bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictive Genetic Screening and Clinical Findings in Multiple Endocrine Neoplasia Type I Families
Authors: Kopp Ina , Bartsch Detlef , Wild Anja , Schilling Thomas , Nies Christoph , Bergenfelz Anders , Rieder Harald , Simon Babette , Rothmund Matthias 
Published: October 2003

Abstract.Germline mutations of the MEN1 gene have been identified as the causative genetic defect of multiple endocrine neoplasia type I (MEN‐I), an autosomal dominantly inherited condition. To establish the basis for predictive family screening we evaluated the spectrum of MEN1 gene mutations in MEN‐I patients treated at our institution. Relatives at risk were subjected to predictive genetic screening after genetic counseling. Gene carriers were subjected to extensive clinical screening for MEN‐I, including biochemical tests for basal hormone concentrations in blood and urine, a standardized meal stimulation test and imaging procedures (ultrasonography, computed tomography, magnetic resonance imaging). Among index patients of 15 independent MEN‐I kindreds, 14 heterozygous MEN1 germline mutations were identified by single‐strand conformational variant analysis (SSCV) and direct DNA sequence analysis. Of 51 individuals at risk, 26 predictively tested relatives with the wild‐type MEN1 gene could be excluded from further screening procedures because they had not inherited the disease. In all previously presumed unaffected relatives with the mutant gene, our extensive clinical screening program revealed at least one manifestation of MEN‐I. Furthermore, 22 additional diagnoses could be established in identified MEN‐I patients. We show that mutation analysis enables predictive genetic screening for MEN‐I families, providing a valuable tool for genetic counseling and clinical management. An extensive clinical screening program focusing on genetically proven individuals at risk allows detection of MEN‐I manifestations at an early, asymptomatic stage of the disease. Controlled, prospective studies are now required to prove whether timely appropriate treatment on the basis of predictive screening might help improve disease‐related quality of life and prolong life expectancy in MEN‐I kindreds.
Comparative NMR studies of diffusional water permeability of red blood cells from different species: XIV. Little Penguin, Eudyptula minor
Authors: Benga G.H. , Chapman B.E. , Cox G.C. , Kuchel P.W. 
Published: October 2003

AbstractAs part of a programme of comparative measurements of diffusional water permeability (Pd) the red blood cells (RBC) from Little Penguin (Eudyptula minor) were studied. The cell dimensions were measured with light and electron microscopy, and by a newly described non‐invasive technique, NMR q‐space analysis. In view of its relative novelty for cell biologists, an overview of this technique is presented. The RBC revealed an ellipsoidal shape that is characteristic of avian RBC, with axis lengths (“diameters”) estimated to be: a=16.0 μm; b=9.6 μm; c=5.0 μm. The values of Pdwere: 2.0×10−3cm s−1at 5 °C, 3.3×10−3cm s−1at 10 °C, 4.6×10−3cm s−1at 15 °C and ∼5.4×10−3cm s−1at 20, 25, 30, 37 and 42 °C.There was a lack of inhibition of water permeability by p‐chloromercuribenzensulfonate (PCMBS), the well‐known inhibitor of RBC aquaporin. It was notable that in the temperature range 5–20 °C the NMR parameters, and hence the permeability, varied linearly as is found for other species, but at temperatures higher than 20 °C there was no temperature‐dependence of Pd.Consequently, there was an obvious break at ∼20 °C in the Arrhenius plot, of the mean residence life time of water inside the cells, 1/Te, versus temperature. For temperatures less than 20 °C the activation energy Ea,dwas 45.6±6.6 kJ/mol. For temperatures higher than 25 °C Ea,dwas zero. The lack of inhibition of water permeability by PCMBS and the very high value of Ea,dfor diffusive water exchange suggests that the water permeation occurs primarily via the membrane bilayer per se, i.e., there is no aquaporin in Little Penguin RBC. The discontinuity at ∼20 °C in the Arrhenius plot is an interesting finding, not seen before in other species, and we suggest that it reflects a phase transition in the membrane lipids.
Syndecan‐2 expression enhances adhesion and proliferation of stably transfected Swiss 3T3 cells
Authors: Villena Joan , Berndt Christine , Granés Francesc , Reina Manuel , Vilaró Senén 
Published: October 2003

