JerMa88/BMC_Gastroenterology_Peer_Reviews huggingface dataset:
Review for 10.1186/1471-230X-3-4 (2003)

Reviewer's report 
 The course of traumatic pancreatitis in a patient with pancreas divisum: a case report Title: 
Authors: 
Dr Evangelia G Chryssou ( gellych@hotmail.com )
Panos Prassopoulos ( prassop@med.uoc.gr )
Prof John Mouzas ( mouzas@med.uoc.gr )
Thomas G Maris ( tmaris@med.uoc.gr )
Nicholas Gourtsoyiannis ( gournick@med.uoc.gr )
 1  25 Nov 2002 Version: Date: 
 Prof Jose Sahel Reviewer: 
 A paper whose findings are important to those with closely related research Level of interest: 
interests 
 Other (see below) Advice on publication: 
This paper reports on a case of pancreas divisum complicated by a cyst in the head of the pancreas, 
developped on the dorsal segment, and associated with a slight dilatation of the dorsal duct system. 
The peculiarity of the observation is that acute attacks of pancreatic pain were observed 4 months after a blent abdominal trauma. Several questions arise but answers are unclear or controversial. 
1/ Were the recurrent attacks of pancreatitis (8 episodes) secondary to the cyst or to pancreas 
divisum itself ? Since endoscopic cyst-duodenostomy was followed by both disappearance of the cyst and improvement of the patient's condition, the first hypothesis is likely to be right. 
2/ MRCP confirmed the diagnosis of pancreas divisum and showed a cyst in the head of the 
pancreas and a dilatation of the dorsal ducts. 2-1 : This technique of imaging is usually unable to show the communication between ducts and the cyst (exept when IV secretin is done). In the observation it can be said that there was a continuity, 
rather than a communication, between the cyst and the dorsal ducts. The only way to demonstrate a 
communication should be dorsal pancreatography but unfortunately, cannulation of the minor papilla 
was unsuccessful. 
2-2 : There is a discrepancy between the slight dilatation of the dorsal ducts, and the " atrophy " of 
the body and tail of the pancreas demonstrated by MRI. 
3/ Was the cystic lesion secondary to the abdominal trauma ? This is questionable, especially 
because of the small size of the cyst and its location in the head (and not in the body as usually 
reported) of the pancreas. The authors do not indicate whether an imaging work-up (echography, 
CT) was performed at the time of the blunt trauma. 
4/ Follow-up of the patient should be continued since he " is still unfrequently, complaining of mild 
upper abdominal pain ". If a relationship can be established between pain and pancreas divisum, or 
between pain and pancreatitis located on the dorsal duct system (was the patient alcoholic ?), then a 
treatment of the ductal abnormality should be tried by either endoscopic sphincterotomy of the minor 
papilla, or dorsal duct stenting or surgical sphincteroplasty of the minor papilla. 
Competing interests: 
None declared.
Review for 10.1186/1471-230X-3-4 (2003)

Reviewer's report 
 The course of traumatic pancreatitis in a patient with pancreas divisum: a case report Title: 
Authors: 
Dr Evangelia G Chryssou ( gellych@hotmail.com )
Panos Prassopoulos ( prassop@med.uoc.gr )
Prof John Mouzas ( mouzas@med.uoc.gr )
Thomas G Maris ( tmaris@med.uoc.gr )
Nicholas Gourtsoyiannis ( gournick@med.uoc.gr )
 3  5 Feb 2003 Version: Date: 
 Jose Sahel Reviewer: 
 A paper whose findings are important to those with closely related research Level of interest: 
interests 
 Other (see below) Advice on publication: 
The new version seems now acceptable. 
Competing interests: 
None declared.
Review for 10.1186/1471-230X-3-4 (2003)

Reviewer's report 
 The course of traumatic pancreatitis in a patient with pancreas divisum: a case report Title: 
Authors: 
Dr Evangelia G Chryssou ( gellych@hotmail.com )
Panos Prassopoulos ( prassop@med.uoc.gr )
Prof John Mouzas ( mouzas@med.uoc.gr )
Thomas G Maris ( tmaris@med.uoc.gr )
Nicholas Gourtsoyiannis ( gournick@med.uoc.gr )
 3  6 Feb 2003 Version: Date: 
 Miin-Fu Chen Reviewer: 
 A paper of limited interest Level of interest: 
 Other (see below) Advice on publication: 
I agreed with the author's responses to the reviewers and recommend that the 
manuscript by Chryssou et al can be accepted as a case report to publish in your journal. 
Competing interests: 
None declared.
Review for 10.1186/1471-230X-3-3 (2003)

Reviewer's report 
 Transfection of IL-10 expression vectors into endothelial cultures attenuates alpha 4 beta Title: 
7-dependent lymphocyte adhesion mediated by MAdCAM-1 
Authors: 
Makoto Sasaki ( msasak@lsuhsc.edu )
Paul Jordan ( pjorda1@lsuhsc.edu )
Jeff Houghton ( jhough@lsuhsc.edu )
Xianmin Meng ( mengderm@yahoo.com )
Makoto Itoh ( mitoh@med.nagoya-cu.ac.jp )
Takashi Joh ( tjoh@med.nagoya-cu.ac.jp )
J. S. Alexander ( jalexa@lsuhsc.edu )
 1  24 Dec 2002 Version: Date: 
 Dr Soichiro Miura Reviewer: 
 A paper of considerable general medical or scientific interest Level of interest: 
 Accept after discretionary revisions Advice on publication: 
This is an interesting report in which authors suggested that gene therapy of the gut microvasculature 
with IL-10 vectors significantly attenuated the TNF-alpha-induced lymphocyte adhesion to endothelial 
cells as well as TNF-alpha-induced expression of MAdCAM-1. However, I have several concerns as 
follows; 
1. In this manuscript, the authors describe SVEC4-10 cell line as lymphatic endothelial cells. I suppose 
that this is a venular endothelial cell line, not a lymphatic-endothelium derived cell line? Since biological 
nature of lymphatic endothelial cells are largely different from that of venular endothelial cells, the 
vascular origin of this cell line should be carefully presented. 
2. In this paper, there is no evidence that TNF-alpha-stimulated lymphocyte adhesion was due to the enhanced MAdCAM-1 expression. Because TNF-alpha may also upregulate other adhesion molecules (i.e. ICAM-1, VCAM-1 etc.), and because the TK-1 adhesion is only 50% MAdCAM-1 dependent, the 
authors should clarify the effect of IL-10 transfection on other adhesion molecules, and their roles in 
enhanced lymphocyte adhesion. 3.It is intriguing that IL-10 transfection did not affect the basal levels of MAdCAM-1 expression as well as lymphocyte adhesion to the endothelial cells. This means that there is a significant difference in 
regulation of MAdCAM-1 expression between basal and stimulated conditions. Please explain more in 
detail about the possible reason for this in the Discussion. 
Minor Comments: 
1. How IL-10 transfection affect the morphology, proliferation or permeability of this cell line? These 
informations are important to the reader to consider clinical application. 2. Abstract line 13, TNF-alpha induced -1 expression. 
Competing interests: 
None declared.
Review for 10.1186/1471-230X-3-3 (2003)

