bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of vascular endothelial growth factor and brain‐derived neurotrophic factor on cavernosal nerve regeneration in a nerve‐crush rat model
Authors: Hsieh P.‐S. , Bochinski D.J. , Lin G.T. , Nunes L. , Lin C.S. , Lue T.F. 
Published: August 2003

OBJECTIVETo test the hypothesis that an intracavernosal injection with brain‐derived neurotrophin factor (BDNF) and vascular endothelial growth factor (VEGF) can facilitate nerve regeneration and recovery of erectile function after cavernosal nerve injury.MATERIALS AND METHODSThe study included 25 Sprague‐Dawley rats; four had a sham operation, seven bilateral nerve crushing with no further intervention, and 14 bilateral nerve crushing with either an immediate (seven) or delayed for 1 month (seven) intracavernosal injection with BDNF+VEGF. Erectile function was assessed by cavernosal nerve electrostimulation at 3 months, and neural regeneration by NADPH‐diaphorase staining and tyrosine hydroxylase (TH) staining of penile tissue and major pelvic ganglia (MPG).RESULTSAfter nerve crushing, the functional evaluation at 3 months showed a lower mean (sd) intracavernosal pressure (ICP) with cavernosal nerve stimulation, at 33.9 (15.3) cmH2O, than in the sham group, at 107.8 (18.1) cmH2O. With an immediate injection with BDNF+VEGF the ICP was significantly higher than in the controls, at 67.8 (38.5) cmH2O. Even delayed injection with BDNF+VEGF improved the ICP, to 78.0 (21.8) cmH2O. Histological analysis of specimens stained for NADPH and TH showed a significant change in the morphology of terminal branches of the cavernosal and dorsal nerves, and the staining quality of the neurones in the MPG. The number of positively stained nerve fibres tended to revert to normal after treatment with BDNF+VEGF.CONCLUSIONAn intracavernosal injection with BDNF+VEGF appears to both prevent degeneration and facilitate regeneration of neurones containing neuronal nitric oxide synthase in the MPG, dorsal nerve and intracavernosal tissue. Therefore it might have therapeutic potential for enhancing the recovery of erectile function after radical pelvic surgery.
Laparoscopic computer‐assisted pyeloplasty: the results of experimental surgery in pigs
Authors: Hubert J. , Feuillu B. , Mangin P. , Lobontiu A. , Artis M. , Villemot J.P. 
Published: August 2003

The attraction of using the Da VinciTM robotic system is considerable, despite the great costs involved. The three‐dimensional view and the wide degree of freedom of movement allows, as we are told, a procedure which can be learned more quickly than standard laparoscopic surgery. The authors from France describe their early experience with the technique and provide an overview of other robotic methods.OBJECTIVETo evaluate the experimental feasibility of laparoscopic computer‐assisted pyeloplasty for pelvi‐ureteric junction obstruction.MATERIALS AND METHODSFourteen pyeloplasties were undertaken in pigs using a laparoscopic transperitoneal approach and the robotic surgical system (da VinciTM, Intuitive Surgical Inc., Sunnyvale, CA, USA).RESULTSThe robotic surgical system provides real‐time three‐dimensional stereoscopic vision. Manipulating the intracorporeal endo‐wristed instruments from a remote console allows laparoscopic manoeuvres that are as easy as those during open surgery. Surgeons with no particular experience in laparoscopic surgery could learn complex surgery easily and quickly.CONCLUSIONThis technique provides faster training and the possibility of undertaking complex laparoscopic procedures, especially reconstructive, with less fatigue for the surgeon.
Alveolar bone loss associated with glucose tolerance in Japanese men
Authors: Marugame T. , Hayasaki H. , Lee K. , Eguchi H. , Matsumoto S. 
Published: August 2003

