bluuebunny/crossref_metadata_2025_split huggingface dataset:
Augmented response in plasma brain natriuretic peptide to dynamic exercise in patients with left ventricular dysfunction and congestive heart failure
Authors: Kato M. , Kinugawa T. , Ogino K. , Endo A. , Osaki S. , Igawa O. , Hisatome I. , Shigemasa C. 
Published: March 2003

Abstract. Kato M, Kinugawa T, Ogino K, Endo A, Osaki S, Igawa O, Hisatome I, Shigemasa C (Tottori University Faculty of Medicine, Yonago, Japan). Augmented response in plasma brain natriuretic peptide to dynamic exercise in patients with left ventricular dysfunction and congestive heart failure. J Intern Med 2000; 248: 309–315.Objectives. We have previously demonstrated that patients with symptomatic congestive heart failure (CHF), but not with asymptomatic left ventricular dysfunction (LVD), have augmented plasma atrial natriuretic peptide (ANP) response to exercise. Plasma brain natriuretic peptide (BNP) response to exercise is less extensively studied. The aim of this study was to determine whether responses of plasma BNP during exercise normalized for exercise workload are altered in patients with LVD and CHF.Subjects and methods. Twenty‐nine patients with LVD, 32 patients with CHF (NYHA classes II–III) and 27 age‐matched control subjects were studied. Ventilatory, plasma ANP and BNP responses were assessed during symptom‐limited cardiopulmonary exercise testing. Plasma natriuretic peptide levels were measured at rest and immediately after peak exercise. The increment in plasma BNP was divided by the increment in oxygen uptake (Vo2) from rest to peak exercise, and this ratio [BNP exercise ratio: (peak BNP – rest BNP)/(peak Vo2– rest Vo2)] was compared amongst the three groups.Results. Peak Vo2 (Control, LVD and CHF: 28.2 ± 1.7, 21.1 ± 1.8, 16.2 ± 0.6 mL min−1 kg−1, respectively), anaerobic threshold and peak workload became smaller as heart failure worsened. Resting and peak plasma ANP levels were significantly higher only in CHF, whilst resting and peak plasma BNP levels displayed a significant and continuous increase from normal subjects to LVD and CHF. The ANP exercise ratio (1.25 ± 0.36, 2.61 ± 0.57, 7.72 ± 1.65,
anovaP = 0.0002) was significantly higher only in patients with CHF, whilst the BNP exercise ratio (0.35 ± 0.10, 2.60 ± 0.69, 4.98 ± 0.97,
anovaP = 0.0001) was significantly higher in patients with LVD and became progressively higher in patients with CHF.Conclusions. These data showed that the BNP exercise ratio, an exercise plasma BNP response normalized with exercise workload, was augmented in patients with LVD, and became progressively higher in CHF, suggesting that an augmented exercise BNP ratio exists early in the course of developing CHF.
Controlled drug delivery: therapeutic and pharmacological aspects
Authors: Urquhart J. 
Published: March 2003

Abstract. Urquhart J (Department of Epidemiology, Pharmaco‐epidemiology Group, Maastricht University, Maastricht, the Netherlands). Controlled drug delivery: therapeutic and pharmacological aspects (Internal Medicine in the 21st Century). J Intern Med 2000; 248: 357–376.Concerted work to develop human pharmaceuticals based on rate‐controlled drug delivery systems began in 1970. Today there are over three dozen such products, plus a few for veterinary use. In addition, osmotic minipumps have been extensively used since 1978, resulting in over 6000 publications in the pharmacological, endocrinological and physiological literature. Rate‐controlled delivery provides for drug entry into the bloodstream continuously at either a constant or a modulated rate. By this means, one avoids the usual peak and trough pattern of drug concentrations in plasma, with its echoing peak and trough pattern of drug actions, during the interval between successive doses. In contrast to the happenstance release kinetics of rapid‐release dosage forms, rate‐controlled delivery systems can be designed to provide specific temporal patterns of drug concentration in plasma, for the purpose of optimizing the selectivity of drug action, the interval between successive administerings of drug and the likelihood that the next administering will occur at the proper time.
Multidrug resistance in haematological malignancies
Authors: Sonneveld P. 
Published: March 2003

