bluuebunny/crossref_metadata_2025 huggingface dataset:
Emerging role of calprotectin in gastroenterology
Authors: POULLIS ANDREW , FOSTER RUSSELL , MENDALL MICHAEL A , FAGERHOL MAGNE K
Published: June 2003

Abstract  Calprotectin is a calcium and zinc binding protein of the S100 family derived predominantly from neutrophils and monocytes. It is detectable in body fluids and tissue samples and is emerging as a valuable marker in the diagnosis, and the monitoring and determining of the prognosis of commonly encountered gastroenterological conditions. Fecal calprotectin, in particular, has for a long time been regarded as a promising marker of gastrointestinal pathology and has now been established as a routine test in Norway and at several centers in the UK.

© 2003 Blackwell Publishing Asia Pty Ltd
Alteration of aquaporin mRNA expression after small bowel resection in the rat residual ileum and colon
Authors: TSUJIKAWA TOMOYUKI , ITOH AKIHIKO , FUKUNAGA TETSUYA , SATOH JIN , YASUOKA TAKASHI , FUJIYAMA YOSHIHIDE
Published: June 2003

Background: Diarrhea occurring after small bowel resection gradually improves due to intestinal adaptation. It is known that several water channels, termed aquaporins (AQP), are expressed in the gastrointestinal tract and facilitate water transport. However, the changes of AQP after bowel resection remain unclear. In the present paper, the alterations in AQP mRNA expression were investigated after a massive small bowel resection in the rat residual ileum and colon.

Methods: The 6‐week‐old male Sprague–Dawley rats (n = 15) underwent an 80% distal small bowel resection. The residual ileum and colon were dissected on postoperative day 1, 3, 5 or 7 (n= 3 on each day). Total RNA was purified from each mucosa, and the expressions of AQP and sodium‐dependent glucose transporter (SGLT1) mRNA were analyzed by northern blot. The plasma vasoactive intestinal polypeptide (VIP) concentrations on the preoperative day and postoperative day 1 were assayed.

Results: In the residual small intestine, the expression of AQP‐1 and AQP‐3 mRNA increased significantly on postoperative day 1. The AQP‐7 mRNA increased on postoperative day 3, but the AQP‐4 mRNA did not change after the bowel resection. The SGLT1 mRNA gradually decreased after the bowel resection. In the colon, the expression of AQP‐3 increased on postoperative day 1 and 7, but AQP‐4 mRNA did not change after surgery. The AQP‐8 mRNA levels increased slightly on postoperative day 7. Plasma VIP concentration did not change between preoperative day and postoperative day 1.

Conclusions: These results indicate that several AQP, except for AQP‐4, were up‐regulated after a massive small bowel resection, and that AQP might play important roles during adaptation.

© 2003 Blackwell Publishing Asia Pty Ltd
Rabeprazole in a one‐week eradication therapy of Helicobacter pylori: Comparison of different dosages
Authors: MARIO FRANCESCO DI , DAL BÒ NADIA , ARAGONA GIOVANNI , MOUSSA ALI M , IORI VERONICA , CAVESTRO GIULIA M , PILOTTO ALBERTO , LEANDRO GIOACCHINO , FRANCESCHI MARILISA , RUGGE MASSIMO , FRANZÈ Angelo
Published: June 2003

Aim: Many data regarding omeprazole‐, lanzoprazole‐ and pantoprazole‐based triple therapy for Helicobacter pylori (H. pylori) eradication have been reported, but there is few data present regarding rabeprazole (R). We report the efficacy and tolerability of rabeprazole in different dosages in association with clarithromycin (C)and tinidazole (T) in H. pylori eradication.

Design and Methods: Ninety‐four H. pylori‐positive patients with dyspeptic symptoms were enrolled and randomly allocated to eradication therapy in two different one‐week regimens. In regimen A, 47 patients received R 20 mg b.i.d, C 500 mg b.i.d and T 500 mg b.i.d, while in regimen B, 47 patients received R 10 mg b.i.d, C 500 mg b.i.d and T 500 mg b.i.d. Eradication of H. pylori was evaluated by a 13C urea breath test (UBT) two months after the end of the therapy.

