bluuebunny/crossref_metadata_2025_split huggingface dataset:
Simultaneous glyburide/metformin therapy is superior to component monotherapy as an initial pharmacological treatment for type 2 diabetes
Authors: Garber A. J. , Larsen J. , Schneider S. H. , Piper B. A. , Henry D. ,   The Glyburide/Metformin Initial Therapy Study Group
Published: March 2003

Objective: To evaluate whether simultaneous initial treatment of both insulin resistance and impaired β‐cell insulin secretion with glyburide/metformin tablets is superior to monotherapy with each component agent.Research Design and Methods: In this randomized, parallel‐group, placebo‐controlled, multicentre study, 806 patients with type 2 diabetes (mean duration, 3 years) who had failed diet and exercise were randomly assigned to 4 weeks of therapy with placebo, glyburide 2.5 mg, metformin 500 mg, glyburide/metformin 1.25/250 mg, or glyburide/metformin 2.5/500 mg once daily. Doses were then titrated over 8 weeks based on glycaemic response. The primary outcome measure was change from baseline in mean HbA1c after 20 weeks. Changes in fasting plasma glucose, lipids and body weight were also assessed along with 2‐h postprandial glucose and insulin values after a standardized meal.Results: At week 20, patients taking glyburide/metformin 1.25/250 mg or 2.5/500 mg tablets had greater reductions in HbA1c levels (−1.48% and −1.53% respectively) compared with placebo (−0.21%; both p < 0.001), glyburide (−1.24%; p = 0.016 and p = 0.004 respectively) or metformin (−1.03%; both p < 0.001). Fasting plasma glucose concentrations were reduced more in both glyburide/metformin groups compared with placebo and metformin (p < 0.001); patients in both combination therapy groups also had significantly lower postprandial glucose concentrations compared with placebo, glyburide and metformin.Conclusions: Initial combination treatment with glyburide/metformin tablets produces greater improvements in glycaemic control than either glyburide or metformin monotherapy. The superiority of initial therapy with glyburide/metformin tablets may arise from simultaneous treatment of both pathophysiological defects of type 2 diabetes.
Structure and function of pilosebaceous units on the heads of small mammals (Insectivora, Chiroptera, Rodentia)
Authors: Haffner Marianne 
Published: March 2003

AbstractHaffner, M. 2000. Structure and function of pilosebaceous units on the heads of small mammals (Insectivora, Chiroptera, Rodentia). —Acta Zoologica (Stockholm) 81: 195–203The cranial integument of 32 species was examined for increased sebum production and structures serving sebum storage and expulsion by means of light and scanning electron microscopy. The head is rich in sebaceous glands in all species. Some have no further specializations other than regions with enlarged sebum production. These regions either need extra protection per se or they are situated where they can be used for fur grooming directly or be easily reached by the forepaws. The water shrew stores sebum that it can possibly apply as a water‐repellent lipid coating for the fur if required. All vespertilionid bats not only have huge glandular complexes with storage chambers, but also structures for the retaining and application of sebum. Stabilizing elements reflect the extent of external pressure on the specialized pilary canal during sebum discharge. Originally simple hair follicles evolved highly adapted pilosebaceous complexes that possibly produce scent themselves or at least a carrier substance for scent secreted by the many apocrine glands on the snout.
Ultrastructural study of the bacillary, granular and mucoid proboscidial gland cells of Riseriellus occultus (Nemertini, Heteronemertini)
Authors: Junoy Juan , Montalvo Sagrario , Roldán Carmen , García‐Corrales Pedro 
Published: March 2003

AbstractJunoy, J., Montalvo, S., Roldán, C. and García‐Corrales, P. 2000. Ultrastructural study of the bacillary, granular and mucoid proboscidial gland cells of Riseriellus occultus (Nemertini, Heteronemertini). — Acta Zoologica (Stockholm) 81: 235–242.The ultrastructure of six types (G5‐G10) of proboscidial gland cells whose cell necks emerge independently on the epithelium surface is analysed and compared with data from other nemerteans. These types differ in cytological features, as well as in the morphology of their respective secretory granules. Secretory granules of the types G5 and G6 have a bacillary shape, and differ from each other based on their contents and dimensions. Secretory granules of the types G7 and G8 are spherical to ovoid; type G8 gland cells are monociliated, and their secretory granules contain a paracrystalline material. Types G9 and G10 gland cells are typically goblet‐shaped; secretory granules in the type G9 have a spherical shape, contain a homogeneous electron dense material and maintain their individuality, whereas those of the G10 type are elongate and have fibrillar contents, showing a tendency to fuse before they are extruded. The mucus sheet of the proboscis is responsible for lubrication of its epithelial surface. Secretion products of type G10 gland cells form the background substance of this mucus, and those of the G5 type confer stickiness to it. Type G9 gland cells could provide the toxic component to the mucus, and type G7 and G8 gland cells could be concerned with the production of enzymatic secretions.
Fine structure of sheet‐webs of Linyphia triangularis (Clerck) and Microlinyphia pusilla (Sundevall), with remarks on the presence of viscid silk
Authors: Benjamin Suresh P , Düggelin Marcel , Zschokke Samuel 
Published: March 2003

