bluuebunny/crossref_metadata_2025_split huggingface dataset:
Change of glycaemic status in Chinese subjects with impaired fasting glycaemia
Authors: Ko G. T. C. , Chan J. C. N. , Cockram C. S. 
Published: March 2003

AbstractAims  To examine the risk of progression to diabetes in Chinese subjects with impaired fasting glycaemia (IFG) or normal fasting glucose (NFG).Methods  Between 1988 and 1996, 657 Hong Kong Chinese subjects underwent annual screening, using an oral glucose tolerance test, until they had developed diabetes, or until June 1997, when the data were analysed. All subjects had a risk factor associated with the development of diabetes such as a history of gestational diabetes or a family history of diabetes. The follow‐up interval for the subjects ranged from 0.87 to 8.54 years and of the 657, 319 had fasting plasma glucose levels of < 7.0 mmol/L where a fasting glucose level of ≥ 7.0 mmol/L was used to diagnose diabetesResults  Of the 319 nondiabetic subjects, 55 had IFG and 264 had NFG. After a median follow‐up of 1.12 years (range: 0.87–8.54 years), 27 progressed to diabetes. The Kaplan‐Meier analysis of progression to diabetes showed significant differences between subjects with IFG and subjects with NFG. Using Cox regression analysis, IFG (β = 3.51, SE = 1.63, P = 0.032) and smoking (β = 3.60, SE = 1.50, P = 0.017) were found to be independently associated with progression to diabetes.Conclusions  In Hong Kong Chinese with risk factors for glucose intolerance, IFG status is an independent risk factor for progression to diabetes.Diabet. Med. 18, 745–748 (2001)
Sex hormones regulate the contribution of PKCε and PKA signalling in inflammatory pain in the rat
Authors: Dina Olayinka A. , Aley K. O. , Isenberg William , Messing Robert O. , Levine Jon D. 
Published: March 2003

AbstractWe have evaluated the contribution of differences in second messenger signalling to sex differences in inflammatory pain and its control by sex hormones. In normal male but not female rats, epinephrine‐induced mechanical hyperalgesia was antagonized by inhibitors of protein kinase Cε (PKCε), protein kinase A (PKA) and nitric oxide synthetase (NOS). Similarly, in PKCε knockout mice, a contribution of PKCε to epinephrine‐dependent mechanical hyperalgesia occurred in males only. In contrast, hyperalgesia induced by prostaglandin E2, in both females and males, was dependent on PKA and NO. In both sexes, inhibitors of mitogen‐activated protein kinase/extracellular‐signal related kinase kinase (MEK) inhibited epinephrine hyperalgesia. In gonadectomized females, the second messenger contributions to epinephrine hyperalgesia demonstrated the pattern seen in males. Administration of oestrogen to gonadectomized females fully reconstituted the phenotype of the normal female. These data demonstrate gender differences in PKCε, PKA and NO signalling in epinephrine‐induced hyperalgesia which are oestrogen dependent and appear to be exerted at the level of the β‐adrenergic receptor or the G‐protein to which it is coupled.
Cellular kinetics of an allergic‐type response in a sheep mammary gland model of inflammation
Authors: Bischof R. J , Meeusen E. N. T 
Published: March 2003

SummaryBackground  Tissue recruitment of eosinophils and activated lymphocytes is a characteristic feature of allergic reactions. However, little is known about the involvement of specific adhesion molecules in the traffic of leucocytes during the allergic response.Objective  To use a sheep mammary infusion model to characterize the kinetics of cell recruitment and expression of cellular adhesion molecules and activation markers on eosinophils and lymphocytes involved in an allergic‐type response.Methods  Mature non‐lactating ewes were primed and challenged by direct infusion of the mammary glands with nematode larvae. Using a non‐invasive method of saline infusion and ‘milking’ of the glands, large numbers of inflammatory cells were repeatedly sampled over 10 to 96 h following their migration into the mammary gland lumen, and analyzed by 2‐colour flow cytometry.Results  Leucocyte recruitment into the mammary lumen was characterized by two separate phases involving an acute neutrophilic response at 10 h post‐challenge, followed by a dramatic reduction in neutrophils and appearance of eosinophils and activated lymphocytes. From 48 h post‐challenge, eosinophils were predominant and represented 40 to 65% of leucocytes in the mammary lavage (MAL). Increases in activated CD4+ T cells and γδ+ T cells were also observed at this time‐point. The kinetics of expression of cell surface molecules on eosinophils and lymphocytes in blood and MAL were compared during the course of the allergic‐type reaction. Adhesion molecule expression on lymphocytes was modulated following allergen challenge and an activation of MAL vs. blood lymphocytes was seen during the later stages of the allergic response. Eosinophil expression of VLA‐4 and l‐selectin was down‐regulated compared with blood at all time‐points examined. There were high levels of expression of CD11b and CD44 on eosinophils during the early compared to the late‐phase of the allergic reaction.Conclusion  These results indicate the existence of two separate mechanisms of eosinophil recruitment during the allergic inflammatory response.
Specific immunoglobulin E and immunoglobulin G antibodies to toluene diisocyanate‐human serum albumin conjugate: useful markers for predicting long‐term prognosis in toluene diisocyanate‐induced asthma
Authors: Park H.‐S. , Lee S.‐K. , Kim H.‐Y. , Nahm D.‐H. , Kim S.‐S. 
Published: March 2003

