bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chronic myelogenous leukaemia – new therapeutic principles
Authors: O'Dwyer Michael E. , Druker Brian J. 
Published: March 2003

O’Dwyer ME, Druker BJ (Oregon Health Sciences University, Portland, USA). Chronic myelogenous leukaemia – new therapeutic principles. J. Intern Med 2001; 250: 3–9The deregulated tyrosine kinase activity of the BCR‐ABL fusion protein is the cause of malignant transformation in almost all cases of chronic myelogenous leukaemia (CML), making BCR‐ABL an ideal target for pharmacological inhibition. Signal transduction inhibitor (STI571) (formerly CGP57 148B), is an ABL specific, tyrosine kinase inhibitor. In preclinical studies, it has been shown to selectively kill BCR‐ABL expressing cells, both in‐vitro and in vivo. The results of clinical studies to date are highly encourageing and STI571 promises to be an important addition to the therapy of CML.
Lack of association between polymorphisms of catalase, copper–zinc superoxide dismutase (SOD), extracellular SOD and endothelial nitric oxide synthase genes and macroangiopathy in patients with type 2 diabetes mellitus
Authors: Ukkola O. , Erkkilä P. H. , Savolainen M. J. , Kesäniemi Y. A. 
Published: March 2003

Abstract. Ukkola O, Erkkilä PH, Savolainen MJ, Kesäniemi YA (University of Oulu, Oulu, Finland). Lack of association between polymorphisms of catalase, copper–zinc superoxide dismutase (SOD), extracellular SOD and endothelial nitric oxide synthase genes and macroangiopathy in patients with type 2 diabetes mellitus. J Intern Med 2001; 249: 451–459. Objectives. The association between the polymorphisms of three different antioxidative enzyme – catalase, copper–zinc superoxide dismutase (Cu/ Zn‐SOD) and extracellular superoxide dismutase (EC‐SOD) – genes and macroangiopathy was examined in patients with type 2 diabetes mellitus. The prevalence of the missense Glu298Asp variant of the endothelial nitric oxide synthase (eNOS) gene and its association with macroangiopathy were also determined. Design. Cross‐sectional study. Setting. District around Oulu University Hospital, North Finland. Subjects and methods.  A total of 239 patients with type 2 diabetes mellitus and 245 control subjects were screened. Genotypes were determined by polymerase chain reaction (PCR) technique. The diagnosis of coronary heart disease (CHD) was based on clinical and ECG criteria. The prevalences of cerebrovascular (CVD) and peripheral vascular diseases (PVD) were assessed on the basis of clinical criteria. Laboratory analyses were carried out in the hospital laboratory. Results. No differences in the genotype distributions and allele frequencies of the antioxidative enzymes were found between type 2 diabetes mellitus patients and controls. The eNOS genotypes and allele frequencies were also similar in the diabetic patients and controls being close to that reported earlier in the British population. None of the polymorphisms were associated with macro‐ or microangiopathy or hypertension. However, male diabetic patients with eNOS Asp298Asp genotype had higher plasma very‐low density lipoprotein (VLDL) cholesterol and VLDL‐triglyceride concentrations than those with the genotypes Glu298Glu or Glu298Asp (P < 0.01 for trend). Conclusions. The polymorphism of catalase, Cu/Zn SOD and EC‐SOD genes were not related to cardiovascular disease in type 2 diabetes mellitus patients. The eNOS Glu298Asp variant was associated with plasma VLDL‐containing lipoproteins but not with macroangiopathy in diabetic male patients. The findings do not support the notion that the polymorphisms of the key antioxidative enzymes could be amongst the factors that explain the high prevalence of macroangiopathy in patients with type 2 diabetes mellitus.
Treatment of benign nodular goitre with mildly suppressive doses of L‐thyroxine: effects on bone mineral density and on nodule size
Authors: BALDINI M. , GALLAZZI M. , ORSATTI A. , FOSSATI S. , LEONARDI P. , CANTALAMESSA L. 
Published: March 2003

