bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pro- and anti-inflammatory cytokine release in open versus endovascular repair of abdominal aortic aneurysm
Authors: Rowlands T E , Homer-Vanniasinkam S 
Published: March 2003

Abstract

Background
Pro- and anti-inflammatory cytokine release occurs with abdominal aortic aneurysm (AAA) repair although the relative contribution of each is currently poorly understood. Ischaemia–reperfusion injury is thought to play a greater role following open (OR) than endovascular (ER) repair, with resultant greater perioperative morbidity.

Methods
Thirty-two patients undergoing OR (n = 16) and ER (n = 16) of AAA were studied. Systemic venous (SV) blood was taken at induction (baseline), 0 h (last clamp off), 4, 24, 72 and 144 h, and femoral venous (FV) blood (indwelling catheter; lower torso venous effluent) at 0, 4 and 24 h. The cytokines interleukin (IL) 6, IL-8 and IL-10 were measured in these samples.

Results
In OR, SV and FV IL-6 increased from baseline to a peak at 24 h (SV 589 pg/ml (P = 0·001 versus baseline) and FV 848 pg/ml (P = 0·05)) before declining at 144 h. In ER, there was a similar pattern but the increase was smaller (24 h: SV 260 pg/ml (P = 0·003 versus baseline) and FV 319 pg/ml (P = 0·06)) at all equivalent timepoints compared with OR. IL-8 peaked earlier (4 h) from baseline in both groups before declining by 144 h, and significant differences between SV and FV were seen only in the OR group. IL-10 levels peaked in both groups at 24 h before declining at 144 h, and there were no significant locosystemic differences between the groups.

Conclusion
Venous pro-inflammatory cytokine changes (IL-6) are consistent with significantly greater lower-torso reperfusion injury in patients undergoing OR. Smaller responses were seen after ER (IL-6 and IL-8), although both groups showed a similar anti-inflammatory response (IL-10); this pro- and anti-inflammatory imbalance may account for the increased morbidity assoicated with OR.
Systemic levels of glyceryl trinitrate following topical application to the anoderm do not correlate with the measured reduction in anal pressure
Authors: Jonas M , Barrett D A , Shaw P N , Scholefield J H 
Published: March 2003

Abstract

Background
Topical 0·2 per cent glyceryl trinitrate (GTN) lowers resting anal pressure (RAP) and heals two-thirds of chronic anal fissures. Over 50 per cent of patients experience headache, presumably through systemic absorption, but the pharmacokinetics of GTN ointment are unknown. This study evaluated the systemic absorption profile of GTN, and correlation between plasma GTN levels, RAP, haemodynamic variables and side-effects.

Methods
Thirty healthy volunteers were recruited with local medical school ethics committee approval. Continuous static anal manometry was performed for 10 min before and 2 h after application of 0·2 per cent GTN (0·5 g) to the anoderm. Blood samples were taken from an intravenous cannula, and pulse and blood pressure were measured before application of GTN, and 10, 20, 30, 40, 50, 60, 90, 120 and 180 min thereafter. Details of side-effects were recorded.

Results
GTN was detected in the plasma 10 min to 3 h after topical application. RAP was significantly reduced after 10 min, but had returned to pretreatment values by 120 min. Pulse was statistically unchanged during the study; systolic blood pressure was significantly lower 20–90 min after GTN application, and diastolic pressure was decreased throughout the study. Headaches were experienced by 14 of 30 volunteers after a median (range) of 41 (4–120) min, persisting for 74 (30–176) min, with an intensity score of 19 (5–30) mm represented on a 100-mm linear visual analogue scale. There was no correlation between plasma GTN concentration, RAP, and the onset, duration or intensity of headaches.

Conclusion
Topical GTN acts locally on the internal anal sphincter; systemic levels do not contribute significantly to the reduction in RAP. There is marked interindividual variation in plasma GTN levels, and no correlation with haemodynamic variables and side-effects.
Prospective study of open preperitoneal mesh repair for recurrent inguinal hernia
Authors: Kurzer M , Belsham P A , Kark A E 
Published: March 2003