AbstractAims Type 2 diabetes is known to affect alveolar bone loss (ABL). The purpose of this study was to examine whether impaired glucose tolerance (IGT) is associated with ABL, as is diabetes.Methods A case–control study was performed with 664 Japanese men aged 46–57 years. Panoramic radiographs revealed 513 severe ABL cases, 22 moderate ABL cases, and 129 controls with good alveolar bone. Diabetes status was classified into normal glucose tolerance (NGT), impaired fasting glucose (IFG), IGT, and newly diagnosed diabetes according to the fasting plasma glucose and 75‐g oral glucose tolerance test (OGTT). Diabetes under treatment was excluded. Odds ratios (ORs) and 95% confidence intervals (CIs) were obtained from ordinal logistic regression analysis. Statistical adjustment was made for total cholesterol, HDL‐cholesterol, triglyceride, rank in the Self Defence Forces (SDF), cigarette‐years, alcohol use, body mass index, previous 10 years’ brushing habits and instrument use other than toothbrush, and history of periodontal treatment.Results A significant, approximately three‐fold increase in the crude OR (crude OR = 3.28; 95% CI = 1.16–9.27) and non‐significant 2.6‐fold increase in the adjusted OR (adjusted OR = 2.55; 95% CI = 0.86, 7.54) of ABL was observed among men with newly diagnosed Type 2 diabetes compared with the reference group (NGT combined with IFG). However, there was no association between IGT and ABL (adjusted OR = 0.99; 95% CI = 0.59,1.64).Conclusions Type 2 diabetes, but not IGT, was positively associated with ABL. Preventive maintenance against periodontitis is important in middle‐aged men with diabetes.
Activation of the innate immune system as a predictor of cardiovascular mortality in Type 2 diabetes mellitus
Authors: Pickup J. C. , Mattock M. B. 
Published: August 2003

AbstractAims Activation of innate immunity may play a major role in the development and pathophysiology of Type 2 diabetes; we therefore investigated whether a marker of innate immunity (serum sialic acid) predicts cardiovascular disease (CVD) and all‐cause mortality in Type 2 diabetes.Methods Type 2 diabetic subjects (n = 128, age 31–64 years at outset) participating in the Lewisham Diabetes Survey were followed up for a mean of 12.8 years. Baseline measurements were made of serum sialic acid and known or putative risk factors for CVD. Cause of death was coded from death certificates, post mortem examination and hospital records.Results Fifty‐six (43%) subjects had died after 12.8 years. The major cause of death was CVD (71.4%), predominantly coronary heart disease (62.5%). Baseline variables significantly associated with CVD mortality were sialic acid and CVD (borderline significance smoking and cholesterol). In multivariate analysis, significant independent predictors of CVD mortality were sialic acid [standardized relative risk (95% confidence interval) 1.53 (1.12, 2.10)], age, male sex and existing CVD.Conclusions Activated innate immunity (low‐grade inflammation) is a risk factor for CVD mortality in Type 2 diabetes, independently of other known risk factors, including existing CVD. Since activation of the innate immune system predicts Type 2 diabetes, it may be a common antecedent of both Type 2 diabetes and CVD.
Effects of atorvastatin on glucose homeostasis, postprandial triglyceride response and C‐reactive protein in subjects with impaired fasting glucose
Authors: Costa A. , Casamitjana R. , Casals E. , Álvarez L. , Morales J. , Masramón X. , Hernández G. , Gomis R. , Conget I. 
Published: August 2003

AbstractAims To investigate the effects of atorvastatin on glucose homeostasis, the basal and postprandial lipid profiles and the CRP levels (C reactive protein) in subjects with impaired fasting glucose (IFG).Methods Thirty‐three subjects (22 men and 11 women) were included in our study. All displayed an IFG (fasting plasma glucose between 6.1 and 7.0 mmol/l) on at least two occasions during the last 6 months prior the study. They were randomly assigned to receive either 40 mg atorvastatin/day (n= 16) or placebo (n= 17) over 16 weeks, in a double‐blind design. Before and after the end of the study all participants underwent on three consecutive days: a 75‐g oral glucose tolerance test, a frequent sampling intravenous glucose tolerance test with Minimal Model analysis and a meal tolerance test (glucose, insulin and triglycerides). CRP was measured before and after the treatment period.Results CRP decreased significantly in the atorvastatin‐treated group compared with the placebo group (percent change respect initial values; −42.3 %[−21.5 to − 63.1] and −9.6%[15.0 to −34.0], respectively, p < 0.01). Atorvastatin treatment did not produce any change in oral glucose tolerance categories or induce any change in glucose and insulin response in OGTT. The statin produced a trend towards a significant improvement in insulin sensitivity as expressed by a change in Si from baseline to the end of treatment. Atorvastatin reduced the postprandial response of triglycerides to the meal test compared with placebo (19–26 % across the meal test, p < 0.05) correlating with the amelioration observed in Si (−0.34, p < 0.05; percentage changes).Conclusion Our results suggest that the use of statins in subjects with IFG seems to include other potentially beneficial actions in addition to their cholesterol‐lowering effects.
Motivational/solution‐focused intervention improves HbA1c in adolescents with Type 1 diabetes: a pilot study
Authors: Viner R. M. , Christie D. , Taylor V. , Hey S. 
Published: August 2003

