bluuebunny/crossref_metadata_2025 huggingface dataset:
Distensibility of the mouse rectum: application of impedance planimetry for studying age‐related changes
Authors: Lundby  , Dall  , Gregersen  , Overgaard  , Laurberg
Published: March 2003

Rectal distensibility is an important parameter for investigation of anorectal function. The aim of the present paper was to study pressure–cross‐sectional area (CSA) relations and distensibility of the rectum in mice aged 15–78 weeks using impedance planimetry. A four‐electrode probe system located inside a balloon was designed to determine pressure–CSA relations in the mouse rectum. CSA was estimated from measurements of the electrical impedance of saline inside a balloon. The method was validated in studies in vitro showing high accuracy and good reproducibility. The method was applied in measurements of inter‐ and intra‐individual variation and age‐related variation of rectal pressure–CSA relations and distensibility. Repeated distension every third day in a cohort of 10 mice did not change the CSA during a 4‐week period and there was no long‐term effect of repeated measurements. There was an age‐related increase in rectal CSA in the distended state until the mice were 26 weeks of age (P = 0.004). The unloaded size of the rectum did not change with age. The distensibility of the rectum did not vary significantly with age, though there was a tendency to a higher distensibility during growth followed by decline with age (P = 0.08). In conclusion, this study presents a simple, minimally invasive in vivo model for repeated evaluation of rectal distensibility in mice. The mouse model will provide a tool for analysing relative changes in rectal biomechanical properties in different future disease models.
Positive cost effectiveness of early diagnosis of colorectal cancer
Authors: Bolin  , Korman  , Stanton  , Talley  , Newstead  , Donnelly  , Hall  , Ho  , Lapsley
Published: March 2003

Background

Studies examining interventional screening have lacked accurate data, because costs of hospital infrastructure, nursing and disinfection have not been included. We compared all costs of different strategies for screening, including colonoscopy, to provide a rational basis for decisions in early diagnosis. The costs, although based on Australian data, are probably applicable to all developed countries.

Methods

Comprehensive cost data from Australian private day endoscopy centres, public and private hospitals, physicians, anaesthetists and pathologists were used to assess medical and infrastructure hospital costs for various methods of screening. The data were processed using the Office of Technology Assessment colorectal cancer screening model.

Results

Annual or triennial faecal occult blood tests (FOBT; Hemoccult®) are cost‐effective, particularly with assumed 10‐year dwell times (the time taken for an adenoma to become a cancer), the costs per year of life saved being $US 26 015 and $US 24 756, respectively. Colonoscopy at 5‐ or 10‐year intervals is also cost‐effective with similar dwell times, and colonoscopy every 10 years with a cost of $27 159 per year saved is comparable to annual or triennial FOBT. Double contrast barium enema at either 3‐ or 5‐year intervals is cost‐effective, but ideally should be combined with an annual FOBT, reducing the cost effectiveness of these options. FOBT also is ideally combined with flexible sigmoidoscopy; an annual FOBT and 5‐yearly flexible sigmoidoscopy is cost‐effective with both 5‐ and 10‐year dwell times, though less than FOBT or colonoscopy. A once‐only colonoscopy at age 50 is not cost‐effective.

Conclusions

Annual or triennial FOBT, double contrast barium enema (DCBE) 3 and 5 and colonoscopy 5 and 10 are all cost‐effective. There is less value in combining FOBT and flexible sigmoidoscopy, or flexible sigmoidoscopy alone. Physicians therefore have the option of offering individuals a range of cost‐effective screening strategies, including colonoscopy.
The effect of abdominal rectopexy with mesh on anal sphincter and bowel function in patients with complete rectal prolapse; special reference to age of patient
Authors: Aitola  , Hiltunen  , Matikainen
Published: March 2003

Objective

 The main source of concern in patients with rectal prolapse is usually incontinence and constipation developing post‐operatively. It has been claimed that sphincter pressures improve only after non‐implant surgery. The aim of this study was to assess our own results after mesh rectopexy.

Patients and methods

 We reviewed the results in 50 patients on whom posterior abdominal Marlex mesh rectopexy for complete rectal prolapse had been performed. These patients underwent pre‐ and post‐operative anal manometry. Sixteen of them also underwent colon transit time study before and after the operation. They were followed clinically for a median of 5 months.

Results

 Twenty‐two of the 38 patients (58%) with preoperatively defective anal control regained full continence. Resting anal canal pressures improved significantly after surgery in all cases (P=0.001), including those who regained full continence (P=0.005). The change in continence in all patients correlated inversely with the preoperative (r=–0.43, P=0.003) and post‐operative (r=–0.40, P=0.005) resting anal pressures. The change in resting anal pressures after surgery was significantly better in patients under 40 years of age (mean 19 cmH2O) than in those 40 years or older (mean 4 cmH2O) (P=0.01). All four preoperatively incontinent patients regained full continence in the younger group as opposed to only 50% (17/34) in the older group. Colon transit time normalized in three of the four patients with preoperatively slow transit time and five patients with preoperatively normal transit time developed slow transit.

