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  • 1
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 91 (1984), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. A malodorous, homogeneous, grey, thin and non-purulent discharge, which resembles non-specific vaginitis occurs in 20% of women with an intrauterine contraceptive device (IUCD); four times more common than in non-users. The aim of this investigation was to study the bacteriological aetiology of this ITJCD-associated vaginal discharge, and to assess whether the infection was ascendent. No specific microbiological aetiology was found, but the normal, Lactobacillus-dommated microbial vaginal flora was replaced by Gardnerella vaginalis and certain anaerobic species in IUCD-users with the discharge. Clue cells, pepper-salt phenomenon and curved rods and/or fusiform-shaped rods demonstrated by microscopy, were typical of symptomatic patients. The endometrium and the IUCD were infected with these species in the symptomatic group more often than in IUCD-users who had no symptoms or in the control women who did not use the IUCD.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1520-5835
    Source: ACS Legacy Archives
    Topics: Chemistry and Pharmacology , Physics
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Annals of the New York Academy of Sciences 442 (1985), S. 0 
    ISSN: 1749-6632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Natural Sciences in General
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    International journal of colorectal disease 4 (1989), S. 244-246 
    ISSN: 1432-1262
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Three adult women with previously unoperated vulvar anus underwent surgical treatment for faecal incontinence which developed in adulthood. The obvious cause of incontinence in these patients was the weakening of pelvic floor musculature by aging and pregnancy. Two of the patients had several associated anomalies. The anus was transposed to the normal perineal position through the well-developed external sphincter found posterior to the vulvar anus. Faecal continence improved markedly in all patients.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    International journal of colorectal disease 3 (1988), S. 1-16 
    ISSN: 1432-1262
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    International journal of colorectal disease 10 (1995), S. 10-14 
    ISSN: 1432-1262
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Afin d'étudier les effets à long terme de la procto-colectomie avec rétablissement de la continuité par une poche en J en cas de colite ulcéro-hémorragique, 100 patients consécutifs ont été examinés en moyenne à 5,6 ans après l'anastomose iléo-anale. Avant l'intervention chirurgicale, 73% des patients étaient soumis à un traitement aux stéroïdes et 22% avaient présenté une poussée aiguë de colite. Le taux global de complications précoces et tardives est respectivement de 40 et 33%. Le taux d'échec était de 5% et la totalité des échecs ayant nécessité une excision de la poche sont survenus au cours des trois premières années post-opératoires. La pouchite (36%) constitute la complication tardive la plus fréquente. Une poussée aiguë de colite avant la chirurgie représente un important signe pronostique d'un risque de complications anastomotiques tardives, d'incontinence, voire d'échec thérapeutique. La fréquence quotidienne des selles varie de 4,5 à 6,9. Après une période d'apprentissage de la continence, la situation se normalise et une incontinence mineure est observée chez 57% des patients. La majorité des patients (72%) était soit très satisfaite, soit n'avait aucun problème dans leurs activités quotidiennes. Dix patients étaient mécontents après la chirurgie pour des raisons médicales de manière évidente dans la plupart des cas.