AbstractWe examined the webs of Linyphia triangularis (Clerck) and Microlinyphia pusilla (Sundevall) using light and scanning electronic microscopic techniques and compared them with the better known orb‐webs. The linyphiid sheet‐web consists of an unordered meshwork of fibres of different thicknesses. The sheet is connected to the scaffolding by means of attachment discs. Thin threads with globules, which appear similar to the viscid silk droplets of orb‐webs, are present in most webs examined. Webs of M. pusilla had a higher density of these globules than did webs of L. triangularis. Webs of both species possess five types of thread connections and contain no aqueous glue for prey capture. Instead, unlike orb‐webs, the sticky substances produced by the linyphiid aggregate glands cement the different layers and threads of the sheet by drying up after being produced. Due to their function, sheet webs may not require viscid silk, thereby leading to a more economic web. The assumption made in most previous studies, that the globules in linyphiid webs have the same properties and function as viscid silk in orb‐webs, is unfounded.
Day‐case ureteroscopy: an observational study
Authors: Taylor A.L. , Oakley N. , Das S. , Parys B.T. 
Published: March 2003

Objective To evaluate the outcome after day‐case ureteroscopy (used in diagnosing and managing ureteric disease, primarily urolithiasis), as awareness of reduced resources has resulted in increasing pressure to undertake procedures in a day‐surgery setting. Patients and methods All patients presenting to the unit and requiring ureteroscopy between May 1995 and May 2000 were considered for a day‐surgery procedure. The assessment of suitability comprised anaesthetic and social factors; no urological criteria precluded a day‐surgery procedure. Outcomes after day‐case ureteroscopy, including immediate or delayed admissions and subsequent inpatient management, were reviewed retrospectively. Results Sixty‐three day‐case ureteroscopies were performed on 56 patients (mean age 47 years, range 19–78); eight procedures were diagnostic. Therapeutic ureteroscopies included one balloon dilatation of a ureteric stricture and 54 procedures for urolithiasis, with 98% stone clearance. Most patients were discharged with a JJ stent in situ. Of nine patients requiring immediate admission, seven were for pain control; eight were discharged on the following day. Seven patients required delayed admission 1–13 days after the procedure, three for stent‐related symptoms and three for infection. No significant predictors of immediate or delayed admission were identified, although antibiotic prophylaxis was associated with a reduced admission rate. Conclusion Ureteroscopy can be used successfully as a planned day‐case procedure in a dedicated day‐surgery unit, with few patients requiring hospitalization. Implementation of analgesia protocols and routine antibiotic prophylaxis may reduce admission after day‐case ureteroscopy.
Urgency, urge incontinence and voiding symptoms in men and women aged 70 years and over
Authors: Nuotio M. , Jylhä M. , Luukkaala T. , Tammela T.L.J. 
Published: March 2003

