bluuebunny/crossref_metadata_2025 huggingface dataset:
Transmission of enteric non‐A, non‐B hepatitis virus in Macaca mulatta, monkeys by intraportal route: Subsequent passages of HEV virus
Authors: GUPTA H. , JOSHI Y. K. , VARMA A. , SHENOY S. , SRIRAMCHARI S. , IYENGER B. , TANDON B. N.
Published: March 2008

Abstract Macaca mulatta monkeys have been used for the transmission of enteric non‐A, non‐B hepatitis (HEV) virus by intraportal route. Subsequent passages of HEV virus have been completed in these monkeys. In the first passage, 2 monkeys were inoculated by intra‐portal route with 27–34 nm virus‐like particles (VLP) obtained from known epidemics of HEV hepatitis in India, and biochemical and serological changes in the blood, histological changes in the liver and excretion of 27–34 nm VLP in the stool were studied. Results were compared with those of 4 negative control monkeys inoculated with stool extracts from healthy individuals. The second passage of 27–34 nm VLP was carried out on 2 monkeys using pools of stool suspension positive for 27–34 nm VLP from first passaged animals. Similarly, the third passage of 27–34 nm VLP was completed intraportally in another monkey. All monkeys developed acute hepatitis, as evidenced by transient elevation of aminotransferases, histopathological changes in the liver, development of antibodies aggregating 27–34 nm VLP and excretion of 27–34 nm VLP in stools. No control monkeys developed these features.
The effect of misoprostol, omeprazole and sucralfate on nicotine‐ and ethanol‐induced gastric injury and gastric mucosal blood flow: A comparative study
Authors: HUI W. M. , CHEN B. W. , CHO C. H. , LAM S. K. , LUK C. T.
Published: March 2008

Abstract Nicotine, which is thought to be responsible for part of the pharmacological effect of smoking, exacerbates gastric mucosal injury in rats. The effects of misoprostol (12.5 μg to 100 μg), omeprazole (12.5 mg to 100 mg) and sucralfate (50 to 400 mg) on gastric mucosal blood flow and mucosal injury induced by nicotine were studied in an ex vivo gastric chamber preparation in rats. Rats were pretreated with nicotine (25 μg/mL orally) for 10 days and ethanol was added to the gastric chamber preparation. Laser Doppler flowmetry was used to measure the gastric mucosal blood flow and mucosal damage (ulcer index) was assessed by the area of haemorrhagic lesions. The ulcer index was significantly higher in rats pretreated with nicotine. Treatment with misoprostol and omeprazole lowered the ulcer index significantly compared with controls. The peak and summation blood flows were lower in nicotine‐treated rats but failed to reach statistical significance. The peak blood flow (blood flow at 45 min) and the summation blood flow were significantly higher with all doses of sucralfate, misoprostol and omeprazole than in controls (P<0.05). The increase in gastric mucosal blood flow was significantly higher with sucralfate and misoprostol than with omeprazole. We conclude that sucralfate, misoprostol and omeprazole prevent nicotine‐ and ethanol‐induced gastric mucosal damage and are accompanied by an increase in gastric mucosal blood flow. This indicates that smoking exacerbates gastric mucosal injury and that cytoprotective and site‐protective agents can reduce injury by these noxious agents.
Low‐dose cimetidine in the acute treatment of duodenal ulcer. Comparison of a single nocturnal dose regimen with a twice daily regimen
Authors: KANG J. Y. , GUAN R. , TAY H. H. , YAP I. , WEE A. , MATH M. V. , LABROOY S. J.
Published: March 2008

Abstract A 0.5 g daily dose of cimetidine was as effective as a 1 g dose in the acute treatment of duodenal ulcer patients in Hong Kong. The aims of the present study were, first, to determine whether low‐dose cimetidine treatment was as effective as standard doses in acute duodenal ulcer treatment of patients in Singapore, and second, to compare a single nocturnal dosage regimen with a twice daily regimen. In this single centre, double‐blind, controlled trial, 282 patients with endoscopically proven duodenal ulcer were randomized to receive four weeks’ treatment with cimetidine using one of three dosage regimens: (A) 800 mg at night; (B) 400 mg at night; or (C) 400 mg twice daily. Two hundred and forty‐seven patients were evaluated. The incidences of healing at four weeks were: (A) 40/80 (50%), (B) 39/88 (44%); and (C) 48/79 (61%); (B vs C: P<0.05; A vs C: NS; 95% confidence limits: –5% to 27%; A vs B: NS, 95% confidence limits: –6% to 21%). Of 183 patients who had antral biopsies taken, 176 (96%) had histological gastritis, while 167 (91%) were positive for Helicobacter‐like organisms. The occurrence of gastritis or Helicobacter‐like organisms had no influence on ulcer healing. A 400 mg dose of cimetidine is therefore suboptimal for the treatment of duodenal ulcer in patients in Singapore. A single nocturnal dosage regimen may be less effective than a twice daily regimen.
Wilson's disease in an Australian Aborigine
Authors: CRAWFORD D. H. G. , SHEPHERD R. , COOKSLEY W. G. E. , PATRICK M. , POWELL L. W.
Published: March 2008

Abstract Wilson's disease is due to a genetically determined defect inherited as an autosomal recessive trait. Most reported cases have been caucasoid. This report describes a case of Wilson's disease in an Australian Aboriginal girl, only the second such case reported.
Oesophageal and ileal ulceration in Behcet's disease
Authors: LORENZETTI MARK E. , FORBES IAN J. , ROBERTS‐THOMSON IAN C.
Published: March 2008

Abstract Over a six‐year period a Caucasian girl with chronic neutropaenia developed recurrent mouth ulceration, genital ulceration, ileitis and deep ulcers involving the upper oesophagus. These features constitute an incomplete form of Behcet's disease with the rare manifestation of oesophageal ulceration and the previously unreported association with chronic neutropaenia.
Collagen synthesis by cultured rat liver cells isolated from chronically alcohol‐treated rats
Authors: TAKASE SHUJIRO , ENYAMA KEIKO , TAKADA AKIRA
Published: March 2008

