JerMa88/BMC_Gastroenterology_Peer_Reviews huggingface dataset:
Review for 10.1186/1471-230X-10-129 (2010)

Reviewer's report
Title:Laparoscopic versus conventional appendectomy - a meta-analysis of
randomized controlled trials
Version: 2Date:11 October 2010
Reviewer: Stefan Sauerland
Reviewer's report:
The authors have revised their manuscript in many different aspects, and I thank
them for their efforts. However, the problems addressed in my initial comments
No. 6 and 8 are still not fully solved.
In their reply to my comment No. 6, the authors state that "absence of blindness
may influence the results" on pain. Rather than speculating on this issue, I would
have preferred a simple sensitivity analysis comparing the results between
blinded and open trials. This would allow an empirical assessment on how strong
blinding does influence pain results.
As described in my initial comment No. 8, I feel that results on operating time
should be rounded to one decimal place or full minutes. It is correct to extract
precise data from the primary studies, but it is statistical overprecision to report
pooled results for operating time with two decimals places, because nobody
measures operating time in seconds (0.01 minutes = 0.6 seconds).
As all my other comments have been addressed, I recommend the manuscript
for publication.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-10-129 (2010)

Reviewer's report
Title:Laparoscopic versus conventional appendectomy - a meta-analysis of
randomized controlled trials
Version: 2Date:22 October 2010
Reviewer: Anette Sundfor Jacobsen
Reviewer's report:
I think this paper is now appropriate and acceptable.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
No competing interests.
Review for 10.1186/1471-230X-10-128 (2010)

Reviewer's report
Title:Vesicocutaneous fistula formation during treatment with sunitinib malate:
Case report
Version: 2Date:3 September 2010
Reviewer: Cristina Gravalos
Reviewer's report:
Cases of fistula formation, sometimes associated with tumor necrosis and/or
regression, in some cases with fatal outcome, have been reported with sunitinib.
However, so far, there are few reports in the literature of patients treated with
sunitinib who developed fistula and more information about this rare adverse
event is needed.
This manuscript describes the case of a woman with advanced GIST treated with
sunitinib after progression to imatinib. She developed a first fistula
(enterocutaneous fistula) after the administration of imatinib and a second fistula
(vesicocutaneous fistula) with sunitinib. This is the first case reported with
vesicocutaneous fistula related with sunitinib. Even more, this case is very
interesting because of the double formation of fistula in a patient with GIST
treated with two different TKIs.
The CT images show that the second fistula was developed in the tumour mass
which infiltrated the abdominal wall and bladder. In this case, sunitinib could
contribute to the development of the tumour fistula associated with tumor
necrosis and it is clear that fistula healed after sunitinib discontinuation.
My comments are:
1. Background
First paragraph. In the phase III trial of sunitinib in GIST, diarrhea is 29% instead
of 33% (see table 2 of the article by Demetri et al. Lancet 2006). Please, modify.
2. Discussion
First paragraph. In the NCIC CTG trial IND 184, four patients had fistulae
develop on study treatment and an additional patient developed a fistula 3.5
months after discontinuation of therapy. No objective responses were observed
in the 19 patients enrolled in the study, even if the absence of fistula. So, please,
modify this sentence: “Those who developed fistulae during treatment in that
study did not develop objective responses, …” because there were no responses
at all.
First paragraph. Ng et al (Gastric Cancer 2003) described the case of one
patient, not patients. So, please modify this sentence: “On the other hand,
notable tumour shrinkage results in the complete healing of fistulae in patients
with GIST under imatinib therapy [10]”.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Review for 10.1186/1471-230X-10-128 (2010)

Reviewer's report
Title:Vesicocutaneous fistula formation during treatment with sunitinib malate:
Case report
Version: 3Date:22 October 2010
Reviewer: Axel Bex
Reviewer's report:
The authors have sufficiently considered my suggestions, I have no further
comments to add.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I have received honoraria for consultancy for Pfizer, GSK, Bayer and Novartis
Review for 10.1186/1471-230X-10-128 (2010)

Reviewer's report
Title:Vesicocutaneous fistula formation during treatment with sunitinib malate:
Case report
Version: 3Date:22 October 2010
Reviewer: Georgios Papaetis
Reviewer's report:
After the revision made, the manuscript can be accepted for publication.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Review for 10.1186/1471-230X-10-127 (2010)

