bluuebunny/crossref_metadata_2025_split huggingface dataset:
Specific T‐cell receptor usage with cytokinemia in Henoch–Schönlein purpura nephritis associated with Staphylococcus aureus infection
Authors: Hirayama K. , Kobayashi M. , Muro K. , Yoh K. , Yamagata K. , Koyama A. 
Published: March 2003

Abstract. Hirayama K, Kobayashi M, Muro K, Yoh K, Yamagata K, Koyama A (Department of Internal Medicine, Institute of Clinical Medicine, University of Tsukuba; and Department of Nephrology, Tokyo Medical University Kasumigaura Hospital, Ibaraki, Japan) Specific T‐cell receptor usage with cytokinemia in Henoch–Schönlein purpura nephritis associated with Staphylococcus aureus infection (Original article). J Intern Med 2001; 249: 289–295. Objectives. We sought to evaluate the mechanism of Henoch–Schönlein purpura nephritis (HSPN) associated with Staphylococcus aureus (S. aureus) infection. Design. We evaluated six male patients with HSPN associated with S. aureus infection. Routine laboratory examinations, bacteriological examination, histological examination, and analysis of serum cytokine levels were performed in all cases. In addition, peripheral blood mononuclear cells (PBMC) obtained from the six patients and 45 normal individuals were stained with labelled‐monoclonal antibodies against six variable parts of the β‐chain (Vβ) of the T‐cell receptor (TCR), and stained cells were analysed by flow cytometry. Results. Patients with HSPN associated with S. aureus infection showed features of the nephrotic syndrome with rapidly progressive glomerulonephritis, as well as varying degrees of mesangial proliferative glomerulonephritis with crescent formation. Serological examination showed elevated levels of serum IgA and IgG as well as immune complexes after the onset of infection. The percentage of Vβ‐(5.2 + 5.3) and Vβ 8‐positive cells in patients with HSPN were significantly higher than in normal individuals; moreover, specific TCR‐Vβ usage was not observed in patients with HSPN whose S. aureus infection had improved. Serum levels of IL‐1β, IL‐2, IL‐6, IL‐8 and TNF‐α in patients with HSPN were significantly higher than in normal individuals, and normalized at the healing stage of S. aureus infection. Conclusion. Conventional antigens and/or staphylococcal enterotoxins originated from S. aureus might have been involved in the pathogenesis of HSPN in the present cohort. Therefore, steroid or other immunosuppressive therapies could not be utilized despite the high activity of glomerulonephritis, and as a result the prognoses of these cases of HSPN were serious.
Nicotine infusion acutely impairs insulin sensitivity in type 2 diabetic patients but not in healthy subjects
Authors: Axelsson T. , Jansson P.‐A. , Smith U. , Eliasson B. 
Published: March 2003

Abstract. Axelsson T, Jansson P‐A, Smith U, Eliasson B (Sahlgrenska University Hospital, Göteborg, Sweden). Nicotine infusion acutely impairs insulin sensitivity in type 2 diabetic patients but not in healthy subjects. J Intern Med 2001; 249: 539–544. Objectives. The aim of this study was to examine if an acute nicotine infusion alters insulin sensitivity to a similar degree in type 2 diabetic patients as in healthy control subjects. Design. Double‐blind, cross‐over, placebo‐controlled, randomized experimental study. Nicotine 0.3 μg kg–1 min–1 or NaCl was infused (2 h) during a euglycaemic hyperinsulinaemic clamp (4 h) to assess insulin sensitivity. Setting. University research laboratory. Subjects. Six male and female type 2 diabetic patients [DM2; age 54 ± 10 (mean ± SD) years; body mass index (BMI) 25.6 ± 2.9 kg m–2] treated with diet or one oral hypoglycaemic agent and six age‐ and BMI‐matched control subjects (Ctr). Main outcome measures. Insulin sensitivity (rate of glucose infusion per kg fat free body mass and minute), nicotine and free fatty acid (FFA) levels, pulse rate and blood pressure. Results. The infusions produced similar nicotine levels in both groups. In the absence of nicotine, DM2 were more insulin resistant than Ctr (6.7 ± 0.4 vs. 10.9 ± 0.3 mg kg–1 LBM min–1, respectively; P < 0.0001). This insulin resistance was further aggravated by the nicotine infusion in DM2 but not in Ctr (4.6 ± 0.3 vs. 10.9 ± 0.3 mg kg–1 LBM min–1; P < 0.0001). Only minor differences were seen in FFA levels, pulse rates and blood pressure. Conclusions. At this low infusion rate, nicotine aggravated the insulin resistance in DM2 but not in Ctr. This finding may be because of the (dysmetabolic) diabetic state per se or to an increased sensitivity to environmental factors associated with a genetic predisposition for type 2 diabetes. These results show that diabetic subjects are particularly susceptible to the detrimental effects of nicotine.
Cost of illness of adult diabetes mellitus underestimated if comorbidity is not considered
Authors: Norlund A. , Apelqvist J. , Bitzén P.‐O. , Nyberg P. , Scherstén B. 
Published: March 2003

