bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pulmonary diffusion capacity in patients with systemic lupus erythematosus
Authors: NAKANO MASAAKI , HASEGAWA HISASHI , TAKADA TOSHINORI , ITO SATOSHI , MURAMATSU YOSHIYUKI , SATOH MAKOTO , SUZUKI EIICHI , GEJYO FUMITAKE 
Published: March 2003

Objective: The aim of this study was to clarify the characteristics of pulmonary function tests (PFT), especially carbon monoxide diffusion capacity (DLCO), and their correlation with clinical features and immunological findings in patients with systemic lupus erythematosus (SLE).Methodology: Vital capacity (VC) and DLCO were analysed retrospectively in 110 sequential Japanese SLE patients with active disease between 1985 and 1999. In 38 patients, serial measurements of PFT were also assessed during high‐dose corticosteroid therapy.Results: DLCO was reduced in 52 patients (47%) and a restrictive impairment of PFT was observed in nine patients (8%). The prevalence of pulmonary fibrosis was 13%. Reduced DLCO was frequently observed, even in patients with neither pulmonary fibrosis nor a restrictive pattern. No correlation between immunological data and reduced DLCO was found, except for the presence of anti‐RNP. Patients with Raynaud’s phenomenon showed a higher prevalence of DLCO impairment than those without this phenomenon. Although immunological parameters improved significantly after the corticosteroid therapy, no significant change in the level of DLCO was observed.Conclusions: Impairment of DLCO was frequently observed in patients with SLE who had no clinical respiratory abnormalities. DLCO impairments were correlated with Raynaud’s phenomenon clinically, and the presence of anti‐RNP immunologically. No significant correlation was found between impairment of DLCO and disease activity of SLE.
Chronic cough at a non‐teaching hospital: Are extrapulmonary causes overlooked?
Authors: AL‐MOBEIREEK ABDULLAH F. , AL‐SARHANI AWADH , AL‐AMRI SALEH , BAMGBOYE ELIJAH , AHMED SYED 
Published: March 2003

Objective: To estimate the prevalence, assess the diagnostic approach and to identify specific causes and treatment response of chronic persistent cough (CPC) in consecutive adult patients attending the chest clinic at a non‐teaching hospital in Riyadh, Saudi Arabia.Methodology: Chronic persistent cough was defined as cough persisting for more than 3 weeks. Patients were assessed clinically and investigated according to the suspected diagnosis. The specific causes were confirmed by appropriate investigations, as well as response to specific therapy. Improvement in cough following therapy was assessed subjectively by patients on a scale from 0 to 100%.Results: Of 1332 patients seen in the chest clinic, 136 (10.2%; 95% confidence interval 8.6–11.8%) presented with CPC as the main complaint. One hundred patients (55% males) were assessed, after excluding 36 patients who were lost to follow up. The common presenting diagnoses (for the 81 patients who had previously consulted a physician) were upper respiratory tract infection (17.1%), asthma (15.9%), bronchitis (9.8%) and unknown in 30.8% of patients. Final diagnoses (as a sole or contributory cause) were established in 96% of patients and included rhinosinusitis (RS; 60%), asthma (26%), gastro‐oesophageal reflux (GERD; 9%), postinfectious cough (8%) and bronchiectasis (5%). The agreement between the presenting and final diagnoses was generally poor, especially for extrapulmonary causes, which was as low as 5.3%. All patients, except for one, had complete or substantial improvement in the severity of cough.Conclusions: In a non‐teaching hospital setting, CPC is a common benign disorder that rarely requires specialized investigations and is easily treated once the causes are identified. The multiplicity of causes and extrapulmonary triggers of CPC, particularly RS, are often overlooked. The principal causes in our series remain the same as in studies elsewhere, namely RS, asthma and GERD.
Comparison between specified percentage and fifth percentile criteria for spirometry interpretation in Thai patients
Authors: DEJSOMRITRUTAI WANCHAI , WONGSURAKIAT PHUNSUP , CHIERAKUL NITIPATANA , CHAROENRATANAKUL SUCHAI , NANA ARTH , MARANETRA KHUN NANTA 
Published: March 2003

