bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of weight loss on the metabolic syndrome
Authors: Case C. C. , Jones P. H. , Nelson K. , O'Brian Smith E. , Ballantyne C. M. 
Published: March 2003

Aim: Individuals with the metabolic syndrome (MS), a clustering of risk factors [triglycerides, glucose, high‐density lipoprotein cholesterol, blood pressure (BP), abdominal obesity] defined by the National Cholesterol Education Program (NCEP), are at high risk for coronary heart disease and type 2 diabetes mellitus, and may benefit from aggressive lifestyle modification.Methods: We reviewed 1 year of consecutive patients' charts to determine the prevalence of the MS in obese individuals enrolled in a medically supervised rapid weight loss programme, the correlation of weight change with the components of the MS, and response to diet‐induced weight loss.Results: Out of 185 individuals, 125 (68%) met the NCEP definition of the MS. A moderate decrease in weight (6.5%) induced by a very low calorie diet (VLCD) resulted in substantial reductions of systolic (11.1 mmHg) and diastolic (5.8 mmHg) blood pressure (BP), glucose (17 mg/dl), triglycerides (94 mg/dl) and total cholesterol (37 mg/dl) at 4 weeks (all p < 0.001). These improvements were sustained at the end of active weight loss (average 16.7 weeks; total weight loss 15.1%), with further significant reductions in BP and triglycerides. Weight loss was related to the changes in each criterion of the metabolic syndrome.Conclusions: The MS is prevalent in two‐thirds of obese individuals enrolling in a structured weight loss programme. Moderate weight loss with a VLCD markedly improved all aspects of the MS.
Fasting serum adiponectin concentration is reduced in Indo‐Asian subjects and is related to HDL cholesterol
Authors: Valsamakis G. , Chetty R. , McTernan P. G. , Al‐Daghri N. M. , Barnett A. H. , Kumar S. 
Published: March 2003

Aims: Adiponectin is a 30‐kDa protein secreted by adipose tissue. The aim of the present study was to compare serum adiponectin in male Indo‐Asian and Caucasian subjects and examine its association with fat topography and metabolic parameters.Methods: Diabetic and non‐diabetic male subjects (n = 48) were studied. A single observer carried out blood pressure and anthropometric measurements. Serum glucose, insulin, lipid profile and adiponectin (measured by RIA) were measured on a fasting sample.Results: There was no statistically significant difference in serum adiponectin between diabetic and BMI‐matched non‐diabetic subjects. However, serum adiponectin was lower in Indo‐Asians compared with BMI‐matched Caucasians, [median adiponectin (interquartile range) 3.3 (2.1–3.9) vs. 4.9 (3.5–6.6) μg/ml respectively (p = 0.016)]. Univariate analysis showed serum adiponectin to be positively associated with HDL in diabetic (p = 0.039) and non‐diabetic subjects (p = 0.0098). Waist circumference (p = 0.02), saggital diameter (p = 0.04) were negatively correlated with serum adiponectin in diabetic subjects. Multiple regression analysis including waist, HDL, fasting insulin, age, diabetes and ethnicity in all subjects showed HDL to be the best predictor of serum adiponectin.Conclusions: Serum adiponectin is associated with HDL cholesterol and central obesity. Caucasians have higher serum adiponectin levels compared with Indo‐Asians. Further studies are needed to explore basis for the association of adiponectin with HDL cholesterol and the reason for lower levels in Indo‐Asians.
Histology and biochemical composition of the autotomy mantle of Ficus ficus (Mesogastropoda: Ficidae)
Authors: Liu L. L. , Wang S. P. 
Published: March 2003

