bluuebunny/crossref_metadata_2025_split huggingface dataset:
Randomized clinical trial of non-mesh versus mesh repair of primary inguinal hernia
Authors: Vrijland W W , van den Tol M P , Luijendijk R W , Hop W C J , Busschbach J J V , de Lange D C D , van Geldere D , Rottier A B , Vegt P A , IJzermans J N M , Jeekel J 
Published: March 2003

Abstract

Background
The optimum method for inguinal hernia repair has not yet been determined. The recurrence rate for non-mesh methods varies between 0·2 and 33 per cent. The value of tension-free repair with prosthetic mesh remains to be confirmed. The aim of this study was to compare mesh and non-mesh suture repair of primary inguinal hernias with respect to clinical outcome, quality of life and cost in a multicentre randomized trial in general hospitals.

Methods
Between September 1993 and January 1996, all patients scheduled for repair of a unilateral primary inguinal hernia were randomized to non-mesh or mesh repair. The patients were followed up at 1 week and at 1, 6, 12, 18, 24 and 36 months. Clinical outcome, quality of life and costs were registered.

Results
Three hundred patients were randomized of whom 11 were excluded. Three-year recurrence rates differed significantly: 7 per cent for non-mesh repair (n = 143) and 1 per cent for mesh repair (n = 146) (P = 0·009). There were no differences in clinical variables, quality of life and costs.

Conclusion
Mesh repair of primary inguinal hernia repair is superior to non-mesh repair with regard to hernia recurrence and is cost-effective. Postoperative complications, pain and quality of life did not differ between groups.
Engineered nonphosphorylating glyceraldehyde 3‐phosphate dehydrogenase at position 268 binds hydroxylamine and hydrazine as acyl acceptors
Authors: Marchal Stéphane , Branlant Guy 
Published: March 2003

Nonphosphorylating nicotinamide adenine dinucleotide (phosphate)‐dependent aldehyde dehydrogenases (ALDHs) catalyze the oxidation of aldehydes into either nonactivated acids or CoA‐activated acids. The NADP‐dependent nonphosphorylating glyceraldehyde 3‐phosphate dehydrogenase (GAPN) belongs to the first subclass. It catalyzes the irreversible oxidation of glyceraldehyde 3‐phosphate into 3‐phosphoglycerate via a two step mechanism in which deacylation is rate‐limiting. Recent studies on GAPN from Streptococcus mutans have shown that residue Glu268 plays an essential role only in the deacylation step [Marchal, S., Rahuel‐Clermont, S. & Branlant, G. (2000) Biochemistry39, 3327–3335]. The substitution of Glu268 by alanine or glutamine leads to mutants in which the attacking water molecule involved in the hydrolytic process is poorly activated. Activity can be restored by the presence of hydroxylamine and hydrazine. Neutral and protonated forms of both nucleophiles are recognized by the deacylating subsite of both mutants. pH rate profiles of deacylation show pKa values of 6.3 and 8.1 with hydroxylamine and hydrazine, respectively, which are those of the nucleophiles in solution. The increase in enzymatic rate is probably due to a high local concentration and not to a change of the chemical reactivity of both nucleophiles upon their binding within the active site of both mutants. The deacylation subsite of the wild‐type also binds hydroxylamine and hydrazine but as inhibitors of the hydrolytic process and not as acyl acceptors.Altogether, the results point out the crucial role of the carboxyl group of Glu268 in preventing nucleophiles, other than water, from binding as efficient acyl acceptors. This may also explain why CoA‐dependent ALDHs never possesses a glutamate residue at position 268.
Structural studies on the O‐polysaccharide of the lipopolysaccharide produced by Citrobacter rodentium (ATCC 51459)
Authors: MacLean Leann L. , Perry Malcolm B. 
Published: March 2003