AbstractSyndecans (heparan sulfate proteoglycans) participate in cell—cell and cell—matrix adhesion and are co‐ and low‐affinity receptors for growth factors and enzymes, respectively. We examined the influence of stable syndecan‐2 expression in Swiss 3T3 cells on cell‐adhesion and proliferation. Higher syndecan‐2 expression changed cell morphology and increased spreading and adhesion in these cells and proliferation induced by FCS and FGF‐2. This emphasizes the role of syndecan‐2 in the integration of signals from soluble and insoluble factors.
An empirical analysis of financial services processes with a front‐office or back‐office orientation
Authors: Safizadeh M.Hossein , Field Joy M , Ritzman Larry P 
Published: October 2003

AbstractIn a departure from most other empirical studies of service organizations, this study employs a lower‐level unit of analysis and explores service processes with front‐office or back‐office orientations. Moreover, unlike past studies, no front‐office process has a corresponding back‐office process in our sample. The analysis of unrelated front‐office and back‐office processes offers a more rigorous examination of the customer contact model. The findings by and large support the premise of this model for breaking up the activities involved in a service delivery process. Our most surprising finding relates to the levers for achieving outstanding performance. The best performers among the processes with a front‐office orientation emphasize capital investment, while the best performers among those with a back‐office orientation embrace higher degrees of labor intensity. It appears that in order to achieve its superior performance, each process type adopts an additional design characteristic commonly attributed to the opposite process type.
Synthesis and absorption markers of cholesterol in serum and lipoproteins during a large dose of statin treatment
Authors: Miettinen T. A. , Gylling H. 
Published: October 2003

AbstractBackground  Serum contains noncholesterol sterols, which are reliable markers of cholesterol metabolism, but their presence and importance in different lipoproteins have been insufficiently studied.Materials and methods  Serum and lipoprotein cholesterol precursors squalene, cholestenol, desmosterol and lathosterol (markers of cholesterol synthesis) and cholestanol and plant sterols (markers of cholesterol absorption), and absorption efficacy and absolute synthesis of cholesterol were studied at baseline and during 6‐month atorvastatin (80 mg day−1) treatment by the sterol balance technique in men with type 2 diabetes.Results  At baseline, approximately 14% of serum squalene was transported by VLDL, 12% by IDL, 40% by LDL and 30% by HDL. The respective values for the noncholesterol sterols were approximately 8, 4, 61 and 26%. The squalene to cholesterol ratios were highest in VLDL and IDL, those of cholestenol, desmosterol and absorption marker sterols were gradually higher, and that of lathosterol lower from VLDL to HDL. Atorvastatin reduced LDL cholesterol by approximately 50%, decreased the absolute cholesterol synthesis and turnover by approximately 40%, but increased significantly the fractional and mass absorption of cholesterol. In accordance with the fecal data, the ratios of the precursor sterols to cholesterol were reduced (−50%), but those of squalene (+48%) and the absorption sterols increased (e.g. 2·6‐fold for sitosterol) similarly in each lipoprotein, but progressively from VLDL to HDL.Conclusions  Effective lowering of LDL cholesterol by large dose of statin is associated with decreased synthesis and turnover of cholesterol and increased fractional and mass absorption of cholesterol. These changes are detectable by noncholesterol sterols in serum and in different lipoprotein fractions.
Inhibition of intracellular tumour necrosis factor (TNF)‐α and interleukin (IL)‐6 production in human monocytes by iloprost
Authors: Czeslick E. G. , Simm A. , Grond S. , Silber R.‐E. , Sablotzki A. 
Published: October 2003

AbstractBackground  To investigate the effects of iloprost as a stable prostacyclin analogue on intracellular expression of IL‐6 and TNF‐α of lipopolysaccharide (LPS)‐stimulated human monocytes in a whole blood system assessed by flow cytometry.Material and methods  Whole blood of six healthy volunteers processed immediately after withdrawal and twice on different days (six measurements per experiment) was stimulated in two different settings with LPS (final concentrations 0·2 ng mL−1 and 10 ng mL−1) and incubated with iloprost (final concentrations in each experiment were 0·01 nm, 0·1 nm, 0·3 nm, 1 nm, 3 nm, 10 nm, 30 nm and 100 nm) for 3 h at 37 °C and 5% CO2. Intracellular expression of IL‐6 and TNF‐α was assessed by flow cytometry.Results  Our investigations showed, for the first time, that iloprost (0·1 nm up to 100 nm) caused a dose‐dependent inhibitory effect of IL‐6 production in human monocytes stimulated with LPS (10 ng mL−1), which was even more obvious in monocytes stimulated with lower concentrated LPS (0·2 ng mL−1). Iloprost (0·1 nm up to 100 nm) was found to inhibit TNF‐α production of LPS‐stimulated monocytes in a dose‐dependent fashion not influenced by LPS concentration.Conclusions  Apart from the vasodilatory and antithrombotic effects, iloprost may also down‐regulate the intracellular expression of IL‐6 and TNF‐α in human monocytes.
Prognostic value of interleukin‐6, plasma viscosity, fibrinogen, von Willebrand factor, tissue factor and vascular endothelial growth factor levels in congestive heart failure
Authors: Chin B. S. P. , Blann A. D. , Gibbs C. R. , Chung N. A. Y. , Conway D. G. , Lip G. Y. H. 
Published: October 2003