Reviewer's report
Title:Laparoscopic and open resection for colorectal cancer: an evaluation of
cellular immunity
Version: 1Date:1 August 2010
Reviewer: Simon Ng
Reviewer's report:
Major:
This prospective study aimed to compare the cellular immune response of
laparoscopic versus open resection of colorectal cancer. The authors found that
some of the components of the immune system are less suppressed after
laparoscopic than after open surgery (especially on postoperative day 4).
The observation that laparoscopic colorectal surgery is associated with better
preservation of cellular immunity when compared with open surgery has been
repeatedly reported by other researchers; the same issue has been thoroughly
addressed by a randomized study (Leung et al. Surg Endosc 2003; 17:
1305-1310). The findings of the present study essentially do not contribute
anything new to the literature.
I have some concerns about the patient selection criteria in this study, as those
with perioperative complications were excluded. Postoperative morbidity is
usually an important outcome parameter in most studies comparing laparoscopic
and open colorectal surgery; patients with complications will often have slower
recovery. The reported faster postoperative recovery in the laparoscopic group in
this study may not be reflecting the true clinical picture, as it is merely
representing a highly selected group of patients without complications. How
many patients with complications were excluded in both groups? The comparison
of postoperative recovery and hospital stay between the two approaches would
become meaningless if all patients with complications were excluded.
Minor:
Although there was no difference in age, gender, ASA classification, and tumor
status between the two groups, the authors did not tell us about the details of
medical comorbidities in both groups, e.g. diabetes mellitus, use of steroids,
other immunological diseases, etc, that could have a major impact on the cellular
immune responses after surgery.
Discretionary:
It is difficult to appreciate the differences in immune responses between the two
groups on the box plots as presented. It would be better to use simple line
graphs.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Review for 10.1186/1471-230X-10-127 (2010)

Reviewer's report
Title:Laparoscopic and open resection for colorectal cancer: an evaluation of
cellular immunity
Version: 1Date:12 August 2010
Reviewer: Matthias Wichmann
Reviewer's report:
Dear Authors:
Congratulations on this interesting clinical study. As you are aware it does add to
the available literature in this area of research and confirms previous findings by
other groups.
I think your work should be published in it's current form but requires review by a
native speaker to make it more interesting to read. Provided the language
changes are done the work should be published without other revisions.
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-10-127 (2010)

Reviewer's report
Title:Laparoscopic and open resection for colorectal cancer: an evaluation of
cellular immunity
Version: 3Date:15 September 2010
Reviewer: Simon Ng
Reviewer's report:
The authors have attempted to address my previous concerns and clarified the
differences regarding the observed cellular immune responses between their
manuscript and previous published studies. I agree with them that their better
results may reflect progress of laparoscopic colorectal cancer surgery nowadays
in China.
Minor Essential Revisions:
In their cover letter, the authors have indicated that 5 patients with complications
were excluded from the study, and the authors have explained the rationale
behind. I think they should include these information and data in the results
section. This will allow the readers to have a better understanding of the overall
picture, especially when the authors are still trying to compare the short-term
clinical outcome data between the laparoscopic and open surgery groups.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Review for 10.1186/1471-230X-10-126 (2010)

Reviewer's report
Title:Association of the -511C/-31T haplotype of IL-1beta and genotypes of
Helicobacter pylori-vacA with chronic gastritis and gastric ulcer
Version: 1Date:24 May 2010
Reviewer: Mitsushige Sugimoto
Reviewer's report:
General:
The authors investigated the effects of bacterial factors of H. pylori (vacA) and
host genetic factors of IL-1B on the development of gastritis and peptic ulcer.
Authors showed that the host IL-1B polymorphisms could play a role in
determining kinds of H. pylori-related diseases in Mexican population. Previously,
although there were many studies to investigate association of diseases
development and host genetic factors of IL-1B, results were controversial, as
suggested by authors. Therefore, this study may have potential to evaluate
evidences of this field.
Major comments:
1. Most important thing of this study is to have sufficient sample number to
evaluate significances. Is it enough? Please analyze sample power and add this
information in revised paper.
2. It is difficult to consider risks of H. pylori infection-related disease development
by only one parameter, such as IL-1B and vacA genotype. How about combined
analysis of IL-1B and vacA genotype?
3. Authors introduced that two previous studies have investigated the
IL-1B-31C>T polymorphism in Mexican population. Were there differences in
prevalence of IL-1B genotypes (control and patients) between previous studies
and this study? If so, it may suggest sampling error.
4. As authors suggested, the association of IL-1B polymorphism on development
of diseases controversial in the world. Therefore, it will be required to measure
IL-1beta level among different genotype groups in Mexican population.
5. Authors explained that the lack of a significant association between the vacA
genotypes with gastric ulcer when compared to chronic gastritis could be
explained by the similarity between the genotypic frequencies in both gastritis
and peptic ulcer. In East-Asian population, most of strains were cagA-positive,
vacA s1 and m1 genotypes. If so, above explanation will be acceptable.
However, prevalence of s1 and m1 were 82-88% and 50-58%. Therefore, I think
there is variation. One of causes may be sampling error, especially in gastric
ulcer, and loss of sample number.
Minor comments:
1. There are many typographical error in this version. Please check carefully.
2. How about mixed infection of H. pylori? Previous Mexican study had high rate
of mixed infection.
3. Do you have data of grade of gastric mucosal atrophy?
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Review for 10.1186/1471-230X-10-126 (2010)