Abstract. Baldini M, Gallazzi M, Orsatti A, Fossati S, Leonardi P, Cantalamessa L (Department of Internal Medicine, University of Milan, IRCCS Ospedale Maggiore and Istituto Ortopedico G. Pini, Milan, Italy). Treatment of benign nodular goitre with mildly suppressive doses of L‐thyroxine: effects on bone mineral density and on nodule size. J Intern Med 2002; 251: 407–414. Objectives. To evaluate (i) the demineralizing effect of L‐thyroxine (LT4) therapy at doses mildly inhibiting serum thyroid stimulating hormone (TSH) in patients with benign nodular goitre; (ii) the efficacy of treatment on nodule size. Design. Cross‐sectional study comparing euthyroid women with nodular goitre treated with LT4 for ≥ 2 years (52 ± 32 months, range 24–138, median 42) and a matched group with untreated goitre. Subjects. A total of 89 female outpatients (53.3 ± 9 years; 36 pre‐ and 53 postmenopausal), 43 treated and 46 untreated. Main outcome measures. Bone mineralization was measured with total body and regional mineralometry [dual energy X‐ray absorptiometry (DEXA)], and indirectly evaluated with biochemical parameters (alkaline phosphatase, osteocalcin). Efficacy of LT4 therapy was assessed by measuring the nodule size during ultrasonography. The adequacy of the treatment was evaluated on the basis of serum TSH levels. Results. No significant differences were found at DEXA for total body and regional mineralization (P > 0.05 for all comparisons) in treated and untreated patients, both in pre‐ and postmenopausal states. Evaluation of the nodule size during the ultrasound scan showed a reduction of ≥ 30% in 11 of 43 treated patients (26%) versus none of the untreated, an unchanged size in 29 treated patients (67%) versus 18 untreated, an increase of nodules and/or new nodule development in three treated patients (7%) versus 28 untreated (61%). Conclusions. L‐thyroxine (LT4) treatment at doses slightly suppressing TSH does not significantly affect bone mineralization, nor does it represent a risk factor for osteoporosis, even in postmenopausal patients. The efficacy of this therapeutic schedule on goitre size is comparable with the effects previously reported with suppressive doses.
Adulteration of Chinese herbal medicines with synthetic drugs: a systematic review
Authors: Ernst E. 
Published: March 2003

Abstract. Ernst E. (University of Exeter, Exeter, UK). Adulteration of Chinese herbal medicines with synthetic drugs: a systematic review (Review Article). J Intern Med 2002; 252: 107–113.The popularity of Chinese herbal medicines (CHMs) demands a critical analysis of safety issues. The aim of this systematic review is to summarize data regarding adulterations of CHMs with conventional drugs. Literature searches were carried out in six databases. Articles containing original data on adulterations were considered without language restrictions. Eighteen case reports, two case series and four analytical investigations were identified. The list of adulterants contains drugs associated with serious adverse effects like corticosteroids. In several instances, patients were seriously harmed. One report from Taiwan suggests that 24% of all samples were contaminated with at least one conventional pharmacological compound. It is concluded that adulteration of CHMs with synthetic drugs is a potentially serious problem which needs to be addressed by adequate regulatory measures.
Atypical attack of acute intermittent porphyria – paresis but no abdominal pain
Authors: Andersson C. , Nilsson A. , Bäckström T. 
Published: March 2003

Abstract. Andersson C, Nilsson A, Bäckström T (University Hospital, Umeå, Sweden; and Primary Health Care Centre, Arvidsjaur). Atypical attack of acute intermittent porphyria – paresis but no abdominal pain (Case report). J Intern Med 2002; 252: 265–270.We report a case of acute intermittent porphyria (AIP) in a 45‐year‐old woman. Her first attack occurred at the age of 38. Because of escalating cyclical premenstrual attacks, the following 2 years, depletion of the endogenous sex hormone was considered as haeme arginate treatment proved insufficient. Gonadotropin releasing hormone agonist treatment with low‐dose oestradiol add back was quite successful initially but was abandoned after 18 months when progesterone add back precipitated a severe attack. Following hysterectomy and oophorectomy at age 42 and oestradiol add back, a remarkable monthly regularity of attacks ensured periodically but with milder symptoms. Two years after surgery, preceded by six attack‐free months, a puzzling symptom‐shift occurred, from abdominal pain, back and thigh pain during the attacks, to solely severe distal extensor paresis in the arms. Haeme arginate treatment interrupted the progress of the paresis almost immediately and motor function improved considerably up to the 9‐month follow‐up. Electrophysiological examination revealed only motor neuropathy, consistent with axonal degeneration. Subsequently the symptoms changed yet again, to sensory disturbances with numbness and dysesthesia as the primary expression followed by rather mild abdominal pain. However, cyclical attacks occurred, despite absence of endogenous ovarial hormone production, possibly attributable to impaired oestrogen metabolism in the liver, or adrenal oestrogen production. Treatment comprising oophorectomy, low‐dose oestradiol add back and haeme arginate infusion for 2 days on the appearance of early AIP symptoms is now quite successful affording improvement in life quality.
A case of POEMS syndrome associated with reactive amyloidosis and Waldenström's macroglobulinaemia
Authors: Kihara Y. , Hori H. , Murakami H. , Hatakeyama Y. , Yoshikawa I. , Hamada T. , Otsuki M. 
Published: March 2003