SummaryBackground Our previous study reported that more than 50% of toluene diisocyanate (TDI)‐induced asthma patients had persistent asthmatic symptoms even after complete avoidance. Although specific IgE (sIgE) has been detected in a portion of patients with TDI‐asthma, a recent investigation suggests that the presence of serum specific IgG (sIgG), not sIgE, is more closely associated with positive bronchoprovocation test (BPT) results.Objective To evaluate the possible role of sIgE and sIgG in predicting long‐term prognosis of TDI‐asthma.Materials and methods Forty‐one TDI‐asthma patients whose diagnosis was confirmed by TDI‐BPT, and 20 unexposed healthy controls were enrolled. Both sIgE and sIgG to TDI‐human serum albumin (HSA) conjugate were detected by ELISA. All patients with persistent asthmatic symptoms took anti‐asthmatic medications during the follow‐up period (mean: 67.5 months) and were instructed to avoid exposure to TDI. Airway hyper‐responsiveness to methacholine (AHM) was monitored every year during the study period. The patients were classified into three groups according to changing patterns of AHM and asthmatic symptoms as follows: group I, no improvement with persistent asthmatic symptoms (n = 12); group II, partial improvement with persistent asthmatic symptoms (n = 13); group III, in remission (n = 16).Results Favourable prognosis was associated with a mild degree of AHM at initial diagnosis (P < 0.05). Although there were no significant differences in the prevalence of sIgE antibody to TDI‐HSA conjugate among the three groups (P > 0.05), prevalence of sIgG in group I tended to be higher than in group II (0.05 < P < 0.1). However, the levels of sIgG were significantly higher in group I than in group II (P = 0.05), whereas levels of sIgE were significantly higher in group II than in group I (P = 0.014). No significant differences were noted in exposure duration, sex, age, atopic status, and total IgE level among the three groups (P > 0.05).Conclusion This study confirmed that a favourable outcome is related to a mild degree of AHM and to low levels of sIgG to predict persistent asthmatic symptoms, it also suggested that the presence of high serum‐specific IgE at initial diagnosis may represent a better prognosis.
Atopy may be related to exercise‐induced bronchospasm in asthma
Authors: Koh Y. I. , Choi I. S. , Lim H. 
Published: March 2003

SummaryBackground Recent studies suggest that atopy may be associated with exercise‐induced bronchospasm (EIB) in asthma. However, it is not clear whether atopy is related to EIB, regardless of airway hyper‐responsiveness (AHR) to methacholine, because asthmatic subjects often show AHR to exercise and methacholine simultaneously.Objective To investigate whether atopy is related to EIB in asthmatic subjects, independently of AHR to methacholine.Methods Fifty‐eight male asthmatic subjects were studied. Initial spirometry was performed. Skin prick test was carried out, using 53 common allergens including mites dust antigen. Atopy score was defined as a sum of mean weal diameters to all allergens tested. Methacholine bronchial provocation testing was performed. Twenty‐four hours later, free running test was performed. Positive EIB was defined as a 15% reduction or more in FEV1 from baseline after exercise.Results All subjects had AHR to methacholine. The degree of AHR to methacholine in asthmatics with EIB was similar to that in asthmatics without EIB. However, atopy score and skin reaction to Dermatophagoides pteronyssinus significantly increased in asthmatics with EIB compared with those without EIB (P < 0.05, respectively). Furthermore, the degree of EIB significantly correlated with atopy score in all subjects (r = 0.35, P < 0.01). This relationship was maintained even after the exclusion of EIB‐negative asthmatic subjects.Conclusion Atopy defined as skin test reactivity may contribute to the development of EIB in asthma, independently of AHR to methacholine.
Endometrial ablation using a distensible multielectrode balloon: a long‐term follow‐up report
Authors: Jones Kevin D. , Spangler Laura , Sutton Christopher 
Published: March 2003