Incorporation rates of 14C‐proline into collagen hydroxyproline in cultured Ito cells and hepatocytes isolated from chronically alcohol‐treated rats were studied in order to clarify the role of Ito cells in the development of alcoholic liver fibrosis pathogenesis. In the cultured Ito cells isolated from alcohol‐treated rats, prolyl hydroxylase activity significantly increased. Total collagen synthesis tended to increase in the alcohol group, and the increase in intracellular intact collagen was statistically significant. More than half of the 14C‐radioactivity in intact collagen in cultured Ito cells from control rats was found in collagen other than types I and III collagen (mainly type IV collagen). In Ito cells from alcohol‐treated rats, synthesis of collagen other than type I and III significantly increased and type I collagen synthesis tended to be decreased. No significant difference was found in collagen synthesis between the cultured hepatocytes from alcoholic and control rats. These results suggest that chronic alcohol consumption stimulates collagen synthesis in Ito cells, especially type IV collagen. This stimulation of Ito cells may play a role in the development of alcoholic liver fibrosis.
Could activated charcoal be used to adsorb intraduodenal Methyl tert‐butyl ether spillage during its use in the dissolution of gallstones?
Authors: ILETT KENNETH F. , LAURENCE BERNARD H. , HACKETT L. PETER
Published: March 2008

Methyl tert‐butyl ether (MTBE) is becoming more frequently used in the non‐surgical removal of cholesterol gallstones. However, during its introduction into the biliary tract, some spillage can occur and subsequent systemic absorption has been reported to lead to a variety of side effects. We have carried out in vitro experiments to assess the ability of activated charcoal to adsorb MTBE. A 10% aqueous suspension of activated charcoal was mixed with MTBE and its adsorption was estimated subsequently by gas chromatography. Adsorption varied from 38% at an activated charcoal: MTBE ratio of 1:1, to 96% at a ratio of 8:1. Only 3.2% of the adsorbed MTBE could be desorbed by resuspending the sedimented activated charcoal: MTBE complex in an equivalent volume of fresh distilled water. The results indicate that a single dose of activated charcoal (> 12 g) may be effective in minimizing systemic absorption of MTBE spilt during gallstone dissolution.
Carboxyl terminal glycine extended progastrin (gastrin‐G) in gastric antral mucosa of patients with gastric or duodenal ulcer and in gastrinomas
Authors: AZUMA TAKESHI , MAGAMI YASUSHI , HABU YASUKI , KAWAI KEIICHI , TAGGART R. THOMAS , WALSH JOHN H.
Published: March 2008

Recently, carboxyl terminal glycine extended progastrin (gastrin‐G), the immediate biosynthetic precursor of amidated gastrin, was found in human gastric antral mucosa. To investigate the nature of gastrin amidation in pathophysiological conditions, we examined gastrin and gastrin‐G levels and their molecular forms in gastric antral mucosa of healthy controls and patients with gastric or duodenal ulcer and in gastrinomas. There were no significant differences between controls and gastric or duodenal ulcer patients in antral gastrin and gastrin‐G levels, the ratio of gastrin‐G to gastrin and the pattern of their molecular forms. In contrast, gastrin and gastrin‐G levels and the ratio of gastrin‐G to gastrin in gastrinomas were much higher than those in antral mucosa of controls or ulcer patients. The predominant molecular form of gastrin‐G was different between two Zollinger‐Ellison syndrome (ZES) cases. These results suggest that there are no significant differences between healthy controls and patients with gastric or duodenal ulcer in the nature of gastrin amidation, and that the nature of gastrin amination in gastrinomas is different from that in normal gastrointestinal tissues.
A controlled study of glypressin versus vasopressin in the control of bleeding from oesophageal varices
Authors: CHIU KING‐WAH , SHEEN I‐SHYAN , LIAW YUN‐FAN
Published: March 2008

To evaluate the therapeutic effect of glypressin (triglycyl‐lysine‐vasopressin, C52H74N16O15S2.2C2H4O2.5H2O) in the treatment of oesophageal variceal bleeding, a randomized controlled trial of glypressin and vasopressin was conducted in 54 cirrhotic patients with oesophageal varices bleeding. Bleeding ceased within 24 h in 50% (13/26) of patients treated with glypressin and in 53.6% (15/28) of patients given vasopressin. Re‐bleeding within 7 days occurred in 30.8% (4/13) of the glypressin group and in 20.0% (3/15) of the vasopressin group. There was no statistically significant difference in the therapeutic effect between glypressin and vasopressin. In the glypressin group, bleeding was more easily stopped in non‐hepatocellular carcinoma (HCC) cirrhotic patients of Pugh's criteria A or B than in patients of Pugh's criterion C or HCC. We conclude that glypressin and vasopressin have similar therapeutic effect. In considering the application convenience, glypressin is an alternative to vasopressin in the treatment of bleeding varices in patients of good liver function reserve.
Characterization of peripheral blood lymphocytes in patients with non‐cirrhotic portal fibrosis: A comparison with cirrhotics and healthy controls
Authors: NAYYAR A. K. , SHARMA B. K. , SARIN S. K. , MALHOTRA P. , BROOR S. L. , SACHDEV G.
Published: March 2008

