bluuebunny/crossref_metadata_2025 huggingface dataset:
Molecular and cellular pathology of hepatocellular carcinoma
Authors: NG IRENE
Published: October 2010

Mutations of the p53 gene are common in hepatocellular carcinoma (HCC) and have been found in 13–33% of HCC in Asia and 23% of HCC in Hong Kong. In addition, p53 overexpression has been found to be associated with poorer cellular differentiation and larger tumour size and may be a late event in hepatocarcinogenesis. The p53 gene is important in controlling cell cycle, apoptosis and DNA repair. The cyclin‐dependent kinase inhibitor p21WAF1/CIP1, which is downstream of p53, is regulated by both p53‐dependent and p53‐independent pathways. We found that HCC with p53 mutations had lower levels of p21 expression than those without p53 mutations. Moreover, p21 protein expression of the tumours was significantly higher in the tumours than in the corresponding non‐tumorous livers. When the tumours were stratified into two groups, those with higher expression were found to have a significantly lower incidence of multiple tumour nodules and lower incidence of tumour microsatellite formation. p21 Expression was, however, not associated with p53 expression. Higher p21 expression is associated with solitary tumour nodules and fewer tumour microsatellites, but may not be enough to suppress tumour progression. Insulin‐like growth factor II (IGF‐II) gene has complex regulation of transcription resulting in multiple mRNA being produced and different mRNA occur in the adult and foetus. Using northern blot analysis, repression of normal adult promoter and re‐expression of foetal promoters of IGF‐II are common events in HCC, with repression of the normal adult promoter in 93% of the HCC transcripts and re‐expression of the foetal transcripts (6 and 5 kb, respectively) in 40% of tumours. In addition, IGF‐II expression was significantly more frequent in older patients. This may suggest that spontaneous expression of IGF‐II late in life may promote the growth of tumours which have already arisen through other mechanisms, but foetal re‐expression, itself, may not be enough to contribute to tumour progression.
Replicative efficiency and pathogenicity of hepatitis B virus e‐minus precore variant
Authors: WEN YU‐MEI , MA ZHANG‐MEI , TU HONG , ZHAI WEI‐RONG , HE LI‐FANG , YAO XIN
Published: October 2010

To study the replicative efficiency and pathogenicity of hepatitis B virus precore variant (A1896), anti‐hepatitis B virus e antigen (HBe) titre was studied in naturally occurring wild‐type virus infection, A1896 variant infection and dual infection. Higher titre of anti‐HBe was found in patients with no virus replication and in patients coinfected with the wild‐type virus and A1896 variant, which suggest that anti‐HBe may either act as an inhibitor of virus replication or as selective pressure for the A1896 variant. Three site‐directed mutants were constructed in the duck hepatitis B virus (DHBV) precore region. A frame shift in the encapsidation signal region abolished replication of DHBV; mutation in the initiation codon of the precore and mutation to generate a termination codon at the distal region of the precore resulted in decreased replication in the duck model. More significant pathological changes were found in the liver tissues of ducks infected with the mutant which mimicked the HBV A1896 variant.
Liver transplantation in Asia: Problems and practice
Authors: FAN ST
Published: October 2010

Liver transplantation in Asia has been difficult to establish due to: a reluctance in Asians to donate organs; a lack of financial support; and the predominance of hepatitis B in the population, which effectively reduces the number of cadaveric organs. To overcome the problem of organ shortage, living‐related liver transplantation for paediatric patients was rapidly established initially at Kyoto University, Japan, and then in several centres in Asia. Living‐related liver transplantation was extended to adults using the left lobe in 1994 and using the right lobe in 1996. Up to May 1998, 785 liver transplantations had been performed in major centres in Asia with a patient survival rate approaching 80%. To overcome the problem of hepatitis B viral infection, lamivudine is now used peri‐operatively. Lamivudine is shown to be very effective in preventing graft reinfection. Of the 15 patients who received lamivudine and liver transplantation at Queen Mary Hospital, hepatitis B surface antigen (HBsAg) disappeared in 11 patients and hepatitis B virus DNA was not detectable in any of them. Two patients had a reappearance of HBsAg after an initial loss, but their liver grafts were not affected by hepatitis. Compared with hepatitis B immunoglobulin, lamivudine is definitely cheaper and more convenient. In conclusion, even though there are major obstacles to liver transplantation in Asia, steady progress is being made. Hopefully, when the number of cadaveric grafts increases in future, an increasing number of patients can benefit.
Multimodality treatment of hepatocellular carcinoma
Authors: TANG ZHAO‐YOU , ZHOU XIN‐DA , MA ZENG‐CHEN , WU ZHI‐QUAN , FAN JIA , LIN ZHI‐YING , LU JI‐ZHEN , LIU KANG‐DA , YE SHENG‐LONG , YANG BING‐HUI
Published: October 2010

