bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of treatment with acarbose and insulin in patients with non‐insulin‐dependent diabetes mellitus associated with non‐alcoholic liver cirrhosis
Authors: Gentile S , Turco S , Guarino G , Oliviero B , Annunziata S , Cozzolino D , Sasso F. C , Turco A , Salvatore T , Torella R 
Published: March 2003

Summary AimNon‐insulin‐dependent diabetes mellitus (type 2 diabetes) not responding to dietary treatment alone in patients with non‐alcoholic liver cirrhosis is characterized by high postprandial hyperglycaemia. The control of postprandial hyperglycaemia in such patients, is generally achieved by the means of progressively higher doses of insulin, with an increasing risk of hypoglycaemia in the late postprandial period. The aim of this study was to evaluate the use of acarbose for the control of postprandial hyperglycaemia in 100 patients with well‐compensated liver cirrhosis and type 2 diabetes treated with insulin.MethodsThe study was double blind with randomization of treatments into acarbose (52 patients) vs. placebo (48 patients) with parallel branches over a period of 28 weeks.ResultsAll patients tolerated the treatments well and no significant variations in liver function tests were observed (< 5% vs. pretreatment). A significant reduction of several parameters was observed only after acarbose treatment: fasting glycaemia (173 ± 28 vs. 146 ± 19 mg/dl; p < 0.01), postprandial glycaemia (230 ± 24 vs. 148 ± 20 mg/dl; p < 0.01), mean glycaemia (206 ± 20 vs. 136 ± 13 mg/dl; p < 0.01), mean variation (180 ± 14 vs. 51 ± 10 mg/dl; p < 0.01), HbA1c (8.9 ± 0.8 vs. 7.2 ± 0.5; p < 0.05), C‐peptide 2 h after a standard meal (4.5 ± 1.9 vs. 2.8 ± 1.7 ng/ml; p < 0.05), whereas the parameters did not change significantly after the placebo. After acarbose treatment a significant increase of intestinal voiding/week (+ 116% vs. + 10%; p < 0.01) and a parallel reduction of blood ammonia levels (− 52 ± 9% vs. − 9 ± 5%; P < 0.01) were observed.ConclusionsThe results clearly document the good tolerability and the absence of toxic effects of acarbose on liver, due to the lack of both intestinal absorption and hepatic metabolism of the drug at doses in the therapeutic range. In fact, acarbose increases the peristalsis movements of the gut, stimulates the proliferation of the saccarolytic bacteria and simultaneously reduces the proliferation of proteolytic bacteria, thus resulting active in the reduction of blood ammonia levels. These effects of acarbose may be advantageously exploited in the treatment of type 2 diabetic patients with well‐compensated non‐alcholic liver cirrhosis.
Comparison of adipose tissue changes following administration of rosiglitazone in the dog and rat
Authors: Toseland C. D. N. , Campbell S. , Francis I. , Bugelski P. J. , Mehdi N. 
Published: March 2003

SummaryRosiglitazone (BRL‐49653‐C), a thiazolidinedione, is a potent agonist for the nuclear hormone receptor peroxisome proliferator‐activated receptor gamma (PPARγ). Thiazolidinediones have been reported to induce adipocyte differentiation in vitro and there is limited data on their effects in vivo. The objective of this study was to compare the effects of rosiglitazone on adipocyte differentiation between dogs and rats. Morphological (light and ultrastructural) and morphometric evaluations were conducted on perirenal adipose tissue from dogs that have been treated for 1 month with 0.4, 5, 60 mg/kg/day and rats treated for the same period with 80 mg/kg/day. There was a dose‐related change in the phenotype of white adipose tissue in dogs, reflected by an increase in nuclear numerical density (up to threefold) and cytoplasmic area fraction (up to 2.1‐fold). In addition, there was an enlargement of the nuclei and a reduction in the size of the white adipocyte lipid vacuoles. Ultrastructural changes included an increase in the number of mitochondria per adipocyte. In the rat, similar changes were seen in nuclear numerical density (1.5‐fold increase) and cytoplasmic area fraction (2.2‐fold increase). There were also increased numbers of mitochondria per cell in white adipocytes giving them similar numbers of mitochondria to brown adipocytes. In the brown adipocytes, there was a reduction in cytoplasmic area fraction with a corresponding increase in the size of the lipid filled vacuoles in other words there was a converging of the phenotypes of the white and brown adipose tissues.
Effects of the Magenstrasse and Mill operation for obesity on plasma leptin and insulin resistance
Authors: Carmichael A. R. , Johnston D. , King R. F. G. J. , Sue‐Ling H. M. 
Published: March 2003