AbstractAims We piloted a motivational and solution‐focused therapy group intervention to improve glycaemic control in young people 11–17 years with poorly controlled Type 1 diabetes (mean annual HbA1c > 8.5%).Methods Seventy‐seven subjects agreed to be assessed for a pilot non‐randomized controlled trial. Subjects completed psychological questionnaires and were given feedback designed to encourage entry into the intervention. Twenty‐one young people opted to enter the intervention groups (cases). Two intervention groups consisting of five to six subjects were conducted in each age band 10–13 years and 14–17 years. Twenty of those who did not opt to join the groups were randomly selected to act as controls. Cases and controls were well matched for age, HbA1c, duration of diabetes and socio‐economic status.Results The intervention produced a significant improvement of 1.5% in HbA1c in cases (P < 0.05) at 4–6 months post intervention compared with no change in controls. This improvement was partly maintained at 7–12 months post intervention.Conclusions These pilot data suggest that a motivational/solution‐focused group intervention is promising in improving HbA1c in adolescents and should be investigated further in a randomized controlled trial.
The albuminuric action of atrial natriuretic peptide is not modified by ACE‐inhibition with perindopril in Type 2 diabetes
Authors: Moore K. B. , McKenna K. , Tormey W. P. , McDonald D. , Thompson C. J. 
Published: August 2003

AbstractAims Atrial natriuretic peptide (ANP) increases urine albumin excretion (UAER) in humans with Type 1 diabetes. The aim of this study was to establish if ANP increases UAER in microalbuminuric subjects with Type 2 diabetes and to examine whether the albuminuric action of ANP was inhibited by pre‐treatment with the ACE‐inhibitor perindopril.Methods Seven microalbuminuric, normotensive males with Type 2 diabetes were entered into a randomised, double‐blind, three‐armed study of (i) intravenous infusion of ANP (0.25 µg/kg/min in 0.9% NaCl) after 3 weeks’ pre‐treatment with placebo, (ii) intravenous infusion of vehicle (0.9% NaCl only) after 3 weeks’ pre‐treatment with placebo, or (3) intravenous infusion of ANP (0.25 µg/kg/min in 0.9% NaCl) after 3 weeks’ pre‐treatment with perindopril, 4 mg daily.Results Baseline parameters were similar on all three study days. During the placebo/vehicle arm there was no change in urine flow rate (UFR, P = 0.61), urine cyclic guanosine monophosphate (UcGMP P = 0.48) or UAER (P = 0.99). During the placebo/ANP arm there was a rise in UFR [13.7 ± 2.8 (mean ± sd) to 25.7 ± 7.7 mL/min, P < 0.001], UcGMP (60.0 ± 36.6 to 160.8 ± 118.5 µmol/mmolCr, P = 0.045) and UAER {5.13 [2.4–11.6][median (range)] to 71.6 [21.6–175.1] mg/mmolCr, P < 0.001}. Pre‐treatment with perindopril did not alter the changes in UFR (P = 0.63), UcGMP (P = 0.46) or UAER (P = 0.99) to infusion of ANP, compared with the placebo/ANP arm.Conclusion ANP increases UAER in microalbuminuric patients with Type 2 diabetes and the albuminuric action of ANP is not inhibited by pre‐treatment with the ACE inhibitor perindopril.
Irish diabetes detection programme in general practice
Authors: Smith S. M. , Holohan J. , McAuliffe A. , Firth R. G. 
Published: August 2003