Results: Four patients (two in each regimen) did not complete treatment. The H. pylori eradication rate was 91.4% in group A compared to 89.3% in group B (P‐value not significant). Minor side‐effects were reported in 4.2% of group A and 6.4% of group B patients.

Conclusion: Rabeprazole showed good efficacy and tolerability in one‐week H. pylori therapy at 20 mg b.i.d and 10 mg b.i.d, suggesting the use of the lower dosage.

© 2003 Blackwell Publishing Asia Pty Ltd
Rabeprazole treatment attenuated Helicobacter pylori‐associated gastric mucosal lesion formation in Mongolian gerbils
Authors: SUZUKI HIDEKAZU , MIYAZAWA MASAHARU , NAGAHASHI SHOICHI , SATO MASARU , BESSHO MOTOAKI , NAGATA HIROSHI , MIURA SOICHIRO , ISHII HIROMASA
Published: June 2003

Background and Aim: Although rabeprazole (RPZ), a proton pump inhibitor, has been reported to have a bactericidal effect on Helicobacter pylori (H. pylori), no studies have been conducted regarding the effect of RPZ on gastric mucosal lesion formation caused by this bacterium. In the present study, we investigated the effect of RPZ on H. pylori‐associated gastric mucosal lesion formation.

Methods: Sixty‐two male Mongolian gerbils were inoculated with H. pylori (ATCC43504) (Hp group) and 60 gerbils with the culture media alone (control group). Some gerbils in the Hp group and in the control group were injected with RPZ (1 mg/kg/day, for 7 days) at the 5th week. Gerbils were evaluated at the 12th, 24th and 48th weeks.

Results: In the Hp group, all gerbils were persistently infected for 24 weeks, but 36% became negative for H. pylori at the 48th week. In the Hp + RPZ group, 18% of gerbils at the 12th week, 40% at the 24th week, and 80% at the 48th week, became negative for H. pylori. The level of neutrophil infiltration was significantly decreased in the Hp + RPZ group in comparison to the Hp group, possibly through the effects of RPZ on initial bacterial colonization and resultant inflammation. Even in the gerbils that became H. pylori‐negative, the level of neutrophil infiltration was lower in the Hp + RPZ group than in the Hp group. RPZ treatment significantly increased the level of the reduced form of glutathione (GSH) at the 48th week. The elevated levels of the reduced form of GSH may have been reduced by an antioxidation process in the H. pylori‐positive Hp + RPZ group.

Conclusion: Administration of RPZ not only inhibited gastric H. pylori colonization, but also reduced gastric mucosal inflammation in gerbils, possibly through its antibacterial action as well as pharmacological recruitment of the reduced form of GSH.

© 2003 Blackwell Publishing Asia Pty Ltd
Preclinical study of endoscopic ultrasonography with electronic radial scanning echoendoscope
Authors: NIWA KATSUSHI , HIROOKA YOSHIKI , ITOH AKIHIRO , HASHIMOTO SENJU , HIRAI TAKANORI , TAKEDA KINICHI , GOTO HIDEMI
Published: June 2003

Background: To evaluate the imaging possibility of a newly designed electronic radial scanning echoendoscope (ER‐ES).

Methods: In the in vivo study of swine, we obtained B‐mode endoscopic ultrasonography (EUS) images of the gastric and gallbladder (GB) walls and checked the ability to detect Doppler signals using ER‐ES and electronic linear array echoendoscope (EL‐ES). Furthermore, in the ex vivo study of swine, B‐mode EUS images of fixed gastric and GB wall specimens were obtained using ER‐ES, EL‐ES and mechanical radial scanning echoendoscope (MR‐ES). In the study of resected human specimens, we obtained B‐mode EUS images of five resected GB specimens (three normal GB, one cholecystitis and one cancerous) using the three types of echoendoscope.