Objectives: The present study was conducted to determine the degree of agreement between the interpretation of spirometry using a specified percentage of predicted value (SPC) and the fifth percentile (FPC) as the cut off between normal and abnormal.Methodology: Spirometric values were collected for 1754 subjects attending the respiratory service at Siriraj Hospital between February 2000 and April 2001. These values included forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, maximal mid‐expiratory flow (FEF25–75%) and peak expiratory flow (PEF). A comparison of results between SPC and FPC was performed. The SPC cut‐off values for FVC, FEV1, FEV1/FVC, FEF25‐75% and PEF were 80% predicted, 80% predicted, 70%, 65% predicted and 80% predicted, respectively. The FPC cut‐off values were calculated from reference equations for the Thai population. Inter‐rater agreement was calculated as the kappa score.Results: High kappa scores were obtained for FVC (0.84), FEV1 (0.88) and FEF25–75% (0.80). However, poor agreement was found for FEV1/FVC (0.72) and PEF (0.61). When the cut‐off values for SPC were modified to 90% of predicted values for FEV1/FVC and to 65% of predicted values for PEF, agreement was substantially improved to 0.92 and 0.89, respectively.Conclusions: Interpretation by SPC using cut‐off values of 80% predicted for FVC and FEV1 and 65% predicted for FEF25–75% resulted in good agreement with FPC. However, the SPC cut‐off values for FEV1/FVC and PEF should be modified to 90% predicted and 65% predicted, respectively.
Pollination system and evolution of dioecy from distyly in Mussaenda parviflora (Rubiaceae)
Authors: Naiki Akiyo , Kato Makoto 
Published: March 2003

AbstractThe floral morphology and reproductive ecology of a scandent shrub species, Mussaenda parviflora Miq. (Rubiaceae), were studied on Iriomote and Amami Ohshima Islands, Japan. The morphological study demonstrated that M. parviflora was gynodioecious. Crossing experiments, however, revealed that it was functionally dioecious. The flowers were visited mainly by butterflies in the daytime and mainly by crepuscular hawkmoths in the evening. Dioecy in this species is thought to have evolved from distyly. Dioecy of this species, which is pollinated by long‐tongued Lepidoptera, is unusual as the evolution of dioecy from distyly in plants with long corolla tubes is thought to have been triggered by a pollinator shift from long‐ to short‐tongued insects. In this species, however, two floral morphological features may have caused the evolution. The first feature is the presence of many upward‐facing hairs covering the inner surface of the upper part of the corolla tube; these hairs appear to have impeded pollen flow from long‐ to short‐styled flowers. The second feature is the overlap in anther height between the two types of flowers, which may have reduced seed set by clogging stigma with incompatible pollen grains. Accordingly, male sterility in long‐styled plants may have evolved.
Ecological and evolutionary trends in wetlands: Evidence from seeds and seed banks in New South Wales, Australia and New Jersey, USA
Authors: Leck Mary A. , Brock Margaret A. 
Published: March 2003

AbstractAquatic plants include a variety of life forms and functional groups that are adapted to diverse wetland habitats. Both similarities and differences in seed and seed‐bank characteristics were discovered in comparisons of Australian (New South Wales) temporary upland wetlands with a North American (New Jersey) tidal freshwater marsh having both natural and constructed wetlands. In the former, flooding and drying are unpredictable and in the latter water levels vary diurnally and substrate is constantly moist. The hydrologic regimen provides the overriding selective force, with climate an important second factor. Other factors related to water level, such as oxygen availability, temperature and light, vary spatially and temporally, influencing germination processes, germination rates and seedling establishment. Seed and seed‐bank characteristics (size, desiccation and inundation tolerance, germination cues and seed‐bank longevity and depletion) differ, with the Australian temporary wetland being more similar to the small‐seeded persistent seed bank of the constructed wetland site than to the natural tidal freshwater site with its larger seeds, transient seed bank and seasonal spring germination. Some non‐spring germination can occur in the tidal constructed wetland if the soil is disturbed. In contrast, seeds in the temporary Australian wetlands germinated in response to wet/dry cycles rather than to season. Functional groups (e.g. submerged, amphibious) are more diverse in the Australian temporary wetlands, where all species tolerate drying. We suggest that the amphibious zone, with its hydrologic gradient, is the site of selection pressure determining establishment of wetland plants from seed. In this zone, multiple selective factors vary spatially and temporally.
Adaptive advantages of aerial seed banks
Authors: Lamont Byron B. , Enright N. J. 
Published: March 2003