Reviewer's report 
 Transfection of IL-10 expression vectors into endothelial cultures attenuates alpha 4 beta Title: 
7-dependent lymphocyte adhesion mediated by MAdCAM-1 
Authors: 
Makoto Sasaki ( msasak@lsuhsc.edu )
Paul Jordan ( pjorda1@lsuhsc.edu )
Jeff Houghton ( jhough@lsuhsc.edu )
Xianmin Meng ( mengderm@yahoo.com )
Makoto Itoh ( mitoh@med.nagoya-cu.ac.jp )
Takashi Joh ( tjoh@med.nagoya-cu.ac.jp )
J. S. Alexander ( jalexa@lsuhsc.edu )
 1  14 Jan 2003 Version: Date: 
 David Binion Reviewer: 
 A paper of considerable general medical or scientific interest Level of interest: 
 Accept without revision Advice on publication: 
The paper is a straightforward and interesting report of the inhibition of MAdCAM-1 expression in a 
mouse endothelial cell line using IL-10 transfection. This is the first report of MAdCAM-1 inhibition using 
a transfection based strategy. The data is succinct and convincing, and is an important contribution to 
the area of experimental microvascular gene therapy, with potential relevance to human IBD. 
Competing interests: 
None declared.
Review for 10.1186/1471-230X-3-2 (2003)

Reviewer's report 
 Dieulafoy's lesion of duodenum: a case report Title: 
Authors: 
Mohammed Ibrarullah ( m_ibrarullah@yahoo.co.in )
Dr Gajanan D Wagholikar ( drgajanan2002@yahoo.com )
 1  19 Dec 2002 Version: Date: 
 cemalettin ertekin Reviewer: 
 A paper of considerable general medical or scientific interest Level of interest: 
 Accept after discretionary revisions Advice on publication: 
1. Are the conclusions drawn adequately supported by the data shown: if not, 
to mention the effective treatment modality as injection therapy, two cases are not acceptable, it can be 
only a suggestion 
2. Does the work have any serious flaws that should preclude publication? 
No 
3. Are sufficient details provided to allow replication of the work or comparison with related analyses: if 
not, what is missing? The treatment modalities should be expressed in more details. For instance, although band ligation plays an important role in endoscopic treatment of upper gi bleedings including Dieulafoy lesions,it is 
not discussed in this manuscript. References can be updated. Extra gastric location of the lesion can be 
stressed with examples. 
4. Does the manuscript adhere to the relevant standards for reporting and data deposition: if not, in what 
ways? 
Abovely mentioned data can support the contents of article 
5. Do the title and abstract accurately convey what has been found? 
yes 
6. Is the writing acceptable? 
Reevaluation is necessary after corrections 
a) Discretionary revisions 
TERATMENT MODALITIES OF THESE RARE LESIONS SHOULD CERTAINLY CONSIST OF BAND 
LIGATION. THIS MODALITY SHOULD BE MENTIONED IN THIA ARTICLE. ALSO OTHER EXTRA 
GASTRIC LESION SITES MIGHT BE UNDERLINED WITH SOME EXAMPLES TO CLARIFY THE 
IDEA ON THE READERS MIND. 
b) Compulsory revisions 
REFERENCES SHOULD BE UPDATED 
Competing interests: 
None declared.
Review for 10.1186/1471-230X-3-2 (2003)

Reviewer's□report 
□Dieulafoy's□lesion□of□duodenum:□a□case□report Title: 
Authors: 
Mohammed□Ibrarullah□( m_ibrarullah@yahoo.co.in )
Dr□Gajanan□D□Wagholikar□( drgajanan2002@yahoo.com )
□2□ □30□Jan□2003 Version: Date: 
□cemalettin□ertekin Reviewer: 
□A□paper□of□considerable□general□medical□or□scientific□interest Level□of□interest: 
□Other□(see□below) Advice□on□publication: 
[see□comments□to□editors] 
Competing□interests: 
None□declared.
Review for 10.1186/1471-230X-3-1 (2003)

Reviewer's□report 
□Solitary□Pancreatic□Tuberculous□Abscess□Mimicking□Prancreatic□Cystadenocarcinoma:□Report□of□ Title: 
a□Case 
Authors: 
Quanda□Liu□( liuquanda@sina.com )
Zhenping□He□( hezp@sina.com )
Ping□Bie□( biep@sina.com )
□1□ □20□Sep□2002 Version: Date: 
□Dr□Pieter□ter□Borg Reviewer: 
□A□paper□of□limited□interest Level□of□interest: 
□Accept□after□discretionary□revisions Advice□on□publication: 
General□remarks□ 
The□primary□aim□of□the□present□case□report□is□to□increase□doctors'□awareness□of□pancreatic□tuberculosis, 
in□order□to□avoid□misdiagnosis.□Although□pancreatic□involvement□is□without□any□doubt□a□rare□ 
manifestation□of□tuberculosis,□several□case□reports□have□been□published□previously.□However,□since□ 
early□recognition□may□significantly□influence□patient's□outcome,□publication□will□be□of□value.□ 
Discretionary□revisions□ 
An□unexplained□finding□in□the□present□patient□is□the□enlarged□spleen,□which□did□not□decrease□in□size□after 
otherwise□successful□treatment.□Since□the□authors□describe□variceal□bleeding□caused□by□splenic□vein□ 
thrombosis□as□a□complication□of□pancreatic□tuberculosis,□additional□data□on□the□possible□presence□of□ 
splenic□or□portal□vein□thrombosis□and□subsequent□(segmental)□portal□hypertension□could□be□added.□ 
In□the□discussion□the□authors□state□that□"antituberculous□chemotherapy□with□aspiration□or□pigtail□drainage 
may□be□sufficient".□However,□evidence□supporting□the□need□for□aspiration□or□drainage□is□lacking,□and□ 
several□previous□case□reports□describe□successful□treatment□without□drainage□(1-3).□The□authors□should□ 
(at□least□briefly)□discuss□this□treatment□option.□ 
The□authors□could□report□on□possible□TBC□contacts□other□than□affected□family□members□the□presented□ 
patient□might□have□had.□ 
In□the□abstract□and□in□the□background□section,□the□authors□state□that□pancreatic□tuberculosis□is□always□ 
initially□misdiagnosed□as□pancreatic□cancer.□Since□several□case□reports□report□accurate□diagnosis□with□ 
for□example□fine-needle□aspiration,□"always"□should□at□least□be□replaced□by□"frequently"□(1,□4).□ 
1.□Evans□JD,□Hamanaka□Y,□Olliff□SP,□Neoptolemos□JP.□Tuberculosis□of□the□pancreas□presenting□as□ 
metastatic□pancreatic□carcinoma.□A□case□report□and□review□of□the□literature.□Dig□Surg□2000;17(2):183-7.□ 
2.□Echenique□Elizondo□M,□Amondarain□Arratibel□J,□Compton□CC,□Warshaw□AL.□Tuberculosis□of□the□ 
pancreas.□Surgery□2001;129(1):114-6.□ 
3.□Ozden□I,□Emre□A,□Demir□K,□Balci□C,□Poyanli□A,□Ilhan□R.□Solitary□pancreatic□tuberculosis□mimicking□ 
advanced□pancreatic□carcinoma.□J□Hepatobiliary□Pancreat□Surg□2001;8(3):279-83.□ 
4.□Riaz□AA,□Singh□A,□Robshaw□P,□Isla□AM.□Tuberculosis□of□the□pancreas□diagnosed□with□needle□ aspiration.□Scand□J□Infect□Dis□2002;34(4):303-4.□ 
Competing□interests: 
None□declared.
Review for 10.1186/1471-230X-3-1 (2003)