By 1996, 2898 patients with pathologically proven hepatocellular carcinoma (HCC) had been treated at the Liver Cancer Institute of Shanghai Medical University. The 5 year survival in the entire series was 36.2%, being increased from 4.8% in 1958–70, 12.2% in 1971–83, to 50.5% in 1984–96 and 274 patients had survived more than 5 years. The increase in the survival rate could be attributed to the decreasing mean tumour diameter (11.7, 10.5 and 9.5 cm, respectively) and multimodality treatment. In addition to small HCC resection (5 year survival 64.9%, n = 735) and large HCC resection (5 year survival 37.4%, n = 1050), the following deserves to be mentioned. First, the 5 year survival of unresectable HCC treated by palliative surgery increased from 0% to 7.2% to 20.0%, which was related to the increase in use of multimodality treatment, particularly in those followed by second‐stage resection. Second, cytoreduction and sequential resection is a new field with a significant potential in the treatment of localized unresectable HCC in a cirrhotic liver. Cytoreduction can be achieved by surgery, such as hepatic artery ligation, cannulation, cryosurgery and their combination, and followed by intrahepatic arterial chemoembolization, targeting therapy or regional radiotherapy. Ninety of 647 patients with unresectable HCC so treated had marked shrinkage of tumour and received second‐stage resection; the 5 year survival was 71.4%. Third, non‐surgical cytoreduction was mainly achieved by transcatheter arterial chemoembolization (TACE); for 70 patients with second‐stage resection following TACE, the 5 year survival was 56.0%. Finally, re‐resection of subclinical recurrence of tumour after curative HCC resection was performed in 155 patients; the 5 year survival calculated from the first resection was 50.9%, which played an important role in increasing the 5 year survival in the resection group (from 13.0% to 29.5% to 56.2%). It is concluded that multimodality treatment with combined and sequential use of different modalities and repeated use of some modalities is of substantial benefit for localized unresectable HCC.
Patient selection and listing policies for liver transplantation
Authors: Keeffe Emmet
Published: October 2010

Liver transplantation expanded rapidly during the first three decades of its application but has undergone slower growth over the past few years because of a limited supply of donor organs. The growing discrepancy between available donor organs and patients listed for transplantation has fuelled recent debate regarding patient selection criteria and listing policies for liver transplantation. Allocation and distribution regulations of the United Network for Organ Sharing have also recently undergone changes to balance the principles of utility (i.e. the overall benefits of liver transplantation to society) and justice (i.e. the needs of the individual patient). The ideal geographical area over which organs can be distributed to balance utility and justice remains uncertain, although there are pressures to widen sharing of donor organs. The sickest patient who has been waiting the longest still receive the next available donor organ, but listing policies for the sickest patients, those with fulminant hepatic failure or acute decompensation of chronic liver disease, were recently revised. A uniform minimal listing criteria that proposes listing patients when their estimated survival with liver disease is less than that expected after liver transplantation was recently proposed and has generally been accepted. Finally, cost–outcome analyses and the reality of managed care with the transfer of financial risk from insurers to providers is beginning to have an influence on patient selection criteria.
Antiviral therapy for hepatitis B and C in Asians
Authors: Lai Ching‐Lung
Published: October 2010

The clinical features and treatment of chronic hepatitis C in Chinese patients are the same as in Caucasian patients except that 27% of Chinese chronic hepatitis C patients have hepatitis C virus (HCV) genotype 6a. In contrast, Chinese patients with chronic hepatitis B (CHB) differ from Caucasian patients because the Chinese patients are immunologically tolerant to hepatitis B virus (HBV), having acquired hepatitis B infection perinatally or in early childhood. In the treatment of CHB, the short‐term aims of loss of hepatitis B virus early antigen (HBeAg) and HBV‐DNA need to be reassessed. In 1296 Chinese CHB patients, 67.7% of those who developed complications of cirrhosis or hepatocellular carcinoma, were HBeAg‐antibody positive. Longer follow up of patients is, therefore, required to assess the time efficacy of a treatment regimen. After long‐term follow up (median 90 months) of 206 Chinese CHB patients treated with interferon α (IFNα) compared with 203 untreated subjects, IFNα conferred no benefit in cumulative HBeAg seroconversion or in HBV‐DNA negativity as determined by polymerase chain reaction assays or in decreasing long‐term complications of cirrhosis and hepatocellular carcinoma. Lamivudine is a novel nucleoside analogue. In a recent 1 year study in 358 Chinese CHB patients, lamivudine treatment was associated with substantial histological improvement (including a reduction in fibrosis), with HBV‐DNA suppression and normalization of alanine aminotransferase levels. However, lamivudine may have to be given on a long‐term basis, as withdrawal of lamivudine results in rebound of HBV‐DNA to pretreatment levels. The long‐term effects of lamivudine are currently being assessed.
Does Asian race affect hepatitis B virus recurrence or survival following liver transplantation for hepatitis B cirrhosis?
Authors: So Samuel , Esquivel Carlos , Imperial Joanne , Garcia Gabriel , Monge Humberto , Keeffe Emmet
Published: October 2010

To assess whether Asian race is an independent variable affecting survival and hepatitis B virus (HBV) recurrence after liver transplantation, the results of 27 consecutive liver transplants performed between June 1994 and April 1997 for HBV cirrhosis were analysed. In the group of 13 Asians, 38% had associated hepatocellular carcinoma and 62% had positive hepatitis B virus early antigen (HBeAg) or elevated HBV‐DNA before transplant. Prophylactic hepatitis B immunoglobulin (HBIG) was administered perioperatively and long term at 4–6 weekly interval. Four patients with elevated HBV‐DNA received lamivudine before transplantation. The 3 year actuarial patient survival rate was 100% in both Asian and non‐Asian patients. Twenty‐six patients remained seronegative for hepatitis B virus surface antigen after transplantation. The incidence of post‐transplant HBV recurrence was similar: 0% in Asians compared with 7% in non‐Asians. There was no recurrence in the group of 12 patients who were HBV‐DNA or HBeAg negative pretransplant.
Resection versus transplantation for hepatocellular carcinoma
Authors: Esquivel Carlos , Keeffe Emmet , Garcia Gabriel , Imperial Joanne , Millan Maria , Monge Humberto , So Samuel
Published: October 2010