AbstractProlonged storage of seeds on the plant is called serotiny. It is well represented in fire‐prone, nutrient‐poor and seasonally dry, woody vegetation in Australia, South Africa and North America. Serotiny maximizes the number of seeds available for the next generation by storing successive seed crops and protecting them from granivores, agents of decay and fire heat. It is an advantage when annual seed production is insufficient for self‐replacement in any single year and greatly increases the range of fire frequencies tolerated. While serotiny is a form of environmentally enforced dormancy, it has little in common with soil storage of seeds in terms of its ecology and trade‐offs. Our models have shown that optimal levels of serotiny depend on fire frequency in relation to lifespan of the species, probability of interfire recruitment and the extent of fluctuations in fire intervals. Serotiny is adaptive when the cue for seed release, usually fire, also creates superior conditions for seedling establishment. For serotiny to be an advantage over soil storage, it is essential that any fire is followed by reliable recruitment conditions. Intermediate levels of serotiny are favored as fire intervals approach the lifespan of the species, or if there is a substantial resource cost at short intervals. As the probability of interfire recruitment increases, maximum population growth shifts from strong serotiny under short fire intervals to no serotiny at long fire intervals. As variation about the mean fire interval increases, the optimal level of serotiny declines slightly.
Pollinator limitaton in a deceptive orchid, Pogonia japonica, on a floating peat mat
Authors: MATSUI KIYOSHI , USHIMARU TSUSHI , FUJITA NOBORU 
Published: March 2003

AbstractDeceptive orchid species that offer no floral rewards to pollinators often experience pollinator limitation because they. The breeding system and fruit set were investigated in order to examine pollinator limitation for a population of a deceptive orchid, Pogonia japonica, on a floating peat mat in Mizorogaike Pond, western Japan.

Fruit sets for outcross‐pollinated, self‐pollinated and pollinator‐excluded flowers

were 75%, 80%, and 0%, respectively. Thus, this species was

self‐compatible but neither autogamous nor apogamous. The fruit set for open‐pollinated

flowers was 22.9% and 17.4% in 1994 and 1995, suggesting that pollinator

limitation did occur in the field. Larger flowers were more likely to develop into

fruit than smaller ones in open pollination (36%vs 8%). Thus,

flower size seems to affect fruiting of this species. No effective visits by major

pollinators such as bees, which could carry pollinia, were observed during 16.5 h

of observation during daytime. Instead, thrips were often found moving on gynostemium

or pollinia and circumstantial evidence that suggests thrips may partly transfer

pollen in pieces out of a granular pollinium of P. japonica was obtained.

Pogonia japonica should come to use thrips as a pollinator to supplement low fruit set under limited flower visitation by major pollinators.
Delay of liver maturation as a cause of transient neonatal galactosemia
Authors: Ono Hiroaki , Mawatari Hideo , Mizoguchi Nobuyuki , Eguchi Takaatsu , Sakura Nobuo , Hamakawa Mochiyuki 
Published: March 2003

Abstract Background: Because a large amount of serum α‐fetoprotein (α‐FP) is synthesized in the liver of the fetus or premature newborn, high concentrations or delayed degradation of serum α‐FP during the neonatal period may reflect hepatic immaturity.
Methods
: In order to evaluate the relationship between transient neonatal galactosemia and delay of liver maturation, the concentration and half‐life of serum α‐FP during the neonatal period were measured in patients with transient galactosemia and in normal neonates.
Results
: No significant differences were observed in the serum concentration of α‐FP between normal and galactosemic patients less than 1 month of age. However, the half‐life of serum α‐FP was significantly longer in galactosemic patients between 15 and 60 days of age compared with age‐matched normal neonates.
Conclusion
: Based on these results, we hypothesize that delay of liver maturation during the neonatal period, especially during the first 2 months after birth, can be a cause of transient neonatal galactosemia.
Preperitoneal fat thickness in childhood obesity: Association with serum insulin concentration
Authors: Tamura Akiho , Mori Tetsuo , Hara Yoji , Komiyama Atsushi 
Published: March 2003

