bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dobutamine stress surface mapping of myocardial ischemia in Kawasaki disease
Authors: Takechi Nobuyuki , Seki Takashi , Ohkubo Takashi , Ogawa Shunichi 
Published: March 2003

Abstract

Background
: To detect and localize myocardial ischemia, a method that does not require physical exertion is sometimes needed in children with Kawasaki disease.
Methods
: Dobutamine stress body surface mapping was performed in 115 children with a history of Kawasaki disease (58 without coronary artery lesions, 40 who had coronary lesions without myocardial ischemia and 17 with myocardial ischemia). The maximum infusion rate of dobutamine was 30 μg/kg per min. Myocardial ischemia was diagnosed by the presence of an area of hypoperfusion on scintigraphy at rest and/or an increase in hypoperfusion during a dobutamine stress test compared with resting scintigraphy. We studied the number of leads that showed significant ST depression on the isopotential map (nST), the number of the row containing the lead with the smallest negative value on the isointegral map (Imin), and the localization of myocardial ischemia on the isointegral map. Based on findings in patients without coronary artery lesions, we defined the criteria for detecting myocardial ischemia as nST ≥ 1 and Imin≤ 4.
Results
: The sensitivity of detecting myocardial ischemia was 94.1% using nST and 41.7% using Imin, while the specificity of these methods was 98.9 and 96.9%, respectively. The localization of myocardial ischemia on stress body surface mapping was 100% concordant with that determined by stress myocardial scintigraphy.
Conclusions
: Dobutamine stress body surface mapping for the detection of myocardial ischemia is a non‐invasive, more convenient and repeatable test compared with exercise myocardial scintigraphy and it is a more objective test compared with exercise echocardiography. Dobutamine stress body surface mapping is useful for the identification and localization of silent myocardial ischemia in pediatric patients with Kawasaki disease, especially those who cannot perform tests involving physical exercise.
Skeletal development of achondroplasia: Analysis of genotyped patients
Authors: Matsui Yoshito , Kawabata Hidehiko , Ozono Keiichi , Yasui Natsuo 
Published: March 2003

Abstract

Background
: Achondroplasia is a skeletal dysplasia caused by substitution of arginine for glycine at codon 380 (G380R) mutation of the fibroblast growth factor receptor 3. To date, the developmental course of the phenotype (short stature and skeletal characteristics) has not been clarified in the genotyped population.
Methods
: The relationship between age and clinical data (height, arm span and measurements of skeletal radiographs) were statistically analyzed from 27 achondroplasia patients with the G380R genotype.
Results
: The height standard deviation score had positive correlation and decreased with age, while span‐to‐height ratio did not. Among measurements of skeletal radiographs, the pelvic index, which represents the squared pelvis deformity, were correlated and increased with age. However, interpedicular distance of the first and fourth lumbar vertebrae (L1:L4) ratio as an index for the caudally narrowed pattern of the lumbar spinal canal and fibula‐to‐tibia ratio for the disproportionally long fibulae were not correlated and did not increase with age.
Conclusion
: In making a clinical diagnosis of achondroplasia in early infancy, it should be noted that short stature and squared pelvis deformity are not prominent.
Childhood hypoplastic anemia with sugar chain anomaly of red cell membranes
Authors: Shibuya Atsushi 
Published: March 2003

Abstract

Background
: Childhood hypoplastic anemia of unknown etiology had not existed until now. To assess pathophysiological differentiation in childhood hypoplastic anemia, we analyzed red cell membrane components in six children with hypoplastic anemia of unknown etiology.
Methods
: The six children all had chronic moderate anemia and thrombocytopenia. They also showed hypoplastic marrow cellularity with erythroblastopenia, megakaryocytopenia, and mild morphological anomalies (pelger Hëut anomaly of neutrophils and bi‐ or trinuclear erythroblasts), except for one child who had normal platelets and megakaryocytes. Red blood cells of patients and several anemic children, cord blood and healthy controls were analyzed by the peanut lectin agglutination (PNA) test, flow cytometry, sodium dodecyl sulfate_polyacrylamide gel electrophoresis of membrane proteins, high performance liquid chromatography (HPLC) of sugar chains and the colony‐forming assay of bone marrow erythroblasts.
Results
: In the six children, the PNA agglutination test showed a persistent positive reaction not only for peripheral red blood cells but also for bone marrow erythroblasts. This was not observed in other anemic children and healthy controls. With HPLC analysis, the sugar chains of red blood cell membranes showed the loss of sialic acid from O‐linked oligosaccharides.
Conclusions
: Our results suggested that the abnormality of red blood cells from these patients was attributable to abnormal surface sugar chains (loss of sialic acid from O‐glycan), which are already present at the erythroblast stage in the bone marrow and that may be responsible for a group of anemias.
Comparative randomized study: Administration of natural and synthetic surfactant to premature newborns with respiratory distress syndrome
Authors: Giannakopoulou Christina , Hatzidaki Eleftheria , Korakaki Eftychia , Christodoulaki Maria , Margari Kalliope‐Maria , Mamoulakis Dimitris 
Published: March 2003