AbstractBackgroundRecurrent inguinal hernia presents a significant clinical problem with high re-recurrence and complication rates, particularly when an anterior approach is used. This study evaluated the open preperitoneal approach for repair of recurrent inguinal hernia.MethodsThis was a prospective cohort study of 101 consecutive patients with 114 recurrent inguinal hernias. All were operated on using an open preperitoneal technique and prosthetic mesh by the method of Stoppa or Wantz. Follow-up was at 2–6 weeks, 15 and between 42 and 54 months.ResultsThere were no major complications. There was one infection and one case of retention of urine. There were no testicular complications. There were five recurrences, all within 6 months of operation, four of which were among the first 20 cases. Modifications to the original technique were made, and one recurrence occurred in the remaining 81 patients (1 per cent) or 106 hernias (1 per cent).ConclusionPreperitoneal mesh repair gives results far superior to those of the commonly used anterior approach. It is safer and easier to learn than laparoscopic repair and is the procedure of choice for complex multirecurrent inguinal hernia.
Early detection of colorectal cancer using high-magnification chromoscopic colonoscopy
Authors: Hurlstone D P , Fujii T , Lobo A J 
Published: March 2003

Abstract

Background
Endoscopic techniques aimed at early detection of colorectal cancer (CRC) and its precursors, permitting targeted in vivo luminal treatments, have been developed by the Japanese since the early 1990s. The introduction of this new technology to the UK (i.e. magnification endoscopes) may permit earlier and more accurate diagnosis. According to Japanese data, magnification chromoscopy can be used to predict histology and invasive depth of cancer, and help in the detection of flat and depressed colonic lesions. Flat and depressed lesions are not purely Japanese phenomena: they exist with a similar incidence in the UK.

Methods
A Medline search was performed for the years 1955–2001 using the following medical subject headings and search methodology: colorectal cancer and colonoscopy or aberrant crypt foci or molecular kinetics or flat/depressed lesions or chromoscopy.

Results and conclusion
Early CRC, in the form of flat or depressed lesions, can be difficult to detect using conventional colonoscopic techniques and penetrate the colonic mucosa deeply. The implications of detecting these lesions in relation to current approaches to the prevention of CRC are profound.
Serum angiogenin concentrations in young patients with diabetes mellitus
Authors: Chiarelli F. , Pomilio M. , Mohn A. , Tumini S. , Verrotti A. , Mezzetti A. , Cipollone F. , Wasniewska M. , Morgese G. , Spagnoli A. 
Published: March 2003

AbstractBackground  Angiogenin serum levels were measured in a large group of type 1 diabetic young patients, looking at whether increased Angiogenin concentrations are associated with long‐term glycemic control and microvascular complications.Materials and methods  Four groups of patients were compared to 223 age‐ and sex‐ matched healthy controls: 196 type 1 diabetic patients (age range 3–24 years, onset of diabetes before the age of 12 years; duration of disease longer than 2 years), without microvascular complications were divided into three groups on the basis of age (group 1, n = 37, age < 6 years; group 2, n = 71, age 6–12 years; group 3, n = 88, age > 12 years); 53 adolescents and young adults (age 16·1–29·7 years) with diabetic microvascular complications (background, preproliferative or proliferative retinopathy, albumin excretion rate 20–200 µg min−1) (group 4).Results  Angiogenin serum levels were significantly increased in diabetic pre‐school and pre‐pubertal children, and particularly elevated in pubertal subjects compared with age‐ and sex‐matched controls. Adolescents and young adults with microvascular complications had very high angiogenin concentrations. One‐year mean HbA1c values were correlated with angiogenin levels (r = 0·389; p < 0·01). In poorly controlled diabetics (HbA1c > 10%), long‐term (2 years) improvement of glycemic control determined a significant reduction of angiogenin concentrations in both pre‐school and pre‐pubertal children as well as in pubertal youngsters.Conclusions  Angiogenin serum concentrations are increased in diabetic children even before puberty. Severity of microvascular complications is associated with markedly increased angiogenin serum levels. Long‐term tight glycemic control determines a consistent reduction of angiogenin concentrations.
Evidence of an affinity threshold for IgE‐allergen binding in the percutaneous skin test reaction
Authors: Pierson‐Mullany L. K. , Jackola D. R. , Blumenthal M. N. , Rosenberg A. 
Published: March 2003

