bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long‐term ventilator support in patients with Werdnig–Hoffmann disease
Authors: Sakakihara Yoichi , Kubota Masaya , Kim Shoei , Oka Akira 
Published: March 2003

Abstract Background: Withholding and withdrawing life‐sustaining treatment for patients with Werdnig–Hoffmann disease (WHD) have been accepted as standard medical practice in most Western countries. However, a number of Japanese pediatricians are providing ventilator care for patients with this otherwise fatal disorder. We investigated the attitude of physicians in Japan who are providing ventilator care for patients with WHD.
Methods
: A postal questionnaire was sent to 40 hospitals where pediatricians were taking care of 55 ventilator‐assisted patients with WHD. Their views were sought on aspects of the care of these patients.
Results
: Thirty‐three pediatricians from 31 hospitals responded to the questionnaire. Mechanical ventilation was initiated as an emergency measure in one‐third (12/32) of the patients before obtaining full informed consent from the parents. Two‐thirds (19/32) of parents asked the physicians to start ventilator care for the patients, while only three parents asked for the life‐sustaining treatment to be withheld. Although 80% (24/30) of the physicians thought that the quality of life of the ventilator‐dependent patients with WHD was inadequate, about half (17/30) answered that they would start ventilator assistance if they had a new patient with WHD.
Discussion
: Strong familial endorsement for the prolongation of a patient’s life, the secure national insurance and general pro‐life beliefs could have affected physicians’ decisions in favor of providing life‐sustaining treatments for patients with WHD.
Serum C‐reactive protein in the differential diagnosis of childhood meningitis
Authors: Tatara Ryohei , Imai Hiroyuki 
Published: March 2003

Abstract Background: Although determination of serum C‐reactive protein (CRP) is considered one of the most useful tests for differentiating between bacterial and aseptic meningitis, its diagnostic accuracy in comparison with other laboratory parameters is yet to be further evaluated.
Methods
: A total of 192 pediatric cases, aged between 2 months and 14 years, comprising patients with bacterial meningitis (n=66) and aseptic meningitis (n=126), were retrospectively analyzed on the basis of data from the initial examination. The area under the best fit binormal curve of the receiver operating characteristics (Az) for CRP was determined and compared with that for several other analytic parameters, including white blood cell count and erythrocyte sedimentation rate of peripheral blood, standard cerebrospinal fluid analysis variables and the combination test (probability of acute bacterial meningitis (pABM)) derived from Hoen’s model.
Results
: Compared with each of the other variables, the Az for serum CRP (0.97~0.02) was found to be significantly greater (P<0.01) for all except pABM (0.99~0.01; P>0.05). False‐negative cases among the CRP test results were found to have been examined too early.
Conclusions
: The diagnostic accuracy of a single CRP determination was found to be equivalent to that of the most effective combination test. Patients with meningitis in whom serum CRP values are determined at least 12 h after the onset of fever and are <2 mg/dL are far less likely to have bacterial meningitis.
Immunoglobulin subgroups in children with febrile seizures
Authors: Çaksen Hüseyİn , Öner Ahmet Faİk , Arslan Şükrü , Kan Muhİttİn Cengİz , Cesur Yaşar , Üner Abdurrahman 
Published: March 2003

Background
: The aim of the present study was to determine whether or not there was a role for immunoglobulin (Ig) or IgG subgroups in the pathogenesis of febrile seizures (FS).
Methods
: Serum levels of IgA, total IgG, IgM, IgE, IgG1, IgG2, IgG3 and IgG4 were measured in 34 children with FS and in 37 healthy children used as a control group. Both patients and controls were divided into two groups according to age (group I, 6–24 months; group II, 25–72 months).
Results
: Compared with controls, mean IgG4 levels in patients were found to be decreased in both groups I and II (group I: 95~14 vs 57~5, respectively, P=0.01; group II: 178.5~38.5 vs 65.1~24.5, respectively, P<0.01), while mean IgG2 levels were found to be decreased only in group II patients (170~16 vs 103~22; P<0.05).
Conclusions
: The results of the present study suggest that Ig subclass deficiencies may be responsible for the infections connected with FS or that they may be related to the pathogenesis of FS in some children.
Effects of albumin infusion therapy on total and unbound bilirubin values in term infants with intensive phototherapy
Authors: Hosono Shigeharu , Ohno Tsutomu , Kimoto Hirofumi , Nagoshi Ren , Shimizu Masaki , Nozawa Masayo 
Published: March 2003

