bluuebunny/crossref_metadata_2025_split huggingface dataset:
Altered serotonin immunoreactivities in the left colon of patients with colonic inertia
Authors: Zhao R. H. , Baig M. K. , Mack J. , Abramson S. , Woodhouse S. , Wexner S. D. 
Published: March 2003

BackgroundSerotonin is an important positive regulator of colonic motility and transit. Its quantity and distribution in the left colon could be abnormal in patients with colonic inertia (CI) and contribute to the disease.AimTo evaluate serotonin positive cells and immuno‐reactivities in the mucosa, submucosa and muscularis propria of the left colon from patients with CI was compared to a control group.Patients and methodsNineteen patients who underwent subtotal colecotomy for CI were assessed. The control group consisted of 15 patients who underwent left hemicolectomy for colonic cancer; histologically normal tissue specimens were used. Immunohistochemical staining for serotonin was performed. In the mucosa, the average number of serotonin positive cells per microscopic field (200 × ) was determined. The positively stained area (square pixels) in the mucosa, submucosa and muscularis propria per microscopic field (200 × ) was calculated utilizing a computer image analysis program.ResultsIn the mucosa, both the number of serotonin positive cells and positively stained area were significantly higher in the patient group than in controls (P < 0.05). The difference in serotonin positive area in the submucosa in the CI group compared to the control group was not statistically significant. There was a very significant correlation between the serotonin positive area in the submucosa and muscularis propria in controls (r=0.65, p < 0.01), but not in patients with CI.ConclusionThe increased serotonin level in patients with CI may contribute to the disease or be an adaptive response to some other pathology. The lack of a positive correlation in serotonin levels between the submucosa and muscularis propria in CI patients suggests that the coordinated distribution of serotonin may be disrupted in CI.
Diverticular colitis – therapeutic and aetiological considerations
Authors: Evans J. P. , Cooper J. , Roediger W. E. W. 
Published: March 2003

ObjectiveTreatment of diverticulitis may change when associated with mucosal inflammation of either ulcerative‐like or Crohns‐like colitis. To determine effective treatment of diverticular colitis, four cases were analysed. Mechanisms to account for the colitis associated with diverticulitis are put forward.Patients and treatmentFour cases had colitis and active diverticulitis established by clinical, colonoscopic or CT evidence of active inflammation. Biopsies confirmed mucosal inflammation: two with ulcerative colitis‐like and two with granulomata suggestive of Crohns‐like colitis. Treatment for colitis in all cases included sulphasalazine and steroids in two cases.ResultsColitis subsided in three cases but one had continuing inflammatory polyps and one case did not resolve. Segmental resection was performed in two cases one with continuing colitis and one with inflammatory polyps. No further attacks of colitis have occurred since the initial observations were made or operations performed.ConclusionAn association of colitis with diverticulitis has been confirmed by present observations and case reports of others. Colitis requires medical treatment and if inflammation fails to resolve, segmental resection is indicated. Diverticular colitis, either ulcerative colitis‐like or Crohns‐like, is part of the spectrum of acute diverticulitis.
Prospective analysis of quality of life after reversal of a defunctioning loop ileostomy
Authors: Camilleri‐Brennan J. , Steele R. J. C. 
Published: March 2003

ObjectiveTo measure changes in patients' quality of life following reversal of a defunctioning ileostomy in patients who had a curative anterior resection for rectal cancer.Patients and methodsTwenty consecutive patients undergoing reversal of a loop ileostomy following low anterior resection for primary rectal cancer participated. They answered three quality of life questionnaires: the European Organization for the Research and Treatment of Cancer (EORTC) QLQ‐C30 and QLQ‐CR38, and the SF‐36. Questionnaires were answered before reversal, on discharge home, and at 3 and 6 months postoperatively.ResultsReversal of the defunctioning ileostomy resulted in significant improvements in global quality of life, physical function, social function, role‐physical and energy‐vitality scores. Post‐operative diarrhoea and frequency improved over six months, but one third of patients had mild incontinence of faeces which did not improve with time. Emotional function, mental health, future perspective, perception of body image and general health perception did not change significantly after reversal. There was a significant negative correlation between defaecation‐related problems, global quality of life and body image.ConclusionReversal of a defunctioning loop ileostomy improves most patients' overall quality of life. Therefore, once it is considered safe to reverse a stoma, an early operation may give the patient a longer time with an improved quality of life.
The contemporary management of haemorrhoids
Authors: Beattie G. C. , Wilson R. G. , Loudon M. A. 
Published: March 2003