Reviewer's report 
 Solitary Pancreatic Tuberculous Abscess Mimicking Prancreatic Cystadenocarcinoma: Report of Title: 
a Case 
Authors: 
Quanda Liu ( liuquanda@sina.com )
Zhenping He ( hezp@sina.com )
Ping Bie ( biep@sina.com )
 1  9 Oct 2002 Version: Date: 
 Prof Gregory Kouraklis Reviewer: 
 A paper of considerable general medical or scientific interest Level of interest: 
 Unable to decide on acceptance or rejection until the authors have responded Advice on publication: 
to the compulsory revisions 
Compulsory revisions 
The authors report an extremely rare case of a young woman with primary pancreatic tuberculosis, who 
was initially diagnosed as pancreatic cystadenocarcinoma. 
This unusual case emphasizes the preoperative diagnostic difficulties and that in all suspected cases of 
pancreatic carcinoma an attempt should be made to confirm the diagnosis by Ultrasound guided needle 
biopsy. Eventhough, I agree with the authors view that cytological confirmation is mandatory before a 
diagnosis of pancreatic carcinoma is established (1), the authors should report in the discussion that 
others believe that preoperative biopsy should not perform when carcinoma is suspected, because of 
the potential risk of tumor dissemination (2). References 1. Kouraklis G, Glinavou A, Karayiannakis A, Karatzas G: Primary tuberculosis of the pancreas 
mimicking a pancreatic tumor. Int J Pancreatol 29(3):151-153, 2001 
2. Warshaw AL: Implications of peritoneal cytology for staging of early pancreatic cancer. Am J Surg 161:26-30, 1991 
Competing interests: 
None declared.
Review for 10.1186/1471-230X-3-1 (2003)

Reviewer's report 
 Solitary Pancreatic Tuberculous Abscess Mimicking Prancreatic Cystadenocarcinoma: Report Title: 
of a Case 
Authors: 
Quanda Liu ( liuquanda@sina.com )
Zhenping He ( hezp@sina.com )
Ping Bie ( biep@sina.com )
 2  22 Nov 2002 Version: Date: 
 Prof Gregory Kouraklis Reviewer: 
 A paper of considerable general medical or scientific interest Level of interest: 
 Accept without revision Advice on publication: 
The revised article could be now accepted for publication. 
Competing interests: 
None declared.
Review for 10.1186/1471-230X-2-23 (2002)

Reviewer's report 
 Expression of cytokine and chemokine mRNA and secretion of tumor necrosis factor-a by Title: 
gallbladder epithelial cells: Response to bacterial lipopolysaccharides 
Authors: 
Christopher E Savard ( cesavard@u.washington.edu )
Thane A Blinman ( blinman@email.chop.edu )
Ho-Soon Choi ( choihs@hanyang.ac.kr )
Sung-Koo Lee ( sklee@amc.seoul.kr )
Stephen J Pandol ( Stephen.Pandol@med.va.gov )
Sum P Lee ( splee@u.washington.edu )
 2  7 Oct 2002 Version: Date: 
 Dr KA Papadakis Reviewer: 
 A paper whose findings are important to those with closely related research Level of interest: 
interests 
 Accept without revision Advice on publication: 
The authors have addressed each comment that was raised in my critique. 
Competing interests: 
None declared.
Review for 10.1186/1471-230X-2-22 (2002)

Reviewer's report
 Adenosine preconditioning attenuates hepatic reperfusion injury in the rat by preventing the Title:
down-regulation of endothelial nitric oxide synthase
Authors:
Ferdinand Serracino-Inglott (fsinglott@hotmail.com )
Ioannis T Virlos (itvirlos@hotmail.com )
Nagy A Habib (nagy.habib@ic.ac.uk )
Robin C Willianson (r.williamson@ic.ac.uk )
Robert T Mathie (rmathie@trusthomeopathy.org )
 1  31 May 2002 Version: Date:
 Dr Gina Hotter Reviewer:
 A paper whose findings are important to those with closely related research interests Level of interest:
 Accept after discretionary revisions Advice on publication:
This study is an extension of the author's previous work on the preconditioning field with eemphasis on 
possible applications of adenosine in preventing liver ischemia reperfusion injury. The mechanism is 
postulated to involve endothelial nitric oxide synthase. Although the findings appear to confrirm the 
stated hypothesis, some aspects of the experimental design leave room for discussion. 
Comments 
Results of the present study reveals that the decrease in the inmunoreactivity of endothelial nitric oxide 
synthase ( eNOS) and liver injury after hepatic ischemia reperfusion could be both modulated by adenosine treatment. In addition, the use of L-NNA (an irreversible inhibitor of constitutive NOS as well 
as reversible inhibitor of inducible NOS) leads to the inhibition of the protection confered by adenosine. 
From these results authors conclude that the protective role of adenosine is mediated by upregulation 
of endothelial NOS. 
Authors should use a more specific inhibitor of endothelial NOS to be sure that the inhibition of this NOS
isoform reduces the protection confered by adenosine preconditioning, or alternatively report data ( 
inmunohistochemistry of other specific isoforms) indicative of the non-existence of any NOS up-regulation. 
Competing interests:
None declared.
Review for 10.1186/1471-230X-2-22 (2002)