SummaryBackground  We evaluated the effect of the Magenstrasse and Mill (M & M) operation–a new form of non‐banded vertical gastroplasty–on weight loss, plasma leptin levels and insulin resistance.Methods  Fasting plasma glucose, leptin and insulin levels were measured in 12 normal controls, 39 morbidly obese patients and 39 patients a median 3 years after the M & M procedure. Insulin resistance was calculated by the homeostasis model insulin resistance index.Results  Body mass index mean (s.d.) decreased significantly (p < 0.0001), from 48(7) to 33(5) kg/m2, after the M & M procedure. Fasting plasma leptin concentration in the morbidly obese group was 37.9(15.4) ng/ml, significantly (p < 0.0001) higher than the control group (12.2(8.4)) and the M & M group (19.1(12.7)) ng/ml. Fasting plasma insulin concentrations were also significantly (p < 0.0001) higher in the morbidly obese group compared with than in the M & M group or in the control group: 35.5(22.3) mU/l, 15.5(7.1) mU/l and 13.6(3.4) mU/l, respectively. Insulin resistance was 9.6(7.2) in the morbidly obese group and 3.5(1.9) in the M & M group (p < 0.0001).Conclusion  This is one of the first studies to show that the decrease in insulin resistance after weight loss achieved by anti‐obesity surgery is associated with significantly lower levels of plasma leptin.
Clinical evidence of thiazolidinedione‐induced improvement of pancreatic β‐cell function in patients with type 2 diabetes mellitus
Authors: Ovalle F. , Bell D. S. H. 
Published: March 2003

Background: There is growing evidence in animal and in vitro studies showing that thiazolidinediones (TZDs) improve pancreatic beta cell (β‐cell) function. The aim of this study was to evaluate the effect of thiazolidinediones on the β‐cell function of patients with Type 2 diabetes mellitus (T2DM) in clinical practice.Patients and Methods: This is an observational, nested case‐control study. We identified 28 patients (TZD group), with T2DM, who had had a meal‐stimulated C‐peptide level documented before the addition of troglitazone to a failing double‐therapy regimen with metformin (MET) and sulphonylurea (SU). As a control group (CTRL), we identified 26 patients, with T2DM, who also had had a meal‐stimulated C‐peptide documented before adding MET to a failing SU monotherapy regimen. We then proceeded to prospectively remeasure their meal‐stimulated C‐peptide levels and compared the changes over time between the two groups.Results: Both groups were well matched for age, body mass index (BMI), and HgbA1c before and after treatment. The C‐peptide in the TZD group increased significantly during therapy (from 3.2 ± 0.5 to 4.2 ± 0.5, p = 0.01), whereas it remained unchanged in the CTRL group (from 4.8 ± 0.6 to 5.0 ± 0.5, p = 0.74). The C‐peptide/glucose ratio also increased significantly in the TZD group (from 1.9 ± 0.3 to 3.1 ± 0.3, p = 0.0003) whereas it remained unchanged in the CTRL group (from 3.4 ± 0.7 to 3.4 ± 0.3, p = 0.97). Furthermore, the C‐peptide/glucose ratio of the TZD group, which was significantly lower at baseline compared with the CTRL group (1.9 ± 0.3 vs. 3.4 ± 0.7, p = 0.04), caught up to its level during treatment (3.1 ± 0.3 vs. 3.4 ± 0.3, p = 0.48).Conclusion: Thiazolidinediones seem to induce recovery of pancreatic beta cell function, independently of the correction of glucose toxicity.
Does insulin lispro preserve the physiological defences to hypoglycaemia during intensive insulin therapy with a conventional basal bolus regimen?
Authors: Heller S. R. , Amiel S. A. , Evans M. L. , Kong M.‐F. , Macdonald I. A. , Peacey S. R. 
Published: March 2003