Hepatocellular carcinoma is responsible for more than 1 million deaths per year worldwide and thus remains a challenging medical problem. It causes few or no symptoms and the tumour frequently reaches an enormous size by the time of diagnosis in countries where screening is seldom used. It is generally resistant to commercially available anti‐neoplastic agents and radiation therapy. The principal treatment continues to be resection, either partial or complete, with liver transplantation. However, less than one‐third of patients are surgical candidates for either resection or transplantation at the time of clinical presentation. This review will address the results observed following resection or transplantation for hepatocellular carcinoma.
Malignant melanoma metastatic to the common bile duct
Authors: Garas George , Bramston Brian , Edmunds Simon Ej
Published: October 2010

Metastatic melanoma is renowned for its propensity to spread to almost every organ of the body; however, symptomatic metastases within the biliary tree are very rare. We report two cases of bile duct obstruction from metastatic melanoma. The first case was caused by an intraluminal metastatic melanoma to the common bile duct, while the second case was caused by extraluminal involvement. The unique aspects of these cases include clinical presentations masquerading as biliary colic, cholangitis and obstructive jaundice. Management and follow up for 3 years is presented. Aspects of medical and surgical management, as well as a review of the world's literature are discussed.
Helicobacter pylori infection in childhood: Results of management with ranitidine bismuth citrate plus amoxicillin and tinidazole
Authors: Nijevitch Alexander A , Farztdinov Karim M , Sataev Valery U , Khasanov Rinat Sh , Katayev Valery A , Khusnutdinov Shamil M , Akhunov Eduard D , Kazykhanov Nasghat S
Published: October 2010

Background and Aims: To verify whether a triple therapy bismuth citrate plus amoxicillin and tinidazole eradicates H. pylori infection in pediatric patients.

Methods: Fifty children (30 females; mean age 12.4 ± 1.1 years, range 10–15 years) suffering from upper abdominal complaints and Helicobacter pylori (H. pylori)‐associated gastroduodenal disease were treated with a 4 week course of ranitidine bismuth citrate (400 mg, twice daily) plus oral tinidazole (20 mg/kg) and amoxicillin (50 mg/kg) for the first 2 weeks.

Results: The endoscopic diagnoses were: esophagitis (seven cases), gastritis (six cases), gastroduodenitis (43 cases), duodenitis (one case), gastric ulcer (two cases) and duodenal ulcer (13 cases). Helicobacter pylori was eradicated in 40 (80%) patients and clinical improvement was noticed in 39 (78%) of symptomatic subjects. Duodenal ulcers were healed in all the children, but lymphoid nodular hyperplasia was persistent in all patients, independent of the H. pylori status. The potentially drug‐related adverse events (blackening of the tongue, six patients; diarrhea, one patient; disturbance of taste, two patients) were registered in seven (14%) patients and dark stools were observed in 48 (96%) patients. No children withdrew from the study because of either side‐effects or clinical laboratory changes. No patient had toxic levels of blood bismuth (values ranged between 2.1 and 5.4 μg/L, mean value 3.4 ± 1.04 μg/L).

Conclusions: Findings suggest that the present treatment regimen is effective enough in the resolution of H. pylori‐associated peptic ulcer disease of childhood.
Conditionally immortalized mouse hepatocytes for use in liver gene therapy
Authors: Allen Katrina J , Reyes Rosario , Demmler Kirsten , Mercer Julian F , Williamson Robert , Whitehead Robert H
Published: October 2010

Background and aims: The use of hepatocytes for gene therapy is limited by the difficulty of maintaining and altering primary liver cells in culture. A conditionally immortalized mouse hepatocyte cell line has been developed which can be passaged indefinitely at the permissive temperature (33°C), but fails to proliferate and dies at the non‐permissive temperature (39°C) in vitro.

Methods: Hepatocytes were harvested from a 6 week‐old male transgenic mouse (‘immortomouse’) carrying a thermolabile SV40 Large T gene, using a modified two‐step collagenase perfusion method, and serially passaged at 33°C for more than 1 year. To assess the ability of immortohepatocytes to engraft and populate mouse liver, cells were infused into partially hepatectomized congenic mice via the portal vein (n = 10) or the spleen with (n = 2) and without (n = 2) partial hepatectomy. The ability to transfect immortohepatocytes was assessed using the reporter gene enhanced green fluorescent protein (EGFP).

Results: All immortohepatocytes in culture stained positive by immunohistochemistry for the hepatocyte markers albumin, AFP, CK8 and CK18. In early cultures a proportion of cells also stained strongly for the biliary epithelial markers CK7 and CK19. Late cell cultures were negative for M2PK and CK7 and stained variably with anti‐CK19 antibodies. Cells transferred to the non‐permissive temperature of 39°C ceased proliferation and died within 1 week in vitro. Large T DNA was detected in the liver of all postoperative mice up to 2 weeks post‐hepatocellular transplantation via PCR and Southern blot analysis. The immortohepatocytes were easily transfected with a reporter gene.