AbstractBackground  Congestive heart failure (CHF) carries a poor prognosis with a high mortality rate, frequent hospitalizations and increased risk of thrombotic complications such as stroke. Cytokines may contribute to the progression and prothrombotic state of CHF, including the pro‐inflammatory interleukin‐6 (IL‐6) and the pro‐angiogenic vascular endothelial growth factor (VEGF), both of which are raised in CHF. The procoagulant properties of both cytokines may be mediated via tissue factor (TF), a potent clotting activator. We hypothesized that plasma levels of these markers, as well as levels of plasma viscosity, fibrinogen, soluble P‐selectin and von Willebrand factor (markers of abnormal rheology, clotting, platelet activation, and endothelial damage, respectively) will be useful in predicting morbidity and mortality in chronic stable CHF.Methods and results  One hundred and twenty consecutive out‐patients with chronic stable CHF (92 males; mean [SD] age 64 [11] years, mean [SD] left ventricular ejection fraction of 29 [6]%) were recruited and followed for 2 years during which 42 patients reached a clinical end‐point of all‐cause mortality and cardiovascular hospitalizations, including stroke and myocardial infarction. Plasma IL‐6 (P = 0·003) and TF (P = 0·013) levels, but not other research indices, were higher in those who suffered events compared with those without events. Predictors of end‐points were high (≥ median) TF (P = 0·011), and IL‐6 (P = 0·023) levels, as well as the lowest quartile of a left ventricular ejection fraction (P = 0·007). A strong correlation was present between TF and IL‐6 levels (r = 0·59; P < 0·0001) and with VEGF levels (r = 0·43; P < 0·0001).Conclusion  IL‐6 and TF are predictors of poor prognosis in chronic CHF, raising the hypothesis that IL‐6 may contribute to the progression and thrombotic complications of CHF via its actions on TF expression. Although VEGF did not independently predict outcome in chronic CHF, the possibility arises that it may act with IL‐6 to induce TF expression.
Aortic stiffness and carotid intima‐media thickness: two independent markers of subclinical vascular damage in young adults?
Authors: Oren A. , Vos L. E. , Uiterwaal C. S. P. M. , Grobbee D. E. , Bots M. L. 
Published: October 2003

AbstractBackground  Previous reports have shown that carotid intima‐media thickness (CIMT) and arterial stiffness are strong predictors of subsequent cardiovascular disease (CVD) morbidity and mortality, and are well related to an unfavourable cardiovascular risk profile in middle‐aged and older subjects. These similarities suggest that arterial stiffness may play a role in the development of atherosclerosis or vice versa. However, studies show conflicting results and are limited to elderly subjects. To study this issue further, we evaluated the relation of arterial stiffness to subclinical atherosclerosis in 524 healthy young adults, aged 27–30 years.Methods and Results  Aortic stiffness was assessed using pulse wave velocity (PWV) and CIMT was used as measure of subclinical atherosclerosis. The positive crude correlation between for mean arterial pressure adjusted PWV and CIMT (Pearson's correlation coefficient: 0·11; P = 0·016) attenuated after adjustment for common determinants of both measurements like gender and age (partial correlation coefficient: 0·03; P = 0·512). Furthermore, multivariate linear regression models showed that male gender, age and blood pressure were independent determinants of both CIMT and PWV while body mass index and LDL‐cholesterol were independent determinants of CIMT only.Conclusions  These observations suggest that in healthy young adults arterial stiffness and CIMT reflect two separate entities of vascular damage.
Significant dominance of fibrinogen over immunoglobulins, C‐reactive protein, cholesterol and triglycerides in maintaining increased red blood cell adhesiveness/aggregation in the peripheral venous blood: a model in hypercholesterolaemic patients
Authors: Schechner V. , Shapira I. , Berliner S. , Comaneshter D. , Hershcovici T. , Orlin J. , Zeltser D. , Rozenblat M. , Lachmi K. , Hirsch M. , Beigel Y. 
Published: October 2003

