bluuebunny/crossref_metadata_2025_split huggingface dataset:
Longitudinal estimation of signal‐averaged electrocardiograms in patients with Kawasaki disease
Authors: Kuramochi Yukio , Takechi Nobuyuki , Ohkubo Takashi , Ogawa Shunichi 
Published: March 2003

Abstract
Background
: Myocarditis associated with Kawasaki (KD) disease is prominent, but rarely detected by conventional methods. The hypothesis of this study is to see if signal‐averaged electrocardiogram can detect myocarditis with KD.
Methods
: We obtained signal‐averaged electrocardiograms from 71 patients with KD (mean age 2.8 ± 2.9 years) in the acute (1st−4th week), subacute (5–7th week), and chronic (8th week or later) phases (mean study period 3.5 ± 1.7 years). Sixteen patients who had pericardial effusion, bundle branch block or myocardial ischemia were excluded from this study. The results were compared with those of Holter and 12‐lead electrocardiograms, echocardiography and serum myocardial enzymes. They were also contrasted with the course of each patient.
Results
: The incidence of abnormal findings
on signal‐averaged electrocardiogram was 18.2% in the acute phase
versus 10.9% in the subacute and chronic phases. It differed
significantly higher than the other conventional tests (P < 0.05). Four patients had abnormalities of signal‐averaged electrocardiograms through all three phases. Among these four, two had reduced left ventricular contractility. However, these changes were transient and resolved in the subacute phase. All patients had good courses and no residue.
Conclusion
: This study shows the possibility that signal‐averaged electrocardiogram is more useful to detect myocarditis associated with KD than the other conventional tests. However, we could not define the prognostic value of abnormal signal‐averaged electrocardiograms during this study period.
Central venous catheters in pediatric patients – subclavian venous approach as the first choice
Authors: Çitak Agop , Karaböcüo}lu Metin , Üçsel Raif , Uzel Nedret 
Published: March 2003

Abstract
Background
: It is critical to establish a safe and functional i.v. access in severely sick patients. We evaluated the frequency of application and complications of central venous catheters in a pediatric intensive care unit.
Methods
: Pediatric patients in whom central venous catheters were inserted between March 1997 and May 1999 in the Pediatric Emergency Room and Intensive Care Unit were enrolled in this study. Patients were evaluated with respect to age, sex, weight, central venous catheter indication, site, duration of catheter stay and complications.
Results
: During the study period a total of 156 central venous catheters were successfully inserted into 146 patients. Of the 156 central venous catheter attempts, 148 (94.9%) were placed into the subclavian vein, six were inserted into the femoral vein, and two into the jugular vein. In 156 attempts, arterial injuries ocurred in 20 cases (12.8%). Pneumothorax developed in two patients on mechanical ventilation. Three catheters had to be removed due to catheter related infections. The mortality rate was 0%.
Conclusions
: We concluded that subclavian central venous catheterization is a safe procedure with minimal complications in pediatric patients. Arterial injury was the most frequent complication. In experienced hands, the succes rate was 100%. Subclavian central venous catheter insertion may be considered as the first approach in critically ill patients.
Management of childhood diseases during the Byzantine period: IV − Juvenile diabetes mellitus
Authors: Ramoutsaki Ioanna A , Dimitriou Helen , Markaki Erasmia‐A , Kalmanti Maria 
Published: March 2003

AbstractAlthough Byzantine physicians seemed to recognize the clinical entity and the symptoms of juvenile diabetes mellitus very well, they did not mention many details about the treatment of the disease. Most probably they treated the young patients in the same way as the adults. It is worth mentioning that diabetes was considered a difficult medical problem.
Nitric oxide metabolites in the urine of full‐term and preterm infants
Authors: Dzik Jolanta M , Dobrzan´ska Anna , Gruszfeld Dariusz , Walajtys‐Rode Elzbieta 
Published: March 2003