Background
: The purpose of the present study was to evaluate the effect of intravenous albumin administration on the serum total and unbound bilirubin values in term non‐hemolytic hyperbilirubinemic neonates during intensive phototherapy.
Methods
: Fifty‐eight infants (gestational age 39.4~1.4 weeks; birth weight 3245~435 g) were given phototherapy with similar light energy. Twenty infants (control group) received only phototherapy, while 38 others (albumin‐treated group) were also given human albumin at 1 g/kg bodyweight, i.v., during the first 2 h of phototherapy.
Results
: When comparing changes in total and unbound bilirubin values 0, 2, 6 and 24 h after entering the study between the albumin‐treated group and the control group, there was a significant reduction in the serum unbound bilirubin values at the end of albumin treatment and at 6 and 24 h. However, there was no significant reduction in total serum bilirubin values during the study period. In the albumin‐treated group, the mean serum unbound bilirubin reduction from the baseline level at the end of albumin treatment and at 6 and 24 h was 0.40~0.19, 0.41~0.20 and 0.43~0.20 μg/dL, respectively.
Conclusions
: The results suggest that albumin priming may be effective for an immediate reduction in serum unbound bilirubin values, the fraction that is potentially neurotoxic.
Low‐dose doxapram therapy for idiopathic apnea of prematurity
Authors: Yamazaki Toshio , Kajiwara Masato , Itahashi Kazuo , Fujimura Masanori 
Published: March 2003

Abstract

Background
: Doxapram is contraindicated for newborn infants in Japan because of its serious side effects. However, because of encouraging results of recent studies regarding the efficacy and safety of therapy for apnea of prematurity (AOP) with lower doses of doxapram than those previously proposed, approximately 60% of Japanese neonatologists continue to use doxapram at small doses. Caution is warranted because the sample sizes of the former studies are inadequate to evaluate doxapram for both its beneficial and harmful effects. Therefore, we conducted the present study in order to investigate the efficacy and harmful events of low‐dose doxapram therapy for idiopathic AOP in very low‐birth weight (VLBW) infants in a larger population.
Methods
: One hundred and six VLBW infants with idiopathic AOP were treated with doxapram at a dose of 0.2–1.0 mg/kg per h in combination with methylxanthines and the frequency of apnea and secondary outcomes were compared with a group of control infants.
Results
: An approximate 80% reduction in the frequency of apnea was found with only minimal side effects following low‐dose doxapram. Although there were no significant differences in secondary outcomes between the doxapram‐treated and control groups, mortality in doxapram‐treated infants was significantly lower than that in control infants.
Conclusions
: Patients with AOP unresponsive to treatment with methylxanthines may benefit from the addition of low‐dose doxapram.
Measles seroprevalence in Izmir with special emphasis on measles vaccination policy for Turkey
Authors: Egemen Ayten , Aksit Sadik , Ozacar Tijen , Kurugol Zafer , Keskinoglu Pembe , Pehlivan Tamer , Mutlu Sefika 
Published: March 2003

Abstract

Background
: Measles outbreaks seem to occur every 2‐ to 3‐year intervals in Turkey. However, sero‐epidemiological studies are limited. Knowing the prevalence of measles susceptibility as measured either by serologic markers of immunity or surveys of vaccination coverage is an important tool to assess the risk for measles outbreaks.
Methods
: In order to determine the seroprevalence of measles antibodies among a 1 to 29‐year‐old population in İzmir (Turkey) and to develop the best vaccination policy for measles, a total of 600 people aged from 1 to 29 were selected for the study with cluster sampling. The information on sociodemographic characteristics, vaccination status and measles history was gathered for each participant. Measles‐specific IgG antibodies were screened qualitatively by using microenzyme immune assay for 595 subjects.
Results
: Of the 595 participants screened for the measles antibodies, 56 (9.4%) were seronegative. The proportion of the susceptible individuals in the age groups of 1–4, 5–9, 10–14, 15–19 and 20–29 was 20.0, 10.4, 6.0, 10.3 and 3.0%, respectively. The logistic regression analysis showed that none of the independent characteristics (sex, socioeconomic status, past measles history, vaccination status) with the exception of age group, was significantly associated with measles seronegativity.
Conclusion
: The optimal measles vaccination policy for Turkey may be to increase vaccination coverage above 90%, to conduct a catch‐up campaign covering persons aged 1–19, regardless of previous vaccination status. Another factor to consider is to adopt a routine two‐dose vaccination, giving the first dose at 12_15 months of age and the second dose at school entry.
Serum levels and differential expression of CD44 in childhood leukemia and malignant lymphoma: Correlation with prognostic criteria and survival
Authors: Taçyildiz Nurdan , Çavdar Ayhan O. , Yavuz Gülsan , Gözdaşoglu Sevgi , Ünal Emel , Ertem Ulya , Duru Feride , Ikinciogullari Aydan , Babacan Emel , Kuzu Isinsu , Cin Şükrü 
Published: March 2003

