bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ex‐vivo comparison of the haemostatic properties of standard transurethral resection and transurethral vaporization resection of the prostate
Authors: Reich O. , Schneede P. , Zaak D. , Siebels M. , Hofstetter A. 
Published: July 2003

OBJECTIVETo compare the haemostatic properties of standard transurethral resection of the prostate (TURP) and transurethral vaporization resection of the prostate (TUVRP), as perioperative bleeding is still regarded as the major complication of prostate resection.MATERIALS AND METHODSIsolated blood‐perfused porcine kidneys were used to determine the haemostatic efficacy of TURP and TUVRP (using two different electrodes). Bleeding was quantified precisely in relation to tissue ablation for the two techniques, and specimens were evaluated histologically.RESULTSBoth TUVRP groups had significantly less bleeding (P = 0.005) than the TURP group for a standardized ablation volume of perfused kidney tissue (18.9, 19.5 and 24.1 mL/min, respectively). The different TUVRP electrodes had no significant haemostatic differences. The histology showed significantly (P = 0.03) larger coagulation zones for the TUVRP groups than for standard TURP.CONCLUSIONSTUVRP ex‐vivo was associated with significantly better haemostasis than TURP. The haemostatic properties of different active electrodes for TUVRP seem to be equivalent.
Putative protein markers in the sera of men with prostatic neoplasms
Authors: Lehrer S. , Roboz J. , Ding H. , Zhao S. , Diamond E.J. , Holland J.F. , Stone N.N. , Droller M.J. , Stock R.G. 
Published: July 2003

OBJECTIVETo describe the preliminary identification of serum proteins that may be diagnostic markers in prostate cancer.PATIENTS AND METHODSThe study included 11 men referred for treatment of localized prostate cancer, 12 with benign prostatic hyperplasia (BPH) and 12 disease‐free controls. For serum protein analysis, the protein‐chip array surface‐enhanced laser desorption/ionization (SELDI) technique was used (Ciphergen Biosystems, Fremont, CA). SELDI combines protein‐chip technology with time‐of‐flight mass spectrometry, and offers the advantages of speed, simplicity and sensitivity.RESULTSThree protein peaks were identified in the serum of men with prostate cancer and BPH, but not in controls, with relative molecular masses of 15.2, 15.9 and 17.5 kDa. These three proteins were significantly associated with BPH and prostate cancer when compared with controls (P = 0.001, 0.004, and 0.011, respectively, Kruskal–Wallis test). Interestingly, the 17.5 kDa protein was more abundant in five men with stage T1 prostate cancer than in eight with stage T2 (P = 0.016, two tailed Mann–Whitney U‐test corrected for ties).CONCLUSIONSThese proteins, particularly the 15.9 kDa one, may be used for the diagnosis or monitoring of prostate cancer and differentiation from BPH, and have the potential for antibody‐based chip SELDI‐TOF technology. Identified proteins may be targets for immunotherapy.
Impedance measurements and connexin expression in human detrusor muscle from stable and unstable bladders
Authors: Sui G.P. , Coppen S.R. , Dupont E. , Rothery S. , Gillespie J. , Newgreen D. , Severs N.J. , Fry C.H. 
Published: July 2003

Three of this month's Scientific Discovery papers highlight the importance of collaboration in delivering high quality scientific research. As scientific technology increases in power and cost, and specific areas of interest become more specialized, it is becoming more difficult to cover all aspects of a completeresearch story. Collaborating with other experts in the field or other fields, including industry, allows strong scientific proof to be generated for the hypothesis and aims. Building strong collaborative,inter‐disciplinary, multi‐institutional, international groups with academic and industrial partners is the way forward for all discovery. We look forward to publishing more of these collaborative papersin future issues of the BJU International.OBJECTIVESTo test the hypothesis that intercellular electrical coupling is altered in human detrusor smooth muscle from patients with unstable bladders.MATERIALS AND METHODSHuman detrusor biopsy samples were obtained from patients with stable and unstable bladders. Intracellular electrical impedance was measured with alternating current (20 Hz−300 kHz) across the ends of detrusor strips in an oil‐gap, after correcting for extracellular space resistance. Gap junctions were identified by localization of connexins (Cx), specifically Cx45, Cx43 and Cx40 transcripts, using immunoconfocal microscopy.RESULTSTotal intracellular resistivity was greater in strips from unstable than from stable bladders (median 1246 vs 817 Ω.cm). The increase was attributed to an increase in junctional resistance; cytoplasmic resistance was unchanged. Cx43 was localized to a submucosal layer and to connective tissue; Cx40 label was confined to endothelial cells of blood vessels. Cx45 labelling was localized to detrusor bundles and appeared to be less marked in samples from unstable bladders. Semi‐quantitative analysis of Northern blots showed that Cx45 expression in unstable was less than that in stable bladders.CONCLUSIONSThese data suggest that intercellular coupling is reduced in detrusor from unstable bladders. Cx45 was localized to the detrusor layer, with Cx 43 more evident in the suburothelial mucosa. Cx45 labelling was less intense in detrusor samples from unstable bladders. These results are consistent with reduced gap junction coupling in detrusor from unstable bladders.
Associations between insulin resistance and thrombotic risk factors in high‐risk South Asian subjects
Authors: Kain K. , Catto A. J. , Grant P. J. 
Published: July 2003

