bluuebunny/crossref_metadata_2025_split huggingface dataset:
Submicroscopy and stable isotope geochemistry of carbonates and associated palygorskite in Iranian Aridisols
Authors: Khademi H. , Mermut A. R. 
Published: November 2003

SummaryPedogenic carbonates in arid and semi‐arid regions of the world have a great significance as palaeoecological and palaeoclimatological indicators and form a major pool in the carbon cycle. We analysed the ultra‐microfabric and the stable isotope composition of C and O in pedogenic carbonates in colluvial soils derived from limestone in an arid region of central Iran. Our objective was to determine the conditions for the formation of soft pedogenic carbonate nodules and their co‐existence with palygorskite in the palaeo‐argillic horizon. Scanning electron microscopy revealed that the calcite aggregates were matted with palygorskite. Ultra‐microtome cuts, examined using transmission electron microscopy, provided more detailed information about the fundamental particle association of secondary carbonates and palygorskite. Although less abundant, other silicate clays were detected in both the acid‐insoluble clay fractions and in ultra‐cuts, mostly in fine clay size, suggesting the engulfing of palygorskite by growing calcite or illuviation of palygorskite during or after formation of the calcite. Coatings of illuvial clays on calcite crystals support the hypothesis that palygorskite was trapped by pedogenic carbonate when the climate was wetter than it is today to form an argillic horizon. However, electron microscopic evidence of the occurrence of fibres on the immediate pedogenic carbonate particle surfaces suggests the in situ formation of palygorskite. The δ13C and δ18O values of pedogenic carbonates suggest that these carbonates were formed in an environment with more available moisture and more C4 plants than now.
Long‐term outcome of kidney transplant using non‐heart‐beating donor: multicenter analysis of factors affecting graft survival
Authors: Hattori Ryohei , Ono Yoshinari , Yoshimura Norio , Hoshinaga Kiyotaka , Nishioka Tsukasa , Ishibashi Michio , Ohshima Shinichi 
Published: November 2003

Abstract: This multicenter study was retrospectively evaluated for the predictive factors affecting the long‐term graft survival of a kidney transplant from a non‐heart‐beating donor (NHBD).Patients and method: A total of 706 patients received transplants from NHBD in 11 centers between 1986 and 2000 and the results were entered into the analysis. The patients were treated with cyclosporine‐ or tacrolimus‐based immunosuppressive therapy. Graft survival was calculated by the Kaplan–Meier method. Factors selected for univariate analysis were donor age, and acute early and acute late rejection. Hypertension (HT), hyperlipidemia (HL), and diabetes mellitus were also analyzed in 638 recipients whose graft survived for more than 1 yr.Results: In the cases using NHBD, graft survival for 1, 5, and 10 yr was 87, 69, and 53%, respectively. Donor age of over 55 yr, acute early and late rejection, post‐transplant HT and diabetes at the first post‐operative year were shown to be significantly harmful on long‐term graft survival. For longer graft survival in NHBD kidney transplantations, reducing acute rejection, and controlling blood pressure and sugar are crucial.
Endothelial function is more impaired in hemodialysis patients than renal transplant recipients
Authors: Oflaz Huseyin , Pusuroglu Hamdi , Genchallac Hakan , Demirel Seref , Bugra Zehra , Sever Mehmet S , Yildiz Alaattin 
Published: November 2003

Abstract: Background: Endothelial dysfunction (ED) is a common precursor and denominator of cardiovascular events including development of atherosclerosis. In this cross‐sectional, controlled study, we aimed to investigate ED measured by ischemia‐induced forearm vasodilatation in chronic hemodialysis (HD) patients and renal transplant recipients (rTX).Patients and methods: Thirty‐nine HD patients, 39 rTX and 38 normotensive healthy controls were included. There was no difference in age and gender distribution among the study groups. The mean time spent on dialysis and transplantation were 74 ± 46 and 68 ± 39 months. Serum high sensitive C‐reactive protein (hs‐CRP) and plasma fibrinogen levels were measured. Endothelium dependent post‐ischemic vasodilatation of brachial artery was used to evaluate ED.Results: The hs‐CRP and plasma fibrinogen levels were significantly increased in HD patients when compared with rTX. On high resolution ultrasonographic examination, post‐ischemic vasodilatation values in HD patients (9.55 ± 6.47%) were significantly lower than rTX (14.39 ± 8.06%, p = 0.007) and controls (20.42 ± 6.10%, p < 0.001). Renal transplant recipients also had significantly lower post‐ischemic vasodilatation values than controls (p = 0.001). The hs‐CRP levels were negatively correlated with endothelium‐dependent dilatations in TX (r = −0.59, p = 0.001), however, this correlation was not detected in HDp.Conclusion: Patients with end‐stage renal disease have ED. Endothelial function is more impaired in HD patients than rTX. Different mechanisms might be responsible for ED in HD patients and rTX.
Hypoglycaemia after pancreas transplantation: usefulness of a continuous glucose monitoring system
Authors: Esmatjes Enric , Flores Lilliam , Vidal Merce , Rodriguez Lucia , Cortés Antoni , Almirall Lourdes , Ricart Maria J , Gomis Ramón 
Published: November 2003

