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PubMedDate not supplied

Fast fluid-attenuated inversion-recovery (FLAIR) MRI in the assessment of intraaxial brain tumors.

This study demonstrates the value of a fast fluid-attenuated inversion-recovery (FLAIR) technique in the assessment of primary intraaxial brain tumors. Twenty-one patients with primary intraaxial brain tumors were examined by T2-weighted, proton-density-weighted fast spin echo, fast FLAIR, and contrast-enhanced T1-weighted spin echo using identical slice parameters. The images were evaluated using quantitative and qualitative criteria. Quantitative criteria were tumor-to-background and tumor-to-cerebrospinal fluid (CSF) contrast and contrast-to-noise ratio (CNR). The qualitative evaluation was performed as a multireader analysis concerning lesion detection, lesion delineation, and image artifacts. In the qualitative evaluation, all readers found the fast FLAIR to be superior to fast spin echo in the exact delineation of intraaxial brain tumors (P < .001) and the delineation of enhancing and nonenhancing tumor parts. Fast FLAIR was superior in the delineation of cortically located and small lesions but was limited in lesions adjacent to the ventricles. Fast FLAIR provided a significantly better tumor-to-CSF contrast and tumor-to-CSF CNR (P < .001). The tumor-to-background contrast and tumor-to-background CNR of the fast FLAIR images were lower than those of T2-weighted spin-echo images but higher than those of proton-density-weighted spin-echo images. FLAIR images had more image artifacts influencing the image interpretation in only two patients. Signal hyperintensities at the ventricular border were present in 92% of the patients. They are common findings in fast FLAIR and should be included into the image interpretation.

Adult↗
PubMed2005

FAST: a novel protein structure alignment algorithm.

We present a novel algorithm named FAST for aligning protein three-dimensional structures. FAST uses a directionality-based scoring scheme to compare the intra-molecular residue-residue relationships in two structures. It employs an elimination heuristic to promote sparseness in the residue-pair graph and facilitate the detection of the global optimum. In order to test the overall accuracy of FAST, we determined its sensitivity and specificity with the SCOP classification (version 1.61) as the gold standard. FAST achieved higher sensitivities than several existing methods (DaliLite, CE, and K2) at all specificity levels. We also tested FAST against 1033 manually curated alignments in the HOMSTRAD database. The overall agreement was 96%. Close inspection of examples from broad structural classes indicated the high quality of FAST alignments. Moreover, FAST is an order of magnitude faster than other algorithms that attempt to establish residue-residue correspondence. Typical pairwise alignments take FAST less than a second with a Pentium III 1.2GHz CPU. FAST software and a web server are available at http://biowulf.bu.edu/FAST/.

Algorithms↗
PubMed1993

Fast Na+ current in circular smooth muscle cells of the large intestine.

Whole-cell voltage clamp was carried out on freshly dispersed single smooth muscle cells from adult rat and human colons to investigate the regulation of the Ca2+ channels. In this study, we unexpectedly discovered the existence of a fast Na+ channel current. With normal physiological salt solution (PSS) plus 4-amino-pyridine (3 mM) in the bath and high-Cs+ solution in the pipette to inhibit outward K+ currents, an inward current possessing fast and slow components was observed when the cell membrane was depolarized to a value more positive than -20 mV from a holding potential of -100 mV. When Ca2+ ions were removed from the PSS, or when nifedipine (10 microM) and Ni2+ (30 microM) were simultaneously applied, the slow component disappeared and the fast component remained. The fast current component became almost completely inactivated within 10 ms. This fast component was dependent on extracellular Na+ concentration and was inhibited by tetrodotoxin (TTX) dose dependently (IC50 of 130 nM in rat and 14 nM in human). These results suggest that the slow component of inward current was a Ca2+ channel current, whereas the fast component was a TTX-sensitive fast Na+ channel current. The threshold voltage, the voltage for peak current, and the reversal potential for the fast Na+ current were, respectively, about -50, -20, and +50 mV in rats, and -40, 0, and +60 mV in humans. The incidence of cells possessing fast Na+ currents depended on the region of the colon.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1995

Dopamine antagonist effects on locomotor activity in naive and ethanol-treated FAST and SLOW selected lines of mice.