Non‐cirrhotic portal fibrosis (NCPF) is a common cause of portal hypertension in India. Its aetiopathogenesis is not well understood. To investigate the possibility of an immune mediated injury, phenotypes of peripheral blood lymphocytes were studied in 15 NCPF patients and were compared with an equal number of compensated cirrhotics and matched healthy controls. The population of total peripheral T lymphocytes (T1) and suppressor/cytotoxic phenotype (T8) was significantly (P < 0.01) decreased in NCPF patients compared with controls. The sub‐populations of helper/inducer lymphocytes (T4) and total B lymphocytes, however, were comparable with controls. The ratio of T4 to T8 lymphocytes was significantly (P < 0.01) increased in NCPF patients in comparison with controls. Similar changes in the lymphocyte population were also observed in cirrhotic patients. Further investigations are required to identify whether the cellular alterations seen in NCPF have a pathogenetic basis or are secondary to the disease process itself.
Portal circulation in monkeys and humans studied after ingestion of a capsule containing a radionuclide
Authors: SHIOMI SUSUMU , KUROKI TETSUO , UEDA TADASHI , NISHIGUCHI SHUHEI , NAKAJIMA SHINYA , KOBAYASHI KENZO , KURAI OSAMU , IKEOKA NAOKO , MONNA TAKEYUKI , OCHI HIRONOBU
Published: March 2008

Capsules (8 times 30 mm) of technetium‐99m pertechnetate were designed for measurement of portal blood flow. Most of the radionuclide entered the superior mesenteric vein. The capsule was taken orally and monitored with a collimator for scintigraphy until it reached the small intestine, when a magnetic field completed an electrical circuit in a sensor, burning a thread, releasing a spring, and discharging the preparation.

A study in crab‐eating monkeys (Macaca fascicularis) showed that the radionuclide in the small intestine circulated through the superior mesenteric vein to the portal vein and liver. Portal scintigraphy through the small intestine could be analysed in the same way as per‐rectal portal scintigraphy, in which blood flow mostly from the inferior mesenteric vein is evaluated.

A study of four volunteers showed that, after the radionuclide was released, it circulated through the superior mesenteric vein to the portal vein and liver. Use of a capsule enclosing a radioisotope was possible, and the procedure seemed to be safe.

The use of the per‐small intestine method plus the per‐rectal method should give more accurate results than either method used alone, because the haemodynamics of both the superior and inferior mesenteric vein would be reflected.
Causative agents of acute diarrhoea in the first 3 years of life: Hospital‐based study
Authors: KHAN M. MUBASHIR A. , BAQAI R. , IQBAL J. , GHAFOOR A. , ZUBERI S. , BURNEY M. I.
Published: March 2008

During the 2 years of the study, 402 patients and an equal number of age‐ and sex‐matched controls were investigated for the presence of diarrhoeal pathogens. Pathogenic organisms were recovered from 277 (68.9%) patients and 97 (24.1%) controls. In the patient group, possible bacterial pathogens were found in 210 (52.2%) cases. Enteropathogenic Escherichia coli (EPEC) was the most frequently found potential pathogen, being recovered in 132 cases (32.8%) with serotypes 026, 086, 0111 and 0124 being the most frequently identified. Other bacterial pathogens identified were enterotoxigenic E. coli (ETEC) 57 (14.2%), Shigella 13 (3.2%) and Salmonella eight (2%). Rotavirus was identified in 33 (8.2%) cases. Mixed bacterial and viral infections were also seen in 26 (6.5%) cases.

In the control group, enteric pathogens were recovered from 97 (24.1%) specimens. The most common bacterial pathogen found in this group was again EPEC (40, 9.9%), with serogroups 018, 044, 0111 and 0126 being the most frequent. Giardia lamblia and Entamoeba histolytica were found in 31 (7.7%) and 10 (2.5%) controls, respectively. Rotavirus was found in 16 (4%) controls. The results of both centres where the study was performed (Karachi and Rawalpindi) were compared.
Serum pepsinogen I levels in patients with non‐ulcer dyspepsia
Authors: CHANG FULL‐YOUNG , CHENG JIUNN‐TARNG , LEE FA‐YAUH , WANG TE‐FONG , LAI KWOK‐HUNG , LEE SHOU‐DONG , TSAI YANG‐TE
Published: March 2008

In order to understand whether the serum pepsinogen I (PGI) levels of non‐ulcer dyspepsia (NUD) patients differed from those of healthy controls and which kends of factors might influence these levels of the former, serum PGI levels were determined by radio‐immunoassay in 120 healthy controls and 361 NUD patients. The mean serum PGI level was significantly lower in NUD patients than in the controls (75.8 ± 38.2 ng/mL versus 95.9 ± 39.3 ng/mL; P < 0.0001); in NUD patients, it was significantly higher in males than in females (79.6 ± 40.4 ng/mL versus 63.2 ± 26.4 ng/mL; P < 0.001). However, corrected serum PGI levels according to the lean body mass disclosed no sex difference. Nevertheless, there was a weak correlation between the ages of patients and serum PGI levels (r= 0.403). The serum PGI levels in blood groups A, B, AB and O did not differ significantly. Smoking might be a decisive factor, for the mean serum PGI level was significantly higher among the smokers than among the non‐smokers (86.7 ± 44.6 ng/mL versus 70.6 ± 33.7 ng/mL; P < 0.001). It is concluded that the mean serum PGI level of NUD patients, while affected by sex, age, smoker status and the body size, is lower than that of the healthy controls. Without endoscopy, assay of serum PGI level has no place in the diagnosis of dyspepsia because of the wide overlapping of serum PGI levels between NUD patients and patients with other common gastric lesions.
Campylobacter pylori infection: Experience in a multiracial population
Authors: GOH K. L. , PEH S. C. , WONG N. W. , PARASAKTHI N. , PUTHUCHEARY S. D.
Published: March 2008

Over a 15‐month period, 399 patients with dyspepsia were investigated for the presence of Campylobacter pylori infection. Half of the patients (50.6%) had Campylobacter organisms in the antrum of the stomach. C. pylori was found in 96.1% of patients with histological changes of chronic active gastritis in the antrum. Of patients with duodenal and gastric ulcers, 87.8% and 87.5%, respectively, had Campylobacter organisms, as did 39.3% of patients with non‐ulcer dyspepsia. C. pylori infection was most commonly found in Chinese and Indians. Although the prevalence of infection appeared to increase with age, there was an equal distribution amongst the sexes.
Auto‐immune (lupoid) hepatitis: An entity in the spectrum of chronic active liver disease*
Authors: Mackay Ian R.
Published: March 2008

The concept of auto‐immune hepatitis as a disease entity evolved from the descriptions of ‘chronic active hepatitis’ (CAH) in the 1950s. Several types of CAH are distinguished by disease‐specific features. The distinctive (but not exclusive) markers for auto‐immune CAH include: a negative test for HBsAg; female; Northern European ethnic background; multisystem disease expression; histological CAH with large areas of periportal piecemeal necrosis and plasmacytosis; pronounced hypergammaglobulinaemia; serum auto‐antibodies; the HLA B8‐DR3 phenotype; responsiveness to corticosteroid therapy; and rarity of supervening hepatocellular carcinoma.