Abstract
Background
: In newborn full‐term and preterm infants the urine nitrites and nitrates (NOx) were measured, in order to investigate the effects of different pathological conditions (infection, hypoxia) on systemic nitric oxide production.
Methods
: Urine nitrites and nitrates were determined by means of the Griess reaction, after reduction of nitrates to nitrites with nitrate reductase.
Results
: The NOx level was higher in preterm (278 nmol/mL) than full‐term (176 nmol/mL) infants. Low NOx (115 nmol/mL) levels accompanied generalized infections, while its high contents (650 nmol/mL) was found in cytomegalovirus and one case of Pneumocystis carinii infection. Moderate increase of NOx production was observed in infants with local pulmonary infections and encephalopathies.
Conclusion
: The results indicate urinary NOx level is lowered in infants with life‐threatening generalized infection. A possibility of a rapid test based on newborn urinary NOx level determination is considered.
Inflammatory changes in the lungs of premature infants with symptomatic patent ductus arteriosus
Authors: Nakamura Toshihiko , Takasaki Jiro , Ogawa Yunosuke 
Published: March 2003

Abstract
Background
: The aim of the study was to observe the inflammatory changes during the therapy for symptomatic patentductus arteriosus (sPDA).
Methods
: We investigated biochemically the sample of the tracheobroncheal aspirates (TA) from 11 intubated prematureinfants. Three i.v. doses of indomethacin (0.2 mg/kg) were administered with 24‐h intervals. The samples were dividedinto two groups, the effective occasions (n = 10) and non‐effective occasions (n = 6). Theamounts of myeloperoxidase (MPO), soluble L‐selectin (sL‐selectin) in TA, and the polymorphonuclear leukocytes (PMN) of peripheralblood stream and TA were analyzed before and after treatment of sPDA with indomethacin.
Results
: In effective occasions, there were significant decreases of peripheral PMN and MPO and PMN in TA. However, thisgroup had a significant increase of sL‐selectin. In non‐effective occasions, five out of six samples had decreases of MPO and PMNin TA, but not significantly. In contrast, there was a significant decrease of sL‐selectin.
Conclusion
: These data suggested that anti‐inflammatory change after closure of sPDA may be caused by not only indomethacinitself, but also ductal closure itself. However, futher study is necessary to clarify the relationship between the closure of theductus itself and anti‐inflammatory action in the lung.
Meatus tightly covered by the prepuce is associated with urinary infection
Authors: Hiraoka Masahiro , Tsukahara Hirokazu , Ohshima Yusei , Mayumi Mitsufumi 
Published: March 2003

Abstract
Background
: Almost all newborns have phimosis, which is known as one of the risk factors for urinary infection. The present study analyzed which specific prepuce conditions correlated with the development of febrile urinary infection in Japanese male infants.
Methods
: The subjects consisted of 100 children, 64 boys and 36 girls, with febrile urinary infection. Prepuces were classified by their retractability in the male patients and in 714 healthy boys.
Results
: Ninety‐four percent of first febrile urinary infections occurred before 7 months of age in boys, whereas only 37% of the girls had first infections by that age. The prepuce covered the external urethral meatus in 96% of the healthy boys aged 3 years or less. A gentle retraction maneuver could not uncover the urethral meatus in approximately 40% of the boys aged 0−6 months. The frequency started to decline spontaneously after that age. Male patients aged 0−6 months significantly more often had tightly covered meatus than did healthy neonates (85%vs 42%, P < 0.0001).
Conclusions
: These findings indicate that it is specifically those boys whose external urethral meatus are tightly covered with foreskin who constitute the high‐risk group for urinary infection. Awareness of this observation should help with diagnosing and managing urinary infection in young boys.
DNA damage in children treated with imipramine for primary nocturnal enuresis
Authors: Dündaröz RuŞen , Türkbay Tümer , Sürer Ilhami , Gök Faysal , Denlİ Metin , Baltaci Volkan 
Published: March 2003

Abstract
Background
: Despite the fact that primary nocturnal enuresis (PNE) is self‐limited and pathologically benign, the emotional stress and inconvenience that it produces, warrants treatment. Imipramine is one of the widely used drugs in PNE treatment. Although some mutagenic effects were suggested in imipramine administration, this toxicity has never been investigated in enuretic patients. The aim of this study was to evaluate the association of exposure to imipramine with DNA damage.
Methods
: Thirty‐five children treated with imipramine for at least 4.5 months who were in otherwise good health were accepted into the investigation. Twenty healthy sisters or brothers of the patients who did not use any long‐term drugs were studied simultaneously as the control group. Comet assay was used to evaluate DNA damage.
Results
: Damaged (limited and extensive migrated) cells of the enuretic children who were taking imipramine were statically higher than that of the control group (P < 0.05) indicating a detectable DNA damaging effect of imipramine in human lymphocytes.
Conclusion
: Our finding suggests that the difference in comet scores between two groups was induced by the imipramine treatment. The other possibility to be considered is the psychological stress of the children who were concerned by the symptoms and their parent's anxiety. As our preliminary data were based on a limited number of children, further research is needed considering the importance of this possible toxic effects which may be associated with mutagenicity.
Australian clinical nurse supervisors’ ethical decision‐making style
Authors: Berggren Ingela , Bégat Ingrid , Severinsson Elisabeth 
Published: March 2003

