JerMa88/BMC_Gastroenterology_Peer_Reviews huggingface dataset:
Review for 10.1186/1471-230X-11-30 (2011)

Reviewer's report
Title:Acute pericarditis due to alpha-interferon therapy for chronic HCV hepatitis
- Case report
Version: 2Date:1 February 2011
Reviewer: NAOYA SAKAMOTO
Reviewer's report:
Overall comments;
In this paper, authors describe a case of pericarditis as a rare complication of
peginterferon plus ribavirin combination therapy. This report is well written and
concise. The link between the medication and the adverse events has been
described by time relation between medication and by correlation of the
symptoms with withdrawal and re-challenge of medication.
1. Title should be more precisely stated, such as “Acute pericarditis due to
pegylated interferon alpha …"
2. Authors should cite the following recent case report.
Nishio K, Konndo T, Okada S, Enchi M: Pericarditis and chronic inflammatory
demyelinating polyneuropathy during therapy with pegylated interferon alfa-2a for
chronic hepatitis C. World J Hepatol. 2010;2(9):358-61.
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 according to the present assessment
of this manuscript.
Review for 10.1186/1471-230X-11-28 (2011)

Reviewer's report
Title:The study of visceral hypersensitivity and psychological stress in
gastroesophageal reflux disease
Version: 2Date:14 February 2011
Reviewer: Zhuo Wang
Reviewer's report:
Discretionary revisions
1. Figure 2, are there data for acid infusion for the control group? If so, should
present the data here.
2. Figure 1 & 5, some labels are partly obstructed. Also for labels in all figures,
consider using a different font.
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-11-28 (2011)

Reviewer's report
Title:The study of visceral hypersensitivity and psychological stress in
gastroesophageal reflux disease
Version: 2Date:21 February 2011
Reviewer: Daniel Sifrim
Reviewer's report:
The manuscript is much improved. The study focus and narrative is more clearly
defined and communicated, and the written English is now excellent.
Specific comments:
• The study question is now well defined, and scientifically relevant.
• The methods are well described. The acid/saline/anticipation protocol might
have been better in a random fashion. For example, the psychological
anticipation to a perfusion that “may cause heartburn” is likely to be altered
depending on whether or not they actually felt heartburn during the prior acid
infusion.
• The authors’ use of the NERD-SI- group is accepted. The group is still likely to
include those with FH. It would also be of interest to know the SI in the other
groups.
• The data appears sound. The dramatic reduction in the reported recruitment
numbers presumably reflects the elimination of a large part of the psychological
data.
• The conclusions now fit the data more accurately. Obviously a large volume of
data has been filtered to make these conclusions, and this must be remembered
in interpreting the results. However the principle that brain activation between the
groups may differ is an interesting one and deserves further study.
Discussion of limitations:
This is a useful addition. I agree that the checking of PPI responsiveness in all
groups would have been appropriate. I feel that the authors sell themselves short
by making this the last section of the article. It could be put earlier in the
discussion, leaving the final paragraph as a positive statement about their
interesting findings.
Importance:
The content of the paper is of significant interest to people interested in the
pathogenesis of GERD.
Major compulsory revisions:
Nil
Minor compulsory revisions
Nil
Discretionary revisions
1. Place the comments of limitations earlier in discussion.
Recommendation
• Accept after discretionary revisions
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
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-11-25 (2011)

Reviewer's report
Title:Perspectives on gastroesophageal reflux disease in primary care: the
REFLEX study of patient-physician agreement
Version: 1Date:20 September 2010
Reviewer: Maarten Hemmink
Reviewer's report:
Dear authors,
This interesting and well-written study is performed with a large number of
patients and with a large number of participating physicians. It regards the level
of agreement between patients and physicians about the prescribed PPI therapy
and shows that there is considerable difference between the patient’s and the
physician’s view on the effect of the prescribed therapy. Please find the
suggestions below.
Major Compulsory Revisions
1. Abstract section (conclusion): please rephrase the last sentence. According to
the aim of the study agreement between patients and physicians should be the
main outcome, this is not reflected by the conclusion.
2. As this is an industry-sponsored study it may be good to provide some data
about the kind of prescribed PPI.
3. Methods: how was the data collected? Did the physician collect the patient’s
questionnaires, or were they sent by mail?
Minor Essential Revisions
1. Methods/Results section: it is likely that the collected data about the
expectations of patients and physicians, and their lever of agreement, is
influenced by the fact that these data is collected after the start of the therapy.
2. If available, it should be interesting to add information about the patient’s
health related quality of life.
3. Result section, residual symptoms and impact, 2nd paragraph: please remove
the last sentence, as this does not add any useful information, or clarify in the
discussion why this is important.
4. Discussion section: 3rd paragrap: the last 2 sentences are clear and are the
main result of the study. The following sentences need some rephrasing:
“patient-physician agreement … daytime heartburn” is this difference really
interesting and significant? If so, differ kappa values significantly? In addition to
this: the next sentence “However … (good agreement).” does not seem to clarify
the authors conclusion and could be removed.
Discretionary Revisions
1. Figure 2: x-axis: “Patient’s expectation of treatment” should be “patient’s and
physician’s expectations”
2. Table 2: k-values: a suggestion to increase the readability of the table: kappa
value expressed in 2 decimals instead of 3
3. Methods: please clarify why the use of OTM by patients is scored according to
the physician, why not by the patient’s questionnaires?
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-11-25 (2011)