Abstract. Sonneveld P (University Hospital Rotterdam – Dijkzigt, The Netherlands). Multidrug resistance in haematological malignancies (Internal Medicine in the 21st Century). J Intern Med 2000; 247: 521–534.The development of refractory disease in acute myeloid or lymphoblastic leukaemias (AML, ALL) and multiple myeloma (MM) is frequently associated with the expression of one or several multidrug resistance (MDR) genes. MDR1, MRP1 and LRP have been identified as important adverse prognostic factors in AML, T‐ALL and MM. Recently, it has become possible to reverse clinical multidrug resistance by blocking P‐glycoprotein‐mediated drug efflux. The potential relevance of these reversal agents of MDR and potential new approaches to treat refractory disease are discussed.
Molecular epidemiology
Authors: Boffetta P. 
Published: March 2003

Abstract. Boffetta P (Unit of Environmental Cancer Epidemiology, International Agency for Research on Cancer, Lyon, France). Molecular epidemiology (Internal Medicine in the 21st Century). J Intern Med 2000; 248: 447–454.The use of biomarkers in epidemiology is not new, but recent developments in molecular biology and genetics have increased the opportunities for their use. However, epidemiological studies based on biomarkers, which belong to the discipline defined as ‘molecular epidemiology’ are subject to the same problems of design and analysis as ‘traditional’ epidemiological studies. If biomarkers offer new opportunities to overcome some of the limitations of epidemiology, their added value over traditional approaches should be systematically assessed. Biomarkers should be validated though transitional studies; consideration to sources of bias and confounding in molecular epidemiology studies should be no less stringent than in traditional studies.
A case of POEMS syndrome with high concentrations of interleukin‐6 in pericardial fluid
Authors: Shikama N. , Isono A. , Otsuka Y. , Terano T. , Hirai A. 
Published: March 2003

Abstract. Shikama N, Isono A, Otsuka Y, Terano T, Hirai A (Department of Internal Medicine, Chiba Municipal Hospital; and Second Department of Internal Medicine, Chiba University School of Medicine, Chiba, Japan). A case of POEMS syndrome with high concentrations of interleukin‐6 in pericardial fluid. J Intern Med 2001; 250: 170–173.The POEMS syndrome (plasma cell dyscrasia with polyneuropathy, organomegaly, endocrinopathy of various forms, monoclonal gammopathy, skin changes) is a rare multisystem disorder of unknown pathogenesis. Overexpression of proinflammatory cytokines has been implicated in the pathogenesis of POEMS syndrome, however, it is not known whether there is an association between abnormalities in cytokines and pericardial fluid. We present a case of POEMS syndrome with high concentrations of interleukin‐6 (IL‐6) in pericardial fluid. In our patient, pericarditis developed into cardiac tamponade, and the concentration of IL‐6 in pericardial fluid was remarkably elevated compared with that in serum (1760 vs. 6.57 pg mL–1). We suggest that IL‐6 is associated with the progression or maintenance of pericarditis as a result of POEMS syndrome.
Use of complementary and alternative medicine remedies in Sweden. A population‐based longitudinal study within the northern Sweden MONICA Project
Authors: Nilsson M. , Trehn G. , Asplund K. 
Published: March 2003

Abstract. Nilsson M, Trehn G, Asplund K (University Hospital, Umeå, Sweden). Use of complementary and alternative medicine remedies in Sweden. A population‐based longitudinal study within the northern Sweden MONICA Project. J Intern Med 2001; 250: 225–233. Objectives. Previous studies have shown a high prevalence of users of complementary and alternative medicine (CAM) remedies in Anglo‐Saxon countries. We have explored the use of CAM remedies in Sweden, its distribution in different population groups and time trends during the years 1990–99. Design and subjects. Within the framework of the population‐based northern Sweden Multinational Monitoring of Trends and Determinants of Cardiovascular Disease (MONICA) Project, randomly selected 25–74‐year‐old participants in risk factor surveys performed in 1990, 1994 and 1999 responded to questions about their use of CAM remedies. The participation rate was 72%. Results. Amongst 5794 respondents in the 1999 survey, 30.5% reported that they had taken a CAM product (vitamins, minerals or biological CAM remedy) in the preceding 2 weeks. Vitamins/minerals only had been taken by 11.7% and other CAM remedies (dominated by fish oil, ginseng and Q10) with or without vitamins/minerals by 18.8%. Use of CAM remedies was more frequent in women than in men and more frequent in people with high than with low level of education. The prevalence was unrelated to a history of severe cardiovascular disease or diabetes but significantly more common in subjects with poor self‐perceived health, particularly so in women. During 1990–99, the use of CAM remedies increased, more in women than in men. Conclusions. The prevalence of CAM remedy use (other than vitamins and minerals) is high in Sweden. It has been increasing during the 1990s. Its use is particularly common in women, well‐educated people and in those with poor self‐perceived health.
Screening for adult coeliac disease – which serological marker(s) to use?
Authors: Lagerqvist C. , Ivarsson A. , Juto P. , Persson L. Å. , Hernell O. 
Published: March 2003