Conclusion

 Internal sphincter pressures do improve after mesh rectopexy for rectal prolapse, and the change also correlates with the improvement in continence. Internal sphincter function and continence recover better in younger patients.
A randomized trial of rubber band ligation with or without injection sclerotherapy in the treatment of piles
Authors: Ackroyd  , Dicks  , Shorthouse
Published: March 2003

Objectives

 Rubber band ligation (RBL) is an effective treatment for piles but may be followed by pain and bleeding. It is postulated that the addition of injection sclerotherapy (IS) may reduce these complications. This trial aims to compare the use of RBL alone with RBL + IS in the treatment of piles.

Patients and methods

 Sixty patients with piles were randomized to RBL alone (n=30) or RBL + IS (n=30). Each patient was given a pro forma on which to record the amount of pain (on a visual analogue scale) and bleeding (none, slight or heavy) for 10 days following treatment. Patients were subsequently asked to describe the overall symptomatic outcome in the 6‐week follow‐up clinic (worse, same, slightly better, much better). Long‐term outcome was ascertained by a telephone survey.

Results

 Symptomatic improvement was similar in both groups (median score (range)=1.5 (0–2) vs 2 (0–2); P=NS), and there was no difference in pain (median score (range)=6 (0–77) vs 6 (0–50); P=NS). However, the amount of bleeding was significantly less in the RBL + IS group (median score (range)=3.5 (0–12) vs 0 (0–10); P < 0.001). The long‐term outcome was similar in both groups.

Conclusion

 The addition of IS to RBL does not affect procedure‐related pain or symptomatic outcome, but significantly reduces the risk of post‐bleeding.
A prospective randomized trial of consultant‐led injection sclerotherapy compared with nurse practitioner‐led noninvasive interventions in the management of patients with first and second degree haemorrhoids
Authors: Porrett T. R. C. , Lunniss P. J.
Published: March 2003

Objective

To determine whether nurse practitioner (NP)‐led advice in relation to bowel and defaecatory habits in haemorrhoidal disease is as effective as local invasive treatment (sclerotherapy) in the management of patients with symptomatic 1st and 2nd degree haemorrhoids, with respect to both alleviation of presenting symptoms and relapse rate, and patients’ understanding of their condition.

Patients and methods

In a prospective randomized trial, 25 patients with bleeding haemorrhoids were allocated to receive either standard medical injection sclerotherapy (Group 1, n=13) or NP‐led advice, information and bowel habit retraining (Group 2, n=12). Bulking agents were offered, when deemed appropriate, to patients in both groups. Treatment was administered by two clinicians only. Patients were assessed at 8 weeks, 4 months and finally at 6 months post treatment and any symptoms present were graded.

Results

At 6 months, symptomatic improvement was similar in both groups (mean range 3 points) with a patient expected to get better with a good degree of confidence (C.I: 2–4 points). However those patients in Group 2 would be expected to have a slightly better minimum level of improvement (GP 1 P=0.004 GP 2 P=0.0005). At six months, there was no statistical difference between the two groups with regard to the patient’s perception of the amount of information given, the clarity of the explanation, and the ability of the patient to understand and discuss their problem. In relation to understanding the cause of their problem patients in Group 2 felt they had a higher level of understanding of the cause of their problem (U=13, NA=7, NB=10, P=0.05) and felt more able to prevent their problem returning (U=12, NA=7, NB=10, P=0.05).

Conclusion

A bulking agent and Nurse led education, advice and bowel habit retraining is as effective in reducing the incidence of bleeding from 1st and 2nd degree haemorrhoids as injection sclerotherapy. Patients who consult a NP with symptomatic 1st and 2nd degree haemorrhoids feel more empowered in the long term. Non‐invasive bowel retraining methods should be offered as an alternative to more traditional, invasive treatments for patients with symptomatic early haemorrhoidal disease.
Diverticular colitis: diagnosis and management
Authors: Rampton D. S.
Published: March 2003

Diverticular colitis is a recently recognized nosological entity in which a chronic focal mucosal sigmoid colitis occurs in association with diverticulosis. It usually presents with rectal bleeding and may be difficult to distinguish clinically, endoscopically and pathologically from other segmental colitides including ulcerative, Crohn’s, ischaemic, infective and NSAID‐induced colitis as well as diverticulitis. Uncontrolled data suggests that most patients respond satisfactorily to treatment with a high fibre diet, antibiotics and/or aminosalicylates, but a minority with persistent or recurrent symptoms require sigmoid resection. This paper reviews the literature on diverticular colitis and concludes with an algorithm suggesting the optimal management of patients who present with rectal bleeding in association with segmental sigmoid colitis and diverticulosis.
Long‐term results of faecal diversion for refractory perianal Crohn’s disease
Authors: Régimbeau J. M. , Panis Y. , Cazaban L. , Pocard M. , Bouhnik Y. , Matuchansky C. , Valleur P.
Published: March 2003

Background and aims

Faecal diversion (FD) for refractory anoperineal Crohn’s disease (APCD) is thought to be unsatisfactory with a low overall rate of defunctioning stoma closure. However, only a few patients have so far been reported in the literature. The aim of this study was to reassess the long‐term efficiency of FD for APCD.

Methods

Among 136 patients who were operated for APCD over a 18‐year period, 17 underwent FD. The factors assessed were the mortality and morbidity of stoma formation, the evolution of anoperineal Crohn’s disease after FD, and predictive factors of FD effectiveness.