Conclusions: Immortohepatocytes can survive in vivo after transfer to liver, and will be useful as a model for hepatic gene therapy.
Clinical significance of hepatitis C virus infection to alcoholics with cirrhosis in Korea
Authors: Kwon So Young , Ahn Myoung Soo , Chang Hee Jin
Published: October 2010

Background/Methods: To investigate the prevalence and clinical significance of hepatitis C virus (HCV) infection and its relationship with the development of hepatocellular carcinoma (HCC), 162 consecutive alcoholic patients with cirrhosis were studied. Alcohol intake and parenteral risk factors were investigated by interview using a questionnaire. All patients had consumed at least 80 g alcohol/day for at least the past 5 years. Sera were tested for anti‐HCV using a third‐generation enzyme immunoassay (EIA), hepatitis B s antigen (HBsAg), anti‐HBs, anti‐HBc and anti‐HIV. Serum HCV‐RNA was detected by a one‐tube reverse transcription–polymerase chain reaction (RT‐PCR) method. Patients were classified into three groups accroding to the presence or absence of viral markers: (i) cases without anti‐HCV or HBsAg (group A); (ii) cases with HBsAg only (group B); and (iii) cases with anti‐HCV only (group C). Demographic and clinical findings were compared among the three groups.

Results: Anti‐HCV was present in 17 cases (10.5%) and HBsAg was present in 47 cases (29%). No patient had both anti‐HCV and HBsAg. Group C subjects were the oldest, but the duration of drinking in this group was similar to that of group A. There was no significant difference in the daily alcohol intake among the three groups. Previous surgical operations and tattooing were more frequent in group C. Only one patient in group C was an intravenous drug user. The combined rate of HCC was significantly higher in groups B and C than in groups A (34, 23.5 and 6.1%, respectively). Laboratory data showed a higher platelet count, higher albumin level, lower bilirubin level and lower aspartate aminotransferase/alanine aminotransferase ratio in group C patients than in the other two groups. Hepatitis C virus RNA was detected in 14 of 85 cases tested (16.5%), in 11 of 12 cases (91.7%) with anti‐HCV and in three of 73 cases (4.1%) without anti‐HCV.

Conclusions: Hepatitis C virus infection is frequent in alcoholic patients with cirrhosis in Korea. Hepatitis C virus, as well as hepatitis B virus, infection may have a synergistic effect on the development of HCC in alcoholic patients.
Interspousal transmission of TT virus: Low efficiency and lack of apparent risk factors
Authors: Liu Chun‐Jen , Kao Jia‐Horng , Chen Wendy , Tsai Ruey‐Jen , Chen Pei‐Jer , Lai Ming‐Yang , Chen Ding‐Shinn
Published: October 2010

Background: The TT virus (TTV) is a newly identified human DNA virus and little is known about its non‐parenteral transmission. The aim of the present study was to explore the prevalence of TTV infection in spouses of index cases and the related risk factors.

Methods: Serum TTV‐DNA was studied in spouses of 41 subjects with TT viremia. For couples in which both husband and wife had TT viremia, nucleotide sequences of the open reading frame‐1 region were analyzed by phylogenetic tree constructions.

Results: Three (7%) of 41 spouses were positive for TTV‐DNA. No differences were noted between index patients with seropositive spouses and those without seropositive spouses with regard to clinical characteristics, including parenteral risk factors and exposure duration. Nucleotide sequence comparison and phylogenetic tree analysis of the viral genome in three TTV‐infected couples revealed the isolates to be closely related in two, with a homology of 97 and 98%, respectively.

Conclusions: These results suggest that interspousal transmission of TTV does occur; however, the efficiency of transmission is low compared with hepatitis C virus and GB virus‐C. There are no apparent risk factors for transmission between spouses and further studies are needed to clarify other modes of non‐parenteral transmission.
Clinical impact of genotype 1 TT virus infection in patients with chronic hepatitis C and response of TT virus to α‐interferon
Authors: Nishizawa Yoshio , Tanaka Eiji , Orii Koji , Rokuhara Akinori , Ichijo Tetsuya , Yoshizawa Kaname , Kiyosawa Kendo
Published: October 2010

Background: The relationship between genotype 1 TT virus (TTV) infection and the status of chronic hepatitis C was studied.

Methods: A total of 52 patients with chronic hepatitis C who were treated with interferon (IFN)‐α were enrolled in the present study. Of those, 12 were infected with genotype 1 TTV and 40 were uninfected.

Results: Clinical backgrounds, including mean age, sex, blood transfusion history, serum alanine aminotransferase (ALT) level, and the results of liver biopsy did not differ between patients with and without genotype 1 TTV infection. The distribution of hepatitis C virus (HCV) genotypes did not differ between the two groups of patients, but TTV‐infected patients tended to have a lower serum HCV‐RNA level than uninfected patients (median (range) 26.0 (< 1–460) vs 135 (1.2–740) kilo copies/mL, respectively; P = 0.065). Patients with a sustained response of HCV to IFN‐α were significantly more common in TTV‐infected than ‐uninfected patients (58 vs 23%, respectively; P = 0.018). Multivariate logistic regression analysis revealed that patients with a sustained response of HCV correlated significantly with the serum HCV‐RNA level (P = 0.006), but not with the presence or absence of genotype 1 TTV infection (P = 0.161). Serum TTV‐DNA decreased with IFN‐α therapy in all 12 patients and remained negative in six patients even after treatment. There was no correlation between patients with a sustained response of HCV and the same of TTV. Serum ALT levels correlated with changes in the status of HCV viremia, but not with changes in the status of TTV viremia.

