bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serum cholestasis markers as predictors of early outcome after liver transplantation
Authors: Ben‐Ari Ziv , Weiss‐Schmilovitz Hemda , Sulkes Jaqueline , Brown Marius , Bar‐Nathan Nathan , Shaharabani Ezra , Yussim Alexander , Shapira Zaki , Tur‐Kaspa Ran , Mor Eytan 
Published: December 2004

Abstract:  Background:  Early cholestasis is not uncommon after liver transplantation and usually signifies graft dysfunction. The aim of this study was to determine if serum synthetic and cholestatic parameters measured at various time points after transplantation can predict early patient outcome, and graft function.Methods:  The charts of 92 patients who underwent 95 liver transplantations at Rabin Medical Center between 1991 and 2000 were reviewed. Findings on liver function tests and levels of serum bilirubin, alkaline phosphatase (ALP), and gamma glutamyl transpeptidase (GGT) on days 2, 10, 30, and 90 after transplantation were measured in order to predict early (6 months) patient outcome (mortality and sepsis) and initial poor functioning graft. Pearson correlation, χ2 test, and Student's t‐test were performed for univariate analysis, and logistic regression for multivariate analysis.Results:  Univariate analysis. Serum bilirubin ≥10 mg/dL and international normalized ratio (INR) >1.6 on days 10, 30, and 90, and high serum ALP and low albumin levels on days 30 and 90 were risk factors for 6‐month mortality; serum bilirubin ≥10 mg/dL on days 10, 30, and 90, high serum ALP, high GGT, and low serum albumin, on days 30 and 90, and INR ≥1.6 on day 10 were risk factors for sepsis; high serum alanine aminotransferase, INR >1.6, and bilirubin ≥10 mg/dL on days 2 and 10 were risk factors for poor graft function. The 6‐month mortality rate was significantly higher in patients with serum bilirubin ≥10 mg/dL on day 10 than in patients with values of <10 mg/dL (29.4% vs. 4.0%, p = 0.004). Patients who had sepsis had high mean serum ALP levels on day 30 than patients who did not (364.5 ± 229.9 U/L vs. 70.8 ± 125.6 U/L, p = 0.005). Multivariate analysis. Significant predictors of 6‐month mortality were serum bilirubin ≥10 mg/dL [odds ratio (OR) 9.05, 95% confidence intervals (CI) 1.6–49.6] and INR >1.6 (OR 9.11, CI 1.5–54.8) on day 10; significant predictors were high serum ALP level on day 30 (OR 1.005, 1.001–1.01) and high GGT level on day 90 (OR 1.005, CI 1.001–1.01). None of the variables were able to predict initial poor graft functioning.Conclusion:  Several serum cholestasis markers may serve as predictors of early outcome of liver transplantation. The strongest correlation was found between serum bilirubin ≥10 mg/dL on day 10 and early death, sepsis, and poor graft function. Early intervention in patients found to be at high risk may ameliorate the high morbidity and mortality associated with early cholestasis.
Ontogenic emergence and localization of larval skin antigen molecule recognized by adult T cells of Xenopus laevis: Regulation by thyroid hormone during metamorphosis
Authors: Watanabe Mikihito , Ohshima Madoka , Morohashi Miyuki , Maéno Mitsugu , Izutsu Yumi 
Published: December 2004

Results from previous studies using an inbred strain of Xenopus laevis have led to the proposition that metamorphosis includes the events by which the newly differentiating adult immune system, including T lymphocytes, recognizes and eliminates larval skin cells as ‘non‐self’. More recently, a larval antigen targeted by adult T cells was identified as a 59 kDa protein with a specific peptide sequence. Using antisera directed against the larval antigen and the peptide, immunohistochemistry and western blotting were done to examine expression of the 59 kDa larval antigen in the skin during larval and metamorphic periods. There was no expression before Nieuwkoop and Faber stage 53. Expression was first seen at the beginning of metamorphic stage 54, when hind limbs appear, and increased thereafter, in apical and skein cells of both trunk and tail regions. In the trunk region, expression started to decrease at stage 58, until it completely disappeared at stage 62 (metamorphic climax). In the tail skin, however, expression persisted throughout the metamorphic stages. Treatment of larvae with thyroid hormone (TH) resulted in repression of expression of the 59 kDa molecule in a dose‐dependent manner. Downregulation occurred earlier in the trunk than in the tail skin. These results suggest involvement in metamorphic events of an immunological mechanism: differential expression of the larval antigen in the trunk and tail skin cells due to their differing concentration of TH results in the tail, but not the trunk skin, being selectively attacked by the newly differentiating adult‐type immune system.
Visualization of palisade veins in esophageal varices by endoscopic color Doppler ultrasonography
Authors: SATO TAKAHIRO , YAMAZAKI KATSU , TOYOTA JOUJI , KARINO YOSHIYASU , OHMURA TAKUMI , KUWATA YASUAKI , AKAIKE JUN , SUGA TOSHIHIRO 
Published: December 2004