The FAST and SLOW lines of mice are being selectively bred in replicate for differential sensitivities to the locomotor activating effects of ethanol. Whereas FAST-1 and FAST-2 mice are stimulated by 2.0 g/kg ethanol, SLOW-1 and SLOW-2 mice are not stimulated, and are often depressed, by this dose. The dopamine antagonists, SCH-23390 (D1) and raclopride (D2), produced dose-dependent decreases in the locomotor activity of EtOH-naive mice of both lines and replicates; however, FAST and SLOW mice were not differentially sensitive to these effects. The absence of a line difference in activity response to the dopamine antagonists suggests that dopamine receptor function has not been altered by selective breeding for differences in sensitivity to the stimulant effects of ethanol. The ethanol-stimulated activity of FAST-1 and FAST-2 mice was decreased by administration of the dopamine antagonists, haloperidol and raclopride, at doses that had no effect on basal locomotor activity. SCH-23390 decreased ethanol-stimulated activity of FAST-1, but not FAST-2 mice. The ethanol-induced activity changes of SLOW mice were generally unaffected by antagonist administration. These results suggest a role for dopaminergic systems in mediating ethanol-stimulated activity in selectively bred FAST mice. Coadministration of SCH-23390 and raclopride decreased ethanol-induced activation to a greater degree than either drug alone, further suggesting that both D1 and D2 receptor systems contribute to the full expression of the ethanol stimulant response.

Animals↗
PubMed1983

Nature of "residual fast channel" dependent action potentials and slow conduction in guinea pig ventricular muscle and its modification by isoproterenol.

The nature of "residual fast channel" dependent action potentials and conduction was studied in guinea pig ventricular papillary muscle in which the resting potential was reduced to 58 +/- 1 mV in high K+ (16.7 mM) Tyrode's solution, with or without isoproterenol (0.1 microM). In the absence of isoproterenol, the action potential had a slur on the upstroke and the maximum rate of rise (Vmax) was composed of 2 separable peaks: the early large (32 +/- 7 V/s, Vmax,fast) and the late small (10 +/- 2 V/s, Vmax,slow) ones. The conduction velocity ranged from 30 to 35 cm/s. The Vmax,fast was selectively depressed by l-verapamil (1 microgram/ml), indicating that the impulses were transmitted through incompletely inactivated ("residual") fast channels. Lidocaine (2 micrograms/ml) depressed Vmax,fast with reduction of conduction velocity to about 20 cm/s just before the conduction block. Isoproterenol quadrupled the Vmax,slow but decreased Vmax,fast. As a result, the Vmax,slow overrode the Vmax,fast without change in the conduction velocity. In the absence of isoproterenol, there was no rate-dependent change in the action potential duration and the effective refractory period among the rates of 0.1, 0.5, and 0.9 Hz. Isoproterenol produced rate-dependent shortening in action potential duration with rate-independent shortening of postexcitation refractoriness, thereby resulting in a significant shortening in the effective refractory period at faster rates (0.5 and 0.9 Hz). Results suggest that the "residual fast channel" could produce "slow conduction" and that the ionic channels (fast or slow) responsible for the slow conduction may alternate according to local concentrations of tissue catecholamines.

Action Potentials↗
PubMed1995

Effect of hepatic vagotomy on plasma insulin levels during fasting in rats.

