bluuebunny/crossref_metadata_2025 huggingface dataset:
Gall‐bladder glycoprotein synthesis and secretion during cholesterol gallstone formation in the mouse
Authors: WHITING M. J. , WATTS J. MCK.
Published: March 2008

AbstractGlycoprotein synthesis by the gall‐bladder was studied during cholesterol gallstone formation in mice fed a diet supplemented with 1% cholesterol and 0.5% cholic acid for up to 6 weeks. Within 1 week, this lithogenic diet induced a 5 fold increase in the cholesterol saturation of gall‐bladder bile, which remained near‐saturated for the next 5 weeks. Cholesterol gallstones were infrequent until the fourth week of the diet. Glycoprotein synthesis was measured as the incorporation of3H‐glucosamine by mouse gall‐bladder explants in organ culture and was found to double after 4 weeks of the diet when expressed per gall‐bladder. This increase could be explained by a marked enlargement of the gall‐bladder with a greater number of mucus‐secreting cells. Gall‐bladder glycoprotein synthesis and secretion did not appear to be regulated by prostaglandins, since indomethacin blocked prostaglandin synthesis but did not inhibit glycoprotein synthesis. High molecular weight mucin glycoprotein accounted for around one‐third of gall‐bladder glycoprotein secretion.

These results are consistent with the hypothesis that gall‐bladder mucin acts as a nucleating agent for cholesterol crystal and gallstone formation. However, this mouse model for cholesterol gallstone formation is different from the prairie dog model, not only in dietary requirements, but also in the effect of the diet on the gall‐bladder, and possibly in the mechanism of regulation of gall‐bladder much glycoprotein synthesis.
Liver abscess: What determines the prognosis?
Authors: CRAIG PHILIP I. , STEVENS ALEX , FARRELL GEOFFREY C. , LITTLE J. MILES
Published: March 2008

Records of all patients with liver abscess who presented to a teaching hospital between 1979 and 1986 were reviewed in order to determine prognostic factors and optimal treatment. Of 32 patients, the diagnosis was made ante‐mortem in 30, and 24 patients survived. Patients who died tended to be older and more likely to exhibit confusion and other features of systemic toxicity at presentation. Fine needle aspiration, guided by computerized tomography, provided the correct diagnosis in 18 of 19 patients. Of 24 patients with isolated abscesses (1 or 2) 22 survived, whereas six of eight patients with multiple (more than 2) abscesses died (P < 0.001). Aspirates from patients who survived appeared to grow anaerobes more commonly (NS), whereas those from non‐survivors more often grew multiple organisms which usually included Gram‐negative bacilli (P < 0.01). All patients received broad spectrum antibiotics and a drainage procedure was carried out in 26. Of 19 patients treated by percutaneous drainage, 12 recovered, one required hepatic resection before recovering, and six died (four with multiple abscesses). Of nine patients (all with 1–2 abscesses) treated by open drainage, all eventually recovered, but three needed additional procedures. Six of eight non‐survivors compared with four of 24 survivors had predisposing biliary sepsis (P < 0.01). It is concluded that isolated liver abscesses are relatively benign, commonly grow anaerobes, and are usually resolved with antibiotics and drainage (closed or open), whereas multiple abscesses occur in sicker, older patients who are usually jaundiced with uncontrolled biliary sepsis. The prognosis in patients with multiple liver abscesses is poor irrespective of treatment.
Liver microvascular flow in rats: Quantitation by laser Doppler flowmetric technique and effects of sodium dehydrocholate
Authors: KOO ANTHONY
Published: March 2008

An in vivo in situ liver preparation in anaesthetized male Sprague‐Dawley rats was devised for simultaneous measurements of hepatic microvascular flow and bile flow. The micro‐vascular flow on the surface of the liver was continuously recorded by laser Doppler flowmetric technique whilst bile flow was quantitated by connecting the bile duct cannula to a drop counter. Sodium dehydrocholate was infused (0.2 ml in 2–5 min) both via a cannula in the splenic artery and via a cannula in the superior mesenteric vein. Results showed that sodium dehydrocholate, given by either route, increased the liver microvascular flow and bile flow. A cross‐plot between the hyperaemic and hypercholeretic responses corresponding to the same dose of sodium dehydrocholate revealed a significant correlation (P < 0.01) between the sodium dehydro‐cholate‐induced hypercholeresis and hyperaemia. Furthermore, the increase of microvascular flow occurred significantly (P < 0.05) earlier than the hypercholeretic response. Results thus suggested that an increase of plasma blood flow was essential for the development of hypercholeresis induced by sodium dehydrocholate.
Serum procollagen‐III‐peptide: Failure to reflect the extent of hepatic fibrosis
Authors: ROBERTS F. D. , SANDFORD N. L. , BRADBEAR R. A. , COOKSLEY W. G. E. , POWELL L. W. , HALLIDAY J. W.
Published: March 2008

