bluuebunny/crossref_metadata_2025 huggingface dataset:
Daytime sympathetic hyperactivity in OSAS is related to excessive daytime sleepiness
Authors: DONADIO VINCENZO , LIGUORI ROCCO , VETRUGNO ROBERTO , CONTIN MANUELA , ELAM MIKAEL , WALLIN B. GUNNAR , KARLSSON TOMAS , BUGIARDINI ENRICO , BARUZZI AGOSTINO , MONTAGNA PASQUALE
Published: August 2007

The aim of this study was to investigate the relationships among sympathetic hyperactivity, excessive daytime sleepiness (EDS) and hypertension in obstructive sleep apnoea syndrome (OSAS). Ten newly diagnosed OSAS patients with untreated EDS and daytime hypertension underwent polysomnography (PSG) and daytime measurements of plasma noradrenaline (NA), ambulatory blood pressure (BP), muscle sympathetic nerve activity (MSNA) by microneurography and objective assessment of EDS before and during 6 months of compliance‐monitored continuous positive airway pressure (CPAP) treatment. One month after the start of CPAP, BP, MSNA and NA were significantly lowered, remaining lower than baseline also after 3 and 6 months of treatment. CPAP use caused a significant improvement of sleep structures, and reduced EDS. A statistical correlation analysis demonstrated that EDS was not correlated with sleep measures obtained from baseline PSG (% sleep stages, apnoea and arousal index, mean oxygen saturation value), whereas daytime sleepiness was significantly correlated with MSNA. Furthermore, MSNA and BP showed no correlation. Our data obtained from selected patients suggest that the mechanisms inducing EDS in OSAS are related to the degree of daytime sympathetic hyperactivity. Additionally, resting MSNA was unrelated to BP suggesting that factors other than adrenergic neural tone make a major contribution to OSAS‐related hypertension. The results obtained in this pilot study need, however, to be confirmed in a larger study involving more patients.
Pulsed radio‐frequency electromagnetic fields: dose‐dependent effects on sleep, the sleep EEG and cognitive performance
Authors: REGEL SABINE J. , TINGUELY GILBERTE , SCHUDERER JÜRGEN , ADAM MARTIN , KUSTER NIELS , LANDOLT HANS‐PETER , ACHERMANN PETER
Published: August 2007

To establish a dose–response relationship between the strength of electromagnetic fields (EMF) and previously reported effects on the brain, we investigated the influence of EMF exposure by varying the signal intensity in three experimental sessions. The head of 15 healthy male subjects was unilaterally exposed for 30 min prior to sleep to a pulse‐modulated EMF (GSM handset like signal) with a 10 g‐averaged peak spatial specific absorption rate of (1) 0.2 W kg–1, (2) 5 W kg–1, or (3) sham exposed in a double‐blind, crossover design. During exposure, subjects performed two series of three computerized cognitive tasks, each presented in a fixed order [simple reaction time task, two‐choice reaction time task (CRT), 1‐, 2‐, 3‐back task]. Immediately after exposure, night‐time sleep was polysomnographically recorded for 8 h. Sleep architecture was not affected by EMF exposure. Analysis of the sleep electroencephalogram (EEG) revealed a dose‐dependent increase of power in the spindle frequency range in non‐REM sleep. Reaction speed decelerated with increasing field intensity in the 1‐back task, while accuracy in the CRT and N‐back task were not affected in a dose‐dependent manner. In summary, this study reveals first indications of a dose–response relationship between EMF field intensity and its effects on brain physiology as demonstrated by changes in the sleep EEG and in cognitive performance.
Nocturnal sleep, daytime sleepiness, and napping among women with significant emotional/behavioral premenstrual symptoms
Authors: LAMARCHE LYNNE J. , DRIVER HELEN S. , WIEBE SABRINA , CRAWFORD LEAH , DE KONINCK JOSEPH M.
Published: August 2007

The objective of this study is to examine daytime sleepiness and alertness and nap characteristics among women with significant emotional/behavioral premenstrual symptoms, and to determine their relationship with nocturnal sleep. Participants spent one night during the follicular phase and two nights during the late‐luteal phase, one of which occurred after a 40 min opportunity to nap, sleeping in the laboratory. Subjective measures of sleepiness and alertness were completed during the afternoon of each recording. Setting took place at the sleep laboratory at the University of Ottawa. A total number of participants were 10 women with significant and nine women with minimal emotional/behavioral premenstrual symptoms (mean age 26 years). The results were compared with the follicular phase, both groups of women had less slow wave sleep and more stage 2 sleep at night, as well as a higher daytime and nocturnal mean and maximum temperature during the late‐luteal phase. Women with significant symptoms were sleepier and less alert during the late‐luteal phase and had a higher overall mean nocturnal temperature compared with women with minimal symptoms. No significant differences were found between the two groups on nap characteristics and nocturnal sleep characteristics. Results show that women with more severe premenstrual symptoms are sleepier during the late‐luteal phase than women with minimal symptoms. The increased daytime sleepiness seems to be unrelated to nocturnal sleep or nap characteristics.
Adverse childhood experiences associated with sleep in primary insomnia
Authors: BADER KLAUS , SCHÄFER VALÉRIE , SCHENKEL MAYA , NISSEN LUKAS , SCHWANDER JÜRG
Published: August 2007