The present investigation was designed to evaluate the effect of a selective hepatic vagotomy (HV) on the insulin response in rats fasted for 24 h when blood glucose levels were or were not maintained by a constant glucose infusion. Rats were divided into three dietary groups: one group of normally fed rats, one group of 24-h fasted rats, and one group of 24-h fasted rats infused with glucose throughout the fasting period. Each of these groups was subdivided into HV and sham-operated (SHM) rats. Fasting without glucose infusion resulted in a significant (p < 0.05) decrease in plasma glucose, liver glycogen, and insulin concentrations and in a significant (p < 0.01) increase in beta-hydroxybutyrate and FFA concentration. Despite the maintenance of plasma glucose concentrations in the glucose-infused groups, the concentrations of liver glycogen and insulin were still decreased (p < 0.01) and the concentrations of beta-hydroxybutyrate were still increased (p<0.05) at the end of the fasting period. However, no significant differences in insulin or in beta-hydroxybutyrate concentration were found between HV and SHM rats. It is concluded that the decline in plasma glucose concentration during fasting does not totally explain the insulinopenic response to fasting, and that the liver, through the mediation of the hepatic vagus nerve, does not seem to contribute to insulinopenia in 24-h fasted rats.

Animals↗
PubMed2007

Fast-track surgery in infants and children.

BACKGROUND/PURPOSE: Fast-track surgery is not well established for infants and children. The aim of our prospective study was to investigate the feasibility of fast-track concepts for pediatric surgical procedures including laparoscopic techniques. METHODS: Fast-track concepts, including immediate postoperative feeding, immediate mobilization, and morphine sparing pain treatment, were established for pyeloplasty, appendectomy, bowel anastomosis, fundoplication, hypospadia repair, and full/partial nephrectomy. All consecutive patients undergoing these procedures were prospectively investigated from June 2004 to June 2005. Patients with additional relevant diseases, reoperation, and perforated appendicitis were excluded from fast-track treatment. The length of hospital stay was compared with data derived from the German reimbursement system with German diagnosis-related groups for patients with a similar case mix index and hospitals with a similar structure. RESULTS: Of a total of 159 patients (mean age, 5.8 +/- 5.3 years), 113 (71%) were finally treated according to the fast-track protocols. There were no complications associated with fast-track surgery. The intensity of pain during the immediate postoperative period was higher than 5 on a 10-point scale in children older than 4 years. Analgesia was excellent at all other time points. The mean hospital stay of fast-track patients was 2.3 +/- 1 days and was significantly shorter (P < .01) compared with German diagnosis-related group data for all procedures (pyeloplasty, 1.9 +/- 0.9 vs 12.2 +/- 0.2; nephrectomy, 1.9 +/- 1.0 vs 14.4 +/- 2.8; bowel anastomosis, 3.2 +/- 0.6 vs 12.9 +/- 2.4; fundoplication, 3.2 +/- 0.8 vs 15.2 +/- 4.2; appendectomy, 3.7 +/- 2.4 vs 6.3 +/- 1.8; hypospadia repair, 2.1 +/- 1 vs 8.4 +/- 1.4). Two readmissions were recorded. Ninety-six percent of patients and parents scored the fast-track concepts as excellent. CONCLUSION: The feasibility of fast-track concepts in children is excellent, with short duration of hospitalization and high comfort.

Child↗
PubMed1999

The efficacy of focused abdominal sonography for trauma (FAST) as a screening tool in the assessment of injured children.

PURPOSE: Focused abdominal sonography for trauma (FAST) is rapidly gaining acceptance as an effective and accurate way to determine significant abdominal injury. The authors analyzed their experience in 94 children with blunt torso trauma (BTT) to assess FAST accuracy in identifying operative lesions and utility in avoiding additional diagnostic studies. METHODS: The authors' pediatric trauma registry was queried to identify all children with BTT who underwent FAST as part of their initial trauma assessment. Accuracy was determined by calculating sensitivity and specificity using as true positives those children with lesions requiring operative intervention. Utility was analyzed by reviewing the need for additional diagnostic or therapeutic intervention in those patients with negative FAST findings and negative clinical examination findings. RESULTS: Three of these 94 children had lesions that required laparotomy. One was FAST positive (sensitivity, 33.3%). One of two FAST-negative patients was a child in extremis from a suspected thoracic aortic disruption, and the other was a child with an intestinal disruption in whom peritoneal signs developed 24 hours after injury. Of 89 FAST-negative children, 20 underwent abdominal computed tomography (CT) at the surgeon's request. Eight of these patients were found to have minor visceral injury that required no further treatment. The remaining 69 included the child with the aortic disruption and 68 patients whose hospital course was uneventful and required no additional intervention. CONCLUSIONS: From the practical perspective of indicating need for operative intervention in BTT, FAST has a high specificity (95%); however, it is not particularly sensitive (33%). This excellent specificity in combination with clinical examination underscores FAST utility by avoiding unnecessary diagnostic intervention in 72% of the patients in this study.