    Notes: Abstract To study the long-term effects of restorative proctocolectomy with J-pouch for ulcerative colitis 100 consecutive patients were examined a mean of 5.6 years after ileal pouch-anal anastomosis (IPAA). Seventythree percent of patients were on steroids and 22% had a preceding severe attack of colitis before IPAA. The overall early and late complication rates were 40% and 33%, respectively. Failure rate was 5% and all failures requiring pouch excision occurred within the first three post-operative years. Pouchitis (36%) was the commonest late complication. A preceding severe attack of colitis was an important prognostic sign of late anastomotic complications, troublesome incontinence and ultimate failure. The daily mean stool frequency varied from 4.5 to 6.9. After a short learning period continence — stabilised and minor incontinence was common (57%). The majority of patients (72%) were either very satisfied or had no problems in daily activities after IPAA. Ten patients were dissatisfied after surgery due to obvious medical reasons in most of them.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1432-0428
    Keywords: Adipose tissue lipoprotein lipase ; insulin ; glucose ; insulin sensitivity ; lipoproteins
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In order to assess the short-term effects of hyperinsulinaemia and hyperglycaemia on adipose tissue lipoprotein lipase activity and on serum lipoproteins, we measured these variables in ten normal subjects during euglycaemic and hyperglycaemic hyperinsulinaemic clamps. The mean steady-state plasma glucose and insulin concentrations, respectively, were 4.7 mmol/l and 101 mU/l during euglycaemic moderate-insulin clamp, 4.9 mmol/l and 565 mU/l during euglycaemic high-insulin clamp, and 8.8 mmol/l and 148 mU/l during hyperglycaemic clamp. Saline infusion was used as control. The adipose tissue lipoprotein lipase activity rose significantly over 5 h during high-insulin clamp (p〈0.01) and during hyperglycaemic clamp (p〈0.05), but did not change during the moderate-insulin clamp. The magnitude of change of lipoprotein lipase activity from baseline (either rise or fall) was inversely related to the preclamp activity during euglycaemic moderate-insulin clamp (r= -0.67), during hyperglycaemic clamp (r= -0.68) and during infusion of saline (r= -0.75, p〈0.05). Total serum triglyceride concentration decreased significantly during all clamp studies compared with the control experiment. This change was mainly accounted for by a decrease of VLDL triglyceride. The LDL cholesterol level fell by an average of 5% (p〈0.05) during the high-insulin clamp and by 10% (p〈0.05) during the hyperglycaemic clamp. The HDL cholesterol level did not change significantly. It is concluded that adipose tissue lipoprotein lipase activity in man is increased by physiological insulin levels during hyperglycaemia and also by supraphysiological insulin levels during euglycaemia, but is not influenced by physiological hyperinsulinaemia without hyperglycaemia. Low basal lipoprotein lipase activity is more sensitive to insulin-glucose stimulation than primarily high lipoprotein lipase activity. Acute hyperinsulinaemia decreases VLDL triglyceride and LDL cholesterol concentrations.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1432-0428
    Keywords: Triglycerides ; gemfibrozil ; insulin resistance ; Type 2 (non-insulin-dependent) diabetes mellitus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Hypertriglyceridaemia and insulin resistance are closely associated but it is unknown whether hypertriglyceridaemia per se contributes to insulin resistance. In the present study we examined whether gemfibrozil, by lowering triglyceride levels, improves the glucoregulatory and antilipolytic action of insulin in Type 2 (non-insulin-dependent) diabetes mellitus. Twenty patients were randomly allocated to receive either placebo or gemfibrozil 1200 mg daily for 12 weeks in a double-blind study. Very low density lipoprotein triglyceride levels decreased in the gemfibrozil group by 42±12% (p〈0.01). Gemfibrozil had no effect on the diurnal concentration of non-esterified fatty acids (NEFA). At the randomization HbA1c levels were comparable (7.6±0.3 vs 7.8±0.2%, NS) and increased slightly both in the gemfibrozil (8.2±0.4%, p〈0.05) and placebo groups (8.0±0.3%, NS). Pre- and post-treatment diurnal glucose and insulin concentrations remained unchanged. Basal pre- and post-treatment hepatic glucose production rates were comparable in both groups and similarly suppressed by insulin. Rate of whole body glucose disposal during a low-dose insulin infusion (serum insulin ∼90 pmol/l) (pre- vs post-gemfibrozil 11.9±1.1 vs 11.1±0.7, pre- vs post-placebo 9.9±1.1 vs 10.8±0.8 μmol·kg−1·min−1, NS for both) and a high-dose insulin infusion (serum insulin ∼500 pmol/l) (16.2+-1.7 vs 17.7±2.7, 17.1±4.2 vs 17.4±2.9 μmol·kg−1·min−1, respectively, NS for both) remained unchanged. Basal pre- and post-treatment NEFA turnover rates were comparable in both groups and similarly suppressed by insulin. Also rates of total lipid oxidation, plasma NEFA oxidation and non-oxidative NEFA metabolism remained unchanged in both groups. We conclude that gemfibrozil effectively lowers serum triglycerides but has no effect on insulin sensitivity of glucose and NEFA metabolism. The data suggest that hypertriglyceridaemia is a consequence rather than a cause of insulin resistance in Type 2 diabetic patients.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1432-0428
