempted, but with limited success. The present study describes the expression of recombinant (rec) ProDer p 1, a recombinant precursor form of Der p 1, in CHO cells. <i>Methods:</i> As optimization of the codon usage may allow successful overexpression of protein in mammalian cells, a synthetic gene encoding ProDer p 1 was designed on the basis of the codon usage frequently found in highly expressed human genes. Gene synthesis was accomplished from a set of 14 mutually priming overlapping oligonucleotides and after two runs of polymerase chain reaction. <i>Results:</i> COS cells transiently transfected with the synthetic ProDer p 1 gene produced up to 5–10 times as much ProDer p 1 compared with the expression level obtained after transfection with the authentic gene. To stably express the recombinant allergen, CHO-K1 cells were transfected with the ProDer p 1 synthetic gene, and one amplified recombinant clone produced up to 30 mg of recProDer p 1 per liter in the culture medium before purification. recProDer p 1 was secreted as an enzymatically inactive single-chain molecule presenting three glycosylated immunoreactive forms of 41, 38 and 36 kD. When examined with respect to direct binding, recProDer p 1 and natural Der p 1 displayed very similar IgE reactivities. However, IgE inhibition and histamine release assays showed a much higher reactivity to natural Der p 1 compared to recProDer p 1. <i>Conclusions:</i> These data indicated that codon optimization represents an attractive strategy for high-level production of allergen in mammalian cells.
Identification of a <i>Hevea brasiliensis</i> Latex Manganese Superoxide Dismutase (Hev b 10) as a Cross-Reactive Allergen
Authors: Wagner Stefan , Sowka Slawomir , Mayer Christina , Crameri Reto , Focke Margit , Kurup Viswanath P. , Scheiner Otto , Breiteneder Heimo 
Published: April 2003

<i>Background:</i> Cross-reactive allergens play an increasingly important role in latex allergy in complicating both the diagnosis and time course of allergic symptoms. Manganese superoxide dismutase (MnSOD), a ubiquitous protein of prokaryotic and eukaryotic organisms, was described as a cross-reactive allergen in <i>Aspergillus fumigatus</i>. Little information is available on the importance of this pan-allergen in <i>Hevea brasiliensis</i> latex. The aim of this study was to clone and express MnSOD from <i>H. brasiliensis</i> latex, and to obtain the soluble and immunologically active recombinant allergen for diagnosis of latex allergy and to investigate possible cross-reactivities with the structurally related <i>A. fumigatus</i> and human MnSODs. <i>Methods:</i> A complementary DNA coding for <i>Hevea</i> latex MnSOD was amplified by PCR. The recombinant protein was produced in <i>Escherichia coli</i> with an N-terminal hexahistidyl tag. Enzymatic activity of the recombinant protein was determined using an enzyme assay for SODs. IgE immunoblotting and IgE inhibition assays were performed to characterize the recombinant allergen and its cross-reactivity. <i>Results:</i> A <i>Hevea</i> latex MnSOD consisting of 206 amino acid residues was cloned and expressed in <i>E. coli</i>. The allergen was designated Hev b 10. The recombinant protein was enzymatically active, indicating the correct folding of the protein. In immunoblots, latex- as well as <i>A. fumigatus</i>-allergic patients revealed IgE binding to recombinant (r)Hev b 10. Cross-reactivity to Asp f 6, the MnSOD from <i>A. fumigatus</i>, and human MnSOD was determined by inhibition of IgE binding to these MnSODs by rHev b 10. <i>Conclusions:</i> Hev b 10 is a new cross-reactive allergen of <i>H. brasiliensis</i> which belongs to the ‘latex-mold’ group of latex allergens. Furthermore, it is a candidate for primary sensitization in patients allergic to the pan-allergen MnSOD.
Urticaria and Rhinitis to Shrubs of <i>Ficus benjamina</i> and Breadfruit in a Banana-Allergic Road Worker: Evidence for a Cross-Sensitization between Moracea, Banana and Latex
Authors: De Greef J.M. , Lieutier-Colas F. , Bessot J.C. , Vérot A. , Gallerand A.M. , Pauli G. , de Blay F. 
Published: April 2003

<i>Background:</i> We report the case of a road worker with a food allergy to banana, who developed urticaria and rhinitis when cutting shrubs of <i>Ficus benjamina</i> and breadfruit. He did not develop an allergy to latex of <i>Hevea brasiliensis.</i><i>Results:</i> Sensitization to latex of <i>F. benjamina, H. brasiliensis,</i> breadfruit and banana was demonstrated using skin tests and specific IgE measurements. RAST inhibitions procedures showed that specific IgE to breadfruit latex cross-reacted more strongly with latex of <i>H. brasiliensis</i> and banana than with latex of <i>F. benjamina</i> with the same extract. <i>Conclusion:</i> Given the wide distribution of Moracea trees in tropical regions, sensitization to latex of <i>H. brasiliensis</i> and banana could be a consequence of sensitization to Moracea members; <i>F. benjamina</i> does not seem to be the only Moracea responsible for cross-allergy with latex and fruit. Consequently, it seems interesting to test other members of the Moracea family in patients sensitized to latex of <i>H. brasiliensis</i> and banana. Sensitization to breadfruit could be a risk factor for sensitization to latex of <i>H. brasiliensis.</i>