The objectives were to explore the association between self‐reported adverse childhood experiences (ACE) and sleep in adults suffering from primary insomnia and to examine the impact of presleep stress on this relationship. Fifty‐nine patients with primary insomnia, aged 21–55 years, were administered the Childhood Trauma Questionnaire (CTQ) and then divided into two groups according to the achieved scores: with moderate/severe or low/no reports of ACE. The participants spent three consecutive nights in the sleep laboratory in order to record polysomnographic and actigraphic sleep parameters. A stress induction technique was administered by activating negative autobiographical memories immediately before sleep in the second or third night. Results show that 46% of the insomniac patients reported moderate to severe ACE. This group exhibited a significantly greater number of awakenings and more movement arousals compared to patients with low or no reports of ACE. Actigraphic data also indicated more disturbed sleep and increased nocturnal activity for the high‐ACE group. On the other hand, no specific group differences were found with regard to stress condition. The results support the assumption that it is possible to identify a subgroup among patients with primary insomnia who has experienced severe maltreatment in childhood and adolescence. This subgroup appears to differ in several sleep parameters, indicating a more disturbed sleep compared to primary insomniacs with low or no reports of ACE. With regard to sleep‐disturbing nightly patterns of arousal, parallels between individuals with high ACE and trauma victims as well as post‐traumatic stress disorder‐patients suggest themselves.
Pharmacokinetics of oxytetracycline in the American horseshoe crab, Limulus polyphemus
Authors: NOLAN M. W. , SMITH S. A. , JONES D.
Published: August 2007

The American horseshoe crab, Limulus polyphemus, is regularly cultured and maintained in research laboratories and public aquaria. Rising concerns over the health of these captive animals makes the diagnosis and treatment of pathological conditions in L. polyphemus essential. This study investigated the kinetics of oxytetracyline following either intravascular or oral dosing. Oxytetracylcine is a broad‐spectrum antibiotic used in the treatment of various bacterial diseases of aquatic animals. A noncompartmental model was developed to describe the pharmacokinetics of oxytetracycline (OTC) in the horseshoe crab. The following parameters were determined for a single intravascular bolus of 25 mg/kg OTC: AUC = 9524.60 μg·h/mL, MRT = 443.65 h, Clb = 0.044 mL/min/kg, Vd(ss) = 1.164 L/kg, t1/2 = 128.3 h, Cmax = 55.90 μg/mL, Cave = 27.39 μg/mL. Following a single oral bolus of 25 mg/kg, these parameters were calculated: AUC = 5861.81 μg·h/mL, MRT = 395.89 h, Clb = 0.071 mL/min/kg, Vd(ss) = 1.688 L/kg, t1/2 = 210.0 h, Cmax = 7.83 μg/mL, Cave = 2.89 μg/mL, F = 61.56%.
The recent spread of a vertically transmitted virus through populations of Drosophila melanogaster
Authors: CARPENTER JENNIFER A. , OBBARD DARREN J. , MASIDE XULIO , JIGGINS FRANCIS M.
Published: August 2007

The sigma virus is a vertically transmitted pathogen that commonly infects natural populations of Drosophila melanogaster. This virus is the only known host‐specific pathogen of D. melanogaster, and so offers a unique opportunity to study the genetics of Drosophila–viral interactions in a natural system. To elucidate the population genetic processes that operate in sigma virus populations, we collected D. melanogaster from 10 populations across three continents. We found that the sigma virus had a prevalence of 0–15% in these populations. Compared to other RNA viruses, we found that levels of viral genetic diversity are very low across Europe and North America. Based on laboratory measurements of the viral substitution rate, we estimate that most European and North American viral isolates shared a common ancestor approximately 200 years ago. We suggest two explanations for this: the first is that D. melanogaster has recently acquired the sigma virus; the second is that a single viral type has recently swept through D. melanogaster populations. Furthermore, in contrast to Drosophila populations, we find that the sigma viral populations are highly structured. This is surprising for a vertically transmitted pathogen that has a similar migration rate to its host. We suggest that the low structure in the viral populations can be explained by the smaller effective population size of the virus.
Macoma balthica in the White and Barents Seas: properties of a widespread marine hybrid swarm (Mollusca: Bivalvia)
Authors: STRELKOV PETR , NIKULA RAISA , VÄINÖLÄ RISTO
Published: August 2007

A main molecular subdivision in the circumpolar Macoma balthica complex has been described between Atlantic and Pacific taxa. In NE Europe, the clams of the White and Barents Seas, however, show deviant genetic structures. Using allozyme and mitochondrial DNA data, we explore the hypothesis that these deviations result from hybridization between an Atlantic (M. b. rubra) and an invading Pacific (M. b. balthica) lineage. A practically pure Atlantic Macoma extends from France north to the Varanger Peninsula (NE Norway), whereas populations farther east have genetic compositions intermediate between true Atlantic and true Pacific. Admixture estimates range from 32 to 90% Pacific contribution, with a notable deviation in a nearly pure Atlantic outpost in the Mezen Bay (NE White Sea). The pattern of variation is not one of a simple collinear mixing however. Different characters exhibit different degrees of introgression, and the relative introgression varies regionally. Yet, there are practically no interlocus genotypic disequilibria between the diverged loci, which brings out the White Sea–Barents Sea M. balthica as the best‐documented marine animal hybrid swarms so far, arisen through amalgamation of genomes previously isolated since pre‐Pleistocene times. On top of the main admixture pattern, strong geographical structuring is also seen in characters unrelated to the principal systematic distinction. The persistence of the regional patterns indicates restricted gene flow at the present time, despite the high dispersal potential of the species. The causes of this structuring could be in a complex history of colonization events and features of local hydrography enhancing isolation and divergence of populations.
Molecular signatures of Pleistocene sea‐level changes that affected connectivity among freshwater shrimp in Indo‐Australian waters
Authors: DE BRUYN MARK , MATHER PETER B
Published: August 2007