AbstractWhen the foot of the figsnail Ficus ficus is mechanically stimulated, a portion of the mantle on the side of the inner lip, recognized as the autotomy tissue, swells then autotomizes. Studies of the behaviour and population dynamics of mantle autotomy in F. ficus have previously been reported, but here, a detailed description of the structure of the autotomy tissue is presented for the first time. Whether or not this autotomy tissue has the secondary function of a storage compartment was also investigated through analysis of its biochemical composition. Figsnails were collected from the coast of Kaohsiung, Taiwan. Histological observations indicated that the most obvious feature of the autotomy tissue is the extensive network of muscle fibres and connective tissues. In the swollen autotomy tissue, not only do the epithelia rupture, but the connective tissue expands threefold on the dorsal side and 15‐fold on the ventral side. Chemical analysis of body composition indicated that the average contents of protein, lipid, carbohydrate and ash in the foot, mantle and autotomy tissue are in the range of 55.6–76.5%, 0.6–14.1%, 2.0–27.9% and 6.5–13.5%, respectively, with the caloric value ranging from 4.7 to 5.5 kcal g−1 dry wt. The content of carbohydrate in the autotomy tissue is much less than that in the foot and mantle, i.e. 2.0–6.8% vs. 13.0–27.9%. There is no indication that the autotomy tissue serves as an energy reserve. Hence, it is suggested that the autotomy tissue functions only as a defensive weapon.
The dorsal strand of Polyandrocarpa misakiensis (Protochordata: Ascidiacea): a light and electron microscopic study
Authors: Koyama H. 
Published: March 2003

AbstractThe dorsal strand of a budding ascidian, Polyandrocarpa misakiensis, was studied by light and electron microscopy. The length and morphology of this organ vary even among zooids in the same colony. After curving between the paired posterior nerve trunks, the strand turns left and terminates in a dead end. The dorsal strand of this species is one of the simplest types among ascidians, since there is no branching, no extensive nerve plexus, and no neuronal or non‐neuronal endocrine cells surrounding it. The strand mainly consists of a simple cuboidal epithelium, but has several variations, such as multilayered regions, and protrusions of a cellular chain. The strand cells usually have mitochondria, free ribosomes and a Golgi complex of dictyosomal type. There are many mitotic cells in the strand epithelium. The presence, between the cerebral ganglion and dorsal strand epithelium, of cells with morphology intermediate between the strand and neuronal cells suggests that the dorsal strand might supply cellular components, such as neurones, to the cerebral ganglion in adult zooids. At the caudal end, the strand cells show ultrastructural features suggesting active protein synthesis and secretion. These cells appear to be liberated from the epithelium to release the content of their granules.
Fuseudoxid: the elusive sexual stage of the calycophoran siphonophore Crystallophyes amygdalina (Clausophyidae: Crystallophyinae)
Authors: Pagès F. , Pugh P. R. 
Published: March 2003

AbstractWe have identified the sexual stage of the calycophoran siphonophore Crystallophyes amygdalinaMoser, 1925 and it appears to be closely related to the undescribed Eudoxia X. In both of these sexual stages, the bract and gonophore have become fused together as a single entity. This new type of siphonophoran sexual stage warrants the creation of a particular terminology and here we name it a fuseudoxid (fused eudoxid). To demonstrate these findings, both fuseudoxids are described, and their phylogenetic relationships as well as the systematic position of the genus Crystallophyes are discussed. The subfamily Crystallophyinae Moser (1925) is re‐established.
Distribution of glial cells in the central nervous system of the pulmonate snail Megalobulimus oblongus identified by means of a glial fibrillary acidic protein marker
Authors: Santos Paula dos , Gehlen Günther , Faccioni‐Heuser M. Cristina , Zancan Denise M. , Achaval Matilde 
Published: March 2003

AbstractThe distribution of the glial cells in the pulmonate gastropod Megalobulimus oblongus was studied by means of an immunohistochemical procedure. These cells expressed glial fibrillary acidic protein in their cell bodies as well as in their processes. In all ganglia of the central nervous system, four types of glial cells were identified. The glial lacunar network and the perineuronal glial cells were found in the cortical region of the ganglia, and the perisynaptic and the fibrous glial cells in the neuropilar region. However, in the procerebrum of the cerebral ganglion the glial cells only had a reticular distribution throughout the cellular area. These observations provide morphological evidence of glial cell functions. These cells are probably involved in the support of neurones, the uptake and/or degradation of neurotransmitters, the transfer of metabolic substrates to neurones, as well as the regulation of ionic constituents of extracellular space. As occurs in vertebrates, there is a strong relationship between the different cellular components of the central nervous system of this invertebrate.
A scanning electron microscopic study of germ cell maturation in the reproductive tract of the male soupfin shark (Galeorhinus galeus)
Authors: McClusky Leon M. 
Published: March 2003