Aim: Insulin lispro used in an intensive basal/bolus regimen produces equivalent glycaemic control to human‐soluble insulin but reduces rates of hypoglycaemia. We tested the hypothesis that the use of rapid‐acting analogues might prevent the development of defective hypoglycaemic counterregulation during intensive insulin therapy.Methods: Ten patients with type 1 diabetes (four female, mean age 33 ± 3 years, diabetes duration 12 ± 2 years) participated in an open, randomized cross‐over study, with 2 months run‐in and 4‐month treatment periods using either lispro or human‐soluble insulin before meals and human NPH insulin (NPH) at night. The total of reported hypoglycaemic episodes (lispro vs. soluble, 123 vs. 128) and HbA1c (6.1 ± 0.2 vs. 6.6 ± 0.2%) were similar during both treatments. At the end of each period, we measured symptomatic, counterregulatory and cognitive responses, and glycaemic thresholds during hypoglycaemia, induced with a hyperinsulinaemic clamp (blood glucose of 5, 4.5, 3.5 and 2.5 mmol/l).Results: We found similar overall responses of adrenaline, cortisol, growth hormone and total symptom score. Glycaemic thresholds for rises in adrenaline (3.1 ± 0.2 vs. 3.1 ± 0.2 mmol/l, p = 0.76), cortisol (2.2 ± 0.1 vs. 2.2 ± 0.1 mmol/l, p = 0.16), growth hormone (3.3 ± 0.15 vs. 2.9 ± 0.2 mmol/l, p = 0.13), symptoms (3.2 ± 0.2 vs. 3.3 ± 0.1 mmol/l, p = 0.051) and impaired cognitive function (3.0 ± 0.2 vs. 3.0 ±0.2 mmol/l, p = 0.20) were also similar.Conclusion: Four months of intensive treatment, with insulin lispro used pre‐prandially and isophane at night, produced relatively preserved but equivalent physiological responses to hypoglycaemia as those on soluble insulin. Longer periods of treatment or alternative regimens may be necessary to demonstrate beneficial effects on hypoglycaemic physiological responses.
Serum homocysteine concentration is related to diabetes mellitus, but not to coronary heart disease, in Saudi Arabians
Authors: Al‐Nozah M. , Al‐Daghri N. , Bartlett W. A. , Al‐Attas O. , Al‐Maatouq M. , Martin S. C. , Kumar S. , Jones A. F. 
Published: March 2003

Introduction: Plasma homocysteine (HCYS) concentration is believed to be an independent risk factor for atherosclerosis.Methods: HCYS was measured in a cohort of 584 Saudi Arabians participating in a national screening study of coronary heart disease (CHD) risk factors. A total of 173 subjects (114 men and 59 women) had clinical CHD, of whom 82 (47.4%) had type 2 diabetes mellitus (56 men and 26 women). A further 127 subjects (60 men and 67 women) also had type 2 diabetes mellitus but no CHD. A total of 284 individuals (120 men and 164 women) were recruited as healthy controls, and had no previous history of CHD or diabetes. Serum HCYS was measured by high‐performance liquid chromatography (HPLC) with electrochemical detection.Results: Univariate analysis showed HCYS concentrations were significantly lower in those with diabetes mellitus (DM) than in controls, for both men [8.7 (4.2–18.6) vs. 10.5 (4.5–20.5) mmol/l, median (5th−95th percentiles, p = 0.009] and women [6.3 (3.3–24.0) vs. 8.1 (4.0–17.9) mmol/l, p = 0.049]. Stepwise multivariate regression analysis indicated a relationship between HCYS concentration and age, sex and the presence of DM, but not with CHD.Conclusions: In the Saudi Arabian population, serum HCYS is not a risk factor for CHD, but is lower in patients with DM.
Effects of gemfibrozil on insulin resistance to fat metabolism in subjects with type 2 diabetes and hypertriglyceridaemia
Authors: Whitelaw D. C. , Smith J. M. , Nattrass M. 
Published: March 2003