AbstractAims There is recognized association of thrombotic factors to insulin resistance in White Europeans. South Asians are more insulin resistant compared with white Europeans and express increased metabolic features of insulin resistance. The aim of the study was to determine whether there was any relationship between insulin resistance and thrombotic risk factors in healthy South Asian subjects.Methods Healthy South Asians (n = 185) clinically free from ischaemic heart disease, ischaemic stroke or peripheral vascular disease were randomly recruited. Partial correlations of homeostasis model assessment (HOMA) (surrogate of insulin resistance) were analysed with two fibrinolytic and five coagulation factors.Results Age and gender‐adjusted HOMA was significantly correlated to plasminogen activator inhibitor‐1 (0.51, P = 0.0001), tissue plasminogen activator antigen (r = 0.40, P = 0.0001), fibrinogen (r = 0.28, P = 0.0001), von Willebrand factor (r = 0.17, P = 0.03), factor XIIa (r = 0.22, P = 0.006) factor VII antigen (r = 0.19, P = 0.02) and factor XIII B subunit (r = 0.30, P = 0.001).Conclusions Insulin resistance significantly clusters with fibrinolytic and coagulation factors in South Asians, which may contribute to high prevalence of vascular disease in this population.
The renin–angiotensin system and the long‐term complications of diabetes: pathophysiological and therapeutic considerations
Authors: Gilbert R. E. , Krum H. , Wilkinson‐Berka J. , Kelly D. J. 
Published: July 2003

AbstractThe relationship between the renin–angiotensin system (RAS) and the progression of diabetic renal disease has been a major focus of investigation over the past 20 years. More recently, experimental and clinical studies have also suggested that the RAS may have a pathogenetic role at other sites of micro‐ and macrovascular injury in diabetes. Complementing major advances into the understanding of the local, as distinct from the systemic RAS, a number of large clinical trials have examined whether blockade of the RAS might provide protection from the long‐term complications of diabetes, beyond that due to blood pressure reduction alone. While some controversy remains, these studies have, in general, suggested that angiotensin converting enzyme (ACE) inhibition and more recently, angiotensin receptor blockade reduce the development and progression of diabetic nephropathy, cardiovascular disease and possibly retinopathy. This review will focus on recent developments in our understanding of the tissue‐based RAS and its role in end‐organ injury in diabetes, the results of recent clinical trials and newer strategies for the pharmacological manipulation of the RAS.
Early detection of emotional and behavioural problems in children with diabetes: the validity of the Child Health Questionnaire as a screening instrument
Authors: Cameron F. J. , Smidts D. , Hesketh K. , Wake M. , Northam E. A. 
Published: July 2003