AbstractGerm cell maturation in the reproductive tract of the soupfin shark (Galeorhinus galeus) was studied using scanning electron microscopy (SEM). The SEM showed changes in Sertoli cytoplasm volume during spermatogenic development. In immature spermatocysts in the germinal zone, spermatogonia were embedded in Sertoli cytoplasm. In spermatogonial spermatocysts, Sertoli cells were adluminally located in the spermatocyst, with spermatogonia enveloped in the basal portions of the cytoplasm. During the round spermatid stage, Sertoli cytoplasm was very scanty. Spermatid elongation was accompanied by a progressive increase in the volume of Sertoli cytoplasm, notably around the spermatid heads. In the mature spermatocyst, bundles of spermatozoa are totally enveloped by Sertoli cytoplasm. Spermatozoa occurred randomly in the epididymis. However, in the ampulla ductus deferentis, spermatozoa reaggregated and were embedded in a mucoid substance to form highly ordered spherical bundles. In the sperm bundle, the spermatozoa heads were arranged such that the helical turns of adjacent spermatozoa were precisely aligned, and all the heads in the bundle formed a distinct apex. This study demonstrates the utility of exploring the relationship between germ cells and Sertoli cells in an evolutionarily ancient vertebrate, such as the shark.
Retrospective review and long‐term follow‐up of radical cystectomy in a developing country
Authors: Gaitonde K. , Goyal A. , Nagaonkar S. , Patil N. , Singh D.R. , Srinivas V. 
Published: March 2003

Objective To retrospectively review the clinical data from patients undergoing radical cystectomy for bladder cancer, and to analyse the complications and survival rates associated with this operation in a developing country. Patients and methods The study comprised 105 patients who underwent radical cystectomy from 1986 to 1993. Data were collected from retrospective reviews of hospital and physician's office records, and by contact with the patients. Metastatic status was evaluated before surgery and tumours staged using the Tumour‐Nodes‐Metastasis classification. The indication for surgery was histologically confirmed muscle invasion after transurethral resection biopsy, or endoscopically uncontrollable superficial disease. The data were analysed to assess the perioperative complications and long‐term survival, with 5‐year survival rates determined using Kaplan–Meier survival curves. Results The complication rate was 27.6%; most of the complications were managed conservatively with good results and re‐operation was required in only two patients. There were two deaths (1.9%) at 15–45 days after surgery, but none during surgery. Patients were divided into node‐negative and node‐positive groups for analysis and 5‐year survival rates determined; for node‐negative organ‐confined disease ( pT3A) the survival was 68% and for nonorgan‐confined disease ( pT3B) 25%. The 5‐year survival rate in the presence of nodal metastases was 13% for N1 and none for N2 disease. Six patients developed urethral recurrence, detected on follow‐up urethral‐wash cytology. Five of these patients underwent urethrectomy, and four of the six survived for 5 years. Pelvic recurrence occurred in five patients (4.7%), none of whom survived for 5 years. Conclusion Radical cystectomy and pelvic lymph node dissection remains the mainstay of treatment in muscle‐invasive bladder cancer. This is a relatively safe procedure with minimal morbidity and mortality; 68% of the present patients with organ‐confined disease survived 5 years and 12 patients were alive at 10 years, indicating the effectiveness of this operation in selected cases. However, < 29% of patients with nonorgan‐confined and nodal metastatic disease survived 5 years, thereby implying the need for more effective adjuvant therapy in these patients. Radical cystectomy is a viable option in developing countries, with 5‐year survival rates comparable with most large published series.
The cost‐effectiveness of preoperative testing (basic office assessment vs urodynamics) for stress urinary incontinence in women
Authors: Weber A.M. , Taylor R.J. , Wei J.T. , Lemack G. , Piedmonte M.R. , Walters M.D. 
Published: March 2003