Abstract In order to test the hypothesis that serum levels of the amino terminal propeptide of type III procollagen (PPCP III) reflect hepatic fibrosis, we have studied PPCP III levels in 30 patients with genetic haemochromatosis (GH), a disease which is characterized by progressive fibrosis without significant inflammation or necrosis. Patients with alcoholic liver disease and chronic hepatitis were included as comparative diseases in which fibrosis occurs concurrently with inflammation and necrosis. Of 13 GH cases with cirrhosis, four (30%) had normal serum PPCP III levels, while of 17 GH cases without cirrhosis, two (12%) had elevated levels. The mean serum concentrations of the cirrhotic and non‐cirrhotic GH groups were not significantly different when patients with excessive alcohol consumption (> 80 g/day) were excluded from the GH groups. In 29 subjects with alcoholic liver disease, serum PPCP III correlated significantly with both fibrosis (P < 0.01) and necrosis (P < 0.02) but not with inflammation. In 23 subjects with chronic hepatitis, PPCP III levels correlated significantly with inflammation when assessed histologically (P < 0.01) or as reflected by serum AST (P < 0.01), but not with fibrosis or necrosis. Furthermore, the correlation between PPCP III and inflammation was not strengthened when the three features (inflammation, necrosis and fibrosis) were combined into a single variable. We conclude that elevated PPCP III levels in chronic liver disease do not reflect solely the extent of fibrosis but are also influenced by inflammation and necrosis and are thus of limited clinical value in predicting hepatic histopathology.
Epidemiology of HBsAg carriers in India. A holistic approach to control of hepatitis‐B reservoir
Authors: TANDON B. N. , JOSHI Y. K. , GANDHI B. M. , IRSHAD M. , GUPTA H. , GUPTA M. L.
Published: March 2008

AbstractMorbidity and mortality due to hepatitis B virus (HBV) infection is a matter of concern all over the world. The incidence of HBV infection depends upon the human reservoir particularly located in Asian Pacific and some of the African countries. Knowledge of the epidemiology of HBV infection is essential to formulate a strategy for its control. Six thousand and twenty‐four persons of different categories which included urban, rural, pregnant, non‐pregnant, diabetic, alcoholic and occupational high‐risk groups were tested for HBsAg. Personal and environmental factors contributing to the development of the HBsAg carrier state were studied. It was found that hospital environment, blood transfusion, perinatal transmission and urbanization were the major factors responsible for the spread of the HBV infection. A holistic approach for the control of HBV infection, which should include an improvement of the hospital and urban environment, complete exclusion of commercial blood donors and HBsAg screening of the voluntary blood donors is recommended, while immunoprophylaxis should be reserved for the protection of high‐risk groups and to prevent perinatal transmission.
The effects of smoking and nicotine on the parietal cell mass of human beings and rats
Authors: FU‐NING GUO , GUO‐ZHEN CHEN , SHI‐QIANG LIU , YAN‐HAN YOU , SHI‐ZHEN YUAN
Published: March 2008

Abstract On 94 patients with duodenal ulcer and 44 controls, parietal cell mass (PCM), as derived from pentagastrin‐stimulated peak acid output (PAO), was significantly greater in chronic cigarette smokers than in non‐smokers. Smokers and non‐smokers did not differ in their fasting and postprandial serum gastrin concentrations, and in the frequency of familial ulcer, although basal acid output (BAO) and BAO/PAO were significantly higher in smokers, suggesting the presence of hypervagotonia. Chronic hypodermic administration of depot nicotine in rats resulted in significant dose‐dependent increase in PAO and PCM as determined histologically, supporting the results of the human studies. Acute administration of nicotine, however, did not cause any increase in acid output, indicating that it had no effect on parietal cell function. Chronic nicotine administration also led to significant increase in antral G cell mass as determined by immunohistochemical labeling, and in peptone‐stimulated serum gastrin. The effects on PCM and G cells were abolished by the simultaneous administration of atropine. Nicotine induced gastric electrical and motor activities in rats similar to those induced by carbachol, and the effects of both agents could be blocked by atropine. Nicotine had no effect on gastric mucosal blood flow in rats as estimated by neutral red clearance. We conclude that cigarette smoking in man and chronic nicotine administration in rats cause parietal cell hyperplasia, plus, in rats, G cell hyperplasia, possibly through a cholinergic mechanism.
Metabolic activation of polycyclic aromatic hydrocarbons by human colonic mucosa and Bacteroides fragilis
Authors: TASICH M. , HAFNER L. , PIPER D. W. , STIEL D.
Published: March 2008

Abstract The Ames Salmonella mutagenicity assay has been used to assess the metabolic activation of the following polycyclic aromatic hydrocarbons by human colonic microsomes (S9) and a cell‐free extract of Bacteroides fragilis (Bf): 2‐aminoanthracene, 1‐naphthylamine, 2‐naphthylamine, 2‐aminofluorene, 2‐acetylaminofluorene, anthracene, benzo(a)pyrene, 3‐methylcholanthrene, 7, 12‐dimethylbenzanthracene, acridine, 9‐aminoacridine and 3‐methylindole.

2‐Aminoanthracene and 2‐aminofluorene were the only compounds activated. In both cases, activation was dose‐dependent and 2‐aminofluorene exhibited synergistic activation by S9+Bf, as has previously been demonstrated with 2‐aminoanthracene.

The organospecific aliphatic colonic carcinogen, 1, 2‐dimethylhydrazine was not activated in this system. Metabolic activation by S9+Bf is thus restricted to aromatic compounds with three rings and an amino group in position 2.

These findings are consistent with enzymic substrate specificity, and are compatible with an enzymic basis for activation of polycyclic aromatic hydrocarbons by B. fragilis, present in large concentrations in the colonic lumen, and colonic microsomes.
Hepatobiliary excretion and enterohepatic circulation of bacterial chemotactic peptide (FMLP) in the rat
Authors: ANDERSON R. P. , WOODHOUSE A. F. , HOBSON C. H. , MYERS D. B. , BROOM M. F. , CHADWICK V. S.
Published: March 2008