AbstractObjectives To assess the prevalence of undiagnosed diabetes, impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) in patients over the age of 40 years attending their general practitioner (GP) in Ireland, through opportunistic screening, using a three‐step screening tool involving self‐determined high‐risk groups, random venous plasma glucose (RVPG) measurement and oral glucose tolerance tests.Design In participating general practices, 100 consecutive patients > 40 years, completed a screening questionnaire relating to diabetes‐related symptoms and risk factors. Patients with previously diagnosed diabetes were not excluded from the study and the screening instrument included a question about known diabetes. Patients without known diabetes mellitus (DM) and with at least two risk factors and/or symptoms underwent a RVPG test. Those with an RVPG above 5.5 mmol/l underwent an oral glucose tolerance test.Results Forty‐one practices returned 3821 questionnaires. The prevalence of Type 2 diabetes mellitus in the study population was 9.2% (353), of whom 23.5% (83) were previously undiagnosed. DM was detected on the basis of an RVPG > 11.1 mmol/l in 0.8% (32) of the studied population. DM was detected on the basis of the oral glucose tolerance test in 1.3% (51) of the population. One per cent (39) had a fasting plasma glucose (FPG) ≥ 7.0 mmol/l, 0.6% (24) had a 2‐h > 11.0 mmol/l and 0.3% (12) had both. Diabetes would not have been detected in 12 people had the 2‐h test been omitted. The prevalence rate for IFG and/or IGT was 3.9% (148). Of the 103 patients with IGT, 83 (81%) would have been missed had the GTT been omitted.Conclusion Opportunistic diabetes screening in general practice using a screening questionnaire followed by RVPG testing and GTT for those above 5.5 mmol/l is feasible, with a high participation rate. The use of GTTs rather than fasting glucose testing alone improves patient identification, in particular those with IGT who are at higher cardiovascular risk.
The risk of stillbirth in pregnancies before and after the onset of diabetes
Authors: Wood S. L. , Jick H. , Sauve R. 
Published: August 2003

AbstractAims There is significant controversy as to whether or not stillbirth is increased in pregnancies prior to the onset of diabetes. An observed increase may be indicative of risks associated with untreated gestational diabetes. It is generally accepted that the risk of stillbirth in pregnancies that occur after the onset of diabetes has been diminished by modern obstetric care. However, the degree of residual risk is not well quantified. This study sought to examine the rates of stillbirth before and after the onset of diabetes compared with the general population.Methods Retrospective cohort and nested case–control study. The study population was drawn from the UK‐based General Practice Research Database, comprising some 300 practices, with data collection from the late 1980s until September 1999. From the base population, 913 diabetic women who had had a pregnancy were identified and 10 000 subjects without diabetes were randomly chosen as controls. Stillbirth was defined as death in utero after 20 weeks or with birth weight > 500 g.Results The stillbirth rates were higher in prediabetic pregnancies (19.7/1000), and in those occurring after the diagnosis of diabetes (33.7/1000), compared with the non‐diabetic population (5.5/1000). Stillbirths were matched to four live births by maternal age and year of birth. Prediabetic pregnancy and pregnancy after the onset of diabetes were strongly associated with stillbirth: odds ratio (OR) = 4.68 (1.67, 13.08) and OR = 4.39 (2.22, 8.64), respectively.Conclusions The risk of stillbirth was increased in both prediabetic and post‐diabetic pregnancy.
Pregnancy in women with Type 2 diabetes: 12 years outcome data 1990–2002
Authors: Dunne F. , Brydon P. , Smith K. , Gee H. 
Published: August 2003

AbstractAim Twelve years’ outcome analysis of pregnancies in women with Type 2 diabetes in a multiethnic geographically defined area.Methods Information about 182 women delivered between 1990 and 2002 was ascertained from a regional computerized database. The main outcome measures were rates of miscarriage, stillbirth, neonatal/postnatal deaths, congenital malformations, birth weight, mode of delivery, and neonatal unit care as well as maternal morbidities of polyhydramnios, postpartum haemorrhage, pregnancy‐induced hypertension/pre‐eclampsia.Results Among 182 singleton pregnancies, 161 (88%) resulted in a live outcome. There were 16 (8.8%) spontaneous miscarriages, two (1.2%) stillbirths, and three (1.6%) terminations. Congenital malformations occurred in 18 pregnancies (99/1000). There were two early and one late neonatal deaths and two further deaths in the postnatal period. Twenty‐eight percent of infants were large for gestational age, with 15 (9.3%) greater than 4 kg. Fifty‐three percent were delivered by caesarean section and 68 (37%) required admission to neonatal unit (NNU) care. Hypertension/pre‐eclampsia was two times, polyhydramnios three times, and postpartum haemorrhage six times more common than in non‐diabetic women.Conclusions Women with Type 2 diabetes have a less satisfactory pregnancy outcome compared with the general population. Infants have a two‐fold greater risk of stillbirth, a 2.5‐fold greater risk of a perinatal mortality, a 3.5‐fold greater risk of death within the first month and a six‐fold greater risk of death up to 1 year compared with regional/national figures. They have an 11 times greater risk of a congenital malformation. We need to develop better educational and screening strategies if we are to improve.
Assessing progression and efficacy of treatment for diabetic retinopathy following the proliferative pathway to blindness: implication for diabetic retinopathy screening in Taiwan
Authors: Liu W‐J. , Lee L‐T. , Yen M‐F. , Tung T‐H. , Williams R. , Duffy S. W. , Chen T. H‐H. 
Published: August 2003