AbstractBackground  New concepts in the management of haemorrhoidal disease have recently rekindled interest in this common pathology. General and subspecialist colorectal surgeons were surveyed to assess their impact on the current management of haemorrhoids.Methods  A questionnaire was sent to all members of the Association of Coloproctology of Great Britain and Ireland (ACPGBI) and the Association of Surgeons of Great Britain and Ireland (ASGBI). Regarding indications for surgery, surgical techniques, day case haemorrhoidectomy (DCH) and postoperative treatment regimens. ASGBI members were asked to state their subspecialist interest and estimated time devoted to colorectal practice.Results  There were 406 (71%) ACPGBI respondents and 483 (68%) ASGBI respondents. Eighty‐four (12%) ASGBI respondents performed no elective colorectal surgery. One hundred and ninety‐nine (35%) of ACPGBI respondents saw between 6 and 10 new haemorrhoid patients per week whereas three hundred (42%) of ASGBI respondents saw between 1 and 5 per week. Non‐operative management included routine advice on fluid and diet by the majority of surgeons, with banding carried out in 79% (ACPGBI) and 75% (ASGBI) and injection sclerotherapy in 61% (ACPGBI) and 56% (ASGBI). The Milligan Morgan haemorrhoidectomy was performed in 265 (46%; ACPGBI) and 336 (47%; ASGBI). ACPGBI members used Submucosal diathermy (148, 26%vs 67, 9%; ASGBI (P < 0.01; χ2 test with Yates correction)) and stapled anoplasty (61, 11%vs 14, 2%; ASGBI (P < 0.01; χ2 test with Yates correction)) more often. DCH was performed in 117 (20%; ACPGBI) and in 48 (7%; ASGBI)(P < 0.01; χ2 test with Yates correction).Conclusions  In this sample of surgeons, operative management varies according to specialist interest. There was a trend towards day case haemorrhoidectomy. Whilst more surgeons have accepted the use of postoperative techniques to reduce pain, only a small minority have, as yet, adopted new surgical techniques such as stapling.
A novel indicator for surveillance colonoscopy following colorectal cancer resection
Authors: Skaife P. , Seow‐Choen F. , Eu K. W. , Tang C. L. 
Published: March 2003

AbstractIntroduction  Current surveillance for recurrent intraluminal or metachronous colorectal cancer following resection is largely undertaken by colonoscopic examination of the remaining colon. The burden on colonoscopic services is high and the procedure is expensive. Immunological faecal occult blood testing (FOBT) is a sensitive and specific test for detecting colorectal cancer, and may fine tune the need for timely surveillance colonoscopy.Methods  Consecutive patients due for surveillance colonoscopy following colonic resection for cancer were prospectively studied. Each patient had a single faecal sample obtained at per rectal examination on a gloved examining finger. This was subjected to immunological FOBT in the clinic, and patients were categorized as FOBT positive or negative, according to the result. Colonoscopy as well as ultrasound or CT of the liver were performed within eight weeks of FOBT.Results  Six hundred and eleven patients had both FOBT and colonoscopy. Fifty‐nine (13.6%) were categorized as FOBT‐positive. Of these, nine had biopsy‐proven recurrent or metachronous cancer, 12 patients had one, or more adenomatous polyps, one patient had radiation proctitis and two patients had pan‐colonic mucositis following chemotherapy. In the remaining 552 FOBT‐negative patients, no cancers were found. Thirty‐eight patients had polyps that were removed. The sensitivity and specificity for detecting cancer by immunological FOBT was 100% sensitivity for detecting adenomatous polyps was 24% but specificity was 93%.Conclusion  The immunological faecal occult blood test provides sensitive detection of metachronous and recurrent cancer in postoperative surveillance. Routine application may be used to reduce the frequency of colonoscopic surveillance, as a negative FOBT may be taken as a sign that colonoscopy may be deferred safely.
Effects of niacin‐bound chromium supplementation on body composition in overweight African‐American women
Authors: Crawford V. , Scheckenbach R. , Preuss H. G. 
Published: March 2003