A major paradigm in evolutionary biology asserts that global climate change during the Pleistocene often led to rapid and extensive diversification in numerous taxa. Recent phylogenetic data suggest that past climatic oscillations may have promoted long‐distance marine dispersal in some freshwater crustacea from the Indo‐Australian Archipelago (IAA). Whether this pattern is common, and whether similar processes are acting on diversification below the species level is unknown. We used nuclear and mitochondrial molecular variation in a freshwater‐dependent decapod crustacean (Macrobrachium rosenbergii), sampled widely from the IAA, to assess the impact of Pleistocene sea‐level changes on lineage diversification in this species. Fitting of an isolation with migration model enabled us to reject ongoing migration among lineages, and results indicate that isolation among both mainland–mainland and mainland–island lineages arose during the mid‐Pleistocene. Our data suggest a scenario of widespread marine dispersal during Pleistocene glacial maxima (in support of the ‘Pleistocene marine dispersal hypothesis’) when sea levels were low, and geographical distances between fresh watersheds were greatly reduced, followed by increased isolation as sea levels subsequently rose.
Changes in colonic motility and the electrophysiological properties of myenteric neurons persist following recovery from trinitrobenzene sulfonic acid colitis in the guinea pig
Authors: Krauter E. M. , Strong D. S. , Brooks E. M. , Linden D. R. , Sharkey K. A. , Mawe G. M.
Published: August 2007

Abstract  Persistent changes in gastrointestinal motility frequently accompany the resolution of colitis, through mechanisms that remain to be determined. Trinitrobenzene sulfonic acid (TNBS) colitis in the guinea pig decreases the rate of propulsive motility, causes hyperexcitability of AH neurons, and induces synaptic facilitation. The changes in motility and AH neurons are sensitive to cyclooxygenase‐2 (COX‐2) inhibition. The aim of this investigation was to determine if the motility and neurophysiological changes persist following recovery from colitis. Evaluations of inflammation, colonic motility and intracellular electrophysiology of myenteric neurons 8 weeks after TNBS administration were performed and compared to matched control conditions. Myeloperoxidase levels in the colons were comparable to control levels 56 days after TNBS treatment. At this time point, the rate of colonic motility was decreased relative to controls following treatment with TNBS alone or TNBS plus a COX‐2 inhibitor. Furthermore, the electrical properties of AH neurons and fast synaptic potentials in S neurons were significantly different from controls and comparable to those detected during active inflammation. Collectively, these data suggest that altered myenteric neurophysiology initiated during active colitis persists long term, and provide a potential mechanism underlying altered gut function in individuals during remission from inflammatory bowel disease.
Dichotomy of food and inhalant allergen sensitization in eosinophilic esophagitis
Authors: Sugnanam K. K. N. , Collins J. T. , Smith P. K. , Connor F. , Lewindon P. , Cleghorn G. , Withers G.
Published: August 2007

Background:  Eosinophilic esophagitis (EE) is an emerging condition where patients commonly present with symptoms of gastroesophageal reflux disease and fail to respond adequately to anti‐reflux therapy. Food allergy is currently recognized as the main immunological cause of EE; recent evidence suggests an etiological role for inhalant allergens. The presence of EE appears to be associated with other atopic illnesses.

Objectives:  To report the sensitization profile of both food and inhalant allergens in our EE patient cohort in relation to age, and to profile the prevalence of other allergic conditions in patients with EE.

Method:  The study prospectively analyzed allergen sensitization profiles using skin prick tests to common food allergens and inhalant allergens in 45 children with EE. Patch testing to common food allergens was performed on 33 patients in the same cohort. Comorbidity of atopic eczema, asthma, allergic rhinitis and anaphylaxis were obtained from patient history.

Results:  Younger patients with EE showed more IgE and patch sensitization to foods while older patients showed greater IgE sensitization to inhalant allergens. The prevalence of atopic eczema, allergic rhinitis and asthma was significantly increased in our EE cohort compared with the general Australian population. A total of 24% of our cohort of patients with EE had a history of anaphylaxis.

Conclusion:  In children with EE, the sensitization to inhalant allergens increases with age, particularly after 4 years. Also, specific enquiry about severe food reactions in patients presenting with EE is strongly recommended as it appears this patient group has a high incidence of anaphylaxis
The role of the intestinal microbiota in the development of atopic disorders
Authors: Penders J. , Stobberingh E. E. , Brandt P. A. van den , Thijs C.
Published: August 2007

The prevalence of atopic diseases, including eczema, allergic rhinoconjunctivitis and asthma, has increased worldwide, predominantly in westernized countries. Recent epidemiological studies and experimental research suggest that microbial stimulation of the immune system influences the development of tolerance to innocuous allergens. The gastrointestinal microbiota composition may be of particular interest, as it provides an early and major source of immune stimulation and seems to be a prerequisite for the development of oral tolerance. In this review the observational studies of the association between the gut microbiota and atopic diseases are discussed. Although most studies indicated an association between the gut microbiota composition and atopic sensitization or symptoms, no specific harmful or protective microbes can be identified yet. Some important methodological issues that have to be considered are the microbiological methods used (traditional culture vs molecular techniques), the timing of examining the gut microbiota, the definition of atopic outcomes, confounding and reverse causation. In conclusion, the microbiota hypothesis in atopic diseases is promising and deserves further attention. To gain more insight into the role of the gut microbiota in the etiology of atopy, large‐scale prospective birth cohort studies using molecular methods to study the gut microbiota are needed.
Detection of natural killer T cells in the sinus mucosa from asthmatics with chronic sinusitis
Authors: Yamamoto H. , Okamoto Y. , Horiguchi S. , Kunii N. , Yonekura S. , Nakayama T.
Published: August 2007

Background:  Chronic sinusitis (CS) with asthma generally exhibits a high degree of sinus tissue eosinophilia and recurrence often occurs even after surgical therapy. However, the cause has not yet been fully clarified.

