bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient's perceptions of biofeedback therapy for obstructive defaecation
Authors: Pager C. K. , Solomon M. J. , Rex J. 
Published: March 2003

ObjectiveThe aim of this study is to assess the long‐term outcomes of a biofeedback treatment programme for obstructive defaecation up to five years after completion of treatment, reporting from the patients' perspective the subsequent progression of defaecation difficulties and the perceived usefulness of the biofeedback training and its components.MethodsA biofeedback program for obstructive defaecation at a major hospital in Sydney provided 37 patients with reading material, taught defaecation techniques, and prescribed simulated defaecation and anal relaxation exercises to practice between their monthly biofeedback sessions. Twenty‐nine of these patients were contacted by telephone an average of 23 months after last attending and asked to rate the present severity of their condition, changes since last attending biofeedback, and which aspects of the program they found most helpful.ResultsOf patients who completed the program, 70% achieved at least a 15% improvement in perceived symptom severity. Those who completed the program and achieved benefit were more likely to name the exercises as the most helpful program component. At the time of follow‐up, however, there was no difference in perceived symptom severity between program completers and noncompleters. Program completers, and those followed up more than two years after last attending biofeedback, were more likely to report a worsening in symptom severity subsequent to their final treatment session.ConclusionsThis study confirms the favourable short‐term outcomes achieved by some patients completing biofeedback treatment for obstructive defaecation. The findings suggest that biofeedback equipment may be economically used in an educative and corrective role, and that other factors such as education, exercises and counselling alone play an important role. Finally, the benefits of biofeedback may not be maintained through long‐term follow‐up, raising questions as to the natural history of the disorder and the long‐term effectiveness of biofeedback treatment.
Intra‐dermal methylene blue, hydrocortisone and lignocaine for chronic, intractable pruritus ani
Authors: Botterill I. D. , Sagar P. M. 
Published: March 2003

ObjectiveTo assess the use of intradermal methylene blue, lignocaine and hydrocortisone in cases of chronic pruritus ani refractory to standard primary, dermatological and colorectal care.MethodsFive ml 1% methylene blue, 100 mg hydrocortisone and 15 ml 1% lignocaine were injected into the peri‐anal skin of 25 patients with chronic pruritus ani which had proved refractory to standard care. Clinical and telephone follow‐up was undertaken.ResultsAfter one injection of the above solution, 16 (64%) of patients were rendered symptom free. Repeat injection in those initial nonresponders ultimately rendered 22 (88%) symptom free overall. Morbidity was 4%. Treatment failure occurred in three patients (12%).ConclusionsMethylene blue used in solution with hydrocortisone and lignocaine can achieve effective control of pruritus ani in 88% of patients who have failed to respond to standard dermatological, hygiene and surgical treatments.
Factors associated with nocturnal hypoglycaemia among patients with type 2 diabetes new to insulin therapy: experience with insulin lispro
Authors: Bastyr E. J. , Huang Y. , Brunelle R. L. , Vignati L. , Cox .D. J. , Kotsanos J. G. 
Published: March 2003

SummaryAim: To identify factors associated with nocturnal hypoglycaemia in patients with type 2 diabetes who were new (< 2 months therapy) to insulin therapy.Methods: A randomised, multicentre, 12‐month parallel open‐label study compared the clinical safety and efficacy of insulin lispro with regular human insulin. A cohort of North American patients completed a health‐related quality of life (HRQOL) questionnaire which included questions related to the Health Beliefs Model (HBM). Measurements of hypoglycaemia rate and short‐and long‐term glucose control assessed clinical safety and efficacy. Three hundred and sixty‐five type 2 diabetic patients were enrolled in the study, and 195 North American patients completed the HRQOL questionnaire.Results: After adjustment for demographic and psychological factors, the study population demonstrated lower nocturnal hypoglycaemia risk with insulin lispro. Higher nocturnal hypoglycaemia risk was associated with reduced body mass index (b.m.i.), lower age, and basal ultralente insulin therapy. The associated hypoglycaemia risk was lower with increased alcohol consumption. Patients who completed the HRQOL survey demonstrated higher risk for nocturnal hypoglycaemia if they: (1) had more troublesome hyperglycaemia symptoms in the week before starting insulin; (2) were more confident in their ability to control their diabetes; or (3) thought that diabetes control did not offer a clear health benefit. Nocturnal hypoglycaemia risk was inversely associated with fear of hypoglycaemia.Conclusions: Type 2 diabetic patients new to insulin therapy demonstrated lower risk of nocturnal hypoglycaemia with insulin lispro. Practitioners should consider patient characteristics and psychological factors that may predispose type 2 diabetes patients to nocturnal hypoglycaemia when initiating insulin therapy.
Preliminary study of oral polylactide microcapsulated insulin in vitro and in vivo
Authors: Ma X. Y. , Pan G. M. , Lu Z. , Hu J. S. , Bei J. Z. , Jia J. H. , Wang S. G. 
Published: March 2003