Summary Aim: This pilot study was designed to determine whether 600 μg niacin‐bound chromium ingested daily over 2 months by African‐American women undergoing a modest dietary and exercise regimen influences weight loss and body composition. Methods: Twenty overweight African‐American women, engaged in a modest diet–exercise regimen, participated in a randomized, double‐blinded, placebo‐controlled, crossover study. They received placebo three times a day (t.i.d.) during the control period and niacin‐bound chromium, 200 μg t.i.d., during the verum period. Control and verum periods were each 2 months in duration. One‐half received placebo first (group 1), the other half received chromium first (group 2). Body weights (b.w.) and blood chemistries were measured by routine clinical methodology. Fat and nonfat body masses were estimated using bioelectrical impedance (electrolipography). Results: In the first group of 10 women receiving niacin‐bound chromium after the placebo period (group 1), b.w. loss was essentially the same, but fat loss was significantly greater and non‐fat body mass loss significantly less with chromium intake. In contrast to the previous findings, there was a significantly greater loss of fat in the placebo compared to the verum period in the second group of eight women who received chromium first (group 2). Blood chemistries were not affected by intake of chromium for 2 months. Conclusions: Niacin‐bound chromium given to modestly dieting‐exercising African‐American women caused a significant loss of fat and sparing of muscle compared to placebo. Once chromium was given at these dose levels, there was a ‘carry‐over’ effect. Blood chemistries revealed no significant adverse effects from the ingestion of 600 μg of niacin‐bound chromium daily over 2 months.
Pathogenesis of vascular disease
Authors: Colwell John 
Published: March 2003

SummaryOnly recently are we beginning to understand the complex interplay of factors involved in vascular disease and diabetes. Insulin resistance provides a starting point to explain the many factors that lead to the more severe vascular disease characteristic of diabetes. Insulin resistance syndrome comprises insulin resistance and compensatory hyperinsulinaemia as well as hypertension, dyslipidaemia, macrovascular disease, and increased plasminogen activator inhibitor‐1 activity. The development of type 2 diabetes may be viewed as the inability of the pancreas to continue to overcome insulin resistance, even with excessive insulin production.
Dissociation between Fas expression and induction of apoptosis in human islets of Langerhans
Authors: Loweth A. C. , Watts K. , McBain S. C. , Williams G. T. , Scarpello J. H. B. , Morgan N. G. 
Published: March 2003

SummaryThere is increasing evidence that inappropriate induction of apoptosis in pancreatic β‐cells may precede the development of type 1 diabetes in animal models and in man. One mechanism by which this has been proposed to occur involves up‐regulation of the death receptor Fas on β‐cells, resulting in apoptosis of the Fas‐bearing β‐cells upon ligation of the receptor. We have examined this hypothesis in isolated human islets of Langerhans and show that–‐in contrast to data obtained with rodent β‐cells–‐expression of Fas per se is not sufficient to allow induction of apoptosis upon addition of agonistic anti‐Fas serum.
Optimizing insulin delivery: assessment of three strategies in intensive diabetes management
Authors: Kalergis M. , Pacaud D. , Strychar I. , Meltzer S. , Jones P. J. H. , Yale J. ‐F. 
Published: March 2003

SUMMARY Objective  To compare three intensive management strategies with respect to metabolic control (glycated haemoglobin, preprandial blood glucose, lipid profile, body weight, hypoglycaemic episodes) and psycho‐social adaptation (quality of life, self‐efficacy, stress and perceived complexity).Research Design and Methods: Fifteen adults with type 1 diabetes completed this 1‐year, randomized, prospective, cross‐over study. The three treatment strategies were categorized according to flexibility with insulin self‐adjustments as follows: Simplified (SIMP) = meal plan based on food exchanges with no self‐adjustments of insulin for food, exercise and stress; Qualitative (QUAL) = meal plan based on food exchanges with qualitative adjustment of insulin for food, exercise and stress; Quantitative (QUANT) = meal plan using carbohydrate counting with quantitative adjustment of insulin for food and qualitative adjustment for exercise and stress. All three strategies allowed for adjustments of insulin for preprandial blood glucose and the option of adjusting diet for exercise. All subjects followed each strategy for 3.5 months.Subjects  kept detailed log sheets where they recorded preprandial blood glucose, insulin dosages, food intake, activity and stress level at least four times/day. The psycho‐social aspects were determined with validated questionnaires that were completed before and after each strategy.Results  There were no statistically significant differences in metabolic control, quality of life and self‐efficacy between the three strategies. The mean (± s.e.) for HbA1 levels (normal < 8.5%) were: Baseline: 10.9 ± 0.06 and End of SIMP = 9.7 ± 0.03; QUAL = 9.5 ± 0.04; QUANT = 10.2 ± 0.04. Body weight and serum lipid levels did not change significantly. The frequency of severe hypoglycaemic episodes for the entire study was 20 episodes/100 patient‐years. Perceived complexity of treatment strategy increased (p < 0.0001) from SIMP to QUANT (least to most flexible). Although the majority of subjects (n = 11) were following a strategy similar to SIMP prior to entering the study, 12 subjects chose to continue with QUAL, three with QUANT and none with SIMP at the end of the study.Conclusions  These results indicate that a strategy that allows for flexibility of self‐adjustments of insulin and is not very complex (such as QUAL) may be the strategy of choice for intensive management programmes.
Impaired glucose metabolism and obesity in Swedish patients with borderline isolated systolic hypertension: Skaraborg Hypertension and Diabetes Project
Authors: Bøg‐Hansen E , Lindblad U , Ranstam J , Melander A , Råstam L 
Published: March 2003