Aim: To examine whether lowering of plasma triglyceride concentrations using the fibrate peroxisome proliferator‐activated receptor (PPAR)α agonist gemfibrozil would influence insulin sensitivity to various aspects of intermediary metabolism among subjects with type 2 diabetes mellitus.Methods: A randomized placebo‐controlled double‐blind study in 12 subjects with type 2 diabetes were treated for 12 weeks after a 12‐week dietary run‐in. Insulin sensitivity was assessed using a low‐dose incremental intravenous insulin infusion.Results: Gemfibrozil significantly reduced fasting serum triglyceride concentrations (p < 0.001) but had no effect on measures of diabetic control. Neither gemfibrozil nor placebo treatment altered insulin sensitivity of glucose or glycerol metabolism during low‐dose insulin infusion, but significant falls in both non‐esterified fatty acid (NEFA) (p = 0.003) and ketone concentrations (p = 0.002) were observed after treatment with gemfibrozil.Conclusions: Gemfibrozil does not affect insulin sensitivity to glucose or fat metabolism in type 2 diabetes but enhances the lowering of plasma NEFA concentrations by insulin, probably by reducing hepatic fatty acid synthesis.
Niacin treatment of the atherogenic lipid profile and Lp(a) in diabetes
Authors: Pan J. , Lin M. , Kesala R. L. , Van J. , Charles M. A. 
Published: March 2003

Objective: We tested the hypotheses that niacin is effective for the separate treatments of abnormalities of LDL particle size, HDL2 percentage and Lp(a) without potential negative effects on glycated haemoglobin.Research Design and Methods: The atherogenic lipid profile lipids, such as triglycerides, small, dense LDL cholesterol (LDLc) particle mass, LDL particle size, total HDLc and HDL2 percentage as well as Lp(a), were measured in 42 diabetic patients with abnormalities of LDL particle size, HDL2 percentage and/or Lp(a) levels before and after niacin treatment. LDL particle size and HDL2 were measured using polyacrylamide gradient gel electrophoreses and Lp(a) was measured by enzyme‐linked immunoabsorbance assay (ELISA).Results: After niacin treatment, LDL peak particle diameter increased from 252 ± 7 Å to 263 ± 7 (p < 0.0001), small, dense LDLc particle mass decreased from 27 ± 11 mg/dL to 15 ± 4 (p < 0.0001), total HDLc increased from 39 ± 7 mg/dL to 51 ± 11 (p < 0.0001), HDL2 as the percentage of total HDLc mass increased from 29 ± 8% to 45 ± 10 (p < 0.0001) and Lp(a) decreased from 43 ± 17 mg/dL to 25 ± 10 (p < 0.0001). Mean haemoglobin A1c level was improved during treatment from 7.6 ± 1.8% to 6.5 ± 1.0 (p < 0.0001) using increased oral agent and insulin treatment doses in more than 90% of the patients. A total of 21% of the patients were unable to tolerate niacin owing to reversible side‐effects, and 14% were unable to adhere to the niacin dosing regimen of three times daily.Conclusions: These data indicate that in diabetic patients, niacin (i) is effective for treating diabetic dyslipidaemias associated with both the atherogenic lipid profile and Lp(a); (ii) must be used with modern and aggressive oral hypoglycaemic agents or insulin treatment; and (iii) is an important drug to treat diabetes dyslipidaemias because of its broad spectrum of effectiveness.
Changes in risk factors for cardiovascular disease with body fat loss in obese women
Authors: Krebs J. D. , Evans S. , Cooney L. , Mishra G. D. , Fruhbeck G. , Finer N. , Jebb S. A. 
Published: March 2003