Much weight is attached to the serological marker auto‐antibodies to nuclear or smooth muscle (actin) antigens (ANA, SMA). However, these auto‐antibodies do not have an absolute association with auto‐immune CAH: the serological reactions are not yet standardized; titres decrease with remission of disease; and other auto‐antibodies mark variant forms of auto‐immune hepatitis. A more confident acceptance of auto‐immune hepatitis as an entity requires detection of a liver‐specific antigen, a valid experimental disease model in animals, and a better understanding of immune‐mediated damage to liver cells.
Experience with MTBE as a solvent for common bile duct stones in patients with T‐tube in situ
Authors: SARAYA A. , RAI R. R. , TANDON R. K.
Published: March 2008

Abstract The postcholecystectomy patients who have a T‐tube in situ offer a convenient route through the T‐tube to perfuse solvents into the common bile duct (CBD) for dissolving any retained common duct stones. If successful, this approach is much simpler and cheaper than the usual therapeutic modality used for CBD stones, namely, endoscopic papillotomy. Thus a most potent cholesterol solvent, methyl t‐butyl ether (MTBE) was perfused through the T‐tube into the CBD of five patients with retained common duct stones. The dose of the solvent varied, 1.5–5 mL 0.5–1 h, given 7–13 times amounting to a total of 20–66 mL. Instillation of MTBE in the T‐tube was alternated with aspiration of the bile through T‐tube. Only one patient showed complete disappearance of the bile duct stone following MTBE perfusion. Others did not show any appreciable response and had to be treated by endoscopic papillotomy (three patients) or mono‐octanoin perfusion (one patient). Side‐effects of MTBE perfusion included pain in the abdomen in all patients, somnolence and nausea/vertigo in two patients and the smell of ether on the breath in two patients. It is concluded that MTBE is not an effective agent for dissolution of retained CBD stones in patients with T‐tube in situ.
Primary sclerosing cholangitis: Clinical and immunopathological review of 21 cases
Authors: JEFFREY G. P. , REED W. D. , LAURENCE B. H. , SHILKIN K. B.
Published: March 2008

Abstract Twenty‐one patients with primary sclerosing cholangitis were seen during 1979–87. The mean age at onset of disease was 51.7 years (range: 13–78 years) with a male: female ratio of 2.5:1. Six (29%) were asymptomatic at the time of diagnosis. Eleven patients (52%) had ulcerative colitis. Cholangiography demonstrated abnormalities limited to the intrahepatic ducts in 10 cases, with both intrahepatic and extrahepatic involvement in 11. Histological features on liver biopsy included: portal tract inflammation and cholestasis in all; paucity of bile ducts in 56%; piecemeal necrosis in 19% and cirrhosis in 6%. Circulating autoantibodies and elevated serum immunoglobulins were found in half of the patients and HLA‐B8 was detected in 53%. A deficiency of circulating CD3 and CD8 cells was not found in the 12 patients tested. The mean follow‐up was 51 months (range: 3–180 months). Three patients died from non‐hepatic causes and another has received liver transplantation. A Kaplan‐Meier curve predicted 70% survival at 72 months.
Haem in the gut. Part II. Faecal excretion of haem and haem‐derived porphyrins and their detection
Authors: Young Graeme P. , John D. James B. ST , Rose Ian S. , Blake Dennis
Published: March 2008

Abstract Only a fraction of haem (ferroprotoporphyrin) finding its way into the gut lumen is absorbed; the major portion enters the colon. There, unabsorbed haem, together with any haem of haemoproteins shed directly into the colonic lumen as haemoglobin or other haemoproteins, are converted by bacteria to a range of haem‐derived porphyrins (HDP) lacking iron. This conversion is a slow and incomplete process and the amount converted in this way depends on colonic transit rate, site of bleeding and amount of luminal haem. As a consequence, faeces contain variable proportions of haem and HDP. The guaiac and tetramethylbenzidine tests give a qualitative index of faecal blood; they depend on the pseudoperoxidase activity of intact haem and cannot detect HDP. These tests perform better for large bowel bleeding than for more proximal bleeding. The fluorimetric HemoQuant assay quantitates both haem and HDP; it performs well for both proximal and distal bleeding. Neither type of test can allow for intestinal absorption of haem or HDP. Quantitation of gastrointestinal bleeding derived from measurement of faecally excreted haem and HDP is, therefore, likely to underestimate haem delivered into the gut lumen. In a given clinical situation, the choice of a haem‐dependent occult blood test must take into account the possibility of colonic conversion of haem to HDP and the possible value of quantitation as opposed to qualitative detection.
Hepatic veno‐occlusive disease associated with comfrey ingestion
Authors: YEONG MEE LING , SWINBURN BOYD , KENNEDY MARK , NICHOLSON GORDON
Published: March 2008

