bluuebunny/crossref_metadata_2025_split huggingface dataset:
Piritramide and Alfentanil display similar respiratory depressant potency
Authors: Bouillon T. , Garstka G. , Stafforst D. , Shafer S. , Schwilden H. , Hoeft A. 
Published: November 2003

Background:  The question whether some opioids exert less respiratory depression than others has not been answered conclusively. We applied pharmacokinetic/pharmacodynamic (PKPD) modeling to obtain an estimate of the C50 for the depression of CO2 elimination as a measure of the respiratory depressant potency of alfentanil and piritramide, two opioids with vastly different pharmacokinetics and apparent respiratory depressant action.Methods:  Twenty‐three patients received either alfentanil (2.3 µg·kg−1·min−1, 14 patients, as published previously) or piritramide (17.9 µg·kg−1·min−1, nine patients) until significant respiratory depression occurred. Opioid pharmacokinetics and the arterial PCO2 (PaCO2) were determined from frequent arterial blood samples. An indirect response model accounting for the respiratory stimulation due to increasing PaCO2 was used to describe the PaCO2 data.Results:  The following pharmacodynamic parameters were estimated with NONMEM [population means and interindividual variability (CV)]: kelCO2 (elimination rate constant of CO2) 0.144 (–) min−1, F (gain of the CO2 response) 4.0 (fixed according to literature values) (28%), C50 (both drugs) 61.3 µg l−1 (41%), keo alfentanil 0.654 (–) min−1 and keo piritramide 0.023 (–) min−1. Assigning separate C50 values for alfentanil and piritramide did not improve the fit compared with a model with the same C50.Conclusion:  Since the C50 values did not differ, both drugs are equally potent respiratory depressants. The apparently lower respiratory depressant effect of piritramide when compared with alfentanil is caused by slower equilibration between the plasma and the effect site. Generalizing our results and based on simulations we conclude that slowly equilibrating opioids like piritramide are intrinsically safer with regard to respiratory depression than rapidly equilibrating opioids like alfentanil.
Implementation of a formal in‐training assessment programme in anaesthesiology and preliminary results of acceptability
Authors: Ringsted C. , Østergaard D. , Van Der Vleuten C. P. M. 
Published: November 2003

Background:  A new reform on postgraduate education in Denmark requires a formal in‐training assessment in all specialties. The aim of this study was to survey the implementation and acceptability of the first example of a nation‐wide in‐training assessment programme for first‐year trainees in anaesthesiology developed by a working group under the Danish Society of Anaesthesiology and Intensive Care Medicine.Methods:  A questionnaire about the implementation of the programme in practice and the characteristics of the trainees was sent to the educational responsible consultant (ERC) in each of the 26 anaesthetic departments in the country with first‐year trainees in anaesthesiology. Standard evaluations of the assessment programme were regularly collected from trainees.Results:  Twenty‐five (96%) departments returned the questionnaire. In total the departments reported on 100 trainees and 83 of these had been enrolled in the programme. Thirteen departments reported in total on 27 trainees who had completed their first year of training and these departments had applied a median 21 (range 17–21) of the 21 tests included in the entire programme. Time constraints and resistance among senior clinicians were the most frequently cited barriers to implementation. Evaluations from trainees showed a generally positive attitude towards most of the programme. They especially praised the programme's effect on structuring training and having a positive effect on learning.Conclusion:  The in‐training assessment programme has been widely implemented across the country. The majority of the programme was acceptable to trainees and had a positive effect on structuring training and on fostering learning.
Functional neuroimaging: a new generation of human brain studies in obesity research
Authors: Tataranni P. A. , DelParigi A. 
Published: November 2003

SummaryObesity is predominantly caused by overeating, an abnormal behaviour for which there is no unequivocal neurophysiological explanation. Functional neuroimaging techniques, such as positron emission tomography (PET) and functional magnetic resonance imaging (fMRI), have recently emerged as new tools to search for regions of the brain that are involved in the regulation of eating behaviours and those that are involved in the pathophysiology of obesity. Using these techniques, a limited number of studies have provided the first in vivo images of the human hypothalamic response to nutritional stimuli and revealed the complexity of the human brain response to hunger, taste, and satiation. Selective differences have been reported in the functional architecture of the brain of obese and lean individuals. We discuss current use and possible future developments of functional neuroimaging applied to obesity research. We conclude that functional neuroimaging provides an increasingly important tool for investigating how different regions of the brain work in concert to orchestrate normal eating behaviours and how they conspire to produce obesity and other eating disorders.
Studies of natural allele effects in mice can be used to identify genes causing common human obesity
Authors: Diament A. L. , Fisler J. S. , Warden C. H. 
Published: November 2003