Abstract. Lagerqvist C, Ivarsson A, Juto P, Persson LÅ & Hernell O (Umeå University, Umeå, Sweden). Screening for adult coeliac disease – which serological marker(s) to use?J Intern Med2001;250:241–248.Objective. To determine which serological marker(s) to use when screening for coeliac disease.Design. In a population‐based cross‐sectional study we compared the use of antigliadin antibodies (AGA) of isotypes IgA and IgG, antiendomysial antibodies (AEA) of isotype IgA and antitransglutaminase antibodies (ATGA) of isotype IgA for detecting coeliac disease amongst adults.Setting. Northern Sweden.Subjects. A total of 1850 of 2500 (74%) invited adults (aged 25–74 years) who were randomly selected from the population register after stratification for age and sex.Main outcome measures. The sensitivity, specificity and predictive values of the AGA, ATGA and AEA tests.Results. Nine cases of biopsy proven, previously undiagnosed coeliac disease were detected by screening. The sensitivity of both ATGA and AEA was 100% whilst AGA IgA and IgG both had a sensitivity of 89%. The AEA test had a specificity of 100% whereas the specificities of the ATGA, AGA IgA and IgG tests were 97, 96 and 78%, respectively. The positive predictive value for the AEA test was 100%, whereas it was considerably lower for the other tests (ATGA > AGA IgA > AGA IgG), with further decreases for all tests when shifting from a clinical to a screening situation.Conclusions. When screening for coeliac disease we suggest a serial testing approach, i.e. an initial ATGA test and, when positive, followed by an AEA test, provided that IgA deficiency has been excluded. However, assessment of the small intestinal mucosal morphology is still required to ascertain the diagnosis.
Exercise‐induced symptomatic ischaemia predicts a poor long‐term prognosis after acute myocardial infarction
Authors: ABBOUD L. , HIR J. , EISEN I. , MARKIEWICZ W. 
Published: March 2003

Abstract. Abboud L, Hir J, Eisen I, Markiewicz W (Rambam Medical Center and Technion School of Medicine, Haifa, Israel). Exercise‐induced symptomatic ischaemia predicts a poor long‐term prognosis after acute myocardial infarction. J Intern Med 2002; 251: 53–60. Study objectives. To evaluate the long‐term prognostic significance of symptomatic ischaemia during exercise testing performed 3 weeks after acute myocardial infarction (AMI). Design. A prospective study with long‐term follow‐up. Setting. A Cardiac Rehabilitation Clinic in a University Hospital. Subjects. A total of 446 patients were allowed to perform exercise testing 3 weeks after AMI and followed for 72 ± 20 months. Measurements and results. Patients were divided into three groups according to whether they had no ECG evidence of ischaemia during exercise testing (334 patients), silent ischaemia (90 patients) or symptomatic ischaemia (22 patients). Cardiac death was significantly more frequent in patients with symptomatic ischaemia when compared with silent ischaemia (31.8% vs. 7.8%, P < 0.01) or when compared with no ischaemia (31.8% vs. 10.2%, P < 0.01). The three groups had a low cardiac mortality during the first 48 months of follow‐up. The prognosis of patients with symptomatic ischaemia worsens markedly thereafter. The results of exercise testing did not predict recurrence of myocardial infarction. Coronary revascularization was performed in 34.4% of those without ischaemia, 47.8% of those with silent ischaemia and 45.5% of those with symptomatic ischaemia (P < 0.01). Conclusions. Patients with symptomatic ischaemia have a good prognosis during the first 4 years of follow‐up. Their prognosis worsens thereafter as opposed to patients with or without silent ischaemia. This high‐risk group of patients with symptomatic ischaemia deserves optimal management including revascularization when appropriate.
Detection and prevention of hepatitis C in dialysis patients and renal transplant recipients. A long‐term follow up (1989–January 1997)
Authors: Almroth G. , Ekermo B. , Månsson A‐S. , Svensson G. , Widell A. 
Published: March 2003