N‐formyl methionyl leucyl 3H‐phenylalanine was used as a model bacterial chemotactic peptide to study the systemic metabolism and excretory pathways for such peptides in the rat. After intravenous bolus infusion, the peptide was rapidly cleared from the systemic circulation with a mean of 22% of the dose being excreted in bile over 2 h. In bile, 53% of radioactivity existed as intact peptide, the remainder was its degradation product, 3H‐phenylalanine. No intact peptide was detected in urine. While previous studies have shown no significant absorption of F‐met‐leu‐phe from normal rat intestine, in the current studies ileal loop infusions of F‐met‐leu‐phe in hyperosmolar solution, to increase gut permeability, resulted in absorption of intact peptide which was recovered in bile. These studies show that bile is a major pathway for excretion of bacterial chemotactic peptide in the rat and confirm the potential for an enterohepatic circulation of peptides from the gut lumen under conditions of increased intestinal mucosal permeability.
Influence of the site of a duodenal ulcer on its subsequent course
Authors: KANG J. Y. , NASIRY ROSAMOND , PIPER D. W.
Published: March 2008

The aim of this study was to determine if the site of a duodenal ulcer influences its subsequent course. Three hundred and eighteen duodenal ulcer patients diagnosed by endoscopy in Sydney were studied. The ulcer was situated on the anterior wall of the bulb in 49% and the posterior wall of the bulb in 23%. These patients were followed up until symptoms recurred or for 1–2 years. The risk of symptom recurrence was unaffected by the site of the index ulcer, occurring in 129 of 157 patients with anterior wall ulcer (82%), 56 of 72 patients with posterior wall ulcers (78%), and 27 of 32 patients with anterior and posterior wall ulcers (84%). Sixty‐four patients were endoscoped within 1 month of recurrence of ulcer‐like symptoms and active ulcer craters were demonstrated in 49 (77%).
Serological survey on hepatitis A and B infections among the residents of social welfare homes in Singapore
Authors: LAM S. K. , QUAK S. H. , RAMAN G. V. , TEO J. , WONG H. B. , OON C. J.
Published: March 2008

A study of the immunological status of hepatitis A and B infections was carried out among the residents of eight social welfare homes in Singapore. The sample population consisted of 440 individuals of whom 55% were Chinese, 21% were Malays and 24% were Indians. The mean age of the study population was 14 years and 4 months. The immunological markers studied included specific IgM antibody and total antibody against hepatitis A virus (anti‐HAV‐IgM and total anti‐HAV respectively); hepatitis B surface antigen (HBsAg), surface antibody (anti‐HBs), core antibody (anti‐HBc) and e antigen (HBeAg), all tested by the enzyme immunoassay (EIA) technique.

While none of the subjects had detectable anti‐HAV‐IgM (HAVAB‐M‐EIA), 12% were positive for total anti‐HAV (HAVAB‐EIA) indicating evidence of past infection. HBsAg was detected (Auszyme II) in 4.5% and of these, half had HBeAg (Abbott‐HBe EIA). Anti‐HBs positivity (AUSAB‐EIA) occurred in 11.6% and the majority (88%) of these had anti‐HBc positivity (CORZYME) as well. The positive rate for anti‐HBc alone was 3.6% reflecting the ‘window’ period after the fall of HBsAg and before the rise of anti‐HBs. At least one of the hepatitis B markers was present in 19.1% of the study population.

The endemic nature of both hepatitis A and B infections in the local population is evident, with infection occurring in all ethnic groups at an early age.
Fermentation in ileostomy bags: Control of excessive gas with diet, pH and antibiotics
Authors: GAFFNEY PHILIP T. , BUTTENSHAW RONALD L. , STILLMAN LENA , WARD MICHAEL
Published: March 2008

The composition of early morning gas from the bags of 10 ileostomates was determined using gas chromatography. Seven of the 10 had a predominance of gases attributable to bacterial fermentation (H2 and CO2, 70 ± 12%). The remaining three contained mainly atmospheric gases, N2 and O2, with only small amounts of fermentation gases (7 ± 3%).

When a controlled low fibre (0.7 g) dinner was substituted for a high fibre (13.5 g) evening meal, there was a corresponding decrease in the volume of fermentation gas in the ileostomy bag the next morning (P < 0.05).

Gas production from ileostomy effluent was inhibited in vitro by 10 < pH < 5 and by antimicrobial agents. The most effective were metronidazole, chloramphenicol, tetracycline, erythromycin and chlorhexidine. These reduced fermentation gas by more than 95%.

It was concluded that the majority of the gas produced by ileostomates is formed by bacterial fermentation of the faecal waste in their ileostomy bag and that this may be controlled by careful manipulation of their diet.
The effects of cisapride on gastric and oesophageal emptying in dystrophia myotonica
Authors: HOROWITZ MICHAEL , MADDOX ANNE , WISHART JUDITH , COLLINS PETER J. , SHEARMAN DAVID J. C.
Published: March 2008

The effects of cisapride on gastric emptying, oesophageal emptying, and gastrointestinal symptoms were evaluated in 10 patients with dystrophia myotonica who had delayed gastric emptying of the solid and/or liquid component of a meal. A double isotope technique was used to measure gastric emptying and oesophageal emptying was measured as the time taken for a bolus of the solid meal to enter the stomach. Gastrointestinal symptoms were assessed by a questionnaire. Gastric and oesophageal emptying and gastrointestinal symptoms were measured before and when each subject had taken cisapride (10 mg, q.i.d., p.o.) for 4 weeks. Cisapride improved solid gastric emptying, and there was a non‐significant trend for improved liquid emptying. Cisapride had no effect on oesophageal emptying. Upper gastrointestinal symptoms were less after cisapride and there was an increased frequency of bowel actions. No side effects were reported. These results indicate that gastroparesis is a treatable cause of morbidity in dystrophia myotonica.
Acute sporadic non‐A, non‐B viral hepatitis of adults in India—Epidemiological and immunological studies
Authors: DATTA RAKESH , PANDA S. K. , TANDON B. N. , MADANGOPALAN N. , BOSE S. L. , ACHARYA S. K. , NAYAK N. C.
Published: March 2008

