bluuebunny/crossref_metadata_2025_split huggingface dataset:
Matrix metalloproteinases (MMPs) in bladder cancer: the induction of MMP9 by epidermal growth factor and its detection in urine
Authors: Nutt J.E. , Durkan G.C. , Mellon J.K. , Lunec J. 
Published: March 2003

OBJECTIVESTo investigate the matrix metalloproteinases (MMPs) 2 and 9 in bladder cancer cell lines stimulated with epidermal growth factor (EGF), and to investigate the presence of gelatinases in the urine of patients with bladder tumours, in relation to the stage and grade of tumour and the EGF receptor (EGFR) status.PATIENTS, SUBJECTS AND METHODSConditioned media from cultured tumour cells were analysed by zymography. Urine samples from 28 patients with transitional cell carcinoma and 12 normal volunteers were also analysed. Western blotting was used to verify the bands of gelatinolytic activity. The EGFR status of the tumours was assessed by immunohistochemistry.RESULTSMMP9 was induced by EGF in the RT112 but not the RT4 bladder tumour cell line, whereas MMP2 production was unaffected by EGF. Gelatin zymography of urine samples from patients with bladder tumours showed high levels of MMP activity, with 78% positive for MMP9 and 28% positive for MMP2. The total gelatinolytic and MMP9 activity were significantly higher in patients with high‐stage invasive tumours than in those with superficial tumours (P < 0.05), and were higher than in normal controls. Gelatinolytic activity at 130 and 200 kDa in urine was identified as MMP9 and MMP2. There was no significant relationship of urinary MMP9 activity to EGFR status of the tumour.CONCLUSIONEGF induces MMP9 but not MMP2 in bladder cells. Analysis of urinary gelatinases is a useful noninvasive technique and both total gelatinase and MMP9 activity are associated with high stages of bladder tumours.
Standardization of the renogram technique for investigating the dilated upper urinary tract and assessing the results of surgery
Authors: O'Reilly P.H. ,   for the Consensus Committee of the Society of Radionuclides in Nephrourology
Published: March 2003

OBJECTIVETo recommend a standard technique for the renographic evaluation of the dilated upper urinary tract, and for evaluating the results of surgery.METHODSThis review is an update of the previously recommended consensus report of the 9th International Symposium of Radionuclides in Nephrourology.RESULTSState‐of‐the‐art recommendations are detailed for standardizing common radionuclide investigations.CONCLUSIONSWhere open, laparoscopic or endourological techniques for treating pelvi‐ureteric junction obstruction are under study, results can only be compared by standardizing the investigational techniques. The guidelines produced here are recommended for this purpose.
Chemosensitization of human prostate cancer using antisense agents targeting the type 1 insulin‐like growth factor receptor
Authors: Hellawell G.O. , Ferguson D.J.P. , Brewster S.F. , Macaulay V.M. 
Published: March 2003

OBJECTIVETo assess the effect of the downregulation of type 1 insulin‐like growth factor receptor (IGF1R) on the chemosensitivity of prostate cancer cells. IGF1R is overexpressed by prostate cancer compared with benign prostatic epithelium and IGF1R expression commonly persists in androgen‐independent metastatic disease at levels comparable to those in the primary.MATERIALS AND METHODSHuman androgen‐independent DU145 prostate cancer cells were transfected with IGF1R antisense oligonucleotides or antisense RNA. Transfected cultures were treated with cisplatin, mitoxantrone, paclitaxel or vehicle control, and survival measured using a clonogenic assay.RESULTSBoth antisense strategies suppressed IGF1R protein levels to 30–50% of those in control cultures. This was associated with 1.5–2‐fold enhancement of sensitivity to cisplatin, mitoxantrone and paclitaxel, and an increase in cisplatin‐induced apoptosis.CONCLUSIONThis approach has potential for development as a clinical treatment for advanced prostate cancer and other chemoresistant tumours.
Corticosteroid use after prostate brachytherapy reduces the risk of acute urinary retention
Authors: Sacco D.E. , Daller M. , Grocela J.A. , Babayan R.K. , Zietman A.L. 
Published: March 2003