Abstract A 23 year old man presented with hepatic veno‐occlusive disease and severe portal hypertension and subsequently died from liver failure. Light microscopy and hepatic angiography showed occlusion of sublobular veins and small venous radicles of the liver, associated with widespread haemorrhagic necrosis of hepatocytes. The patient had been on a predominantly vegetarian diet and, prior to his illness, took comfrey leaves which are known to contain hepatotoxic pyrrolizidine alkaloids. Comfrey is widely used as a herbal remedy, but so far has only been implicated in two other documented cases of human hepatic veno‐occlusive disease. A possible causal association of comfrey and this patient's veno‐occlusive disease is suggested by the temporal relationship of the ingestion of comfrey to his presentation, the histological changes in the liver and the exclusion of other known causes of the disease.
Influence of glutamine and branched chain amino acids on the jejunal atrophy associated with parenteral nutrition
Authors: PLATELL C. , McCAULEY R. , McCULLOCH R. , HALL J.
Published: March 2008

Infusions of conventional parenteral nutrients (CPN) are associated with gut atrophy. This may be due to the absence of glutamine in such solutions. Although glutamine is a preferred gut nutrient, it is excluded from CPN because it is unstable at room temperature. This problem may be circumvented either directly by the infusion of fresh solutions of glutamine, or indirectly by the infusion of branched chain amino acids (BCAA). We evaluated the effect of infusing either glutamine, BCAA, or glutamine plus BCAA‐enriched CPN on the rat jejunum. Sixty male Wistar rats were randomized to receive 6 days of either conventional parenteral nutrition (CPN), CPN plus 1.5% glutamine (GLN), CPN plus 2% BCAA (BCAA), CPN plus 0.8% BCAA and 1.0% glutamine (GLN/BCAA), or a normal oral diet (Chow). Standardized segments of jejunum were then removed for assessment. Compared with the CPN group, both the GLN/BCAA and the BCAA groups had greater mucosal weights (P < 0.05) and mucosal protein concentrations (P < 0.05), the GLN/BCAA group had greater jejunal weights (P < 0.05), and the GLN group had an increased jejunal weight (P < 0.05) and a higher crypt cell production rate (P < 0.05). We conclude that the infusion of glutamine or BCAA‐enriched parenteral nutrition improves jejunal morphology compared with conventional parenteral nutrition.
Cystic disease of the liver following prenatal and perinatal exposure to aflatoxin B1 in rats
Authors: NAIDU N. R. GOPAL , SEHGAL S. , BHASKAR K. V. S. , AIKAT B. K.
Published: March 2008

Experiments were designed to elucidate the differences, if any, in the liver histology induced by aflatoxin B in newborn and adult animals. The transfer of toxic metabolites from pregnant rats to their litters was confirmed by thin layer chromatography of liver homogenates in the latter. Extensive cystic lesions of the biliary and hepatic type developed only in young animals. Multifocal hepatic necrosis, bile ductular proliferation, areas of altered hepatocytes, neoplastic nodules and hepatocellular carcinoma constituted the total spectrum in both adult and newborn animals. Increased susceptibility to the toxins early in life appears to be responsible for this intriguing phenomenon. These aspects may have a bearing on the genesis of childhood liver disease.
Pathological and laboratory findings in LEC/Otk rats that spontaneously develop hepatic injury
Authors: KAWANO KAZUYA , HIRASHIMA TSUKASA , MORI SHIGEHITO , BANDO SUMIO , YONEMOTO KENICHI , ABE FUMIKO , GOTO HIROHIKO , NATORI TAKASHI
Published: March 2008

The LEC strain of rats that spontaneously develops hepatic injury has been introduced into specific pathogen‐free (SPF) conditions (SPF‐LEC/Otk). The present communication describes the clinical and pathological features of the SPF‐LEC/Otk rats. The characteristic features of these animals are as follows: (i) Jaundice develops in almost all rats with increase in the P‐GPT level; (ii) The animals show episodes of jaundice, a high P‐GPT level and liver cell necrosis, but only slight inflammatory cell infiltration; (iii) The liver cells show characteristic microvesicular fatty changes; (iv) The P‐GPT level shows increases, first at 18 weeks and then at 25 weeks of age; (v) The rats show immunological disorders, such as deficiency of immunoglobulins, especially IgG1, and of helper T cells; (vi) Infectious agents such as viruses do not seem to be involved, although this possibility cannot be absolutely excluded; (vii) The immunological disorders are not directly associated with the occurrence of liver cell necrosis; and (viii) The pattern of inheritance (autosomal single‐recessive trait) of the disease strongly suggests that it is due to a genetic metabolic disorder.
Hepatocyte hepatitis B surface antigen expression in chronic hepatitis B virus carriers in Singapore: Correlation with viral replication and liver pathology
Authors: WEE AILEEN , YAP IVY , GUAN RICHARD
Published: March 2008

The hepatocyte hepatitis B surface antigen (HBsAg) expression in 149 liver biopsies from 124 chronic hepatitis B virus (HBV) carriers was correlated with serum HBV DNA status and histologic activity. Hepatocyte HBsAg was stained by the peroxidase‐antiperoxidase method and serum HBV DNA was determined by dot blot hybridization. Sixty‐five biopsies (44%) showed minimal changes (MC), 82 biopsies (55%) showed chronic liver disease (CLD) and 2 biopsies (1%) showed hepatocellular carcinoma. Hepatocyte HBsAg was found in 144 biopsies (97%). It was present in the cytoplasm of 141 specimens (95%) and/or plasma membrane of 48 specimens (32%). Approximately half (45%) of the cytoplasmic HBsAg‐positive biopsies showed discrete distribution, while the other half (55%) were grouped. Fifty‐five per cent (77 of 141) of cytoplasmic HbsAg‐positive biopsies had CLD, while 44% (62 of 141) showed MC. There was no relationship between the presence of cytoplasmic HBsAg or its topographic distribution with disease activity. Membrane HBsAg distribution was similar for both groups of patients (MC vs CLD: 25 of 65 (38%) vs 23 of 82 (28%); P= NS). Serum HBV DNA was detected in 98 patients (66%) and was seen mostly in association with CLD (CLD vs MC: 61%vs 39%, P < 0.001). It was also detected more often in the sera of patients with membrane HBsAg than in those with cytoplasmic HBsAg staining (41 of 48 (85%) vs 97 of 141 (67%); P < 0.02). However, discrete distribution of cytoplasmic HBsAg was associated with positive serum HBV DNA when compared with grouped distribution (52 of 63 (83%) vs 43 of 78 vs (55%); P < 0.005).
Efficacy of endoscopic sclerotherapy on long‐term management of oesophageal varices: A comparative study of results in patients with cirrhosis of the liver, non‐cirrhotic portal fibrosis (NCPF) and extrahepatic portal venous obstruction (EHO)*
Authors: BHARGAVA D. K. , DASARATHY S. , SUNDARAM K. R. , AHUJA R. K.
Published: March 2008