Summary Aim: Although the oral route for insulin delivery is the most convenient, directly administered oral insulin is degraded by proteolytic enzymes in the gastrointestinal (GI) tract. Polylactide was prepared in order to microcapsulate the insulin to avoid the enzymes in the GI. The physical characteristics and therapeutic possibilities of polylactide microcapsulated insulin (PLA‐MCI) were studied in vivo and in vitro. Methods: PLA‐MCI was prepared by the two‐step method of emulsion and solvent extraction. Its morphologic character was observed by scanning electron microscopy (SEM). The insulin release profile was determined in vitro by insulin measurement and in vivo by blood glucose measurement after the force‐feeding of 66 diabetic rats. Results: When the microcapsule was spherical in shape (diameter 1.5–2.0μm) the entrapment efficiency of insulin was 90% and the loading rate was 10% (W/W). The PLA‐MCI (which contained 3.0 units of insulin/mg of PLA) had peak release rates of 65–74% over 6–8 h in phosphate buffer. The same dose of PLA‐MCI (insulin 2.5 mg) led to decreased responses (from 28% to 68% of control blood glucose levels) in the level of blood glucose in 32 rats which had not fasted after they had been force‐fed. When 1.2, 1.8, 2.2 and 3.0 mg of insulin + PLA‐MCI was administered to eight diabetic rats, their blood glucose levels decreased by 28%, 36%, 54% and 78%, respectively. Conclusions: PLA microcapsules are capable of protecting insulin from degradation by the proteolytic enzymes in the GI and of alleviating hyperglycaemia for a prolonged period of time in diabetic rats. It may therefore be considered as a new carrier for oral insulin.
Clinical evaluation of pioglitazone in patients with type 2 diabetes using α‐glucosidase inhibitor and examination of its efficacy profile
Authors: Hayashi Y. , Miyachi N. , Takeuchi T. , Takeuchi Y. , Kamiya F. , Kato T. , Imaeda K. , Okayama N. , Shimizu M. , Itoh M. 
Published: March 2003

Aim: Pioglitazone is considered to reduce insulin resistance. This study was conducted to evaluate the efficacy, safety and clinical profile of pioglitazone in patients whose type 2 diabetes were poorly controlled with α‐glucosidase inhibitor alone or α‐glucosidase in combination with sulfonylurea.Methods: Twenty patients with type 2 diabetes were treated with pioglitazone (30 mg q.d.) orally for 16 weeks.Results: There were significant reductions in HbA1C, FPG and postprandial plasma glucose at week 16. As adverse events, oedema, hypoglycaemia‐like reaction, increases in LDH, CPK, etc. were noted. There was no significant change in TNF‐α. Leptin levels increased significantly at week 16 and were still increasing 4 weeks after the treatment. Per cent body fat was almost constant throughout the study period. When efficacy was classified by demographic variables, pioglitazone was found to be more effective in the subjects who had a higher postprandial 2‐h plasma glucose level, leptin level or per cent body fat value.Conclusion: Pioglitazone was considered to be effective when used in patients whose type 2 diabetes were poorly controlled with α‐glucosidase inhibitor alone or α‐glucosidase in combination with sulfonylurea.
The comparative morphology of the larynx in snakes
Authors: Young Bruce A. 
Published: March 2003