Reviewer's□report 
□Adenosine□preconditioning□attenuates□hepatic□reperfusion□injury□in□the□rat□by□preventing□the□ Title: 
down-regulation□of□endothelial□nitric□oxide□synthase 
Authors: 
Ferdinand□Serracino-Inglott□( fsinglott@hotmail.com )
Ioannis□T□Virlos□( itvirlos@hotmail.com )
Nagy□A□Habib□( nagy.habib@ic.ac.uk )
Robin□C□Willianson□( r.williamson@ic.ac.uk )
Robert□T□Mathie□( rmathie@trusthomeopathy.org )
□1□ □28□Aug□2002 Version: Date: 
□Prof□Giorgio□Della□Rocca Reviewer: 
□A□paper□of□considerable□general□medical□or□scientific□interest Level□of□interest: 
□Accept□after□discretionary□revisions Advice□on□publication: 
a)□Discretionary□revisions□ 
The□paper□deals□with□a□very□interesting□topic:□ischemia-reperfusion□injury,□that□can□be□applied□to□so□ 
many□field□of□interest.□The□use□of□I.V.□adenosine□seems□to□decrease□the□reperfusion□injury□in□this□ 
animal□model.□It□may□be□of□higher□interest□if□applied□on□human□beings.□The□discussion□section□may□ 
be□extended□as□it□may□be□direct□to□clinical□application□in□solid□organ□transplantations.□ 
b)□Compulsory□revisions□ 
page□5.□Methods□-□Experimental□procedures.□ 
Line□3:□change□Hypnorm□with□its□pharmacological□compound.□ 
Line□6.□Lectromed□UK:□model□and□Town□are□missing.□ 
Line□24.□You□have□to□justify□the□arterial□route□of□administration.□ Page□9.□Discussion.□ Line□1.□"The□activation□of□pro-inflammatory□genes□with□thw□subsequent□expression□of□ 
pro-inflammatory□cytokines............involved□in□the□pathogenesis□of□hepatic□reperfusion□injury"□is□to□ 
supported□by□literature.□You□can□add□a□reference□or□you□have□to□address□that□it□is□suggestive□but□it□is□ 
only□an□author's□opinion.□ 
Line□11.□"Adenosine,□by□preventing....."□it□is□the□same□reported□above,□as□the□only□reference□you□cite□ 
is□n.□12□(line□17)□dealing□with□cardiac□ischemia-reperfusion□and□not□with□the□liver.□ 
Line□22.□"By□altering□blood□flow...."□Add□reference□or□address□it□is□an□author's□position.□ Table□1.□ You□have□to□report□in□the□table□the□p□values□(written□in□the□text)□ 
This□table□need□to□be□changed□as□it□is□too□omogeneous.□You□have□to□put□in□evidevce□the□firs□column□ 
on□the□right□in□which□you□report□the□groups□and□the□results□reported□in□the□column□of□geometric□ 
mean,□as□this□is□the□main□findings□of□this□paper.□ 
Competing□interests: 
None□declared.
Review for 10.1186/1471-230X-2-22 (2002)

Reviewer's□report 
□Adenosine□preconditioning□attenuates□hepatic□reperfusion□injury□in□the□rat□by□preventing□the□ Title: 
down-regulation□of□endothelial□nitric□oxide□synthase 
Authors: 
Ferdinand□Serracino-Inglott□( fsinglott@hotmail.com )
Ioannis□T□Virlos□( itvirlos@hotmail.com )
Nagy□A□Habib□( nagy.habib@ic.ac.uk )
Robin□C□Willianson□( r.williamson@ic.ac.uk )
Robert□T□Mathie□( rmathie@trusthomeopathy.org )
□2□ □6□Sep□2002 Version: Date: 
□Dr□Gina□Hotter Reviewer: 
□A□paper□whose□findings□are□important□to□those□with□closely□related□research□ Level□of□interest: 
interests 
□Accept□without□revision Advice□on□publication: 
I□have□revised□carefully□the□revised□manuscript□:"Adenosine□preconditioning□attenuates□hepatic□ 
reperfusion□injury□in□the□ 
rat□by□preventing□the□down-regulation□of□endothelial□nitric□oxide□synthase"□and□I□consider□that□my□ 
original□criticism□have□been□satisfactorily□answered 
Competing□interests: 
None□declared.
Review for 10.1186/1471-230X-2-22 (2002)

Reviewer's□report 
□Adenosine□preconditioning□attenuates□hepatic□reperfusion□injury□in□the□rat□by□preventing□the□ Title: 
down-regulation□of□endothelial□nitric□oxide□synthase 
Authors: 
Ferdinand□Serracino-Inglott□( fsinglott@hotmail.com )
Ioannis□T□Virlos□( itvirlos@hotmail.com )
Nagy□A□Habib□( nagy.habib@ic.ac.uk )
Robin□C□Willianson□( r.williamson@ic.ac.uk )
Robert□T□Mathie□( rmathie@trusthomeopathy.org )
□2□ □18□Sep□2002 Version: Date: 
□Prof□Giorgio□Della□Rocca Reviewer: 
□A□paper□of□considerable□general□medical□or□scientific□interest Level□of□interest: 
□Accept□without□revision Advice□on□publication: 
As□far□as□it□regards□the□authors,□they□answered□to□all□my□original□ 
criticisms.□I□can□say□that□the□paper□is□now□suitable□for□publication.□ 
Competing□interests: 
None□declared.
Review for 10.1186/1471-230X-2-21 (2002)

Reviewer's report
 The liver is a common extra-glandular target in primary Sjogren's syndrome: A retrospective Title:
review
Authors:
Mariana J Kaplan (makaplan@umich.edu )
Robert W Ike (rike@umich.edu )
 1  18 Jun 2002 Version: Date:
 Prof David Kershenobich Reviewer:
 A paper of considerable general medical or scientific interest Level of interest:
 Unable to decide on acceptance or rejection until the authors have responded Advice on publication:
to the compulsory revisions
This is an interesting work that addresses a topic which is 
frequently forgotten by clinicians. There are however several issues 
which the authors should clarify that would help to better 
understand the liver involvement in primary Sjogren's syndrome. 
1.- The criteria of liver disfunction that the authors use are not 
clearly defined in the manuscript , they need to be indicated in the 
text. 
2.- Similarly , a statement must be made as to what criteria do 
the authors consider to define the abormalities of liver function as persistent or intermittent. 
3.- The authors state that the prevalence of liver disfunction (criteria 
to be defined) in patients with primary SS. is 49.1 %, however the real figure may be 40 % as the 14 cases without liver function test 
probably did not have overt clinical liver disease. 
4.- What is the percentage of association of hepatic disease with 
other systemic features and autoimmunity of primary SS ? 
5.- It would be of interest if the authors could be more specific in 
time when they say that in all cases the diagnosis of primary SS. antedated the onset of liver disease or its diagnosis, in particular 
as many of the patients where receiving drugs that by itself may be 
hepatotoxic and responsible of some of the laboratory abnormalities. The issue of drug toxicity is not addressed in the discussion, I think that it is very relevant that his issue surface in 
the discussion.
Competing interests:
None declared.
Review for 10.1186/1471-230X-2-21 (2002)