Objective To evaluate the prevalence of urgency, urge incontinence and voiding symptoms, and their associations in older men and women. Subjects and methods A population‐based cross‐sectional survey was conducted involving 171 men and 227 women aged 70 years. The data were collected by interview, with a response rate of 92.8%. Voiding symptoms were defined as weakened and/or intermittent stream. The prevalence of urgency, urge incontinence and voiding symptoms were calculated for men and women aged 70–79 and 80 years. Logistic regression models were used to examine the association of voiding symptoms with urgency, with or without incontinence, adjusted in the separate models for age and in the combined model also for gender. Results The prevalence of urge incontinence was higher than urgency alone in both men and women (23.9% vs 9.8% and 36.4% vs 8.6%, respectively); 71.9% of the men and 48.3% of the women reported voiding symptoms (P < 0.001). Men and women with voiding symptoms were both significantly more likely to report urgency with or without incontinence than those with no voiding symptoms (odds ratio 3.49, 95% confidence interval 1.42–8.57, and 2.34, 1.31–4.17, respectively). Age had no independent effect in men, and in women the effect was marginal. In the combined model female gender (1.98, 1.25–3.16) increased the risk of urgency with or without incontinence. Conclusion Urgency, urge incontinence and voiding symptoms are common and associated with each other in older men and women; the association is stronger in men. Women are at greater risk of having urgency with or without incontinence. Because the study was cross‐sectional a causal relationship cannot be confirmed.
Knowledge and attitudes of Korean parents towards their son's circumcision: a nationwide questionnaire study
Authors: Oh S.‐J. , Kim K.D. , Kim K.M. , Kim K.S. , Kim K.K. , Kim J.S. , Kim H.G. , Woo Y.N. , Yoon Y.L. , Lee S.D. , Han S.W. , Lee S.I. , Choi H. 
Published: March 2003

Objective To evaluate knowledge about the foreskin and circumcision, and to understand the attitudes of parents to circumcision in Korea, where circumcision in childhood is widely practised with no particular religious or medical background. Subjects and methods A nationwide study involving questionnaires was conducted on 5500 parents with at least one son attending elementary school. Responses were obtained from one of the parents. Results The response rate was 76.1% (4183); circumcision was most common in boys when aged 11 years, followed by neonatal circumcision. Of the parents, 91.3% believed that circumcision is necessary, while 2.1% believed it to be unnecessary. The principal reasons given for circumcision were ‘to improve penile hygiene’ (82.4%), followed by ‘to improve future sexual potency’ (7.5%). Among those who did not believe circumcision to be necessary, the most common reason was the expectation of spontaneous retraction of the prepuce with age (55.1%). Most (88.4%) of the parents believed that smegma is not a clean material, and is infected by microorganisms. Most parents (80.6%) thought that circumcision would prevent genital tract infection of the future spouse. Peer pressure was one of the most influential factors in deciding upon circumcision; 41.9% of the parents were anxious that their child might be ridiculed by his peer group unless he was circumcised, while 27.4% of the parents believed that their child might be ridiculed if he was circumcised. Mothers were more positive about circumcision than fathers (P < 0.05). Parents with a higher education and higher socio‐economic status were also more positive about circumcision (P < 0.05). Mothers were prone to emphasize improved sexual potency (P < 0.05). There was no significant difference in response between urban and rural areas. Conclusion This study indicates that common beliefs held by parents about the prepuce or circumcision differ significantly from current medical knowledge, and these beliefs have a major influence on the practice of circumcision in Korea. More clinical research on the natural history of the foreskin is needed, and it is critical that both children and parents are informed about the potential benefits and disadvantages of circumcision.
Decreased nocturnal urinary antidiuretic hormone excretion in enuresis is increased by imipramine
Authors: Tomasi P.A. , Siracusano S. , Monni A.M. , Mela G. , Delitala G. 
Published: March 2003

Objective To assess the role of integrated nocturnal antidiuretic hormone (ADH) secretion in children with enuresis, and possible modifications induced by treatment with imipramine. Patients and methods The morning plasma ADH and nocturnal urinary ADH integrated concentrations were measured in 18 consecutive enuretic children (patients) and 21 age‐ and sex‐matched controls admitted for minor treatment. Diurnal and nocturnal urine production, and plasma and urinary osmolality were also determined; lumbosacral radiography and uroflowmetry were undertaken in the patients. The assessments were repeated after 14 days of treatment with imipramine hydrochloride (orally, 20 mg/night). Results Half the patients had occult spinal malformations but the uroflowmetry results were all within the normal range. The median (95% confidence interval, CI) urinary ADH integrated concentrations were markedly lower in patients, at 29.7 (22.1–37.3) vs 63.0 (35.1–90.8) pg/mL/h (P = 0.03) than in controls. Plasma ADH levels were significantly increased by imipramine (0.64 to 1.47 pg/mL, 95% CI, 0.40–0.89 vs −0.26–3.2; P < 0.001), as were nocturnal urinary ADH integrated concentrations, at 29.7 (22.1–37.3) vs 59.0 (37.3–80.6) pg/mL/h (P < 0.001), and morning plasma osmolality decreased, from 298.5 (294.5–302.5) to 294.9 (292.4–297.3) mosmol/kg (P = 0.003), as was the 24‐h fluid intake, from 983 (721–1245) to 666 (435–897) mL (P = 0.004). Conclusions We conclude that enuretic children have a lower nocturnal ADH excretion; imipramine restores nocturnal ADH excretion, increases morning plasma ADH levels, and causes consistent changes in other biochemical variables.
Developmental changes in the biochemical and functional properties of endothelin receptors in rabbit renal pelvis
Authors: Wada Y. , Latifpour J. , Saito M. , Afiatpour P. , Weiss R.M. 
Published: March 2003