Background Atopy is an aberrant immune response involving allergen‐specific IgE production, though serum IgE concentration is not an entirely reliable diagnostic tool, particularly for epidemiological and genetic studies. There is no clear correlation between IgE and other indicators of atopy such as skin prick tests (SPT)s, and physiological associations are difficult to justify in cases with detectable IgE but negative SPT results.Objective IgE reflects the number of molecules available to produce an atopic response, but the degree of the response is determined by the binding strength (affinity) between receptor‐bound IgE and the allergen. We sought to determine if there was an association between binding affinity and SPT results in people with histories of atopy.Methods Standard SPTs (whole allergen extracts) were administered to people with histories of sensitivities to ragweed and house dust mite. The concentrations and affinities of serum allergen‐specific IgEs were determined using the purified allergens Amb a 1 and Der p 1.Results There was a positive correlation between weal area and allergen‐specific IgE among SPT‐positive donors. However, for those individuals with detectable amounts of allergen‐specific IgE, there was considerable overlap of IgE values between SPT‐positive and ‐negative groups. Among sensitized donors, IgE–allergen interactions were characterized by two or three specific reactions of very high affinity (KA range 108−1011 M). Negative SPT reactions were associated with lowered IgE binding affinities to major allergens. This delimited two groups with atopic disorders: specific IgE(+)/SPT(+) and specific IgE(+)/SPT(–).Conclusion The product of antibody affinity and concentration, which we define as antibody capacity (CAP = KA × IgE), is more informative with regard to describing allergen sensitivity than antibody concentration alone. Antibody binding capacity provides physiological evidence of atopy in some subjects who do not test positively by common methods and suggests an affinity threshold to produce a positive SPT reaction.
Determination of allergenicity to three cow's milk hydrolysates and an amino acid‐derived formula in children with cow's milk allergy
Authors: Caffarelli C. , Plebani A. , Poiesi C. , Petroccione T. , Spattini A. , Cavagni G. 
Published: March 2003

Background Products based on hydrolysed cow milk proteins or amino acid mixtures are recommended in children with cow's milk hypersensitivity. However, some children who are allergic to cow's milk and who clinically react to substitute milk formulas have been observed.Objective To determine the tolerance and allergenicity of protein hydrolysate or amino acid‐derived formulas in children with IgE‐mediated cow's milk allergy.Methods Twenty children with positive cow's milk challenges, positive skin prick tests and/or serum‐specific IgE antibodies to cow's milk were selected. Oral challenges, skin prick tests and serum‐specific IgE antibodies to extensively hydrolysed whey formula, partially hydrolysed whey formula, extensively hydrolysed casein formula and amino acid‐derived formula were performed.Results Five out of 17 (5/17) children reacted to partially hydrolysed whey formula, (3/16) to extensively hydrolysed whey formula, (2/10) to amino acid‐derived formula, (1/16) to extensively hydrolysed casein formula. Only extensively hydrolysed casein formula was tolerated by at least 90% (with 95% confidence intervals) of children. Hydrolysates provoked early and delayed clinical reactions, amino acid mixtures only delayed reactions. Partially hydrolysed whey formula elicited a significantly higher number of positive skin prick test reactions than other formulas. Two children had specific IgE antibodies to extensively hydrolysed whey formula, one to partially hydrolysed whey formula, one to extensively hydrolysed casein formula and none to amino acid‐derived formula.Conclusion In this study, none of the cow's milk substitutes has been found to be non‐allergenic. Our results suggest that in children with IgE‐mediated cow's milk allergy, the first ingestions of extensively hydrolysed cow's milk protein formulas require strict medical supervision because of immediate reactions. This is not the case for amino acid‐derived formula. Moreover, our data suggest that treatment of children allergic to cow's milk with cow's milk substitutes should be monitored for several days to document tolerance.
Inhibition of vasoconstriction by AJ‐2615, a novel calcium antagonist with α1‐adrenergic receptor blocking activity in human conduit arteries used as bypass grafts
Authors: Liu Ming‐Hui , Floten Storm H. , Yang Qin , He Guo‐Wei 
Published: March 2003