Reviewer's□report 
□The□liver□is□a□common□non-exocrine□target□in□Primary□Sjogren's□Syndrome:□A□retrospective□ Title: 
review. 
Authors: 
Mariana□J□Kaplan□( makaplan@umich.edu )
Robert□W□Ike□( rike@umich.edu )
□3□ □4□Sep□2002 Version: Date: 
□Dr□Anne□Marie□Pedersen Reviewer: 
□A□paper□of□limited□interest Level□of□interest: 
□Other□(see□below) Advice□on□publication: 
The□authors□have□dealt□with□my□points□of□critism□and□modified□the□paper□according□to□the□comments.□I□ 
therefore□consider□the□paper□acceptable□for□publication.□ 
However,□I□must□stress□that□I□have□not□recieved□the□tables□which□according□to□the□authors□should□have□ 
been□modified.□ 
Please□note□on□page□5,□"Results",□that□the□authors□have□not□changed□the□number:□73□cases□were□ 
included□in□the□study,□but□according□to□the□parenthesis□it□is□74□cases□(56□women□and□18□men). 
Competing□interests: 
None□declared.
Review for 10.1186/1471-230X-2-20 (2002)

Reviewer's report
 cagA and vacA in strains of Helicobacter pylori from ulcer and NUD patients Title:
Authors:
Gustavo Z Faundez (gfaundez@uec.inta.uchile.cl )
Miriam H Troncoso (mtronco@uec.inta.uchile.cl )
Guillermo G Figueroa (gfiguero@uec.inta.uchile.cl )
 1  11 May 2002 Version: Date:
 Dr Yoshio Yamaoka Reviewer:
 A paper whose findings are important to those with closely related research interests Level of interest:
 Unable to decide on acceptance or rejection until the authors have responded Advice on publication:
to the compulsory revisions
The authors examined the cagA and vacA status in Chilean population and found that cagA+/vacA 
s1m1 genotypes are closely related to duodenal ulcer. There are many similar reports including from South American population. 
cagA+/vacA s1m1 genotypes were really aEoestatisticallyaE higher in duodenal ulcer patients 
compared with in NUD patients, however the differences were trivial (p = 0.035). 
The authors should increase the patientsaETM number; otherwise it is very difficult to evaluate this 
small difference. 
They evaluated the cagA status only by PCR method using one sets of primers. The authors should use
1) multiple sets of primers, 2) PCR for cag empty site or 3) the combination of PCR and Southern blot 
hybridization. 
In title, the authors should not use abbreviations (NUD). 
Competing interests:
None declared.
Review for 10.1186/1471-230X-2-20 (2002)

Reviewer's□report 
□cagA□and□vacA□in□strains□of□Helicobacter□pylori□from□ulcer□and□NUD□patients Title: 
Authors: 
Gustavo□Z□Faundez□( gfaundez@uec.inta.uchile.cl )
Miriam□H□Troncoso□( mtronco@uec.inta.uchile.cl )
Guillermo□G□Figueroa□( gfiguero@uec.inta.uchile.cl )
□1□ □21□Jun□2002 Version: Date: 
□Dr□T□Ando Reviewer: 
□A□paper□whose□findings□are□important□to□those□with□closely□related□research□interests Level□of□interest: 
□Accept□after□discretionary□revisions Advice□on□publication: 
Faundez□et□al.□studied□the□correlation□between□cagA□or□vacA□status□and□clinical□outcomes.□They□ 
concluded□that□being□infected□by□a□H.□pylori□strain□with□genotype□cagA+/vacAs1m1□would□be□associated 
to□an□increased□risk□of□acquiring□a□duodenal□ulcer.□The□study□is□simple□and□well□designed□to□ demonstrate□the□possible□roles□of□cagA□or□vacA□in□the□virulence□of□H.□pylori.□ 
Major□(compulsory□revisions)□ 
1.□They□should□consider□about□discussion,□cite□proper□papers,□and□they□should□improve□it.□In□the□ 
Discussion,□they□discussed□the□difference□of□H.□pylori□strains□between□Asian□and□Latin□American□ 
countries.□The□geographical□differences□of□the□H.□pylori□virulence□are□important.□Ando□et□al.□have□ 
reported□the□difference□between□the□US□and□the□Japanese□strains.□This□paper□gives□them□suggestion□for 
improving□their□discussion.□ 
Minor□(compulsory□revisions)□ 
1.□In□the□Background□row□10,□m1□o□m2□i1/2(R)□m1□or□m2.□ 
Competing□interests: 
None□declared.
Review for 10.1186/1471-230X-2-20 (2002)

Reviewer's□report 
□cagA□and□vacA□in□strains□of□Helicobacter□pylori□from□ulcer□and□NUD□patients Title: 
Authors: 
Gustavo□Z□Faundez□( gfaundez@uec.inta.uchile.cl )
Miriam□H□Troncoso□( mtronco@uec.inta.uchile.cl )
Guillermo□G□Figueroa□( gfiguero@uec.inta.uchile.cl )
□2□ □30□Aug□2002 Version: Date: 
□Dr□Yoshio□Yamaoka Reviewer: 
□A□paper□whose□findings□are□important□to□those□with□closely□related□research□ Level□of□interest: 
interests 
□Accept□without□revision Advice□on□publication: 
The□paper□has□been□improved.□ 
Only□trivial□typos□were□found□(s1m1□y□s2m2□should□be□s1m1□and□s2m2,□wich□should□be□which).□ 
Competing□interests: 
None□declared.
Review for 10.1186/1471-230X-2-19 (2002)

Reviewer’s report
□
Treatment of achalasia: the short-term response to botulinum toxin injection is Title:
independent of any kind of pretreatment
Authors:
Martin Storr (martin.storr@lrz.tum.de )
Peter Born (p.born@lrz.tum.de )
Eckhard Frimberger (e.Frimberger@lrz.tum.de )
Norbert Weigert (n.weigert@lrz.tum.de )
Thomas Roesch (troesch@lrz.tum.de )
Alexander Meining (alex.meining@lrz.tum.de )
Meinhard Classen (m.classen@lrz.tum.de )
Hans Allescher (hans.allescher@lrz.tum.de )
15Jul 2002 Version: Date:
 Dr Guy boeckxstaens Reviewer:
Apaper whose findings are important to those with closely related Level of interest:
research interests
 Accept after discretionary revisions Advice on publication:
The authors have studied whether pretreatment has an effect on the outcome of 
botulinum toxin injection in patients with achalasia. The paper is well written and the 
data are nicely presented. 
1. I realize that it is difficult to collect large numbers of patients that have been 
treated earlier. Nevertheless, it should be stressed that the numbers in the pretreated groups is relatively small. Therefore, I believe that the conclusion (and the title) should be weakened. 
2. Although the outcome (symptom control) may be equal in the different groups, the 
authors should also compare the number of treatment sessions required to obtain 
this success rate. If patients pretreated require more injections than the untreated group, this may indicate an effect on the efficacy of botox injection. 
3. Page 7: What do the authors mean by "sum of the LESPs"? 
4. The mean LESP in patients pretreated was increased and similar to the untreated 
patients. Were there any patients who were treated and had symptoms, but had a 
normal or low LESP? If so, did they behave differently? 
Competing interests:None declared.
Review for 10.1186/1471-230X-2-19 (2002)