Norlund A, Apelqvist J, Bitzén P.‐O, Nyberg P, Scherstén (Swedish Council on Technology Assessment in Health Care, Stockholm; and University Hospital; and Dalby/Lund, University of Lund, Lund, Sweden) Cost of illness of adult diabetes mellitus underestimated if comorbidity is not considered.J Intern Med2001;250:57–65.Objective. To determine costs of illness for adult diabetes mellitus (DM), including complications caused by DM.Design. A population‐based multicentre cross‐ sectional study including an interview and a physical examination of patients identified as having DM. The patients’ medical records were analysed regarding diagnoses and complications attributable to DM.Setting. Eight health care centres of six primary care districts in Southern Sweden.Subjects. 1677 adults aged 25+, cared for at the health care centres, entered the study.Main outcome measures. Utilization of health care and care from relatives and the municipality, absence of short‐ and long‐term sickness, cost of illness.Results. The average annual direct and indirect costs for an adult with DM were calculated to be 61 700 Swedish Kronor (SEK) or 2.5 times higher than earlier estimates. The incremental cost of DM was 34 100 SEK. The cost distribution was 28% for health care, 31% for the municipality and relatives and 41% lost productivity.Conclusions. Calculations for the cost of illness of DM are underestimated if comorbidity caused by DM is not considered. When DM‐related complications are included to identify the actual burden of disease to society, the cost of illness as a result of DM in Sweden is substantially higher than previously estimated.
Prevalence of increased QT interval duration and dispersion in type 2 diabetic patients and its relationship with coronary heart disease: a population‐based cohort
Authors: VEGLIO M. , BRUNO G. , BORRA M. , MACCHIA G. , BARGERO G. , D'ERRICO N. , PAGANO G. F. , CAVALLO‐PERIN P. 
Published: March 2003

Abstract. Veglio M, Bruno G, Borra M, Macchia G, Bargero G, D'Errico N, Pagano GF, Cavallo‐Perin P (Evangelico Valdese Hospital, Torino; University of Torino, Torino; and S. Spirito Hospital, Casale Monferrato; Italy). Prevalence of increased QT interval duration and dispersion in type 2 diabetic patients and its relationship with coronary heart disease: a population‐based cohort. J Intern Med 2002; 251: 317–324. Objective. To evaluate the prevalence of prolonged QT interval and dispersion in a population‐based cohort of type 2 diabetic patients and their relationship with clinical and metabolic variables. Design. Cross‐sectional population‐based cohort. Setting. Diabetes clinics and general practitioners in Casale Monferrato (Northern Italy). Subjects. A total of 1357 patients with known type 2 diabetes (70% of the cohort). Main outcome measures. Albumin excretion rate and coronary heart disease (CHD); a standard supine 12‐lead electrocardiogram (ECG) was recorded and coded according to the Minnesota code criteria. QT interval corrected for heart rate (QTc) > 0.44 s and QTc dispersion > 0.080 s were considered abnormally prolonged. Results. Prevalence of increased QTc duration and QTc dispersion were 25.8% (95% CI 23.5–28.3) and 33.1% (95% CI 30.6–35.7), with no sex differences. No metabolic differences were found, apart from fibrinogen and creatinine levels, which were higher in patients with increased QTc dispersion. Patients with CHD had higher mean adjusted values of QTc and QTc dispersion, whereas no association was found with albumin excretion rate (AER) and diabetes treatment. QTc duration and QTc dispersion were significantly correlated (0.17, P < 0.001). In multiple regression analysis, only CHD was independently associated with QTc, after adjustment for age and sex (β=0.010, P < 0.001, R2=2.5%); as regards QTc dispersion, a similar association with CHD was found (β=0.20, P < 0.001, R2=4.8%). Conclusions. This population‐based study shows a considerably high prevalence of increased QTc and QTc dispersion in type 2 diabetic patients and their association with CHD. These findings have both epidemiological and clinical relevance, as they might be implicated in the excess mortality risk of type 2 diabetic patients.
Cardiovascular prevention before admission reduces mortality following acute myocardial infarction in patients with diabetes
Authors: LÖNDAHL M. , KATZMAN P. , NILSSON A. , LJUNGDAHL L. , PRÜTZ K.‐G. 
Published: March 2003