Aims  Graft spasm may develop during coronary artery bypass grafting and reversal of spasm is still challenging. The purpose of this study was to investigate the in vitro vascular relaxant properties of AJ‐2615 in human internal mammary artery (IMA).Methods  We studied 264 IMA rings taken from 65 patients undergoing coronary artery bypass grafting surgery with organ bath technique. The interaction between AJ‐2615 and various vasoconstrictors was investigated in two ways.Results  AJ‐2615 caused complete relaxation in methoxamine‐contracted IMA rings (100.0±0.0%; n = 8) and nearly full relaxation in potassium chloride‐contracted IMA rings (91.4±5.7%; n = 8) or noradrenaline‐contracted IMA rings (89.3±2.8%; n = 8). AJ‐2615 also induced remarkable relaxation in IMA rings contracted by other vasoconstrictors. In comparison with the α1‐adrenoceptor antagonist prazosin, AJ 2615 showed similar maximal relaxation in IMA rings contracted by methoxamine or norepinephrine. On the other hand, incubation with AJ‐2615 (0.1–1 µm) significantly inhibited all the vasoconstrictor‐mediated vasoconstriction except endothelin‐1 in a concentration‐dependent manner.Conclusions  The results suggested that in human IMA, AJ‐2615 has an inhibitory effect on vasoconstriction mediated by a variety of vasoconstrictors and the mechanism of relaxation may be related to its calcium antagonism and α1‐adrenergic receptor blocking activity. AJ‐2615 may have important clinical implications for patients undergoing coronary artery bypass surgery for reversing and preventing graft spasm.
Contrasting effects of verapamil and amlodipine on cardiovascular stress responses in hypertension
Authors: Lefrandt Johan D. , Heitmann Jörg , Sevre Knut , Castellano Maurizio , Hausberg Martin , Fallon Maura , Urbigkeit Anja , Rostrup Morten , Agabiti‐Rosei Enrico , Rahn Karl H. , Murphy Michael , Zannad Faiez , De Kam Pieter‐Jan , Smit Andries J. 
Published: March 2003

Aims  To compare the effects of two long‐acting calcium antagonists of different types on cardiovascular stress responses in hypertension.Methods  One‐hundred and forty‐five patients with mild to moderate hypertension and a mean (± s.e.mean) age of 51 ± 0.9 years received for 8 weeks the phenylalkylamine verapamil sustained release (240 mg) and the dihydropyridine amlodipine (5 mg) in a double‐blind cross‐over design, both after 4 weeks of placebo. Blood pressure, heart rate and plasma noradrenaline were monitored during 3 min of sustained isometric handgrip and 2 min of cold pressor.Results  Blood pressure was equally reduced by both drugs. After 3 min handgrip, systolic blood pressure, heart rate and rate‐pressure product were lower with verapamil compared with amlodipine. Verapamil attenuated the increases in systolic blood pressure (25 ± 2 vs 30 ± 2 mmHg, difference 4.6, 95% CI (1.0, 8.1), P < 0.01) and rate‐pressure product (3.1 ± 0.2 vs 3.6 ± 0.3 × 103 mmHg × beats min−1, difference 0.5, 95% CI (0.1, 0.9), P < 0.01) during handgrip compared with amlodipine. Similar results were observed during cold pressor. Plasma noradrenaline levels were lower with verapamil compared with amlodipine at rest and after both tests, but the increases in plasma noradrenaline were not significantly different.Conclusions  Verapamil is more effective in reducing blood pressure and rate‐pressure product responses to stress compared with amlodipine. Although plasma noradrenaline is lower with verapamil at rest and after stress, the increase during stress is not different.
Comparison of the clinical efficacy of standard and mucoadhesive‐based nasal decongestants
Authors: Tzachev Christo T. , Mandajieva Mariana , Minkov Evgeniy H. , Popov Todor A. 
Published: March 2003

Aims  To compare two xylometazoline 0.1% preparations: reference commercial solution (RS) and test mucoadhesive solution (TS).Methods  Twenty subjects with perennial allergic rhinitis (age range 18–69 years, 5 atopic, 7 men) applied randomly in turn TS and RS for 5 days in a double‐blind crossover clinical trial. Nasal airflow resistance (NAR), nasal symptoms (6 grade scoring), frequency of application (times/day), and side‐effects were recorded.Results  Mean ratio TS/RS of areas under the resistance/time curves for NAR ±90% CI: 3.56 ± 0.92; mean TS‐RS differences ±95% CI: for congestion: −1.12 ± 0.59, for frequency of application: −1.10 ± 0.20. Subjects experienced fewer side‐effects with TS.
Conclusions

A mucoadhesive solution with a decongestant had a greater and longer lasting effect on nasal congestion in subjects with perennial allergic rhinitis than the commercially available decongestant solution. It also caused fewer side effects.
Spatial correlations of Diceroprocta apache and its host plants: evidence for a negative impact from Tamarix invasion
Authors: Ellingson Aaron R. , Andersen Douglas C. 
Published: March 2003