SummaryAims To assess the validity of the Child Health Questionnaire (CHQ) as a screening tool for detecting ‘at risk’ emotional and behavioural maladjustment in children with diabetes, using the Behaviour Assessment System for Children (BASC) as a gold standard measure.Methods CHQ and BASC were administered to 103 parents of children with Type 1 diabetes, aged 7–12 years. Sub‐scales of the two measures were compared using Pearson's bivariate correlations. CHQ sensitivity and specificity cut‐points were optimized against the BASC borderline category using receiver operating characteristic curves.Results The BASC Externalizing Problems scale correlated strongly with CHQ Behaviour, Global Behaviour, Mental Health, Family Activities and Family Cohesion scales (r‐values −0.68, −0.54, −0.51, −0.59, and −0.42, respectively). BASC Internalizing Problems scale correlated strongly with CHQ Behaviour, Mental Health and Family Cohesion scales (r‐values −0.40, −0.43 and −0.45, respectively). Using receiver operating characteristic curve analysis, the CHQ Mental Health scale most effectively identified children classified as borderline on the BASC Internalizing Problems scale (sensitivity 87%, specificity 78%), while the CHQ Global Behaviour scale most effectively identified children classified as borderline on the BASC Externalizing Problems scale (sensitivity 73%, specificity 82%).Conclusions Significant correlations were seen between the CHQ Global Behaviour and Mental Health scales and the BASC Externalizing and Internalizing scales, respectively. Sequential use of the CHQ, as a screening tool, followed by an established mental health measure such as the BASC, may help identify children with diabetes ‘at risk’ for chronic maladjustment and poor health outcomes.
Evaluation of a new non‐mydriatic digital camera for detection of diabetic retinopathy
Authors: Massin P. , Erginay A. , Ben Mehidi A. , Vicaut E. , Quentel G. , Victor Z. , Marre M. , Guillausseau P. J. , Gaudric A. 
Published: July 2003

AbstractAims To compare the results of fundus photography using a new non‐mydriatic digital camera with the results of reference standard of Early Treatment Diabetic Retinopathy Study (ETDRS) retinal photographs, for the detection of diabetic retinopathy (DR).Methods Fundus colour photographs were taken with a Topcon non‐mydriatic camera of 147 eyes of 74 diabetic patients, without pupillary dilation (five overlapping fields of 45°; posterior pole, nasal, temporal, superior and inferior). Three retinal specialists classified the photographs in a masked fashion, as showing no DR or mild non‐proliferative DR (NPDR) not requiring referral, moderate or more severe NPDR and/or macular oedema, or as non‐gradable image requiring referral. ETDRS 35‐mm colour slides served as reference images for DR detection.Results For moderately severe to severe DR, the sensitivities of detection reported by the three observers were 92, 100 and 92%, respectively, and the specificities, 87, 85, and 88%. For four levels of DR severity (none or mild NPDR, moderate NPDR, severe NPDR and proliferative DR), the percentages of exact agreement between the three observers on the retinopathy grades assigned to the non‐mydriatic photographs and to the ETDRS reference slides were 94.6, 93 and 87.6%, respectively (κ 0.60–0.80). Sixteen eyes of nine patients (11%) were judged ungradable by at least one observer. In a second series of 110 patients, evaluated in the setting of a screening procedure, fewer photographs were ungradable (< 6%).Conclusion These results suggest that fundus photographs taken by the Topcon TRC‐NW6S non‐mydriatic camera, without pupillary dilation, are suitable for DR screening.
Effectiveness of a new brand of stock ‘diabetic’ shoes to protect against diabetic foot ulcer relapse. A prospective cohort study
Authors: Busch K. , Chantelau E. 
Published: July 2003

AbstractAims Diabetic patients with podopathy (diabetic foot syndrome) may need protective footwear, be it customized or industrially produced stock ‘diabetic’ shoes (SDS). The effectiveness of each type of ‘diabetic’ shoe needs to be proven clinically, e.g. in terms of prevention of foot ulceration. The following study assesses a new German SDS, the LucRo® shoe, which consists of rocker‐shaped walking sole, a standardized shock absorption insole, and soft uppers without stiff toe‐caps. The LucRo® SDS has been registered as a Medicinal Product according to the European Community Guideline 93/42/EC.Patients and methods A total of 92 high‐risk diabetic patients (mean age 63 years, duration of diabetes 13 years) with healed foot ulcer were recruited prospectively over 31 months; 87 patients suffered from polyneuropathy, 24 patients had peripheral ischaemic vessel disease. One group of patients (n = 60) received the LucRo® SDS and wore them, while the remaining patients (n = 32) did not receive the SDS and were forced to use their normal footwear. This allocation reflects the haphazard reimbursement policies of the individual patients’ health insurance, and is in accordance with the current German legislation. The patients were followed up for up to 42 months until the first foot ulcer relapse, or the end of the study.Results There were no differences between the groups concerning age, sex, type and duration of diabetes, prevalence of polyneuropathy and peripheral ischaemic vessel disease, frequency of foot care and mortality rate. The first year annual rate of foot ulcer relapse was significantly different between the groups: 60% without SDS vs. 15% with SDS. The overall cumulative ulcer‐free survival was significantly greater with SDS (P < 0.0001, log rank test).Conclusion The LucRo® stock ‘diabetic’ shoe appears effective in the prevention of foot re‐ulceration in high‐risk patients with diabetic podopathy.
From minimal background diabetic retinopathy to profuse sight threatening vitreoretinal haemorrhage: management issues in a case of pregestational diabetes and pregnancy
Authors: Chatterjee S. , Tsaloumas M. D. , Gee H. , Lipkin G. , Dunne F. P. 
Published: July 2003