Background:  Endoscopic color Doppler ultrasonography (ECDUS) is a useful modality for obtaining color flow images of esophageal varices. Levovist is a microbubble echo‐enhancing agent that improves Doppler ultrasound examination. This study is designed to evaluate the usefulness of ECDUS using Levovist in diagnosing palisade veins of esophageal varices.Methods:  The study involved 67 patients with esophageal varices using ECDUS. All 67 patients received Levovist intravenously at a concentration of 300 mg/mL. A 7.5‐mL dose of the contrast agent was injected at a slow infusion rate of 1 mL/min. We compared vessel images detected with precontrast with those detected by enhanced ECDUS.Results:  Color flow images of palisade veins were obtained in 16 (23.9%) of the 67 patients with precontrast ECDUS. Vessel images of palisade veins were detected in 15 of 61 F2 type varices (24.6%) and in one of six F3 varices (16.7%). The color flows of these vessels showed a continuous wave on fast‐Fourier transform analysis. Sixteen palisade veins had velocities in the 3.3 cm/s−11.6 cm/s range. Color flow images of palisade veins were obtained in 27 (40.3%) of the 67 cases by enhanced ECDUS using Levovist. Palisade veins could be delineated after Levovist contrast in 11 patients who could not be detected on precontrast ECDUS. After Levovist contrast, color flow images detected with precontrast ECDUS were enhanced in all patients.Conclusion:  Endoscopic color Doppler ultrasonography with Levovist contrast can improve the diagnostic quality of the palisade veins in esophageal varices.
Pancreatic stenting for the preservation of pancreatic function in chronic pancreatitis with stricture
Authors: UKITA TAKEO 
Published: December 2004

Background:  Although many reports have documented pain relief achieved by pancreatic stenting, the effect of stenting on pancreatic function is less clear. In addition, the effects of stent caliber and patency have not been considered in most previous studies. Pain and pancreatic function after stenting of the main pancreatic duct (MPD) were examined.Methods:  Records of 24 patients with chronic pancreatitis who had an MPD stricture treated with a 10‐Fr stent from June 1996 to June 2002 were reviewed. The average age was 57.0 ± 1 years, and the male : female ratio was 7 : 1. Eleven patients had diabetes mellitus. Stent patency, pancreatic pain and pancreatic endocrine and exocrine function were examined before stenting and 6 months after stenting. Stenting was continued for 1 year or more, with repeated stent exchange every 3 months.Results:  The stent became occluded in 29% of cases, migration occurred in 15% of cases, and the 50% patency time was 125 days. Pancreatic pain was relieved by stenting in all cases. The diameter of the MPD, the Bentiromide test value, weight and body mass index were improved.Conclusion:  Stenting relieves blockage of the main pancreatic duct and provides both pain relief and preservation of residual pancreatic function.
Influence of initial hyperglycaemia, weight and age on the blood glucose lowering efficacy and incidence of hypoglycaemic symptoms with a single‐tablet metformin–glibenclamide therapy (Glucovance®) in type 2 diabetes
Authors: Garber A. , Marre M. , Blonde L. , Allavoine T. , Howlett H. , Lehert P. , Cornes M. 
Published: December 2004