Reviewer's report
 Treatment of achalasia: the short-term response to botulinum toxin injection is independent of any Title:
kind of pretreatment
Authors:
Martin Storr (martin.storr@lrz.tum.de )
Peter Born (p.born@lrz.tum.de )
Eckhard Frimberger (e.Frimberger@lrz.tum.de )
Norbert Weigert (n.weigert@lrz.tum.de )
Thomas Roesch (troesch@lrz.tum.de )
Alexander Meining (alex.meining@lrz.tum.de )
Meinhard Classen (m.classen@lrz.tum.de )
Hans Allescher (hans.allescher@lrz.tum.de )
 1  25 Jul 2002 Version: Date:
 Dr S Bruley des Varannes Reviewer:
 not specified Level of interest:
 Other (see below) Advice on publication:
This paper reports a single center experience of botulinum toxin injection 
in the the treatment of achalasia. The results of this open study are in 
line with those previously published giving a 6-month rate of remission 
between 60 to 70 % of patients (the two thirds). However the analysis 
according to previous treatments adds some original data showing that 
results are not chnaged by the type of previous treatment. 
In conclusion that is a well written paper confirming now well established 
data. The quality of the paper as well as the analysis of results taking 
into account previous treatments in my opinion justify the publication in BMC Gastroenterology. 
Competing interests:
None declared.
Review for 10.1186/1471-230X-2-18 (2002)

Reviewer's report
 Risk factors for hepatitis C virus infection among blood donors in southern Brazil: a case-control Title:
study
Authors:
Ajacio BM Brandao (ajacio@via-rs.net )
Sandra C Fuchs (scfuchs@zaz.com.br )
 2  17 May 2002 Version: Date:
 Prof Charles Hoff Reviewer:
 A paper whose findings are important to those with closely related research interests Level of interest:
 Accept after discretionary revisions Advice on publication:
Since my task is to critique the design and statistical aspects of this ms., I will confine my remarks to 
these topics. 
In my opinion, this is an appropriately designed study with a thoughtful approach to statistical analysis 
and interpretation of results. The authors acknowledge aEoethat the eligible donors were in good health
and did not represent the general populationaE. Thus, they recognize that findings are not completely 
generizable to the population-at-large. I note that in the abstract-results section, they state that a 
aEoerepresentative sample of 178 anti-HCV positive cases and 356 controls were investigated.aE 
However, in the abstract-methods section the numbers are 137 and 274, respectively. I could not find 
an explanation as to why these numbers are different and, unless I have missed it, the authors should 
address this in the ms. 
Sample size estimates for controls and cases were based on a 2:1 ratio of controls to cases and 
acceptable parameters for univariate comparisons. The sample estimates were then increased 30% to 
allow for multivariate analyses and adjustment for confounding factors. Multivariate sample size 
estimation is a bit problematic, but I am inclined to accept their argument. Multivariate analytic approaches were hierarchical in nature and the authors have not chosen stepwise models. An 
hierarchical approach seems justified since larger sample sizes would probably be required for stepwise
regression and, if conducted, Type I error rates could be inflated. Still, for exploratory purposes, it would
have been interesting to see whether the same models were generated in both a forward and backward 
stepwise regression. The use of P values ranging between .05 and .10 as indicating possible trends 
also seems justified in my opinion. 
In general, this is a well-written ms., but I noted a few minor typos/syntactical errors. According to the 
ms. I downloaded, they are: (i) page 2, next-to-last line from the bottom: aEoeeighthaE should be 
aEoeeightaE; (ii) page 6, next-to-last line from the bottom: aEoeSince have being incarcerated doaE, 
this portion of the sentence needs to be rewritten; (iii) page 6, last-line: aEoeassociated toaE should be aEoeassociated withaE. 
Competing interests:
None declared.
Review for 10.1186/1471-230X-2-18 (2002)

Reviewer's report
 Risk factors for hepatitis C virus infection among blood donors in southern Brazil: a case-control Title:
study
Authors:
Ajacio BM Brandao (ajacio@via-rs.net )
Sandra C Fuchs (scfuchs@zaz.com.br )
 2  5 Jun 2002 Version: Date:
 Dr Gilles Delage Reviewer:
 A paper whose findings are important to those with closely related research interests Level of interest:
 Accept after discretionary revisions Advice on publication:
This is a well-written paper describing the results of a case-control study on the risk factors of acquiring 
hepatitis C virus (HCV) infection in Brazilian blood donors. The results confirm previously published 
data on the same topic. This suggests that the epidemiology of HCV infections in Brazil is similar to thatobserved in North America. 
Discretionary revisions: 
1. Selection of controls: the authors should give more details on the procedures used to choose their 
matched controls. The report as it stands does not permit the reader to determine if any bias was 
introduced by the method used for selecting controls. 
2. Apparently, cases were defined as blood donors having twice tested positive for HCV by EIA. Were 
both EIAs done using different manufacturers' kits? Was there any validation of their algorithm, 
comparing it to a "gold standard" (i.e. EIA followed by RIBA or PCR or both)? The authors should 
comment. 
3. In their strategy of grouping risk factors according to hierarchical categories, they did not group 
incarceration with social and sexual behavior. Placing incarceration in that group would appear 
appropriate since intravenous drug use and tattooing are confounding factors for incarceration. The authors should justify their choice or reanalyse after including incarceration in the third group of risk factors. 
Competing interests:
None declared.
Review for 10.1186/1471-230X-2-18 (2002)