OBJECTIVESTo evaluate the role of short‐term steroids after prostate brachytherapy to reduce oedema and thus the risk of urinary retention associated with brachytherapy, as this can require surgical intervention and may even result in incontinence.PATIENTS AND METHODSA retrospective review was conducted on 400 consecutive patients with early‐stage prostate cancer who underwent ultrasonography‐guided transperineal brachytherapy. Androgen deprivation was given to 146 patients for 3 months before the implant and 280 received a 2‐week course of dexamethasone (4 mg twice daily for 1 week then 2 mg twice daily). Forty‐five patients developed acute urinary retention at a median of 12 days after implantation. Univariate and multivariate analyses were used to evaluate the potential risk factors for urinary retention.RESULTSAcute urinary retention developed in 11.1% of the patients and the risk was predicted by increasing prostate volume at the time of diagnosis. This risk was higher (18.8%) for men receiving no dexamethasone and lower (8.2%) for those who did. In the multivariate analysis the volume at diagnosis and the use of dexamethasone remained significant. The use of steroids counterbalanced the effect of increasing prostate volume on the incidence of retention. The risk of retention was higher in those men receiving androgen deprivation to shrink their prostates than in those whose prostates were of suitable size for implantation at the time of diagnosis.CONCLUSIONReducing prostate volume by androgen deprivation before brachytherapy may be less important in preventing brachytherapy‐related urinary retention than the use of corticosteroids to reduce oedema afterward.
Recent trends in the use of radical prostatectomy in England: the epidemiology of diffusion
Authors: Oliver S.E. , Donovan J.L. , Peters T.J. , Frankel S. , Hamdy F.C. , Neal D.E. 
Published: March 2003

OBJECTIVETo describe recent trends in the use of radical prostatectomy (RP) in England, as there is currently no consensus on the most effective treatment for localized prostate cancer, although RP is the treatment of choice among urological surgeons for men aged < 70 years.METHODSRoutine data were assessed to establish the number of RPs performed in England in 1991–99. Age‐standardized operation rates were compared by region and socio‐economic group, and the geographical spread of use mapped.RESULTSThe number of RPs performed annually increased nearly 20‐fold between 1991 and 1999. Rates of surgery were greatest in the London National Health Service (NHS) regions and lowest in the Trent region. Outside London, the risk of surgery in a NHS hospital was significantly greater for men living in the least deprived areas; in London this trend was reversed.CONCLUSIONRapid increases in the use of RP showed marked regional variations, most likely related to access to prostate‐specific antigen testing and the location of surgeons able to carry out radical surgery. By 1999, a third of procedures were still being undertaken in ‘low‐volume’ hospitals, with implications for the quality of care and outcomes. Crucially, these developments occurred in the absence of robust information about the effectiveness of RP. Recent funding of a randomized trial of treatment options in this area is welcome, but wider questions remain about the timing of the evaluation of surgical technologies.
Endoluminal ultrasonography before retrograde endopyelotomy: can the results match laparoscopic pyeloplasty?
Authors: Parkin J. , Evans S. , Kumar P.V.S. , Timoney A.G. , Keeley F.X. 
Published: March 2003

In this paper, the authors assess whether endoluminal ultrasonography is helpful when carried out before retrograde endopyelotomy, and ask whether it can help to produce results comparable to laparoscopic pyeloplasty. They found that endopyelotomy was not as good in the presence of crossing vessels, despite using endoluminal ultrasonography, and they propose that laparoscopic pyeloplasty should be used in this situation. OBJECTIVETo present the results of endopyelotomy using endoluminal ultrasonography (EUS) to identify crossing vessels, as the success rates of endopyelotomy are generally lower than pyeloplasty, especially in patients with crossing vessels.PATIENTS AND METHODSForty‐one consecutive patients who underwent EUS before a planned retrograde endopyelotomy were analysed retrospectively. EUS was used to direct the endopyelotomy incision for patients with crossing vessels. Treatment was considered successful if the patient was asymptomatic and unobstructed or improved on renography. The results were compared to those from 18 patients treated by laparoscopic pyeloplasty, some of whom had undergone EUS.RESULTSCrossing vessels were identified in 27 of the 41 patients (66%). Primary treatment consisted of endopyelotomy for 26 patients and laparoscopic pyeloplasty for 15. The overall success rate for 24 endopyelotomy patients with an adequate follow‐up (mean 19 months) was 71%, with more success in patients with no crossing vessels (11 of 13 (85%) vs six of 11 (55%)). Of the 18 patients treated by laparoscopic pyeloplasty (mean follow‐up 15.1 months) 17 were successful.CONCLUSIONThe results for endopyelotomy were disappointing in patients with crossing vessels, despite using EUS. The results suggest that patients with crossing vessels should be treated by laparoscopic pyeloplasty. More data are needed to compare endopyelotomy with laparoscopic pyeloplasty in patients with no crossing vessels.
Maternity services for women with diabetes in the UK
Authors: Hawthorne G. , Modder J. 
Published: March 2003