Abstract
Background
: The respiratory distress syndrome (RDS) in premature newborns has been etiologically correlated to immature lungs and specifically with surfactant deficiency. Exogenous administration of surfactant is nowadays considered to be the treatment of choice. In this paper we attempt a comparison of clinical results from the administration of natural Alveofact and synthetic Exosurf surfactants in premature newborns with respiratory distress syndrome.
Methods
: The study subjects were 92 premature newborns who had been hospitalized in the Department of Neonatology, of the University of Crete. A total of 42 subjects received synthetic surfactant and 50 subjects received natural surfactant. The surfactant was administered in one to three doses, depending on respiratory support requirements.
Results
: The time of administration was a little
longer for the natural surfactant group. The duration of mechanical
ventilatory support, requiring oxygen, the duration of hospitalization
and the percentage of increase of arterial alveolar partial pressure
oxygen ratio (a/ΑPO2) were slightly
higher for the synthetic surfactant group. The mortality rate during
the neonatal period (28th day) was higher for the synthetic surfactant
group than for the natural surfactant group (38.1 vs 24%).
A similar tendency was noticed also as regards to complications,
e.g. pneumothorax (11.2 vs 5.2%; relative risk (RR)
0.27) intraventricular hemorrhage (34.6 vs 21.1%;
RR 0.61), septicemia (11.5 vs 5.2%; RR 0.46) and
bronchopulmonary dysplasia (12.5 vs 2.8%; RR 0.22).
Conclusion
: The use of natural surfactant seems to offer more advantages in comparison with its synthetic counterpart.
Developmental changes in cyclo‐oxygenase mRNA induction by hypoxia in rat kidney
Authors: Ogawa Tetsushi , Tomomasa Takeshi , Morikawa Akihiro 
Published: March 2003

Abstract
Background
: Prostaglandins, synthesized by cyclo‐oxygenase (COX), regulate renal hemodynamics and also epithelial water and solute transport. Developmental changes occur in COX‐2 mRNA expression and its response to lipopolysaccharide stimulation in rats. We examined age‐related changes in COX mRNA expression induced by hypoxia in the renal cortex and medulla of developing rats.
Methods
: Total RNA was extracted from 1‐ and 4‐week‐old male Wistar rats exposed to one or 4 h of hypoxia (8% O2). Cyclo‐oxygenase mRNA was quantitatively analyzed using a real‐time polymerase chain reaction with dual‐labeled fluorogenic probes.
Results
: Expression of COX‐1 mRNA did not change in response to hypoxia in the cortex or medulla in either infantile or adult rats. In infantile rats, COX‐2 mRNA expression was not induced by one or 4 h of hypoxia. In adults, 1‐ and 4‐h exposures to hypoxia induced COX‐2 mRNA in the renal cortex, and 1‐h of exposure induced COX‐2 mRNA in the medulla.
Conclusions
: Response of expression of COX‐2 mRNA in rats exposed to acute hypoxia show age‐related variability treated by acute hypoxia. Cyclo‐oxygenase‐2 might not play a major role in the hypoxic infantile rat kidney.
Investigation of risk factors for tonsillopharyngitis with macrolide resistant Streptococcus pyogenes in Turkish children
Authors: Çİftçİ Ergİn , DoĞru Ülker , Gürİz Haluk , Aysev Derya , İnce Erdal 
Published: March 2003