Reviewer's report
 Risk factors for hepatitis C virus infection among blood donors in southern Brazil: a case-control Title:
study
Authors:
Ajacio BM Brandao (ajacio@via-rs.net )
Sandra C Fuchs (scfuchs@zaz.com.br )
 2  14 Jun 2002 Version: Date:
 Prof Edward Murphy Reviewer:
 A paper whose findings are important to those with closely related research interests Level of interest:
 Accept after discretionary revisions Advice on publication:
All comments compulsory 
Comments to the authors: 
This is a case control study of risk factors for hepatitis C seropositivity among blood donors in southern 
Brazil. Overall, the study is well done. 
Specific comments: 
In the abstract, results, last paragraph: Delete the word aEoestronglyaE; the data reported are at best 
suggestive of sexual transmission. The last paragraph of the results is duplicative of the conclusion paragraph in the abstract. 
Background, first paragraph: Although reference number four may in fact indicate that 20 to 58% of 
patients with HCV have chronic liver disease, this statistic may have been from a hospital based study and may not be applicable to a healthy blood donor population, and the authors should call attention to 
this. In general risks of disease due to HCV have been overestimated in the literature. 
Methods: Was RIBA testing done to confirm hepatitis C seropositivity? If not, did the author have any 
independent data supporting the use of EIAaETMs only. 
Statistical analysis: Although this hierarchical logistic regression approach is interesting, IaETMm 
concerned that the data in Table 2 regarding environmental risk factors for hepatitis C were not adjusted
for injection drug use. 
Results, second paragraph, last sentence: A minor point aEoesince they have never been screenedaE 
is a commentary and should be reserved for the discussion. 
Results, social and sexual behavior, second paragraph: Although the odds ratio for having two to four 
sexually transmitted diseases was 6.2 the confidence intervals on this value are very wide, therefore it 
does not necessarily represent a strong association. 
Discussion, second paragraph: There is a typographical spelling error in the sentence aEoeHVC testaE.
In the last sentence of the same paragraph, the authors state that aEoesince most episodes of hepatitis
C are free of symptomsaE but they also found a significant association with previous jaundice in Table 
3. 
Discussion, paragraph four, second sentence: A language issue; suggest substituting the word 
aEoeplausibleaE for the word aEoeconceivableaE. 
Discussion, last paragraph, last sentence: Suggest substituting the word aEoealthoughaE for the words 
aEoeeven thoughaE. 
Conclusions: First line. A spelling error aEoeanti-VHCaE. 
Competing interests:
None declared.
Review for 10.1186/1471-230X-2-18 (2002)

Reviewer's□report 
□Risk□factors□for□hepatitis□C□virus□infection□among□blood□donors□in□southern□Brazil:□a□case-control□ Title: 
study 
Authors: 
Ajacio□BM□Brandao□( ajacio@via-rs.net )
Sandra□C□Fuchs□( scfuchs@zaz.com.br )
□3□ □17□Jul□2002 Version: Date: 
□Dr□Gilles□Delage Reviewer: 
□A□paper□whose□findings□are□important□to□those□with□closely□related□research□interests Level□of□interest: 
□Accept□without□revision Advice□on□publication: 
I□have□read□the□authors'□response□to□my□comments□and□find□them□acceptable 
Competing□interests: 
None□declared.
Review for 10.1186/1471-230X-2-18 (2002)

Reviewer's report
 Risk factors for hepatitis C virus infection among blood donors in southern Brazil: a case-control Title:
study
Authors:
Ajacio BM Brandao (ajacio@via-rs.net )
Sandra C Fuchs (scfuchs@zaz.com.br )
 3  5 Aug 2002 Version: Date:
 Prof Edward Murphy Reviewer:
 A paper whose findings are important to those with closely related research interests Level of interest:
 Accept without revision Advice on publication:
This manuscript is now acceptable for publication.
Competing interests:
None declared.
Review for 10.1186/1471-230X-2-17 (2002)

Reviewer's□report 
□Are□Proton□Pump□Inhibitors□the□First□Choice□for□Acute□Treatment□of□Gastric□Ulcers?□A□Meta□ Title: 
Analysis□of□Randomized□Clinical□Trials 
Authors: 
Maribel□Salas□( msalas@caroresearch.com )
Alexandra□Ward□( alexward@caroresearch.com )
Jaime□Caro□( jcaro@caroresearch.com )
□1□ □13□May□2002 Version: Date: 
□Dr□Christian□Pehl Reviewer: 
□A□paper□of□considerable□general□medical□or□scientific□interest Level□of□interest: 
□Accept□after□discretionary□revisions Advice□on□publication: 
Salas□et□collegues□present□a□meta-analysis□of□studies□dealing□with□acid□suppressive□therapy□of□gastric□ 
ulcers.□They□conclude□that□PPIs,□especially□the□newer□ones,□are□the□first□choice□for□gastric□ulcer□ treatment.□ 
Comment□(discretionary□revision):□ 
This□is□a□well□performed□study□with□appropriate□statistics.□However,□at□least□from□a□clinical□point□of□view,□ 
it□appears□questionable□to□exclude□papers□with□treatment□of□helicobacter□pylori,□respectively,□with□a□ 
combined□PPI□and□antibiotic□therapy.□About□60-70%□(with□falling□tendency)□of□gastric□ulcers□are□ 
helicobacter□pylori□positive□and□these□patients□would□receive□immediately□a□combined□therapy□in□clinical□ 
routine.□Since□this□combined□therapy□is□not□done□to□speed□healing□but□to□prevent□a□relapse□of□the□ disease,□it□does□not□seem□necessary□to□exclude□these□papers.□By□the□inculsion□of□these□papers,□the□ 
power□of□the□meta-analysis□would□certainly□increase 
Competing□interests: 
None□declared.
Review for 10.1186/1471-230X-2-17 (2002)

Reviewer's□report 
□Are□Proton□Pump□Inhibitors□the□First□Choice□for□Acute□Treatment□of□Gastric□Ulcers?□A□Meta□ Title: 
Analysis□of□Randomized□Clinical□Trials 
Authors: 
Maribel□Salas□( msalas@caroresearch.com )
Alexandra□Ward□( alexward@caroresearch.com )
Jaime□Caro□( jcaro@caroresearch.com )
□1□ □17□Jun□2002 Version: Date: 
□Dr□Alan□Thomson Reviewer: 
□A□paper□of□considerable□general□medical□or□scientific□interest Level□of□interest: 
□Accept□without□revision Advice□on□publication: 
This□is□a□clearly□written,□thoroughly□researched□meta-analysis□using□appropriate□methodology□to□ 
compare□the□gastric□ulcer□healing□rates□at□different□time□intervals□versus□ranitidine□or□omeprazole. 
Competing□interests: 
I□have□spoken□for□or□performed□research□for□the□following:□Abbott,□AstraZeneca,□Axcan,□Byk,□Ferring,□ 
GlaxoSmithKline,Janssen-Ortho,□Procter□&□Gamble,□Schering,□and□Solvay.□ 
I□do□not□own□stocks□or□shares□in□any□of□these□compaines,□and□have□no□financial□or□non-financial□ 
competing□interests.
Review for 10.1186/1471-230X-2-16 (2002)