Results

Mean follow‐up after FD was 135 ± 79 months (range 20–328). Initial healing of APCD was observed in 11 patients (65%), allowing stoma closure after 14 ± 9 months (range 3–52). The 6 other patients underwent abdominoperineal resection (APR) for persistent APCD. Three of the 11 patients with normal bowel continuity underwent secondary APR for APCD recurrence. Thus, at the end of follow up 9 (53%) patients had definitive end ileostomy and 8 (47%) continued to have normal bowel continuity with a mean follow up of 124 ± 90 months (range 12–292) after stoma closure. The presence of rectal lesions at the time of FD was the only predictive factor of poor outcome: 8/9 (89%) patients with rectal lesions underwent APR vs 1/8 (13%) patients without rectal lesion (P < 0.01).

Conclusions

Faecal diversion for anoperineal Crohn’s disease produced a high initial rate of anoperineal lesion healing. After long‐term follow‐up, results of faecal diversion are good (normal bowel continuity was restored in 89%) in patients without associated rectal lesions. However, in patients with associated rectal lesions, the prospects for restoring continuity were limited, thus making faecal diversion a questionable procedure.
Colonic malignancy arising in colitis – a single unit experience
Authors: Armstrong A. M. , Khosraviani K. , Irwin S. T. , Maxwell R. J.
Published: March 2003

Objectives

Colorectal malignancy complicating inflammatory bowel disease constitutes 1% of all colorectal malignancies. Although its overall numbers are low it represents the greatest cause of colitis related mortality in these patients. This paper describes the management of 24 patients presenting to a single unit over a period of 10 years.

Methods

The names of patients were collected prospectively when they presented with malignancy. Clinical details were collected by retrospective review of charts.

Results

In all, 24 patients with 27 malignancies were identified. The median age of presentation with malignancy was 56 years. Most patients were treated with proctocolectomy. Other patients were treated with segmental colectomy. In these patients the surgical procedure was dictated by the stage of the cancer, the age and comorbid state of the patient and the severity of ongoing colitis.

Conclusions

Malignancy arising in colitis will constitute only a small part of a colorectal practice. The optimum method for detecting early, and potentially curable, disease has not been defined. Surgery should be tailored to the individual needs of the patient.
Traumatic `degloving' of the colon in blunt abdominal injury
Authors: Armstrong T. , Blaquiere R. M. , Varshney S. , Primrose J. N.
Published: March 2003

We describe two cases of traumatic `degloving' of the colon in blunt abdominal trauma. This is an extremely rare injury with the potential to present late. The mechanism of injury appears to be a combination of focal blunt abdominal trauma associated with a shearing force. The potential diagnostic dilemma posed by colonic `degloving' is outlined and following review of the literature we conclude that CT scanning is the most reliable way of detecting such injuries, if emergency laparotomy is not indicated.
Management of recurrent colorectal carcinoma
Authors: Brethauer S. A. , Magrino T. J. , Riffenburgh R. H. , Johnstone P. A. S.
Published: March 2003

Background/objective  The records of patients treated for adenocarcinoma of the colon and rectum between 1 January 1988 and 31 December 1995 at Naval Medical Center San Diego were reviewed. Analysis was made of patients who developed recurrences after potentially definitive primary therapy.

Methods  A retrospective review of 410 patients diagnosed with colorectal cancer at our institution was conducted. The focus of this review was to identify patients with recurrent disease after curative initial procedures, and to determine how recurrences were detected and treated. Survival data for 48 patients undergoing various curative and palliative procedures, or no therapy, were generated.

Results  The decision to re‐operate with curative intent was made after a multidisciplinary review of restaging studies. Laparoscopy was not used in this determination. Curative resection of recurrence confers increased survival over non‐curative surgery and no surgery (P < 0.001). This is misleading because of patient selection; several patients undergo potentially curative surgery but are determined intraoperatively to best be palliated, or to have further surgery aborted. Analysis of results in patients undergoing potentially curative surgery vs. those undergoing planned palliation vs. those not operated reveals that these also provide significantly different outcomes (P < 0.003).

Conclusions  Proper delineation of resectable lesions in patients with recurrent colorectal cancer contributes to better outcomes for them. That determination is difficult, and efforts are underway in our institution and elsewhere to better delineate which patients are optimal preoperatively. We consider multidisciplinary Tumor Board evaluation to be central to this process.
The management of persistent and recurrent chronic anal fissures
Authors: Brown S. R. , Taylor A. , Adam I. J. , Shorthouse A. J.
Published: March 2003

There are numerous definitive reviews concerning aetiology and management of acute and chronic anal fissures. The problem of persistence and recurrence after surgical and nonsurgical therapy has not been specifically addressed and there is little evidence‐based guidance for the management of this difficult group of patients. A review of the literature with particular reference to persistence and recurrence of chronic anal fissures is presented and an algorithm of management incorporating evidence‐based data is suggested.
Simple equipment for decompression of the colon during laparotomy for large bowel obstruction
Authors: Soulsby R. , Radley S.
Published: March 2003

A simple method is described for decompressing the colon at laparotomy for large bowel obstruction.
Palliative stenting of malignant large bowel obstruction
Authors: Seymour K. , Johnson R. , Marsh R. , Corson J.
Published: March 2003

Objective

Untreated malignant large bowel obstruction is rapidly fatal. Short‐term palliation of symptoms can be achieved by formation of a stoma in those patients for whom resection surgery is inappropriate. In the final months of life, a stoma represents a significant burden for both patients and carers. Palliative endoluminal stenting may therefore be an attractive alternative option for this poor prognosis group. In this paper, we examine our experience of palliative endoluminal colonic stenting.