Abstract 1. The hypothesis that the habitat‐scale spatial distribution of the Apache cicada Diceroprocta apache Davis is unaffected by the presence of the invasive exotic saltcedar Tamarix ramosissima was tested using data from 205 1‐m2 quadrats placed within the flood‐plain of the Bill Williams River, Arizona, U.S.A. Spatial dependencies within and between cicada density and habitat variables were estimated using Moran's I and its bivariate analogue to discern patterns and associations at spatial scales from 1 to 30 m.2. Apache cicadas were spatially aggregated in high‐density clusters averaging 3 m in diameter. A positive association between cicada density, estimated by exuvial density, and the per cent canopy cover of a native tree, Goodding's willow Salix gooddingii, was detected in a non‐spatial correlation analysis. No non‐spatial association between cicada density and saltcedar canopy cover was detected.3. Tests for spatial cross‐correlation using the bivariate IYZ indicated the presence of a broad‐scale negative association between cicada density and saltcedar canopy cover. This result suggests that large continuous stands of saltcedar are associated with reduced cicada density. In contrast, positive associations detected at spatial scales larger than individual quadrats suggested a spill‐over of high cicada density from areas featuring Goodding's willow canopy into surrounding saltcedar monoculture.4. Taken together and considered in light of the Apache cicada's polyphagous habits, the observed spatial patterns suggest that broad‐scale factors such as canopy heterogeneity affect cicada habitat use more than host plant selection. This has implications for management of lower Colorado River riparian woodlands to promote cicada presence and density through maintenance or creation of stands of native trees as well as manipulation of the characteristically dense and homogeneous saltcedar canopies.
Important causes of hypoglycaemia in patients with diabetes on peritoneal dialysis
Authors: Mehmet S. , Quan G. , Thomas S. , Goldsmith D. 
Published: March 2003

Abstract
Aim  Diabetes is now the commonest cause of end‐stage renal failure, so there are many diabetic patients receiving dialysis therapy. There are several important ways in which dialysis practice can impinge unfavourably on glucose control. This study focuses on the interaction between maltose‐derived metabolites in a new peritoneal dialysis fluid and blood glucose measurements using reagent sticks that depend on the glucose dehydrogenase method.Case report We report the cases of three patients, with insulin‐treated diabetes and end‐stage renal disease treated with peritoneal dialysis, who experienced symptomatic hypoglycaemia with inaccurate glucose readings on reagent strips when converted to icodextrin.Conclusion Careful teamwork between diabetes and renal physicians and specialist nurses is highly desirable to achieve good glucose control in a group of patients at particular risk of microvascular and macrovascular complications.Diabet. Med. 18, 679–682 (2001)
Prevalence of and risk factors for erectile dysfunction in Hong Kong diabetic patients
Authors: Siu S. C. , Lo S. K. , Wong K. W. , Ip K. M. , Wong Y. S. 
Published: March 2003

AbstractAim  To estimate the prevalence of erectile dysfunction (ED) in Chinese diabetic men and to identify its risk factors, we carried out a cross‐sectional survey of 500 Chinese diabetic men attending a community hospital diabetic clinic in Hong Kong.Methods  Patients were interviewed and asked to report on their experience of ED as defined in the National Institutes of Health Consensus Conference 1993. Diabetic complications and patient clinical data were obtained from patients' medical records.Results  Of the 486 patients studied, the prevalence of ED was 63.6% (95% confidence interval 59.3–67.9%). The prevalence of ED increased with age, from 33.3% to 73.8% for diabetic men aged between 21 and 80 years (P = 0.001). Severity of ED also increased with age. Among diabetic men with ED, there was no report of complete ED for diabetic men aged 40 years and below, whereas the proportion of patients with complete ED increased from 7.4% to 71.1% between the ages of 41 and 80 years. ED occurred early in the course of the disease, with a prevalence increasing from 56.0% in men with diabetes mellitus (DM) for < 5 years to 72.0% in those with DM for > 20 years (P = 0.038). Duration of DM was also associated with severity; the proportion of patients with complete ED increased from 30.8% for those with DM for < 5 years to 72.2% for those with DM for ≥ 20 years (P < 0.001). Using logistic regression analysis, DM duration, diabetic complications including retinopathy, abnormal albuminuria and sensory neuropathy, and higher level of education were associated with a higher risk of ED. By polychotomous logistic regression, age was the only factor found to be associated with the severity of ED, after adjusting for other variables.Conclusions  Chinese diabetic patients have a prevalence of self‐reported ED that appears to be higher than that of Western populations. This may be due to cultural differences and the association of abnormal albuminuria and hypertension.Diabet. Med. 18, 732–738 (2001)