Aims of the study:  To elucidate the pathogenesis of this refractory disease, we examined the infiltration of natural killer T (NKT) and type 1 helper T (Th1)/type 2 helper T (Th2) cells, and the cytokine expression in the sinus mucosa.

Methods:  Sinus mucosal specimens were obtained surgically from 16 CS patients with nasal polyps. The NKT cells, Th1/Th2 cells and the expression of IL‐4, IL‐5, IL‐13 and IFN‐γ were examined by a polymerase chain reaction or flow cytometry. Nasal mucosal specimens from six other patients with allergic rhinitis (AR) were examined in a similar manner.

Results:  The NKT cells were detected to varying degrees in the sinus mucosa from asthmatic CS patients, but neither in the nonasthmatics nor in the nasal mucosa from the patients with AR. The Th2 cells and Th2 cytokines were expressed at significantly higher levels in the sinus mucosa from the CS patients with asthma in comparison to those without asthma. However, the Th1 cell infiltration and IFN‐γ expression were not different between these groups.

Conclusion:  Natural killer T cells may, therefore, play important roles in the enhanced Th2 cytokine expression and increased infiltration of Th2 cells and eosinophils observed in the sinus mucosa from asthmatic CS patients through MHC‐independent mechanisms.
Revascularization of trachea in lung and tracheal transplantation
Authors: Nakanishi Ryoichi
Published: August 2007

Abstract:  Ischemia is the primary risk factor for airway complications in double lung transplantation using tracheal anastomosis and in tracheal transplantation. Many treatment options as to revascularization for the trachea were herein described and reviewed. They include direct revascularization (using a conduit such as artery or vein), revascularization with tissue wrapping (using omentum, muscle, internal thoracic artery pedicle, pleura, or pericardial fat pad), and with drug administration (using corticosteroid hormone, prostaglandin, or angiogenic factor). As there are few organized reports including new information on revascularization for the trachea these days, this review article would help thoracic surgeons who get engaged transplantation.
A polymorphic variant in the MHC2TA gene is not associated with systemic lupus erythematosus
Authors: Linga‐Reddy M. V. Prasad , Gunnarsson I. , Svenungsson E. , Sturfelt G. , Jönsen A. , Truedsson L. , Nordmark G. , Rönnblom L. , Alarcón‐Riquelme M. E.
Published: August 2007

Single‐nucleotide polymorphisms (SNPs) in the major histocompatibility complex class II transactivator (MHC2TA) gene encoding the class II transactivator have been associated with multiple sclerosis, rheumatoid arthritis, and myocardial infarction in the Swedish population. We used a case–control approach to investigate the prevalence of a relevant variant in Swedish systemic lupus erythematosus (SLE) cohorts to determine whether SLE shares the same MHC2TA susceptibility allele as the other diseases. No differences were observed between cases and control subjects at either the allele or genotype levels. Furthermore, no significant correlations were found when comparing different clinical and serological SLE phenotypes. This particular polymorphism rs3087456 of the MHC2TA gene does not appear to influence genetic susceptibility to SLE in the Swedish population. We conclude that our data support neither allelic nor genotype association between the MHC2TA SNP and SLE.
Liver transplantation for hepatocellular carcinoma in children
Authors: Sevmis Sinasi , Karakayali Hamdi , Özçay Figen , Canan Oğuz , Bilezikci Banu , Torgay Adnan , Haberal Mehmet
Published: August 2007

Abstract:  We present our experience with living‐donor liver transplantation in the treatment of nine children with hepatocellular carcinoma. Between January 2001 and March 2007, we performed 81 liver transplantations in 79 children at our center. Nine of the 79 children (11.3%; mean age, 9.7 ± 5.5 yr; age range, 12 months–16 yr; male‐to‐female ratio, 2:1) underwent an living‐donor liver transplantation because of hepatocellular carcinoma. Two of nine children received right lobe grafts, three received left lateral segment grafts, and the remaining four children received a left lobe graft. According to the TNM staging system, two children had stage 1 carcinoma, three had stage 2, and four had stage 4A1. The mean follow‐up was 19.8 ± 10.6 months (range: 7–32 months). There has been only one tumor recurrence, which occurred in the omentum 26 months after liver transplantation. There was no evidence of recurrence or AFP elevation in the other eight children. Both graft and patient survival rates are 100%. In conclusion, liver transplantation is a life‐saving procedure for children with chronic liver disease with accompanying hepatocellular carcinoma. During follow‐up of patients with chronic liver disease, serial AFP screening and combined radiologic imaging studies should be mandatory.
Novel Erythrocyte Pits in the Small Tropical Ruminant, Lesser Mouse Deer
Authors: Fukuta K. , Orui T. , Tanaka K. , Sasaki M. , Endo H. , Ismail D. B. , Kudo H. , Kimura J.
Published: August 2007

We examined unique erythrocyte pits of the peripheral blood and bone marrow in the lesser mouse deer, Tragulus javanicus, using scanning electron microscope (SEM) and transmission electron microscope (TEM). Under the SEM observation, the pit was observed as a hole on both mature erythrocytes of the peripheral blood and immature erythrocytes of the bone marrow. By the TEM, the mature erythrocytes had a vacuole, which showed complicated shape and occupied considerable space within the cytoplasm. The vacuole was communicated extracellularly by perforation, which corresponded to the hole on the cell surface. In the bone marrow, erythroblast and reticulocytes have a cytoplasmic vacuole. This abnormal feature of the erythrocytes is peculiar to the mouse deer, and not found in other tropical ruminants. Despite the disadvantage of volume loss from the small erythrocytes, the mouse deer were healthy and showed no signs of anaemia.
The Effect of Selenium and Vitamin E on the Lymphocytes and Immunoglobulin‐containing Plasma cells in the Lymphoid organ and Mucosa‐Associated Lymphatic Tissues of Broiler Chickens
Authors: Khan M. Z. I. , Akter S. H. , Islam M. N. , Karim M. R. , Islam M. R. , Kon Y.
Published: August 2007