Patients

Twenty patients, 11 males and 9 females of median age 81 years were referred for stenting. All had left sided colonic cancers. Ten patients had confirmed metastases on presentation, four had fixed rectal cancers and the remainder had severe comorbidity limiting surgical options. Stents were placed endoscopically using a radiologically controlled `stent over wire' technique.

Results

Stenting successfully relieved the obstruction in 18 of the 20 patients attempted. In one patient the stricture could not be negotiated and the procedure was abandoned. Eleven patients have died of their disease, their median duration of palliation was 50 days (3–152 days). The rest of the patients continue in follow‐up and have had 80 days median palliation (14–257 days). One stent‐related complication has been observed in a patient who suffered anal pain due to fracture and migration of part of a stent into the low rectum. This complication occurred after 250 days and the distal stent fragment was removed with further symptom relief.

Conclusion

Carefully selected patients benefit from colonic endoluminal stenting with relief of obstructive symptoms. They may be spared the potential problems associated with palliative stoma formation.
Colonic resection for colovesical fistula: 5‐year follow‐up
Authors: Walker K. G. , Anderson J. H. , Iskander N. , McKee R. F. , Finlay I. G.
Published: March 2003

Objectives  The outcome of colovesical fistula management may be unsatisfactory; complications are reported in up to 45% of patients. Published studies are retrospective and tend to lack standardized management strategies and long‐term follow‐up. This cohort study assesses a policy of resection of colovesical fistulae in continuity with any distal colorectal stricture, and includes 5‐year follow‐up.

Method  All patients undergoing surgery in our institution for colovesical fistula between February 1991 and April 1995 were entered into the study. The fistulae were resected in continuity with any distal bowel stricture, according to a standard single‐stage operative protocol. Postoperative mortality and morbidity were recorded, and prospective review was undertaken at April 2000.

Results  Nineteen consecutive patients entered the study. The source of the fistula was diverticular disease (n = 14), colorectal cancer (n = 3), trauma (n = 1) or Crohn's (n = 1) disease. Thirteen patients had a colorectal stricture. One patient died due to ischaemic colitis within 30 days of surgery. Eleven other patients died of unrelated causes before April 2000, in whom there was no evidence of fistula recurrence before death at a median of 37 months after operation (range 2–95 months). At 5‐year follow‐up there was no evidence of fistula recurrence in the seven remaining patients.

Conclusions  A policy of resection of the fistula and associated colorectal stricture with primary bowel anastomosis and bladder drainage, resulted in no recurrences and low morbidity. However comorbidity is important in this patient population, most of whom will die from unrelated causes within a few years.
The impact of bowel cancer awareness week
Authors: Pullyblank A. M. , Dixon N. , Dixon A. R.
Published: March 2003

Objectives  To assess knowledge of Bowel Cancer Awareness Week (BCAW) amongst patients attending their general practice surgery and to identify whether BCAW could increase knowledge of colorectal cancer symptoms.

Method  Questionnaire study with ethics committee approval. Patients attending non‐emergency clinics in a single general practice during the week following BCAW were given a questionnaire. Respondents were asked for knowledge of colorectal cancer symptoms, sources of this information and awareness of BCAW compared to similar knowledge of breast cancer.

Results  Seventy‐seven patients responded (96% response rate, median age 42, 40% male). Eighty‐five percent could name a breast cancer symptom compared to only 44% who could name a colorectal cancer symptom (McNemar's χ2, P < 0.0001). Respondents identified more sources of information for breast than colorectal cancer. Only 21% had heard of BCAW and none could name any symbol for bowel cancer awareness whereas 69% were aware of Breast Cancer Awareness Month and 28% could name its symbol (McNemar's χ2, P < 0.0001). Multivariate analysis demonstrated that patients who were aware of BCAW were 4.6 times more likely to have knowledge of colorectal cancer symptoms (95% CI 1.25–17.1).

Conclusions  Despite their similar incidence, knowledge of colorectal cancer is much less than breast cancer. In part this may be due to the greater publicity given to breast cancer. BCAW can increase knowledge of colorectal cancer symptoms but currently, too few people are aware of it.
Diabetes and vascular disease
Authors: Garber Alan J.
Published: March 2003

Cardiovascular and cerebrovascular disease are two of the most important causes of morbidity and mortality in the USA and worldwide. The impact of these conditions is even more profound in patients with diabetes. The aims of the Vascular Disease Working Group in the articles that follow are to review the impact of cerebrovascular and cardiovascular disease in the general population, and, specifically, in the patient with diabetes, and to suggest appropriate treatment. Important steps to decreasing the risk of these diseases in diabetic patients are strict glycaemic control, control of hypertension, and modification of dyslipidaemia.
Variations in plasma soluble tumour necrosis factor receptors after diet‐induced weight loss in obesity
Authors: Bastard J. ‐P. , Jardel C. , Bruckert E. , Vidal H. , Hainque B.
Published: March 2003