On the basis of tests for specific IgM class antibodies in the serum, infections by hepatitis A virus, hepatitis B virus and hepatitis non‐A, non‐B virus accounted for 7%, 37.8% and 54.2% respectively of 286 cases of acute sporadic viral hepatitis in adults from three different regions of India. Epstein‐Barr virus and cytomegalo virus were insignificant (0.5–1%) aetiological agents. Approximately one‐quarter of all non‐A, non‐B (NANB) cases were additionally HBsAg carriers; there were significant differences in regional frequencies. NANB hepatitis commonly affected individuals in the mid‐fourth decade and occurred throughout the year with small peaks in different seasons. No antigen‐antibody reaction could be demonstrated in various immunological tests including radioimmunobinding using acute and convalescent phase sera. Neither were virus‐like particles visualized in acute phase sera on electron and immuno‐electron microscopy. However, rhesus monkeys inoculated with acute phase serum from a case of NANB hepatitis developed distinct hepatocellular changes at 43–55 days after inoculation, which had some features of similarity with experimental NANB hepatitis of other simian species. Sporadic NANB hepatitis is a major health problem throughout India and intensive study is needed on its epidemiology and aetiology.
Determination of cellular retinol‐binding protein in human hepatocellular and colorectal carcinomas by radioimmunoassay
Authors: OKUNO MASATAKA , KATO MICHIMASA , KANAI MASAMITSU , MUTO YASUTOSHI
Published: March 2008

A study was conducted to determine the tissue levels of cellular retinol‐binding protein (CRBP), serum retinol‐binding protein (RBP) and retinoids in hepatocellular carcinoma (HCC) and in colorectal adenocarcinoma. CRBP, which has a molecular weight of 14 900 daltons and an isoelectric point of 4.9, was purified from human liver. An antihuman CRBP antibody was raised in the turkey and further purified by immunosorbent affinity chromatography on CRBP‐coupled Sepharose column. A radioimmunoassay for CRBP using this antibody was established. RBP was measured by an enzyme immunoassay and retinoids were measured by high‐performance liquid chromatography analysis. Retinol levels in liver tumours were significantly decreased compared with those in respective non‐cancerous adjacent tissues. Retinyl ester levels in liver tumours were also significantly decreased compared with those in the adjacent tissues. CRBP levels in liver tumours were significantly decreased compared with those in the adjacent tissues, whereas no significant difference was observed in the CRBP level between the colon tumours and adjacent colon tissues. RBP levels in liver tumours were also significantly decreased compared with those in the adjacent tissues. The decreased CRBP levels in liver tumours may, at least in part, account for the local deficiency of retinol in HCC, whereas colon tumours may grow independently, regardless of retinol status.
Changes of serum aminotransferase activities in relation to serum hepatitis Be antigen levels in chronic type B hepatitis
Authors: KURAI KIYOHIKO , IINO SHIRO , KOIKE KAZUHIKO , ENDO YASUO , OKA HIROSHI
Published: March 2008

The purpose of this study was to determine the level of serum hepatitis Be antigen (HBeAg) during hepatitis B virus carriage and its clinical significance. The mean level of serum HBeAg, quantitated by solid‐phase enzyme immunoassay, was 5924 units in asymptomatic carriers (s.d. = 5534, n= 100), 3044 units in patients with chronic persistent hepatitis (s.d. = 4826, n= 34), 3599 units in chronic active hepatitis (s.d. = 4953, n= 45) 1348 units in liver cirrhosis (s.d. = 2379, n= 25) and 766 units in hepatocellular carcinoma (s.d. = 1257, n= 18). In the 10 HBeAg‐positive patients with chronic active hepatitis, the fluctuation in HBeAg level was followed by changes in alanine aminotransferase (ALT) activity. Among the 36 peaks of HBeAg and ALT, HBeAg peaks preceded ALT peaks in 22 and simultaneous peaks were present in 14. The changes of HBeAg level were closely related to increase in disease activity as estimated by ALT activities; therefore, HBeAg quantitation can be a useful predictor of disease activity in chronic hepatitis B.
Discriminant factors of gastric ulcer healing by colloidal bismuth
Authors: KOO JARLEY , LAM SHIU‐KUM
Published: March 2008

One hundred and twelve patients with 49 corpus and 35 prepyloric gastric ulcers and 28 duodenal ulcers associated with gastric ulcers were entered into a stratified, controlled double‐blind randomized study comparing the healing efficacy of colloidal bismuth suspension with placebo. Healing of corpus and prepyloric ulcers, but not duodenal‐ulcer associated gastric ulcers, was significantly better with the bismuth compound than with placebo. The clinical, personal, ulcer and acid secretory data of these patients were prospectively collected and evaluated by stepwise discriminant analysis in two phases. In the first phase, the collected data of 91 consecutive patients were entered into computer analysis. The derived discriminant function classified patients into healed and unhealed categories with a sensitivity of 82%, specificity of 77%, positive diagnostic value of 73%, negative diagnostic value of 85% and diagnostic efficiency of 79%. In phase two, the discriminant function from phase 1 was applied prospectively to 21 patients to predict the outcome of treatment. Five out of five healed and 11/16 unhealed gastric ulcers were correctly predicted, giving a diagnostic efficiency of 76%. The present study shows that healing or non‐healing of gastric ulcer can be predicted with reasonable accuracy by discriminant analysis. In addition, discriminant analysis identified, aside from the efficacious drug, ulcer size, young age, co‐existing duodenal ulcer, and concomitant medical condition as adverse factors for gastric ulcer healing.
Reduced natural killer cell activity in gluten‐sensitive enteropathy
Authors: DREW P. A. , HETZEL P. A. S. , SMITH J.
Published: March 2008