AbstractObjective  To present long term follow up data on patients treated at The Royal Surrey County Hospital, who took part in an evaluation study of the Vesta™ system.Study design  A prospective follow‐up study at 3.5–5 years following treatment.Subjects and methods  Twenty‐five patients were asked to complete a questionnaire detailing their medical history since the initial Vesta™ system procedure, together with a validated pictorial blood loss assessment chart. A life table analysis of the patients enrolled into the European study was also carried out at 2 years.Results  Of the 25 patients, a TCRE had to be carried out as a second operation in two patients because of continuing menorrhagia, and one patient had a pictorial blood loss score of >150 but did not want further treatment at 5 years. Therefore, treatment with the Vesta™ system failed to relieve the original symptoms or avoid second surgery in 3/25 (12%) of the patients in the long term. Life table analysis of the patients enrolled into the European study has demonstrated a failure rate of 11% at 2 years.Conclusion  Our long term results suggest that the efficacy of the Vesta™ System at 2 years persists at 3.5–5 years following treatment.
HLA‐DRB1, ‐DQA1, ‐DQB1 and DPB1 susceptibility alleles in Cameroonian type 1 diabetes patients and controls
Authors: Mbanya J. C. , Sobngwi E. , Mbanya D. N. S. 
Published: March 2003

SummaryIt is known that certain combinations of alleles within the human leucocyte antigen (HLA) complex are associated with susceptibility or resistance to type 1 diabetes. Variable associations of DR and DQ with type 1 diabetes are documented in Caucasians but rarely in African populations; however, the role of HLA‐DP genes in type 1 diabetes remains uncertain. In order to investigate the HLA class II associations with type 1 diabetes in Cameroonians, we used sequence‐specific oligonucleotide probing (SSOP) to identify DRB1, DQA1, DQB1 and DPB1 alleles in 10 unrelated C‐peptide negative patients with type 1 diabetes and 90 controls from a homogeneous population of rural Cameroon. We found a significantly higher frequency of the alleles DRB1*03 (χ2 = 17.9; P = 0.001), DRB1*1301 (χ2 = 37.4; P < 0.0001), DQA1*0301 (χ2 = 18.5; P = 0.001) and DQB1*0201 (χ2 = 37.4; P < 0.001) in diabetes patients compared to the control group. The most frequent alleles in the control population were DQA1*01, DQB1*0602 and DRB1*15. The DRB1*04 allele was not significantly associated with type I diabetes in our study population. We observed no significant difference between patients and controls in DPB1 allele frequency. In conclusion, the data in Cameroonian diabetes patients suggest the existence of HLA class II predisposing and specific protective markers, but do not support previous reports of a primary association between HLA‐DP polymorphism and development of type I diabetes .
MICA and MICB microsatellite alleles in HLA extended haplotypes
Authors: Bolognesi E. , D'Alfonso S. , Rolando V. , Fasano M. E. , Praticò L. , Momigliano‐Richiardi P. 
Published: March 2003

SummaryThe present study is a contribution to the definition of the linkage disequilibrium relationship of MICA and MICB with adjacent loci and to the characterization of extended HLA haplotypes. These issues are of importance for the identification of disease associations and for a better definition of donor–recipient compatibility in bone‐marrow grafts through the typing of haplospecific markers. The distribution of the five alleles of MICA and the 13 alleles of MICB microsatellites, located, respectively, in MICA transmembrane exon 5 and in MICB intron 1, was examined in 133 healthy Italian individuals previously typed for HLA class I, class II and complement loci and for the TNFa microsatellite. The MICB microsatellite was also analysed in 49 HTCLs for which MICA typing was already available. Very strong linkage disequilibria with HLA‐B and TNFa were detected in the Italian population for both MICA and MICB microsatellite alleles, in spite of the high mutability rate of the larger MICB alleles. Some strong associations were also detected between MICB and DRB1. The strongest associations (P < 0.001,D′ > 0.7) were those of MICA‐A4 with HLA‐B18, B27 and TNFa1, MICA‐A5 with HLA‐B35, B61 and B62, MICA‐A5.1 with HLA‐B7, B8, B13, B63 and MICB‐CA24, MICA‐A6 with HLA‐B51, MICA‐A9 with HLA‐B39, B57 and TNFa2, MICB‐CA14 with HLA‐B14, B27 and TNFa1, MICB‐CA15 with HLA‐B52, TNFa4 and TNFa13, MICB‐CA17 with HLA‐B7 and TNFa11, MICB‐CA18 with HLA‐B13 and TNFa7, MICB‐CA22 with HLA‐B57, and MICB‐CA24 with HLA‐B8 and TNFa2. From pairwise associations in the random panel and results for the homozygous cell lines it was possible to deduce the MICA and MICB microsatellite alleles present in many of the well‐known Caucasoid extended haplotypes.
Promoter region polymorphism of the CD14 gene (C–159T) is not associated with psoriasis vulgaris
Authors: Karhukorpi J. , Ikäheimo I. , Karvonen J. , Karttunen R. 
Published: March 2003