Citrobacter rodentium is the etiologic agent of transmissible murine colonic hyperplasia (TMCH) and is the only Citrobacter species known to posses virulence factors homologous to human enteropathogenic and enterohemorrhagic Escherichia coli. Members of this species are considered clonal and represent the only known attaching and effacing bacterial pathogen of mice and thus provides a useful animal model for studying the molecular basis of attaching and effacing pathology. The lipopolysaccharide (LPS) produced by C. rodentium has not been previously studied or its possible role as a virulence factor determined. The structure of the LPS has been undertaken as a first step in an investigation of its possible role in pathogenesis.The structure of C. rodentium (ATCC 51459, prototype TMCH isolate, original biotype 4280, previously designated DBS 100) LPS was determined from composition and methylation analyses, mass spectrometry, and two‐dimensional nuclear magnetic resonance spectroscopy. The antigenic O‐polysaccharide was found to be a high molecular mass branched polymer of repeating pentasaccharide units composed of 2‐acetamido‐2‐deoxy‐d‐glucose (d‐GlcNAc), d‐glucose (d‐Glc), and l‐rhamnose (l‐Rha) in the molar ratio 2 : 2 : 1 linked through phosphate, and has the structure:
Cardiac adaptation to intensive training in prepubertal swimmers
Authors: Triposkiadis F. , Ghiokas S. , Skoularigis I. , Kotsakis A. , Giannakoulis I. , Thanopoulos V. 
Published: March 2003

Abstract Background  Despite the increasing involvement of child athletes in intensive training regimens, little is known about the influence of such training on autonomic regulation and cardiac structure and function.Patients and methods  Twenty‐five highly trained (12–14 h weekly for at least 4 years) swimmers (aged 11·9 ± 1·6 years; 15 males, 10 females) and 20 non‐training normal children who served as controls (aged 11·3 ± 0·6 years; 14 males, 6 females) were studied. Heart rate variability analysis in the time and frequency domains was performed on 15 min resting heart rate acquisitions. Left ventricular morphology and systolic function was studied with two‐dimensional guided M‐mode echocardiography. The transmitral flow velocity profile was assessed with pulsed Doppler. Parameters measured included the peak early (E) and peak late (A) transmitral flow velocity and their ratio (E/A). Left atrial (LA) volumes were determined at mitral valve (MV) opening (maximal, Vmax), at onset of atrial systole (P wave of the ECG, Vp), and at MV closure (minimal, Vmin) from the apical 2‐ and 4‐chamber views, using the biplane area‐length method. LA systolic function was assessed with the LA active emptying volume (ACTEV) = Vp‐Vmin and the LA active emptying fraction (ACTEF) = ACTEV/Vp.Results  Average NN (967·1 ± 141·8 vs. 768·4 ± 85·6 ms, P < 0·0001), logSDNN (1·89 ± 0·14 vs. 1·80 ± 0·17 ms, P < 0·05), logPNN 50% (1·66 ± 0·23 vs. 1·46 ± 0·35, p < 0·05), and logHF power (3·13 ± 0·32 vs. 2·95 ± 0·26 ms2, p < 0·05) were greater in swimmers than in controls. Left ventricular end‐diastolic diameter was greater (32·3 ± 3·3 vs. 29·5 ± 3·3 mm m−2, P < 0·02) in swimmers than in controls, whereas the left ventricular septal (5·9 ± 1 vs. 5·6 ± 0·8 mm m−2, P = NS) and posterior wall thickness (5·7 ± 0·9 vs. 5·4 ± 0·8 mm m−2, P = NS) were similar in the two groups. The E/A ratio was greater (2·2 ± 0·49 vs. 1·78 ± 0·36, P < 0·003) whereas the A velocity was lower (0·41 ± 0·09 vs. 0·50 ± 0·13 m s−1, P ≤ 0·02) in swimmers than in controls. Vmax was greater (18·6 ± 4·8 vs. 14·9 ± 5·3 cm m−2, P < 0·03), whereas ACTEF was lower (36 ± 12% vs. 44·2 ± 12%, P < 0·04) in swimmers than in controls.Conclusion  Cardiac adaptation to intensive training in prepubertal swimmers includes vagal predominance, a mild increase in left ventricular dimensions without significant changes in septal or posterior wall thickness, and increased LA size associated with depressed LA systolic function. Evaluation of LA size and systolic function may contribute to a better understanding of the characteristics of the ‘athlete’s heart’ in children and to the differential diagnosis between left ventricular adaptive and pathologic changes.
An evaluation of the effects of high‐dose fexofenadine on the central nervous system: a double‐blind, placebo‐controlled study in healthy volunteers
Authors: Hindmarch I. , Shamsi Z. , Kimber S. 
Published: March 2003