The aim of this study was to investigate the variations in the plasma levels of the soluble tumour necrosis factor receptor type‐I (sTNFR‐I) and type‐II (sTNFR‐II) during weight loss which was induced by 3 weeks on a very low calorie diet (3.9 ± 0.1 MJ/day), in 17 non‐diabetic obese women. Plasma sTNFR‐I concentrations decreased significantly after weight loss (p < 0.05), but there was no significant change in plasma sTNFR‐II. As the diet was associated with a significant decrease in body fat mass (≈2.5 kg), this result supports the emerging concept that adipose tissue can produce significant amounts of sTNFR‐I and that this production can be modified by weight loss in human obesity
The effects of intensive glycaemic control on body composition in patients with type 2 diabetes
Authors: Bagg W. , Plank L. D. , Gamble G. , Drury P. L. , Sharpe N. , Braatvedt G. D.
Published: March 2003

SUMMARY

Aim  To examine the effects of improved glycaemic control over 20 weeks on the type and distribution of weight change in patients with type 2 diabetes who at baseline have poor glycaemic control.

Methods  Forty‐three patients with type 2 diabetes and HbA1c > 8.9% were randomised to either intensive glycaemic control (IC) n = 21 or usual glycaemic control (UC) n = 22 for 20 weeks. Dual energy X‐ray absorptiometry was used to assess the type and distribution of weight change during the study.

Results  After 20 weeks HbA1c was significantly lower in patients randomised to IC than UC (HbA1c IC 8.02 ± 0.25% vs. UC 10.23 ± 0.23%, p < 0.0001). In the IC group weight increased by 3.2 ± 0.8 kg after 20 weeks (fat‐free mass increased by 1.8 ± 0.3 kg) compared to 0.02 ± 0.70 kg in UC (p = 0.003). The gain in total body fat mass comprised trunk fat mass (IC 0.94 ± 0.5 kg vs. UC 0.04 ± 0.4 kg, p = 0.18) and peripheral fat mass (total body fat – trunk fat) (IC 0.71 ± 0.32 kg vs. UC −0.21 ± 0.28 kg, p = 0.04). Blood pressure and serum lipid concentrations did not change over time in either group.

Conclusions  Intensive glycaemic control was associated with weight gain which was distributed in similar proportions between the central and peripheral regions and consisted of similar proportions of fat and fat‐free mass. Blood pressure and serum lipid concentrations were not adversely affected.
Effect of misoprostol (PGE1) on glucose metabolism in type‐2‐diabetic and control subjects
Authors: Lee N. A. , Matsuda M. , Bressler P. , Pratipanawatr T. , Glass L. , Mandarino L. J. , DeFronzo R. A.
Published: March 2003

In vitro and in vivo studies have demonstrated that prostaglandins of the E series enhance muscle glucose uptake. We examined the effect of acute misoprostol (PGE1) administration on whole body insulin‐mediated glucose disposal, as well as the major intracellular pathways of glucose metabolism in type 2 diabetic (n = 10) and non‐diabetic (n = 4) subjects. Each subject received two 240‐min euglycaemic insulin (40 mU/m2/min) clamp studies with tritiated glucose and indirect calorimetry. During one of the insulin clamp studies, 200 µg of misoprostol was ingested at 90 and 150 min after the start of the insulin infusion. Insulin‐mediated total body glucose disposal, glycolysis, glycogenesis and glucose oxidation were similar during the insulin clamp studies performed without and with misoprostol in both the diabetic and non‐diabetic groups. These results demonstrate that the acute administration of misoprostol does not enhance insulin‐mediated glucose disposal in either type‐2‐diabetic or non‐diabetic subjects.
Expression of resistin in the adipose tissue is modulatedby various factors including peroxisome proliferator‐activated receptor α
Authors: Fukui Y. , Motojima K.
Published: March 2003

Aim: Resistin has been suggested to link obesity to diabetes by antagonizing insulin action. However, this model is based on limited observations and how resistin links the two complex processes is not known. In this study, we investigated the effects of various factors on the expression of resistin and examined the generality of the proposal.

Methods: Total RNA was isolated from the adipose tissues of lean, obese and peroxisome proliferator‐activated receptor (PPAR)α‐null mice fed a control diet or that contained a PPAR ligand, and analysed by Northern blotting using cDNAs for resistin, leptin, aP2 and other mRNAs as probes. For quantitative analysis, an image analyser was used.

Results: Basal expression of resistin mRNA was suppressed by obesity, but the extent of suppression differed significantly among the mouse strains and types of adipose tissue examined. Anti‐diabetic thiazolidinediones induced resistin expression in the lean mice and showed smaller effects in obese mice. Furthermore, PPARα was shown to play an important role in constitutive expression of resistin in the adipose tissue.