SummaryKeratinocytes of psoriatic skin show aberrant expression of membrane‐bound CD14 (mCD14). In addition, soluble CD14 (sCD14) is elevated in the sera of psoriatic patients. The mechanisms leading to increased CD14 expression and secretion in psoriasis are poorly understood. A bi‐allelic polymorphism in the promoter region of the CD14 gene controls CD14 expression on monocytes and sCD14 levels in the sera of healthy subjects. In this context, we explored the CD14 promoter region genotypes of 63 Finnish patients with psoriasis and 126 non‐psoriatic controls using a new ARMS‐PCR method. No differences in the CD14 genotype frequencies were found between the groups. Thus, our results suggest that the enhanced CD14 expression in psoriasis is not attributable to functional variants of CD14 (–159C/T).
A literature review and update on the prevention and management of fluid overload in endometrial resection and hysteroscopic surgery
Authors: Varol Nesrin , Maher Peter , Vancaillie Thierry , Cooper Michael , Carter Jonathan , Kwok Adrian , Pesce Andrew , Reid Geoffrey 
Published: March 2003

AbstractObjective The purpose of this study is to provide safe guidelines to minimize the risk of fluid absorption and its complications at operative hysteroscopy.Design Retrospective review of the literature.Results Two of the major complications of fluid intravasation at hysteroscopic surgery are hyponatraemic encephalopathy and death. Fluid intravasation remains a risk despite optimal instrumentation and the use of minimal pressures to distend the uterus. While multiple factors affect the amount of fluid absorption and significant variability can exist between very similar cases, monitoring of fluid balance remains the most important issue. Techniques relying on volume measurements are less accurate than those using weight measurements and can potentially lead to significant underestimation of fluid absorption. A continuous automated weighing system provides an easy, less time‐consuming and valid method of monitoring fluid deficit. We believe the safe limit for accurately measured fluid loss should be 800 mL, as 1000 mL of glycine intravasation results in a very significant decrease in serum sodium which is sufficient to bring a normonatraemic patient into the abnormal range. It is safer to perform hysteroscopic surgery under local anaesthesia as the earliest symptoms of encephalopathy, i.e. nausea, vomiting, weakness, will alert the surgeon and anaesthesist about impending serious complications, and corrective measures can be taken earlier than when the patient is under general anaesthesia.Conclusion Fluid overload with subsequent hyponatraemic encephalopathy and death is one of the most significant complications in operative hysteroscopy. Following a protocol which entails the use of local anaesthesia and accurate fluid monitoring and sets a limit to fluid deficit will minimize this risk.
A prospective evaluation of pain and acceptability during outpatient flexible hysteroscopy and endometrial biopsy
Authors: Abbott Jason , Hawe Jed , Phillips Graham 
Published: March 2003

AbstractObjective To compare the pain of outpatient flexible hysteroscopy and endometrial sampling in women who have abnormal uterine bleeding.Design A prospective cohort study.Setting A minimal access gynaecological training unit within a district general hospital in north‐east England.Subjects 100 women referred consecutively for assessment of abnormal uterine bleeding.Main outcome measures Pain experienced with hysteroscopy and endometrial biopsy, as assessed by visual analogue score, and patient acceptability assessed by questionnaire.Results Endometrial biopsy was found to be the most painful part of the assessment and was significantly more painful than either hysteroscopy or insertion of the speculum (P  < 0.0001). The overall success of outpatient hysteroscopy in this series was 93%. On an intention‐to‐treat basis, procedure acceptability was 92% and only 9% of women required additional oral analgesia following the procedures. Of the women, 51% found the experience of outpatient hysteroscopy less painful than a cervical smear.Conclusion Outpatient flexible hysteroscopy is a viable first‐line investigation for abnormal uterine bleeding. Endometrial biopsy should be used selectively.
Accuracy of emergency department bedside ultrasonography
Authors: Rowland Jane L , Kuhn Marie , Bonnin Robert LL , Davey Michael J , Langlois Suzanne LeP 
Published: March 2003