Background As regards central nervous system (CNS) effects there are three types of antihistamines. Those that cross the blood‐brain barrier and cause widespread impairment of cognitive and psychomotor function; those that cross into the brain and, although without much impairment at low clinical doses, have a dose‐related relationship to impairment; and those that do not cross into the brain and therefore possess no intrinsic potential for impairing CNS function.Objecitve To investigate the acute effects of fexofenadine (360 mg) on various aspects of cognitive and psychomotor function in comparison to placebo and promethazine (positive internal control), an antihistamine known to produce psychomotor and cognitive impairment.Methods Fifteen healthy volunteers received fexofenadine 360 mg, promethazine 30 mg and placebo in a 3‐way cross‐over, double‐blind study. For each treatment condition, subjects were required to perform a series of tests of cognitive function and psychomotor performance at baseline and 1, 3, 5 and 7 h post‐dose. The test battery consisted of critical flicker fusion (CFF), choice reaction time (CRT), compensatory tracking task (CTT) and a subjective assessment of sedation (LARS).Results Fexofenadine was not distinguishable from placebo in any of the objective and subjective tests for up to seven hours following drug administration. However, all measures were significantly impaired following the administration of promethazine, which confirms the sensitivity of the test battery for sedation. The effects of fexofenadine and placebo were not significantly different from one another, whereas promethazine caused an overall reduction in CFF thresholds when compared to placebo (P < 0.05). There was an overall significant increase (impairment) in recognition, motor and total reaction time (P < 0.05), and both the tracking accuracy and reaction time aspects of CTT were significantly impaired (P < 0.05) following the administration of promethazine. In contrast, the effects of fexofenadine could not be distinguished from the placebo condition. Subjective ratings of sedation were significantly higher with promethazine when compared to placebo (P < 0.05) and fexofenadine (P < 0.05).Conclusions Fexofenadine at a dose of 360 mg is demonstrably free from disruptive effects on aspects of psychomotor and cognitive function in a study where the psychometric assessments have been shown to be sensitive to impairment, as evidenced by the effects of the verum control promethazine 30 mg. The identification of an antihistamine (fexofenadine) devoid of central effects even at supra‐clinical doses separates it from currently available first and second generation drugs with no objective evidence of CNS side‐effects on cognition and psychomotor function, and highlights the need for the introduction of a third generation of non‐sedative antihistamines.
Increased nasal mucosal swelling in subjects with asthma
Authors: Hellgren J. , Torén K. , Balder B. , Palmqvist M. , Löwhagen O. , Karlsson G. 
Published: March 2003

Objective The objective of this study was to evaluate nasal mucosal swelling with acoustic rhinometry in subjects with asthma and in healthy controls.Methods We examined 184 individuals with asthma and compared with 156 randomly selected controls outside the pollen season, where 144 subjects in the asthma group and 80 controls had a previous history of non‐infectious rhinitis (NIR). Nasal mucosal swelling was assessed with acoustic rhinometry before and after nasal decongestion with oxymetazoline and was analysed for the cross‐sectional area (4 cm from the nostril) and the volume between 3.3 and 4 cm from the nostril. Symptom scores for nasal blockage, secretion, itching and sneezing were assessed on a 0–10 visual analogue scale as well as peak nasal inspiratory flow and spirometry.Results Before decongestion there was a decrease in the cross‐sectional area at 4 cm (1.32 cm2 vs. 1.59 cm2, mean left + right P = 0.04) and in the volume (1.70 vs. 1.91 cm3P = 0.03) in the asthma group compared with healthy controls. After decongestion there were no significant differences in cross‐sectional area at 4 cm (1.66 vs. 1.73 cm2P = 0.32) or volume (2.12 vs. 2.24 cm3P = 0.32). Combined nasal symptom scores were higher in the asthma group (1.8 vs. 0.8, P = 0.0001) and peak nasal inspiratory flow was lower (119 vs. 124 L/min, P = 0.38) than the healthy controls. FEV1 (% predicted) was also lower in asthma group (84 vs. 93%P < 0.0001).Conclusion We have been able to demonstrate an increased nasal mucosal swelling in a population sample of persons with asthma compared to healthy controls. These data support previous reports of a generalized airway inflammation in patients with asthma and suggest that acoustic rhinometry can be used to monitor the nasal mucosal swelling in these patients.
Factors affecting black rhino monitoring in Masai Mara National Reserve, Kenya
Authors: Walpole Matthew J. 
Published: March 2003