Abstract
Background
: Streptococcus pyogenes is the most important causative agent of tonsillopharyngitis. Although penicillin is the drug of choice in streptococcal tonsillopharyngitis, macrolides are recommended drugs in patients who have an allergy to penicillin. However, resistance to macrolides is an important problem in some regions of the world. Risk factors for resistance development have not been investigated sufficiently.
Objectives
: To investigate the risk factors for the development of tonsillopharyngitis with macrolide resistant S. pyogenes.
Methods
: Three hundred and forty‐five children with tonsillopharyngitis caused by S. pyogenes were investigated for various risk factors. Streptococcus pyogenes isolated from children's throat culture were examined for erythromycin, clarithromycin and azithromycin susceptibility.
Results
: Two hundred and sixty‐three children were found eligible for the analysis of risk factors. Resistances to erythromycin, clarithromycin and azithromycin were detected as 3.8, 4.2 and 4.2%, respectively. Macrolide use of the family members in the last 3 months (odds ratio = 7.04, P = 0.005) has been determined to be a risk factor for the development of tonsillopharyngitis with macrolide resistant S. pyogenes.
Conclusion
: Restriction of macrolide antibiotic use appears to be the most important measure to prevent the development of tonsillopharyngitis with resistant S. pyogenes.
Dual chamber cardiac pacing in children: Single chamber pacing dual chamber sensing cardiac pacemaker or dual chamber pacing and sensing cardiac pacemaker?
Authors: Bostan Özlem M. , Çeliker Alpay , Karagöz Tevfik , Özer Sema , Özme Şencan 
Published: March 2003

Abstract
Background
: Dual chamber pacemakers (single chamber pacing dual chamber sensing cardiac pacemaker (VDD) and dual chamber pacing and sensing cardiac pacemaker (DDD)) are being used frequently in children and adolescents. The aim of this study was to verify the safety and performance of the VDD and DDD pacing systems, and to evaluate the differences between two pacing modes with regard to atrial sensing and tracking functions.
Methods
: In this study, we evaluated 14 patients with VDD pacing and 15 patients with DDD pacing between 1994 and 2000. In the patient group with VDD pacing, all had congenital or acquired atrioventricular (AV) block. In the patient group with DDD pacing, 11 had congenital or acquired AV block, three had sinus node dysfunction with AV conduction disturbance and one had idiopathic hypertrophic subaortic stenosis. Twenty‐eight devices were implanted in the subpectoral area using the transvenous route. After implantation the atrial tracking capabilities of the pacing systems were analyzed by telemetry, Holter monitoring, and treadmill exercise testing.
Results
: The mean age of patients in the VDD pacing group was younger. The percentage of congenital heart disease was higher in the DDD pacing group. There was no significant difference regarding fluoroscopy time during implantation and follow‐up time between the two groups. During implantation, in the VDD pacing group the mean sensed atrial signal was 3.1 ± 1.3 mV and this decreased to 1.37 ± 0.68 mV (P < 0.05) during follow‐up. This pattern was also observed in DDD group (3 ± 2 mV vs 1.9 ± 1.5 mV, P < 0.05). Although the P wave measurement at implantation did not differ between the two groups, it was significantly higher in the DDD pacing group at the last control. Three patients with VDD pacing were reprogrammed to VVI or single chamber pacing and sensing, rate adaptive cardiac pacemaker because of complete loss of AV synchrony. There was no atrial sensing problem in the DDD pacing group. During the follow‐up, one patient with VDD pacing developed diaphragmatic stimulation and required lead revision. In one patient with DDD pacing, venous thrombosis occurred in the right subclavian vein and was treated with thrombolytic therapy. During treadmill exercise testing, in one patient with VDD and one patient with DDD pacing temporary failure of atrial sensing occurred. At 24 h Holter monitoring, intermittent loss of atrial sensing was documented in two patients with VDD pacing.
Conclusions
: Dual chamber pacing in children with DDD or VDD pacemakers is a suitable method for bradycardia treatment. Atrial sensing problems may occur in VDD pacemakers. Therefore, DDD pacing mode should be preferred whenever suitable for the patient to maintain the AV synchrony.
Nitric oxide further attenuates pulmonary hypertension in magnesium‐treated piglets
Authors: Haas Kelly Mullins , Suzuki Satoshi , Yamaguchi Nobuyuki , Kato Ineko , Ban Kyoko , Tanaka Taihei , Fukuda Sumio , Togari Hajime 
Published: March 2003