Abstract. Löndahl M, Katzman P, Nilsson A, Ljungdahl L, Prütz K‐G (Helsingborg Hospital, Helsingborg, Sweden). Cardiovascular prevention before admission reduces mortality following acute myocardial infarction in patients with diabetes. J Intern Med 2002; 251: 325–330. Objectives. Previous studies have shown that patients with diabetes mellitus have an increased mortality after suffering from acute myocardial infarction (AMI). Patients with diabetes have several risk factors for cardiovascular disease. Our objective was to quantify the prevalence of pharmacological cardiovascular prevention at admission and relate such treatment to short and long‐term mortality following AMI in patients with and without diabetes. Design and subjects. All patients discharged from the Department of Internal Medicine at Helsingborg Hospital in 1996 and 1997 with a principal diagnosis of AMI were included in the study. Patients were divided into two groups according to the presence or absence of diabetes. Cardiovascular risk factors, on‐going medication, type of ward following admission, peak creatine kinase MB mass (CKMB) and immediate treatment were registered. Information about death was obtained from the national register. Kaplan–Meier analysis was performed for life‐expectancy. Results. A total of 673 patients with AMI were registered, of which 117 (17.4%) had diabetes. No differences in 30 days (17.1% vs. 15.3%) or 1‐year (24.8% vs. 27.4%) mortality were seen between the diabetes and control groups, whereas the 2‐year mortality was significantly higher in the diabetes group (40.2% vs. 29.1%). Cardiovascular risk factors occurred more often in the diabetes group and the use of aspirin, ACE‐inhibitors, statins and diuretics was significantly more frequent. In patients treated with aspirin, in combination with either statin or angiotensin converting enzyme (ACE)‐inhibitor, or both, no differences were seen in 30 days, 1 or 2‐year mortality between groups. Conclusion. In contrast to earlier studies we did not find an increased 30 days and 1‐year mortality in patients with diabetes suffering from AMI. This discrepancy was linked to a higher frequency of pharmacological cardiovascular prevention, a finding supporting the hypothesis that survival of a diabetes patient after AMI could be affected by factors operating before the infarction.
Muscle strength, Na,K‐pumps, magnesium and potassium in patients with alcoholic liver cirrhosis – relation to spironolactone
Authors: AAGAARD N. K. , ANDERSEN H. , VILSTRUP H. , CLAUSEN T. , JAKOBSEN J. , DØRUP I. 
Published: March 2003

Abstract. Aagaard NK, Andersen H, Vilstrup H, Clausen T, Jakobsen J, Dørup I (University of Aarhus, Aarhus, Denmark). Muscle strength, Na, K‐pumps, magnesium and potassium in patients with alcoholic liver cirrhosis – relation to spironolactone. J Intern Med 2002; 252: 56–63. Objectives. To evaluate the muscle strength in relation to muscle contents of magnesium (Mg), potassium (K) and sodium, potassium (Na,K)‐pumps in patients with alcoholic cirrhosis. Design. An open cross‐sectional study. Setting and subjects. Fifty‐one consecutive patients with liver cirrhosis admitted to the Department of Hepatology, Aarhus University Hospital, Denmark, and 28 age‐ and sex‐matched healthy control subjects. Main outcome measures. Biopsies of skeletal muscle were performed in patients and controls for measurements of Mg, K, and Na,K‐pumps. Furthermore, maximum isokinetic knee extension and skeletal muscle mass were evaluated. Results. Muscle mass, muscle strength, muscle Mg and muscle K were substantially reduced in the patients (P < 0.01, all), and fell with increasing severity of the liver disease reflected in the Child‐Pugh (C‐P) class. Patients treated with spironolactone for 2 weeks or more, had increased muscle strength, muscle Mg and content of Na,K‐pumps, compared with the rest of the patients (P < 0.05, all). In a multivariate analysis of the patients, skeletal muscle mass, muscle Mg and daily alcohol consumption (g) were independent predictors of isokinetic muscle strength (P < 0.05, all). Conclusions. Patients with alcoholic liver cirrhosis showed considerably reduced muscle strength and muscle Mg was an independent predictor of muscle strength. Surprisingly, in the spironolactone treated patients, muscle weakness was less pronounced, possibly because of the action of spironolactone on muscle Mg, K and Na,K‐pump content.
Invasive pulmonary aspergillosis resulting in respiratory failure during neutrophil recovery from postchemotherapy neutropenia in three patients with acute leukaemia
Authors: Takuma T. , Okada K. , Uchida Y. , Yamagata A. , Sawae Y. 
Published: March 2003