The present research has been designed to understand the effect of selenium and vitamin E on the lymphocyte and changes in the frequency of Ig‐containing plasma cells in the lymphatic organ and ileum (representative organ for mucosa‐associated lymphatic tissues) of different postnatal stages of Kasilla broiler chickens. A routine haematoxylin and eosin (H and E) stain were used to study the histology of the lymphocytic changes, and indirect immunoperoxidase staining method was performed for the study of the distributional and dynamical changes of the Ig‐containing plasma cells within the lymphatic tissues and in the ileum of control broilers and in the broilers supplemented with different concentration of selenium and vitamin E in the diet. Histologically, the population of lymphocytes decreased in the lobules of the thymus, medulla of bursal follicles, splenic masses, lymphatic nodules of the cecal tonsil, and villi of the ilium in 0.1 mg and 0.5 mg selenium supplemented broilers in comparison with the control. The population of these cells was found to increase in 150 mg and 300 mg vitamin E supplemented chickens in the present study. In the spleen IgG‐ and the IgM‐containing plasma cells were more than IgA‐containing plasma cells. In contrast, in the cecal tonsil and ileum IgA‐containing plasma cells were more than IgG‐ and IgM‐containing plasma cells. The frequency of these immunopositive cells were decreased in 0.1 mg and 0.5 mg selenium supplementated chickens, and increased their frequency in the chickens supplemented with 150 mg and 300 mg vitamin E. In the spleen the frequency of IgM‐containing plasma cells and both in the cecal tonsil and ileum, the IgG‐containing plasma cells were more decreased by selenium supplementation which restored in their population by vitamin E supplementation.
Analysis of Patients with Esophageal Varices Surviving More Than Three Years after Endoscopic Injection Sclerotherapy
Authors: NARITAKA Yoshihiko , HAGA Shunsuke , YAGAWA Yuichi , SHIMAKAWA Takeshi , KAZUBE Takao , HOSOKAWA Toshihiko , OHTANI Yoichi , KIKUCHI Tomomitsu , KAJIWARA Tetsuro , OI Itaru , ICHIOKA Shisho , OGAWA Kenji
Published: August 2007

Of the 205 patients treated by endoscopic injection sclerotherapy in the past 8 years and 4 months, 70 patients (34.1%) have survived more than 3 years. There were more Child's class A patients (p < 0.05) and fewer Child's C patients (p < 0.01) in this group as compared to 51 patients who died within 3 years. In addition, complications due to hepatoma were significantly lower (p < 0.01) in this group. The long‐term cumulative survival rates of those who had already survived over 3 years were 82% at the 5‐year and 78% at the 7‐year follow‐up. There was no significant difference among 3 groups classified by severity of liver damage or timing of the therapy.

Rebleeding was noted in 13 patients (18.3%) and the cumulative bleeding rates were 9% at the 1‐year, 14% at the 3‐year, 18% at the 5‐year and 21% at the 7‐year follow‐up. In 12 of these patients hemostasis was obtained by the second sclerotherapy. There was no significant difference in the long‐term prognosis between patients who experienced repeat bleeding, and those who did not.

Endoscopic findings in patients with rebleeding were characteristic in that the red color sign remained pronounced despite the fact that the varices had shrunk from F2 or larger to F1 in 6 patients. Bleeding occurred from the gastric varices in 4 patients. One of them died due to gastric bleeding, but 3 were operated on after sclerotherapy.

For improving prognosis, it is important to carefully observe the clinical course and to perform additional aggressive treatments for complete obliteration of varices.
Squamous Cell Papilloma of the Esophagus ‐A Report of Two Cases and a Review of the Literature‐
Authors: HAYASHI Ryoichi , NAKAYAMA Jun , INOUE Atsushi , KOMATSU Osamu , KATSUYAMA Tsutomu , INOUE Kazuaki
Published: August 2007

We present two cases of squamous cell papilloma of the esophagus (SPE) diagnosed by panendoscopy and confirmed by histology. In one case the SPE was removed by endoscopy, and in the other, the SPE detached during severe vomiting. Our patients both had a previous history of heartburn and repeated vomiting. An immunological study for human papilloma virus (HPV) was conducted in both cases, with negative results.
Colonoscopic Diagnosis of Typhoid Fever: —A Case Report—
Authors: HYUN Jin Hai , SHIM Kyung Bo , CHOI Jai Keun , KIM Main Kyu
Published: August 2007

Abstract: A case of typhoid fever was studied colonoscopically. Several scattered ulcers were observed at the ileocecal area and the course of their healing was followed by colonoscopic examination. The ulcers were discrete and punched out in appearance. Chloramphenieol was administrated, and the ulcers were observed to gradually diminish in size and number
Clinical Evaluation of Endoscopic Gastric Mucosal Resection
Authors: TANAKA Keizo , SHIBUE Tadashi , TAKASAKI Yoshihisa , SAMESHIMA Yukinori , MATSUMOTO Jun , YAMASHITA Yukihiro , ARIMA Terukatsu
Published: August 2007

Abstract: Endoscopic gastric mucosal resection (EGMR), by which a large specimen can be obtained, has been developed for the diagnosis and treatment of the borderline lesion (B. L.) or early gastric cancer (EGC), since biopsy specimens obtained by conventional techniques are too small to make an accurate diagnosis in number of cases. Thirty‐eight lesions in 35 cases (26 lesions in 23 cases with B. L. and 12 lesions in 12 cases with EGC) were resected for the purpose of treatment by EGMR, and 24 lesions (6 submucosal tumors, 3 B. L. s, 14 cases of EGC and 1 malignant lymphoma) for the purpose of diagnosis. By means of histological examination of the bite biopsy specimens following EGMR, twenty‐three lesions in 26 cases (89%) with a B. L. and 8 in 12 cases (67%) with EGC for treatment by EGMR were found to have been completely resected.