Abstract. Almroth G, Ekermo B, Månsson A‐S, Svensson G, Widell A. (University Hospital of Linköping; University Hospital of Malmö, Sweden) Detection and prevention of hepatitis C in dialysis patients and renal transplant recipients. A long‐term follow up (1989–January 1997). J Intern Med 2002; 251: 119–128. Background. Hepatitis C is frequent problem in dialysis wards. Design. A long time (1989–97) follow up of hepatitis C virus (HCV) infection in a Swedish nephrology unit was performed with anti‐HCV screening, confirmatory antibody tests, viral RNA detection and molecular characterization. Case histories were reviewed with focus, onset of infection, liver morbidity and mortality. Results. In October 1991, 10% (19 of 184) of the patients in the unit (haemodialysis‐, peritoneal dialysis and transplanted patients) were verified or suspected HCV carriers, whilst the number at the end of 1996 was 8% (13 of 157). Most patients were infected before 1991 but only in one case from a known HCV‐infected blood donor. No new HCV infections associated with haemodialysis occurred during the study period. A total of 13 of 24 viremic patients had HCV genotype 2b, a pattern suggesting nosocomial transmission. This was further supported by phylogenetic analysis of HCV viral isolates in seven. HCV viremia was also common in patients with an incomplete anti‐HCV antibody pattern as 8 of the 12 indeterminant sera were HCV‐RNA positive. Conclusions. Awareness, prevention, identification of infected patients and donor testing limited transmission. Indeterminant recombinant immunoblot assays (RIBA)‐results should be regarded with caution as a result of the relative immunodeficiency in uremic patients. Our data indicate nosocomial transmission in several patients.
Relationships between left ventricular mass and the renin–angiotensin system, catecholamines, insulin and leptin
Authors: Malmqvist K. , Öhman K. P. , Lind L. , Nyström F. , Kahan T. 
Published: March 2003

Abstract. Malmqvist K, Öhman KP, Lind L, Nyström F, Kahan T (Karolinska Institutet Danderyd Hospital, Stockholm; Faculty of Health Sciences, Linköping; University Hospital, Uppsala, Sweden). Relationships between left ventricular mass and the renin–angiotensin system, catecholamines, insulin and leptin. Journal of Internal Medicine 2002; 252: 430–439.Objectives. Several neurohormonal systems have been suggested to stimulate myocardial cell growth, and thus take part in the development of left ventricular (LV) hypertrophy. We studied associations between LV mass and markers of the renin–angiotensin–aldosterone system (RAAS), the sympathetic nervous system, glucose homeostasis and leptin.Design. A total of 115 hypertensive patients with LV hypertrophy and two age‐ and gender‐matched control groups consisting of 38 hypertensive patients without LV hypertrophy and 38 normotensive subjects were included. We examined determinants of the RAAS, plasma levels and 24‐h urinary excretions of noradrenaline and adrenaline, plasma proinsulin, insulin, glucose, leptin and LV mass by echocardiography.Results. Plasma renin activity (PRA) and serum aldosterone were higher (both P < 0.001) in the LV hypertrophy group than in patients without LV hypertrophy and normotensive subjects (1.0 ± 0.8, 0.2 ± 0.2 and 0.2 ± 0.2 ng mL−1 h−1, and 327 ±126, 269 ± 146 and 221 ± 80 pmol L−1, respectively). PRA and aldosterone both related (P < 0.001) to LV mass index (r = 0.44 and 0.27, respectively). Catecholamine levels and excretions were similar in all three groups and did not relate to LV mass index. Proinsulin, insulin and leptin levels were all elevated in the hypertensive patients (P < 0.01), but proinsulin, insulin, insulin sensitivity (by the homeostasis model assessment) and leptin did not relate to LV geometry, when indexed for body size.Conclusions. Plasma renin activity and serum aldosterone levels are elevated in hypertensive LV hypertrophy and relate to LV mass index. In addition to blood pressure, activation of the RAAS may be an important nonhaemodynamic mechanism in the control of LV hypertrophy.
Intestinal pseudo‐obstruction and urinary retention: cardinal features of a mitochondrial DNA‐related disease
Authors: García‐Velasco A. , Gómez‐Escalonilla C. , Guerra‐Vales J. M. , Cabello A. , Campos Y. , Arenas J. 
Published: March 2003