There is an increased risk of malignancy—particularly of lymphoma—associated with coeliac disease. Because natural killer (NK) cells are thought to play a role in immune surveillance against tumours, the activity of NK cells was studied in patients with coeliac disease who were being treated with a gluten‐free diet. The 18 patients had a median age of 39 years (range: 13–75) and had been on the gluten‐free diet for a median of 4 years (1 week‐18 years). The NK cell activity of the peripheral blood mononuclear cells was assayed by measuring the 51Cr release from labelled K562 cells. The specific cytotoxicity of the cells from the patients were significantly lower than controls at effector: target cell ratios of 100: 1, 50: 1 and 25: 1. The experimental data were fitted to a mathematical model which described the relationship between effector: target cell ratio and specific cytotoxicity. Comparison showed that the maximum NK cytotoxicity by cells from treated patients was significantly less than from controls, and that the cytotoxicity was reduced over the whole range of effector: target cell ratios.
The effects of a prostaglandin E1 analogue, misoprostol, on gastric mucosal blood volume index and haemoglobin oxygenation in humans
Authors: SATO NOBUHIRO , KAWANO SUNAO , FUKUDA MASUKI , KAMADA TAKENOBU
Published: March 2008

A double‐blind placebo‐controlled parallel design study was conducted in 12 healthy male volunteers to examine the effects of misoprostol, a newly synthesized prostaglandin E1 analogue, on gastric mucosal haemodynamics in human. The indices of mucosal blood volume (expressed as ΔEr) and mucosal blood haemoglobin oxygenation (Hb‐SO2) were measured at 20 locations in the stomach prior to and after administration of misoprostol or its placebo using reflectance spectrophotometry during endoscopy. It was found that after misoprostol administration, mucosal blood volume was increased by approximately 10–25% throughout the stomach without any significant change in mucosal blood Hb‐SO2. Administration of placebo produced no significant change in these parameters. The results suggest that misoprostol has the potential to accelerate healing of gastric ulcers by increasing the gastric mucosal blood volume and oxygenation in addition to its gastric acid antisecretory activity.
Naloxone inhibition of pentagastrin‐stimulated gastric acid output in rats
Authors: KOO A. , SHUM W. K.
Published: March 2008

An in situ stomach lumen‐perfusion technique is described for measuring the gastric acid output in anaesthetized rats. With this technique, 0.15 mol/l NaCl was continuously perfused into the gastric lumen and the outflowing perfusate was collected. The pH value of the out‐flowing perfusate was recorded every minute for 10 min, and after correcting for the change of volume, the pH values were converted into hydrogen ion activity. The basal gastric acid output in a group of 25 rats thus studied was 9.7 μmol H+/kg per 10 min (s.e.m. = 1.12, n= 25). Local blockade of opiate receptors in the gastric mucosa was performed by adding naloxone to the NaCl perfusate for 30 min. Naloxone at three concentrations, 0.1, 1, and 10 μmol/l, did not produce a significant change of the basal gastric output. Pentagastrin (0.05–20 μg/kg, i.v.) increased the basal gastric acid output in a dose‐dependent manner. Naloxone (10 μmol/l) significantly shifted the pentagastrin‐stimulated gastric acid output response curve to the right (P < 0.05, analysis of variance), and produced a sixfold change of pentagastrin dose. The results suggest that the opiate receptor in the gastric mucosa might affect gastric acid secretion by interacting with gastrin receptors. Local blockade of the opiate receptor by naloxone decreased the pentagastrin‐stimulated acid output.
Alimentary tract tuberculosis. A continuing challenge to gastroenterologists—Report of 55 cases
Authors: YASAWY M. I. , AL KARAWI M. A. , MOHAMED A. E.
Published: March 2008

Although uncommon in developed countries gastrointestinal tuberculosis is an important treatable disease and the diagnosis is often difficult. Between November 1982 and November 1985 tuberculosis was diagnosed in 544 patients at the Armed Forces Hospital, Riyadh. Of these 55 (10.11%) had tuberculosis of the gastrointestinal tract confirmed by histology and/or microbiology, from material obtained during surgical exploration or endos‐copy. Disease was located in the oesophagus and stomach (4), small bowel (18), large bowel (15), peritoneum (21) and liver (11). The proportion of alimentary tract tuberculosis found in this study is high when compared with other reports. The presentation, diagnosis and response to treatment of these 55 patients is described and the value of endoscopy in diagnosis is illustrated.
Absence of transmission of hepatitis B by fibreoptic upper gastrointestinal endoscopy
Authors: LOK ANNA S. F. , LAI CHING‐LUNG , HUI WAI‐MO , NG MATTHEW M. T. , WU PUI‐CHEE , LAM SHIU‐KUM , LEUNG ELSIE K.Y.
Published: March 2008

A prospective survey on all patients undergoing fibreoptic upper gastrointestinal endoscopy during a 3 month period was conducted to determine the risk of transmission of hepatitis B. Four hundred and sixty‐eight patients underwent 637 endoscopy examinations in 47 endoscopy sessions. Of these, 15% were positive for hepatitis B surface antigen (HBsAg), 58.9% anti‐HBs/anti‐HBc‐positive and 26.1% negative for hepatitis B virus (HBV) markers on entry into the study. One hundred and eleven patients with no HBV markers underwent endoscopy during the same sessions as 69 HBsAg‐positive patients. Forty of these patients were endoscoped subsequent to HBeAg‐positive patients on at least one occasion. None of the HBV‐negative patients seroconverted to HBsAg or anti‐HBs/anti‐HBc at the end of 6 months. It was demonstrated that with a standard cleaning procedure there was no evidence of endoscopic transmission of HBV infection even in an endemic area.
Intrahepatic expression of HBsAg and HBcAg in asymptomatic HBsAg carriers and its follow‐up
Authors: KIYOSAWA KENDO , YAMAMURA NOBUYOSHI , SODEYAMA TAKESHI , YODA HIDETOSHI , IMAI YASUHARU , IMAI HARUHIKO , FRANCA SUENIA M.T. , FURUTA SEIICHI
Published: March 2008