AbstractBackground  It is not clear what is the relative importance of fibrinogen, immunoglobulins, highly sensitive C‐reactive protein (hs‐CRP), cholesterol and triglyceride concentrations on the appearance of aggregated red blood cells in the peripheral blood.Design  Six hypercholesterolaemic patients undergoing regular LDL apheresis that were examined repeatedly before and following the procedure.Results  We determined the degree of erythrocyte adhesiveness/aggregation in relation to the concentration of the above‐mentioned macromolecules in 80 samples. In a linear logistic regression the respective R2 values for fibrinogen, total cholesterol, triglycerides, hs‐CRP, IgG, IgM and IgA were 0·45 (P < 0·0001), 0·2 (P < 0·0001), 0·02 (P = 0·02), 0·001 (P = NS) and 0·002 (P = NS), respectively. We further analyzed the potential of ApoA, ApoB and Lpa to participate in red cell adhesiveness/aggregation and found them to be not significant.Conclusions  In a milieu of adhesive macromolecules, lipids and inflammation‐sensitive proteins including fibrinogen, total cholesterol, triglycerides, hs‐CRP and immunoglobins G, M and A, fibrinogen has a dominant role in maintaining the red blood cell adhesiveness/aggregation in the peripheral venous blood. These findings are relevant for the research directed at finding new apheretic modalities to reduce the degree of red blood cell adhesiveness/aggregation in the peripheral blood.
Adventures in the origin of modern operative laparoscopy
Authors: Clarke H. Courtenay 
Published: October 2003

ABSTRACTObjective  Development of instruments and methods for surgery through small incisions, which allowed indigent patients to leave hospital early, in Port of Spain, Trinidad.Methods  At the State University of New York at Buffalo, these methods and instruments were combined with laparoscopy to open this era of modern operative laparoscopy.Interventions  Frenzy of marketing for the highest profit margin; useless and dangerous technology; ravishing of patents; surgeon adventurers for fame and fortune; clip, cut and burn surgery; complications, and laparoscopic surgery at the point of disrepute.Results  Regulation; criteria; cost‐effectiveness; suturing and tying; training; fewer complications; application to most organs and cavities of the body, and acceptance of minimal access surgery.
Temporary ovarian suspension
Authors: Trehan A. K. 
Published: October 2003

ABSTRACTBackground  Following the division of adhesions, ovarian cystectomys, and/or the excision or coagulation of endometriosis, pelvic pain may continue because of re‐formation of adhesions between the posterior surface of the ovary and the ovarian fossa. Various methods of adhesion prevention, such as the use of Interceed, Intergel or heparinized saline etc., have proved unsuccessful. Temporary ovarian suspension is a simple technique of suspending the ovary, for 5–7days, by attachment to the anterior abdominal wall. This allows separation of the raw area on the ovary and the ovarian fossa until surface epithelialization has occurred. When the suture is removed, the ovary falls back to its anatomical position.Objective  To describe and discuss this simple technique of suspending the ovaries.Intervention  The anterior abdominal wall is transilluminated with the laporoscope to demonstrate any major blood vessels, especially the inferior epigastric vessels. The junction of the lateral one‐quarter and the medial three‐quarters, approximately 1 inch above the inguinal ligament is the site on the anterior abdominal wall used for ovarian suspension. Non‐absorbable number 0 Prolene on a straight needle is used for suturing. The needle is pushed into the abdominal cavity at the abovementioned site; it picks up the ovary and comes out of the abdominal wall at the same site. The thread is tied on the anterior abdominal wall, with appropriate adjustment of the tension. The stitch is covered with a transparent dressing which is left in position until the day of removal of the stitch.
Transcervical resection of the endometrium and myometrium: a review of 111 patients after 6 years
Authors: Lupton Martin , Coltart T. 
Published: October 2003

ABSTRACTObjective  To determine the medium‐ to long‐term amenorrhoea rate and patient satisfaction following transcervical resection of both the endometrium and inner myometrium (TCREM).Design  A prospective audit of 111 patients.Subjects  111 patients referred with menorrhagia, and concomitant dysmenorrhoea in 74% of cases.Setting  Queen Charlotte's and Chelsea Hospital for Women, London.Methods  Data relating to patient history, operational details, subsequent bleeding and pain, satisfaction and complications, were obtained from a pro forma, case notes and an annual questionnaire with a menstrual calendar. The patients were followed up for six full years.Results  103 women (93%) completed the audit. By the sixth year of follow up 78% of the women were satisfied with the result of their TCREM, 64% being amenorrhoeic.Conclusion  Resection of both the endometrium and inner myometrium appears to offer an improved amenorrhoea rate compared with resection of the endometrium alone. Patient satisfaction is high and there was no apparent increase in morbidity. This applied to women with both menorrhagia and dysmenorrhoea.
Laparoscopic management of cystic adnexal masses
Authors: Mettler Liselotte , Schollmyer Thoralf , Doshi Praful , Lehmann‐Willenbrock Enrique , Hohn Andre , Moharram Ahmed E. 
Published: October 2003