AbstractThis paper explores clinical nurse supervisors’ ethical styles with regard to supervision in health care. Eighty‐six registered nurses, all with experience of supervising clinical nurses and students in nursing, completed a specifically designed questionnaire. A qualitative interpretative content analysis identified three core themes: (i) ‘Is it safe?’; (ii) ‘Is it right?’; and (iii) ‘Is it kind?’, describing the clinical nurse supervisors’ ethical styles. The first core theme ‘Is it safe?’ covered the supervisors’ rules, codes and values that guide their supervisory actions, as well as two subthemes: (i) empowerment and (ii) integrity. The second core theme ‘Is it right?’ described the supervisors’ responsibility and advocacy as well as the ethical dilemmas experienced in the supervisory process. The third core theme ‘Is it kind?’ included the supervisors’ relationships with patients, professionals and supervisees. The results demonstrate the value of offering a support system, such as clinical supervision, which helps nurses to explore their professional identity for the benefit of the patients.
Development of the Chronic Obstructive Pulmonary Disease Activity Rating Scale: Reliability, validity and factorial structure
Authors: Morimoto Michiko , Takai Kenichi , Nakajima Kazuo , Kagawa Koujiro 
Published: March 2003

Abstract The purpose of the present study was to develop the Chronic Obstructive Pulmonary Disease (COPD) Activity Rating Scale (CARS) to measure life‐related activity in patients with COPD, and to confirm its reliability and constructive validity in a factorial structure model. The subjects consisted of 114 patients with COPD. An 88‐item life‐related activity list, generated previously from a literature review, was administered. The secondary structural model consisted of four factors with 12 items. The results of the confirmatory factor analysis by structural equation modeling showed the fit criteria to be statistically significant. The internal consistency of the 12 items was highly reliable (Cronbach's α = 0.924). The CARS score was correlated with pulmonary function tests, breathlessness, and the health‐related quality of life (QOL) scales in Pearson correlation coefficient. The results suggest that the COPD Activity Rating Scale is a valid scale for the assessment of life‐related activity in patients with COPD.
Expression of transitional cell‐specific genes, uroplakin Ia and II, in bladder cancer: Detection of circulating cancer cells in the peripheral blood of metastatic patients
Authors: Yuasa Takeshi , Yoshiki Tatsuhiro , Isono Takahiro , Tanaka Tsutomu , Hayashida Hideshi , Okada Yusaku 
Published: March 2003

Background: Uroplakins (UP), urothelium‐specific transmembrane proteins, are present only in urothelia and may be good candidates as tumor markers specific for transitional cell carcinomas (TCC). We investigated the expression of UP‐Ia and UP‐II genes in the tissues and peripheral blood of patients with TCC. Methods: We investigated UP‐Ia and UP‐II gene expression in tissues from 12 patients with TCC by reverse transcription–polymerase chain reaction (RT‐PCR). HT1197, a TCC cell line, was used as an indicated cell line to assess a detection system for the UP‐II gene‐expressing cancer cells by nested RT‐PCR. We also investigated UP‐II gene expression in the peripheral blood of 12 other patients with TCC by nested RT‐PCR. Results: Prior to the investigation of UP‐Ia and UP‐II gene expression, a partial nucleotide sequence of human UP‐II gene cDNA was determined to prepare the primers for RT‐PCR. Uroplakin genes were expressed in both cancerous and non‐cancerous urothelia taken from all patients examined by RT‐PCR. The detection sensitivity of our assay showed that one cancer cell could be detected in 5 mL peripheral blood. UP‐II gene‐expression was detected in the peripheral blood from all three patients with metastatic TCC but not from the nine patients with non‐metastatic TCC nor the three healthy volunteers. Conclusions: Uroplakins may be employed as tumor markers for transitional cell cancer, because they are highly conserved and well expressed, not only in non‐cancerous cells but also in cancer cells. Furthermore, detection of UP‐II gene expression in blood by nested RT‐PCR may provide helpful information in the diagnosis and management of TCC.
Recurrence of sigmoid colon carcinoma in the residual urethra after cystectomy
Authors: Yoshimura Koji , Isogawa Yoshiaki , Yoshida Hiroshi , Kawase Norio , Taki Yoji 
Published: March 2003