Reviewer's report
Title:Perspectives on gastroesophageal reflux disease in primary care: the
REFLEX study of patient-physician agreement
Version: 3Date:7 January 2011
Reviewer: Maarten Hemmink
Reviewer's report:
I do not have any more comments, the authors have (sufficiently) adapted the
manuscript to my suggestions
Review for 10.1186/1471-230X-11-26 (2011)

Reviewer's report
Title:Hospital-based, prospective, multicentre surveillance to determine the
incidence of intussusception in children aged < 15 years in Germany
Version: 1Date:10 November 2010
Reviewer: Mahomed Patel
Reviewer's report:
This paper offers an interesting statistical technique to incorporate
under-reporting of intussusception in estimating disease incidence and has a
sound rationale. Its focus is primarily for validating the technique. However, I do
not have the appropriate statistical expertise required to comment on the
appropriateness of using the model in this context.
1. Is the question posed by the authors well defined?
Yes
2. Are the methods appropriate and well described?
The epidemiological techniques are appropriate, but I do not have the required
expertise to comment on the statistical methods.
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?
The epidemiological aspects are described adequately.
Minor essential revision: An alternative method to assess under-reporting cited
by the authors is the capture-recapture technique. It would be helpful to describe
the relative merits of the two techniques.
6. Are limitations of the work clearly stated?
Yes.
Minor essential revision: It would be useful if the authors would (a) comment on
the validity of the ICD codes for identifying all cases with IS at the hospitals (e.g.
the quality assurance methods used to assess validity of the codes in identifying
all cases with IS); and (b) provide some indicators on the quality of the ESPED
data (e.g. peer-reviewed publications of the data or evidence of the quality and
usefulness of the system).
7. Do the authors clearly acknowledge any work upon which they are building,
both published and unpublished?
Yes.
8. Do the title and abstract accurately convey what has been found?
Yes
9. Is the writing acceptable?
It is acceptable, but some sentences need further editing to simplify the message
e.g. second sentence under the ‘Background’ of the Abstract.
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:
I declare that I have no competing interests
Review for 10.1186/1471-230X-11-26 (2011)

Reviewer's report
Title:Hospital-based, prospective, multicentre surveillance to determine the
incidence of intussusception in children aged < 15 years in Germany
Version: 1Date:21 November 2010
Reviewer: TRABELSI ABDELHALIM
Reviewer's report:
The question posed by authors in this manuscript is how to have an accurate
estimation of the incidence of intussusception in children aged <15 years in
Germany, this question was very well defined by authors and the methods used
were very clearly described, the manuscript adhere to the relevant standards for
reporting and data deposition ,
Discussion and conclusion are adequately supported by the data,.
The title and abstract accurately convey what has been found and the writing is
acceptable
I have a very little number of a minor revision to recommend to authors:
Page 8 and 12 specialization and not specialisation
Page 20 figure 3 and not 2
Page 21 fig 4 and not 3
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
'I declare that I have no competing interests'
Review for 10.1186/1471-230X-11-26 (2011)

Reviewer's report
Title:Hospital-based, prospective, multicentre surveillance to determine the
incidence of intussusception in children aged < 15 years in Germany
Version: 1Date:28 December 2010
Reviewer: Yi-Hau Chen
Reviewer's report:
This manuscript presents a detailed statistical procedure for estimating the IS
incidence rate, adjusting for under-reporting. The estimation procedure seems
correct and suitable. Some minor comments follow.
(1) It would be helpful to show a figure for the estimated distribution of
underreporting of IS cases V(p).
(2) I cannot understand the statement on the middle of page 12: "For the age
group below two years of age and below one year of age this is the case for 10
and 11 hospitals, respectively." Please clarify.
Level of interest: An article whose findings are important to those with closely
related research interests
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-11-27 (2011)