Abdominal Injuries↗
PubMed2002

Comparative study of fast MR imaging: quantitative analysis on image quality and efficiency among various time frames and contrast behaviors.

The purpose of this study is to quantitatively compare the image quality and efficiency provided by widely available fast MR imaging pulse sequences. A composite phantom with various T1 and T2 values and subjected to periodic motion was imaged at 1.5 T. The fast MRI sequences evaluated included fast spin-echo (FSE), single shot fast spin-echo (SSFSE), echo-planar imaging (EPI), multi-slice gradient recalled (MPGR), fast MPGR (FMPGR), and fast multi-slice spoiled gradient echo (FMPSPGR). T1-weighted (T1WI), T2-weighted (T2WI), proton-density-weighted (PDWI), and T2*-weighted (T2*WI) images were evaluated in breath-hold and non-breath-hold time frames. Analysis included measurement of image signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), nonuniformity, ghosting ratio, SNR per unit time and CNR per unit time. Among fast T2WI sequences, FSE with breath-hold time frame resulted in the highest image quality and in superior SNR and CNR efficiency by a factor of 5 or 6 as compared with conventional spin echo sequence. Among fast T1WI sequences, FMPGR and FMPSPGR both with non-breath-hold time frame produced the highest image quality and SNR and CNR efficiency by a factor of greater than 5 as compared with conventional spin echo. Among fast PDWI and T2*WI sequences, FSE produced the highest SNR and CNR, and was maximally efficient with a factors of greater than 6 as compared with conventional spin echo.

Echo-Planar Imaging↗
PubMed1999

Lesion load quantification on fast-FLAIR, rapid acquisition relaxation-enhanced, and gradient spin echo brain MRI scans from multiple sclerosis patients.

Previous studies have addressed the issue of the usefullness of fast fluid-attenuated (fast-FLAIR), rapid acquisition relaxation-enhanced (RARE), and gradient spin echo (GRASE) sequences in small groups of patients with multiple sclerosis (MS). The aim of this study was to assess and compare the lesion volumes and the intra-rater reproducibility of such measurements using fast-FLAIR, dual echo RARE, and dual echo GRASE brain scans from a large sample of MS patients. Using a 1.5 Tesla scanner, fast-FLAIR, dual echo RARE, and dual echo GRASE scans (24 axial, 5-mm thick contiguous interleaved slices) of the brain were obtained from 50 MS patients. Total lesion loads (TLL) were assessed twice using a semi-automated local thresholding segmentation technique by the same rater from the scans obtained with the three techniques. Mean TLL were 20.3 mL for fast-FLAIR, 16.6 mL for RARE, and 17.6 mL for GRASE sequences. Mean TLL detected by the three techniques were significantly heterogeneous (p < 0.001); at post-hoc analysis, the mean lesion volume detected on fast-FLAIR images was significantly higher than that on both RARE and GRASE images (p < 0.001) and the mean TLL on GRASE scans was significantly higher than that on RARE scans (p = 0.001). The mean values of intra-observer coefficient of variation for TLL measurements were similar for the three techniques (2.69% for fast-FLAIR, 2.33% for RARE, and 2.65% for GRASE). Our results confirm that fast-FLAIR sequences detect higher lesion volumes than those detected by other magnetic resonance imaging (MRI) sequences with shorter acquisition times. However, the reproducibility of TLL measurements is comparable among fast-FLAIR, RARE, and GRASE. This suggests that when assessing MS disease burden with MRI, the choice of the pulse sequence to be used should be dictated by the clinical setting.