SummaryAlthough genes causing rare Mendelian forms of human obesity have provided much useful information about underlying causes of obesity, these genes do not explain significant proportions of common obesity. This review presents evidence that animal models can be used to uncover subtle genetic effects on obesity and can provide a powerful rigorous compliment to human association studies. We discuss the advantages of animal models of obesity, various approaches to discovering obesity genes, and the future of mapping and isolating naturally occurring alleles of obesity genes. We review evidence that it is important to map naturally occurring obesity genes using quantitative trait locus (QTL) mapping, instead of mutagenesis and knockout models because the latter do not allow study of interactions and because naturally occurring obesity alleles can interfere with cloning from mutagenesis projects. Because a substantial percentage of human obesity results from complex interactions, the underlying genes can only be identified by direct studies in humans, which are still very difficult, or by studies in mice that begin with QTL mapping. Finally, we emphasize that animal model studies can be used to prove that a specific gene, only associated with obesity in humans, can indeed be the underlying cause of obesity in mammals.
Rudimentary uterine horn: Management of a diagnostic enigma
Authors: Chakravarti Swati , Chin Kirk 
Published: November 2003

The aim of this study was to review the presentation, diagnosis, investigations, management, and outcome in women with a unicornuate uterus and a noncommunicating rudimentary horn.The study group consisted of three women diagnosed between the 1998 and 2000 as having a noncommunicating rudimentary uterine horn. This retrospective study investigated the diagnostic tools and complications in these women.All the women had a detailed menstrual history, a pelvic examination by a senior gynecologist, and an ultrasound scan. Table I outlines the clinical symptoms and investigations undertaken.

Correlation of symptoms, clinical findings and investigations

Symptoms

Case
Age
Abdominal pain
Dysmenorrhoea
Exam findings
Pelvic USS
MRI scan
Laparoscopy
Hysteroscopy
IVU
Treatment no.

1
21
Chronic abdominal and pelvic, many hospital admissions
Yes
Mass felt in left adenexa
Mass 5×3x1 cm Near uterus on left
Non‐communicating rudimentary horn on left
Rounded rudimentary horn attached to uterus on left, Main uterus on right
–
NAD
Laparotomy: thick chocolate material, horn excised, cavity closed in two layers

2
18
Acute lower abdominal pain Laparotomy‐
Yes
NAD
Uterus deviated to right. Mass 3×4 cm on left near uterus
–
Main uterus on right, unicornuate horn with fibrous band on left
Left ostium not seen
NAD
Laparoscopy: as above

3
23
Yes, PV bleeding, and positive urine pregnancy test
–
Tenderness and swelling left adenexa
9‐week viable pregnancy in left adenexa ectopic pregnancy
–
Right unicornuate uterus with normal tube and ovary Pregnant left rudimentary horn
–
NAD
Laparoscopy excision of rudimentary horn wit products of conceptionh pregnant uterine horn
Is there any difference in measurement of pelvic floor muscle strength in supine and standing position?
Authors: Bø Kari , Finckenhagen Hanne Borg 
Published: November 2003

Background.  Traditionally, pelvic floor muscle function and strength have been measured in a supine position. However, stress urinary incontinence most often occurs in an upright position, and an important clinical question is whether measurement of pelvic floor muscle strength in the supine position reflects strength in standing. The purpose of the present study was to investigate whether there is a significant and clinical difference in pelvic floor muscle strength measurement in supine and standing position.Methods.  Eighteen women, mean age 43.4 years (range 31–64 years), with symptoms of stress and mixed incontinence attending a pelvic floor muscle‐training program participated in the study. Measurement of pelvic floor muscle strength was conducted with a fiberoptic microtip transducer connected to a balloon catheter inserted into the vagina (Camtech AS, Sandvika, Norway). Measurement of resting pressure, maximum squeeze pressure, and holding period in seconds, were assessed in random order in supine and standing position.Results.  The mean difference between supine and standing resting pressure was 8.6 cmH2O (95% CI 4.9–12.3), p < 0.001, between supine and standing maximum strength 0.3 cmH2O (95% CI − 4.0 to 3.4), p = 0.884, and between supine and standing holding period 0.9 s (95% CI − 3.3 to 1.4), p = 0.409.Conclusion.  Vaginal resting pressure was significantly higher in the standing compared to the supine position. Neither maximal strength nor holding time was different when comparing the two positions. Measurement of vaginal squeeze pressure is easier to perform and standardize in the supine compared to the standing position, and seems to reflect pelvic floor muscle strength in the standing position.
Oral misoprostol (100 μg) versus vaginal misoprostol (25 μg) in term labor induction: a randomized comparison
Authors: Shetty Ashalatha , Livingstone Iona , Acharya Santanu , Rice Pat , Danielian Peter , Templeton Allan 
Published: November 2003