Reviewer's report
Title:Synchronous carcinoid and gastrointestinal stromal tumour of the stomach:
a case report.
Version: 1Date:2 December 2010
Reviewer: Marek Wronski
Reviewer's report:
The manuscript, which I reviewed with interest, reports a case of coexisting
carcinoid and gastrointestinal stromal tumor within the stomach. Concomitant
tumors are quite rare and present particular diagnostic and treatment challenges.
There is growing evidence confirming that the coexistence of gastrointestinal
stromal tumors and adenocarcinomas is not coincidental. In contrast, the
synchronous occurrence of a carcinoid and GIST seems to be just a coincidence,
and as such has little clinical or scientific significance.
Major compulsory revisions
1. The authors conclude that the patients with synchronous GIST and carcinoid
should have a meticulous follow-up because of a high risk and important
consequences of possible metastases. This statement, however, applies to all
the patients with cancer diseases, but the conclusions should reflect the lessons
learned from the discussed case.
Minor essential revisions
1. According to the recent WHO classification, “neuroendocrine tumor” is the
preferred term for the neoplasms originating from the diffuse neuroendocrine
system, irrespective of their location. The term “carcinoid” is currently
discouraged, although still commmon in everyday clinical practice. I would advise
to follow the recommended terminology throughout the manuscript.
2. The first carcinoid tumor should be classified as well differentiated
neuroendocrine tumor with uncertain behavior rather than “a carcinoid with
aggressive clinical behaviour”.
3. “...tumour size and mitotic activity are the most significant parameters (for
GISTs)” – The authors should be more specific and explain what this significance
refers to (tumor malignant potential, prognosis).
4. The authors noted that the co-occurrence of GISTs with other neoplasms is
high and ranges from 4,5% to 33%. Similarily, neuroendocrine tumors coexist
with other neoplasms at a comparable rate. I would recommend to include this
information in the text. In view of so high tumor co-occurrence in both GIST and
carcinoid patients, the fact that the synchronous occurrence of these two
neoplasms have been reported so rarely, contradicts the hypothesis about their
common pathogenesis.
5. The resected specimen is quite small for a partial gastrectomy. Was a wedge
gastric resection performed rather than a partial resection?
6. There are too many figures in the manuscript. I would advise to limit the
images to Figures 1, 3A and B, 4A and B.
Level of interest: An article of insufficient interest to warrant publication in a
scientific/medical journal
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-11-27 (2011)

Reviewer's report
Title:Synchronous carcinoid and gastrointestinal stromal tumour of the stomach:
a case report.
Version: 1Date:9 December 2010
Reviewer: Abbas Agaimy
Reviewer's report:
The author report their experience with a case of gastric carcinoid followed by
GIST and a second carcinoid, this is an interesting case and represents a further
documentation of this phenomenon. It also underscores the importance of getting
biopsy of metachronous lesions.
However some points need be addressed before publication:
Minor Essential Revisions:
1. The number of reported cases is not only 2; Maiorana et al (Arch Pathol Lab
Med 2000) described one other case. This should be quoted. Also, in the review
by agaimy et al (Semin Diagn Pathol, 2006) a total of 13 carcinoid tumors were
associated with GIST, 4 of the carcinoids arose in the stomach. The author
should focus on these relecant papres and not on review-type data on GIST and
their treatment as this is not the focus of their paper).
2. Abstract: it has never been previously described a similar combination of
clinical..
This is clearly overdressing and should be omitted.
3. Introduction:
GISTs show a clear predilection for the gastrointestinal tract.. this makes no
sense as GISTs are by definition gastrointestinal neoplasms.
4. significant parameters..you mean prognosis parameters?
5. Discussion/Conclusion:
it has never been formerly described a similar combination of clinical and
histopathological characteristics. Please correct sentence for symantic and
grammer.
6. Furthermore, our case seems to be the first concerning a male patient.
This is also irrelevant as gender is not a peculiarity in carcinoid or GIST tumors.
7. localized within deeper levels..I think you mean within deeper layers…
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-11-27 (2011)

Reviewer's report
Title:Synchronous carcinoid and gastrointestinal stromal tumour of the stomach:
a case report.
Version: 1Date:14 December 2010
Reviewer: Nikolaos Salemis
Reviewer's report:
The authors present a case of a synchronous occurrence of a gastrointestinal
stromal tumor and a carcinoid tumor of the stomach.
It is of course an extremely rare and interesting case. It is well written.
My comments are:
Minor essential revisions
1. Please define the type of gastrectomies that were performed in the 2
surgeries. Reconstruction of the GI tract in each case?
2. Why was the patient placed on imatinib, since the GIST was completely
excised and there was no recurrent or metastatic disease? Please use
supportive citation.
Kind regards
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.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-11-24 (2011)