Abstract

Background
: The clinical significance of visceral fat accumulation in childhood obesity has remained controversial.
Methods
: In 35 subjects (18 boys and 17 girls) aged 9–15 years, visceral and subcutaneous fat were estimated by measuring the maximum thickness of preperitoneal fat (Pmax) and the minimum thickness of subcutaneous fat (Smin) in the upper median abdomen, respectively, by ultrasonography. The associations with fasting serum insulin levels converted to logarithm (log(IRI)) were studied for six obesity‐related indices, including the obesity index, body fat percentage, waist‐to‐hip circumference ratio (WHR), Pmax, Smin and the ratio of Pmax to Smin (abdominal wall fat index, AFI).
Results
: In girls, the log(IRI) was positively correlated with the Pmax, obesity index, body fat percentage and Smin. In contrast, the log(IRI) was positively correlated only with the Pmax and Smin in boys. There were no significant correlations between the log(IRI) and the WHR or AFI in either sex. The Pmax revealed the highest correlation with the log(IRI) in both boys (r=0.703, P<0.001) and girls (r=0.921, P<0.0001).
Conclusion
: These results indicate the important contribution of visceral fat accumulation to the development of hyperinsulinemia, regardless of sex. Accordingly, it is suggested that evaluating Pmax by ultrasonography may be the most sensitive and reliable method of predicting insulin resistance‐associated metabolic derangements in children, compared with other conventional indices of obesity.
Nasopharyngeal colonization with penicillin‐resistant Streptococcus pneumoniae in Turkish children
Authors: Çiftçi Ergin , Doğru Ülker , Aysev Derya , Ince Erdal , Güriz Haluk 
Published: March 2003

Abstract Background: Streptococcus pneumoniae is one of the major infectious agents observed in children. In spite of the fact that penicillin is preferred in the treatment of infections caused by S. pneumoniae, there has been a world‐wide increase in the frequency of penicillin‐resistant S. pneumoniae.
Methods
: One hundred and fifty sick children with a clinical diagnosis of pneumonia, meningitis, acute otitis media, acute sinusitis and septicemia or bacteremia, and 150 healthy children without any infection were examined. Streptococcus pneumoniae, which were isolated from the nasopharynx, were analyzed with respect to penicillin susceptibility using the agar dilution method.
Results
: The S. pneumoniae carriage rate was observed to be 43.3% in the group of sick children and 30.0% in the control group (P<0.05). The penicillin resistance of S. pneumoniae isolated from the nasopharynx was determined to be 35.4% from a total of 110 isolates, with an intermediate resistance of 32.7% and a high resistance of 2.7%. The penicillin resistance of S. pneumoniae carried in the nasopharynx was determined to be 41.5% in the group of sick children and 26.6% in the control group (P>0.05). Resistance rates of other antibiotics were determined as follows: cefotaxime 2.7%, erythromycin 19%, clarithromycin 5.4%, tetracycline 21.8%, trimethoprim–sulfamethoxazole 4.5% and rifampin 0%.
Conclusions
: Penicillin resistance of S. pneumoniae has recently become a problem in Turkey. Because of this, we require new strategies to limit the spread of drug‐resistant S. pneumoniae.
Case‐control study of perinatal factors and hepatoblastoma in children with an extremely low birthweight
Authors: Maruyama Kenichi , Ikeda Hitoshi , Koizumi Takenobu , Tsuchida Yoshiaki , Tanimura Masako , Nishida Hiroshi , Takahashi Naoto , Fujimura Masanori , Tokunaga Yasuyuki 
Published: March 2003

Abstract Background: There is a significant association between hepatoblastoma and low birthweight. A case‐control study was conducted to reveal risk factors for hepatoblastoma in children of extremely low birthweight (<1000 g).
Methods
: Prenatal and postnatal histories, including parental histories, of 12 hepatoblastoma cases and 75 birthweight‐matched controls were compared.
Results
: The gestational age of the hepatoblastoma cases (23–32 weeks; median 25 weeks), tended to be lower than that of the controls (23–36 weeks; median, 27 weeks; P=0.072). The time for an infant’s bodyweight to return to the same level as the birthweight also tended to be longer in hepatoblastoma cases than in controls (P=0.055). All hepatoblastoma cases received oxygen therapy for a period of 4–508 days (median 114 days), which was significantly longer than the 0–366 days (median 62 days) in the controls (P=0.022). Furosemide was given to all hepatoblastoma cases and was used for a significantly longer period in these infants (6–460 days; median 89 days) than in the controls (0–241 days; median 44 days P=0.027). A univariate Cox regression demonstrated that the time taken to regain bodyweight at birth and the duration of both oxygen therapy and furosemide treatment were significantly associated with the development of hepatoblastoma (hazard ratio (HR)=1.044, P=0.013; HR=1.006, P=0.001; and HR=1.007, P=0.001, respectively). Although there were significant correlations between the factors, a multivariate Cox regression analysis identified the duration of oxygen therapy as a significant independent risk factor (HR=1.006, P=0.001).
Conclusions
: Oxygen therapy and furosemide treatment, along with the rate of growth, are risk factors for the development of hepatoblastoma in children of extremely low birthweight, and the duration of oxygen therapy is the most important factor in predicting the development of hepatoblastoma. Further studies are necessary to determine the real reasons for the development of hepatoblastoma and to protect children of low birthweight from the development of cancer.
Safety and immunogenicity of live attenuated varicella vaccine in 9‐month‐old children
Authors: Kanra Güler , Ceyhan Mehmet , Özmert Elif 
Published: March 2003