Abstract. García‐Velasco A, Gómez‐Escalonilla C, Guerra‐Vales JM, Cabello A, Campos Y, Arenas J (Universitary Hospital 12 de Octubre, Madrid, Spain). Intestinal pseudo‐obstruction and urinary retention: cardinal features of a mitochondrial DNA‐related disease (Case report). J Intern Med 2003; 253: 381–385.The syndrome of mitochondrial myopathy, encephalopathy, lactic acidosis and stroke‐like episodes (MELAS) is a multisystemic disorder associated in most of the patients with an A to G transition at nucleotide position 3243 in the transfer RNA (tRNA)Leu(UUR) (A3243G) of the mitochondrial DNA. This syndrome is characterized by the preponderant involvement of skeletal muscle and central nervous system, but urinary or gastrointestinal symptoms are seldom documented. Here we report an unusual case of a 52‐year‐old woman with a clinical phenotype characterized by encephalopathy, left hemiparesis, urinary retention and gastrointestinal pseudo‐obstruction. She had the classical A3243G mitochondrial DNA point mutation of MELAS syndrome. We also present a clinically heterogeneous multigenerational pedigree with several affected members in the maternal lineage.
Quantitative X‐ray microanalysis of solutes in individual plant cells: a comparison of microdroplet and in situ frozen‐hydrated data
Authors: Hinde  , Richardson  , Koyro  , Tomos  
Published: March 2003

Two different approaches to X‐ray microanalysis were tested and compared. These were the analysis of sap droplets extracted from individual cells (plants grown and analysed in Bangor, U.K.), and the analysis of cells in situ in frozen tissue (plants grown and analysed in Hannover, Germany). The data suggest that both these methods can produce quantitative data accurately reflecting in vivo concentrations in cereal leaf epidermal cells. The relative merits of the two procedures are discussed with reference to possible sources of error and their application to other cell types. Bulk wheat leaf tissue concentrations of K and Cl did not differ significantly between the two locations, but Ca concentration was significantly higher in the plants grown in Hannover.Microdroplet analysis invariably yielded linear responses in the range of concentrations found in plant tissue (r2 for Ca > 0.97, r2 for K, Cl > 0.99), and interference of other components of the sap was minimal. The calibration curves for the frozen‐hydrated material were typically linear in the same range of concentrations (r2 for K, Ca, Cl > 0.95), and the results for K and Cl concentration in these samples were highly consistent with those measured in the microdroplet experiments. In wheat, for example, the cellular Cl concentration varied between 12 m
M and 119 m
M, but no significant differences were found between the two techniques of measurement. The results for cellular Ca differed in a manner which might be predicted from the results of the bulk tissue analyses.
Microstructural analysis of Al alloys dispersed with TiB2 particulate for MMC applications
Authors: Wang  , Brydson  , Jha  , Ellis  
Published: March 2003

A dispersion of TiB2 particulates in an Al alloy matrix was formed via the in‐situ reaction between mixtures of K2TiF6 (K2ZrF6), KBF4 and molten aluminium. The dispersion of the ceramic phase in the aluminium matrix was also achieved in some experiments by adding exogenous TiB2 particles to the fluoride melt in contact with molten aluminium.In this work, we have examined the microstructure of the as‐cast metal matrix composites using analytical electron microscopy and X‐ray diffraction techniques. The phases formed as a result of the reaction between the molten fluoride flux and liquid aluminium have been identified. These were (Ti, Zr, Al)B2, Al3Ti and possibly AlB12 in the Al‐matrix, and KAlF4 and KMgF3 in the solidified flux. The mechanism of formation of TiB2 and Al3Ti is explained. The role of alloying elements is also explained in the context of interfacial chemistry and dispersion.
Real‐time confocal imaging, during active air abrasion – substrate cutting
Authors: Cook R. J. , Azzopardi A. , Thompson I. D. , Watson T. F. 
Published: March 2003

Air abrasion cutting, using particulates accelerated in a controlled compressed gas stream, is currently being re‐evaluated as a precision tissue removal technique for dental cavity preparation. The minimal vibrations and heat generated during cutting commend the technique for use in the shaping of fragile or brittle materials that are vulnerable to vibrations and thermal stresses.Traditional air abrasion studies have relied solely upon post‐procedure imaging, and cutting process details have been inferred from the nature of the residual surface. In this paper, however, a real‐time confocal microscopic imaging method is described, which for the first time has allowed prior target structure characterization with subsequent imaging of cutting interactions and substrate failure patterns. Using internally focusing long working distance Hill objective lenses, focusing deep to a protective microscope slide and adhesive interfaces, unhindered remote image sampling within the bulk of specimens such as tooth tissue, acrylic and brittle ceramics was possible.Moreover, areas of active cutting and inactive regions were identified within air abraded cavities during their creation. The characteristics of the finished cut surfaces were demonstrated and confirmed the findings of previous SEM studies. The method allowed direct control over all the known variables influencing cutting with particulate streams.