Reviewer's report
Title:Weak Up-regulation of Serum Response Factor in Gastric Ulcers in
Patients with Co-morbidities is Associated with Increased Risk of Recurrent
Bleeding
Version: 1Date:21 October 2010
Reviewer: Jianyuan Chai
Reviewer's report:
The study compared SRF expression in human gastric ulcerated tissues vs.
normal by immunohistochemistry and found SRF up-regulation in ulcers
regardless of what caused ulcers. The study also demonstrated that recurrent
ulcer bleeding rate is increased comorbidities and low expression of SRF and
both factors are independent but synergistic. Up-regulation of SRF in ulcers is
known in animal model, while this study examined human biopses, which is more
clinical relevant.
Minors:
1. In the last setence of the discussion, authors hope in the future study SRF can
be measured in the serum instead of tissue staining. Unfortunately, that is
impossible. SRF is a transcription factor. It cannot be measured by serum
check-up.
2. In multiple places of the text, authors say 'SRF expression on gastric ulcer
tissues', it should be 'in gastric tissues'.
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, and I have assessed the statistics in my report.
Review for 10.1186/1471-230X-11-24 (2011)

Reviewer's report
Title:Weak Up-regulation of Serum Response Factor in Gastric Ulcers in
Patients with Co-morbidities is Associated with Increased Risk of Recurrent
Bleeding
Version: 1Date:16 November 2010
Reviewer: Peter C Konturek
Reviewer's report:
Manuscripts by Cheng et al entitled “Weak up-regulation of serum response
factor in gastric ulcers in patients with co-morbidities is associated with increased
risk of recurrent bleeding” determined the association between
immunohistochemical expression of SRF in gastric ulcers and risk of recurrent
bleeding. The multivariate logistic regression confirmed that co-morbidities and
weak SRF-expression were two independent factors of recurrent gastric ulcer
bleeding.
Major comments:
Both NSAIDs and H.pylori, thr most important damaging factors of gastric
mucosa had no effect on SRF expression. Since SRF plays a central role in ulcer
healing, how this phenomenon could be explained? The authors should discuss
this issue in context of literature.
What was the positive control for immunohistochemical staining for SRF?
Authors should include the positive SRF-immunostaining control in the
manuscript.
SRF is an important component of ulcer healing which promotes migration and
proliferation of gastric epithelial and smooth muscle cells. Authors should analyse
the changes in proliferation index (PCNA or Ki-67) at the ulcer edge in
dependence of SRF expression.
Decrease in SRF expression inhibits angiogenesis driven by VEGF, which plays
a crucial role in ulcer healing. It would be of importance to investigate this aspect
of ulcer healing. Did patients with low SRF-expression had decreased VEGF
expression?
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.
Review for 10.1186/1471-230X-11-24 (2011)

Reviewer's report
Title:Weak Up-regulation of Serum Response Factor in Gastric Ulcers in
Patients with Co-morbidities is Associated with Increased Risk of Recurrent
Bleeding
Version: 2Date:18 February 2011
Reviewer: Peter C Konturek
Reviewer's report:
Tha manuscript can be accepted in the present form
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-11-23 (2011)

Reviewer's report
Title:Safety of pull-type and push-type percutaneous endoscopic gastrostomy
tubes in oncology patients: a retrospective analysis
Version: 1Date:19 November 2010
Reviewer: Ruud Wiggenraad
Reviewer's report:
This is a retrospective study, comparing two methods of PEG placement, both
performed by the gastroenterologist. Significantly more complications are found
with the push type of tube placement.
Drawbacks of this paper are the rather small number of patients and the
retrospective nature of the study.
However it is a compact, clearly written, article dealing with an important question
from everyday practice. Although the results of such a small study have to
interpreted carefully, they may influence decisions in the clinic, are interesting
and worth publishing.
However I have some questions/remarks I would like the authors to respond to
(they are all discretionary revisions)
1. The authors collected 57 patients in three years who received
chemo-radiotherapy for head and neck or esophageal cancer. This is a rather
small number of patients for an academic center and it is likely that in that period
more patients received that treatment. How were these patients selected for PEG
placement? Were other ways of tube feeding used in your hospital for this
category of patients?
2. Please clarify the description of the push method, because it is not completely
clear how the stomach is localized.
3. Interventional radiologists can do PEG (or PUG) placement under ultrasound
guidance. Please discus this method. Would this be an improvement over your
push method or do you expect a comparable complication rate? Is it possible that
some other patients in your hospital were referred to the radiologist?
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-11-23 (2011)