Abstract. Takuma T, Okada K, Uchida Y, Yamagata A, Sawae Y (Kyushu University Graduate School of Sciences, Fukuoka, Japan; University of California, CA, USA; and Shin‐kokura Hospital, Fukuoka, Japan). Invasive pulmonary aspergillosis resulting in respiratory failure during neutrophil recovery from postchemotherapy neutropenia in three patients with acute leukaemia (Case Report). J Intern Med 2002; 252: 173–177.Respiratory failure is a severe complication of invasive pulmonary aspergillosis (IPA). Its pathogenesis is not well understood. We herein describe three cases of subacute respiratory failure that occurred during the recovery phase of neutropenia following induction chemotherapy for acute leukaemia with IPA. In each case, severe neutropenia (19–85 days), high‐grade fever, severe anaemia, the use of granulocyte‐colony‐stimulating factor and increasing infusion volume were noted. As the neutrophil count was recovering, the shadows on the chest X‐ray expanded with progressing hypoxia. We should pay attention to the respiratory failure during the recovery phase of neutropenia in patients with IPA.
Adrenal incidentaloma – experience of a standardized diagnostic programme in the Swedish prospective study
Authors: Bülow B. , Ahrén B. ,   the Swedish Research Council Study Group of Endocrine Abdominal Tumours
Published: March 2003

Abstract  Bülow B, Ahrén B (Lund University, Lund, Sweden) on behalf of the Swedish Research Council Study Group of Endocrine Abdominal Tumours. Adrenal incidentaloma – experience of a standardized diagnostic programme in the Swedish prospective study. J Intern Med 2002; 252: 239–246.Objective.  To report the 5‐year experience of a diagnostic programme for adrenal incidentaloma with special emphasis to diagnose hormonally active and malignant lesions.Design.  A prospective study in which new cases of adrenal incidentalomas in Sweden have been evaluated by a standardized diagnostic protocol between January 1996 and July 2001.Setting.  Thirty‐three different Swedish hospitals have contributed with cases.Subjects.  A total of 381 patients (217 females, 164 males) with adrenal incidentalomas were studied.Interventions.  Diagnostic procedures were undertaken according to a standardized programme. Operation was recommended if the incidentaloma had a size of more than 3–4 cm or if there was a suspicion of a hypersecreting tumour.Main outcome measures.  The size of the incidentaloma, clinical characteristics of the patients and results of biochemical diagnostic tests were registered.Results.  The median age of the patients was 64 years (18–84 years), and the median size of the incidentalomas was 3 cm (1–20 cm). A total of 85(22%) patients were operated. Twenty of thesepatients were diagnosed with a benign hypersecreting tumour and 14 with a malignant tumour. Fourteen of 15 operated patients with diagnosed pheochromocytoma had elevated 24‐h urinary noradrenaline and all of the patients operated because of a biochemical suspicion of aldosterone or cortisol hypersecretion (n = 6) were found to have adrenal adenomas. Of the 14 operated patients with malignant diseases, 10 were adrenal carcinomas (median size 10 cm; range 4–16 cm). In a multiple logistic regression model, incidentaloma size was significantly associated with the risk of a malignant tumour (P = 0.009), and there was a tendency of an association between age/male sex and the risk of a malignancy (both, P = 0.07).Conclusion.  In this Swedish multicentre study of 381 cases with adrenal incidentalomas, 5% had benign hypersecreting tumours and nearly 4% had malignant tumours. The results of the biochemical diagnostic tests used had a high compatibility with the histological diagnosis found at operation in the patients with hypersecreting tumours. Tumour size, male gender and high age were predictive for the risk of a malignant tumour. A follow‐up of the patients is warranted in order to establish whether there are undiscovered cases of malignant or hypersecreting tumours amongst the nonoperated patients.
Endothelium‐dependent flow‐mediated vasodilatation, insulin resistance and the metabolic syndrome in 60‐year‐old men
Authors: Wendelhag I. , Fagerberg B. , Hulthe J. , Bokemark L. , Wikstrand J. 
Published: March 2003