AbstractDeterioration of retinopathy is a recognized complication of pregnancy in Type 1 diabetes. We discuss management issues relating to a case of rapid sight‐threatening progression of retinopathy in pregnancy complicated by pregestational diabetes.
Effect of the rapid‐acting insulin analogue insulin aspart on quality of life and treatment satisfaction in patients with Type 1 diabetes
Authors: Bott U. , Ebrahim S. , Hirschberger S. , Skovlund S. E. 
Published: July 2003

AbstractAims To compare quality of life (QoL) and treatment satisfaction in patients with Type 1 diabetes receiving the rapid‐acting insulin analogue, insulin aspart (IAsp), with that in patients receiving soluble human insulin (HI).Methods In this 6‐month, multinational, randomized, open‐label trial, 424 patients from German‐speaking countries were subjected to psychometric assessment before and after randomization (ratio 2 : 1) to basal‐bolus treatment with either IAsp (n = 283) or HI (n = 141). Patients on HI were advised to keep an injection–meal interval of 30 min, whereas patients on IAsp were advised to inject immediately before meals. Treatment satisfaction and diabetes‐related QoL were assessed using validated instruments to measure the domains of patients’ individual treatment goals, physical complaints, worries about the future, social relations, leisure time flexibility, daily hassles, diet restrictions, burdens and fear of hypoglycaemia, blood glucose fluctuations, self‐efficacy, and fear of insulin analogues.Results After 6 months, IAsp was associated with significantly greater improvement in treatment satisfaction than HI in two different scales (P < 0.01), and in QoL with respect to diet restrictions (P < 0.01). Improved satisfaction was mainly due to increased dietary and leisure time flexibility (P < 0.0001). Twenty‐three percent of the IAsp group vs. 14% of the HI group achieved small but important improvements of total QoL (between‐group difference, P < 0.06). The number needed to treat (NNT) with IAsp for an important increase in QoL was calculated to be 10. Regression analyses of potential predictors of improvement in QoL highlighted patients intensely striving for physical strength (P < 0.01; NNT = 7) and patients feeling less protected against hypoglycaemia (P < 0.005; NNT = 8) as being the most likely to benefit from IAsp.Conclusions Under these study conditions, IAsp improved treatment satisfaction and quality of life regarding diet restrictions when compared with human insulin. The ‘numbers needed to treat’ for important quality of life benefits indicate that the effect of IAsp in this regard is not trivial.
The effects of applied felted foam on wound healing and healing times in the therapy of neuropathic diabetic foot ulcers
Authors: Zimny S. , Schatz H. , Pfohl U. 
Published: July 2003

AbstractAims The application of felted foam is a promising method for plantar pressure reduction in the ulcer region of diabetic foot ulcers, but knowledge of its effects on wound healing is sparse. The objective of this study was to evaluate the effects of felted foam on wound healing in diabetic foot ulcers compared with a standard method of plantar pressure relief.Materials and methods A total of 54 Type 1 or Type 2 diabetic patients with neuropathic diabetic foot ulcers were evaluated in this prospective randomized controlled study. Ulcer healing was assessed by planimetric measurement of the wound area at beginning of the study and after 10 weeks and at least until wound healing. The patients were consecutively enrolled in the study; 24 patients were randomized to the felted foam therapy, and 30 patients were randomized to conventional therapy.Results In the felted foam group, the initial average wound area was 102.3 ± 45.3 mm2 (mean ± sd), and 5.4 ± 3.1 mm2 after 10 weeks with an average healing time of 75 days [95% confidence interval (CI) 67–84]. In the conventional therapy group, the initial average wound area was 112.5 ± 50.8 mm2, and 10.6 ± 4.2 mm2 after 10 weeks with an average healing time of 85 days (95% CI 79–92) (P = 0.03). The mean wound radius decreased by 0.48 mm (95% CI 0.42–0.56) per week in the felted foam group and by 0.39 mm (95% CI 0.35–0.42) per week in the conventional group (P = 0.005).Conclusions The felted foam technique appears to be at least as effective as conventional plantar ulcer treatment. It may be a useful alternative in treating neuropathic foot ulceration, especially in patients who are not able to avoid weight‐bearing reliably.
Therapeutic effect of recombinant human erythropoietin on anaemia with erythropoietin deficiency in diabetic patients
Authors: Kim D. J. , Kim Y. M. , Yun Y. S. , Ahn C. W. , Cha B. S. , Song Y. D. , Lim S. K. , Kim K. R. , Hahn J. S. , Huh K. B. , Lee H. C. 
Published: July 2003