Background
: The present study was conducted to evaluate the safety and immunogenicity of live attenuated varicella vaccine (Oka‐strain) in 9‐month‐old infants.
Methods
: One hundred and fourteen infants were vaccinated once with live attenuated varicella vaccine (Valrix®; SmithKline Beecham Biologicals, Rixensart, Belgium) containing a mean virus titer of 104.0 plaque‐forming units (p.f.u.) per dose. Signs and/or symptoms after vaccination were followed for 42 days. Home visits were made to detect solicited local reactions (0–3 days) and solicited general reactions (0–21 days), as well as unsolicited reactions. Specific varicella antibodies were determined by an indirect immunofluorescence method. The geometric mean titer and seroconversion rate were calculated.
Results
: Signs and/or symptoms were reported in 47.4% (54/114) of cases following vaccination. The only local symptom reported was pain on digital pressure at the injection site and this was reported in 28.1% (32/114) of infants. General symptoms were reported in 38.6% (44/114) of cases. The most frequently reported findings were fever (27.2%), which was mostly mild, restlessness (20.2%) and cough (11.4%). Only four unsolicited symptoms were reported and they were all unrelated to vaccination. No serious adverse event was reported. Of the 109 infants included in the immunogenicity analysis, 105 were seronegative and four were seropositive for antibodies against varicella before vaccination. The vaccine elicited seroconversion in 97.1% of initially seronegative cases. The post‐vaccination geometric mean titer for these infants was 30.9 geometric mean titer (GMT).
Conclusions
: The vaccine was found to be safe and immunogenic when given to infants as young as 9 months of age. This may be of clinical significance during outbreaks of varicella and especially for developing countries.
Ventricular energetics in Fontan circulation: Evaluation with a theoretical model
Authors: Nogaki Mio , Senzaki Hideaki , Masutani Satoshi , Kobayashi Jun , Kobayashi Toshiki , Sasaki Nozomu , Asano Haruhiko , Kyo Shunei , Yokote Yuji 
Published: March 2003

Abstract

Background
: Both pulmonary and systemic circulation must be maintained by a single pump in Fontan circulation. This unique property of Fontan circulation may be related to decreased exercise tolerance or increased instantaneous postoperative mortality rate, often observed in patients with this circulation. To better understand Fontan physiology, the present study theoretically investigated cardiac performance of Fontan circulation by using ventricular–vascular coupling framework analysis.
Methods
: End‐systolic volume elastance (Ees), as a chamber contractile property, and effective arterial elastance (Ea), a lumped measure of ventricular afterload, were estimated both in normal left ventricular systemic circulation and in Fontan circulation.
Results
: End‐systolic volume elastance was decreased and Ea was increased in Fontan circulation. Both ventricular external stroke work (SW) and mechanical efficiency (EFF) under Fontan circulation were lower compared with those under normal circulation. Furthermore, the Ees–Ea relationship in Fontan circulation predicted limited cardiac reserve in terms of SW and EFF. Such cardiac performance in Fontan circulation stemmed from increased impedance due to the additional connection of the pulmonary vascular bed to the systemic vasculature and from the lack of a compensatory increase in contractility for increased afterload.
Conclusions
: Thus, it was inferred that Fontan circulation had intrinsic disadvantages and this may explain, in part, abnormal functional status and decline in survival following this procedure.