Abstract:Background:After pancreas transplantation (PTx) some patients report occasional symptoms of hypoglycaemia and at times, serious hypoglycaemia. Continuous blood glucose monitoring (CBGM) allows determination of the daily glucose profile and detection of unrecognized hypoglycaemia. The aims of our study were to determine the incidence of hypoglycaemia in PTx and evaluate whether the use of CBGM helps to detect unrecognized nocturnal hypoglycaemia.Patients and methods:We studied 12 patients (six males) with normal functioning PTx and kidney transplantation for more than 3 yr, with systemic drainage of endocrine secretion and stable immunosuppression. A 24‐h CBGM using a microdialysis technique (GlucoDay, A. Menarini Diagnostics, Florence, Italy) was performed in all the patients.Results:Three patients had asymptomatic recorded glucose levels below 3.3 nmol/L during the nocturnal period (01:00–07:00 hours) with the glucose levels during these episodes being 2.6, 2.5 and 2.5 nmol/L, and the duration of nocturnal hypoglycaemia being 27, 62 and 93 min, respectively, rising spontaneously without intervention. Patients with hypoglycaemia presented lower glycosylated haemoglobin levels when compared with those not presenting hypoglycaemic episodes, although basal glucose and insulin levels and insulin antibody titres were similar. In one of the three patients presenting hypoglycaemia CBGM was re‐evaluated after including an extra snack at bedtime, with subsequent normalization of the blood glucose profile being observed.Conclusion:Unrecognized nocturnal hypoglycaemia is relatively frequent in patients with PTx and 24‐h CBMG may be useful to detect these episodes.
Elevated urinary 8‐hydroxydeoxyguanosine, a biomarker of oxidative stress, and lack of association with antioxidant vitamins in chronic obstructive pulmonary disease
Authors: IGISHI Tadashi , HITSUDA Yutaka , KATO Kazuhiro , SAKO Takanori , BURIOKA Naoto , YASUDA Kazuhito , SANO Hiroyuki , SHIGEOKA Yasushi , NAKANISHI Hirofumi , SHIMIZU Eiji 
Published: November 2003

Objective:  The purpose of this study was to investigate whether patients with COPD are under oxidative stress and to elucidate the relationship between the level of oxidative stress and antioxidant vitamins.Methodology:  Nineteen male patients with COPD and 13 age‐ matched male control subjects were studied. Urinary 8‐hydroxydeoxyguanosine (8‐OHdG) concentrations were determined using an enzyme‐linked immunosorbent assay kit and corrected for creatinine concentrations. Serum levels of vitamin C, α‐tocopherol, and β‐carotene were determined by high performance liquid chromatography.Results:  The median (interquartile range) 8‐OHdG excretion was 8.1 ng/mg (5.3–10.9 ng/mg) in control subjects and 12.2 ng/mg (9.8–15.5 ng/mg) in COPD patients (P < 0.01). Urinary 8‐OHdG levels were significantly elevated in ex‐smokers in the COPD group compared with ex‐smokers in the control group. Urinary 8‐OHdG level was negatively correlated with FVC (r = −0.42, P = 0.016), FEV1 (r = −0.49, P = 0.0048), and oxygen tension in arterial blood (r = −0.41, P = 0.0005). No significant differences in antioxidant levels were demonstrated between the two groups. There were no significant correlations between urinary 8‐OHdG excretion and the serum concentrations of antioxidant vitamins.Conclusion:  The burden of oxidative stress was observed to increase in COPD patients as judged by urinary 8‐OHdG. A depletion of antioxidant vitamins in serum was not essential for this phenomenon. Elevated urinary 8‐OHdG level may not be attributable to smoking status or to antioxidant vitamins in COPD.
Effects of IL‐1β, TNF‐α, and macrophage migration inhibitory factor on prostacyclin synthesis in rat pulmonary artery smooth muscle cells
Authors: ITOH Akihide , NISHIHIRA Jun , MAKITA Hironi , MIYAMOTO Kenji , YAMAGUCHI Etsuro , NISHIMURA Masaharu 
Published: November 2003