Abstract

Background
: The CD44, a cell surface proteoglycan, participates in a variety of function including tumor dissemination and metastasis. However, there are no available data on the prognostic significance of CD44 expression of tumor tissue correlated with serum sCD44 level in childhood leukemias and lymphomas.
Methods
: Serum levels and leukemic cell tumor tissue expression of CD44 were detected in 54 children with acute leukemia and malignant lymphoma. Serum samples were obtained from all patients before treatment and during remission. Twelve age‐matched healthy children were included as a control group.
Results
: The serum CD44 levels were significantly higher in patients with Hodgkin’s disease (HD), non‐Hodgkin’s lymphoma (NHL), Burkitt’s lymphoma (BL) and acute lymphoblastic leukemia (ALL) than those in the control group. The median values were 1627.0, 1336.0, 1318.5, 1730.4, 902.7 ng/mL, respectively, and P<0.001, P<0.01, P<0.01, P<0.05 in comparisons, respectively. However, there was no significant difference between acute myeloid leukemia (AML) and the control group (median values: 900.3 and 902.7 ng/mL, respectively, P>0.05). Serum sCD44 levels significantly declined in HD, NHL and ALL patients who were in complete remission (median values: 684.0, 573.8 and 1101.1 ng/mL, respectively, P<0.05 in each comparison). Patients with HD had higher levels of serum sCD44 and correlated well with higher erythrocyte sedimentation rate (ESR), B‐symptoms and advanced‐stage disease (P<0.05, P<0.05 and P<0.01, respectively). Expression of CD44 was significantly high in patients with HD and NHL who were in advanced stages of disease. High serum CD44 level was also associated with high tumor tissue expression of CD44 in patients with HD and BL. In addition, patients with higher levels of serum sCD44, had a poorer outcome and survival than those with lower sCD44 levels in HD and NHL groups.
Conclusions
: A high serum sCD44 level and/or tumor tissue expression at diagnosis is associated with poor prognostic criteria and/or unfavorable outcome in childhood leukemias and lymphomas.
Management of childhood diseases in the Byzantine period: I − Analgesia
Authors: Ramoutsaki Ioanna A. , Dimitriou Helen , Kalmanti Maria 
Published: March 2003

AbstractEvidence on the use of pain relievers for medical purposes in childhood was traced in medical treatises during Byzantine times(4th to 15th century ad). The texts of Aetius, Paulus Aeginitis, Orivasios and others strongly reveal influences fromancient Greek medicine. Greek physicians of the times, who helped the medical thinking of antiquity to stay alive, used opium withmandragoras, hyoscyamos and other sedative herbs to produce a kind of anesthetic state and to relieve pain. However, in children’scases they chose to selectively use substances in more standardized quantities, mainly in mixtures. Less aggressive methods such aswarm baths, or appropriate food were highly respected by them and recommended for the treatment of sick children.
Prevention of respiratory syncytial virus infections in high‐risk infantsby monoclonal antibody (palivizumab)
Authors: Groothuis Jessie R. , Nishida Hiroshi 
Published: March 2003

AbstractRespiratory syncytial virus (RSV) is a major viral pathogen whichcauses serious respiratory illness in infants and children worldwide.Palivizumab (Synagis) is an anti‐RSV monoclonal antibody administeredintramuscularly for the prevention of severe RSV respiratory diseasein high‐risk infants and young children. The IMpact‐RSV trial, thepivotal multicenter, randomized, placebo‐controlled trial performedin the USA, Canada and the United Kingdom demonstrated an overall55% reduction in hospitalization rate due to RSV infection inpreterm infants (≤ 35 weeks gestation)with and without chronic lung disease (CLD). Subgroup analysis in prematureinfants without CLD revealed an even greater reduction in RSV hospitalizationrates (78%). Adverse events were infrequent and did notdiffer between placebo and palivizumab groups. Injection site reactionswere infrequent and mild; no differences were observed between palivizumaband placebo subjects. Palivizumab does not interfere with administrationof other pediatric vaccines. Comprehensive parent education programsregarding prevention of infection, avoidance of risk factors forinfection, careful adherence to infection control policies, andrecognition of early symptoms of RSV infection remain important componentsof RSV prevention strategies. In light of the lack of effectivevaccines for this serious health risk, palivizumab offers the onlyoption for prophylaxis against RSV disease in high‐risk infants.
Relationship between erythropoietin levels both in cord serum and amniotic fluid at birth and abnormal fetal heart rate records
Authors: Kakuya Fujio , Shirai Masaru , Takase Masashi , Ishii Noriyuki , Ishioka Tooru , Hayashi Tokitsugi , Kasamo Mitsunori , Kawamura Mitsuhiro , Sasaki Kiminori 
Published: March 2003