Intrahepatic expression of hepatitis B surface antigen (HBsAg) and hepatitis B core antigen (HBcAg) was investigated in 46 asymptomatic HBsAg carriers by a direct immuno‐fluorescent method. In 21 HBeAg positive carriers, HBsAg was expressed diffusely on the membrane of hepatocytes, with associated cytoplasmic localization in a few scattered hepato‐cytes. HBcAg was expressed in the nucleus of many hepatocytes and in the cytoplasm of a few scattered hepatocytes, but not on the cell membrane. In 25 anti‐HBe positive carriers, HBsAg was expressed on the surface and in the cytoplasm of hepatocytes diffusely and/or focally, but neither intrahepatic HBcAg nor serum HBV‐DNA was detected. Repeat liver biopsies were performed in 17 patients. In eight of 13 HBeAg‐positive HBsAg carriers, who developed histologically proven chronic hepatitis and liver cirrhosis, the localization of HBsAg in liver had changed from a membranous to a mixed (membrane and cytoplasm) pattern, and localization of HBcAg in liver had changed from a predominantly nuclear to a predominantly membranous and cytoplasmic pattern. However, in two HBeAg and two anti‐HBe positive cases who showed no biochemical and histologic change at follow‐up, the intrahepatic expressions of HBsAg and HBcAg in the second biopsies remained unchanged. Thus, decrease in membranous expression of HBsAg and increase in membranous and cytoplasmic expression of HBcAg were associated with progression to chronic liver disease. This suggests that membranous HBcAg may represent the major target in the process of injury to hepatocytes.
Lactose malabsorption in Central Australian Aboriginal children hospitalized with acute enteritis
Authors: EDGELEY GRAEME R. , DAVIDSON GEOFFREY P. , GOODWIN DEBORAH A. , RINGENBERGS MARGARETE L. , ERLICH JOHN , ROBB TREVOR A.
Published: March 2008

The prevalence and duration of lactose malabsorption was studied in 64 Central Australian Aboriginal children requiring hospitalization for acute enteritis. Lactose malabsorption was determined by the breath‐hydrogen test. Sixty‐nine per cent were shown to malabsorb lactose, a figure similar to that for well nourished urban European children, hospitalized for acute enteritis. Whereas 90 per cent of the European children became lactose‐tolerant 1 month later, only three of 32 aboriginal children were lactose‐tolerant after 3 months. Lactose malabsorption was also associated with more frequent hospitalizations in affected children.

Coronavirus‐like particles were the commonest agent isolated from Aboriginal children. The majority of the Aboriginal children were malnourished (< 80% standard weight for age) which may have been contributed to by their lactose malabsorption and explain why this failed to recover in the same way as European children. The possibility of lactose malabsorption must be taken into consideration when managing Aboriginal children with acute diarrhoeal disease and undernutrition. The use of the breath‐hydrogen test allows an accurate diagnosis of lactose malabsorption to be made in Aboriginal children with diarrhoea so that appropriate dietary management can be instituted.
The diagnosis of mass lesions in the pancreas by fine needle aspiration biopsy
Authors: HEWETT P. J. , LANGLOIS S. LEP. , ORELL S. R.
Published: March 2008

Fifty‐eight cases of pancreatic mass lesions investigated by fine needle aspiration biopsy (FNAB) are reported. Biopsies were performed either at laparotomy or percutaneously using ultrasound or computer to mography scanning as a guide. Twenty‐seven biopsies were reported as consistent with or highly suspicious of adenocarcinoma of the pancreas; five with metastatic carcinoma, one with lymphoma and two with islet cell tumours. Nineteen patients had negative biopsies. The false‐negative rate was 11% and four biopsies were unsatisfactory. There were no false‐positive diagnoses. FNAB is an effective way to obtain cytological confirmation of a pancreatic mass lesion.
The localization of the site(s) of neurotensin release in man and dog
Authors: EAVES E. R. , KORMAN M. G. , MERCURI J. , WARD F. , HANSKY J.
Published: March 2008

The major source of neurotensin in the gut is the ‘N’ cell and this is found in the highest density in the ileum. The ingestion of food, particularly fat, causes the biphasic release of neurotensin‐like immunoreactivity (NTLI) into the circulation. The early peak occurs sooner than expected if it is due to the presence of chyme in the ileum, suggesting that the early release of neurotensin is due to a more proximal concentration of N cells or that neurotensin is released from the ileum by a more proximal stimulus. This paper investigates the site(s) of neurotensin release by studying: three groups of patients with various resections of the small intestine and the fashioning of duodenostomies, jejunostomies and ileostomies; and the dog with chronic gastric, duodenal and ileal fistulae, and following ileal resection. The results indicate that the jejunum and ileum are critical in the release of neurotensin following fat stimulation and that the stomach and duodenum have no direct role. The stimulation of the jejunum by fat causes the early rise of plasma NTLI by releasing neurotensin from the ileum. If chyme is prevented from passing to the distal jejunum the magnitude of the early peak is diminished and the second, later, peak is abolished. The second peak of plasma NTLI is due to the direct luminal stimulation of the distal jejunum and ileum by the products of fat digestion. Ileal resection completely abolishes any release of plasma NTLI in response to fat. It was concluded that the source of neurotensin released by the ingestion of food is the ileum. The release of neurotensin from the distal gut is dependent upon a signal from the proximal to the distal gut. The identity of the signal is unknown, but it is either neural or humoral and previous studies suggest a cholinergic‐dependent reflex.
The microscopic distribution of 99mTc‐labelled phagocytes in resected bowel in patients with acute Crohn's disease: correlation with histological changes
Authors: BARTHOLOMEUSZ F. D. L. , DURBRIDGE T. C. , DREW P. , SHEARMAN D. J. C. , ROWLAND R. , HETZEL D. , CHATTERTON B. , BAKER R.
Published: March 2008