ObjectiveTo compare the cost‐effectiveness of preoperative testing strategies in women with stress incontinence symptoms, as although urodynamic testing is used to improve the diagnostic accuracy in women with incontinence, the clinical and economic consequences of different levels of testing have not been evaluated.Materials and methodsDecision analysis was used to evaluate basic office assessment (BOA) and urodynamic testing for women with stress incontinence symptoms who were candidates for primary surgical treatment. Costs were calculated using the Federal Register. Parameter estimates for the effectiveness of treatment for different diagnoses of incontinence were based on published reports. Incremental cost‐effectiveness was defined as the cost in dollars per additional patient cured of incontinence.ResultsUrodynamics did not improve the effectiveness of treatment; both strategies of a BOA and urodynamic testing resulted in a cure rate of 96% after initial and secondary treatments. The mean cost of care (including initial and secondary treatments and outcomes) was similar for the two strategies ($5042 for BOA, $5046 for urodynamic testing). With BOA reduced testing costs were balanced by increased costs for patients who failed the initial treatment. Under baseline assumptions, one additional cure of incontinence (incremental cost‐effectiveness) using the urodynamic strategy cost $3847, compared with BOA. By sensitivity analyses, BOA was less costly than urodynamics when the prevalence of genuine stress incontinence was  80%.ConclusionThese findings do not support the routine use of urodynamics before surgery in women likely to have genuine stress incontinence, and provide the justification for randomized trials of preoperative testing strategies.
Religious circumcision under local anaesthesia with a new disposable clamp
Authors: Schmitz R.F. , Schulpen T.W.J. , Redjopawiro M.S. , Liem M.S.L. , Madern G.C. , Van Der Werken C. 
Published: March 2003

Objective To compare the results using a new disposable clamp (the Taraklamp Circumcision Device®, TCD, Taramedic Europe BV, Bilthoven, The Netherlands), used since 1998 in one clinic, and the conventional dissection technique (CDT) in another clinic, for religious circumcision in infants. Subjects and methods The TCD and CDT were compared prospectively; the duration of the procedure, complications and postoperative pain were recorded. The cosmetic result and the degree to which the parents were satisfied were evaluated after 6 weeks. After obtaining informed consent, 275 boys were included in the study (median age 3 years). Results The median operative duration was 8 min less for the TCD (15 vs 7 min; P < 0.001). There was no difference in complication rate (bleeding in one vs two; infection in two vs three) and postoperative pain was comparable in both groups. The cosmetic results were better for the TCD group (P < 0.001). The parents' satisfaction score for the procedure was equal in the groups, at 8, on a scale of 1 (very bad) to 10 (extremely good). Conclusion A religious circumcision outside the hospital with the TCD is quicker and leads to a better cosmetic result than with the CDT, without increasing morbidity.
Endoscopic treatment of urinary incontinence in children with primary epispadias
Authors: Duffy  , Ransley  
Published: March 2003

Objective To evaluate the efficacy of the endoscopic insertion of polydimethylsiloxane particles (MacroplastiqueTM , Uroplasty Inc) (MPQ) into the posterior urethral region of boys with urinary incontinence and primary epispadias.Patients and methods Between 1991 and 1995, 12 boys aged 3–7 years (mean 4.8) received an endoscopic submucosal injection with MPQ into the posterior urethra to correct urinary incontinence; the 12 boys were wet day and night. All patients had undergone a modified Cantwell epispadias repair before injection. The procedure was performed 24 times with a total volume of 83 mL of material injected into 59 sites in the posterior urethra (mean volume per injection 1.4 mL). The mean follow‐up after injection was 10.8 months (range 3–22).Results Three patients became completely dry, the degree of incontinence was improved in six and there was no change in three.Conclusion The preliminary results of this relatively non‐invasive treatment are encouraging.
Predicting regional lymph node metastasis in carcinoma of the penis: a comparison between fine‐needle aspiration cytology, sentinel lymph node biopsy and medial inguinal lymph node biopsy
Authors: Senthil Kumar  , Ananthakrishnan  , Prema  
Published: March 2003