Abstract
Background
: Our data in rats suggest that an elevated amniotic fluid erythropoietin (EPO) level at birth indicates antepartum fetal hypoxia. However, the short gestation period in rats does not permit a direct comparision of our data with humans.
Methods
: We conducted a retrospective study of the relationship between EPO levels at birth and abnormal fetal heart rate (FHR) records in 113 infants.
Results
: Among the cesarean section group, the cord serum and amniotic fluid EPO levels in the infants with antepartum abnormal FHR records were significantly higher than those in the control infants. Among the vaginal delivery group, the cord serum EPO levels in the infants with intrapartum abnormal FHR records was significantly higher than that in the control infants. The EPO levels in either cord serum and amniotic fluid discriminated between infants with antepartum abnormal FHR records. The control infants had a sensitivity of 83% and a specificity of 96%. Six of the seven infants with abnormal EPO levels in both cord serum and amniotic fluid had symptoms of prolonged fetal hypoxia. Five infants with abnormal EPO levels in only cord serum had symptoms of acute fetal hypoxia before birth. Four of the 14 infants with abnormal EPO levels at birth had poor outcomes in the neonatal period.
Conclusions
: We concluded that EPO levels in both cord serum and amniotic fluid at birth are valuable for determining the timing of fetal hypoxia and may predict the outcome in the neonatal period.
Serodiagnosis of Helicobacter pylori infection is not accurate for children aged below 10
Authors: Okuda Masumi , Miyashiro Eikichi , Koike Michio , Tanaka Tomoyuki , Bouoka Mina , Okuda Syuuji , Yoshikawa Norishige 
Published: March 2003

Abstract
Background
: In order to investigate the immune response to Helicobacter pylori in childhood, we compared anti‐H. pylori IgG and IgA antibodies with H. pylori antigen in the stool and examined the clinical usefulness of the anti‐H. pylori IgG and IgA antibodies.
Methods
: This study included 157 children who were seen at our hospital. Serum and stool samples were obtained for these children. Antibodies to H. pylori were examined using an H. pylori IgG enzyme‐linked immunosorbent assays (ELISA) and an H. pylori IgA ELISA. Analysis of stool samples was carried out by the H. pylori stool antigen (HpSA) enzyme immunoassay.
Results
: Of the 157 children, 45 children were HpSA positive, 110 were negative and two were undetermined. Out of 45 HpSA positive patients, 25 children were both IgG and IgA positive and seven were negative for both IgG and IgA antibodies. Of the 110 patients who were HpSA negative, 97 were negative for both antibodies. All HpSA positive children older than 10 years were positive for IgG and IgA antibodies, but of the HpSA positive children under the age of 10, only 18 out of 35 (51.4%) were positive for IgG antibodies or IgA antibody.
Conclusion
: These facts suggested that an immature immune response or tolerance to H. pylori exists in childhood and serodiagnosis of H. pylori infection is less useful in children aged below 10.
Clinical experiences of microsurgical side‐to‐end epididymovasostomy for epididymal obstruction
Authors: Eguchi Jiro , Nomata Koichiro , Hirose Takeshi , Nishimura Naoki , Igawa Tsukasa , Kanetake Hiroshi , Saito Yutaka , Higami Yoshikazu 
Published: March 2003

Background: Some surgical treatments are performed for obstructive azoospermia in urology and good results have been reported. Of 61 azoospermic patients who visited our department of urology, nine were diagnosed as having epididymal obstruction of unknown etiology. Methods: We describe nine consecutive side‐to‐end epididymovasostomy procedures performed on these patients. These procedures are microsurgical two‐layer anastomosis. Results: Of the nine men, five (55.6%) had sperm in the ejaculate postoperatively and, up until publication, the pregnancy rate was 33.3% (three of nine). Conclusions: These results suggest that reconstruction of the seminal tract should be considered first for obstructive azoospermia.
Psoas abscess associated with iliac vein thrombosis and piriformis and gluteal abscesses
Authors: Arai Yutaka , Kawakami Takahiro , Soga Hiroki , Okada Yusaku 
Published: March 2003