Reviewer's report
Title:Association of the -511C/-31T haplotype of IL-1beta and genotypes of
Helicobacter pylori-vacA with chronic gastritis and gastric ulcer
Version: 1Date:30 May 2010
Reviewer: Hossein Dabiri
Reviewer's report:
Major Compulsory Revisions
I – according to the manuscript clarification, it is a case - control study that try to
make an association between IL-1beta polymorphisms and genotypes of
Helicobacter pylori (HP) with chronic gastritis and gastric ulcer, but the control
group is not selected correctly. In the other word for study of role of IL-1beta, the
presence of HP in study group and absence of that in control group is the study
error (HP is confounding factor), however the comparison between chronic
gastritis and gastric ulcer is fine.
II - For appropriate comparison of a factor role in different groups, we have to
normalize and homogenize the groups in order to minimizing the effect of
confounding factors, but in the current study, the three study groups (control,
chronic gastritis, and gastric ulcer) are not homogenous (i.e. Age, education,
family history of gastritis, smoking and etc. are varying in three groups). As a fact
the development of ulcer is multifactorial, therefore how you can explain the
development of gastric ulcer or chronic gastritis is due to different polymorphisms
of IL1-beta not due to differences in age, hygiene condition, smoking habit or…?
On the other words, the authors could not define the exact role of different
polymorphism on clinical outcomes in presence of so many confounding factors
(table 2).
Minor Essential Revisions
I - the manuscript should be revised for English errors
II - giving reference should be rechecked (the first paragraph of page 6)
III - first paragraph of methods section should be written clearly
VI - Result section, paragraph 1: ages should be given by sd (i.e. 26 ± 12)
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
'I declare that I have no competing interests'
Review for 10.1186/1471-230X-10-126 (2010)

Reviewer's report
Title:Association of IL1B -511C/-31T haplotype and Helicobacter pylori vacA
genotypes with gastric ulcer and chronic gastritis
Version: 4Date:6 September 2010
Reviewer: Mitsushige Sugimoto
Reviewer's report:
No
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Review for 10.1186/1471-230X-10-126 (2010)

Reviewer's report
Title:Association of IL1B -511C/-31T haplotype and Helicobacter pylori vacA
genotypes with gastric ulcer and chronic gastritis
Version: 4Date:17 September 2010
Reviewer: Rafael Barreto-Zuñiga
Reviewer's report:
Reviewer's report
Title: Association of the -511C/-31T haplotype of IL-1beta and genotypes of
Helicobacter pylori-vacA with chronic gastritis and gastric ulcer
Version: 1 Date: 17 September 2010
Reviewer: Rafael Barreto-Zuñiga
Reviewer's report:
Minor Essential Revisions
I send to you the review (in English and Spanish) of the manuscript by Martinez
N, Garza E, Reyes-Betancourt et al. 'Association of the -511C/-31T haplotype of
IL-1beta and genotypes of Helicobacter pylori-vacA with chronic gastritis and
gastric ulcer'
The manuscript by Martínez N, et al. examines the association of the IL-1B -511
T>C and -31 C>T polymorphisms with the presence of chronic gastritis and
gastric ulcer and to analyze the association of the H. pylori vacA genotypes with
the development of gastric ulcer.
Minor comments: After re-viewed answer manuscript by Martinez N, et al. I think
will be good for the publication in the Journal.
Level of interest: An article whose findings are important to those with closely
related research interests. An article of importance in its field.
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
'I declare that I have no competing interests'
Review for 10.1186/1471-230X-10-126 (2010)

Reviewer's report
Title:Association of IL1B -511C/-31T haplotype and Helicobacter pylori vacA
genotypes with gastric ulcer and chronic gastritis
Version: 4Date:22 September 2010
Reviewer: Hossein Dabiri
Reviewer's report:
There is no comment.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Review for 10.1186/1471-230X-10-125 (2010)