A prospective study was conducted to compare the results of long‐term endoscopic variceal sclerotherapy in patients with different aetiologies of portal hypertension. A total of 404 consecutive patients were included. There were 234 patients with hepatic cirrhosis, 83 with non‐cirrhotic portal fibrosis (NCPF) and 87 with extrahepatic portal venous obstruction (EHO). The mean follow‐up for patients with cirrhosis, NCPF and EHO was 25, 37 and 28 months. A total of 73 (31%) patients with cirrhosis, 19 (23%) with NCPF and 10 (11.5%) with EHO rebled (P < 0.05) on follow‐up, prior to eradication of varices. Irrespective of the aetiology, 40 (17%) patients of Child's A class, 42 (33%) of Child's B and 20 (50%) of Child's C class rebled (P<0.01). The median bleeding free period (BFP) was longer (P<0.05) in patients with EHO than in cirrhotics. Patients in Child's A class had significantly longer BFP than those in Child's B, and the latter had a longer BFP than those in Child's C class (P<0.01). The probability of 7‐year survival was also better with EHO (97.5%) and NCPF (73.6%) than cirrhotics (41%). Survivals in patients with EHO and NCPF were comparable (P<0.1). Similarly 7‐year survival irrespective of aetiology in Child's A patients (90.7%) was longer than in Child's B (28.8%), and longer in Child's B than Child's C patients (0%). Success of eradication was greater (P<0.05) in EHO (92%) and NCPF (87%) than cirrhotic patients (75%). This was also related to the Child's status of patients. Recurrence of varices, and complications related to the procedure, were not influenced by Child's status or by the aetiology of portal hypertension. For a given Child's class, the results of scierotherapy in the different aetiological groups were similar.

We conclude that the results of long‐term sclerotherapy are affected primarily by the Child's scores and indirectly by the aetiology of portal hypertension.
Proliferation and cytotoxicity of lectin‐induced lymphokine‐activated killer (LILAK) cells
Authors: SHIMIZU YUTAKA , KUROKI TETSUO , SHIOMI SUSUMU , KOBAYASHI KENZO , MONNA TAKEYUKI
Published: March 2008

More than 1011 killer cells are needed for adoptive immunotherapy, but it is difficult to obtain so many from patients. Peripheral blood lymphocytes (PBL) treated with lectin and then with recombinant interleukin‐2 (rIL‐2) give many lectin‐induced lymphokine‐activated killer (LILAK) cells, studied here for proliferation, cytotoxicity, IL‐2 receptors (IL‐2R) and subsets. PBL obtained from hepatoma patients or healthy adults were incubated with phytohaemagglutinin (PHA) or concanavalin A (ConA) for 3 days and with rIL‐2 for 4 days. Then the medium was replaced with fresh medium containing rIL‐2 every 3 or 4 days, with the volume increased as cells proliferated. Cytotoxicity was expressed as the percentage lysis of target cells by 4 h 51Cr release. LILAK cells from healthy adults increased 120‐fold in 2 weeks when incubated with ConA; the lymphokine‐activated killer (LAK) cells increased 7‐fold. The percentage of IL‐2R+ cells increased more with ConA than with rIL‐2 alone. ConA induced more suppressor T cells than PHA. LILAK cells obtained from patients by PHA treatment increased 180‐fold in 2 weeks. Their cytotoxicity to Daudi cells was 1% before culture and 91% in 2 weeks; that of LAK cells was 60%. LILAK cells were cytotoxic to the tumour target cells, but not to allogeneic PBL. Adoptive immunotherapy may become more practical if many LILAK cells can be obtained at once by large‐scale culture, such as by a hollow‐fibre system.
Non‐alcoholic steatohepatitis: Impaired antipyrine metabolism and hypertriglyceridaemia may be clues to its pathogenesis
Authors: FIATARONE J. R. , COVERDALE S. A. , BATEY R. G. , FARRELL G. C.
Published: March 2008

Non‐alcoholic steatohepatitis resembles alcoholic liver disease in hepatic morphology but appears to have a different natural history. We sought to assess the nature of non‐alcoholic steatohepatitis by a prospective study of its clinical progression and the relationship of biochemical abnormalities to changes in serum lipids among 15 patients with this disorder. In addition, antipyrine clearance (Cl‐AP), which reflects hepatic microsomal oxidative capacity, was measured serially. Although initial liver histology included micronodular cirrhosis in five cases and bridging fibrosis in another three, only one patient developed a hepatic complication during 1–10 years (median: 3.7) of follow up. This confirms the relatively benign nature of non‐alcoholic steatohepatitis. Moreover, Cl‐AP, which was below the normal range in 13 patients, did not change significantly during 10–40 months of follow up. However, compared with other chronic liver diseases, the reduced Cl‐AP was disproportionately low relative to the uniformly normal serum albumin concentration and other indices of hepatic metabolic function. This is consistent with selective impairment of endoplasmic reticular drug oxidizing enzymes. Hyperlipidaemia was present in 11 patients. In three of these, diet‐induced correction of serum triglyceride elevation was associated with reduction of hepatocellular damage as indicated by serum enzyme levels. A hypothesis that unites these and earlier findings is that release of cytokines may occur in non‐alcoholic steatohepatitis and produce accumulation of free fatty acids in the liver, leading to focal necro‐inflammatory lesions and the destruction or down‐regulation of cytochrome P450.
Role of hepatic artery in haemodynamics in normal and cirrhotic livers in rats
Authors: SHIBAYAMA YURO , NAKATA KATSUJI
Published: March 2008