After further histological examination of EGMR specimens obtained for diagnosis, one out of 3 B. L. s was diagnosed as EGC (IIa) and the others as bengin lesions. Out of 14 EGC cases, 6 were diagnosed as carcinoma, 3 as B. L. s and 5 as benign lesions.

In Group III lesions obtained by conventional endoscopic biopsy, 8 out of 40 lesions (20%) were defined as EGC, 28 lesions (70%) as a B. L. and 4 lesions (10%) as benign lesions respectively by means of histological examination of the EGMR specimens.

Although obvious side effects were observed in 4 cases, these patients could be treated by endoscopic management or drug therapy.

It can be concluded that EGMR, by which large specimens can be obtained, is a useful procedure for the purpose of diagnosing and treating gastric mucosal lesions without causing major risk.
Pancreatoscopy for Mucus Producing Pancreatic Tumor
Authors: FUJITA Naotaka , LEE Shigeki , KOBAYASHI Go , KIMURA Katsumi , WATANABE Hiromitsu , MOCHIZUKI Fukuji
Published: August 2007

Abstract: The mucus producing tumor of the pancreas (MPT) is now drawing attention because of its characteristic clinical features. It is characterized by abundant secretion of mucin into the cystic cavity or the main pancreatic duct and relatively benign biological behavior. In this paper, endoscopic characteristics of MPT and the role of pancreatoscopy in the diagnosis of this entity are discussed. Eight cases of MPT with various histological backgrounds were examined with pancreatoscopy. Six cases underwent peroral pancreatoscopy and intraoperative pancreatoscopy was performed in four cases. The endoscopic findings of MPT are summarized as follows: 1) Granular change of the epithelium of the pancreatic duct. 2) Papillary tumor with dilatation of capillary vessles on its surface. 3) Irregularity or detachment of the epithelium of the pancreatic duct. The findings mentioned above in 1), 2) and 3) were obtained in three cases, two cases, and two cases, respectively. Except in one case, the border of the lesion with the neighboring normal mucosa was well identified.

We conclude that pancreatoscopy is a quite useful diagnostic tool in cases of MPT, especially for determining the extent of the lesion.
A Small Gastric Cancer in Association with Menetrier Disease
Authors: YUKAWA Masahiko , FUJIMORI Takahiro , TABATA Tomomi , TERAMOTO Tadahisa , HIRAYAMA Daisuke , SATONAKA Kazuhiro , KITAZAWA Souhei , MAEDA Sakan , KOJIMA Takane , NAGASAKO Kou
Published: August 2007

Abstract: We studied a 57‐year‐old man who was diagnosed as having giant rugae at a mass‐screening for gastric cancer. He was examined endoscopically for check‐up purposes. In addition to giant rugal folds which occurred throughout the entire fundus and body of the stomach, a type IIc lesion was noted in the posterior lower wall of the gastric body. A biopsy revealed signet ring cell carcinoma. A total gastrectomy was performed. A resected specimen was serially sectioned and underwent histopathological examination; hypertrophy and cystic elongation of the gastric glands indicative of so‐called giant hypertrophic gastritis was seen. The histological type of the type IIc lesion was undifferentiated adenocarcinoma with the signet ring cells being confined to the mucosal layer. This patient had a rare case of Menetrier's disease complicated by intramucosal carcinoma.
Transoral Tracheal Intubation for Gastroscopy in Rats
Authors: SCHWAB Gerhard , WETSCHER Gerold , KLIMA Gunther , MAIRINGER Thomas , POINTNER Rudolph , BODNER Ernst
Published: August 2007

Abstract: A new method of orotracheal intubation in rats which was developed to prevent apnea during upper gastrointestinal endoscopiy is described. After the anesthetized animals are relaxed with an I. V. injection of Vecuronium, orotracheal intubation was performed with a thin endoscope under complete visual control. After relaxation is achieved the glottis is wide open and intubation can be performed carefully without any medianical irritation of the larynx. After placement of the tube in the trachea, the fiberoptic was removed and pressure–controlled ventilation occurred.

This technique can be widely applied in any kind of rat experiment, where controlled ventilation is required.
Mucosal Tag of the Duodenum: —Report of a Case—
Authors: KUBOTA Shinzo , TERAMOTO Tadahisa , UENO Naohiko , KISHIMOTO Miyako , NAGAO Munehiko , YU Housai , TATEIWA Makoto , IRIE Kazuhiko , KITAZAWA Souhei
Published: August 2007

Abstract: We studied a 66‐year‐old female who had a dull epigastric pain. An upper gastrointestinal (GI) series revealed a cordlike protrusion in the duodenal region, and a gastroendoscopic examination was performed and revealed a mucosal tag (MT) about 3 cm in length in the duodenal bulb. The MT was resected endoscopically and was found to be lined by normal duodenal mucosa and to have developed hyperplasia of the Brunner's glands. This MT was considered to be a congenitally‐developed, hamartomatous hyperplasia of the duodenal mucosa, and of the Brunner's glands in particular.
A Newly Improved Jointed Sliding Tube, Type ST‐CX2 for Use During Colonoscopy
Authors: TADA Masahiro , SHIMIZU Seiji , OHTSUKA Hirotomo , OKAMURA Masako , ISO Akitada , SOBAJIMA Junko , ITOH Yoshiyuki , KAWAI Keiichi
Published: August 2007