Objective:  Cytokines have been implicated in the pathophysiology of pulmonary hypertension. We sought to explore the possibility that prostacyclin is a link.Methodology:  We tested the effects of the cytokines interleukin‐1β (IL‐1β), tumour necrosis factor‐α (TNF‐α), and macrophage migration inhibitory factor (MIF) on arachidonic acid metabolism of pulmonary artery smooth muscle cells (PASMCs) with special regard to prostacyclin (PGI2) that protects against pulmonary hypertension. Cultured rat PASMCs were treated with IL‐1β, TNF‐α, or MIF. Expression of prostacyclin synthase (PGIS) and cyclooxygenase‐2 (COX‐2) mRNAs, and PGI2 synthesis, were measured.Results:  We found that PGIS mRNA expression was suppressed by high concentrations of TNF‐α and MIF, while COX‐2 mRNA was induced by all three cytokines tested. IL‐1β increased PGI2 production in a dose‐dependent manner. TNF‐α and MIF also increased PGI2 production, but to a far lesser degree at high concentrations. TNF‐α paradoxically decreased PGI2 production at a low concentration.Conclusions:  These results suggest that TNF‐α and MIF are potentially antagonistic to the action of PGI2 in rat PASMCs via down‐regulation of PGIS mRNA. Simultaneous induction of COX‐2 mRNA may further counteract the action of PGI2 by increasing the levels of eicosanoids other than PGI2.
Increased macrophage inflammatory protein‐1α and ‐1β in BAL fluid of bronchiolitis obliterans organizing pneumonia
Authors: ASANO Toru , OGUSHI Fumitaka , TANI Kenji , TAMIYA Hiroyuki , NISHIOKA Yasuhiko , SONE Saburo 
Published: November 2003

Objective:  CC chemokines are mainly chemotactic for monocytes and lymphocytes. The aim of this study was to evaluate the involvement of the CC chemokines, macrophage inflammatory protein (MIP)‐1α and MIP‐1β, in the pathogenesis of bronchiolitis obliterans organizing pneumonia (BOOP).Methodology:  The concentrations of MIP‐1α and MIP‐1β in BAL fluid (BALF) obtained from patients with BOOP (n = 13) and control patients (CP, n= 18) were measured by enzyme‐linked immunosorbent assay.Results:  MIP‐1α in BALF was significantly higher in patients with BOOP (mean ± SD; 123.8 ± 98.0 pg/mL) than in CP (62.5 ± 46.1 pg/mL). Significantly higher MIP‐1β was also detected in patients with BOOP (51.6 ± 72.5 pg/mL) than in CP (6.4 ± 3.7 pg/mL). The concentration of MIP‐1α significantly correlated with the percentage of lymphocytes in BALF, and the concentration of MIP‐1β significantly correlated with the numbers of lymphocytes, neutrophils and eosinophils in BALF. Both MIP‐1α and MIP‐1β in BALF were decreased after corticosteroid therapy and this was accompanied by decreased lymphocytes in BALF.Conclusion:  This study suggests that MIP‐1α and MIP‐1β may play important roles in the recruitment of immuno‐inflammatory cells into the lungs, and may contribute to the pathogenesis of BOOP.
Underdiagnosis and undertreatment of COPD in primary care settings
Authors: TAKAHASHI Tsuneyuki , ICHINOSE Masakazu , INOUE Hiroshi , SHIRATO Kunio , HATTORI Toshio , TAKISHIMA Tamotsu 
Published: November 2003