Background: Current guidelines for obesity management emphasize the improvements in health risks associated with weight losses of 5–10% initial weight. However, most of the data is derived from periods of acute weight loss and may not represent the true effect in the longer term or in obese but otherwise healthy individuals. This study examines the temporal changes in risk factors for cardiovascular disease with weight change over 52 weeks.Methods: In total, 57 overweight women (age 43.7 ± 9.1 years, mean BMI of 31.7 kg/m2, range 27.2–38.5 kg/m2) with no other significant medical history, entered a milk‐based, low‐energy weight loss programme for 12 weeks and were then monitored without further intervention until 52 weeks. Weight, fat mass, fasting plasma insulin, lipids and blood pressure were measured at 0, 12, 24 and 52 weeks.Results: The mean weight change in sequential periods was −11.6% (p < 0.0001), +1.1% (p = 0.02) and +5.2% (p < 0.0001). The change from baseline to 1 year being −6.0% (p < 0.0001) an 11% (p < 0.0001) reduction in initial body fat mass. Initial weight loss (0–12 weeks) was positively correlated with greater longer term weight loss (0–52 weeks, r = 0.75, p < 0.0001) and not with weight regain (12–52 weeks, r = 0.14, p = 0.28). Despite significant improvements in insulin sensitivity, lipid profile and blood pressure (BP) with acute weight loss, in the group overall, only benefits in BP were maintained after 52 weeks. However, improvements in insulin sensitivity were sustained in those who maintained more than 5% weight loss, and those with higher baseline metabolic risk had greater benefits with weight loss. Change in waist circumference was better than BMI or fat mass in predicting improvements in metabolic risk in these obese women.Conclusions: This study suggests, in otherwise apparently healthy obese women, the rationale of targeting individuals most likely to benefit from weight management. Most importantly it highlights the need to focus on achieving initial weight losses of greater than 10% to maintain longer term losses of at least 5% and the associated health benefits.
Outer retinal fine structure of the garfish Belone belone (L.) (Belonidae, Teleostei) during light and dark adaptation – photoreceptors, cone patterns and densities
Authors: Reckel Frank , Melzer Roland R. , Smola Ulrich 
Published: March 2003

AbstractIn the present EM study, we investigate the retina of Belone belone, a visually‐orientated marine predator living close to the water surface. In the duplex retina, four morphologically different cone types are observed: unequal and equal double cones, long single cones and triple cones. In the light‐adapted state, five different cone patterns occur: row, twisted row, square, pentagonal and hexagonal patterns. High double cone densities are found ventro‐nasally, ventro‐temporally and dorso‐temporally. Throughout the retina the double cone/single cone ratio is 2 : 1, in the ventral part, however, a 1 : 1 ratio occurs. In the vitreous body we found a curtain‐like intraocular septum dividing the retina into two morphologically different regions. In most areas of the dark‐adapted retina the cone patterns are absent at the ellipsoid level, with long single cones standing more vitreally in the light path than double cones. The mosaics are retained, however, in the outer nuclear layer. Typical dark adaptation, i.e. the retinomotor movements of the retinal pigment epithelium and photoreceptors in response to the dark adaptation (light change) is not present in the peripheral ventral and parts of the central ventral area. In both regions we found a twisted row pattern of cones having a vitreal position. The findings are discussed with respect to the photic habitat and feeding habits of this species.
Epidermal receptor development and sensory pathways in vitally stained amphioxus (Branchiostoma floridae)
Authors: Holland Nicholas D. , Yu Jr‐Kai 
Published: March 2003