Objective.  To compare the efficacy of vaginal misoprostol (25 μg) to oral misoprostol (100 μg) in labor induction at term.Methods.  One hundred and one women at term, with indications for labor induction and cervical Bishop's scores of less than 8, were randomly assigned to receive 100 μg of oral misoprostol or 25 μg vaginal misoprostol after random allocation. This could be repeated every 4 h to a maximum of five doses. The number delivering vaginally within 24 h of the induction was the main outcome measure.Results.  Of those who delivered vaginally (74.5% in the oral group vs. 72% in the vaginal group), significantly fewer women delivered within 24 h of induction in the oral group (42.1% vs. 72.2%, RR 0.6, 95% CI 0.4–0.9), with more women receiving more than one dose (45.7% vs. 16.7%, RR 2.7, 95% CI 1.2–6.0). More women in the oral group received oxytocin (68.6% vs. 44%, RR 1.6, 95% CI 1.1–2.2), and the induction to delivery interval was shorter in the vaginal group, although this was not statistically significant [28.9 h (SD 20.2) vs. 20.6 h (SD 16.1), mean difference − 8.3 h, 95% CI − 16.8 to 0.2]. There were no differences in the modes of delivery, uterine hyperstimulation rates or in the neonatal outcomes.Conclusion.  Vaginal misoprostol in its currently recommended dose of 25 μg seems to be more efficacious than the 100 μg oral dose.
Complications during set‐up procedures for laparoscopy in gynecology: open laparoscopy does not reduce the risk of major complications
Authors: Chapron C. , Cravello L. , Chopin N. , Kreiker G. , Blanc B. , Dubuisson J. B. 
Published: November 2003

Objective.  To compare the risk of major complications during the set‐up procedures for laparoscopy according to whether the classic technique (creation of the pneumoperitoneum followed by introduction of the optics trocar) or open laparoscopy is used.Methods.  Comparison was made of two retrospective series each carried out in a department promoting one of the two techniques. The setting was a university‐affiliated hospital. Two groups of patients were compared: group A, classic laparoscopy, n = 8324; group B, open laparoscopy, n = 1562. We investigated the set‐up procedures of operative laparoscopy according to the rules of classic or open laparoscopy.Results.  The risk of failure requiring conversion to laparotomy is significantly higher in the group of patients who underwent open laparoscopy [three cases (0.19%) vs. 0 case (0.0%); p = 0.004]. The risk of major complications is comparable in the two groups [group A, four cases (0.05%) vs. group B, three cases (0.19%); p = 0.08]. In the classic laparoscopy group there were four major complications: one injury to the aorta and three bowel injuries. In the open laparoscopy group there were three major complications: two bowel injuries and one postoperative occlusion.Conclusions.  Open laparoscopy does not reduce the risk of major complications during the set‐up procedures for laparoscopy. Randomized prospective trials are indispensable for comparing the risks involved with the classic technique and those of open laparoscopy.
Alterations in the expression of selected MHC antigens in premalignant lesions and squamous carcinomas of the uterine cervix
Authors: Chil Arkadiusz , Sikorski Marek , Bobek Małgorzata , Jakiel Grzegorz , Marcinkiewicz Janusz 
Published: November 2003