AbstractYoung, B.A. 2000. The comparative morphology of the larynx in snakes. —Acta Zoologica(Stockholm)81: 177–193The larynx and glottal tube were examined in 10 specimens each of 22 snake species. Qualitative analysis through dissection and clearing and staining revealed distinct morphological variation in the cartilage and intrinsic musculature of the larynx. Quantitative analysis of nine morphometric characters revealed laryngeal sexual dimorphism in three species, significant interspecific differences in the coefficients for every morphometric feature regressed on body size, no significant intraspecific differences in the log transformed means, and poor discrimination of species using principal component analysis. The observed variations in laryngeal morphology did not correlate with the phylogeny of the species, or with habitat preferences.
Ultrastructure of the seminal receptacle and the dimorphic sperm in the commensal bivalve Mysella bidentata (Veneroida; Galeommatoidea; Montacutidae)
Authors: Jespersen Åse , Lützen Jørgen 
Published: March 2003

Abstract Jespersen, Å. and Lützen, J. 2001. Ultrastructure of the seminal receptacle and the dimorphic sperm in the commensal bivalve Mysella bidentata (Veneroida: Galeommatoidea: Montacutidae). —Acta Zoologica (Stockholm) 82: 107–115The seminal receptacle and the euspermatozoa and paraspermatozoa of Mysella bidentata were examined at an ultrastructural level and the results were compared with earlier findings of the same and other species of the Montacutidae. The euspermatozoon has a slender 13 µm long nucleus and a 1.1 µm long bullet‐shaped acrosome. The acrosome of the paraspermatozoon is almost identical in ultrastructure to that of the euspermatozoa but is longer (1.9 µm) and more slender and is bent at an angle to the diminutive nucleus (1.1 µm long). The unpaired seminal receptacle is lined by a heavily ciliated epithelium and a non‐ciliated epithelium with short and broad microvilli. Euspermatozoa only are stored in the receptacle. They are densely packed and orientated with their heads towards the non‐ciliated epithelium. In this position they develop numerous extremely fine microvilli from the acrosome which apparently serve to attach them to the epithelial microvillar surface. Stored sperm may presumably remain functional for at least six months. A possible function of paraspermatozoa could be to clump sperm into sperm bags to keep them in suspension.
Structure of the ovaries in larvae and mature females of euholognathan stoneflies (Plecoptera)
Authors: Rościszewska Elżbieta 
Published: March 2003

AbstractThe morphology of ovaries, oviducts and egg capsules in four species of euholognathan stoneflies was investigated. The characteristic features found were as follows: (i) numerous, long ovarioles, that open individually to the extensively folded, lateral oviducts; (ii) a thin, morphologically undifferentiated chorion; (iii) a thick gelatinous layer (extrachorion) which acts as an adhesive layer fixing the eggs to the substrate. Additionally, in the larval ovariole of Leuctra sp. the terminal filament anlage and clusters of germ cells have been found. These observations are in agreement with the classification of stonefly ovaries as primary (true) panoistic.
Microscopic structure of the sperm storage tubules in the polygynandrous alpine accentor, Prunella collaris (Aves)
Authors: Chiba Akira , Nakamura Masahiko 
Published: March 2003

AbstractWe describe the microscopic structure of the sperm storage tubules (SSTs) of the polygynandrous alpine accentor, Prunella collaris. The SSTs were found at the utero‐vaginal junction of the oviduct and were composed of a single layer of columnar epithelium. The cells of the tubule proper were non‐ciliated and had a round or oval nucleus in their basal portion. Their cytoplasm was finely or coarsely vacuolated due to lipid inclusions. Under the electron microscope, the epithelial cells exhibited a number of mitochondria, Golgi bodies, occasional lysosome‐like dense bodies, granular endoplasmic reticula, junctional complex, and tonofilaments. The apical margin of the cells was fringed with numerous microvilli. The epithelial lining of the SSTs was devoid of mucous cells, but showed occasional infiltration of lymphoid cells. No contractile elements were found in association with the SSTs, but a close apposition of unmyelinated nerve fibres to the basal part of the SST cells was recognized. Intraluminal sperm were arranged in bundles, and their heads were orientated towards the distal portion of the SSTs. Evidence for engulfment of sperm by the SST cells was obtained for the first time. A sign of atrophy or regression of the SSTs was found in one specimen.
Polymorphism in the sperm ultrastructure among four species of lizards in the genusTupinambis(Squamata: Teiidae)
Authors: Tavares‐Bastos L. , Teixeira R. D. , Colli G. R. , Báo S. N. 
Published: March 2003