AbstractThe black rhino in Africa is slowly recovering from poaching. This has been achieved in part by maintaining ongoing monitoring as part of intensive protection and biological management. However, the efficacy of population monitoring methods has not been assessed. Rhino surveillance records and rainfall data were used to determine which ecological and operational factors affected monthly rhino sightings by vehicle patrols in Masai Mara, Kenya. Comparisons of sightings capture rates using different ground‐based and aerial methods were also conducted. Stepwise multiple regression revealed a model (adjustedR2 = 0.66) predicting monthly rhino sightings with four significant factors; number of patrols, rhino population size, rainfall over the previous 2 months and a dummy variable for the month of August. The latter two variables represent the negative effects of long grass growth and the annual wildebeest migration on rhino sightings, and result in seasonal deficiencies in monitoring. During vehicle patrols, 51% of sightings were made whilst moving, and 49% were made whilst stationary and scanning with binoculars, although sightings capture rate was an order of magnitude higher when stationary. Equally, sightings capture rate from hot air balloons was twice that during vehicle‐based patrols, although with less accuracy of identification. The introduction of foot patrols would increase patrol cost‐effectiveness and fill seasonal troughs, thereby providing better all‐round surveillance.
Profile of patients with lower back pain in Dr Saiful Anwar Hospital, Malang, Indonesia
Authors: Djais Nursamsu , Kalim Handono 
Published: March 2003

Abstract Aim: To determine the profile of patients with lower back pain (LBP). Methods: A retrospective study was carried out on patients who presented to Dr Saiful Anwar Hospital (a referral hospital), Malang, Indonesia, from January to December 2000. Results: During the 1‐year period of the study, 456 patients with LBP presented at the Dr Saiful Anwar Hospital. There were 206 female patients (45.2%) with an average age of 46 ± 14.1 years (range: 17–86 years) and 250 male patients (54.8%) with an average age of 45 ± 13.9 years (range: 17–82 years). There were 219 patients affected under the age of 45 years (48%). The educational background of cases was 77 (16.4%) with an academic education, 142 (31.1%) with senior high school, 66 (14.5%) with junior high school, 82 (18%) with elementary school and 89 (19.5%) with an unknown educational background. Conclusions: Lower back pain was more frequent in men than in women. There were no differences statistically in the prevalence of LBP according to age group, sex and educational level.
A case of recurrent parotid swelling, syncope, arthritis and nephrotic syndrome
Authors: Thong Bernard Yu‐Hor , Lau Tang‐Ching , Chong Pek‐Yoon , Chew Stephen Tec‐Huan , Tan Puay‐Hoon 
Published: March 2003

AbstractThe differential diagnoses and histopathological findings of a case of recurrent parotid swelling, syncope, arthritis and nephrotic syndrome will be discussed. Primary Sjögren's syndrome is rarely associated with granulomatous inflammation, panniculitis and systemic amyloidosis. Multi‐organ failure, in particular cardiac amyloidosis, is potentially fatal.
State of the art: Juvenile idiopathic arthritis
Authors: Manners Prudence J. 
Published: March 2003

AbstractJuvenile idiopathic arthritis (JIA) is the most common of the autoimmune musculoskeletal conditions in children. As awareness of this condition increases, so too does the apparent prevalence reported from countries around the world, suggesting that significant numbers of children with JIA have previously gone undiagnosed. Prevalence varies with race and possibly geography. However, JIA should no longer be considered as a rare condition.In the past decade, there have been definite advances in understanding the pathogenesis of JIA, and there have been parallel advances in therapies. There have been fairly modest advances in the classification of JIA, but there is at least heightened international debate on the issue, which will lead to progress. It is estimated that nearly one‐third of children with this condition continue into adult life with inflammatory joint disease, and therefore the burden of disease remains significant.
Implications of geitonogamous pollination for floral longevity in Iris gracilipes
Authors: Ishii H. S. , Sakai S. 
Published: March 2003

Summary

We analysed the longevity of individual flowers with respect to the effects of the floral display size of a plant (number of flowers open at one time) and spatial arrangement of flowers in Iris gracilipes (A. Gray). We found that the actual floral longevity of this species (about 2 days) was much shorter than that predicted by the model of Schoen and Ashman (about 7–10 days).
A large display size and an overlap of flowering periods within a shoot facilitated successive pollinator probes within a plant, though the frequency of pollinator visits per flower was independent of display size. Consequently, the cost of geitonogamous selfing increased with an increase in display size and an overlap of flowering periods within a shoot. The short floral longevity of this species would be effective in such situations because shorter floral longevity leads to a smaller display size and a smaller overlap of flowering periods within a shoot.
A small display size and small overlap of flowering periods within a shoot could also be realized by the strategy that staggers the flowering period of each flower without floral longevity being shortened (extended blooming). However, a mutant plant with an extended blooming schedule would be unlikely to invade the population because of the stabilizing selection pressure on the flowering date. This may be why such a short floral longevity, rather than extended blooming, has evolved in this species.
Why do flowers of a hummingbird‐pollinated mistletoe face down?
Authors: TADEY M. , AIZEN M. A. 
Published: March 2003