Abdominal scintiscans performed after the injection of autologous phagocytes labelled with 99mTc‐stannous colloid particles provide an accurate assessment of the extent of disease in active inflammatory bowel disease. To study the correlation between phagocyte accumulation and histological indices of the degree of inflammation within bowel wall, the distribution of radiolabel within five freshly resected specimens of ileum and one of colon was assessed in five patients with active Crohn's disease. Each patient was injected with autologous 99mTc‐labelled phagocytes prior to surgery. Multiple tissue samples (blocks) were taken along the length of the fresh resected specimen of bowel. The radioactive count of each block was obtained and they were then studied independently by two histopathologists who graded 12 histological features according to predefined criteria. High counts correlated with ulceration and submucosal mononuclear aggregates (P < 0.05). Very low counts were obtained in mesentery and non‐ulcerated bowel. This study confirms the selective accumulation of 99mTc‐labelled phagocytes within areas of ulcerated bowel in patients with active Crohn's disease.
Aqueous or emulsified diazepam in upper endoscopy: A randomized trial
Authors: CHUNG S.C.S. , LEUNG J.W.C.
Published: March 2008

A randomized comparison between diazepam in aqueous form and in fatty emulsion was performed in Chinese patients undergoing upper gastrointestinal endoscopy. One hundred and eighty‐four patients completed the study. The sedative effect is similar with both preparations. Aqueous diazepam caused significantly more pain on injection (75%) and more late venous complication (41%) than the emulsified form (13% and 9% respectively). Thrombosis and thrombophlebitis frequently extended beyond the site of injection. Diazepam in emulsion form caused significantly less venous complications and is therefore superior to the aqueous form for intravenous use.
Detection of hepatitis B surface antigen by a monoclonal radioimmunoassay in the serum of alcoholic patients
Authors: POYNARD THIERRY , MARCELLIN PATRICK , WANDS JACK , NAVEAU SYLVIE , DUBREUIL PASCAL , PILLOT JACQUES , CHAPUT JEAN‐CLAUDE
Published: March 2008

The presence of HBV infection has been retrospectively assessed using monoclonal radioimmunoassay (M‐RIA) in the sera of 269 alcoholics. There were three subjects with normal liver, 92 had steatosis, 32 had fibrosis, 15 had acute alcoholic steatosis and 127 had cirrhosis. The HBsAg M‐RIA was performed by the sandwich method using high affinity IgG and IgM monoclonal antibodies. The M‐RIA was more sensitive for detection of HBV when compared with conventional RIA, the former detecting 15 out of 269, the latter detecting five out of 269 (5.6% and 1.9% respectively; P= 0.02). Among the 264 patients negative for conventional RIA, the prevalence of a positive M‐RIA test was no different between patients who lacked HBV related antibodies (seven out of 196; 3.6%) compared with patients with at least one antibody (three out of 68; 4.4%). The prevalence of HBsAg detected by M‐RIA was higher in alcoholic patients with cirrhosis (9.4%) compared with patients without cirrhosis (2.1%; P < 0.01). These results suggest that all alcoholic patients could have a low production, or an abnormal expression, of HBV or could be infected by an hepatitis B variant virus. HBV or an hepatitis B variant virus could have in some cases a causative role in the pathogenesis of cirrhosis.
Auto‐immune hepatitis: Lifting the seventh veil
Authors: MACKAY IAN R.
Published: March 2008

Knowledge of auto‐immune chronic active hepatitis (AI‐CAH) has developed since the 1940s. Using the analogy of the seven veils, the lifting of the first six could be represented by the finding of: hypergammaglobulinaemia; recognition of the clinical syndrome; the hepatic histopathology; the auto‐immune serological markers; the response to corticosteroid/immuno‐suppressive drugs; and the immunogenetic association with HLA B8; DR3. The lifting of the seventh veil, the ultimate understanding of AI‐CAH, will require the following: consensus on criteria for specifying auto‐immune hepatitis as an entity; identification of a liver‐specific auto‐antigen (or hepatocellular neo‐antigen) as target of the immune attack; the nature of the immune effector process which causes hepatocellular destruction; the basis of the deranged immunoregulatory processes expressed as decreased immune suppressor activity; and processes by which ‘anti‐immune’ drugs exert their ameliorative effects. Auto‐immune hepatitis is not unique in the paucity of data on these questions.
Short communication: Fulminant hepatitis induced by cimetidine
Authors: KIMURA HIROSHI , AKAMATSU KOUICHI , SAKAUE HIROSHI , NOGAWA MASANORI , OHTA YASUYUKI
Published: March 2008

Despite the widespread use of cimetidine, there have been only few reports of cimetidine‐induced severe liver damage. This is an account of a 44 year old woman who developed, after a year of daily administration of cimetidine, fulminant hepatitis which was confirmed by unintentional rechallenge.
Sucralfate protection against ethanol‐induced injury of rat gastric mucosa in vitro and in vivo
Authors: SEWELL R. B. , KIM D. , YEOMANS N. D.
Published: March 2008