AbstractDiabetic pregnancy is high risk in those regions within the UK that have reported on such an outcome. There is a paucity of information about diabetic pregnancy outcome in the rest of the UK but it seems appropriate to assume that poor outcome is widespread. Previously reports have highlighted problems with the delivery of preconception care and the lack of agreement about the screening and diagnosis of gestational diabetes. The provision of maternity services for women with diabetes in the UK is reviewed. Service development is traced from the 1980s to more recent surveys from Scotland and the former Northern region of England. Service provision has improved over the years in those regions that have agreed and audited standards for provision of care. There is a lack of information about current services within the UK but this will be partly addressed by the forthcoming survey of organization of services co‐ordinated by the Confidential Enquiry into Stillbirths and deaths in Infancy (CESDI), which will survey England, Wales and Northern Ireland. In Scotland the Scottish Intercollegiate Guidelines ‘Management of diabetes in pregnancy’ has been implemented and audited. A similar guideline of agreed standards of care is needed for the rest of the UK.
The GP perspective: problems experienced in providing diabetes care in UK general practice
Authors: Agarwal G. , Pierce M. , Ridout D. ,   Primary Care Diabetes (the Primary Care Section of the British Diabetic Association)
Published: March 2003

AbstractAims To describe the problems and barriers perceived by general practitioners (GPs) whilst providing diabetes care in primary care in England and Wales and to identify those health authorities (HAs) in which primary care reported the most and least difficulty.Design Descriptive postal survey using a self‐administered questionnaire.Subjects One thousand eight hundred and seventy‐three randomly sampled GP practices (one in five practices).Results One thousand three hundred and twenty (70%) responded. Getting patients to alter their lifestyles was perceived as causing the most difficulty in managing individual patients, followed by lack of time, patients’ nonattendance, noncompliance with medical regimens and poor communication with secondary care. The greatest barriers to practices providing desirable care were lack of time/under‐funding and keeping up to date in the area of diabetes, followed by lack of space, inadequate chiropody, dietetics, ophthalmology and access to secondary care. There are important differences between HAs in the difficulties experienced by primary care teams and we have ranked the HAs accordingly.Conclusion The study has identified what problems need tackling in order to assist primary care to deliver good quality diabetes care, and has highlighted HAs where primary care needs further help, and HAs where examples of good practice may be found and useful lessons learnt. This should form the basis of a needs‐based research and development programme for diabetes in primary care.
Type 2 diabetes mellitus, cognitive impairment and dementia
Authors: Stewart R. , Liolitsa D. 
Published: March 2003

Summary Aims We set out to examine the evidence for an association between cognitive impairment or dementia and the presence of Type 2 diabetes mellitus (DM). We also sought evidence of potential mechanisms for such an association. Methods A literature search of three databases was performed and the reference lists of the papers so identified were examined, using English language papers only. Results We found evidence of cross‐sectional and prospective associations between Type 2 DM and cognitive impairment, probably both for memory and executive function. There is also evidence for an elevated risk of both vascular dementia and Alzheimer’s disease in Type 2 DM albeit with strong interaction of other factors such as hypertension, dyslipidaemia and apolipoprotein E phenotype. Both vascular and non‐vascular factors are likely to play a role in dementia in diabetes. Conclusions Current classification structures for dementia may not be adequate in diabetes, where mixed pathogenesis is likely. Further research into the mechanisms of cognitive impairment in Type 2 DM may allow us to challenge the concept of dementia, at least in these patients, as an irremediable disease.Diabet. Med. 16, 93–112 (1999)
Effects of insulin administration in a group of high‐risk, non‐diabetic, first‐degree relatives of Type 1 diabetic patients: an open pilot trial
Authors: Rodríguez‐Villar C. , Conget I. , Casamitjana R. , Ercilla G. , Gomis R. 
Published: March 2003