AbstractAimsThe natural history and treatment efficacy of diabetic retinopathy (DR) play important roles in the evaluation of screening. Therefore, the natural history of DR and rates of transition after treatment (including metabolic control and laser photocoagulation) from no diabetic retinopathy (NDR) to blindness were quantified.MethodsWe studied a cohort of 795 patients with diabetes mellitus (DM) receiving fundus examination in the ophthalmology out‐patient department of one medical centre between 1 January 1990 and 31 December 1992 in Taiwan. Follow‐up data until 31 December 1998 were collected by chart review. Two multistate Markov models were proposed to assess the efficacy of the treatment regime in reducing progression to blindness.ResultsThe average times spent in states (i) no diabetic retinopathy (NDR), (ii) background diabetic retinopathy (BDR), (iii) preproliferative diabetic retinopathy (PPDR), and (iv) proliferative retinopathy (PDR) were 10.86 years, 8.33 years, 1.67 years, and 2.17 years, respectively. Early detection of PPDR may lead to a 60% reduction in PDR and an 83% reduction in blindness. Simulated results based on these parameters show that an annual screening programme, a biennial screening regime and a 4‐yearly screening regime can lead to 54% (95% confidence interval (CI): 44–62%), 51% (95% CI: 41–59%), and 46% (95% CI: 36–54%) reductions in blindness, respectively.ConclusionsAssessing the progression of DR following the proliferative pathway in this study suggests that screening for DR is worthwhile and that a 4‐year interscreening interval for patients as yet without DR may be justified.
Is digital image compression acceptable within diabetic retinopathy screening?
Authors: Basu A. , Kamal A. D. , Illahi W. , Khan M. , Stavrou P. , Ryder R. E. J. 
Published: August 2003

AbstractAims The National Screening Committee (NSC), whilst recommending the use of digital mydriatic retinal photography for diabetic retinopathy screening, has not yet accepted the use of digitally compressed images for grading. By greatly reducing the file size, however, compression of images is invaluable for storage and for its rapid transmission across computer networks. We undertook a study to compare the different levels of JPEG compression with the original bit‐mapped image to determine whether there was any loss of clinical detail following compression.Methods Three hundred and thirty images were analysed in this study. These images had been captured from 66 eyes consecutively photographed in a diabetic retinopathy screening programme, using a Sony DXC‐950 P 3CCD colour video camera mounted on a Canon CR6‐45NMf fundus camera. Single 45° macula‐centred images were taken from each eye. The images were compressed using the JPEG algorithm within Adobe Photoshop (version 4.0) and then displayed with a Sony Trinitron colour monitor. Four different levels of compression were used, JPEG‐1, JPEG‐2, JPEG‐3, JPEG‐4, and an objective analysis was undertaken using ‘lesion counts’. The compressed images were assessed separately and blindly and the results compared with their original BMP images.Results Eight BMP images could not be evaluated (five right eye and three left eye). A total of 290 images were therefore used in the final evaluation. All the JPEG‐1 images with file sizes between 16 and 24 kb were found to be ‘pixelated’, while the JPEG‐4 images (66–107 kb) appeared similar to the original BMP (1.3 Mb) images. Both JPEG‐2 and JPEG‐3 images had significantly lower counted lesions than the BMP images.Conclusions From our findings we can conclude that only some degree of image compression (compression ratios of 1 : 20 to 1 : 12) with file sizes of 66–107 kb is permissible using JPEG format, whereas the images obtained after higher compression ratios may not be suitable for diabetic retinopathy screening.