To examine the degree of influence of the hepatic artery on microcirculation in the liver, microscopic observation of blood flow in the hepatic minute blood vessels and the sinusoids and pressure measurements at key points in hepatic vascular pathways in vivo were performed before and after hepatic artery ligation in normal and cirrhotic rats. In normal rats, portal vein pressure (109mmH2O) fell 10mmH2O after hepatic artery ligation, but the pressures of the terminal portal venule, the terminal hepatic venule and the inferior vena cava did not change. In cirrhotic rats, portal vein pressure (206 mmH2O) and terminal portal venule pressure (106mmH2O) fell 23 and 10mmH2O after hepatic artery ligation respectively: the pressures in the terminal hepatic venule and the inferior vena cava did not change. These results suggest that the pressure transmitted from the hepatic artery was mostly supplied to the intrahepatic portal vein in normal rats and both to the intrahepatic portal vein and to the sinusoids in cirrhotic rats. In both normal and cirrhotic rats, however, the pressure transmitted from the hepatic artery was about 10 per cent of the initial portal vein pressure, and the blood flow in minute vessels and sinusoids did not change after hepatic artery ligation. Accordingly, it is believed that the hepatic artery plays only a small role in the haemodynamics of the liver in both normal and cirrhotic rats, irrespective of the distribution and manner of the hepatic arterial termination.
Prevalence of hepatitis C virus antibody in an area endemic for hepatitis B virus and human T cell leukaemia virus
Authors: OCHI SHIGEKI , ONJI MORIKAZU , SHIRAISHI KAZUHITO , OHTU KYOKO , AKAO TOMOHIRO , YANO YOSHITO , TAKEI NOBUYUKI , MATSUI HIKARU , OHTA YASUYUKI , UMEDA MASAKICHI
Published: March 2008

To clarify the prevalence of concurrent infection with hepatitis C virus (HCV), hepatitis B virus (HBV) and human T cell leukaemia virus (HTLV), we measured HCV antibody in the population of a district endemic for HBV and HTLV infection. Blood samples were collected in June 1990 from 579 inhabitants of four islands of Uwa Bay in the southwest of Ehime Prefecture in Japan. Anti‐HCV antibody against C100–3 protein was detected using an enzyme‐linked immunosorbent assay kit (Ortho Diagnostics). Thirteen of the 579 inhabitants (2.2%) were positive for anti‐HCV, and this prevalence rate was not significantly different from the frequency of anti‐HCV in Tokyo blood donors. A total of 11% (64 of 579) of the subjects were positive for HBsAg and 3.3% (19 of 579) were positive for anti‐HTLV. These frequencies of HBsAg and anti‐HTLV positivity were distinctly higher than the respective means of Japanese. All anti‐HCV positive individuals were negative for HBsAg and anti‐HTLV, while 54% (7 of 13) had increased alanine aminotransferase levels. These data suggest that the prevalence of HCV infection is not high even in an area endemic for HBV and HTLV infection.
Effects of stress on growth of transplanted hepatic tumours and immune responses
Authors: SEKIYA CHIHIRO , KOHDA HIRONOBU , YOSHIDA NORIYUKI , OHHIRA MASUMI , UEHARA AKIRA , UEDE TOSHIMITSU , KIKUCHI KOKICHI , NAMIKI MASAYOSHI
Published: March 2008

Growth of transplanted hepatic tumours (T‐9) was enhanced in immune rats under stress, compared with immune rats in an unstressed condition. Compared with unstressed immune rats, killer activity of mononuclear cells infiltrating the tumours against T‐9 cells was significantly reduced in stressed immune rats. In contrast, killer activity of splenocytes obtained from stressed immune rats against T‐9 cells was elevated compared with that from unstressed immune rats. In addition, natural killer cell activity of mononuclear cells infiltrating the tumours obtained from stressed immune rats was significantly reduced compared with that from unstressed immune rats. Cell populations infiltrating tumour tissues were identified by flow cytometric analysis. The percentage of CD8+ cells in mononuclear cells isolated from tumour tissues of stressed immune rats was reduced compared with that of unstressed immune rats. Furthermore, interleukin‐2 responsiveness of splenocytes was suppressed in stressed immune rats, whereas T cell function as reflected by phytohaemagglutinin‐ or Concanavalin A‐reactivity was unaffected by stress. Collectively, it is likely that stress suppressed the generation of cytotoxic cells from the spleen cells of immune rats.
Faecal clearance of α1‐antitrypsin reflects disease activity and correlates with rapid turnover proteins in chronic inflammatory bowel disease
Authors: MIURA SOICHIRO , YOSHIOKA MASAHIRO , TANAKA SHIN , SERIZAWA HIROSHI , TASHIRO HIROKAZU , ASAKURA HITOSHI , TSUCHIYA MASAHARU
Published: March 2008

Abstract Faecal clearance of α1‐antitrypsin was measured in patients with ulcerative colitis and Crohn's disease and compared with disease activity and markers of protein‐calorie malnutrition. Patients with active ulcerative colitis and Crohn's disease showed elevated clearance of α1‐antitrypsin and clearance declined in most patients with induction of remission. However, even with inactive disease, elevated protein loss persisted in some patients, presumably reflecting residual inflammation in the intestinal mucosa. There was a significant correlation between clearance of α1‐antitrypsin and serum levels of retinol‐binding protein and transferrin in patients with ulcerative colitis and with retinol‐binding protein in patients with Crohn's disease. Clearance of α1‐antitrypsin reflects disease activity in inflammatory bowel disease and correlates with serum levels of rapid‐turnover proteins such as retinol‐binding protein and transferrin, which are markers for the presence of protein‐calorie malnutrition.
Duplex Doppler ultrasound of the ligamentum teres and portal vein: A clinically useful adjunct in the evaluation of patients with known or suspected chronic liver disease or portal hypertension
Authors: GIBSON PETER R. , GIBSON ROBERT N. , DONLAN JOHN D. , DITCHFIELD MICHAEL R. , BHATHAL PRITHI S.
Published: March 2008