AbstractObjectives:To determine which focused ultrasound examinations can be interpreted accurately by emergency physicians who have limited training and experience. To determine whether image quality and/or the operator’s level of confidence in the findings correlates with accurate scan interpretation.Methods:A prospective sample of consenting adult emergency department patients with the conditions was selected for study. Scans were performed by emergency physicians who had attended a 3‐day focused ultrasound examinations instruction course. All scans were videotaped and subsequently reviewed by a radiologist. Accuracy was determined by comparing the emergency physicians scan interpretation with preselected gold standards. Chi‐squared tests were employed to determine if the individual performing the scan, the type of scan, patient’s body habitus, image quality and/or operator confidence were reliable predictors of accuracy.Results:Between September 1997 and January 1999, 221  scans were studied. Accuracy varied widely depending on the type of scan performed: aortic scans were 100% accurate whereas renal scans had 68% accuracy. On bivariate analyses, there was little variation in the various operators’ levels of proficiency and accuracy of interpretation was not associated with patient body habitus, image quality or operator confidence.Conclusions:Neophytes can accurately perform and interpret aortic scans; additional training and/or experience appear to be necessary to achieve proficiency in conducting most of the other scans studied. Inexperienced operators are unable to discern whether their scan interpretations will prove accurate.
Analysis of the study design and manuscript deficiencies in research articles submitted to Emergency Medicine
Authors: Taylor David McD , Brown Anthony FT 
Published: March 2003

AbstractObjective:To describe and analyse the study design and manuscript deficiencies in original research articles submitted to Emergency Medicine.Methods:This was a retrospective, analytical study. Articles were enrolled if the reports of the Section Editor and two reviewers were available. Data were extracted from these reports only. Outcome measures were the mean number and nature of the deficiencies and the mean reviewers’ assessment score.Results:Fifty‐seven articles were evaluated (28 accepted for publication, 19 rejected, 10 pending revision). The mean (± SD) number of deficiencies was 18.1 ± 6.9, 16.4 ± 6.5 and 18.4 ± 6.7 for all articles, articles accepted for publication and articles rejected, respectively (P = 0.31 between accepted and rejected articles). The mean assessment scores (0–10) were 5.5 ± 1.5, 5.9 ± 1.5 and 4.7 ± 1.4 for all articles, articles accepted for publication and articles rejected, respectively. Accepted articles had a significantly higher assessment score than rejected articles (P = 0.006). For each group, there was a negative correlation between the number of deficiencies and the mean assessment score (P > 0.05). Significantly more rejected articles ‘… did not further our knowledge’ (P = 0.0014) and ‘… did not describe background information adequately’ (P = 0.049). Many rejected articles had ‘… findings that were not clinically or socially significant’ (P = 0.07). Common deficiencies among all articles included ambiguity of the methods (77%) and results (68%), conclusions not warranted by the data (72%), poor referencing (56%), inadequate study design description (51%), unclear tables (49%), an overly long discussion (49%), limitations of the study not described (51%), inadequate definition of terms (49%) and subject selection bias (40%).Conclusions:Researchers should undertake studies that are likely to further our knowledge and be clinically or socially significant. Deficiencies in manuscript preparation are more frequent than mistakes in study design and execution. Specific training or assistance in manuscript preparation is indicated. See Commentary, page 407.
Angioedema in the emergency department: A presentation of lymphoma
Authors: Wellwood Jeremy , Taylor Kerry , Wright Susan , Bentley Mark , Eliadis Paul 
Published: March 2003

AbstractA 58‐year‐old woman presented to emergency departments on several occasions with episodic angioedema. Lymphoplasmacytic lymphoma with an IgM paraprotein (Waldenstrom’s macroglobulinemia) was eventually diagnosed 14 months later in association with acquired C1 esterase inhibitor deficiency. Resolution of the angioedema and C1 esterase inhibitor deficiency was achieved with danazol and treatment of the underlying lymphoma.