Aim:  To evaluate the efficacy and incidence of hypoglycaemic symptoms associated with fixed combinations of metformin and glibenclamide (glyburide in the USA) formulated within a single tablet (tablet strengths 250 mg/1.25 mg, 500 mg/2.5 mg and 500 mg/5 mg), in comparison with metformin 500 mg and glibenclamide 2.5–5 mg monotherapy, in clinically important patient subgroups within the type 2 diabetic population.Methods:  A total of 1856 patients from three randomized, double‐blind, multicentre, parallel‐group clinical trials were stratified at baseline according to HbA1C (< 8% or ≥ 8%), age (< 65 years or ≥ 65 years) and body mass index (BMI; < 28 kg/m2 or ≥ 28 kg/m2). The effects of study treatments on HbA1C and the incidence of hypoglycaemic symptoms were determined in each subgroup.Results:  The combination treatments were more effective than either monotherapy irrespective of baseline HbA1C, age or BMI in each trial. Antihyperglycaemic effects were greater in patients with HbA1C ≥ 8% at baseline, especially with the combinations. The majority of hypoglycaemic symptoms with glibenclamide‐containing treatments occurred in patients with HbA1C < 8% at baseline. Neither age nor BMI had a marked effect on the efficacy of the combination treatments, and there was no increase in hypoglycaemic symptoms in older patients.Conclusions:  Single‐tablet metformin–glibenclamide combination treatment is more effective than metformin or glibenclamide monotherapy, and is well tolerated in patients with hyperglycaemia inadequately controlled by diet and exercise or antidiabetic monotherapy, irrespective of their severity of hyperglycaemia at baseline, age or weight.
Polynesians: prone to obesity and Type 2 diabetes mellitus but not hyperinsulinaemia
Authors: Simmons D. , Thompson C. F. , Volklander D. 
Published: December 2004

SUMMARY Aims  To compare the extent of hyperinsulinaemia among New Zealand Europeans and Polynesians (an ethnic group at high risk of Type 2 diabetes mellitus).Methods  A cross‐sectional survey from randomly selected households was conducted in inner urban South Auckland.Subjects  were either European, Maori or Pacific Islands Polynesians aged 40–79 years and were screened for diabetes using a random blood glucose. Those with an elevated result, and 20% randomly selected from those with a normal screening result, were invited to a 75‐g glucose tolerance test. WHO criteria (1998) for diabetes were usedResults  In those aged 40–59 years, total prevalence of diabetes was 7.5 (6.2–9.0)% in Europeans but 21.1 (16.6–25.6)% among Maori and 25.0 (19.8–30.1)% among Pacific peoples; obesity (body mass index ≥ 31.0 kg/m2) was present in 26% Europeans, 63% Maori and 69% Pacific peoples. Non‐diabetic Polynesians were relatively hyperglycaemic and hyperinsulinaemic. After adjusting for the degree of obesity, Polynesians had similar insulin levels to Europeans.Conclusions  These findings indicate that Polynesians are not intrinsically insulin resistant as a group, a prerequisite found in most other ethnic groups at high risk of Type 2 diabetes mellitus. The high prevalence of Type 2 diabetes in Polynesians could be the result of their high prevalence of obesity.
Association studies of variants in promoter and coding regions of beta‐cell ATP‐sensitive K‐channel genes SUR1 and Kir6.2 with Type 2 diabetes mellitus (UKPDS 53)
Authors: Gloyn A. L. , Hashim Y. , Ashcroft S. J. H. , Ashfield R. , Wiltshire S. , Turner R. C. 
Published: December 2004

SUMMARY Aims  The beta‐cell ATP‐sensitive potassium channel consists of two subunits, SUR1 and Kir6.2. Population association studies have shown that three variants in SUR1 and one in Kir6.2 are associated with Type 2 diabetes. These polymorphisms do not result in a functional change or affect splicing, suggesting that they could be in linkage disequilibrium with a pathogenic mutation. The present study aimed firstly to screen the promoter regions of SUR1 and Kir6.2 to determine whether mutations in linkage disequilibrium with the silent variants lie in regulatory regions, which might lead to changes in gene expression. Secondly, novel and previously described variants associated with Type 2 diabetes (SUR1 exon 16–3t, exon 18 T, and Kir6.2 E23K) were investigated in the UKPDS cohort.Methods  The promoter sequences of both genes were screened by single‐stranded conformational polymorphism analysis for variants associated with Type 2 diabetes. The previously reported variants were evaluated in 364 Type 2 diabetic and 328 normoglycaemic control subjects.Results  Two variants were detected in the SUR1 promoter, a three base insertion (caa) at −522 bp and a single base substitution at − 679 bp (c→g). Neither of the variants were associated with diabetes, nor were they in a sequence consensus region for transcription factors. No association with diabetes was observed for either SUR1 variant. However, in contrast, analysis of the Kir6.2 E23K variant showed that the KK homozygosity was more frequent in Type 2 diabetic than control subjects. Variants were not associated with clinical characteristics nor did they affect response to sulphonylurea therapyConclusion  There is no support at present for mutations in either Kir6.2 or SUR1 promoter sequences contributing to Type 2 diabetes. However, the minimal promoter region of SUR1 has yet to be investigated. The E23K variant of Kir6.2 is associated with Type 2 diabetes mellitus in the UKPDS cohort.
Use of alternative medicines in diabetes mellitus
Authors: Ryan E. A. , Pick M. E. , Marceau C. 
Published: December 2004