Conclusion: Our results indicated that diverse factors modulate the expression of resistin in the adipose tissues of mice, and suggested that resistin is not a master hormone linking obesity to diabetes.
Nicotine treatment decreases food intake and body weight viaa leptin‐independent pathway in Psammomys obesus
Authors: Sanigorski A. , Fahey R. , Cameron‐Smith D. , Collier G. R.
Published: March 2003

It has been reported previously that leptin may be involved in nicotine's ability to reduce body weight. Our aim was to investigate whether the anorexic action of nicotine is related to the actions of leptin by utilizing lean leptin‐sensitive and obese leptin‐resistant Psammomys obesus. Lean and obese P. obesus were assigned to receive nicotine sulphate at 6, 9 or 12 mg/day or saline (control) for 9 days (n = 6–10 in each group), administered using mini‐osmotic pumps. Food intake, body weight, plasma leptin concentrations, plasma insulin and blood glucose were measured at baseline and throughout the study period. Nicotine treatment reduced food intake by up to 40% in lean and obese P. obesus. Plasma leptin levels fell significantly only in lean nicotine‐treated animals, whereas no changes were observed in obese nicotine‐treated animals. However, both lean and obese nicotine‐treated animals had similar reductions in body weight. Our results show that nicotine has dramatic effects on food intake and body weight, however, these changes appear to be independent of the leptin signalling pathway.
Morphology of the nasal capsule of Heloderma suspectum with comments on the systematic position of helodermatids (Squamata: Helodermatidae)
Authors: Bernstein Peter
Published: March 2003

A serially sectioned embryonic head of Heloderma suspectum formed the basis for a three‐dimensional reconstruction of the cartilaginous nasal capsule and its membrane bones. Further, the soft parts of the nasal capsule were analysed microscopically. The embryonic nasal capsule is described and compared to the morphological conditions in other lizards, especially the varanids, which many recent authors believe to be their closest relatives.

The results support the close affinities between the helodermatids and the varanids. Both groups have a well developed recessus lateralis in a cartilaginous capsule, entered by the nasal concha. Further, in both groups a fragmentation of the cartilago paraseptalis occurs in a comparable location and form. Heloderma has no double lacrimal duct, in contrast to previous accounts, but the two canaliculi at the origin of the duct fuse noteworthy far ahead (in other squamates they fuse in front of the bulbus oculi). In the varanids the two branches of the lacrimal duct remain separate and open separately.

Some unique features of Heloderma are presented as well, above all the presence of a second concha.
Ultrastructure and functional morphology of a nematalycid mite (Acari: Actinotrichida: Endostigmata: Nematalycidae): adaptations to mesopsammal life*
Authors: Haupt Joachim , Coineau Yves
Published: March 2003

Nematalycid mites have undergone extreme changes of body shape in adaptating to life in tiny spaces between grains of fine sand. Because of their minute size, the morphology of these organisms can only be reconstructed from ultrathin serial sections. The cuticle forms regular alternating palettes on the surface; such a structure may also function as a plastron. Movement of the body is effected by a continuous secondary muscle layer beneath the epidermis which operates in connection with the cuticular palettes. This movement represents a hitherto unknown mode of reptation, which can be understood as an adaptation to moving among sand particles. The appendages have been reduced to a minute size. The morphology of the digestive tract is described and conclusions are drawn concerning nutrition.
Cuticle structure and systematics of the Macrobiotidae (Tardigrada, Eutardigrada)
Authors: Guidetti Roberto , Rebecchi Lorena , Bertolani Roberto
Published: March 2003

The cuticle of tardigrades is characterized by three main layers: epicuticle, intracuticle and procuticle. Pillars are present in the epicuticle of almost all heterotardigrades, but these structures are also known in a few species of eutardigrades. The apparent heterogeneity of the cuticular ultrastructure in several species of the Macrobiotidae (Eutardigrada) prompted us to analyse the structure of the cuticle in this family. Eleven species in several genera were investigated with light and/or electron microscopy. All the species of the genera Murrayon and Dactylobiotus showed pillars in the epicuticle, whereas the examined species of Macrobiotus, Richtersius and Xerobiotus completely lacked pillars. Therefore, in the Macrobiotidae, in contrast to what appears with light microscopy, the cuticle is homogeneous within each genus examined at the electron microscopic level. Considering the absence of pillars in the Macrobiotidae a synapomorphy, we propose the erection of two new subfamilies. Macrobiotinae subfam. n. is characterized by the absence of pillars in the epicuticular layer and includes, in addition to the genera Macrobiotus, Xerobiotus and Richtersius, the genera Pseudohexapodibius, Adorybiotus, and probably also Minibiotus, Calcarobiotus and Pseudodiphascon. Murrayinae subfam. n. is characterized by the presence of pillars in the epicuticular layer and includes the genera Murrayon, Dactylobiotus and, probably, Macroversum.
Structure of ovarioles in Adelges laricis, a representative of the primitive aphid family Adelgidae
Authors: Szklarzewicz Teresa , Wne k Agnieszka , Biliński Szczepan M.
Published: March 2003