Background. The objective of the study was to determine whether there is a correlation between expression of selected major histocompatibility complex (MHC) antigens and the presence of carcinoma and premalignant lesions of the cervix. We also attempted to determine whether there is a correlation between expression of the selected MHC antigens in each grade of cervical intraepithelial neoplasia (CIN) and invasive carcinoma of the cervix.Methods. Quantitative comparative analysis of MHC class I and class II expression between specimens of the uterine cervix was carried out. For detecting human leukocyte antigen (HLA) class I molecules, two primary antibodies were used, recognizing either epitopes of all free heavy chain class I molecules or epitopes of the HLA‐Bw4 antigen. HLA class II antigens were detected by antibodies reacting with the α‐chain of the HLA‐DR molecule. An indirect immunoperoxidase technique was carried out using paraffin‐embedded sections. The following groups of sections were formed: squamous metaplasia, CIN of different grades, and invasive carcinoma. The specimens were taken from women in whom routine histopathologic diagnosis of cervical lesions had been performed.Results. A significant decrease in the mean number of stained cells showing expression of MHC class I antigens (HC 10 and Bw4) was found in the invasive cancer group of specimens. A decrease in Bw4 expression was also found in the CIN III group. The highest expression of the HLA‐DR antigens was detected in the metaplastic epithelium compared to the other groups. In the dysplastic epithelium the expression of the HLA‐DR antigens was increased in the highest grade of dysplasia (CIN III). Upregulation of HLA‐DR expression was detected in invasive cancer specimens.Conclusions. Alterations in MHC expression are found in premalignant lesions and squamous carcinomas of the uterine cervix. Quantitative assessment with the use of an image analysis system is valuable in helping to discriminate staining patterns of HLA expression. Further studies are indicated to evaluate the prognostic value of the expression of selected MHC antigens.
Effect of Prostatein, the Major Protein Produced by the Rat Ventral Prostate, on Phagocytic Cell Functions
Authors: Maccioni Mariana , Cabezas Laura E. , Rivero Virginia E. 
Published: November 2003

Problem:  To determine whether prostatein, the major protein produced and secreted into the seminal fluid by the rat ventral prostate has any effect on the phagocytic cell functions in vitro.Method of study:  Analysis was done by determining if purified prostatein added to cells obtained from the peritoneal cavity has any effect on their phagocytic and intracellular killing capacity. Also, we analyzed the effect of prostatein on the production of oxygen and nitrogen intermediates, measuring these metabolites by Nitroblue tetrazolium assay and by the Griess reaction respectively.Results:  Prostatein possess the ability to inhibit in vitro the phagocytic and killing properties of peritoneal rat leukocytes in a dose‐dependent manner. The addition of a polyclonal antiserum against prostatein specifically blocks this inhibitory effect. Moreover, prostatein inhibits the production of oxygen and nitrogen intermediates by these cells.Conclusion:  Regulation of the production of reactive oxygen species in the reproductive tract is extremely necessary to avoid their deleterious effects on the sperm motility and the fertilization process. We propose that prostatein, a protein supplied by an accessory gland like prostate, can inhibit the macrophage function, showing an important antioxidant effect.
Differential Gene Expression of Cytokine and Cell Surface Molecules in T cell Subpopulation Derived from Mammary Gland Secretion of Cows
Authors: Asai Ken‐ichi , Yamaguchi Takahiro , Kuroishi Toshinobu , Komine Yumiko , Kai Kenzo , Komine Ken‐ichi , Kumagai Katsuo 
Published: November 2003

Problem:  As T cell subpopulations in the mammary gland secretion (MGS) of cows dynamically vary through the lactation cycle, their functional analysis is important to understand the mammary immune responses.Method of study:  T cell subpopulations were positively selected from MGS during lactation period and non‐lactation period (dry period) by a magnetic cell sorter. The messenger RNA (mRNA) expression of cytokine and cell surface molecules in the subpopulations stimulated with anti‐CD3 was investigated using reverse transcription‐polymerase chain reaction (RT‐PCR).Results:  CD4+ T cells from MGS significantly expressed mRNA of interferon (IFN)‐γ, interleukin (IL)‐2, granulocyte‐macrophage colony‐stimulating factor (GM‐CSF), transforming growth factor (TGF)‐β, tumor necrosis factor (TNF)‐α, IL‐4, CD40 ligand (CD40L), Fas ligand (FasL) and IL‐2 receptor (IL‐2R) during dry period, and mRNA of IFN‐γ, IL‐2 and TGF‐β during lactation period. Their expression during lactation period was always less than that during dry period. CD8+ T cells from MGS substantially expressed mRNA of IFN‐γ, IL‐2, GM‐CSF, TGF‐β, TNF‐α, FasL and IL‐2R during dry period and mRNA of IFN‐γ, GM‐CSF, TGF‐β, TNF‐α and c‐kit during lactation period. The TGF‐β, TNF‐α, c‐kit and IL‐2R mRNA expression of T cells in MGS during lactation period mostly depended on γδ T cells. Interestingly, c‐kit mRNA was exclusively expressed in γδ T cells.Conclusions:  The cytokine expression of T cells in MGS of cows depended on the T cell subpopulations. The present findings suggested that the activation of γδ T cells via c‐kit receptor participated in the suppressed expression of cytokine mRNA in T cells during lactation period.
Self-assembly of Particle Wires in 2-D Ordered Array
Authors: Masuda Yoshitake , Itoh Minoru , Koumoto Kunihito 
Published: November 2003