Abstract. Kihara Y, Hori H, Murakami H, Hatakeyama Y, Yoshikawa I, Hamada T, Otsuki M (University of Occupational and Environmental Health, Japan, School of Medicine, Kitakyushu, Japan). A case of POEMS syndrome associated withreactive amyloidosis and Waldenström's macroglobulinaemia (Case report). J Intern Med 2002; 252: 255–258.A72‐year‐old Japanese man presented with a 5‐year history of fatigue, night sweats, oedema of dorsum of foot, muscle weakness, and paresthesia of the lower extremities. On examination, the patient fulfilled the diagnostic criteria for POEMS syndrome, but was unusual in that he also had underling Waldenström's macroglobulinaemia with IgM κ. The M protein of POEMS syndrome is usually IgG and IgA with λ light chains. To our knowledge, there are only three cases of POEMS syndrome with IgM κ including our case. Autopsy findings revealed that small lymphocytes were more prominent than plasma cells in the bone marrow. These plasma cells were stained with IgM κ. Amyloid deposits identified by Congo red stain were detected predominantly in the vascular walls of the gastrointestinal tract, pancreas and kidney. This amyloid protein was classified as amyloid associated protein. This is the first case of POEMS syndrome associated with reactive amyloidosis and Waldenström's macroglobulinaemiae.
Circulating oxidized low‐density lipoprotein (LDL) is associated with risk factors of the metabolic syndrome and LDL size in clinically healthy 58‐year‐old men (AIR study)
Authors: Sigurdardottir V. , Fagerberg B. , Hulthe J. 
Published: March 2003

Abstract. Sigurdardottir V, Fagerberg B, Hulthe J (Sahlgrenska University Hospital, Göteborg University, Gothenburg, Sweden). Circulating oxidized low‐density lipoprotein (LDL) is associated with risk factors of the metabolic syndrome and LDL size in clinically healthy 58‐year‐old men (AIR study). J Intern Med 2002; 252: 440–447.Objectives. Hypothetically the atherogenic effect of the metabolic syndrome may be mediated through the increased occurrence of small LDL‐particles which are easily modified to atherogenic oxidized LDL (ox‐LDL). The aim of this study was to test this concept by examining the association between circulating ox‐LDL, LDL‐particle size, and the metabolic syndrome.Design and results. A population‐based sample of clinically healthy 58‐year‐old men (n = 391) was recruited. Ox‐LDL was measured by ELISA (specific monoclonal antibody, mAb‐4E6) and LDL‐particle size by gradient gel electrophoresis. The results showed that ox‐LDL significantly correlated to factors constituting the metabolic syndrome; triglycerides (r = 0.43), plasma insulin (r = 0.20), body mass index (r = 0.20), waist‐to‐hip ratio (r = 0.21) and HDL (r = −0.24); (P < 0.001). Ox‐LDL correlated also to LDL‐particle size (r = −0.42), Apo‐B (r = 0.70), LDL (r = 0.65); (P < 0.001) and, furthermore, with Apo A‐1 (r = −0.13) and heart rate (r = 0.13); (P < 0.01).Conclusion. The metabolic syndrome was accompanied by high plasma ox‐LDL concentrations compared with those without the syndrome. Ox‐LDL levels were associated with most of the risk factors constituting the metabolic syndrome and was, in addition related to small LDL‐particle size. To our knowledge the present study is the first one to demonstrate that circulating ox‐LDL levels are associated with small LDL‐particle size in a population representative sample of clinically healthy middle‐aged men. The high degree of intercorrelation amongst several factors makes it difficult to clarify the independent role of any specific factor.
Nosocomial enterococcal endocarditis: a serious hazard for hospitalized patients with enterococcal bacteraemia
Authors: Fernández‐Guerrero M. L. , Herrero L. , Bellver M. , Gadea I. , Roblas R. F. , De Górgolas M. 
Published: March 2003