AbstractWe describe, for the first time, the ultrastructure of the spermatozoa of four species of the genusTupinambis(Squamata, Teiidae). We identified seven polymorphic characters within this genus: the presence and shape of the perforatorial base plate, the presence of the epinuclear lucent zone, the presence of a unilateral ridge in the acrosome, the presence of a central density within the proximal centriole, the number of mitochondria and dense‐bodies sets, and the shape of mitochondria. We analysed the evolution of the seven polymorphic characters by mapping them onto a current phylogeny of the species ofTupinambis, using the teiidsAmeiva ameivaandCnemidophorus sexlineatusas outgroups. Our results indicate that sperm ultrastucture characters, although of great value for phylogeny at higher taxonomic levels in reptiles and other groups, are poor predictors of phylogeny when considering the species ofTupinambisstudied here. We failed to identify evidences that homoplasy in sperm ultrastructure among the species ofTupinambisis due to convergent adaptation, suggesting that the polymorphism may be selectively neutral in this group.
A new interpretation of the female genitalia in Macrocyclops albidus (Copepoda, Cyclopidae)
Authors: Defaye D. , Cuoc C. , Barthélémy R.‐M. 
Published: March 2003

AbstractThe female genital structures of Macrocyclops albidus (Cyclopidae, Eucyclopinae) were studied using light and electron microscopy. The results confirm that the exterior genital area shows only a copulatory pore, located anteromedially on the ventral face of the genital double‐somite, and paired gonopores (not directly visible), situated laterally under the P6 plates. An internal seminal receptacle, composed of several parts, is connected to the gonopores by ventro‐lateral cuticular extensions or seminal ducts. The lateral site of communication shows a complex set of connections between the seminal receptacle and the oviducts (via the egg‐laying ducts). The structure until now designated as ‘transverse ducts’, visible by transparency on the ventral face, is in fact constituted of internal cuticular thickenings resulting of the fusion of the 6th thoracic somite and the 1st abdominal somite forming the genital double‐somite and appearing externally as a part of the suture line; the term ‘suture cord’ is proposed to designate it. The functioning of the system is explained.
The surgical results of the pubovaginal sling procedure using polypropylene mesh for stress urinary incontinence
Authors: Kuo H.‐C. 
Published: March 2003

Objective To investigate the surgical results after a pubovaginal sling procedure using polypropylene mesh in women with stress urinary incontinence (SUI). Patients and methods Sixty‐four women with different types of SUI underwent a pubovaginal sling procedure, using polypropylene mesh. The sling was placed at the level of the proximal half of the urethra and tied with adequate tension, but not obstructing the bladder outlet. A video‐urodynamic study and transrectal ultrasonography were undertaken before and after surgery. The surgical results were assessed and the urodynamic changes compared at different stages. Results At a median follow‐up of 24 months, 52 patients (81%) were completely continent, 10 (16%) had an improvement but with mild SUI, and two had persistent SUI requiring a second sling procedure. The treatment result was considered satisfactory by 55 patients (86%). The video‐urodynamic study showed no significant change in voiding pressure, cystometric capacity and residual urine volume after surgery. The bladder neck opening time was increased at 7 days and the maximum flow rate increased at 3 months after surgery. Transrectal ultrasonography showed that all the polypropylene mesh slings were located beneath the bladder neck and proximal urethra, with no notable granuloma formation around the sling. Conclusion The pubovaginal sling procedure is effective in treating female SUI, using polypropylene mesh as the sling material. The video‐urodynamic results showed that a pubovaginal sling of polypropylene mesh causes no bladder outlet obstruction when the correct surgical technique is used.
Laparoscopic Palomo varicocelectomy in the adolescent is safe after previous ipsilateral inguinal surgery
Authors: Barqawi A. , Furness P. , Koyle M. 
Published: March 2003