Reviewer's report
Title:IQGAP1 and IQGAP2 are Reciprocally Altered in Hepatocellular
Carcinoma
Version: 1Date:3 September 2010
Reviewer: Jun-ichi Okano
Reviewer's report:
White CD et al. investigated the involvement of IQGAP1 and IQGAP2 in the
pathogenesis of human hepatocellular carcinoma (HCC) and implied the
possibility that these proteins might be utilized in the diagnosis of HCC. Their
data are mostly consistent with the theory that IQGAP2 may represent a tumor
suppressor and IQGAP1 an oncogene in HCC. However, I have some concerns
as below.
<Major Compulsory Revisions>
They examined the expression levels of IQGAP1 and IQGAP2 in normal liver,
adenoma, cirrhosis, and HCC. They need to see them in dysplastic nodules,
which can be often difficult to differentiate from HCC morphologically. The results
may give an answer if IQGAP1 and IQGAP2 can be useful markers in
discriminating HCC and dysplastic nodules.
In table 2, although they say that no significant correlation was noted between
expression of IQGAP1 or IQGAP2 and any clinical or pathological features, there
is no such information in table 1. Expression levels of IQGAP1 and IQGAP2 need
to be demonstrated by every parameter, even when there is no significant
correlation between them.
They say in discussion that increased IQGAP1 and/or decreased IQGAP2
expression may be a characteristic of a more invasive and metastatic HCC
phenotype. This appears to contradict the results of figure 3 showing no
correlation between expression levels of IQGAP1 and/or IQGAP2 and tumor
stages. How would they compromise with this point?
< Discretionary Revisions>
As they described in the background session, IQGAP1 binds a variety of
signaling molecules including Cdc42 and Rac1, ERK and MEK kinases,
beta-catenin, E-cadherin, APC, and mTOR. It would be curious to see if these
molecules are activated in HCC cells and tissues with high expression levels of
IQGAP1. If they could find some of these molecules are simultaneously activated
with IQGAP1, this could further clarify the pathogenesis of HCC and could be
useful in increasing the accuracy of the diagnosis of HCC.
Best regards,
Jun-ichi Okano, M.D.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Review for 10.1186/1471-230X-10-125 (2010)

Reviewer's report
Title:IQGAP1 and IQGAP2 are Reciprocally Altered in Hepatocellular
Carcinoma
Version: 1Date:3 September 2010
Reviewer: shinji osada
Reviewer's report:
Discretionary Revisions
Level of interest: An article of outstanding merit and interest in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-10-125 (2010)

Reviewer's report
Title:IQGAP1 and IQGAP2 are Reciprocally Altered in Hepatocellular
Carcinoma
Version: 1Date:7 September 2010
Reviewer: Yinkun Liu
Reviewer's report:
1. Although the western blot and IHC validation was done, according to the
description, a sufficient number of individual independent specimens need to be
quantified by analysis. Moreover, expression of IQGAP1 and IQGAP2 on same
single sample should be presented, rather than only expression rates.
2. There will be serious remodeling of liver at the cirrhosis stage. Is the cirrhosis
compensated? What clinical criteria were used to match the groups? There is no
information about such clinical criteria; details have to be provided to exclude the
possibility of bias.
3. The reciprocal IQGAP expression pattern may be a characteristic of a more
invasive and metastatic HCC phenotype. More evidances shouald be given by
the functional assays on cell adhesion, motility, invasion as well as the colony
formation in soft agar. In anothr [oint of view, how does this alternation of
IQGAPs to be regulated during HCC progression.
4. In the study, a high degree of sensitivity and specificity for IQGAP1 positivity
and IQGAP2 negativity in HCC should be supported by more strong evidences,
not only positive expression rates. Does it only dependent on the ability of
metastasis?
5. Based on pyrosequencing, authors concluded methylation of the Iqgap2
promoter is not the principle mechanism by which IQGAP2 is downregulated in
HCC. What be contributed to the paper objective by the result?
Level of interest: An article of limited interest
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Review for 10.1186/1471-230X-10-125 (2010)

Reviewer's report
Title:IQGAP1 and IQGAP2 are Reciprocally Altered in Hepatocellular
Carcinoma
Version: 2Date:24 September 2010
Reviewer: Jun-ichi Okano
Reviewer's report:
I have read carefully their revised article entitled “IQGAP1 and IQGAP2 are
Reciprocally Altered in Hepatocellular Carcinoma.” by White CD et al. They have
answered our questions in most parts. Therefore, I believe their revised article is
acceptable in BMC Gastroenterology except two minor points as below.
1. In page 5, lines 6 and 7, spaces are lost before units. “lysed in lysis buffer
(50mM Tris (pH 8.0), 100 mM NaF, 30 mM Na4P2O7, 2 mM Na2MoO4, 5 mM
EDTA, 2mM Na3VO4)” should be “lysed in lysis buffer (50 mM Tris (pH 8.0), 100
mM NaF, 30 mM Na4P2O7, 2 mM Na2MoO4, 5 mM EDTA, 2 mM Na3VO4)”.
2. In page 7, line 3, a space is necessary between “positive if more than 10% of
cells stained strongly in the cytoplasm.” and semi-title “Quantitative real-time
PCR”.
Best regards,
Jun-ichi Okano, M.D.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Review for 10.1186/1471-230X-10-124 (2010)