Objective:  The aim of this study was to improve the detection of COPD in a primary care setting and to evaluate the subsequent management of these patients by general practitioners.Methodology:  A two‐step protocol was followed: patients were screened for airway obstruction and their subsequent management status reviewed. Screening spirometry was performed in 56 primary care settings (23 hospitals and 33 general practices). Inclusion criteria for screening subjects were: (i) ≥40‐year‐old smokers (both current and past smokers) and/or (ii) ≥40‐year‐old patients with respiratory symptoms of chronic cough and sputum. Patients with a previously diagnosed respiratory disease were excluded. In the second part of the study, the diagnosis and the subsequent management status of subjects with airway obstructive changes (FEV1/FVC <70%) were sought from their physician using a questionnaire 2 months after detection.Results:  A total of 1168 patients were screened, with 128 not analysed because of incomplete data, leaving 1040 patients. The percentages of current smokers, ex‐smokers, and non‐smokers among all analysed subjects were 41.7%, 29.8% and 28.5%, respectively. Airway obstructive changes (FEV1/FVC <70%) were found in 27.0% (n = 281) of all analysed subjects. Questionnaires for 194 subjects (with positive screening tests) were sent back by the participating physicians. Eighty‐one per cent (n = 158) of the 194 subjects had COPD and 13.4% (n = 26) had asthma. Sixty‐one per cent (n = 96) of the subjects with moderate to severe COPD according to international guidelines (FEV1 <80% predicted). However, 31.3% (n = 30) did not receive any clinical intervention (smoking cessation advice and/or drug administration).Conclusions:  Screening spirometry in outpatients in a primary care setting can identify many COPD patients. However, COPD management appears to be poor in Japan.
Assessing the impact of abstracts from the Thoracic Society of Australia and New Zealand in Cochrane reviews
Authors: HOPEWELL Sally 
Published: November 2003

Objective:  The aim of this study was to assess the potential impact of including trials, reported in conference abstracts from the Thoracic Society of Australia and New Zealand, in Cochrane reviews.Methodology:  Abstracts from the Thoracic Society of Australia and New Zealand, published in the Australian and New Zealand Journal of Medicine (1981–1998), were read to identify all reports of randomized trials. A search was carried out of the Cochrane Database of Systematic Reviews (Issue 1, 2002) for each trial reported in a conference abstract to try to identify Cochrane reviews in which the conference abstract might be eligible for inclusion. If it was unclear, the authors of the review were contacted.Results:  A total of 187 reports of randomized trials were identified: 101 (54%) had been published as a full report and 86 (46%) remained unpublished. Thirty‐four (72%) were reports of randomized controlled trials and 52 (28%) were quasi‐randomized or possibly randomized trials. The total number of patients included in the trials was 9691; range 4–1203 (median 20; IQR 11–47). No possible Cochrane review was found for 145 of the 187 trials reported in the conference abstracts. Possible reviews were identified for 42 trials, 24 of which were already mentioned in Cochrane reviews. For the remaining 18 trials, only three were said to be eligible for inclusion.Conclusion:  A search of conference abstracts identified a number of reports of randomized trials, potentially eligible for inclusion in reviews of health care. However, the majority of trials were not relevant for inclusion in an existing Cochrane review. This is most likely because there are currently too few reviews to deal with the topics covered in the abstracts.
Pilot study of the safety and effect of intranasal delipidated acid‐treated Mycobacterium vaccae in adult asthma
Authors: SHIRTCLIFFE Philippa M. , GOLDKORN Alexandra , WEATHERALL Mark , TAN Paul L. J. , BEASLEY Richard 
Published: November 2003

Objective:  There is epidemiological and experimental evidence that exposure to mycobacteria has the potential to suppress the development of atopy and/or asthma. Delipidated, deglycolipidated and arabinogalactan‐depleted autoclaved Mycobacterium vaccae (delipidated acid‐treated M. vaccae) has been shown to suppress allergen‐induced airway eosinophilia in mice.Methodology:  Thirty‐seven adults with stable moderately severe asthma who were skin prick test‐positive to house dust mite were randomized to receive two doses 2 weeks apart of delipidated acid‐treated M. vaccae (first dose 0.4 mg and second dose 0.8 mg) or phosphate buffered saline, given as drops intranasally. Safety, tolerability and markers of asthma severity (including peak flow, FEV1, major and minor exacerbations, symptom scores and beta‐agonist use), and nasal symptom scores, blood eosinophil and IgE levels were monitored for 8 weeks.Results:  Delipidated acid‐treated M. vaccae was safe and well tolerated although there was an occasional mild local reaction. There were no statistically significant differences between the treatment group and placebo for any of the outcome variables.Conclusions:  There is a requirement to elucidate the reasons why mycobacterial‐based vaccines have not shown equivalent efficacy in human trials compared with animal models. The role of factors such as duration of disease, route of administration and the active component of mycobacteria need to be addressed.
Effect of ascorbic acid on airway responsiveness in ovalbumin sensitized guinea pigs
Authors: BOSKABADY Mohammad Hossein , ZIAEI Toctam 
Published: November 2003