Summary AimTo assess the prevalence of borderline isolated systolic hypertension (borderline ISH), and to examine its association with other cardiovascular risk factors.MethodsA cross‐sectional community‐based study was carried out in 1993–1994 in Skara, Sweden, including 1109 randomly chosen subjects ≥ 40 years old. Normotension (NT) was defined as systolic blood pressure (SBP) < 140 and diastolic blood pressure (DBP) < 90 mmHg, borderline ISH as SBP 140–159 and DBP < 90 mmHg and hypertension (HT) as SBP ≥160 or DBP ≥ 90 mmHg or ongoing treatment.ResultsThe prevalence of borderline ISH (n = 203) by age was 4% in ages 40–49 years, 15% in ages 50–59 years, 28% in ages 60–69 years and 25% in ages 70–79 years. With borderline ISH as reference, normotensive subjects less often had fasting blood glucose > 5.5 mmol/l (odds ratio (OR): 0.4, 95% CI: 0.26–0.75), BMI > 27 kg/m2 (OR: 0.6, 95% confidence intervals (CI): 0.42–0.85) and known diabetes (OR: 0.4, 95% CI: 0.16–0.95). Hypertensive subjects more often had high density lipoprotein (HDL) cholesterol < 1.0 mmol/l (OR: 2.0, 95% CI: 1.35–2.99), a history of previous cardiovascular disease (CVD) (OR: 1.7, 95% CI: 1.01–2.72), known diabetes (OR: 2.4, 95% CI: 1.29–4.58) and microalbuminuria (men) (OR: 1.9, 95% CI: 1.15–3.11).ConclusionBorderline ISH is a common condition. It is associated with a more unfavourable risk factor profile than that of normotensive subjects concerning primarily glucose metabolism and obesity. The prevalence of known diabetes increased with the degree of hypertension.
Reduction of incretin‐like salivatin in saliva from patients with type 2 diabetes and in parotid glands of streptozotocin‐diabetic BALB/c mice
Authors: Kimura I. , Sasamoto H. , Sasamura T. , Sugihara Y. , Ohgaku S. , Kobayashi M. 
Published: March 2003

SUMMARY Aim  Diabetic xerostomia is a typical syndrome in diabetic complication. We have reported that salivatin (salivary peptide P‐C) derived from human saliva potentiates glucose‐stimulated insulin release and inhibits arginine‐stimulated glucagon release. The present study is aimed to gain further evidence on the physiological role by investigating the diabetic state‐induced change in the amount of salivatin.Methods  The amount of salivatin was measured in saliva taken from patients with type 2 diabetes with ELISA and with rabbit antiserum against human salivatin immunocytochemically in sections of parotid glands from streptozotocin‐diabetic BALB/c mice.Results  The amount of salivatin after a meal was reduced by diabetes in both human saliva and in the serous secretory granule of mouse parotid gland acinar cells.Conclusions  The above results suggest that salivatin lowers hyperglycaemia after meal and sustains the normal blood glucose levels by incretin‐like mechanisms. The function may be damaged by diabetes, and this in turn might make the diabetes worse.
Lactic acidosis in metformin therapy: searching for a link with metformin in reports of ‘metformin‐associated lactic acidosis’
Authors: Lalau J. D. , Race J. M. 
Published: March 2003