Sliding tubes have been developed to keep the sigmoid colon straight and allow the quick insertion of the colonoscope into the proximal colon. However, there are some problems associated with using the sliding tubes currently available. In particular, the attachment of the sliding tube sometimes affects insertion since the effective length of the scope is reduced. A newly developed jointed sliding tube, the ST‐CX2, consists of an inner tube and an outer tube. Both parts are made of polytetrafluoroethylene and are elastic and thin. The length of the ST‐CX2 is only 227 mm when contracted, and it can be used with medium‐length colonoscopes. The sliding tube is 450 mm long when fully extended and its tip can, without exception, be introduced into the descending colon. The development of this new instrument has made total colonoscopy easier.
Injection Sclerotherapy for Esophageal Varices after Total Gastrectomy: Case Reports of Two Patients
Authors: CHIKAMORI Fumio , AOYAGI Hiroyuki , TAKAGAKI Toshiro , SHARMA Niranjan , SHIBUYA Susumu , TAKASE Yasuhiro
Published: August 2007

Injection sclerotherapy was performed in two patients with esophageal varices who had undergone a total gastrectomy and Roux‐en‐ Y esophagojejunostomy for gastric cancer. Both of the patients were diagnosed as having postnecrotic liver cirrhosis due to serum hepatitis. The first patient developed esophageal varices after surgery. The second patient had recurrent esophageal varices after surgery for both gastric cancer and the esophageal varices. Five percent ethanolamine oleate was the sclerosant used together with the contrast medium iopamidol (5% EOI). After intravariceal injection, the flow of the sclerosant was followed by fluoroscopy. The esophageal varices were fed by the branches of the jejunal vein of the arcade of the ascending jejunal limb. The esophageal varices and branches of the jejunal vein were destroyed by three consecutive sessions of sclerotherapy. No complications occurred during or after the therapy. Therefore, injection sclerotherapy, along with varicealography, is one of the most effective methods of treating esophageal varices arising after a total gastrectomy.
A Study on Myogenic Tumors of the Upper Gastrointestinal Tract by Endoscopic Ultrasonography—With Special Reference to the Differential Diagnosis of Benign and Malignant Lesions
Authors: YAMADA Yukihito , KIDA Mitsuhiro , SAKAGUCHI Tetsuaki , NOTO Makoto , UESUGI Hidenaga , SAIGENJI Katsunori , OOGURI Toshihiko , KAN Tomoya
Published: August 2007

Seventy‐six myogenic tumors (60 leimyomas, 3 leiomyoblastomas, 13 leiomyosarcomas) surgically resected from the upper gastrointestinal tract were studied histopathologically to define the characteristics of benign and malignant tumors. Twenty‐nine of these lesions (22 leiomyomas, 3 leiomyoblastomas, 4 leiomyosarcomas) were additionally studied by EUS before resection to investigate the relationship between EUS and histopathological findings and establish a scoring system enabling the differentiation of malignant from benign lesions. The results indicated that coagulative necrosis and bleeding were principally responsible for the heterogeneous internal echo of tumors. Anechoic areas corresponded to colliquative necrosis or cystic degeneration. Five EUS findings of prime importance in identifying malignant myogenic tumors were found to be: (1) a tumor diameter of ±3.0 cm, (2) nodular shape, (3) an ulceration depth of ± 5 mm, (4) a heterogeneous internal echo, and (5) the presence of an anechoic area. Each of these five parameters was assigned a score of 1 Point, and lesions with a total score of 3 or more were evaluated as being malignant. The sensitivity and specificity of our scoring system for myogenic tumors were respectively 100% and 73% in the 29 cases studied by EUS and 100% and 80% for all 76 tumors studied histopathologically.
A Case of a “Vanishing Submucosal Tumor” of the Stomach Which was Suspected of being a Gastric Wall Abscess
Authors: NAKAJIMA Tomoki , KODAMA Tadashi , KASHIMA Kei , NAKAIMA Toshikazu , SHIOMI Takehiko , IMAMURA Masayuki , OGASAWARA Takeshi , KIZU Minoru
Published: August 2007

We report on a case of a “vanishing submucosal tumor” of the stomach in a 76‐year‐old woman who was admitted to our hospital with severe abdominal pain. Laboratory tests revealed marked inflammation. Various radiological, ultrasonographical, and endoscopic findings in addition to the clinical symptoms were compatible with a diagnosis of gastric wall abscess. The tumor vanished before an endoscopic puncture could be performed. We speculate that the disappearance of the tumor and subsequent improvement of the patient's clinical symptoms were the result of spontaneous drainage into the gastric lumen. The findings in this case suggest that there is a spontaneous healing mechanism in this disease.
Inoculation of Rhesus Monkeys with Human Helicobacter pylori: A Long‐term Investigation on Gastric Mucosa by Endoscopy
Authors: FUKUDA Yoshihiro , TAMURA Kazutami , YAMAMOTO Issei , KAWAURA Akihiko , TONOKATSU Yasushi , TSUYUGUCHI Takaichi , OHNO Tadatsugu , SATOMI Masamichi , SHIMOYAMA Takashi
Published: August 2007