Adult↗
PubMed1999

The drop in plasma thyrotropin concentrations in fasted chickens is caused by an action at the level of the hypothalamus: role of corticosterone.

Fasting has severe effects on thyroid metabolism in the chicken: plasma thyroxine (T4) concentrations increase, whereas 3',5,3-triiodothyronine (T3) concentrations decrease. In the present report we studied the effect of fasting at the level of: 1) the pituitary (plasma thyrotropin (TSH) concentrations; the sensitivity of thyrotrophs to corticotropin-releasing hormone (CRH) and TSH-releasing hormone (TRH)); and 2) the hypothalamus (TRH content). A regulatory role of corticosterone is discussed. One day of fasting resulted in a drop in plasma TSH concentrations. Fed and nonfed animals were treated with ovine CRH (oCRH) or TRH. The sensitivity of thyrotrophs to the respective hypothalamic hormones was increased when animals were subjected to a 1-d period of fasting. A 75% (TRH) and 50% (oCRH) increase in plasma TSH was recorded in fasted animals, whereas both secretagogues did not evoke any response in their fed counterparts. The drop in plasma TSH cannot, therefore, be attributed to a loss in sensitivity of thyrotrophs to hypothalamic stimulatory control. In an identical experiment, plasma TSH concentrations decreased, whereas hypothalamic TRH content was higher in fasted animals, suggesting a decreased hypothalamic TRH release toward the pituitary. In both fasting experiments, plasma corticosterone concentrations were increased after 1 d of fasting. Because an i.v. injection of corticosterone-elevated hypothalamic TRH contents and decreased plasma TSH concentrations, a corticosterone-induced TSH decrease during fasting is suggested through an action at the level of the hypothalamus.

Animals↗
PubMed2003

Physico-mechanical properties of a fast-set highly viscous GIC restorative.

UNLABELLED: The fast-setting reaction of 'fast-set' highly viscous glass-ionomer cements (GIC) may result in superior mechanical properties and good wear resistance as the material can theoretically achieve sufficient strength to resist masticatory loads within a shorter time. The aim of this study was to determine the hardness, strength (compressive and diametral tensile) and wear resistance of a 'fast-set' highly viscous GIC (Fuji IX GP Fast). Its regular set counterpart (Fuji IX GP) was used for comparison. The glass powders of the two cements were also characterized. Hardness testing [Vickers' hardness number (VHN)] was performed with a digital hardness tester (load=50 g; dwell time=30 s) and compressive/diametral tensile strength testing (MPa) was conducted based upon British Standards specification for GICs (BS6039, 1981). Wear testing was conducted using a reciprocal compression-sliding wear instrumentation at 20 MPa contact stress against SS304 counter-bodies with distilled water as lubricant. All specimens were immersed in distilled water at 37 degrees C and tested 24 h after start of mixing. Further mechanical tests (hardness and strength) were conducted with specimens stored for 1 week in distilled water at 37 degrees C. The glass powders were characterized using laser particle sizing, standard electron microscope (SEM) and energy dispressure X-ray (EDX) analysis. Results were analysed using multiple analysis of variance (manova) and independent samples t-test at significance level 0.05. No significant difference in hardness, compressive and diametral tensile strength was observed between Fuji IX GP and Fuji IX GP Fast at 1 day. There was also no significant difference in wear at all cyclic intervals. Although the difference in strength was not significant between the two cements at 1 week, Fuji IX GP Fast was significantly harder than Fuji IX GP. Particle size of both cements ranged from 0.3 to 200 microm. The mean particle sizes were, however, different and were 13.43 and 7.13 microm for Fuji IX GP and Fuji IX GP Fast, respectively. Fuji IX GP Fast offers no other advantage over Fuji IX GP with the exception of improved hardness. CLINICAL RELEVANCE: Besides being harder, the fast-set highly viscous GIC restorative offers no other physico-mechanical advantage over its regular set counterpart.