A number of mechanisms for sucralfate protection of gastric mucosa during ulcer healing and protection from experimental injury have been proposed. One currently held postulate that sucralfate acts by inhibiting acid/pepsin attack and creating, at acid pH, a barrier to diffusion of hydrogen ions was tested. The experiments took advantage of a cultured rat antral mucosal model in which ethanol injury is assessed by release of radiolabel from 51chromiumloaded mucosa. In this model, with mucosa cultured in the absence of pepsin activity at a neutral pH, sucralfate conferred marked protection; specific 51chromium release fell from 12.4% (s.e.m. = 0.7) in controls to 8.9% (s.e.m. = 0.9) at 0.5 mg/ml (P < 0.05) and 3.4% (s.e.m. = 0.5) at 2.0 mg/ml (P < 0.001) of sucralfate and was abolished at 10 mg/ml and 40 mg/ml (P < 0.001). Pretreatment with sucralfate in vivo also protected the mucosa against subsequent ethanol challenge in the cultured mucosal model, control 12.3% (s.e.m. = 1.9) versus sucralfate pretreatment 6.9% (s.e.m. = 0.7) (P < 0.02). Using computer‐assisted macroscopic assessment of mucosal damage after ethanol dosage by gavage, it was further demonstrated that sucralfate protection in vivo is dose‐dependent and prolonged, lasting for at least 5 h at a dose of 200 mg/kg. It is concluded that sucralfate‐induced protection of the gastric mucosa is long‐lasting and can occur via mechanisms other than minimization of acid/peptic attack.
Intestinal metaplasia and gastric carcinoma: A histological study of 198 gastrectomy specimens
Authors: NG IRENE O. L. , HO JOANA , NG MATTHEW
Published: March 2008

One hundred and ninety‐eight consecutive gastrectomy specimens (78 gastric carcinomas, 120 benign lesions) were reviewed and examined to study the relation between intestinal metaplasia (IM) and gastric carcinomas (GC). IM was classified as complete (type I) and incomplete (types II and III) depending on the types of mucin secreted. Only type III IM was found to be significantly associated with GC (P= 0.0005) when GC was treated as a group in contrast to non‐neoplastic lesions. On subdivsion into different types of GC, such association was only found in the intestinal type but not the diffuse type. The significance of the association between type III IM and the intestinal type GC is discussed. In addition, dysplasia was significantly associated with GC and not with benign lesions (P < 0.005).
Incidence of achalasia in New Zealand, 1980‐84: An epidemiological study based on hospital discharges
Authors: MAYBERRY JOHN F. , ATKINSON MICHAEL
Published: March 2008

One hundred and fifty‐two patients with achalasia were first admitted to hospital in New Zealand between 1980 and 1984. The discharge of these patients was recorded by the National Health Statistics Centre which records details of all public health hospitals in New Zealand. The overall incidence was 0.95/100 000 population per year and was similar in North and South Islands and in men and women. The incidence increased with age and was 5.4/100 000 population per year in people aged over 80 years old. The disease was more common in Polynesian migrants (1.3/100 000 population per year) than other ethnic groups. Variations in incidence were seen across the Health Boards with the highest incidence of 2.9/100 000 population per year in Hawkes Bay and Tauranga.
Digestive and nutritional status after total gastrectomy with a long Roux‐en‐Y reconstruction
Authors: SMITH ROSS C. , HOLLINSHEAD JOHN , EADE YVONNE L. , HOLLOWAY RICHARD , GILLETT DAVID J.
Published: March 2008

Nineteen patients underwent clinical and nutritional review 1–5.5 years after gastrectomy and long Roux‐en‐Y jejunal reconstruction. Of these, 79% had little or no restriction of daily activity and only one patient became housebound. Although body weight was only maintained at postoperative levels, body protein status, as measured by arm muscle circumference, creatinine height index and plasma proteins, was normal. Body fat stores were reduced, indicating that fat or carbohydrate digestion was impaired. Mild asymptomatic anaemia in six patients was due to iron deficiency in three and folate deficiency in three. Eight patients had low red cell folate values and these patients had low folic acid intakes. It is concluded that a total gastrectomy using a long Roux‐en‐Y loop is usually associated with a satisfactory nutritional and digestive outcome but long‐term supplements of iron and folic acid should be taken.
Identification of calcium‐dependent, phospholipid‐ and calmodulin‐activated protein kinases in rat small intestinal epithelium
Authors: WARHURST GEOFFREY , SMITH GEOFFREY S. , TONGE ANNE , LEES MARTIN , TURNBERG LESLIE A.
Published: March 2008

The mechanisms by which increases in cytosolic calcium promote ion‐secretion in the intestinal epithelium may involve the phosphorylation of key transport proteins in the microvillus membrane. Using both direct and indirect methods evidence has been provided for two distinct calcium‐regulated protein kinase activities in rat small intestinal epithelium — one activated by phosphatidylserine (C‐kinase), the other by calmodulin (CDR‐kinase).

C‐kinase activity was identified in cytosolic and particulate fractions including purified brush border membranes using a specific histone substrate. In the presence of phosphatidylserine and diacylglycerol, calcium markedly stimulated enzyme activity, half‐maximal effects occurring at 2.8X10‐7 mol/1 free calcium. Phorbol esters, known activators of C‐kinase, were also shown to stimulate the phosphorylation of an endogenous peptide (Mr = 94 000) in cell homogenates.

The addition of exogenous calmodulin (10–100 μg/ml) stimulated a 50–75% increase in the labelling of peptide (Mr = 50 000–55 000). Trifluoperazine (0.1–10 μmol/l) inhibited basal phosphorylation of this and other peptides suggesting the likely involvement of a protein kinase activated by endogenous levels of calmodulin. Cytosolic fractions were also able to phosphorylate purified myosin light chains, a known substrate for CDR‐kinase, in the presence of submicromolar concentrations of free calcium (ED50= 2.4X10‐7 mol/l) although no direct stimulation of this activity by calmodulin could be demonstrated. MLC‐phosphorylated activity was not identified in particulate fractions.