Reviewer's report
Title:Safety of pull-type and push-type percutaneous endoscopic gastrostomy
tubes in oncology patients: a retrospective analysis
Version: 1Date:24 November 2010
Reviewer: Shinji Nishiwaki
Reviewer's report:
This manuscript compared the complications and outcomes of PEG in patients
with head/neck or esophageal malignancies using two different techniques, i.e.,
“push” or “pull” type as per the authors’ words. If the authors are evaluating the
two methods, the patients’ backgrounds should be clarified in more detail. There
were several major complications including perforation, bleeding, and sepsis.
Please describe in more detail the circumstances and causes of the major
complications, and how these complications might be prevented or minimized.
Major Compulsory Revisions
#1. The term “push-type PEG” commonly refers to the Sachs-Vine technique,
also known as the “push technique”. The “push technique” is similar to “pull
technique” in that the bumper is placed through the mouth. The method stated as
“push-type PEG” in the manuscript should be referred to as the “introducer
technique” or “introducer method” in general, which was described in the
references # 8, 9 and 17.
#2. The authors compared the short term complications and outcomes of PEG
using the pull- and introducer methods. However, they did not mention whether
the backgrounds of the two groups were comparable. It has been reported that
outcomes and complications are dependent on the nutritional status (e.g. serum
albumin concentration) and severity of the comorbid diseases. If these
backgrounds were significantly different between the groups, it is problematic to
conclude that the conventional pull-type PEG is recommended for patients with
head/neck or esophageal malignancies. The choice of the introducer method was
for patients with high-grade malignant stenosis, possibly indicating that the more
advanced-stage patients undergo the introducer method rather than the
pull-method. It is necessary to describe at least the serum albumin levels and
performance status or the clinical stages of the cancer in Table 1 or in the body
of the manuscript.
#3. There were some severe complications especially in the introducer method
group. Please describe in more detail in the Results section regarding the
complications, especially in case of perforation, bleeding and sepsis. Did a
perforation develop at placement or from accidental dislodgment before the
maturation of the fistula (most frequent reason in general)? Where was the
location (e.g. the gastorpexy site or PEG tube insertion site) of the perforation?
What were the causes of bleeding and sepsis? Furthermore, it is preferable to
describe how to prevent these complications in the Discussion.
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-11-23 (2011)

Reviewer's report
Title:Safety of pull-type and push-type percutaneous endoscopic gastrostomy
tubes in oncology patients: a retrospective analysis
Version: 1Date:19 December 2010
Reviewer: Arno J Dormann
Reviewer's report:
The article of van Dyck et al about "Safety of pull-type and push-type
percutaneous endoscopic gastrostomy tubes in oncology patients: a
retrospective analysis" is a retrospective analysis on 299 pts. in a 3 yrs period
(about 100 a yr).
Methods: The data are analysed on a no standardized retrospective background,
the population is mexed and not compared.
There is not evidence why the two groups can be comparable because the
push-type PEG placement with gastropexy (Freka ® Pexact Fr 15, Fresenius
Kabi AG, Bad Homburg, Germany) was only performed in case of high-grade
malignant stenosis, rendering the use of a conventional upper GI endoscope
impossible. This is the major problem in this study.
Results: Only 19% of the pts. were oncology pts. to evaluate the push-type PEG
placement with gastropexy (Freka ® Pexact Fr 15, Fresenius Kabi AG, Bad
Homburg, Germany). There is not clear what lead to pull and what to push-type
decision.
The antibiotic prophylaxis was not standardized and not clear what the decision
base was.
The complication rate in both groups especially severe complications is
extremely high (comparison lit.). Peristomal infections are not graded in severity
index and there is an extraordinary high rate of perforations (e.g. perforation of
the sigmoid and deaths) which might be due to the low experience of the teams.
Others did never report such high complication rates.
All this might be boosted by the lack of standardized FU (tube dislocation, wound
infection check, peritonitis, ingrown sutures which were not removed, no tube
change, no standard FU ...).
As another risk actor the authors did not state the time difference between PEG
procedure and chemotherapy which should be greater than 3-4 days minimum.
Discussion: The authors conclude that the push-type PEG placement with
gastropexy (Freka ® Pexact Fr 15, Fresenius Kabi AG, Bad Homburg, Germany)
carries a high risk of complications. This is totally in contrast to other publications
who have a great and long-time experience in this technique.
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:
I had salary for some lectures in 2005and 2006 from Fresenius Kabi, no others
interests.
Review for 10.1186/1471-230X-11-23 (2011)