Dental Restoration Wear↗
PubMed1987

Angiotensin-converting enzyme activity decreases during fasting.

UNLABELLED: Serum angiotensin-converting enzyme (ACE) activity varies directly with thyroid hormone levels in states of altered thyroid function. Because T3 levels decrease during fasting, ACE activity was examined to ascertain if it was reduced in this low T3 condition. Eighteen obese euthyroid subjects were hospitalized and placed on a weight-maintaining diet for 4 days. Nine subjects (Group 1) underwent a fast (50 kcal/day) for 8 days. Nine (Group 2) subjects received T3 (5 micrograms q 3 h) during an identical fast. Weight loss was identical in both groups (-4.4 kg). Serum T3 fell in Group 1 from 104 +/- 8 to 50 +/- 4 ng/d/(p less than .05) but was unchanged in Group 2 (114 +/- 11 ng/dl fed vs. 120 +/- 14 ng/dl fasted). Blood pressures fell significantly in Group 1 (mean systolic: 112----104 mmHg; diastolic: 71----65 mmHg, p less than 0.05), but not in Group 2 subjects. ACE activity fell progressively in Group 1 subjects during fasting (14.4 +/- 1.6 U/ml fed vs. 12.8 +/- 1.4 U/ml fasted p less than 0.05). ACE activity was not decreased significantly early in the fast in patients given T3, but by late fast (days 6-8) was reduced to the same degree as in Group 1 subjects. Glucose and insulin levels fell similarly in both groups. CONCLUSIONS: (1) ACE activity is reduced during starvation. This effect is not mediated by T3. (2) Blood pressure reduction during fasting may result from the low T3 levels, but not from decreased ACE activity. Interpretation of serum ACE activity must be viewed in the context of a patient's diet.

Adult↗
PubMed1981

Myosin light chains and the developmental origin of fast muscle.

Physiological characteristics of embryonic and fetal fast muscle function are similar to those of adult slow muscles, whereas most biochemical data suggest that embryonic and fetal fast muscles contain only fast muscle myosin. In the studies reported here, myofibrillar preparations from developing avian pectoral muscle (fast muscle) were isolated and analyzed for myosin light-chain type and synthesis. These analyses show that early in development avian fast muscle synthesizes and assembles myofibrils with light chains of both slow and fast myosins. Later in development, fast muscle no longer assembles myofibrils containing slow myosin light chains due to the cessation of synthesis of slow myosin light chains in mid-development. These in vivo studies indicate that the more developmentally primitive type of skeletal muscle is one that synthesizes both slow and fast myosin light chains independent of its anatomic location, and an event(s) late in fast muscle development results in the repression of synthesis of slow myosin light chains.

Aging↗
PubMed2000

13C/31P NMR assessment of mitochondrial energy coupling in skeletal muscle of awake fed and fasted rats. Relationship with uncoupling protein 3 expression.