Abstract
Introduction
: We report a case of recurrence of sigmoid colon cancer in the residual urethra after cysto‐prostato‐sigmoidectomy.
Methods/Results
: The patient successfully underwent urethrectomy and is currently tumor‐free. To our knowledge, this is the first case of recurrence of a non‐urothelial malignant tumor in the residual urethra.
Diagnosis of pheochromocytoma using [123I]‐ compared with [131I]‐metaiodobenzylguanidine scintigraphy
Authors: FURUTA NOZOMU , KIYOTA HIROSHI , YOSHIGOE FUKUO , HASEGAWA NORIO , OHISHI YUKIHIKO 
Published: March 2003

Background: Patient with pheochromocytoma (PCT) cannot be cured without operation, therefore, preoperative determination of the localization of PCT should be performed accurately. [131I]‐Metaiodobenzylguanidine (MIBG) scintigraphy is a gold standard for the diagnosis of PCT. However, [123I]‐MIBG is also found to accumulate in PCT. In order to clarify the usefulness of [123I]‐MIBG scintigraphy for the local detection of PCT, we compared the distribution of [123I]‐ and [131I]‐MIBG in patients with or without PCT.Methods: [131I]‐ and [123I]‐MIBG scintigraphy was performed in 29 and 16 patients, respectively. In the former group, 14 patients had PCT, 12 had hypertension without any adrenal disorder and three had other diseases. In the latter group, eight patients had PCT, two had hypertension without any adrenal disorder and six had other diseases. The sensitivity, specificity and accuracy of [123I]‐compared with [131I]‐MIBG scintigraphy were compared.Results: The sensitivity of [131I]‐ and [123I]‐MIBG scintigraphy was 85.7 and 90%, respectively. The specificity of each test was 100%. The accuracy of [131I]‐ and [123I]‐MIBG scintigraphy was 93.1 and 95%, respectively. The quality of images obtained using [123I]‐MIBG was better than with [131I]‐MIBG, because [123I]‐MIBG generated a higher dose of γ‐rays with a higher specificity than [131I]‐MIBG. In addition, normal adrenal grands were visualized in 50% of patients tested with [123I]‐MIBG scintigraphy.Conclusions: These results indicate that [123I]‐MIBG scintigraphy is a valuable tool for the local detection of PCT, as is [131I]‐MIBG scintigraphy. Furthermore, it is possible that [123I]‐MIBG can be used as an alternative to [131I]‐MIBG for the detection of PCT. Our study was not a prospective study and the background of the patients was not matched. Further prospective studies are needed in order to determine the efficacy of [123I]‐MIBG scintigraphy for the diagnosis of PCT.
Prolonged nocturnal penile tumescence caused by epinastine
Authors: YAMANAKA MASAKI , KITAMURA MASAYA , IWASA ATSUSHI , KOGA MINORU , MATSUMIYA KIYOMI , OKUYAMA AKIHIKO 
Published: March 2003

Purpose: We report a case of prolonged nocturnal penile tumescence (NPT) caused by the antiallergic agent epinastine.Methods/Results: We measured NPT using Rigiscan‐PlusTM (DacoMed, Minneapolis, MN, USA) with or without the patient having taken epinastine.Conclusions: Considering its pharmacological effects on cyclic nucleotides, epinastine may have an effect on erectile function.
Extragonadal germ cell tumor of the prostate associated with Klinefelter’s syndrome
Authors: NAMIKI KAZUNORI , TSUCHIYA AKIRA , NODA KENJIRO , OYAMA HIRONORI , ISHIBASHI KEIICHIRO , KUSAMA HIROSHI , FURUSATO MASAKUNI 
Published: March 2003