SummaryAims  Enormous advances have been made in medical care but more people are still using herbal or alternative remedies. In chronic conditions such as diabetes patients may turn to alternative remedies that have been purported to improve glycaemic control. This study surveyed diabetic and control subjects about their use of all prescribed medication, over‐the‐counter supplements, and alternative medications.Methods  Subjects were prospectively contacted in person or by telephone. Five hundred and two diabetic subjects and 201 control subjects were asked to provide details about themselves, their diabetes (for the diabetic subjects) and their use of prescribed medication, over‐the‐counter supplements and alternative medications. Subjects were asked to rank their assessment of the effectiveness of each medication. Costs were calculated on a per month basis from average prices obtained from five alternative health stores and five chemist shops.Results  Of the diabetic subjects, 78% were taking prescribed medication for their diabetes, 44% were taking over‐the‐counter supplements and 31% were taking alternative medications. Of the control subjects, 63% were taking prescribed medication, 51% were taking over‐the‐counter supplements, and 37% were taking alternative medications. Multivitamins, vitamin E, vitamin C, calcium and aspirin were the most commonly used over the counter supplements. Garlic, echinacea, herbal mixtures, glucosamine were the most commonly used alternative medications. Chromium was used only by diabetic subjects and then only rarely. Subjects rated the effectiveness of the alternative medications significantly lower than for prescribed medications but still thought them efficacious. Alternative medications purported to have some hypoglycaemic effect were little used by diabetic subjects. Diabetic subjects spent almost as much money on over‐the‐counter supplements and alternative medications together as they did on their diabetic medications.Conclusions  One‐third of diabetic patients are taking alternative medications that they consider efficacious but this is no more than in the control group. The money spent on alternative and non‐prescription supplements nearly equals that spent on prescription medications. In view of the money spent in this area the time is past due to evaluate these remedies and to establish what merit they have.
Rosiglitazone in Type 2 diabetes mellitus: an evaluation in British Indo‐Asian patients
Authors: Barnett A. H. , Grant P. J. , Hitman G. A. , Mather H. , Pawa M. , Robertson L. , Trelfa A. 
Published: December 2004

AbstractAims To evaluate the effectiveness of rosiglitazone in reducing hyperglycaemia in patients with Type 2 diabetes mellitus (DM) of Indo‐Asian origin taking concurrent sulphonylurea therapy.Methods A randomized, double‐blind, placebo‐controlled study of 26 weeks’ duration at 31 primary and secondary care centres in areas of the UK with a high Indo‐Asian population, including 177 patients aged 28–78 years. Rosiglitazone 8 mg/day or matching placebo was added to existing sulphonylurea therapy. The primary endpoint was change from baseline in glycosylated haemoglobin A1c (HbA1c) at week 26.Results The mean changes in HbA1c were −1.16% with rosiglitazone (baseline 9.21%) and +0.26% with placebo (baseline 9.06%) (treatment difference P < 0.001; 95% confidence interval (CI) −1.81, −1.08). HbA1c fell below 8% in 55% and 19% of patients, respectively (treatment difference P < 0.001; 95% CI 0.22, 0.51). The greatest improvements occurred in patients whose glycaemic control was initially poor. Improvements in homeostasis model assessment of insulin sensitivity and pancreatic β‐cell function with rosiglitazone were not accompanied by a change in plasma insulin or C‐peptide after 26 weeks. Free fatty acids fell by 0.09 mmol/l with rosiglitazone and increased by 0.03 mmol/l with placebo (treatment difference P < 0.001; 95% CI −0.19, −0.07).Conclusion Rosiglitazone improved insulin sensitivity, pancreatic β‐cell function, and glycaemic control in Indo‐Asian patients with Type 2 DM who are at greater risk of the complications of Type 2 DM than other ethnic groups.Diabet. Med. 20, 387–393 (2003)
Proton magnetic resonance spectroscopy study of soleus muscle in non‐obese healthy and Type 2 diabetic Asian Northern Indian males: high intramyocellular lipid content correlates with excess body fat and abdominal obesity
Authors: Misra A. , Sinha S. , Kumar M. , Jagannathan N. R. , Pandey R. M. 
Published: December 2004