Reviewer's report
Title:Safety of pull-type and introducer percutaneous endoscopic gastrostomy
tubes in oncology patients: a retrospective analysis
Version: 2Date:31 January 2011
Reviewer: Shinji Nishiwaki
Reviewer's report:
I would like to appreciate for your revision to clarify the problems in the first draft.
In Japan, the introducer was modified recently and is now shifting from the
conventional pull/push method. But I’m afraid that the method might be
sometimes risky if the technique is not inadequate and lead to serious
complication including perforation and hemorrhage. I believe this paper will
provide new evidence in the field of enteral feeding for the patients with
head/neck and esophageal cancer.
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-11-23 (2011)

Reviewer's report
Title:Safety of pull-type and introducer percutaneous endoscopic gastrostomy
tubes in oncology patients: a retrospective analysis
Version: 2Date:6 February 2011
Reviewer: Arno J Dormann
Reviewer's report:
I still think that there are severe technical and physician related problems in this
trial and retrospective analysis.
E.g. a pneumoperitoneum is no complication - it occurs in 50% of all patients and
should not lead to a surgical exploration.
The total rate of severe complications is still very high and might be the result of
anon sufficient technical approach.
Starting a chemotherapy 1 day after the procedure will led to severe
complications because the infection rate is a the highest point on day 3-5 after
intervention.
There is grading of local infections and there is still the weakness of the
retrospective data analysis.
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.
Review for 10.1186/1471-230X-11-23 (2011)

Reviewer's report
Title:Safety of pull-type and introducer percutaneous endoscopic gastrostomy
tubes in oncology patients: a retrospective analysis
Version: 2Date:16 February 2011
Reviewer: Philippe Ducrotte
Reviewer's report:
I agree with the first two reviewers that this paper is suitable to be published in
the BMC-series journal
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-11-22 (2011)

Reviewer's report
Title:Gastrointestinal Flora and Gastrointestinal Status in Children with Autism --
Comparisons to Neurotypical Children and Correlation with Autism Severity
Version: 1Date:2 November 2010
Reviewer: Paul Ashwood
Reviewer's report:
Adams and colleagues seek to determine whether gastrointestinal flora and
gastrointestinal status in children with autism is different when compared with
controls. The experiments are well designed and have been performed on a
large number of children with autism. The data is new and interesting. The paper
is well written and requires few minor but important corrections.
The authors list controls as "neurotypicals" what is the meaning of this term? It
has been argued by many that the neurons of children with autism are typical, or
at least not different from controls and it is the synaptic connections that are
altered. "Neurotypical" is not a valid term and should be removed from the title
and text. Other information regarding the controls should be provided such as
whether they are siblings of the children with autism.
The first paragraph of the discussion stating that gastrointestinal symptoms are
causal for autism is over-reaching. Such a claim cannot be made on the basis of
the data presented here, nor on previous published studies. However, this work
provides new information that is worthy of follow-up studies.
How many children with autism were on some form of dieatry intervention?
These would be informative data.
No gastrointestinal symptoms were present in the control group whereas there
were a number of gastrointestinal symptoms in the children with autism. In the
discussion these differences should be noted. In future studies a group of
controls with similar gastrointestinal symptoms to the children with autism should
be included for comparison.
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-11-22 (2011)

Reviewer's report
Title:Gastrointestinal Flora and Gastrointestinal Status in Children with Autism --
Comparisons to Neurotypical Children and Correlation with Autism Severity
Version: 2Date:24 January 2011
Reviewer: Manya T Angley
Reviewer's report:
The authors revisions are acceptable
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-11-21 (2011)