AbstractChloromethyl (CM) DiI was applied to the exterior of living embryos, larvae, and metamorphic juveniles of amphioxus. This fluorescent dye is taken up preferentially (but not highly selectively) by epidermal receptors and often stains sensory axons to their full extent. Type I primary receptors in the epidermis first become morphologically detectable along the rostrocaudal axis of the 2.5 day larva when their epidermal perikarya extend unbranched axons to the nerve cord. These axons run posteriorly or anteriorly within the nerve cord, depending on whether their perikarya are located, respectively, rostral or caudal to the most posterior pharyngeal slit. In later larvae, axons of type I receptors are organized into a dorsal and a subdorsal sensory tract on either side of the nerve cord. In the epidermis of metamorphic juveniles, CM‐DiI also stains type II receptors (which are axonless, secondary receptors) and ventral pit cells (which may not be receptors). It is probable, but not yet conclusively demonstrated, that peripheral neurites from Retzius bipolar cells (primary intramedullary sensory neurones) synapse with type II secondary epidermal receptors or ramify freely among the other epidermal cells. The discussion considers homologies among epidermal sensory receptors in chordates.
The lateral line canal sensory organs of the Epaulette Shark (Hemiscyllium ocellatum)
Authors: Jørgensen Jørgen Mørup , Pickles James O. 
Published: March 2003

AbstractExamination of the lateral line canals in the Epaulette Shark reveals a much more differentiated sensory system than previously reported from any elasmobranch. Two main types of lateral line canals are found. In one type rounded patches of sensory epithelia are separated by elevations of the canal floor. The other type is a straight canal without restrictions and with an almost continuous sensory epithelium. In addition, we found epithelia (type A) with very long apical microvilli on the supporting cells. These microvilli reach beyond the stereovilli of the hair cells. Another type (B) of sensory epithelium has short microvilli on the supporting cells. In this latter type of epithelium the stereovilli of the hair cells are comparatively tall and reach out beyond the supporting cell microvilli. New hair cells are found widely in both types of sensory epithelia. These always occur as single cells, unlike those described in teleost lateral line canal sensory epithelia where new hair cells seem to form in pairs. Dying hair cells are also widespread, indicating a continuous turnover of hair cells.
An investigation of erectile dysfunction in Gwent, Wales
Authors: Green J.S.A. , Holden S.T.R. , Ingram P. , Bose P. , St George D.P. , Bowsher W.G. 
Published: March 2003

Objective To quantify incidence of erectile dysfunction (ED) and the associated risk factors in men attending community clinics in a large population in Wales, UK. Subjects and methods Of 4060 men who were invited to attend 11 community clinics, primarily to check for prostate disease, 2025 (aged 55–70 years) attended. Of these, 2002 men answered a questionnaire about personal details, medical, family and sexual history, and detailed alcohol and smoking habits. All had their serum prostate‐specific antigen (PSA) analysed and those referred for investigation of prostatic disease underwent serum testosterone analysis. Results Complete ED was reported by 265 men (13.2%), and was closely related to age (r = 0.19, P < 0.001) and medication (r = 0.2, P < 0.001). ED occurred in 6.9% of men aged 55–60 years, 12.5% aged 61–65 and 22.2% of those aged 66–70. Patients taking diabetic medication had the highest relative risk for ED and 11.3% of men with ED were taking nitrates. The numbers of years of smoking had the third closest correlation with impotence (r = 0.16, P < 0.001). A low serum testosterone level was a poor predictor of ED and increasing serum PSA levels did not influence the distribution of ED. Conclusion About 13% of these men aged 55–70 years had complete ED; if this value is extrapolated to the whole of the UK, this equates to almost half a million men being unable to achieve any erections. The estimate would be much greater if those with milder forms of ED are included.