Reviewer's report
Title:Management of patients with biliary sphincter of Oddi disorder without
sphincter of Oddi manometry
Version: 1Date:21 July 2010
Reviewer: Benedetto Mangiavillano
Reviewer's report:
Major Revisions
1. Did the patients performing ERCP plus EBS undergo ERCP pharmacological
prophylaxis with anti-proteasic drugs (es. Gabexate-mesilate)?
2. Please create a flow-chart on the management of these patients.
3. Please report your results in a table to be more simply for the readers.
4. In the section “Results- ERCP and sphincterotomy”: please specify if the
patients undergone ERCP had other risk factors for post-ERCP pancreatitis
(PEP). See: “Risk factors for pancreatitis following endoscopic retrograde
cholangiopancreatography: a meta-analysis. Masci E, Mariani A, Curioni S,
Testoni PA. Endoscopy. 2003 Oct;35(10):830-4”. Did you perform pre-cut
technique during the ERCP? How many of these had sludge/stones? Please
create a table with risk factors, technique, n° of ERCP and outcome of the
patients undergone sphincterotomy.
5. Please report the percentage of PEP after the first ERCP in the EBS treated
patients. You reported a 18% of complications (9 complications on 50 ERCP) but
the treated patients were 24.
6. In the abstract (Results) is reported seventy-eight % of complications. Is it a
correct data?
Minor Revisions
1. In the ”Methods – Patients” and “Methods – Management” section, first line,
please substitute “patients with biliary SOD...” with “patients with a clinical
diagnosis of SOD”.
2. Delete the last sentences in the “conclusions” in the abstract, discussing the
possible multifactorial origin of the SOD pain.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-10-124 (2010)

Reviewer's report
Title:Management of patients with biliary sphincter of Oddi disorder without
sphincter of Oddi manometry
Version: 2Date:7 October 2010
Reviewer: C Mel Wilcox
Reviewer's report:
The authors' changes have markedly improved the quality of the manuscript. The
major limitations still remain and have been acknowledged by the authors.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare I have no competing interests
Review for 10.1186/1471-230X-10-124 (2010)

Reviewer's report
Title:Management of patients with biliary sphincter of Oddi disorder without
sphincter of Oddi manometry
Version: 2Date:8 October 2010
Reviewer: Benedetto Mangiavillano
Reviewer's report:
No other comments
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
no
Review for 10.1186/1471-230X-10-123 (2010)

Reviewer's report
Title:Maximizing the general success of cecal intubation during propofol
sedation in a multi-endoscopist academic centre
Version: 1Date:12 August 2010
Reviewer: Russell Heigh
Reviewer's report:
This is an interesting retrospective review of a large number of colonoscopies
performed under propofol sedation. The most important finding notes in the
Results is that "having a colonoscopy by a less experienced endoscopist
coincided with a 5 fold increased risk of an incomplete procedure by comparison
with colonoscopies handled by a highly experienced specialist; this risk dropped
to a 2 fold increase if the test was performed by a more experienced non
specialist." Unfortunately the authors do not talk about direct remediation of the
underlying quality problem they identified, or of the ethical decision making
involved in allowing unqualified colonoscopists to perform the procedure at all.
Instead, the authors talk about shunting patients who are easier to the least
qualified colonoscopist. Until the core issue is addressed, perhaps with
comparison to other studies where quality outliers are dealt with, the study is not
publishable. Revising the Discussion and Conclusions would merit re review.
Minor points include no mention of: dates when study was conducted, institution
IRB approval, and total number of colonoscopies (instudy and out of study)during
study period In the Discussion"technical machismo" should be substituted for a
more appropriate term, perhaps technical ability.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Review for 10.1186/1471-230X-10-123 (2010)

Reviewer's report
Title:Maximizing the general success of cecal intubation during propofol
sedation in a multi-endoscopist academic centre
Version: 3Date:8 September 2010
Reviewer: franco radaelli
Reviewer's report:
I evaluated the revides version of the manuscript.
The authors well addressed the main concerns raised by the reviewer.
I consider the manuscript now acceptable for pubblication.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests' below
Review for 10.1186/1471-230X-10-123 (2010)