    Keywords: Insulin sensitivity ; obesity ; fat ; non-insulin-dependent diabetes mellitus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Insulin is known to increase expression of the ob gene product leptin in adipose tissue of rodents. We determined whether insulin increases circulating leptin concentrations in humans, and whether this effect might be altered in patients with non-insulin-dependent diabetes mellitus (NIDDM). Plasma leptin concentrations were determined during an 8.5-h hyperinsulinaemic clamp (serum free insulin approximately 480 pmol/l) and during an 8.5-h infusion of physiological NaCl solution (saline) in eight normal subjects (age 51±3 years, BMI 26.3±0.6 kg/ m2, fasting plasma glucose 5.6±0.2 mmol/l) and seven patients with NIDDM (age 54±2 years, 27.0±0.9 kg/m2, 11.1±0.8 mmol/l). Fasting serum insulin level correlated with plasma leptin (r=0.72, p〈0.005), even after adjusting for the percentage of body fat (p〈0.005). During the insulin infusion, a significant increase in the plasma leptin concentration was observed after 6 h (37±14%; 5.2±0.8 vs 3.9±0.6 ng/ml, 6 vs 0 h, p〈0.05) in the normal subjects and after 8.5 h (38±11%; 7.1±1.0 vs 5.5±0.9 ng/ml, 8.5 vs 0 h, p〈0.05) in the patients with NIDDM. During the saline infusion, plasma leptin concentrations decreased significantly in the normal subjects by 11±1% (p〈0.005) and in the patients with NIDDM by 14±1% (p〈0.01) after 2 h. During the infusion of insulin as compared to saline, plasma leptin concentrations were 32±13 (p〈0.05), 53±14 (p〈0.001), 106±15 (p〈0.001) and 165±21 (p〈0.001)% higher at 2, 4, 6 and 8.5 h in the normal subjects, and 11±9 (p〈0.05), 27±10 (p〈0.05), 58±7 (p〈0.001) and 106±13 (p〈0.001)% higher in the patients with NIDDM, respectively. No differences were observed in plasma leptin concentrations between the normal subjects and patients with NIDDM, under any conditions. We conclude that prolonged exposure to insulin increases plasma leptin concentrations in humans implying a role for insulin in chronic but not acute regulation of plasma leptin concentrations. The decrease in plasma leptin concentrations during saline infusion was greater than that expected on the basis of change in serum insulin concentrations, suggesting that factors other than insulin also contribute to regulation of plasma leptin concentrations.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1432-0428
    Keywords: Keywords Hexosamines ; insulin ; glucose ; diabetes mellitus.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Glutamine:fructose 6-phosphate amidotransferase (GFA) is rate-limiting for hexosamine biosynthesis, while a UDP-GlcNAc β-N-acetylglucosaminyltransferase (O-GlcNAc transferase) catalyses final O-linked attachment of GlcNAc to serine and threonine residues on intracellular proteins. Increased activity of the hexosamine pathway is a putative mediator of glucose-induced insulin resistance but the mechanisms are unclear. We determined whether O-GlcNAc transferase is found in insulin-sensitive tissues and compared its activity to that of GFA in rat tissues. We also determined whether non-insulin-dependent diabetes mellitus (NIDDM) or acute hyperinsulinaemia alters O-GlcNAc transferase activity in human skeletal muscle. O-GlcNAc transferase was measured using 3H-UDP-GlcNAc and a synthetic cationic peptide substrate containing serine and threonine residues, and GFA was determined by measuring a fluorescent derivative of GlcN6P by HPLC. O-GlcNAc transferase activities were 2–4 fold higher in skeletal muscles and the heart than in the liver, which had the lowest activity, while GFA activity was 14–36-fold higher in submandibular gland and 5–18 fold higher in the liver than in skeletal muscles or the heart. In patients with NIDDM (n = 11), basal O-GlcNAc transferase in skeletal muscle averaged 3.8 ± 0.3 nmol/mg · min, which was not different from that in normal subjects (3.3 ± 0.4 nmol/mg · min). A 180-min intravenous insulin infusion (40 mU/m2· min) did not change muscle O-GlcNAc transferase activity in either group. We conclude that O-GlcNAc transferase is widely distributed in insulin-sensitive tissues in the rat and is also found in human skeletal muscle. These findings suggest the possibility that O-linked glycosylation of intracellular proteins is involved in mediating glucose toxicity. O-GlcNAc transferase does not, however, appear to be regulated by either NIDDM or acute hyperinsulinaemia, suggesting that mass action effects determine the extent of O-linked glycosylation under hyperglycaemic conditions. [Diabetologia (1997) 40: 76–81]
    Type of Medium: Electronic Resource
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