Objective To examine the effect of age on the biochemical and functional properties, and regional distribution of endothelin (ET) receptors in the rabbit renal pelvis. Materials and methods The properties of ET receptors in 6‐week‐old and 6‐month‐old male rabbit renal pelves were examined using isolated muscle‐bath and radioligand receptor‐binding techniques. Results ET‐1 caused a significant increase in the contractile force in muscle strips from all regions of the renal pelvis from both age groups, with the following rank order: upper = middle > lower. The magnitude of the ET‐1‐induced contractile responses were similar in the lower pelvic regions in both ages, but the responses in the upper and middle regions were significantly greater in younger rabbits. ET‐1 increased the frequency of spontaneous activity in a concentration‐dependent manner in the upper and middle pelvic regions in both age groups, with significantly smaller ED50 values in the younger than in the older rabbits. In both age groups the lower pelvic region lacked spontaneous activity. The density of total ET receptors was higher in the upper and middle regions of the renal pelvis than in the lower renal pelvis of both ages, with the density in the upper and middle regions being greater in older than in younger rabbits. In all regions, ET subtype selective compounds inhibited [125I]ET‐1, binding consistent with the predominance of the ETA receptor subtype, except in the lower region of the older rabbits, in which the densities of ETA and ETB subtypes were similar. In all regions, the younger renal pelvis contained a higher proportion of ETA receptors than in older tissues. Light microscopic autoradiographic data indicated the presence of ETA and ETB receptors in smooth muscle and epithelial cells, respectively. Conclusion These data indicate the presence of regional differences in the density of ET receptors and in the contractile responses to ET‐1 in rabbit renal pelvis, and that although older rabbit renal pelvis contains more total ET receptors than younger renal pelvis, the latter had a higher portion of the ETA receptor subtype and the younger tissues were more responsive to ET‐1.
Detrusor hypocontractility in children with posterior urethral valves arises before puberty
Authors: De Gennaro M. , Capitanucci M.L. , Capozza N. , Caione P. , Mosiello G. , Silveri M. 
Published: March 2003

ObjectivesTo assess prepubertal boys with posterior urethral valves (PUV) using an analysis of pressure‐flow studies to evaluate the voiding phase and thus determine if myogenic failure (hypocontractility) arises before puberty and if it can be detected early.Patients and methodsEleven boys (8–13 years old) with PUV underwent urodynamics and the results were analysed using pressure‐flow mathematical analysis (PFA) of the following variables of detrusor activity: contraction velocity (Vdet ), detrusor contractile power expressed as power factor (WF) and Schafer’s diagram, which differentiates a ‘strong’, ‘normal’ and ‘weak’ detrusor. Vdet and WF were compared with normal values previously determined in boys of similar age and considered ‘low’ if more than 2 SDs below the mean. The results of PFA were compared with standard pressure‐flow studies and the three classical urodynamic patterns in boys with PUV, as determined by voiding symptoms. The subsequent PFA of seven of the 11 boys were also assessed as they had undergone previous urodynamics when <8 years old.ResultsAs assessed by the three patterns of dysfunction, two boys had bladder instability, two had low compliance and three had hypocontractility, with four boys being normal. From the PFA, the Vdet and WF were lower than normal, respectively, in seven and nine of the 11 boys; Schafer’s nomogram showed a ‘weak’ detrusor in seven boys. The PFA suggested a pathology in four of five boys with symptoms and in three of six with no symptoms (two of the six showing a ‘low’ WF). Moreover, in older (11–13 years) boys, all five had a ‘weak’ detrusor, a ‘low’ WF and four a ‘low’ Vdet . Of the seven patients who underwent repeat PFA, three had a stable WF 3 years later, one (normal) worsened slightly and two were clearly worse, while one, who underwent late (at 3 years old) valve ablation, had an increased WF.ConclusionsThe PFA showed hypocontractility in two‐thirds of prepubertal boys with PUV, including asymptomatic patients. These findings confirm the hypothesis that bladder dysfunction in boys with PUV eventually causes detrusor myogenic failure and finally a postpubertal overdistended bladder.
Comparison of different bladder autoaugmentation techniques in a rabbit model
Authors: EliÇevik  , Celayir  , Dervisoglu  , Büyükünal  
Published: March 2003