Conclusions: An opposing relationship between HCV and TTV proliferation was suggested, but coinfection with genotype 1 TTV did not affect the status of chronic hepatitis C.
Quantitative measurement of mRNA coding for the receptors controlling acid secretion in the ovine fundus and antrum by using RT‐PCR
Authors: Kolivas Sotirios , Dow Renee , Jie Ren , Baldwin Graham S , Shulkes Arthur
Published: October 2010

Background and Aims:

Gastric acid secretion is stimulated by the action of gastrin, histamine and acetylcholine on their respective receptors. To determine the regulation of synthesis of these receptors during different gastric secretory states a competitive RT‐PCR method for quantitating the mRNA for these receptors was developed.

Methods:

Partial cDNA clones (400–500 base pairs (bp)) for the ovine gastrin, histamine (H2) and acetylcholine (M3) receptors were isolated and sequenced. These cDNA constructs were modified by the inclusion of approximately 100 bp of unrelated sequence within the plasmids. cDNA was synthesized from a mixture of known amounts of RNA transcribed from the modified plasmids and from total RNA extracted from sheep stomach. Proportional coamplification of mixed cDNA was demonstrated using common primer sets.

Results:

All three receptors were more highly expressed in the fundus than the antrum. The concentration of cholecystokinin‐B/gastrin receptor mRNA was 75‐fold higher in the fundus than in the antrum, and the concentration of both histamine and acetylcholine receptor mRNA were fivefold higher in the fundus than in the antrum. Infusion of gastrin caused a significant increase in fundic histamine mRNA receptor expression, but not in the expression of the gastrin or muscarinic receptors.

Conclusions:

No significant differences were observed in the levels of receptor mRNA between normal adult and fetal animals despite markedly reduced gastric secretion in the fetus, suggesting that gastric receptor gene expression is not the rate‐limiting factor in determining gastric acid secretion in the neonatal animal.
Risk of colorectal cancer in patients with hematologic disease
Authors: Kishida Teruyuki , Yonezawa Masaoki , Shibata Yoshiaki , Tanaka Shu , Shinozawa Isao , Hoshino Tetsuo , Tatsuguchi Atsushi , Feng Li , Sato Jun , Fujimori Shunji , Yoshida Yutaka , Sakamoto Choitsu , Kobayashi Masafumi
Published: October 2010

Background and Aims: A relatively large number of patients with multiple myeloma have been reported to develop a secondary malignancy such as cancer of the breast, biliary system or bowel.

Methods: A retrospective study was perfomed in 734 patients with hematologic disease diagnosed at Nippon Medical School Hospital between May 1984 and September 1994 to determine the incidence of colorectal cancer in these patients based on a history review, colonoscopic findings, and surgical or autopsy data.

Results: Of the 734 patients, 14 (1.9%) had colorectal cancer; two of 11 patients (18.2%) had pure red cell aplasia; two of 25 patients (8%) had multiple myeloma; and three of 46 patients (6.5%) had aplastic anemia. Patients with pure red cell aplasia, multiple myeloma or aplastic anemia had colorectal cancer at a significantly higher rate compared to those with leukemia (P < 0.005, P < 0.02, P < 0.01, respectively).

Conclusions: It is possible that a relatively large number of patients with pure red cell aplasia, multiple myeloma or aplastic anemia will develop a colorectal cancer.
Surgery for adult polycystic liver disease
Authors: Chen Miin‐Fu
Published: October 2010

AbstractAdult polycystic liver disease, commonly associated with polycystic kidney disease, can result in massive hepatomegaly and debilitating symptoms. Surgical intervention for symptomatic polycystic liver disease, such as cyst fenestration or liver resection has been associated with significant morbidity and inconsistent long‐term palliation. However, selected patients with severe symptoms benefit from liver resection and extensive fenestration with acceptable morbidity and mortality. Total hepatectomy and orthotopic liver transplantation may be considered for patients with severe adult polycystic liver disease.
Evaluation of a new referral system for the management of dyspepsia in Hong Kong: Role of open‐access upper endoscopy
Authors: Wong Benjamin Chun Yu , Chan Chi Kuen , Wong Ka Wah , Wong Wai Man , Yuen Man Fung , Lai Kam Chuen , Hu Wayne Hc , Lau George Kk , Lai Ching Lung , Lam Shiu Kum
Published: October 2010

Background: In the management of dyspepsia, upper endoscopy is an important component. In our locality, patients requiring upper endoscopy are conventionally referred to specialist clinics by family physicians. We have introduced the first open‐access upper endoscopy service in Hong Kong, which has allowed family physicians to arrange endoscopy without prior specialist consultation. A study on the outcome of open‐access upper endoscopy in contrast with the conventional referral system was conducted.

Methods: For patients presenting with dyspepsia, family physicians in our region were given the option to arrange upper endoscopy directly with our Medical Endoscopy Unit in addition to the conventional referral to specialist clinics. The results were compared with those from the specialist clinic. A detailed prospective follow up was performed from June to September 1997 to evaluate the outcome and impact of open‐access upper endoscopy.

Results: From November 1996 to September 1999, 978 referrals for open‐access upper endoscopy were received. The service significantly reduced the waiting time for the procedure by 16 weeks. Open‐access upper endoscopy had similar detection rates for peptic ulcers and cancers compared with referrals from specialist clinics. Seventy‐five percent of patients did not require further consultation with their family physicians within 2 months after endoscopy. It is a safe and effective procedure in establishing a definitive diagnosis. All family physicians were satisfied with the open‐access upper endoscopy service.