Objectives.  To evaluate the endothelium‐dependent flow‐mediated vasodilatation (FMD) in the brachial artery and to study the relationship to insulin sensitivity and to the metabolic syndrome in 60‐year‐old clinically healthy men.Subjects.  The men were randomly selected from the general population (n = 55). The subjects with the metabolic syndrome were defined according to a definition proposed by a working group associated with the World Health Organization (WHO).Methods.  Ultrasound images for measurement of lumen diameter of the brachial artery were recorded before and after reactive hyperaemia induced by occlusion of the artery, both with and without ischaemic hand exercise during the occlusion. Insulin‐mediated glucose uptake was determined by euglycaemic hyperinsulinaemic clamp as a measure of insulin sensitivity.Results.  The FMD was in the total group 3.2% when hyperaemia was induced by occlusion only and 8.7% after occlusion plus ischaemic hand exercise (P < 0.001, n = 51). However, no relationship was observed between any measure of FMD and insulin‐mediated glucose uptake (r = −0.05 and r = 0.06, n = 47, P > 0.30). Furthermore, subjects with the metabolic syndrome (n = 13) did not differ in any measure of FMD compared with those with no risk factors (n = 11).Conclusion.  In this study the ultrasound method to evaluate endothelial function did not show that low insulin sensitivity or the metabolic syndrome were associated with impaired FMD in otherwise clinically healthy 60‐year‐old men.
Fitness, fatness and activity as predictors of bone mineral density in older persons
Authors: Stewart K. J. , Deregis J. R. , Turner K. L. , Bacher A. C. , Sung J. , Hees P. S. , Tayback M. , Ouyang P. 
Published: March 2003

Abstract. Stewart KJ, DeRegis JR, Turner KL, Bacher AC, Sung J, Hees PS, Tayback M, Ouyang P (Johns Hopkins Bayview Medical Center, Johns Hopkins University, School of Medicine, Baltimore, MD, USA). Fitness, fatness, and activity as predictors of bone mineral density in older persons. J Intern Med 2002; 252: 381–388.Objectives. To determine relationships of bone mineral density (BMD) with fitness, physical activity, and body composition and fat distribution.Design. Cross‐sectional.Setting. General Clinical Research Center, Johns Hopkins Bayview Medical Center, Baltimore, Maryland.Subjects. Men (n = 38) and women (n = 46), aged 55–75 years with high normal blood pressure or mild hypertension but otherwise healthy.Methods. Aerobic fitness (oxygen uptake) on a treadmill, muscle strength by one‐repetition maximum, activity by questionnaire, abdominal obesity by magnetic resonance imaging; anthropometrics, and body composition by dual energy X‐ray absorptiometry (DXA) which measured total fat and lean mass, and BMD for the total skeleton, lumbar spine (L1–L4) and total hip.Results. Aerobic fitness did not correlate with BMD. Using multivariate analysis to ascertain independent contributions to the variance in BMD, in women, with adjustment for hormone replacement therapy (HRT), total skeleton BMD was independently related to muscle strength and abdominal total fat; total hip BMD to body weight; lumbar spine BMD to abdominal total fat. HRT also influenced BMD in the lumbar spine. In men, lumbar spine BMD was independently related to abdominal total fat physical activity and total hip BMD related to lower body strength. P < 0.05 for all of these correlations.Conclusions. Abdominal obesity and muscle strength emerge as predominant correlates of BMD in older persons with stronger relationships seen in women. Body weight and HRT also explained portions of the variance in BMD in women. Whether abdominal obesity is simply a marker for general obesity or has independent protective effects on bone is yet to be determined.
An integrated approach to the study of living cells by atomic force microscopy
Authors: Nagao  , Dvorak  
Published: March 2003

We describe a technique for studying living cells with the atomic force microscope (AFM) in tapping mode using a thermostated, controlled‐environment culture system. We also describe the integration of the AFM with bright field, epifluorescence and surface interference microscopy, achieving the highest level of integration for the AFM thus far described. We succeeded in the continuous, long‐term imaging of relatively flat but very fragile cytoplasmic regions of COS cells at a lateral resolution of about 70 nm and a vertical resolution of about 3 nm. In addition, we demonstrate the applicability of our technology for continuous force volume imaging of cultured vertebrate cells.The hybrid instrument we describe can be used to collect simultaneously a diverse variety of physical, chemical and morphological data on living vertebrate cells. The integration of light microscopy with AFM and steady‐state culture methods for vertebrate cells represents a new approach for studies in cell biology and physiology.