To examine the relationship between mitochondrial energy coupling in skeletal muscle and change in uncoupling protein 3 (UCP3) expression during the transition from the fed to fasted state, we used a novel noninvasive (31)P/(13)C NMR spectroscopic approach to measure the degree of mitochondrial energy coupling in the hind limb muscles of awake rats before and after a 48-h fast. Compared with fed levels, UCP3 mRNA and protein levels in the gastrocnemius increased 1.7- (p < 0.01) and 2.9-fold (p < 0.001), respectively, following a 48-h fast. Tricarboxylic acid cycle flux measured using (13)C NMR as an index of mitochondrial substrate oxidation was 212 +/- 23 and 173 +/- 25 nmol/g/min (p not significant) in the fed and 48-h fasted groups, respectively. Unidirectional ATP synthesis flux measured using (31)P NMR was 79 +/- 15 and 57 +/- 9 nmol/g/s (p not significant) in the fed and 48-h fasted groups, respectively. Mitochondrial energy coupling as expressed by the ratio of ATP synthesis to tricarboxylic acid cycle flux was not different between the fed and fasted states. To test the hypothesis that UCP3 may be involved in the translocation of long chain free fatty acids (FFA) into the mitochondrial matrix under conditions of elevated FFA availability, [U-(13)C]palmitate/albumin was administered in a separate group of rats with (+) or without (-) etomoxir (an inhibitor of carnitine palmitoyltransferase I). The ratio of glutamate enrichment ((+) etomoxir/(-) etomoxir) in the hind limb muscles was the same between groups, indicating that UCP3 does not appear to function as a translocator for long chain FFA in skeletal muscle following a 48-h fast. In summary, these data demonstrate that despite a 2-3-fold increase in UCP3 mRNA and protein expression in skeletal muscle during the transition from the fed to fasted state, mitochondrial energy coupling does not change. Furthermore, UCP3 does not appear to have a major role in FFA translocation into the mitochondria. The physiological role of UCP3 following a 48-h fast in skeletal muscle remains to be elucidated.

Adenosine Triphosphate↗
PubMed2002

Calculated fast-growing benign prostatic hyperplasia--a risk factor for developing clinical prostate cancer.

OBJECTIVE: Whether there is an association between the development of benign prostatic hyperplasia (BPH) and clinical prostate cancer is controversial. The present report tests the hypothesis of an association between BPH growth and the development of clinical prostate cancer by examining stage, grade and PSA-level in men with recently discovered clinical prostate cancer with slow or fast-growing BPH. If the hypothesis is true, men with fast-growing BPH would have a more advanced clinical prostate cancer. MATERIAL AND METHODS: Two hundred and twenty patients in whom a clinical prostate cancer was diagnosed were consecutively included. The prevalence of atherosclerotic disease, non-insulin-dependent diabetes mellitus (NIDDM) or treated hypertension was provided by the respective patient's medical history. Tallness, body weight, waist measurement, hip measurement and blood pressure were determined. The body mass index (BMI) and waist/hip ratio (WHR) were calculated. Blood samples were drawn to determine triglycerides, total cholesterol, HDL-cholesterol, LDL-cholesterol, uric acid, ALAT and the fasting plasma insulin level. The prostate gland volume was measured using transrectal ultrasound. The annual BPH growth rate was calculated, assuming that the total prostate gland volume was 20 mL at the patient age of forty. The prostate cancer diagnosis was established using the technique of transrectal ultrasound-guided automatic needle biopsy of the prostate. RESULTS: Men with clinical prostate cancer, PSA <50 ng/mL, and with fast-growing BPH had a higher systolic (p = 0.009) and diastolic (p = 0.020) blood pressure, were taller (p < 0.001) and more obese, as determined by body weight (p < 0.001), BMI (p = 0.005), waist measurement (p < 0.001) and hip measurement (p = 0.003). They also had a higher fasting plasma insulin level (p = 0.014) and a lower HDL-cholesterol level (p = 0.067) than men with slow-growing BPH. Moreover, men with clinical prostate cancer, PSA <50 ng/mL, and fast-growing BPH had more pronounced clinical prostate cancer, as measured by grade (p = 0.029) and PSA-level (p = 0.016), than men with slow-growing BPH. In the total material, including men with clinical prostate cancer, PSA >/=50 ng/mL, men with fast-growing BPH also had a higher prevalence of NIDDM (p = 0.039) and a borderline statistical significance for higher stage (p = 0.09) than men with slow-growing BPH. The BPH growth rate was significantly associated with the clinical prostate cancer grade (p = 0.018) and PSA-level (p = 0.002) but not with the clinical cancer stage in a multivariate statistical analysis. CONCLUSIONS: This report confirms findings in previous studies that fast-growing BPH is a risk factor for NIDDM, hypertension, tallness, obesity, dyslipidaemia and hyperinsulinaemia. The present report extends this list of risk factors to include atherosclerotic disease manifestations, hyperuricaemia and higher ALAT levels. The study suggests that fast-growing BPH is a risk factor for developing clinical prostate cancer and, thus, supports the hypothesis of an association between the development of BPH and clinical prostate cancer. The study generates the hypothesis that clinical prostate cancer is a component of the metabolic syndrome and that insulin is a promoter of clinical prostate cancer.