AbstractAims Intramyocellular lipids (IMCL) appears to be important in the pathogenesis of insulin resistance. Correlation of IMCL content of soleus muscle with insulin sensitivity has been reported in the Caucasian population. In the present study, IMCL content was estimated in the soleus muscle of both non‐obese healthy males and Type 2 diabetic males, and correlated with the anthropometric parameters, blood glucose, plasma lipids, and insulin resistance in Asian Indians from North India.Methods Twenty males (Type 2 diabetes mellitus 10; healthy controls 10) with body mass index (BMI) ≤ 25 kg/m2 were recruited in the study. In both healthy and diabetic groups, five subjects had percentage body fat (%BF) ≤ 25, and other five subjects had percentage BF > 25. The following were assessed in all subjects: body composition, fasting blood glucose, lipid profile, insulin levels, insulin resistance by homeostasis model assessment, and proton magnetic resonance spectroscopy (1H MRS) study of the soleus muscle.Results IMCL content was approximately two times higher in Type 2 diabetic males compared with healthy males (P < 0.05). Amongst healthy males, IMCL content was significantly higher (P < 0.05) in subjects with percentage BF > 25 compared with subjects with percentage BF ≤ 25. Similarly, IMCL content was high in subjects with waist–hip ratio (WHR) > 0.95 compared with subjects with WHR ≤ 0.95. In healthy males but not in diabetic males, positive significant correlation of IMCL content of soleus muscle was observed with waist circumference (r = 0.73, P < 0.05) and WHR (r = 0.71, P < 0.05). However, IMCL content did not correlate significantly to insulin resistance in both the groups.Conclusions 1H MRS study of soleus muscle in a small sample of non‐obese Asian Indians showed higher IMCL content in Type 2 diabetics compared with healthy subjects. Non‐obese healthy male subjects having high percentage BF and WHR also had high IMCL content, and it significantly correlated to waist circumference and WHR. However, lack of relationship of IMCL content with insulin resistance in Asian Indians needs further study.Diabet. Med. 20, 361–367 (2003)
Classifying diabetic foot surgery: toward a rational definition
Authors: Armstrong D. G. , Frykberg R. G. 
Published: December 2004

AbstractThe purpose of this manuscript was to describe a classification of diabetic foot surgery performed in the absence of critical limb ischaemia. The basis of this classification is centered on three fundamental variables which are present in the assessment of risk and indication: 1) the presence or absence of neuropathy (loss of protective sensation); 2) the presence or absence of an open wound; 3) the presence or absence of acute, limb‐threatening infection. The conceptual framework for this classification is to define distinct classes of surgery in an order of theoretically increasing risk for high‐level amputation. These classes include: Class I: Elective Diabetic Foot Surgery (procedures performed to treat a painful deformity in a patient without loss of protective sensation); Class II: Prophylactic (Procedure performed to reduce risk of ulceration or reulceration in person with loss of protective sensation but without open wound); Class III: Curative (Procedure performed to assist in healing open wound) and Class IV: Emergent (Procedure performed to limit progression of acute infection). The presence of critical ischaemia in any of these classes of surgery should prompt a vascular evaluation to consider a) the urgency of the procedure being considered and b) possible revascularization prior or temporally concomitant with the procedure. It is our hope that this system begins a dialogue amongst physicians and surgeons which can ultimately facilitate communication, enhance perspective, and improve care.