Objective To evaluate the accuracy of clinical examination and fine‐needle aspiration cytology (FNAC) in detecting groin metastases in patients with carcinoma of the penis, and to assess the positive and negative predictive value (PPV, NPV) of a preliminary sentinel lymph‐node biopsy (SNB) and biopsy of the most medial of the horizontal group of inguinal lymph nodes (MIN) in selecting patients for an ilio‐inguinal block dissection.Patients and methods The study comprised 28 patients (56 groins) with Stage I (one), Stage II (11) and Stage III (16) carcinoma of the penis. All patients underwent a detailed clinical examination followed by FNAC of the palpable inguinal nodes, and were subsequently submitted for block dissection. The MIN, the SN and the rest of the inguinal and iliac nodes were histologically examined separately for metastases.Results The clinical evaluation had a sensitivity of 74%, a specificity of 61%, a PPV of 57% and a NPV of 77%. The corresponding values for FNAC were all 100%, and the specificity and PPV for both MIN and SN were 100%. The sensitivity and NPV of MIN were higher than for SN, although not significantly so.Conclusion Clinical examination alone is inaccurate in selecting patients with carcinoma of the penis for block dissection. FNAC is accurate and specific when nodes are palpable; in those with impalpable nodes a preliminary MIN biopsy followed by SNB if the MIN biopsy is negative will accurately select all patients with metastases in the groin nodes. This can be performed by examining frozen sections of the lymph nodes; if positive, block dissection can be carried out at the same time.
Prostate specific antigen (PSA) value adjusted for transition zone volume and free PSA (γ‐seminoprotein)/PSA ratio in the diagnosis of prostate cancer in patients with intermediate PSA levels
Authors: Kurita  , Terada  , Masuda  , Suzuki  , Fujita  
Published: March 2003

Objectives To determine: (i) whether the accuracy of prostate‐specific antigen (PSA) density is improved by using the transition zone (TZ) volume instead of total prostate volume, with the γ‐seminoprotein (γSP, a measure of free PSA) to total PSA ratio, for detecting prostate cancer; and (ii) to assess the influence of prostate volume on PSA density and γSP/PSA ratio.Patients and methods  From April 1995 to July 1997, 297 consecutive patients (46–88 years old) were examined; all had intermediate serum PSA levels (4–10 ng/mL) and/or abnormal findings on digital rectal examination. All patients underwent transrectal ultrasonography (TRUS)‐guided biopsy, and the prostate and TZ volumes determined from TRUS. The PSA density relative to the total prostate volume (PSAD) and to the TZ volume (PSAT) were then calculated. The total PSA and γSP levels were measured before the diagnostic procedures.Results Of the 297 patients, 62 (21%) were histologically confirmed to have prostate cancer by biopsy. The area under the receiver operating characteristic curve was 0.680 for PSA, 0.684 for PSAD, 0.764 for PSAT, 0.748 for γSP/PSA, 0.885 for γSP/PSA in patients with a prostate volume <40 mL, while it was 0.817 for PSAT in patients with a prostate volume of ≥40 mL. Using a PSAT threshold of 0.17 in patients with a prostate volume of 40 mL, the number of biopsies was reduced by 56% (66 of 118) and 22 of the 25 cancers (88%) were detected. In addition, a γSP/PSA ratio threshold of 40% in patients with a prostate volume of <40 mL decreased the number of biopsies by 75% (88 of 117) and detected 32 of the 37 cancers (87%).Conclusions Prostate volume was significantly and positively correlated with γSP/PSA and negatively correlated with PSAT. Among patients with a PSA level of 4–10 ng/mL, a low γSP/PSA was most useful for detecting prostate cancer when the prostate volume was <40 mL and a high PSAT was useful when the prostate volume was ≥40 mL.