Objective To compare the urodynamic, radiological and histopathological findings of a bladder autoaugmentation method combined with different seromuscular enterocystoplasty (mucosectomized) techniques and the rectus abdominis muscle‐flap (RAMF) technique, and thus devise a method that may eliminate the potential risks of bladder autoaugmentation.Materials and methods The study comprised 20 male New Zealand White rabbits in four groups. In group 1 (control), an autoaugmentation model was created by incising the detrusor muscle of the bladder, forming a large wide‐mouthed bladder diverticulum. In group 2, a full‐thickness RAMF with an intact vascular supply was used to cover the augmented bladder wall. In groups 3 and 4, besides the autoaugmentation procedure, a 5 cm ileal segment with an intact vascular supply was prepared and the mucosal layer of the segment removed. In group 3, the mucosectomized surface of the ileal graft was used to cover the autoaugmented bladder (seromuscular ileocystoplasty, SMEC) and in group 4, the serosal surface of the pedunculated ileal graft was used in reverse to cover the autoaugmented bladder wall (reversed SMEC, RSMEC). All groups were followed using intravenous pyelography (IVP), voiding cysto‐urethrography (VCUG), urodynamic investigations and histopathological analysis for 2 months post‐operatively.Results In all groups except 2 (RAMF), a diffuse bulging of the bladder wall was detected on IVP and VCUG. In groups 1, 3 and 4, there was a significant increase in mean bladder capacity and the compliance also increased. However, in group 2 there was a significant reduction in bladder capacity and compliance, and the histopathological analysis showed severe fibrosis. The fibrotic changes were moderate in groups 1 and 4 and mild in group 3.Conclusions The urodynamic studies, IVP, VCUG and histopathology suggested that the SMEC technique decreased the potential risks of bladder autoaugmentation, had minimal side‐effects and was the most appropriate coat over the uroepithelium after bladder autoaugmentation.
The structure and autonomic innervation of the vesico‐ureteric junction in cases of primary ureteric reflux
Authors: Dixon  , Jen  , Yeung  , Chow  , Mathews  , Gearhart  , Gosling  
Published: March 2003

Objective To determine the histological structure and autonomic innervation of the vesico‐ureteric junction (VUJ) in cases of primary ureteric reflux, to compare the results with those reported previously for non‐refluxing VUJs and thus determine possible structural anomalies which could be responsible for vesico‐ureteric reflux (VUR).Materials and methods Nineteen specimens of VUJs with reflux were obtained from four males and 10 females undergoing ureteric reimplantation. Serial frozen sections were cut and stained either with Masson’s trichrome or immunostained for protein gene product (PGP 9.5), a general nerve marker, dopamine beta hydroxylase (DβH), a marker for noradrenergic nerves, or neuropeptide Y (NPY).Results Longitudinally orientated muscle bundles of narrow diameter accompanied the ureter to its termination at the ureteric orifice, where they merged with those of the superficial trigone. In some specimens, an additional muscle component was identified, situated on the outer aspect of the ureteric muscle coat, consisting of an incomplete layer of distinctive muscle whose constituent cells formed an interlacing meshwork. Occasionally, specimens included detrusor muscle which consisted of relatively large diameter compact bundles separated from the ureter by a connective tissue sheath. DβH‐ and NPY‐immunoreactive (‐IR) nerves were numerous among the ureteric muscle bundles. Many NPY‐IR nerves occurred within the detrusor muscle while DβH‐IR nerves were mainly perivascular. When present, the outer muscle component was richly innervated by both DβH‐ and NPY‐IR nerves. PGP immunoreactivity varied among regions in the same section, PGP‐IR nerves frequently being less numerous than those containing DβH or NPY.Conclusion These results indicate that the morphology of the VUJ in cases of VUR is indistinguishable from the normal VUJ described previously. Furthermore, the density and distribution of DβH‐ and NPY‐IR nerves is identical to that in controls. However, the antigenicity of PGP in the reflux specimens appears to be masked in some regions by an unknown factor.