Summary

Pendant flowers are common among hummingbird‐pollinated plants. A downward orientation of the flower or inflorescence could represent an adaptation to avoid either flower flooding or direct pollen losses from anthers or stigmas under rainy conditions.
We studied the adaptive significance of this trait experimentally in Tristerix corymbosus Kuijt (Loranthaceae), a mistletoe native to the temperate forests of southern South America. We applied three treatments: (i) natural pendant inflorescences; (ii) inflorescences tethered to face up; and (iii) inflorescences tethered to face down (as a control for tethering). We also considered natural exposure to rain as a second factor.
The treatments did not differ significantly in either nectar volume or concentration. Flowers exposed to rain for most of their lives contained more diluted nectar than those that remained dry, but this result did not depend on either inflorescence or flower orientation.
We found significantly fewer pollen tubes in styles of flowers from inflorescences tethered to face up than in flowers receiving the other two treatments, but this could not be attributed to a direct effect of rain exposure. Inflorescence orientation did not affect either the number of pollen grains left in anthers or seed set. No strong evidence was found for differential visitation by hummingbirds in relation to a flower’s angle.
The results of this work support neither the flower‐flooding nor the pollen‐protection hypothesis. However, a flower’s orientation may affect the extent of within‐flower self‐pollination or the efficiency of pollen transfer from a hummingbird’s bill onto a flower’s stigma.
Pulsatile, nyctohemeral and entropic characteristics of GH secretion in adult GH‐deficient patients: selectively decreased pulsatile release and increased secretory disorderliness with preservation of diurnal timing and gender distinctions
Authors: Roelfsema Ferdinand , Biermasz Nienke R. , Veldhuis Johannes D. 
Published: March 2003

Summaryintroduction The present clinical investigation uses a high‐precision GH immunofluorometric assay to examine the postulate that principally the amplitude mode of GH secretory control is disrupted in adults with GH deficiency.patients and methods To this end, we investigated GH secretory dynamics in a cohort of 19 adult GH‐deficient (GHD) patients and 19 age‐, gender‐ and body mass index‐matched controls. GHD was established by blunted (< 7 mU/l) GH release during insulin‐induced hypoglycaemia. Twenty‐four‐hour serum GH concentration profiles obtained by 10‐min sampling were analysed by deconvolution, cosinor analysis and approximate entropy to appraise pulsatile, diurnally rhythmic, and pattern‐dependent GH secretion, respectively.results Deconvolution analysis revealed that pulsatile GH release was decreased by threefold, due to amplitude‐specific damping, detectable GH secretory burst frequency was paradoxically increased by twofold, but basal non‐pulsatile GH release was fully preserved. GH half‐life in patients and controls was similar, thus excluding major kinetic differences. The acrophase (time of maximum) of the 24‐h GH rhythm was unchanged. The regularity of the GH release process, as measured by ApEn, was decreased profoundly in GHD patients (P < 10−8). The changes in GH secretion were similar in irradiated and nonirradiated patients. Daily GH secretion was also comparable in male and female GHD patients, but plasma IGF‐I concentrations were higher in male than female patients (P = 0·031). Furthermore, the gender‐specific GH ApEn difference, evident in controls, was still demonstrable in patients (P = 0·017). The ratio of plasma IGF‐I and pulsatile GH production was increased threefold in patients (P = 0·004), pointing to increased sensitivity to GH in GH deficiency and/or non‐GH‐dependent IGF‐I production.conclusions The present detailed analyses of daily GH secretory dynamics in patients with (moderate) GH deficiency document an amplitude‐specific decrease in pulsatile GH secretion, which is partly compensated for by increased GH pulse frequency. The remarkably disorderly patterns of GH secretion in patients identify other major alterations in GH neuroregulation in such individuals, reflecting withdrawal of expected GH and/or IGF‐I repression of pulsatile GH secretion. Preservation of the nyctohemeral timing of GH release and the gender contrast in GH ApEn in GHD patients would also be consistent with partial retention of central neuroregulation and GH/IGF‐I feedback‐dependent control in hypopituitary subjects.