AbstractAims The aim of this study was to investigate the therapeutic effect of recombinant human erythropoietin (rHuEpo) on anaemia with erythropoietin deficiency in diabetic patients.Methods Twenty diabetic patients with anaemia and Epo deficiency were enrolled. All patients were treated with rHuEpo (Epokine®; 4000 U/day s.c., three times a week) for 8 weeks.Results The responder group (n = 14) had significant increments in haemoglobin compared with the non‐responder group (n = 6) (P < 0.05). No significant differences were found between the responder and non‐responder groups in terms of duration of diabetes mellitus, serum creatinine level, 24‐h urine albumin excretion rates, frequency of diabetic microangiopathy, or HbA1c. There was no difference between the two groups in terms of serum iron and total iron‐binding capacity (TIBC). Serum ferritin level was significantly higher in the responder group than in the non‐responder group (240.3 ± 108.4, 25.8 ± 3.0 µg/l, P < 0.05), as was transferrin saturation (32.7 ± 7.9%, 21.2 ± 5.3%, P < 0.05).Conclusions rHuEpo could be useful in the treatment of anaemia with erythropoietin deficiency in diabetic patients, and the degree of iron storage and functional iron deficiency might be the main cause of hyporesponsiveness to rHuEpo.
Insulin lispro: a potential role in preventing nocturnal hypoglycaemia in young children with diabetes mellitus
Authors: Ford‐Adams M. E. , Murphy N. P. , Moore E. J. , Edge J. A. , Ong K. L. , Watts A. P. , Acerini C. L. , Dunger D. B. 
Published: July 2003

AbstractAims The long duration of action of soluble insulin given in the evening could contribute to the high prevalence of nocturnal hypoglycaemia seen in young children with Type 1 diabetes mellitus (T1DM). We examined whether replacing soluble insulin with insulin lispro reduced this risk in children on a three times daily insulin regimen.Methods Open crossover study comparing insulin lispro vs. soluble insulin in 23 (16 boys) prepubertal children (age 7–11 years) with T1DM on three injections/day; long‐acting isophane insulin remained identical. At the end of each 4‐month treatment arm, an overnight 15‐min venous sampled blood glucose profile was performed.Results Despite similar blood glucose levels pre‐evening meal (lispro vs. soluble: mean ± se 6.5 ± 1.0 vs. 7.1 ± 1.1 mmol/l, P = 0.5), post‐meal (18.00–22.00 h) blood glucose levels were lower on insulin lispro (area under curve 138 ± 12 vs. 170 ± 13 mmol min−1 l−1, P = 0.03). In contrast, in the early night (22.00–04.00 h) the prevalence of low blood glucose levels (< 3.5 mmol/l) was lower on lispro (8% of blood glucose levels) than on soluble insulin (13%, P = 0.01). In the early morning (04.00–07.00 h) mean blood glucose and prevalence of low levels were no different between the two treatment groups, and fasting (07.00 h) blood glucose levels were similar (6.1 ± 0.8 vs. 6.3 ± 0.9 mmol/l, P = 0.8). At the end of each treatment arm there were no differences in HbA1c (lispro vs. soluble 8.6% vs. 8.4%, P = 0.3), or in insulin doses (mean, range 0.97, 0.68–1.26 vs. 0.96, 0.53–1.22 U/kg per day, P = 0.2).Conclusions The shorter duration of action of insulin lispro given before the evening meal may reduce the prevalence of early nocturnal hypoglycaemia without compromising HbA1c in young children with T1DM.