Abstract
Background
: Persistent pulmonary hypertension of the newborn (PPHN) commonly appears as a complication of several pulmonary and non‐pulmonary diseases. The hypoxia possibly inhibits Ca2+ ± dependent K+ channels, thus resulting in membrane depolarization of pulmonary smooth muscle cells, which leads to the opening of Ca2+ channels and Ca2+ entry, resulting in contraction of the vascular smooth muscle. However, magnesium (Mg2+) is an antagonist of Ca2+. We studied the effect of magnesium sulfate on the treatment of hypoxia‐induced pulmonary hypertension and compared to the site of action of nitric oxide (NO).
Methods
: Zero‐day‐old piglets were used in each experiment. The effects of Mg2+ were tested in each hypoxic, normoxic and hyperoxic states. Once the desired physical state was achieved, Mg2+ was administered at a dose of 100 mg/kg approximately every 10 min. In order to determine the exact mechanism of the Mg2+, Nw‐nitro‐l‐arginine (LNNA), a NO synthase‐inhibitor, was administered simultaneously with Mg2+ in some of the experiments.
Results
: There was a significant correlation between the percent reduction of the pulmonary arterial pressure (PAP) caused by magnesium and the level of oxygen (O2) present in the pulmonary artery. The greatest amount of reduction was seen in the hypoxic condition where the least amount of O2 is found. A further reduction in the PAP was seen when NO was given at the end of the Mg2+ trials. There was no significant reduction seen in the systemic arterial pressure.
Conclusion
: Inhaled NO further reduced the PAP in piglets already treated with Mg2+.
Natural progress of blood glucose in full‐term low‐grade low‐birthweight infants
Authors: Ishikawa Norio 
Published: March 2003

Abstract
Background
: Although various authors have suggested the risk of hypoglycemia in practical medicine for low‐birthweight infants is exaggerated, convincing evidence using recent definitions of hypoglycemia is not documented.
Methods
: To evaluate the risk of hypoglycemia in low grade low‐birthweight infants (LGLBWI) (2100 g < birthweight < 2500 g) whose only abnormality is low‐birthweight, whole blood glucose (BGw) was measured five times (0, 0.5, 1, and 4 h after birth and just before the first bottle feeding) in 49 LGLBWI and 38 normal birthweight infants.
Results
: Whole blood glucose was not lower in LGLBWI with a gestational age of 38−40 weeks (GT38LGLBWI) than in normal birthweight individuals with a gestational age of 38−40 weeks at each of the five measuring times. No case of GT38LGLBWI, not even in small for gestational age infants, required treatment for hypoglycemia. The BGw was significantly lower in 37‐week gestational age LGLBWI than in GT38LGLBWI at 0.5 h and 1 h after birth (P < 0.05). However, in all cases with low BGw value (below 30 mg/dL at 1 h after birth), BGw value increased naturally to the normal level 1.5 h after birth. No symptoms of hypoglycemia were observed.
Conclusions
: In the care of hypoglycemia in LGLBWI, attention should be paid first to gestational age, namely, tendency to prematurity. In this study, however, no hypoglycemia that required treatment was found among full‐term normal LGLBWI, even those who were small for gestational age. Frequent blood glucose measurement for those infants is therefore unnecessary.
Self‐Image of People in Their Fifties
Authors: Jamjan Laiad , Jerayingmongkol Prapasri 
Published: March 2003

People in their fifties experience a transitional phase in aging. The impact of physical and emotional change is considerable due to deteriorated health and economic status. With the onset of aging, self‐image of the pre‐senescent provides an understanding of one's perceptions and thoughts on aging. Therefore, increased awareness of the pre‐senescents’ needs has resulted in further development of the nurse's role in health promotion. The main aim of this study was to gain a better understanding of self‐image, a key factor of health promotion in the pre‐senescent. The study participants consisted of 10 women in their fifties from the Aging Club at 43rd Health Center, Bangkok, Thailand. Focus group interview was used to explore self‐image. The interview focused on the concept of health, aging, retirement, and the impact of change.Health results:  The majority (80%) of the participants agreed that the definition of health was the equilibrium of basic needs. The definition of good health to them was a delightful mood. They described the concept of good health as either the balance of excretion, sleep and rest, or being free of disease and personal illness. Three participants complained of health problems because they had to take care of their husbands. Deteriorated health was found to be the stimulus to such aging states as blurred vision, hearing loss, menopause, and osteoporosis.Aging:  The participants accepted that aging was a naturally occurring phenomenon. ‘Age is only a number’, ‘If our minds are still young, our bodies will be youthful.’ They did not want to be called ‘old’.Retirement:  Represents a time when they will be lonely and lack financial support. This also was described as the autumn of life. It was seen as the time to enjoy the golden years of life.The impact of changes:  The participants experienced emotional changes such as increased sensitivity of feelings and needed family support. They also complained of physical changes (i.e. loss of appetite, teeth and agility). Only one participant, who had improved her emotional maturity, was proud of aging.Conclusion:  For the pre‐senescent, the aging transition begins with the changes in one's physical and mental condition. An optimistic attitude towards this process enables the pre‐senescent to approach and better accept the process of aging. Nurses therefore need to continue to develop holistic approaches in caring for the aging.
Association of Activities of Daily Living and Indices of Mental Status with Subsequent 20‐year All‐Cause Mortality in an Elderly Japanese Population
Authors: Kushiro Wakako , Yokoyama Tetsuji , Date Chigusa , Yoshiike Nobuo , Tanaka Heizo 
Published: March 2003