Reviewer's report
Title:Maximizing the general success of cecal intubation during propofol
sedation in a multi-endoscopist academic centre
Version: 3Date:11 September 2010
Reviewer: Russell Heigh
Reviewer's report:
The authors did an excellent job revising the critical aspects of the study. The
study needs just one minor but essential correction, and is then suitable and
ready for publication. The findings are interesting and will be helpful to many
centers considering how to best deliver colonoscopy care to their population.
The error is on page 3 in Background. Rather than the stated expected polyp
detection rates which are inadvertantly reversed, the correct expected rate is
25% in men and 15% in women age 50 or greater undergoing their first
colonoscopy. This minor problem should be simply adressed, and then the paper
should be published. COngratulations to the authors for their important reflection
on their practice, and for the revisions necessary to make the results applicable
to the global community.
Level of interest: An article of outstanding merit and interest in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Review for 10.1186/1471-230X-10-122 (2010)

Reviewer's report
Title:Life-threatening hypersplenism due to idiopathic portal hypertension in
early childhood: Case report
Version: 2Date:29 March 2010
Reviewer: jean de Ville de goyet
Reviewer's report:
Case report type paper; the authors present a patient with a remarkable clinical
presentation, being massive splenomegaly and secondary ipersplenism causing
a lifethreatining clinical condition, mostly ventilation failure by abdominal
distension and diafragmatic compression. They hypothetised idiopathic portal
hypertension as primary disease,with splenectomy being the radical and
complete treatment.
Major Compulsory Revisions:
They are few contradictions or inconcistencies:
- With the primary diagnosis in this child being idiopathic portal hypertension, it is
a requisite to demonstrate that there was an increase in portal pressure: there is
in fact no evidence at all in the paper that portal pressure was high. A grade 1
gastropathy is - per se and in the critical condition of the child - not indicative of
portal hypertension, when all other facts do not support the latter hypothesis.
- The authors refers to the size of portal vein (that is within the normal range for
age!) and hyperdynamic state as a sign of portal hypertension when in fact they
write also "absence of formally abnormal portal vein flow on Doppler Ultrasound"
- Splenomegaly per se is not a sign of portal hypertension, as is not
Hepatomegaly.
- In the worse condition of portal hypertesnion, splenomegaly develops
moderately with time and never causes such rapidly progressing organomegaly
in children; The latter rapid development suggest rather a malformative growth.
Vascular malformations and angiomas typically grow rapidly during early
childhood and some can be associated with major trombopenia and coagulation
disorders causing hemorrhagic diathesis. Even the results of immunochemistry
would be consistent within the latter context.
- Overall, the authors cannot prove that portal hypertension was present and this
is major weakness in discussing the case as presented; they may have faced a
condition with a primary disorder of the spleen causied secondary ipersplenism
and abdominal compression, and of course a resolution of the symptoms after
splenectomy.
Minor Essential Revisions
The terminology "Banti syndrome", a term mostly used in the past to describe
any condition with splenomegaly of uncertain origin, has been quasi abandonned
in literature and nearly disappeared from papers a decade ago. It is nowadays
accepted that in most cases portal hypertension had a specific, but
unrecognised, cause.
Discretionary Revisions
Level of interest: An article of insufficient interest to warrant publication in a
scientific/medical journal
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
'I declare that I have no competing interests'
Review for 10.1186/1471-230X-10-122 (2010)

Reviewer's report
Title:Life-threatening hypersplenism due to idiopathic portal hypertension in
early childhood: Case report
Version: 2Date:7 April 2010
Reviewer: moritz M ziegler
Reviewer's report:
Major Revisions:
1.The author's have concluded that management of IPH may best be done by
splenectomy when secondary sequestration is a complication and the
normalization of the liver and disease process has indicated the role of the
spleeen in its etiology. However, the author's have made no mention of the
well-described observation that splenectomy or even spelenic transposition may
be an effective treatment of portal hypetension alone, and the reduction in the
degree of flow thru the spleen into the portal circulation would be expected to
enhance liver function and reduce portal pressures post-splenectomy
independent of any causality of the spleen and IPH. eNOS, VCAM-1, and ET-1
may play a role in the pathogenesis of IPH, but it is equally plausible that the
author's are reporting a secondary benefit of splenectomy in portal hypertension
reducuing portal pressures. This requires elaboration in the manuscript.
2. The author's have made no mention of the possible role of partial
spelencectomy in this IPH disease management. This would hve the benefit of
treating the high-flow portal state yet salvagng portion of the spleeen for
protecting the infant form blood post-splenectomy infections.
Minor Revisions:
1. A series of spelling and grammatical errors require correction.
Discretionary Revisions:
1. The illustrative figures and tables are valuable and add positively to the quality
of the manuscript.
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Review for 10.1186/1471-230X-10-122 (2010)