Summary Aims To elucidate the effect of prophylactic insulin, in a treatment schedule previously demonstrated to achieve β‐cell rest, in a group of high‐risk, non‐diabetic first‐degree relatives of Type 1 diabetic patients. Methods Ten high risk subjects for Type 1 diabetes mellitus (DM) (seven male/three female, aged 19.8 ± 9.6 years) defined as: first‐degree relatives of Type 1 DM patients, islet cell autoantibodies (ICA) ≥20 Juvenile Diabetes Foundation (JDF) units twice, first phase insulin response (FPIR) to glucose in an intravenous glucose tolerance test ≤10th percentile of a control group were included in an open pilot trial. Five were treated with subcutaneous insulin: 0.1 IU/kg body weight/day of neutral protamine hagedorn (NPH) insulin once a day. Five declined treatment and were used as controls. Control and treatment groups did not differ in terms of age, ICA, insulin autoantibodies (IAA), glutamic acid dehydrogenase (GAD) and FPIR. Results Three out of five subjects in both groups developed Type 1 DM during follow‐up: after 21, and 32–57 months in the insulin‐treated group and after 4, and 18–60 months in the untreated group. Three out of six subjects who developed overt diabetes had a FPIR below the 2nd percentile of the control value at the onset of the study. All subjects who developed diabetes were positive for antibodies to GAD and expressed the HLA‐DR3 or DR4 alleles, whereas only one of the nono‐progessors had these parameters (P < 0.05). During follow‐up, a decrease in ICA titres was observed in the group which received prophylactic insulin in contrast with the untreated group. GAD, as well as insulin secretory capacity, remained unchanged in both groups. Conclusion The subcutaneous administration of insulin (0.1 IU/kg body weight/day of NPH insulin once a day) in our group of high‐risk subjects for Type 1 DM produced only a minor effect in some immunological markers (ICA), without preventing the development of overt disease. The efficacy and safety of insulin used at either a different dose or by a different route, as well as its potential effect in the early phases of prediabetes, warrants further investigation.Diabet. Med. 16, 160–163 (1999)
Effect of different times of administration of a single ethanol dose on insulin action, insulin secretion and redox state
Authors: Trojan N. , Pavan P. , Iori E. , Vettore M. , Marescotti M. C. , Macdonald I. A. , Tiengo A. , Pacini G. , Avogaro A. 
Published: March 2003

Summary Aims Ethanol (EtOH) can affect glucose metabolism by altering the redox state, insulin‐mediated glucose uptake and insulin secretion. We sought to determine the effects of an acute oral EtOH load on insulin secretion and glucose tolerance and the importance of a different timing of administration relative to a glucose load. Methods Eleven subjects underwent a frequently sampled intravenous glucose tolerance test (FSIGT) on three occasions in random order. In one, EtOH was given 50 min ‘before’ the FSIGT; on the second, the same amount was administered 6 min after the glucose pulse (‘during’ study); on the third no EtOH was given. Results Blood EtOH peaked at 4.43 ± 0.24 mmol/l (mean ± sd) in the ‘during’ and 4.16 ± 0.31 mmol/l in the ‘before’ study. No differences were noticed in SI, the index of insulin sensitivity, or in SG, the glucose effectiveness, between the ‘before’, ‘during’ and control studies. There were no differences in the first‐phase insulin secretion between the three studies but a significant increase in the sensitivity to glucose of second‐phase dynamic insulin response, Φ2, in the ‘before’ (0.062 ± 0.036 pmol.min–2.(mg–1.dl–1)–1) and ‘during’ (0.063 ± 0.059) studies, compared to the control study (0.017 ± 0.010, P < 0.05) was observed. No differences were observed in the hepatic extraction of insulin. In the ‘before’ study, there was a significant decline in NEFA (non‐esterified fatty acid) concentration from the baseline (mean 602 ± 51 μmol/l) to the 0 min value (mean 353 ± 37, P < 0.01). During the FSIGT, the mean plasma NEFA concentration was significantly lower in the ‘before’ and in the ‘during’ than in the control study. Conclusion An acute oral EtOH load does not impair glucose metabolism, at least in part because of an increased second‐phase insulin secretion. Since this effect is observed irrespective of whether EtOH is consumed either before or during the glucose load, the existence of a priming effect is questioned.Diabet. Med. 16, 400–407 (1999)
The effect of long‐term glycaemic control on serum lipoprotein(a) levels in patients with Type 2 diabetes mellitus
Authors: Song K. ‐H. , Ahn Y. ‐B. , Yoon K. ‐H. , Cha B. ‐Y. , Lee K. ‐W. , Son H. ‐Y. , Kang S. ‐K. 
Published: March 2003