Conclusions: This is the first Asian report on this service. Open‐access upper endoscopy reduced waiting time from the patient perspective, decreased subsequent consultations with family physicians and reduced referral to specialist clinics as well as increased patient and doctor satisfaction. Both referral systems for endoscopy were similar in terms of the diagnostic yield.
Relationship between cyclooxygenase‐2 expression and K‐ras gene mutation in colorectal adenomas
Authors: Fujita Mikio , Fukui Hirokazu , Morita Katsuo , Fujii Shigehiko , Ueda Yoshihiko , Chiba Tsutomu , Sakamoto Choitsu , Kawamata Hitoshi , Fujimori Takahiro
Published: October 2010

Background and Aims: Cyclooxygenase (COX)‐2 has a trophic effect on gastrointestinal epithelial cells and is associated with the progression of colorectal adenomas. Mutation of the K‐ras gene is also associated with the progression of colorectal adenomas and has recently been suggested to play an important role in the induction of COX‐2. In the present study, we investigated the relationship between COX‐2 expression and K‐ras mutation in colorectal adenomas.

Methods: Twenty‐nine colorectal adenomas were obtained from specimens resected by the use of surgery or endoscopic mucosal resection and analyzed clinicopathologically. Immunohistochemistry was performed to analyze COX‐2 expression in the adenoma specimens. The K‐ras codon 12 mutations were detected by using the polymerase chain reaction‐restriction fragment length polymorphism method.

Results: An increase of COX‐2‐positive cells in adenoma was observed in 11 (37.9%) lesions, 10 (90.9%) of which had a K‐ras gene mutation, suggesting a significant correlation between COX‐2 expression and K‐ras gene mutation in colorectal adenomas. Morphologically, COX‐2‐positive adenomas (13.8 ± 2.6 mm) were significantly larger than COX‐2‐negative ones (5.8 ± 0.9 mm). In addition, the increase of COX‐2‐positive cells in the lesion was observed more frequently in tubulovillous (63.6%) than in tubular (36.4%) adenoma.

Conclusions: Cycloxygenase‐2 expression in colorectal adenoma cells is strongly correlated with K‐ras gene mutation, suggesting that COX‐2 and mutated K‐ras are connectively associated with the progression of colorectal adenoma.
Teaching Health Professionals About Torture
Authors: Jacobsen Lone
Published: October 2010

A multidisciplinary treatment is needed to heal the wounds and give the torture survivors hope for the future.
Empowering Communities–A Strategy Used in Malawi
Authors: Chinombo Anna M.
Published: October 2010

In Malawi, community health nurses and environmental health officers are helping communities to solve their own health problems. Below, the lessons learned in one district.
Connecting to Internet–Search Tools
Authors: Sparks Susan
Published: October 2010

Search tools are timesaving ways to find specific information on the Internet (see also INR, November/December 1998). For information on nursing and health topics, the Metasearching and Specialized Internet Search tools described below can speed up the process. For faster retrieval, bookmark your personal favourite search tools or assign one as your browser startup page.
Synthesis of fructans by partially purified fructosyltransferase activities from Lolium rigidum
Authors: JOHN J. A. ST. , SIMS I. M. , BONNETTH G. D. , SIMPSON R. J.
Published: October 2010

Sucrose: sucrose fructosyltransferase (SST) activity was partially purified from whole shoots of Lolium rigidum by a combination of affinity chromatography, gel filtration and anion‐exchange chromatography. The SST activity co‐eluted with some fructan: fructan fructosyltransferase (FFT) and invertase activities and consequently the partially purified preparation was termed the fructosyltransferase (FT) preparation.

The SST‐like activity in the FT preparation was purified 214‐fold and had an apparent molecular mass of 84000. The FT preparation contained several peptides with an apparent pi of 4.6–4.7. When assayed with sucrose concentrations up to 600 mM, the FT preparation synthesized 1‐kestose at all concentrations, and synthesized 6‐kestose at concentrations of 150 mM and greater. The Km of 1‐kestose production was 0.2 m. When the FT preparation was assayed at a concentration of activity approximately half that measured in fresh tissue with l00mM sucrose, 1‐kestose, or 6G‐kestose as substrates, fructans of degree of polymerization (DP) ≤ 5 were synthesized.

A partially purified FFT activity, free of SST and invertase activities, which synthesized β‐2,1‐glycosidic linked oligofructans of DP ≤ 6, was combined in vitro with the FT preparation (FFT‐FT preparation) to give a ratio of SST: FFT activities similar to that measured in crude enzyme extracts from L. rigidum. The FFT‐FT preparation synthesized oligofructans when assayed with 100 mM concentrations of sucrose, 1‐kestose or 6G‐kestose, but was not able to synthesize fructans of DP ≥ 6 even after extended assays of up to 10 h. The FFT‐FT preparation was also assayed with 100 mM sucrose with small amounts of concentrated sucrose added periodically during the assay to maintain the substrate concentration. In this assay, the FFT‐FT preparation synthesized fructans up to an apparent DP of 17 or greater. The fructans of DP ≥ 6 synthesized in the assay appeared to form two molecular series containing both β‐2,1‐ and β‐2,6‐glycosidic linked fructosyl residues with terminal or internal glucosyl residues. The apparent rate of SST activity in the assay of the FFT‐FT preparation was greater than that measured in a similar assay of the FT preparation alone which did not result in fructans with DP ≥ 6. It was concluded that the FFT‐FT preparation, when assayed with a continual supply of sucrose, contained a factor which promoted synthesis of fructans of DP ≥ 6 and synthesis of β‐2,6‐glycosidic linkages between fructosyl residues.
Using FTA® cards to store avian blood samples for genetic studies. Their application in sex determination
Authors: Gutiérrez‐Corchero Francisco , Arruga M. Victoria , Sanz Lourdes , García Cristina , Hernández M. Angeles , Campos Francisco
Published: October 2010