Abstract.  Fernández‐Guerrero ML, Herrero L, Bellver M, Gadea I, Roblas RF, de Górgolas M (Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Spain). Nosocomial enterococcal endocarditis: a serious hazard for hospitalized patients with enterococcal bacteraemia. J Intern Med 2002; 252: 510–515.Objectives.  Enterococci are a major leading cause of infectious endocarditis and also a common cause of hospital‐acquired bacteraemia, which is not believed to represent a serious hazard for the endocarditis. The incidence and risk factors for infectious endocarditis in patients with hospital‐acquired enterococcal bacteraemia is determined.Methods.  Prospective analysis of 116 patients with enterococcal bacteraemia admitted to medical or surgical wards of a tertiary‐care, university affiliated hospital during a period of 5 years. Echocardiography was performed when indicated by clinical criteria.Results.  Seventy‐five (61.4%) episodes were hospital‐acquired and 47 (38.5%) were community‐acquired. Most patients had one or more underlying chronic diseases and major abdominal (58.6%) or genitourinary (38.6%) surgery. Seventeen patients (14.6%) developed enterococcal endocarditis. By univariate analysis the risk factors associated with endocarditis were community‐acquired infection (P 0.012); monomicrobial bacteraemia (P 0.006); three or more positive blood cultures (P < 0.001); underlying valvulopathy (P < 0.001); presence of a prosthetic valve (P < 0.001) and age (P 0.012). Six patients (8%) developed nosocomial endocarditis. In this group of patients, three or more positive blood cultures (P < 0.01), bacteraemia as a result of Enterococcus faecalis (P 0.007); underlying valvulopathy (P < 0.001) and presence of a prosthetic valve (P < 0.001) were associated with endocarditis. By logistic regression, the presence of underlying valvulopathy and three or more positive blood cultures were associated with endocarditis (OR 21.0; CI 95% 1.65–26.9; P 0.019).Conclusions.  The risk of developing infectious endocarditis in patients with hospital‐acquired enterococcal bacteraemia is significant. Patients with underlying valvulopathy and three or more positive blood cultures with E. faecalis are prone to nosocomial enterococcal endocarditis.
Obesity and myocardial infarction – vulnerability related to occupational level and marital status. A 23‐year follow‐up of an urban male Swedish population
Authors: Hedblad B. , Jonsson S. , Nilsson P. , Engström G. , Berglund G. , Janzon L. 
Published: March 2003

Abstract.  Hedblad B, Jonsson S, Nilsson P, Engström G, Berglund G, Janzon L (Lund University, Malmö University Hospital, Malmö, Sweden). Obesity and myocardial infarction – vulnerability related to occupational level and marital status. A 23‐year follow‐up of an urban male Swedish population. J Intern Med 2002; 252: 542–550.Background.  People, who are single, have a blue‐collar job or low income have an increased cardiovascular risk. This study on myocardial infarction sought to explore whether the socio‐economic pattern of disease has any relationship with obesity.Methods.  In the cohort are 20 099 middle‐aged men of whom 9150 were manual and 9190 nonmanual workers and 1759 were self‐employed. A total of 4081 were single, 16 018 cohabiting. The body mass index (BMI) cut‐off values for overweight and obesity were 25–30 and ≥30 kg m−2, respectively. Local and national registers were used to monitor incidence of events over 18 years.Results.  Obesity was associated with an increased incidence of coronary events and deaths in each occupational group. Being single significantly increased the risk associated with obesity. After stratification for civil status the risk associated with obesity was limited to those who were single and who either had a blue‐collar job or were self‐employed. The multivariate‐adjusted relative risk (RR) of coronary events and deaths in obese manual workers who were single was 1.91 (95% confidence interval: 1.21–3.02) and 2.54 (1.74–3.69), respectively, times higher than it was amongst those who were cohabiting. Amongst those who were self‐employed, the corresponding age‐adjusted RRs were 4.79 (1.69–13.57) and 3.80 (1.62–8.93).Conclusions.  Adjusted for lifestyle and biological risk factors, the increased risk of coronary events and death for obese men with manual jobs was applicable only to those who were single. It is concluded that being single significantly increases the cardiovascular risk associated with obesity.
Paracetamol‐induced hepatotoxicity at recommended dosage
Authors: Kurtovic J. , Riordan S. M. 
Published: March 2003

Abstract. Kurtovic J, Riordan SM (The Prince of Wales Hospital and University of New South Wales, Sydney, Australia). Paracetamol‐induced hepatotoxicity at recommended dosage (Case report). J Intern Med 2003; 253: 240–243.In patients who develop liver damage following moderate paracetamol overdose in the order of 5–10 g daily, recent fasting and nutritional impairment have been identified as key precipitants. Hepatotoxicity caused by paracetamol at recommended dosage, in the absence of exposure to enzyme‐inducing drugs, has recently been described as an idiosyncratic phenomenon. The possible importance of fasting and malnutrition in this setting is uncertain. We report a severely malnourished 53‐year‐old woman who developed severe hepatotoxicity whilst receiving paracetamol at recommended dosage (4 g daily) following a period of fasting, in the absence of enzyme‐inducing agents. Subsequent paracetamol exposure up to 2.6 g daily thrice weekly, in the setting of ongoing malnutrition and fasting as before, did not lead to recurrent liver damage. These findings indicate that paracetamol‐related liver damage occurring within recommended dosage guidelines can be a dose‐dependent rather than necessarily idiosyncratic phenomenon, at least in the setting of recent fasting and severe malnutrition.
Decreasing serum concentrations of all‐trans, 13‐cis retinoic acids and retinol during fasting and caloric restriction
Authors: Berggren Söderlund M. , Fex G. , Nilsson‐Ehle P. 
Published: March 2003