Purpose: We report on a case of extragonadal germ cell tumor of the prostate associated with Klinefelter’s syndrome.Methods/Results: The patient was a 33‐year‐old man. A transrectal prostate biopsy suggested combined germ cell tumor (yolk sac tumor + teratoma). Because there was no tumor except from the prostate, we considered this case to be a primary extragonadal germ cell tumor of the prostate. The prostate tumor responded to systemic chemotherapy with cisplatin, vinblastine and bleomycin and elevated lactate dehydrogenase and α‐fetoprotein levels normalized. In addition to chemotherapy, the patient also underwent radiation therapy.Conclusion: The patient has survived for approximately 4 years since the diagnosis.
Effect of prostatic biopsy on free‐to‐total prostate‐specific antigen ratio in patients with prostate cancer
Authors: Furuya Yuzo , Akakura Koichiro , Ichikawa Tomohiko , Masai Motoyuki , Igarashi Tatsuo , Ito Haruo 
Published: March 2003

Abstract
Background
: We determined the effect of prostatic biopsy on the changes in total and free prostate‐specific antigen (PSA) and free‐to‐total PSA ratio (F/T ratio) and examined if there are differences in these parameters between patients with benign and malignant histologic findings.
Methods
: The concentration of total and free PSA and the F/T ratio were determined in 35 men before and 1 h after prostatic biopsy. The level of PSA was measured with a chemiluminescent enzyme assay. Of 35 patients, nine were diagnosed as having prostate cancer.
Results
: In patients whose biopsy revealed cancer, the F/T ratio was lower than those without cancer, although there were no differences in total and free PSA value before prostatic biopsy. One hour after prostatic biopsy, there was an increase in the level of total and free PSA and the F/T ratio in all men. The increase in the F/T ratio was greater in patients whose biopsies revealed no prostate cancer. In patients with stage B cancer, these parameters increased more than those with stage C/D cancer.
Conclusion
: Prostatic biopsy causes a dramatic increase in total and free PSA. The F/T ratio also increased after biopsy. The PSA response to prostatic biopsy might be different in patients with and without prostatic malignancy. The response might also be different according to stage of prostate cancer.
Interferon therapy for renal cell carcinoma in hemodialysis patients: Report of two patients
Authors: Hanazawa Kisaburo , Tanaka Michio , Watanabe Ryota , Fujime Makoto 
Published: March 2003

AbstractThe method of interferon therapy has not been clarified in hemodialysis patients with renal cell carcinoma. Two hemodialysis patients with renal cell carcinoma were treated with natural interferon‐α. The serum levels of interferon‐α in both patients were measured after 24, 48, 72 and 96 h of injection. In case 1, the serum concentration of interferon‐α after 24 h of injection at a dose of 3 × 106 reached a maximum and decreased gradually. In case 2, the serum concentration of interferon‐α reached a maximum 24 h after injection at a dose of 3 × 106 and decreasing gradually after this. After an injection of interferon‐α at a concentration of 6 × 106 7 days later, the serum concentration of interferon‐α reached a maximum 48 h after the injection and decreased gradually thereafter. The serum interferon‐α concentrations of these cases were higher than normal renal function patients in other literature. It is necessary to modify the interval between injections for hemodialysis patients with renal cell carcinoma.
Clinical experience with BCG alone versus BCG plus epirubicin
Authors: Bilen Cenk YÜcel , Özen Haluk , AKI. FAZI.l Tuncay , AygÜn Cem , Ekici Sinan , Kendi Sezer 
Published: March 2003

Abstract
Background
: Bacillus Calmette–Guérin (BCG) and epirubicin have both been shown to be effective in the treatment of superficial bladder cancer. We studied whether the alternating combination of these agents could improve the efficacy with tolerable side‐effects in the treatment of high‐risk superficial bladder tumors.
Methods
: Forty‐one patients with high‐risk superficial bladder transitional carcinoma were included in this study. Twenty‐one patients were randomized into the BCG group and 20 patients were treated with sequential BCG and epirubicin. The patients were followed for 9–24 months (mean 18 months). Recurrence rates, median time to the first recurrence, progression rate and complications were compared.
Results
: Fifteen percent of the patients in the BCG and epirubicin group and 19% of the patients in the BCG alone group developed tumor recurrence. Tumor progression was observed in 4.7% and 10% in the BCG/epirubicin group and the BCG alone group, respectively. Median time to first recurrence was 11 months for the BCG/epirubicin group and 16 months for the BCG group (P > 0.05). Three patients in the BCG/epirubicin treatment group developed serious side‐effects, which necessitated antituberculosis treatment.
Conclusion
: Because the efficacy of combination was no better than the standard treatment and the alternating combination seemed to be related to a higher incidence of side‐effects, this study albeit small, does not recommend combination therapy of BCG and epirubicin in high risk patients with superficial bladder cancer.