Age Distribution↗
PubMed2007

Differential associations of fast food and restaurant food consumption with 3-y change in body mass index: the Coronary Artery Risk Development in Young Adults Study.

BACKGROUND: Away-from-home food consumption has rapidly increased, though little is known about the independent associations of restaurant food and fast food intake with body mass index (BMI) and BMI change. OBJECTIVE: The aim was to compare the associations of restaurant food and fast food consumption with current and 3-y changes in BMI. DESIGN: Multivariate linear regression models, with control for demographic and lifestyle factors, were used to examine cross-sectional and longitudinal associations of away-from-home eating with BMI by using data from subjects of the Coronary Artery Risk Development in Young Adults Study (n = 3394) obtained at exam years 7 (1992-1993) and 10 (1995-1996). RESULTS: Forty percent of the sample increased their weekly consumption of restaurant or fast food, though mean (+/-SD) changes were -0.16 +/- 2.39 times/wk (P = 0.0001) and -0.56 +/- 3.04 times/wk (P < 0.0001), respectively. Cross-sectionally, fast food, but not restaurant food, consumption was positively associated with BMI. Similarly, higher consumption of fast food at year 7 was associated with a 0.16-unit higher BMI at year 10. After adjustment for baseline away-from-home eating, increased consumption of fast food only (beta: 0.20; 95% CI: 0.01, 0.39) and of both restaurant food and fast food (beta: 0.29; 95% CI: 0.06, 0.51) were positively associated with BMI change, though the estimates were not significantly different (P = 0.47). Increased consumption of restaurant food only was unrelated to BMI change (beta: -0.01; 95% CI: -0.21, 0.19), which differed significantly (P = 0.014) from the estimate for an increase in both restaurant food and fast food intake. CONCLUSIONS: We found differential effects of restaurant food and fast food intakes on BMI, although the observed differences were not always statistically significant. More research is needed to determine whether the differential effects are related to consumer characteristics or the food itself.

Adult↗
PubMed2001

Fast-tracking children after ambulatory surgery.

UNLABELLED: This study was designed to determine the feasibility and benefits of fast-tracking children after ambulatory surgery. One-hundred-fifty-five healthy children undergoing surgical procedures lasting <90 min were studied in a randomized manner. After surgery, children who met predefined recovery criteria in the operating room were entered into one of the study groups. Seventy-one patients (control) were first admitted to the postanesthesia care unit (PACU) and then to the second-stage recovery unit (SSRU). Eighty-four children bypassed the PACU and were directly admitted to the SSRU (Fast-Track group). The demographic data, airway management, and surgical procedures were similar in both groups of patients. During the recovery phase, 62.0% of the PACU group patients and 40.5% of the Fast-Track patients received analgesics (P = 0.01). The total recovery time was 79.1 +/- 48.3 min in the Fast-Track group and 99.4 +/- 48.6 min in the Control group (P = 0.008). A larger percentage of parents in the Fast-Track group (31% vs 16%) reported that their child was restless on arrival at the SSRU (P = 0.037). There were no clinically significant adverse events. However, adequate pain control must be provided before transfer to SSRU. In conclusion, fast-tracking children after ambulatory surgery is feasible and beneficial when specific selection criteria are used. IMPLICATIONS: The results of this study show that the total recovery time is shorter in children who are fast-tracked (bypass the postanesthesia care unit) after ambulatory surgery. A higher percentage of parents of the Fast-Track group felt that their child was restless on arrival at the second-stage recovery unit. Fast-tracking children after ambulatory surgery is feasible and beneficial when specific selection criteria are used.

Adolescent↗