Abstract The prevalence and potential value of the detection of signs of portal hypertension by duplex Doppler ultrasound (DDU) of the ligamentum teres and portal vein in patients with known or suspected chronic liver disease and/or portal hypertension was studied in 136 consecutive patients undergoing clinical assessment including that of liver histopathology. Portal hypertension was considered to be present when any of the following DDU signs, previously demonstrated to be specific for portal hypertension, were present: an enlarged and/or patent para‐umbilical vein, portal vein obstruction or hepatofugal flow in the portal vein. Of 123 patients with parenchymal liver disease, eighty‐three had cirrhosis and, of these, portal hypertension was detected on DDU criteria in 86% of alcoholic cirrhotics and 67% of non‐alcoholic cirrhotics. Of the 42 patients with non‐cirrhotic liver disease, 1 of 7 patients with metastatic liver disease and 3 of 5 patients with alcoholic hepatitis had DDU signs of portal hypertension. Thus, in patients with parenchymal liver disease, DDU had a sensitivity of 73%, specificity of 90% and predictive values of 94 and 62% for positive and negative studies respectively for the detection of cirrhosis. In all 14 patients with portal hypertension secondary to vascular occlusive diseases, DDU examination of the ligamentum teres, portal vein and hepatic vein gave an accurate guide to the site of the occluding lesion. The high positive predictive value of DDU and its ability to aid in localizing the site of increased resistance to flow through the liver suggest that DDU of the ligamentum teres and portal vein is a potentially useful non‐invasive adjunct in the assessment of patients with suspected or known liver disease or portal hypertension.
Aetiology and prognosis of fulminant viral hepatitis in Japan: A multicentre study
Authors: TAKAHASHI YOSHIYATA , SHIMIZU MASARU ,   THE STUDY GROUP OF FULMINANT HEPATITIS
Published: March 2008

In 236 patients with fulminant viral hepatitis (FVH), type B (FBH) was most common (47.5%), followed by non‐A non‐B hepatitis (FNANB, 44.9%) and hepatitis type A (FAH, 7.6%). The survival rate was significantly higher in the FAH group than in the FBH and FNANB groups (61.1, 36.6 and 18.9% respectively), and was significantly higher in the FBH group than in the FNANB group. In spite of screening for hepatitis B virus (HBV), FBH was prevalent (27 of 41) in post‐transfusion cases; this phenomenon is discussed in relation to a recently revealed mutation of HBV. Within a month after the onset of hepatitis symptoms all cases in the FAH, 93% in the FBH and 79% in the FNANB group, developed encephalopathy. When the duration of illness before the onset of encephalopathy was more than 10 days (a subacute form), the survival rate was significantly lower than when encephalopathy developed in less than 11 days (an acute form). This difference could be accounted for by the difference in the relative frequency of aetiological viruses in the two forms and the higher survival rate in the acute, than the subacute, form in the FNANB group.
The Sydney System: Auto‐immune gastritis
Authors: STRICKLAND ROBERT G.
Published: March 2008

The association of gastric auto‐immunity with chronic gastritis has been recognized for more than 30 years. Despite this, little is known about the initiation of auto‐immune gastric mucosal injury or the role of gastric auto‐antibodies in this disease process. The current review describes recent progress in our understanding of these fundamental questions on the origin and progression of auto‐immune gastritis.

In addition, evidence is presented (epidemiologic, clinical, pathologic and experimental) that strongly supports the view that auto‐immune gastritis is a distinctive category of chronic gastritis with significant long‐term sequelae.
Myo‐electrical and motor activity of the stomach in the first days after abdominal surgery: Evaluation by electrogastrography and impedance gastrography
Authors: CLEVERS G. J. , SMOUT A. J. P. M. , VAN DER SCHEE E. J. , AKKERMANS L. M. A.
Published: March 2008

The electrical and motor activities of the stomach were studied in the early postoperative phase after abdominal surgery by means of surface recording techniques: electrogastrography (EGG) and impedance gastrography (IGG). EGG and IGG recordings were made pre‐operatively and on the first and second postoperative days. Physical signs and symptoms related to gastrointestinal motility were assessed. Two patient groups were studied; a group of patients undergoing cholecystectomy (n= 9) was compared with a group with major colonic surgery (n= 14). After colonic surgery, resumption of a normal oral diet was later and nausea and vomiting were seen more frequently than after cholecystectomy. Other physical signs concerning intestinal motility did not differ between the groups. Gastric myo‐electrical activity (0.04–0.06 Hz), recorded eletrogastrographically, tended to decrease in the postoperative phase in both groups, and return to pre‐operative values later in the colonic surgery group. However, none of the differences reached statistical significance. Abnormal gastric activity (tachyarrhythmia) was observed in one pre‐operative patient but in 6 patients (2 cholecystectomy, 4 colonic surgery) after operation. IGG variables were not significantly affected by the operation and were not significantly different between the groups.

No correlation between the symptoms nausea and vomiting in the postoperative phase and the incidence of tachyarrhythmias could be demonstrated in this study. It is concluded that antral myo‐electrical and motor activity, measured with non‐invasive techniques (EGG and IGG), are not grossly abnormal on the first and second postoperative day after abdominal surgery. It is further concluded that abnormal gastric frequencies do not appear to play a major role in the genesis of postoperative nausea and vomiting.