Objective:  The most important pathological feature of asthma is airway inflammation, which results in airway hyper‐responsiveness. We hypothesized that excessive oxidation is likely to contribute to airway inflammation in asthma. The aim of this study was to evaluate the effects of both acute exposure and a 30‐day administration of ascorbic acid (AA), which has an antioxidant effect, on airway responsiveness in sensitized guinea pigs.Methodology:  Guinea pigs sensitized to ovalbumin (OA), were given drinking water without AA (group 2) or with AA (group 3). The responses of tracheal chains of control animals (group 1) and both groups of sensitized guinea pigs (n = 10, for all groups) to cumulative concentrations of methacholine were measured, and the effective concentrations of methacholine causing 50% of maximum response (EC50 M) were obtained. The response of tracheal chains to 0.1% OA, relative to contraction obtained with 10 µmol/L methacholine, was also measured. The tracheal responses to methacholine and OA were measured on tissues both incubated and not incubated with AA.Results:  The tracheal responses of group 2 tissues were significantly greater than those of groups 1 and 3 to both OA and methacholine (P < 0.05). There were no significant differences in tracheal responses to OA and methacholine between groups 1 and 3. Acute incubation of tissues caused a reduction of tracheal response to methacholine in all groups, but this was only significantly differ‐ent for group 3 (P < 0.05). Acute incubation of tissues did not change tracheal response to OA significantly.Conclusion:  These results showed that although short‐term administration of AA had no major effect on tracheal responsiveness among sensitized animals, 30‐day administration of AA could lead to a decrease in airway responsiveness of sensitized guinea pigs to both OA and methacholine.
Examination of expandable metallic stent removed at autopsy
Authors: HOSOKAWA Yoshifumi , TSUJINO Ichiro , SYODA Toshiaki , HORIKOSHI Akira , SAWADA Shigemasa 
Published: November 2003

Objective:  We evaluated the damage to expandable metallic stents (EMS) based upon analysis of EMS removed at autopsy.Methodology:  Seventeen EMS were obtained during autopsy from the main bronchi of nine patients with lung cancer. Each EMS was categorized into one of the following three groups, according to the degree of EMS damage: no damage at all (ND), damage to part of the EMS (PD), and marked damage (MD) that caused loss of function of the airway stent. The removed EMS were examined using a scanning electron microscope.Results:  Of the 17 stents, ND occurred in 13 (7/9 primary, 6/8 secondary), PD in four (all secondary), and MD in none. None of the stents had completely lost the ability to function as an airway stent. Bacterial biofilm formation (BBF) was detected on EMS from four patients.Conclusions:  Bacterial biofilm forms on EMS implanted into the airway. Some physical damage was present in four of 17 EMS, but all remained functional.
Use of the laryngeal mask airway during repair of atrial septal defect in children
Authors: Zerafa M. , Baulch S. , Elliott M.J. , Petros A.J. 
Published: November 2003

SummaryWe describe the elective use of the laryngeal mask airway in two children undergoing cardiopulmonary bypass for repair of an atrial septal defect. Total surgical time was short and cardiopulmonary bypass performed at normothermia allowing removal of the laryngeal mask airway on the operating table on completion of surgery. We were able to adequately oxygenate and ventilate the children throughout the procedure using positive pressure ventilation and spontaneous ventilation. The use of caudal fentanyl and rectal diclofenac aided postoperative pain management. Atrial septal defect repair has become one of the more straightforward cardiac operations partly as a result of new cardiopulmonary bypass techniques. Avoidance of intubation and postoperative ventilation in appropriate patients would make this procedure ideal for ‘fast tracking’ and offers the potential advantages of decreased length of stay in hospital and reduction in overall costs.
An audit of postoperative analgesia after pyloromyotomy
Authors: Habre W. , Schwab C. , Gollow I. , Johnson C. 
Published: November 2003

SummarySeventy‐two cases of pyloric stenosis treated in our institution in the last five years were reviewed in an attempt to determine the need for postoperative analgesia after pyloromyotomy in infants. All children had their wound infiltrated with a mean dose of 2.16±1.43 mg·kg−1 of bupivacaine, and first analgesia was required 9.12±8.04 h after surgery. Paracetamol was the main analgesic administered (average of two doses of approximately 20 mg·kg−1). Only three patients required postoperative opioids. In conclusion, there was a low consumption of analgesics after pyloromyotomy. Furthermore, infiltration of the wound appeared to be beneficial since time to administration of first postoperative analgesia was delayed.