Reviewer's report
Title:Life-threatening hypersplenism due to idiopathic portal hypertension in
early childhood: Case report and review of the literature
Version: 3Date:31 May 2010
Reviewer: moritz M ziegler
Reviewer's report:
The quality of the manuscript is much improved and its "readability" is
satisfactory. The author's have satisfactorily addressed the critques of the
reviewers. The patient outcome result of the case report is excellent, but the
cause-effect relationship of the abnormal marker expression and proposed
pathophysiology of Idiopathic Portal Hypertension is still not without a degree of
speculation since causality could be a "secondary effect" as well. The abstract,
conclusions, tables and figures are all improved and should not need further
modification.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Review for 10.1186/1471-230X-10-122 (2010)

Reviewer's report
Title:Life-threatening hypersplenism due to idiopathic portal hypertension in
early childhood: Case report and review of the literature
Version: 3Date:7 June 2010
Reviewer: Henry Rice
Reviewer's report:
The authors have resubmitted a revised version of a case report entitled
"Life-threatening hypersplenism in early childhood: Case report and review of the
literature." In its present form, there are still far too many shortcomings with this
paper that limit my enthusiasm for publication of this report.
Specifically:
1) The underlying concept of this paper is that idiopathic portal hypertension is
the cause of the underlying disease, rather than hypersplenism itself from other
causes. In the absence of clear documentation of elevated portal pressures, this
presumption remains still unclear, and therefore the overall concept of this report
remains doubtful in my mind.
2) There are still far too many grammatical errors, despite being a revised
submission. Several are highlighted below, but the abundance of them raises
ongoing concerns.
Abstract
1) The concept of "uncontrolled splenic hyperperfusion...with subsequent
hypersplenism" is not proven. As this case may simply represent hypersplenism,
this should be qualified.
2) Again, hyperperfusion is not clearly demonstrated, therefore, the choice of
therapies should be directed toward hypersplenism, not hyerperfusion.
Background
1) Poorly worded and structured. Should be several paragraphs, not just one.
Phrases such as "amongst others" should be edited. Similarly, the word
"etiopathogenesis" is new to me, and not sure what it means. A careful review by
a native English speaking editor would be mandatory prior to reconsider for
publication.
2) The findings of lack of overy hepatic malfunction does not, to my mind, have
anything to do with congenital causes of hypersplenism as opposed to acquired
causes.
Case Presentation
1) Pathogenic findings is not proper heading.
2) Again, conclusions about portal hypertension are not proven, and therefore
should be qualified.
3) Decision to not measure portal pressures sounds resonable, but it is not true
that this child was "critically ill."
4) Page 6, the phrase "antibiotic-resistant septic temperatures" is unclear.
Bacteremia? Fevers? Antibiotic-resistant organisms? To be published in an
English journal, phrases such as this need to be clarified.
Level of interest: An article of limited interest
Quality of written English: Not suitable for publication unless extensively edited
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
No competing interests
Review for 10.1186/1471-230X-10-121 (2010)

Reviewer's report
Title:Cronkhite-Canada syndrome associated with rib fracture: a case report.
Version: 1Date:1 June 2010
Reviewer: Atsushi Irisawa
Reviewer's report:
CCS is interesting disease that has various kind of concominant disease.
I read fascinatingly your manuscript, but it was totally lack of essential data that
suggest direct association between CCS and rib fracture. Both lesions seemed to
just incidentally happen at same time.
I wrote each item below that you should add before your manuscript will be
reconsidered to be accepted.
1. You should add laboratory data on admission and changes after treatment.
2. I would like to know in detail about the etiology of rib fracture. First, did you
check bone metastasis, especially osteolytic bone metastases that are not
sensitive for bone scan? Negative data of bone scan did not guaranty absence of
bone metastases.
Second, you should add hormonal examination. As you know, there are many
hormone and substances associated with bone metabolism.
Third, how about bone densitometry on vertebrae lumbales or caput femoris?
Last, why you did not consider surgical treatment? In this case, you used
corticosteroid that will have harm effect for bone healing. In some patients of
CCS, steroid is used for life long. Then, you should consult to orthopedic surgeon
the bone management.
3. Did he have any medical history of congenital disease, for example
Osteogenesis imperfecta? His general appearance will be helpful for speculation.
Review for 10.1186/1471-230X-10-121 (2010)