Reviewer's report
Title:HMGB1 cytoplasmic translocation in patients with acute liver failure
Version: 1Date:16 December 2010
Reviewer: Hiroki Kuniyasu
Reviewer's report:
Major Compulsory Revisions
1. In Figure 1, viability ratio was indicated to assess the cell damage by LPS and
TNF-alpha. HepG2 cells were growing cells. The cell number should be indicated
in addition to the viability ratio.
2. In Figure 1D and F, extracellular HMGB1 was induced with the optimal dosage
of LPS and TNF-alpha. How the authors translate the phenomenon?
3. In Figure 2C, extracellular HMGB1 should be added to cytoplasmic an nuclear
localization of HMGB1 to assess the HMGB1 distribution.
4. In Figure 2C, the cytoplasmic HMGB1 was increased; however, the nuclear
HMGB1 kept the level. The cytoplasmic HMGB1 is translocated from nucleus or
newly translated? At least, mRNA expression of HMGB1 should be examined.
5. For induce liver damage in HepG2 cells, LPS and TNF-alpha were used.
HMGB1 is well known as an inducer of secretion of TNF-alpha, INF-gamma, and
IL-1beta, which form a vicious cycle. Then the extracellular concentrations of
TNF-alpha, INF-gamma, and IL-1beta should be examined to be compared
between treatments with LPS and TNF-alpha.
6. In Figure 4, the disease status of chronic hepatitis B is completely different
from that of acute liver failure by HBV. The details of clinical data showing how
chronic or how acute should be needed for this type of comparison. The present
form of the data is afraid to be less values.
7. In Figure 4, the histology of acute liver failure showed marked necrotic
reactions. Many hepatocytes showed unintegrated cell structure, which is not
suitable for judging the HMGB1 location. Fig. 4 should be omitted from the
manuscript.
8. The cytoplasmic localization of HMGB1 was clearly indicated by
immunostaining (Fig. 5B); however, the cytoplasmic HMGB1-positive
hepatocytes were scatted in the lobes. The characterization of these cells is
needed.
9. In Fig. 5f, some cytoplasmic HMGB1-positive hepatocytes also showed the
nuclear HMGB1 but some cells did not. What is the different between the two
types of HMGB1 localization?
10. The expression of IL-8 and GRO should be examined in the D-GalN-induced
mouse hepatitis to compare with HMGB1 localization.
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-11-21 (2011)

Reviewer's report
Title:HMGB1 cytoplasmic translocation in patients with acute liver failure
Version: 1Date:20 December 2010
Reviewer: Allan Tsung
Reviewer's report:
In this paper, Zhou and colleagues examine HMGB1 cytoplasmic translocation in
acute liver failure. Several issues that should be addressed:
Minor Essential Revisions
1. Page 6: The authors mention the use of murine macrophages (RAW 264.7
cells), however, there are no experiments using RAW cells in the results.
2. Page 11: The listing of figures in figure 1 should be in alphabetical order- from
A to F, not B to A, D and F to C and E.
3. Page 11-12: LPS induced HMGB1 release at a peak concentration of
400ng/ml. Why are different doses of LPS used for other experiments? (200ng/ml
for figure 1B and 100ng/ml for figure 2 and figure 3.)
4. Page 11-12: Why were HepG2 cells used instead of hepatocytes? It is much
more relavent to the in vivo experiments.
5. Page 12: Figure 5A is not mentioned?
6. Multiple grammatical errors need to be corrected.
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-11-21 (2011)

Reviewer's report
Title:HMGB1 cytoplasmic translocation in patients with acute liver failure
Version: 1Date:30 December 2010
Reviewer: Kohji Okamoto
Reviewer's report:
This is an interesting paper which adds to the understanding of the link hepatic
HMGB1 release, cytoplasmic translocation and ALF.
However, it seems that there is several points contrariety in this report.
1. In HepG2 cell culture, LPS or TNF induced HMGB1 cytolasmic translocation
and release. There is a difference of cytokine release between LPS and TNF.
Why was there the difference of cytokine release between two groups?
2. Furthermore, authors should make the additional experiment which IL8 and/or
GRO can induce HMGB1 release in HepG2.
3. HMGB1 cytoplasmic translocation in hepatocytes of ALF patients caused by
hepatitis B. These cytoplasmic HMGB1 might be a state that HMGB1, released
from nuclear of necrotic hepatic cells, was combined with a receptor (ex. RAGE,
TLR etc) of hepatic cell
4. In animal models, authors showed high percentage of hepatocytes with
HMGB1 cytoplasmic translocation at 3h after injection of D-GalN and LPS. At this
point, the rate of hepatic apoptosis was still low. How much was the ratio of
necrotic hepatocytes? It is known that HMGB1 is released from necrotic cells not
but apoptotic cells. (Scaffidi P et al. Nature 418:191-195,2002).
5. The details of the experiment of HepG2 were not written down in method of
Abstract.
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-11-21 (2011)

Reviewer's report
Title:HMGB1 cytoplasmic translocation in patients with acute liver failure
Version: 3Date:22 February 2011
Reviewer: Kohji Okamoto
Reviewer's report:
Revised manuscript was much improved.
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-11-21 (2011)

Reviewer's report
Title:HMGB1 cytoplasmic translocation in patients with acute liver failure
Version: 3Date:24 February 2011
Reviewer: Hiroki Kuniyasu
Reviewer's report:
Major Compulsory Revisions
The manuscript is well revised to achieve clearer story and details.
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-11-20 (2011)