FTA® cards were used for long‐term storage of avian blood samples. Blood DNA was extracted by a simple method and used in PCR for sex identification of adult and nestling Great Grey Shrikes Lanius excubitor.
Polymorphic microsatellite loci for the mustached tamarin (Saguinus mystax) and their cross‐species amplification in other New World monkeys
Authors: Böhle U.‐R. , Zischler H.
Published: October 2010

We isolated and characterized 10 polymorphic microsatellite loci for the mustached and cotton‐top tamarin (Saguinus mystax and S. oedipus) and also tested their applicability in other New World monkey genera. Six loci proved to be variable in Cebus apella and Saimiri sciureus/S. boliviensis, respectively. We also show that faeces‐derived DNA is suitable for polymerase chain reaction (PCR) analyses of a primate taxon that gives birth to twins with individuals exhibiting a haematopoetic chimaerism. The microsatellite fingerprint patterns do not display a complex mixture of the PCR‐products derived from the alleles of both dizygotic twins, but exhibit the constitutive alleles of one sibling only.
Microsatellite primers for fungus‐growing ants
Authors: Villesen P. , Gertsch P. J. , Boomsma J. J.
Published: October 2010

We isolated five polymorphic microsatellite loci from a library of two thousand recombinant clones of two fungus‐growing ant species, Cyphomyrmex longiscapus and Trachymyrmex cf. zeteki. Amplification and heterozygosity were tested in five species of higher attine ants using both the newly developed primers and earlier published primers that were developed for fungus‐growing ants. A total of 20 variable microsatellite loci, developed for six different species of fungus‐growing ants, are now available for studying the population genetics and colony kin‐structure of these ants.
Discoid Lupus Erythematosus and Lupus Profundus in Childhood: A Report of Two Cases
Authors: Wimmershoff M. B. , Hohenleutner U. , Landthaler M.
Published: October 2010

Abstract: Discoid lupus erythematosus (DLE) is a rare disorder in childhood, with 22 cases reported in the English‐language literature. Less than 2% of patients with DLE have an onset before 10 years of age. We describe two children with DLE and lupus profundus with an onset of the disease at the ages of 11 and 15 years and focus on likely histopathologic differences between DLE in children and in adults. Histopathologic characteristics for childhood DLE might be an intense periadnexal and perivascular infiltrate extending into the interstitium and subcutaneous tissue consisting of lymphocytes, histiocytes, eosinophilic granulocytes, and plasma cells and lacking epidermal atrophy. The diagnosis of DLE in our two patients was established by clinicopathologic correlation based on clinical presentation, histologic and immunofluorescent findings in skin biopsy specimens, and the absence of clinical and laboratory evidence of systemic involvement. Therapy with antimalarials resulted in reduction of the skin lesions, but in one patient severe lipoatrophy occurred.
Calibration of a microchannel plate based extreme ultraviolet grazing incident spectrometer at the Advanced Light Source
Authors: Bakeman M. S. , van Tilborg J. , Sokollik T. , Baum D. , Ybarrolaza N. , Duarte R. , Toth C. , Leemans W. P.
Published: October 2010

We present the design and calibration of a microchannel plate based extreme ultraviolet spectrometer. Calibration was performed at the Advance Light Source (ALS) at the Lawrence Berkeley National Laboratory (LBNL). This spectrometer will be used to record the single shot spectrum of radiation emitted by the tapered hybrid undulator (THUNDER) undulator installed at the LOASIS GeV-class laser-plasma-accelerator. The spectrometer uses an aberration-corrected concave grating with 1200 lines/mm covering 11–62 nm and a microchannel plate detector with a CsI coated photocathode for increased quantum efficiency in the extreme ultraviolet. A touch screen interface controls the grating angle, aperture size, and placement of the detector in vacuum, allowing for high-resolution measurements over the entire spectral range.
Contactless electroreflectance of optical transitions in tunnel-injection structures composed of an In0.53Ga0.47As/In0.53Ga0.23Al0.24As quantum well and InAs quantum dashes
Authors: Kudrawiec R. , Sęk G. , Motyka M. , Misiewicz J. , Somers A. , Höfling S. , Worschech L. , Forchel A.
Published: October 2010

Tunnel-injection structures composed of an In0.53Ga0.47As/In0.53Ga0.23Al0.24As quantum well (QW) and a layer of InAs quantum dashes (QDashes) separated by In0.53Ga0.23Al0.24As barriers of various thicknesses have been investigated by contactless electroreflectance. The observed spectral features have been explained taking into account the optical transitions in a combined system of In0.53Ga0.47As QW and InAs QDash wetting layer. It has been shown that there exist electron and hole states which are localized on both sides of such an asymmetric confinement potential. The latter has allowed concluding that the QDash region in tunnel-injection structures can be easily penetrated by the carriers due to the presence of the wetting layer in the self-assembled structure.
Grid-independent large-eddy simulation using explicit filtering
Authors: Bose Sanjeeb T. , Moin Parviz , You Donghyun
Published: October 2010