Abstract
We developed a novel self-assembly process to fabricate an orderly array of particle wires constructed from a close-packed structure from colloidal solution without preparation of patterned templates. A substrate was immersed into the solution containing particles perpendicular to the liquid surface and the liquid surface was moved downward by evaporation of solution. Particles formed a mono/multi-particle layer and the particle layer was cut by the periodic drop-off of the solution. This process allowed us to fabricate the orderly array of particle wires and to show the high ability of the self-assembly process for fabrication of nano/micro-structures constructed from nano/micro particles or blocks.
Tinzaparin: Considerations for Use in Clinical Practice
Authors: Nutescu Edith A , Shapiro Nancy L , Feinstein Helen , Rivers Christina W 
Published: November 2003

OBJECTIVE: To evaluate the safety and effectiveness of tinzaparin for the prevention and treatment of venous thromboembolism (VTE). DATA SOURCES: A MEDLINE and PubMed database search (1980–December 2002) was conducted. Only articles written in English were reviewed. STUDY SELECTION AND DATA EXTRACTION: Articles reporting the safety, efficacy, and cost-effectiveness of tinzaparin in humans were evaluated. Emphasis was placed on randomized, controlled trials. DATA SYNTHESIS: Tinzaparin sodium is a low-molecular-weight heparin (LMWH) that exerts its anticoagulant effect through inhibition of factors Xa and IIa and release of tissue factor pathway inhibitor from the vascular epithelium. Tinzaparin is indicated for treatment of acute symptomatic deep-vein thrombosis (DVT), with or without pulmonary embolism. Clinical studies suggest that tinzaparin is also effective for VTE prophylaxis, as well as other indications. Once-daily subcutaneous tinzaparin is equally or more effective than intravenous unfractionated heparin (UFH) for prevention and treatment of VTE, at least as safe as UFH for bleeding complications, and requires little or no monitoring. No dose “cap” is required for obese patients, and no initial dosing adjustments are necessary in elderly and/or renally impaired patients, although some monitoring is recommended. The few comparative data available suggest that tinzaparin efficacy may be comparable to that of other LMWHs; more comparative studies are needed. Pharmacoeconomic studies indicate a favorable cost—benefit ratio. CONCLUSIONS: Tinzaparin is safe and effective for prevention and treatment of DVT. Consistent once-daily dosing may facilitate self-administration of tinzaparin in the outpatient setting.
The relationship between shame, eating disorders and disclosure in treatment
Authors: Swan Sarah , Andrews Bernice 
Published: November 2003

Background: This study considered shame in 68 women who had received treatment for eating disorders (EDs) compared to 72 non‐clinical controls, and shame in relation to disclosure in treatment.Method: All participants completed questionnaires on ED and depressive symptoms, and bodily, behavioural and characterological shame and shame around eating. ED women also answered questions on disclosure in treatment.Results: The ED group scored significantly higher than controls on all shame areas when depression was controlled. ED women who were currently symptomatic and those who had recovered scored higher than controls on bodily and characterological shame and shame around eating. Non‐disclosure in treatment was reported by 42% of the ED group and was associated with higher shame in all areas except bodily shame.Conclusions: The study is the first to show a relationship between shame and ED in a clinical sample. It supports existing evidence regarding the importance of bodily shame in women with EDs, and extends the literature in terms of the importance of other shame aspects for ED symptomatology and disclosure. Implications for treatment are discussed.