Abstract: To study the pathogenetic role of Helicobacter pylori, colonization of this organism was attempted in conventional rhesus monkeys. After inoculation of human H. pylori to the gastric mucosa of four 10‐year‐old monkeys, endoscopical and histological examinations were repeated for 10 weeks. The organisms were recovered bacteriologically from all 4 monkeys at the first week, from 3 animals at the 2nd, and from 2 animals at the 6th to 10th week. The endoscopical examination showed only minimum changes in the mucosal appearance such as erythema and erosion due to H. pylori colonization throughout the study. In contrast, the histological examination revealed prominent polymorphonuclear cell infiltration, edema of the mucosa and dissected epithelium at the earlier periods and mononuclear cell infiltration afterwards. The maximum lymphocyte reaction such as clusters or the formation of a thick layer at the bottom of the lamina propria was observed at the 8th week. These results indicated that rhesus monkeys can be infected by human H. pylori resulting in similar pathologic changes in the human stomach, and that this animal model may be useful for future studies.
Immunohistochemical Study of Estrogen Receptor in the Penetrating Type of Early Gastric Cancer
Authors: HIRAYAMA Daisuke , FUJIMORI Takahiro , SATONAKA Kazuhiro , YUKAWA Masahiko , TERAMOTO Tadahisa , KITAZAWA Sohei , MAEDA Sakan , NAGASAKO Kou , ARAO Mototsugu
Published: August 2007

Abstract: The estrogen receptor was studied in a total of 42 cases of gastric carcinoma which included 14 cases of the penetrating type of early gastric carcinoma (PEN), 14 cases of the common type of early gastric carcinomas (EA) and 14 cases of the advanced gastric carcinomas (AD). An immunohistochemical study using the anti‐ER‐D5 antibody revealed that the detection of estrogen receptor‐positive tumor cells was significantly higher in the PEN group and in the AD group than in the EA group. Moreover, the incidence of estrogen receptor immunoreactivity in infiltrative and scirrhous PENs was significantly higher than that in non‐infiltrative and non‐scirrhous PENs. These results suggests that the estrogen receptor may play an important role in infiltrative proliferation and scirrhous growth in the PENs. Furthermore, the results indicated that ER immunostaining procedures applied to endoscopic biopsy specimens could be useful for the endoscopic diagnosis of PEN‐type early gastric cancer.
Endoscopic Findings of Primary Sclerosing Cholangitis—‐Report of a Case—
Authors: TERAI Shuji , AKIYAMA Tetsuji , NAKAMURA Masaaki , AIBE Tsuyoshi , OKITA Kiwamu , SANUKI Kazutoshi
Published: August 2007

Abstract: A case of primary sclerosing cholangitis in which an endoscopic inspection through the fistula produced by percutaneous transhepatic biliary drainage was performed for the treatment of progressive jaundice and supprative cholangitis is presented. These treatments benefited the patient to some degree. After 3 years from the onset, the patient died of multi‐organ failure caused by disseminated intravascular coagulopathy. An autopsy revealed primary sclerosing cholangitis. No evidence of ductal stricture due to malignancy or underlying cholelithiasis was noted.

This report may be the first which discusses the endoscopic findings of a biliary tract stricture in a patient with sclerosing cholangitis.
Histopathological Analysis of the Factors Determining the Echogenicity of Gastric Carcinoma Visualized by Endoscopic Ultrasonography
Authors: SANO Shuichi , IKEDA Masahiro , FUJINO Masayuki A. , MOROZUMI Atsuro , YAMAMOTO Yasuyuki , SUZUKI Hiroshi
Published: August 2007

Abstract: Endoscopic ultrasonography (EUS) reveals a variety of echo patterns in gastric carcinoma. We analysed the factors determining its echogenicity in 47 cases of advanced carcinoma. Echo levels were measured with a densitometer (Model PDM ‐5, Konishiroku, japan) on Polaroid films of ultrasonography. The echogenicity of a tumor (Et) was expressed as the value relative to those of the submucosal layer (EIII) and the proper muscle layer (EIV), (Et‐EIII)/(EIV‐EIII)=echogenicity index (EI). The amount of fiber was expressed as the ratio of the area of fibrosis measured with an image analyser (IBAS‐2000, Zeiss, Germany) on a preparation of Masson‐Trichrome staining. EI corresponded well to the echo levels graded by the conventional method of description and had a strong correlation with the amount of fiber (r =–0.621, p < 0.001) except in two cases of mucinous carcinoma. Scirrhous carcinoma had a significantly smaller El than medullary and intermediate carcinomas. It also had a significantly greater amount of fiber than the others. No significant difference was found in terms of both the EI and amount of fiber when the carcinoma were grouped according to their degrees of differentiation (well, moderate and poor) or their modes of infiltration (α, β and γ). The tumors with short, wave‐shaped “curly fiber” showed a greater EI than those with fine networks of fibers or thick bundles of fibers. Mucinous carcinoma and two cases of intermediate type carcinoma were included in the former group and scirrhous carcinoma was included in the latter group.

In conclusion, the echo levels of gastric carcinoma visualized by EUS are mostly determined by the amount of fiber in the tumor, but are also modified to some extent by the shape and arrangement of those fibers. Scirrhous carcinoma can be distinguished from the other types based on its echo levels.
A Case of Duodenal Crohn's Disease Associated with Ampullar Insufficiency and Cholangitis
Authors: KATO Masahiko , NINOMIYA Mitsuo , SUGIURA Junsaku , KATO Tomohiro , SAITO Koshiro , MORIWAKI Hisataka , TOMITA Eiichi , MUTO Yasutoshi , OHSHIMA Kenjiro , TAKAI Tetsu , IKEDA Yoko , SHIMOKAWA Kuniyasu
Published: August 2007

Abstract: A 67‐year‐old Japanese woman with duodenal Crohn's disease developed cholangitis. Radiographic and endoscopic examinations revealed a marked stenosis of the third portion and a dilatation of the second portion of the duodenum. The endoscopic and histopathological observations showed this disease affected the Vater's papilla. Duodenoscopic manometry indicated a reduced pressure of the phasic sphincter of Oddi, indicating ampullar insufficiency. E. coli was found in the bile culture as the infecting organism. The authors suggest that the cholangitis in this patient was caused by the reflux of duodenal contents into the biliary tract.