The structure of ovaries has been analysed in advanced aphids only. In this paper we report the results of ultrastructural studies on the ovarioles of Adelges laricis, a representative of the primitive aphid family, Adelgidae. The ovaries of the studied species are composed of five telotrophic‐meroistic ovarioles that are subdivided into a terminal filament, tropharium (= trophic chamber) and vitellarium. The tropharium houses trophocytes (= nurse cells) and arrested oocytes. The vitellarium consists of one or two ovarian follicles. The total number of germ cells (trophocytes + oocytes) in the ovarioles analysed varies from 50 to 92 and is substantially higher than in previously studied aphids. The centre of the tropharium is occupied by a cell‐free region, termed a trophic core, which is connected both with trophocytes and oocytes. Trophocytes are connected to the core by means of cytoplasmic strands, whereas oocytes by nutritive cords. Both trophic core and nutritive cords are filled with parallel arranged microtubules. In the light of obtained results the anagenesis of hemipteran ovaries is discussed.
Rotifer muscles as revealed by phalloidin‐TRITC staining and confocal scanning laser microscopy
Authors: Kotikova Elena A. , Raikova Olga I. , Flyatchinskaya Ludmila P. , Reuter Maria , Gustafsson Margaretha K. S.
Published: March 2003

By combining phalloidin‐TRITC staining with confocal scanning laser microscopy (CSLM), the pattern of the musculature in two species of Rotifera, Euchlanis dilatata unisetata and Brachionus quadridentatus is revealed. The same general muscle pattern prevails in both species. The major components of the body wall musculature are: 1. retractor muscles (5 pairs in E. dilatata unisetata and 3 pairs in B. quadridentatus); 2. Two pairs of dorso‐ventral muscles; 3. Two pairs of perpendicular muscles (in E. dilatata unisetata); 4. retractors of the corona (median, lateral and ventral); 5. Foot retractors. In addition, three pairs of cutaneo‐visceral muscles and visceral muscles (including mastax muscles) are described. The sphincter of the corona was found only in B. quadridentatus. The high degree of muscle differentiation points to a high level of development of rotifer muscular system.
Structure of the ovary in Nannochorista neotropica Navás (Insecta: Mecoptera: Nannochoristidae) with remarks on mecopteran phylogeny
Authors: Simiczyjew Bożena
Published: March 2003

Preliminary histological analysis showed that the ovaries in Nannochorista neotropica are composed of numerous ovarioles of panoistic type. In the ovaries of adult females each ovariole consists of a terminal filament, vitellarium and pedicle while a germarium is absent. Morphological observations supported by simple histochemical tests revealed the presence of multiple nucleoli in the oocyte nucleus. The appearance of multiple nucleoli suggests that the extrachromosomal amplification of ribosomal DNA may take place in the oocytes of Nannochorista. The results show that in the structure of the ovariole and the course of oogenesis nannochoristids share noteworthy derived features with boreids, but differ significantly from all other mecopterans. These findings indicate the possible monophyly of an assemblage comprising the Nannomecoptera, Neomecoptera and Siphonaptera.
Floor plate, glia and other support cells in the anterior nerve cord of amphioxus larvae
Authors: Lacalli Thurston C. , Kelly Samantha J.
Published: March 2003

Serial electron micrograph reconstructions and interval series were used to examine the support cells, including glia, of the anterior nerve cord in 6‐, 8‐ and 12.5‐day larvae ofBranchiostoma floridaeand one newly metamorphosed juvenile. The floor plate begins immediately behind the infundibular cells. It consists for the most part of a single file of midline cells, but adjacent lateral floor plate cells occur in some places. The floor plate is interrupted at one point, in the posterior part of the cerebral vesicle above the tegmental neuropile. A class of early developing axons crosses the midline at this point, which suggests that the floor plate may have a developmental role in axon guidance. The structural integrity of the cord is maintained by ependymal and ependymoglial cells that attach to its sides. Two other glial cell types were found in larvae. Both appear to originate adjacent to the floor plate and hence are referred to here as midline glia. Those in somites 1 and 2 remain connected to the central canal; they appear to be a mixed population that may include precursors of midline support cells which are present later in the juvenile. Those caudal to somite 3 detach early from the central canal and develop an extensive network of axial processes; they are referred to here as axial glia and treated as a subcategory of midline glia. Based on their site of origin and the absence of glial filaments, their closest counterpart among vertebrate glia may well be the oligodendrocyte. To our knowledge, this is the first report of a possible amphioxus homologue of this important vertebrate cell type.
The development of the pit organ of Bothrops jararaca and Crotalus durissus terrificus (Serpentes, Viperidae): support for the monophyly of the subfamily Crotalinae
Authors: Hofstadler Deiques Clarice
Published: March 2003

The development of the pit organ and the course of the lateral branch of the ethmoidal nerve of the two South American crotalines Bothrops jararaca and Crotalus durissus terrificus are described in detail using serially sectioned material from fetal stages. Serial sections of the Asian pit vipers Agkistrodon halys halys and Trimeresurus albolabris were included in this work. The viperines, as the sister‐group of the Crotalinae, and the Colubridae, Elapidae and Boidae as their outgroups were used for comparisons. New synapomorphies of the advanced subfamily Crotalinae were found: namely, absence of the foramen epiphaniale and an extracapsular course of the lateral branch of ethmoidal nerve. These results support the monophyly of the crotalines.
Aspects of embryonic and postembryonic development of the Japanese freshwater crayfish Cambaroides japonicus (Crustacea, Decapoda) including a hypothesis on the evolution of maternal care in the Astacida
Authors: Scholtz Gerhard , Kawai Tadashi
Published: March 2003