Background: A 14‐year‐old boy was admitted because of lumbago and high fever. Methods/Results: Computed tomography scans revealed psoas, piriformis and gluteal abscesses as well as right iliac vein thrombus. A right femoral venogram demonstrated compression from the psoas abscess and thrombosis of the common iliac vein. Appropriate surgical drainage, administration of antibiotics and anticoagulant therapy were effective in the present case. Conclusions: This is the first report of primary psoas abscess associated with vein thrombosis and is also unique in that abscesses were multiple without predisposing diseases or trauma.
Changes in resistive index following extracorporeal shock wave lithotripsy
Authors: Aoki Yoshitaka , Ishitoya Satoshi , Okubo Kazutoshi , Okada Takashi , Maekawa Shinya , Maeda Hiroshi , Arai Yoichi 
Published: March 2003

Abstract
Background
: Extracorporeal shock wave lithotripsy (ESWL) has replaced most surgical and endourologic forms of therapy for upper urinary tract stone disease. Despite its proved safety and efficacy, its adverse effects on renal function are still to be identified. A newer diagnostic technique, color Doppler ultrasonography, has brought a new insight into renal function. It enables precise evaluation of the renal vascular supply. Changes in intrarenal vascular resistance after ESWL were studied with Doppler ultrasound techniques.
Methods
: In 70 consecutive patients the resistive index (RI) was measured at an interlober artery before and 30 min after ESWL in the treated and contralateral kidneys. In 17 patients, a follow‐up Doppler study was performed 1 week after ESWL.
Results
: In the treated kidneys, the RI significantly increased from 0.656 ± 0.053 (mean ± SD) at baseline to 0.682 ± 0.053 (P < 0.0001). There was no significant correlation of increase in RI with patient age (r = 0.010) or with pre‐ESWL blood pressure (r = 0.002). Elderly patients (≥ 60 years old, n = 31) had higher RI levels on baseline than younger patients (< 60 years old, n = 39). In 18 of the 31 (58.1%) elderly cases the RI were elevated to greater than 0.7, indicating pathologic changes. In younger patients, only 9 (23.1%) experienced increase in RI up to 0.7 or greater. The contralateral untreated kidneys showed significant change in RI before (0.664 ± 0.045) and after (0.679 ± 0.049) lithotripsy in elderly patients (P < 0.005). A follow‐up Doppler study showed that the mean RI returned to pretreatment levels after 1 week.
Conclusions
: Because of higher RI levels on baseline, elderly patients have a higher risk of post‐ESWL renal tissue damage than younger patients. Clinical implication of RI change in the contralateral kidneys in this study remains to be answered. The measurement of changes in RI with Doppler ultrasound techniques after ESWL may provide useful information for clinical diagnosis of renal tissue damage.
Immunohistochemical finding of α‐1‐antichymotrypsin in tissues of benign prostatic hyperplasia and prostate cancer
Authors: Tanaka Masashi , Suzuki Yoshio , Takaoka Katsuyuki , Murakami Shino , Suzuki Noriyuki , Shimazaki Jun 
Published: March 2003

Abstract
Background
: Ratio of free to total (F/T) prostate‐specific antigen (PSA) is higher in the blood of patients with benign prostatic hyperplasia than those with prostate cancer. To clarify the difference between ratios in these two, α‐1‐antichymotrypsin, the major component of the bound PSA in the blood, was immunohistochemically examined.
Methods
: Tissues were obtained surgically via a retropubic approach from patients with benign prostatic hyperplasia (nine cases) and prostate cancer (27 cases). These samples were processed in paraffin blocks, cut into 5 mm sections and stained with antibodies against α‐1‐antichymotrypsin and PSA.
Results
: The percentage of α‐1‐antichymotrypsin‐stained cells in prostate cancer was higher than that in benign prostatic hyperplasia (P < 0.05). Almost all of glandular and cancer cells were stained with PSA antibody. The percentage of α‐1‐antichymotrypsin‐stained cells in prostate cancer did not correlate to histologic grade, although α‐1‐antichymotrypsin‐stained cells were more widely scattered in high grade tissues. No correlation was found between α‐1‐antichymotrypsin‐stained cells and ratio of F/T in the blood of cancer patients. In about 20% of cancer tissues, histiocytes with positive α‐1‐antichymotrypsin staining were found in stroma but not in that of benign prostatic hyperplasia.
Conclusions
: Prostate cancer tissues are shown to have a richer environment of α‐1‐antichymotrypsin than those of benign prostatic hyperplasia. Some cancer tissues contained α‐1‐antichymotrypsin‐stained histiocytes. These local events may correlate to a high amount of the bound form among total PSA in the blood of prostate cancer patients.