Objective To evaluate the outcome of laparoscopic Palomo varicocelectomy (LPV) in young boys who had undergone previous ipsilateral inguinal surgery (in whom potentially the arterial supply to the testicles may be compromised) in an attempt to assess its safety for the collateral vascular supply in such cases. Patients and methods Over a 5‐year period (1995–2000) 44 patients underwent LPV, where both the spermatic artery and vein were ligated high above the internal ring. Thirteen patients had undergone previous ipsilateral inguinal surgery, which included inguinal hernia repairs in five, orchidopexy in two, communicating hydrocele repair in three and previous varicocele repair in three. All patients were followed clinically at 3 months and 1 year after surgery. Results There were no complications related to laparoscopy or varicocele ligation. No patient developed ipsilateral testicular atrophy; moreover the testis size remained stable or was associated with compensatory growth in all patients. Conclusion Previous inguinal surgery involving the ipsilateral testicle does not appear to affect the collateral blood circulation to the affected testis in boys who undergo LPV mass ligation of the internal spermatic vein and artery. LPV for varicocele is safe in boys who have undergone previous inguinal surgery, suggesting that an adequate collateral blood supply is present.
The relationship of circulating insulin‐like growth factor 1, its binding protein‐3, prostate‐specific antigen and C‐reactive protein with disease stage in prostate cancer
Authors: Latif Z. , McMillan D.C. , Wallace A.M. , Sattar N. , Mir K. , Jones G. , Underwood M.A. 
Published: March 2003

Objective To assess the relationships among circulating insulin‐like growth factor‐1 (IGF‐1), IGF binding protein‐3 (IGFBP‐3), prostate‐specific antigen (PSA) and C‐reactive protein (an indicator of inflammatory systemic response) in patients with prostate disease and cancer of different stages. Patients and methods Circulating IGF‐1, IGFBP‐3, PSA and C‐reactive protein concentrations were measured in patients with BPH (17) or stages T1/T2 (15), T3/T4 (16) and metastatic prostate cancer (12 patients). Results IGF‐1 and IGFBP‐3 concentrations were similar between patients with BPH and those with cancer, and there was no difference between the groups with cancer. In the latter patients there was a significant correlation between age and IGFBP‐3 concentrations (r = − 0.400, P = 0.008) but not with IGF‐1 concentrations. Controlling for age, there were significant partial correlations between C‐reactive protein and IGF‐1 (r = − 0.412, P = 0.008) and IGFBP‐3 (r = − 0.277, P = 0.05). Conclusions These results indicate that circulating IGF‐1 and IGFBP‐3 concentrations do not change with disease stage in prostate cancer, but that they decrease with an increase in the systemic inflammatory response.
Serendipity in detecting disease in low prostate‐specific antigen ranges
Authors: Vis A.N. , Kranse R. , Roobol M. , Van Der Kwast Th.H. , Schröder F.H. 
Published: March 2003

Objective To assess the magnitude of prostate cancer detection by serendipity (the coincidental detection of prostate cancer during the evaluation of an abnormal screening test result) when a digital rectal examination (DRE) and transrectal ultrasonography (TRUS) are used as initial screening tests for prostate cancer in men with low levels of prostate‐specific antigen (PSA; 0.0–3.9 ng/mL). Patients and methods In all, 117 participants of a population‐based screening study were diagnosed with prostate cancer after a standard evaluation of an abnormal screening test result; 49 underwent radical prostatectomy. Serendipity was defined as either: (i) the presence of prostate cancer opposite to the side that raised suspicion for cancer on DRE and/or TRUS; (ii) a negative lesion‐directed biopsy while cancer was present in one or more of the cores of the sextant biopsy; (iii) a tumour volume of < 0.5 mL on radical prostatectomy. Results Depending on the definition, 27–63% of prostate cancers detected at low PSA values were detected coincidentally and not as a result of a true‐positive test result. The proportion of cancers detected by serendipity was inversely correlated with serum PSA level. Conclusion A relatively high proportion of prostate cancers diagnosed in men with low PSA levels, and in which a biopsy was prompted by a suspicious DRE and/or TRUS, are considered to be detected by chance only. As these cancers are mostly small (< 0.5 mL), with potentially low biological aggressiveness, relying on serendipity seems disadvantageous in prostate‐cancer screening. The level of serendipity in prostate cancer detection, the poor performance of the screening test, and high inter‐observer variability, casts further doubt on the utility of DRE (and TRUS) as initial screening tests for prostate cancer in population‐based screening.