Little is known about the biology of the East Asian freshwater crayfish of the genus Cambaroides. Furthermore, the phylogenetic relationships of Cambaroides are controversial. To gain more information about East Asian crayfish and to shed some light on the phylogeny and evolution of freshwater crayfish, some aspects of the embryonic and postembryonic development of the Japanese freshwater crayfish species Cambaroides japonicus are described. The general appearance of the embryo and the growth zone consisting of about 40 ectoteloblasts correspond with the apomorphic pattern described for all other freshwater crayfish species. The occurrence of eight mesoteloblasts is a typical malacostracan character. In addition to the occurrence of freshwater crayfish apomorphies, such as a telson thread, the postembryonic development of C. japonicus follows the ground pattern of the Northern Hemisphere Astacoidea. In particular, some characteristics are in common with the postembryonic development of the Astacidae. These concern the shape of the telson of the juvenile stage 1 and the occurrence of plumose telson setae in juvenile stage 2. Furthermore, the recurved hooks of the hatchlings are lost in the juvenile stage 2, indicating an early independence of the juveniles from the mother. On the other hand, the early appearance of a spermatheca (annulus ventralis) is shared between C. japonicus and the other (American) Cambaridae. The hypothesis is developed that the evolutionary success of the different freshwater crayfish taxa might be related to the stepwise extension of maternal care as an adaptation to the freshwater environment.
Larval development of Japanese ‘conchostracans’: part 1, larval development of Eulimnadia braueriana (Crustacea, Branchiopoda, Spinicaudata, Limnadiidae) compared to that of other limnadiids
Authors: Olesen J. , Grygier M. J.
Published: March 2003

As a part of a project to compare phylogenetically the larval or embryonic development of all major taxa of the Branchiopoda (Crustacea), the larval development of the Japanese spinicaudatan clam shrimp Eulimnadia braueriana Ishikawa, 1895, is described. Seven naupliar stages are recognized, based mainly on significant morphological differences between them, but in one case, on size alone. The seven stages range in length from 156 µm to 760 µm. Nauplius 1 is nonfeeding with incompletely developed and nonfunctional feeding structures. Nauplius 2 has apparently functional feeding structures, including a well‐developed mandibular gnathobase, setulate protopodal endites of the antennae, and setules on various setae involved in swimming and food manipulation. Nauplius 3 is morphologically identical to Nauplius 2, but more than 50% larger. In nauplius 4, the coxal endite (naupliar process) of the antennae develops a bifid tip. Nauplius 5 has a lateral pair of primordial carapace lobes, and the first 4–5 pairs of trunk limb buds are weakly developed, making the anterior part of the trunk wider than the posterior. In nauplius 6, five pairs of trunk limb buds are visible externally and a small carapace has appeared, reaching approximately to trunk limbs 2; also, the pair of large buds behind the mandibles in previous stages has become divided into a large, anterior, setose bud and two smaller, posterior buds. The identities of these structures as either paragnaths or maxillules/maxillae remain uncertain. In nauplius 7, about six pairs of trunk limb buds are visible externally. The general morphology of the nauplius larvae of E. braueriana is much like those of the well‐known Limnadia lenticularis (Linnaeus, 1758) and Eulimnadia texana Packard, 1871, including an elongate, lanceolate labrum; however, because of various heterochronies, the correspondence between the larval sequences of these species is not perfect. There is even less correspondence with the 5‐stage larval development reported for Limnadia stanleyana King, 1855, and the spatulate labra of that species and Jmnadia spp. are different from those of other known limnadiid nauplii. The larvae of E. braueriana possess many typical (and synapomorphic) branchiopod features, such as the general morphology of the appendages involved in feeding and the mode of trunk limb development, while the small buds of the first antennae and the exact number and development of the parts of the trunk limbs are typical for the Spinicaudata.
Detecting and quantifying absorbed irrigation fluid by measuring mannitol and sorbitol concentrations in serum samples, and by ethanol monitoring
Authors: Gehring H. , Hornberger C. , Dibbelt L. , Dörges V. , Eichenauer R. , Schmucker P.
Published: March 2003

Objective To describe a modified and improved technique which, in one measurement, estimates the influx of irrigation fluid during endoscopic endometrial ablation or prostate resection, and provides both rapid confirmation of the diagnosis and an estimate of the amount of fluid absorbed by detecting markers which pass from the irrigation fluid to the serum, i.e. mannitol or sorbitol.

Patients and methods Control samples were taken for analysis before irrigation, and test samples were taken on four occasions during and after intervention, from each of 10 patients undergoing transurethral resection of the prostate. Irrigation fluid was also marked with ethanol (1.5% w/v) and the concentration of this agent measured in the blood and expired air of these patients. The absorbed volume was calculated according to the extracellular distribution space of mannitol.

Results Mannitol and sorbitol could be measured in 85% and 73% of the 40 test samples, respectively. The threshold for full sensitivity for breath ethanol concentration to detect absorption was 132 mL.

Conclusion This method for detecting serum mannitol and sorbitol represents a valid procedure for confirming and quantifying the absorption of irrigation fluid in the clinic, which agrees closely with the already established ethanol monitoring procedure and which should now be considered as a reference procedure.