Reviewer's□report 
□Cathepsin□B□cleavage□of□the□trypsinogen□activation□peptide□(TAP)is□reduced□in□pancreatitis□ Title: 
associated□TAP□mutations□D22G□and□K23R□ 
Authors: 
Niels□Teich□( teichn@medizin.uni-leipzig.de )
Hans□Bodeker□( boedh@medizin.uni-leipzig.de )
Volker□Keim□( keimv@medizin.uni-leipzig.de )
□1□ □28□May□2002 Version: Date: 
□Dr□Miklos□Sahin-Toth Reviewer: 
□A□paper□whose□findings□are□important□to□those□with□closely□related□research□interests Level□of□interest: 
□Accept□after□discretionary□revisions Advice□on□publication: 
Discretionary□revisions.□ 
This□is□a□very□interesting□observation□that□merits□publication□in□the□form□of□a□short□note.□The□experiment□ presented□is□straightforward;□however,□I□disagree□with□the□authorsaETM□interpretations.□It□seems□highly□ 
unlikely□that□decreased□activation□by□cathepsin□B□can□lead□to□pancreatitis.□It□is□generally□accepted□in□the□ 
field□that□pancreatitis□is□caused□by□increased□intrapancreatic□trypsin□activity,□and□I□cannot□see□how□ 
decreased□trypsinogen□activation□by□cathepsin□B□can□result□in□increased□trypsin□activity.□The□ 
loss-of-function□hypothesis□the□authors□cite□is□rather□nebulous□and□the□majority□of□available□biochemical□ 
data□on□hereditary□pancreatitis□(HP)□mutations□simply□do□not□support□it.□ 
The□real□significance□of□the□present□observations□is□that□they□provide□further□(and□stronger!)□evidence□ 
that□autoactivation□rather□than□cathepsin□B□mediated□trypsinogen□activation□is□the□key□pathogenic□event□ in□the□development□of□HP.□In□a□recent□study□Kukor□et□al.□demonstrated□that□HP□mutations□R122H,□N29I□ 
and□N29T□do□not□alter□trypsinogen□activation□by□cathepsin□B,□and□suggested□that□enhanced□cathepsin□B□ 
activation□is□not□the□underlying□cause□of□HP.□However,□the□same□study□still□maintained□the□possibility□ 
that□cathepsin□B□mediated□trypsinogen□activation□plays□some□sort□of□a□role□in□HP.□The□findings□by□Teich□ et□al.□provide□a□strong□indication□that□this□is□not□the□case,□since□mutations□D22G□and□K23R□increase□ 
trypsinogen□autoactivation□(see□authorsaETM□previous□study)□but□clearly□decrease□cathepsin□B□ 
mediated□trypsinogen□activation.□ 
The□authors□should□be□cautious□with□the□interpretation□of□the□pH□dependence□of□the□trypsin-dependent□ 
activation□of□the□model□peptides,□which□they□reported□in□their□previous□study.□These□experiments□were□ 
carried□out□with□bovine□trypsin,□which□is□significantly□less□active□at□acidic□pH□than□human□cationic□trypsin□ 
is.□Therefore,□it□is□likely□that□the□differences□in□autoactivation□the□authors□described□at□pH□8.0□are□true□for 
pH□5.0□as□well.□ 
Compulsory□revision.□ 
The□authors□must□indicate□the□type□of□cathepsin□B□they□used.□Species□(human□or□bovine),□specific□ activity,□protein□concentration,□vendor□with□catalog□number□and□even□a□lot□number□would□be□desirable. 
Competing□interests: 
None□declared.
Review for 10.1186/1471-230X-2-16 (2002)

Reviewer's□report 
□Cathepsin□B□cleavage□of□the□trypsinogen□activation□peptide□(TAP)is□reduced□in□pancreatitis□ Title: 
associated□TAP□mutations□D22G□and□K23R□ 
Authors: 
Niels□Teich□( teichn@medizin.uni-leipzig.de )
Hans□Bodeker□( boedh@medizin.uni-leipzig.de )
Volker□Keim□( keimv@medizin.uni-leipzig.de )
□1□ □6□Jun□2002 Version: Date: 
□Claude□Ferec Reviewer: 
□not□specified Level□of□interest: 
□Accept□after□discretionary□revisions Advice□on□publication: 
he□Teich□et□al□paper□analyses□the□interaction□between□cathepsin□B□and□trypsinogen□in□a□peptide□system.□ 
The□experiment□design□is□unique□and□the□method□used□for□analysing□peptide□cleavage□is□reliable.□The□ 
authors□appropriately□discuss□their□findings□with□respect□to□others□performed□in□different□systems□and,□in□ 
particular,□adresses□the□controversial□issue□whether□gain□of□function□or□loss□of□function□of□trypsin□causes 
pancreatitis.□This□work□would□contribute□to□a□better□understanding□of□the□pathogenesis□of□pancreatitis.□ 
My□only□suggestion□is□that□the□paper□should□be□improved□in□English□writting.□ 
Competing□interests: 
None□declared.
Review for 10.1186/1471-230X-2-14 (2002)

Reviewer's□report 
□Bacterial□cholangitis□causing□secondary□sclerosing□cholangitis.□A□case□report. Title: 
Authors: 
Pieter□CJ□ter□Borg□( terborg@mdl.azr.nl )
Henk□R□van□Buuren□( vanbuuren@mdl.azr.nl )
Annekatrien□CTM□Depla□( bartelsman.depla@chello.nl )
□1□ □7□May□2002 Version: Date: 
□Dr□Yuji□Tanaka Reviewer: 
□A□paper□whose□findings□are□important□to□those□with□closely□related□research□interests Level□of□interest: 
□Accept□after□discretionary□revisions Advice□on□publication: 
This□is□an□interesting□case□report.□Biliary□sphincterotomy□was□performed□at□the□first□ERCP.□This□case□ 
showed□a□rapid□development□of□sclerosing□cholangitis□after□an□episode□of□severe□bacterial□cholangitis.□ 
Thereafter,□the□patient□repeated□bouts□of□cholangitis□during□biliary□stricture□progression.□The□author□ concluded□that□extra□biliary□hepatic□involvement□in□this□inflammatory□process□may□be□a□risk□factor□for□ 
developing□this□rare□complication.□ 
Major□comments;□ 
1.□Secondary□sclerosing□cholangitis□follows□a□severe□episode□of□bacterial□cholangitis.□The□author□ 
concluded□that□extra-biliary□involvement□of□the□hepatic□parenchyma□with□abcess□formation□is□a□risk□ 
factor□for□developing□bacterial□sclerosing□cholangitis.□However,□multiple□liver□abcesses□formation□may□ 
simply□mean□that□bacterial□cholangitis□is□severe.□ 
2.□In□this□case,□biliary□sphincterotomy□was□performed□at□the□first□ERCP.□It□is□probable□that□the□patient□had 
repeated□bouts□of□cholangitis□due□to□sump□syndrome□following□endoscopic□sphincterotomy.□Discuss□ 
about□it.□ 
3.□It□is□also□probable□that□the□stricture□further□progressed□because□there□was□chronic□cholangitis□due□to□ 
sump□syndrome.□ Minor□comments;□ 
1.□How□much□was□the□serum□level□of□alkalinephosphatase(ALP)□?□ 
2.□Did□you□confirm□liver□abcesses□on□abdominal□echo□or□CT□scan□?□ 
Competing□interests: 
None□declared.