ABSTRACTObjective  To analyse all laparoscopic treatment of cystic adnexal tumours in the period 1998–2000.Design  Retrospective evaluation of surgical procedures (Canadian Task Force classification III).Setting  University department of obstetrics and gynaecology.Patients  427 patients with cystic adnexal masses.Interventions  141 patients underwent an adnectomy/ovariectomy and 286 an ovariectomy, ovarian cyst enucleation or biopsy by operative laparoscopy.Results  Laparoscopic treatment was possible in 97% of patients with adnexal masses. In 10 patients (2.3%) a conversion to laparotomy was necessary.Conclusions  After careful evaluation, most cases of adnexal mass can be managed laparoscopically. The risk of missing a malignancy is very low. Proper attention to techniques and training reduces complications and the risk of spillage.
Laparoscopy or laparotomy in the management of benign adnexal cysts in premenopausal women
Authors: Badawy A. M. , Allakkany N. S. , El‐Gohary A. S. , Youssef H. M. , Nazar M. 
Published: October 2003

ABSTRACTObjective  To compare the outcome of laparoscopy and laparotomy in the management, in premenopausal women, of adnexal cysts which were not suspected to be malignant.Patients and methods  In a prospective study, 98 premenopausal patients requiring surgical management for adnexal cystic swellings were assigned to receive laparoscopy (n = 48), or laparotomy (n = 50), at Mansoura University Hospital between April 1997 and July 2001. Inclusion criteria were the presence of adnexal cysts, not suspected to be malignant, with a maximum diameter ≤15 cm by ultrasonography, in non‐pregnant women, aged ≤40 years. Statistical analysis included the t test and the χ2 test.Results  There were no differences in patient characteristics between the two groups including the size of adnexal cysts, adnexal adhesion score or the frequency of bilateral disease. All the cysts were benign. Endometriotic cyst, dermoid cyst and ovarian cystademoma were the most common disorders in the two groups. Cystectomy was performed in the majority of cases (87.5% of laparoscopies and 70% of laparotomies). The laparoscopic approach was associated with significantly less operative morbidity and postoperative analgesic requirement, and shorter hospital stay and recovery period. The percentage of patients who achieved pregnancy was higher after laparoscopy than after laparotomy. There was no adverse effect caused by the spillage of cyst contents during laparoscopic open cystectomy.Conclusions  Operative laparoscopy could replace laparotomy in the management of premenopausal adnexal cysts which are not suspected to be malignant.
Postmenopausal bleeding: management by transvaginal ultrasound scan or outpatient hysteroscopy?
Authors: Böttcher Bettina , Brown Valerie A. 
Published: October 2003

ABSTRACTObjective  The aim of this study was to determine whether transvaginal ultrasound scan or outpatient hysteroscopy represents a more efficient way to investigate postmenopausal bleeding.Design  This was a retrospective study by case note review of women with postmenopausal bleeding (PMB), investigated in clinic A by transvaginal ultrasound scan (TVS) and endometrial biopsy, and in clinic B by outpatient hysteroscopy, between April and October 2000. Women on hormone replacement therapy were excluded.Setting  Two teaching hospital gynaecological units in one city.Results  During the study period 166 women were referred to the clinics; case notes for 10 patients were missing; 84 patients underwent TVS, and 72 outpatient hysteroscopy. The number of visits was significantly lower in the hysteroscopy group, with 13.8% of women making two or more visits compared with 44% in the TVS group (P = 0.01). Of the women investigated by hysteroscopy, 72.2% were discharged after the first visit compared with 61.9% in the TVS group (P ≤ 0.01). Therefore the time from first visit to clinic to clinical diagnosis was significantly shorter after hysteroscopy, with a mean of 2.3 days compared with 8.8 days in the TVS group (P ≤ 0.01). Fewer investigations were required in the hysteroscopy group, with seven women (9.7%) needing more than two investigations compared with 24 (28.6%) in the TVS group. TVS identified other pelvic pathology in five women (6%).Conclusions  Hysteroscopy appears more efficient than TVS for the investigation of postmenopausal bleeding. This results in fewer clinic visits and investigations, a reduction in waiting time for patients and possibly less wasting of resources.