Purpose:  To examine the associations of activities of daily living (ADL) and indices of mental status with the risk of subsequent mortality in an elderly Japanese population.Design:  Prospective cohort study.Participants:  725 men and 984 women aged 65 years or older at time of baseline examination in 1976–1977.Measurements:  Demographic data, levels of disability in ADL, and indices of mental status including self‐rated health (SRH), dementia, and depression.Main outcome measures:  The subsequent 20‐year all‐cause mortality.Results:  (1) Disability in ADL and several indices of mental status (i.e. bad SRH, high dementia score, decreased pleasure, low morale, and prone to tears) were significantly associated with an increased risk of subsequent 20‐year all‐cause mortality. (2) The risk of all‐cause mortality among people who had no disability in ADL with either of bad SRH, decreased pleasure, high dementia score, or low morale was similar to that among people who had some disability in ADL with either good SRH, increased pleasure, low dementia score, or high morale, respectively.Conclusion:  There were strong associations among the levels of disability in ADL and several indices of mental status with subsequent mortality. It was concluded that good mental status may improve longevity even when elderly people have some disability in ADL.
Self‐Image of Aging: A Method for Health Promotion
Authors: Jamjan Laiad , Maliwan Vanda , Pasunant Nitaya , Sirapo‐ngam Yupapin , Porthiban Linchong 
Published: March 2003

In 2020, 15.25% of the Thai population will be over 60. The elderly are those who are considered to be retired and unemployed. Their physical and mental conditions are rapidly changing. They experience many health problems as the result of deteriorating health. Consequently, the health‐care team needs to focus on the elderly's perception of health, self‐image, and health care provided. Understanding the nature of aging will enhance the elderly's health, such that they will perform self‐care and live a more enjoyable life. The aim of this study was to investigate the health perceptions, self‐image and methods of health promotion provided to the elderly. Focus discussion groups consisting of participants over 60 years of age, were formed. One hundred and eight participants from four Aging Clubs of large cities were invited to participate. The participants came from Chiang Mai (n = 30), Phitsanulok (n = 21), Siriraj (n = 20), and the 43rd Health Center Aging Club (n = 37), a suburb near Bangkok.Results:  The majority of participants perceived that ‘Health is composed of a good physical and mental condition’ and ‘physical strength and happy mind’. All participants identified three things that made them healthy: exercise, good food, and having hobbies. The participants practised what they believed. Exercise was seen as excellent medicine, and lack of disease was seen as good fortune. Several participants emphasized that having regular check‐ups, avoiding smoking, and avoiding drinking alcohol, as being healthy. Few of the elderly, in a group of > 70‐year‐olds, from the 43rd Health Center and the Phitsanulok group, mentioned traditional treatment as promoting health. Several participants from Chiang Mai saw fresh air and good ventilation as facilitating health. All participants preferred to meet each other and join in recreational activities at the club for the elderly. Interestingly, the 60–70‐year‐old age group from the Siriraj Aging Club believed life planning and a good sexual relationship were essential for good health. All participants revealed good relationships in their families. They used religious principles to keep their equilibrium and to help maintain their spiritual well‐being. Four major factors were identified as contributing to making the participants feel old: physical changes, declined functions, declined health, and emotional instability. Several participants said they felt old when they were told they were old. Other participants complained of feeling old when they were dependent. They said it caused them to lose their self‐respect.Conclusion:  The study revealed that the different groups of elderly participants had a mutual concept of health. The life experiences of the elderly were based on their beliefs of helpful heath‐care practises. Thus, caregivers need to develop and apply effective and humanistic methods of health promotion for the elderly.