Summary Aims To examine whether long‐term glycaemic control affects lipoprotein(a) (Lp(a)) levels in patients with Type 2 diabetes mellitus. Methods Eighty‐nine Type 2 diabetic patients (38 men, 51 women) were recruited from the diabetes clinic. Based on HbA1c concentrations at baseline, patients were divided into two groups: those with HbA1c <  8.0% (n=  45) and those with HbA1c≥  8.0% (n=  44). Comparisons of Lp(a) levels were made between both groups. The effect of long‐term glycaemic control on Lp(a) levels was investigated in a subgroup of 20 patients, selected from those with baseline HbA1c≥  8%. All these patients were treated with a goal of HbA1c <  7%. Results Lp(a) levels were not significantly different between those with HbA1c <  8.0% and those with HbA1c≥  8.0%. No correlation between Lp(a) and HbA1c or fasting blood glucose levels was noted in diabetic patients as a whole. After 2 years of intensive glycaemic control, all patients exhibited remarkable improvement of therapy: their average HbA1c levels were 6.5 ± 0.7%, being <  7% in 70% of patients. However, no change in Lp(a) levels were observed after 2 years (19.5 ± 14.8–21.4 ± 13.4 mg/dl, P=  0.390). Conclusion These results indicate that improvement of glycaemic control does not affect serum Lp(a) levels in patients with Type 2 diabetes mellitus.
Childhood Type 1 diabetes mellitus and parental occupations involving social mixing and infectious contacts: two population‐based case–control studies
Authors: Fear N. T. , McKinney P. A. , Patterson C. C. , Parslow R. C. , Bodansky H. J. 
Published: March 2003

Summary Aims To test the hypothesis that increased exposure to infections, through parental jobs involving high levels of social mixing, reduces the risk of childhood Type 1 diabetes mellitus. Methods Two population‐based case–control studies of children diagnosed with Type 1 diabetes mellitus from Yorkshire (0–15 years) and Northern Ireland (0–14 years) included 220 and 189 cases and 433 and 465 controls, respectively. Parental occupations were coded using a standard occupational classification. Each job was allocated to high, medium or low levels of social mixing according to a predefined categorization. Odds ratios (OR) for the risk of childhood Type 1 diabetes were estimated for parental social mixing by age at diagnosis. Results Childhood Type 1 diabetes mellitus was not associated with high levels of parental occupational social mixing (Yorkshire – mothers: OR 1.07, 95% confidence interval (CI) 0.76–1.50; fathers: 1.15, 0.75–1.76; Northern Ireland – heads of household, usually the father: 0.78, 0.49–1.25). A larger proportion of mothers (39%) compared to fathers (18% Yorkshire, 17% Northern Ireland) had jobs involving high levels of social mixing. Mothers with high social mixing jobs conferred a nonsignificant reduced risk of Type 1 diabetes among children diagnosed under 5 years of age (0.58, 0.24–1.38) compared to those diagnosed at age 5 years and above (1.14, 0.77–1.69). Conclusions No association between parental occupational social mixing and the risk of childhood Type 1 diabetes mellitus was detected for all ages combined. Mothers were more likely to have jobs involving high levels of social mixing than fathers. The possible protective effect of maternal high occupational social mixing on children diagnosed below 5 years of age merits further investigation.
Clinico‐pathological features of postural hypotension in diabetic autonomic neuropathy
Authors: Khawaja K. I. , Walker D. , Hayat S. A. , Boulton A. J. M. , Malik R. A. 
Published: March 2003

SummaryWe report the clinico‐pathological features and management of a 49‐year‐old male with a 30‐year history of Type 1 diabetes mellitus who had nephropathy (proteinuria 1.81 g/24 h, creatinine 136 μmol/l), proliferative retinopathy and severe somatic and autonomic neuropathy. A sural nerve biopsy demonstrated marked myelinated fibre loss with unmyelinated fibre degeneration and regeneration combined with extensive endoneurial microangiopathy. The management of the patient's blood pressure problems (supine hypertension) and symptomatic postural hypotension is discussed.