The governing equations for large-eddy simulation are derived from the application of a low-pass filter to the Navier–Stokes equations. It is often assumed that discrete operations performed on a particular grid act as an implicit filter, causing results to be sensitive to the mesh resolution. Alternatively, explicit filtering separates the filtering operation, and hence the resolved turbulence, from the underlying mesh distribution alleviating some of the grid sensitivities. We investigate the use of explicit filtering in large-eddy simulation in order to obtain numerical solutions that are grid independent. The convergence of simulations using a fixed filter width with varying mesh resolutions to a true large-eddy simulation solution is analyzed for a turbulent channel flow at Reτ=180, 395, and 640. By using explicit filtering, turbulent statistics and energy spectra are shown to be independent of the mesh resolution used.
Development of a synchrotron biaxial tensile device for in situ characterization of thin films mechanical response
Authors: Geandier G. , Thiaudière D. , Randriamazaoro R. N. , Chiron R. , Djaziri S. , Lamongie B. , Diot Y. , Le Bourhis E. , Renault P. O. , Goudeau P. , Bouaffad A. , Castelnau O. , Faurie D. , Hild F.
Published: October 2010

We have developed on the DIFFABS-SOLEIL beamline a biaxial tensile machine working in the synchrotron environment for in situ diffraction characterization of thin polycrystalline films mechanical response. The machine has been designed to test compliant substrates coated by the studied films under controlled, applied strain field. Technological challenges comprise the sample design including fixation of the substrate ends, the related generation of a uniform strain field in the studied (central) volume, and the operations from the beamline pilot. Preliminary tests on 150 nm thick W films deposited onto polyimide cruciform substrates are presented. The obtained results for applied strains using x-ray diffraction and digital image correlation methods clearly show the full potentialities of this new setup.
Observations on the robustness of internal wave attractors to perturbations
Authors: Hazewinkel Jeroen , Tsimitri Chrysanthi , Maas Leo R. M. , Dalziel Stuart B.
Published: October 2010

Previously, internal wave attractors have been studied in the laboratory in idealized situations. Here, we present a series of experiments in which these conditions are modified. Modifications are made by varying the forcing frequency, by using a nonuniform stratification, by introducing finite amplitude perturbations to the trapezoidal domain, and by using a parabolic domain. All these new experiments reveal the persistence of internal wave attractors that remain reasonably well predictable by means of ray tracing. We conclude that the occurrence of wave attractors is likely to be more general than has previously been thought. The fundamental response of the confined, continuously stratified fluids studied in this paper to a sustained forcing has to be described in terms of internal wave attractors.
Thin film lubrication dynamics of a binary mixture: Example of an oscillatory instability
Authors: Bestehorn Michael , Borcia Ion Dan
Published: October 2010

We study thin film instabilities in liquid films with deformable surface using the lubrication theory. An externally applied vertical temperature gradient may give cause to an instability (Marangoni instability) of the flat motionless film. Contrary to the earlier work where mostly pure fluids were discussed, the focus of the present paper lays on instabilities in mixtures of two completely miscible liquids. We show that the normally found monotonic long-wave instability may turn into an oscillatory one if the two components have a different surface tension and if the Soret coefficient establishes a stabilizing vertical concentration gradient. A systematic derivation of the basic equations in long-wave approximation is given. The character of instabilities is studied using linear stability analysis. Finally, a real system consisting of a water-isopropanol mixture is discussed in some detail.
A Ka-band tunable direct-conversion correlation reflectometer for NSTX
Authors: Kubota S. , Peebles W. A. , Nguyen X. V. , Crocker N. A. , Roquemore A. L. , Holoman T. , Guttadora L. , Kaita R.
Published: October 2010

The recent availability of broadband microwave quadrature mixers in the Ka-band (28–40 GHz) of frequencies has allowed the fabrication of low-cost direct-conversion detection circuits for use in the variable-frequency correlation reflectometer on the National Spherical Torus eXperiment (NSTX). The quadrature receiver in this case can be implemented as a simple homodyne circuit, without the complication of a single-sideband modulator or a feedforward tracking circuit present in more typical designs. A pair of direct-conversion receivers is coupled with broadband microwave voltage-controlled oscillators to construct a flexible dual-channel radar system with a fast frequency settling time of ∼160 μs. A detailed description of the design and a full characterization of the hardware are provided. Examples of turbulence measurements from radial and poloidal correlation reflectometry on NSTX using a poloidal array of antennas (oriented normal to the magnetic flux surfaces for conventional reflectometry) are presented.
Confinement factors and optical gain in subwavelength plasmonic resonators
Authors: Maslov A. V. , Miyawaki M.
Published: October 2010

We define the confinement factor for a subwavelength resonator, present a simple approach to calculate it numerically, and demonstrate that by using a specific resonator based on a silver rod coated with active material. Unlike the common approach of using the profile of the resonant electromagnetic mode, our formulation relies on using the characteristic equation for the complex frequency with inclusion of damping due to Joule and radiative losses. This removes an arbitrariness related to the definition of the mode volume in subwavelength resonators. Our analysis of a coated silver rod suggests that there is an optimal value for the active region thickness. The confinement factors can be comparable to that in Fabry–Perot resonators, radiative losses are comparable or exceed Joule losses and the threshold gain is high.