Reviewer's report
Title:Acetaminophen-cysteine adducts during therapeutic dosing and following
overdose.
Version: 1Date:22 December 2010
Reviewer: Laura K Schnackenberg
Reviewer's report:
The authors provide a well-written report on the measurement of
acetaminophen-cysteine adducts as a potential diagnostic tool for
acetaminophen toxicity. Acetaminophen toxicity is the number one cause of
acute liver failure in the United States and ALT is not necessarily a reliable
marker of acetaminophen-induced toxicity. Further, the rapid metabolism of the
parent compound renders measurements of acetaminophen useless as a
diagnostic tool. However, the authors clearly demonstrate that APAP-Cys is
present even after acetaminophen dosing has ceased. The authors took care in
obtaining data in a number of different populations in order to assess the effects
of different conditions on APAP-Cys concentrations. Overall, this was a nicely
written report. A few minor discretionary revisions follow:
Discretionary Revisions:
1. For Clinical Trial 2, why were only two timepoints acquired?
2. Why was there no placebo arm for Trial 1?
3. On p. 11, in the paragraph starting, “Mean APAP-Cys concentrations tended to
increase…”, it is noted that samples were also collected 1 and 4 days after
dosing ceased in Trial 1 and on days 1 and 3 in Trial 3, however, this does not
seem to be reflected in Table 1.
4. In Table 2, it would be more clear if a column for peak ALT and time to NAC
could be added rather than having all of the information under the Case
description.
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-11-20 (2011)

Reviewer's report
Title:Acetaminophen-cysteine adducts during therapeutic dosing and following
overdose.
Version: 1Date:23 December 2010
Reviewer: James Dear
Reviewer's report:
The paper is further development of APAP-CYS adducts as clinical biomarkers.
The authors are to be congratulated on performing studies in therpeutic dosing -
a situation that is likely to confound clinical use of the marker.
I would like more discussion around the future for APAP-CYS adducts. For
example, do the authors see them having a role outwith the confirmation of
APAP ingestion in patients with an unknown cause for liver injury? Indeed, in
light of their current work could APAP-CYS even be used in this setting (as a
therapeutic dose of APAP leads to adduct formation)?
In the APAP overdose group there was a wide dynamic range of adducts. Do the
values correlate with other markers of liver injury (PT, reaching KCC, creatinine,
encephaolpathy etc?)
I suppose my key question for the authors is what added value do APAP-CYS
adducts provide over and above established markers?
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-11-18 (2011)

Reviewer's report
Title:High APACHE 2 score and long length of bowel resection impair the
outcomes in patients with necrotic bowel induced hepatic portal venous gas
Version: 1Date:24 November 2010
Reviewer: Olivier Monneuse
Reviewer's report:
We have been asked to review the article titled ‘high APACHE 2 score and long
length of bowel resection impair the outcomes in patients with necrotic bowel
induced hepatic portal venous gas’.
The authors studied the risk factors of mortality in patients with hepatic portal
venous gas secondary to intestinal necrosis. This is a retrospective study.
28 consecutive patients had been identified in 7 years. It is an important series of
patients according to the others reported series.
We identified some points that should be taken in account in order to ameliorate
the manuscript:
Major compulsory revisions:
6 patients were excluded of the series. These 6 patients were treated medically.
No medical data justify this attitude among these patients. Were they excluded
because of a major mesenteric infarction? Otherwise in the first paragraph of
results section, the authors claim that “the 6 patients receiving medical treatment
all expired within three days, indicating the necessity of surgical treatment”. No
data in this paper allows such a conclusion. These 6 patients could modifiy the
statistics in intention to treat.
Table 2 is unclear. Some patients appear several times. It seems that patients
with “both small and large bowels involved” appear in other sections either in
“small bowel involved” or “large bowel involved”. It would be better if the total of
patients of column 1 matches to the overall number of patients.
In the last paragraph of introduction the authors claim that the “largest series
contained only 7 patients [9]”. Some of the references report more than 7
patients: ref 19 (11 patients), ref 14 (15 patients, 12 bowel obstructions).
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:
I declare that I have no competing interests
Review for 10.1186/1471-230X-11-18 (2011)

Reviewer's report
Title:High APACHE 2 score and long length of bowel resection impair the
outcomes in patients with necrotic bowel induced hepatic portal venous gas
Version: 2Date:20 January 2011
Reviewer: ABDULZAHRA HUSSAIN
Reviewer's report:
Dear Authors:
I think the article now much stronger after addressing the raised points
Regards
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 interest