Reviewer's report
Title:Cronkhite-Canada syndrome associated with rib fracture: a case report.
Version: 1Date:12 June 2010
Reviewer: Klaus MÃ¶nkemÃ¼ller
Reviewer's report:
Major revisions:
Please check on English grammar and spelling, e.g. "This patient complicated by
rib fracture": this sentence needs rewriting.
Did the patient have any history of trauma, persitent cough or chest pain? Why
did you perform the whole body bone scan? (this is mentoned in the discussion
but should bementioned in the case report).
Please describe the rib fracture more thoroughly. It is unusual for a rib fracture to
persist after three months. Why do you think the fractures still persisted?
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-10-121 (2010)

Reviewer's report
Title:Cronkhite-Canada syndrome associated with rib fractures: a case report.
Version: 2Date:21 August 2010
Reviewer: Atsushi Irisawa
Reviewer's report:
There are no major revisions. There still are a few points to be corrected.
Minor revisions include spell miss and grammatically incorrect sentence.
1) Histological examination of the biopsy specimens from stomach showed
adenomatous poly and from colon showed inflammatory polyp.
2) After one month of home nutrition support therapy, he was admitted to our
hospital the third time to further improve his nutritional condition.
Is the sentence underlined grammatically correct?
Level of interest: An article of limited interest
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Review for 10.1186/1471-230X-10-120 (2010)

Reviewer's report
Title:Autoantibodies to muscarinic acetylcholine receptors found in patients with
primary biliary cirrhosis
Version: 2Date:19 August 2010
Reviewer: Nancy Agmon-Levin
Reviewer's report:
1. Is the question posed by the authors well defined? YES 2. Are the methods
appropriate and well described? YES 3. Are the data sound? YES 4. Does the
manuscript adhere to the relevant standards for reporting and data deposition?
YES 5. Are the discussion and conclusions well balanced and adequately
supported by the data? YES 6. Are limitations of the work clearly stated? YES 7.
Do the authors clearly acknowledge any work upon which they are building, both
published and unpublished?
8. Do the title and abstract accurately convey what has been found? YES 9. Is
the writing acceptable? YES
- Minor Essential Revisions :
This is a nice manuscript on a plausible new association between hmAchR
M3 specific antibodies and primary biliary cirrhosis.
Several comments:
1. The manuscript lack demographic (age, lenth of diagnosis etc), clinical,
biochemical and serological association between those PBC seropositive to
hmAchR M3 antibodies and those who are negative.
2 A more detailed discussion on the lack of clinical correlation between AMA (the
major diagnostic marker) and PBC, as well as the need for new serological
markers which may be of clinical importance is required (see recent manuscript A
comprehensive evaluation of serum autoantibodies in primary biliary cirrhosis J
Autoimmun. 2010
Feb;34(1):55-8.)
Review for 10.1186/1471-230X-10-120 (2010)

Reviewer's report
Title:Autoantibodies to muscarinic acetylcholine receptors found in patients with
primary biliary cirrhosis
Version: 2Date:20 August 2010
Reviewer: Hiroshi Miyakawa
Reviewer's report:
Berg et al. demonstrated the presence of autoantibodies to the hmAcr M3 in PBC
patients.
This paper is interesting and is suitable for publication of this journal.
However, minor revision is needed.
1) Autoantibodies to the hmAcr M3 have been reported in sera from patients with
SjS. The authors reported presence of the autoantibodies also in sera from
patients with PBC.
In patients the antibody-positive patients with PBC, were serum anti-SS-A/SS-B
autoantibodies examined? This issue is important.
2) In test, the last number of references is 45. However, the number of total
references is 46. Authors are needed to edit the references.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Review for 10.1186/1471-230X-10-119 (2010)

Reviewer's report
Title:New PRSS1 and common CFTR mutations in a child with acute recurrent
pancreatitis, could be considered an "Hereditary" form of pancreatitis ?
Version: 1Date:17 March 2010
Reviewer: Atsushi Masamune
Reviewer's report:
Major Compulsory Revisions (which the author must respond to before a
decision on publication can be reached)
This is a well-written paper describing a novel PRSS1 polymorphism, co-existing
with a well-known CFTR mutation, in a patient with recurrent acute pancreatitis.
But, this report deals with a single case report, and the role of the novel PRSS1
mutation remains unknown in the absence of functional study. Because the
patient carries the F508del CFTR mutation, it is likely that the mechanism
underlying the recurrent episodes of acute pancreatitis might be due to the
presence of the CFTR mutation.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.