Abstract. Berggren Söderlund M, Fex G, Nilsson‐Ehle P (Institute of Laboratory Medicine, Lund University, Lund, Sweden). Decreasing serum concentrations of all‐trans, 13‐cis retinoic acids and retinol during fasting and caloric restriction. J Intern Med 2003; 253: 375–380.Objectives.  To investigate the effects of caloric restriction on the serum concentrations of retinoids in man.Design.  Samples were drawn before and during caloric restriction by fasting or 4–6 weeks after gastric surgery.Subjects.  The fasting group included 17 healthy subjects (11 women and six men) and 16 obese patients (10 women and six men) who underwent bariatric surgery (vertical banded gastroplasty).Main outcome measures.  Serum concentrations of all‐trans, 13‐cis, 4‐oxo‐13‐cis retinoic acids and retinol.Results.  The serum concentrations of retinol, all‐trans and 13‐cis retinoic acids decreased by about 20% after 5 days of fasting. After gastroplasty, the serum concentration of retinol, all‐trans, 13‐cis retinoic acids, retinol‐binding protein and transthyretin also decreased to a similar extent after 1 month. In both groups we found a correlation between the delta values of 13‐cis retinoic acid and its metabolite 4‐oxo‐13‐cis retinoic acid. In all subjects there were also correlations between the delta values of the retinoids. However, these correlations were comparatively weak (e.g. r2 = 0.36 for retinol – all‐trans retinoic acid). The change in retinoid concentrations did not correlate to the change of weight or body mass index.Conclusion.  Our results support the hypothesis that serum retinol is one of the determinants of serum concentrations of all‐trans and 13‐cis retinoic acid and that the catabolism of 13‐cis retinoic acid is not affected by fasting. However, in the individual case, S‐Retinol is a poor predictor of S‐All‐trans retinoic acid.
Post failure analysis of 0°/90° ultra high molecular weight polyethylene composite after ballistic testing
Authors: Taylor  , Carr  
Published: March 2003

The ballistic performance of a 0°/90° ultra high molecular weight polyethylene (UHMWPE) composite was investigated. Two areal densities were considered: one for fragmentation protection and one for high velocity bullet protection.The role of microscopy in the post‐failure analysis of the UHMWPE was explored. Stereo, optical and environmental scanning electron microscopy were utilized and attempts were made to correlate the results obtained with other characterization techniques available. These included high speed photography, visual inspection and ultrasonic inspection.Visual inspection revealed the gross effects of ballistic testing. These primarily included deformation and delamination of the composite plate. The result obtained corresponded with the predicted impact event and, for high velocity bullet impact, corresponded well to the images obtained using high speed photography. Optical, stereo and electron microscopy allowed for fibre and matrix characterization. Fibre displacement and pull‐out were also observed on impact and exit faces.
Two new microscopical variants of thermomechanical modulation: scanning thermal expansion microscopy and dynamic localized thermomechanical analysis
Authors: Hammiche A. , Price D. M. , Dupas E. , Mills G. , Kulik A. , Reading M. , Weaver J. M. R. , Pollock H. M. 
Published: March 2003

We describe two ways in which thermomechanical modulation may be used in conjunction with scanning thermal microscopy, in order to distinguish between different components of an inhomogeneous sample. The sample is subjected to a modulated mechanical stress, and the heating is supplied locally by the probe itself.Scanning thermal expansion microscopy is an imaging mode, in which an imposed localized temperature modulation is used to generate thermal expansion, which in turn produces mechanical strain and gives thermal expansion contrast images. We present results using two types of active thermal probe. For polymer/resin samples, the depth of material contributing to the measured thermal expansion is typically a few micrometres. Under certain conditions we observe a reversal in contrast as the frequency of the temperature modulation is increased.In dynamic localized thermomechanical analysis, the modulated stress is applied directly, and accompanied by a localized temperature change, as used in other forms of localized thermal analysis. The resulting modulated lateral force signals are obtained. The glass transition of polystyrene is detected, and shows a significant variation with frequency. The amplitude or phase signal may be used to obtain image contrast for inhomogeneous samples.