SUMMARY Objective  The link between metformin and lactic acidosis in metformin therapy may be causal, associated or coincidental. Our objective was to investigate this link by studying and analysing published reports of so‐called ‘metformin‐associated lactic acidosis’.Research design and methods  systematically searched in the BIOSIS, DERWENT, EMBASE, MEDLINE, and PASCAL databases of the English language and non‐English language literature for all reports of so‐called ‘metformin‐associated lactic acidosis’ published from May 1995 through January 2000. We did not include reports related to metformin overdose or contrast media‐induced renal failure. Metformin accumulation and concurrent pathologies were critically reviewed as precipitating factors for metformin‐associated lactic acidosis. Metformin accumulation was assessed in terms of the recorded measurement of metformin concentration in plasma or, if not available, by the presence of primary renal failure, i.e. renal failure that was not secondary to a shock syndrome.Results  We found 21 reports describing a total of 26 patients. Criteria of lactic acidosis (lactate > 5 mmol/l, pH ≤ 7.35) were not met in four patients. In the remaining 22 patients, plasma metformin concentration was determined in only four, of whom one had a normal value. In the 18 patients with lactic acidosis where plasma metformin concentration data was not available, the presence of primary renal failure was absent or unlikely in six patients, uncertain in two, and likely or proven in 14. With regard to these 14 patients, the precipitating factor was metformin in 12 patients (in the context of renal failure either chronic or acute) and intercurrent pathologies in two others. Overall, lactic acidosis was either absent (n = 4), precipitated by concurrent pathology (n = 8), precipitated by metformin without apparent associated pathology (n = 12) or of uncertain origin (n = 2). Death occurred 10 times but only once in the 12 patients with metformin‐induced lactic acidosis and this was not related to metformin.Conclusions  While the term ‘metformin‐associated lactic acidosis’ is commonly used to depict all situations of lactic acidosis in metformin therapy, true metformin‐associated lactic acidosis, i.e. one which refers to metformin and concurrent pathologies as co‐precipitating factors, was never observed in the studied reports. As there was no mortality due to metformin alone, it is important that physicians are familiar with the range of other risk factors that contribute to lactic acidosis in patients treated with metformin.
Effect of vanadate on glycogen synthesis in dexamethasone‐treated 3T3 adipocytes: evidence for a novel insulin sensitizing action
Authors: Marita A. R. , Anilkumar K. L. 
Published: March 2003

SUMMARY Aim  Type 2 diabetes is characterized by peripheral tissue insulin resistance. The present study was carried out to determine the insulin sensitizing action of vanadium using dexamethasone‐treated 3T3 adipocytes as an in‐vitro model of insulin resistance.Methods  Fully differentiated 3T3 adipocytes were incubated with or without 100 nm dexamethasone in the presence or absence of 200 nm insulin for 6 days. Sodium orthovanadate (0–1000 μm) was added on day 2 and was present during the last 4 days. At the end, insulin (100 nm) stimulated glycogen synthesis was determined.Results  Vanadate treatment for 4 days, caused 2–3‐fold increase in glycogen synthesis in dexamethasone treated adipocytes. At 100 μm, vanadate completely reversed dexamethasone‐induced insulin resistance (by increasing the levels from 9.65 ± 0.80 to 28.4 ± 4.9 nmol/h). In cells treated with dexamethasone and insulin, vanadium was partially active and it caused only 30% increase in glycogen synthesis. Exposure of dexamethasone treated cells for 24 h with vanadium did not affect glycogen synthesis. Under identical condition, vanadium had no significant effect in the normal insulin sensitive adipocytes. Vanadium at 100 μm had no effect on 125I‐insulin binding to insulin‐resistant adipocytes. Glycogen synthesis in the normal and insulin‐resistant adipocytes was stimulated by lithium, an inhibitor of glycogen synthase kinase 3 β, suggesting the involvement of phosphorylation events in dexamethasone‐induced insulin resistance.Conclusions  Since vanadium was active only in the insulin‐resistant adipocytes it is likely that vanadium acts by relieving dexamethasone actions rather than having independent effects. These results provide evidence for the novel insulin sensitizing action of vanadium which might be of future clinical relevance.