Results: In the in vivo study of swine, ER‐ES and EL‐ES depicted the gastric walls as five‐layered, and the GB walls as single‐layered structures. The ability to detect Doppler signals was equal between ER‐ES and EL‐ES. In the ex vivo study of swine, ER‐ES, MR‐ES and EL‐ES equally delineated the gastric walls as five‐layered and GB walls as three‐layered structures. In the study of resected human specimens, results demonstrated the normal GB walls as three‐layered, the cholecystitis as a combination of outer high‐echoic and inner low‐echoic layers, and the cancer as a protruded tumor.

Conclusions: We conclude that ER‐ES has faculties for making B‐mode images as well as EL‐ES and MR‐ES. In addition, in the in vivo study, ER‐ES can analyze blood flow information as well as EL‐ES.

© 2003 Blackwell Publishing Asia Pty Ltd
Effects of lipopolysaccharide on the biliary excretion of bile acids and organic anions in rats
Authors: HOJO MAKOTO , SANO NAOYO , TAKIKAWA HAJIME
Published: June 2003

Background: Lipopolysaccharide is known to be a cause of cholestasis associated with sepsis. It has also recently been reported to down‐regulate the basolateral and canalicular transporters. The aim of the present study was to examine simultaneously the effect of lipopolysaccharide on the biliary excretion of typical substrates of bile salt export pump and multidrug resistance protein 2 in vivo, and the effect of lipopolysaccharide on the amount of these transporters.

Methods: After intravenous administration of O127:B8‐derived lipopolysaccharide (2.5 mg/kg), the biliary excretion of taurocholate and various organic anions was studied, and the protein levels of bile salt export pump and multidrug resistance protein 2 in the crude liver membrane was determined by western blot analysis.

Results: Lipopolysaccharide decreased the biliary excretion of tracer amounts of taurocholate, leukotriene C4, taurolithocholate‐3‐sulfate and temocapril without affecting bile flow. The biliary excretion of high doses of taurocholate and sulfobromophthalein was markedly inhibited by lipopolysaccharide. Lipopolysaccharide decreased bile salt export pump levels in the liver plasma membrane fraction to 48% of control rats, and markedly decreased multidrug resistance protein 2 levels to 17% of control rats.

Conclusions: These findings support the hypothesis that down‐regulation of the canalicular transporters by lipopolysaccharide causes the impairment of the biliary excretion of bile acids and organic anions in cholestasis of sepsis prior to the decrease of bile flow.

© 2003 Blackwell Publishing Asia Pty Ltd
Flow cytometric measurement of tumor necrosis factor‐related apoptosis‐inducing ligand and its receptors in gastric epithelium and infiltrating mucosal lymphocytes in Helicobacter pylori‐associated gastritis
Authors: KOYAMA SHOHEI
Published: June 2003

Background: Tumor necrosis factor‐related apoptosis‐inducing ligand (TRAIL) and its receptors have recently been reported to be responsible for apoptotic signaling molecules. However, little is known about TRAIL‐mediated apoptosis in the human glandular stomach.

Methods: Biopsies from 66 patients (28 Helicobacter pylori‐negative, 38 H. pylori‐positive) were investigated for phenotypic distribution of TRAIL and its receptors DR4/DR5 and DcR2 on mucosal epithelium, and infiltrating mucosal lymphocytes using flow cytometry. Apoptosis of the cells was examined by terminal deoxynucleotidyl transferase (TdT)‐mediated dUTP nick and labeling (TUNEL). In addition, the phenotypic distribution of CD antigens on infiltrating major T‐ and B‐lymphocytes were determined.

Results: Membrane‐bound TRAIL and its receptors were constitutively expressed in all patients with high levels in the gastric mucosal epithelium. In particular, these protein molecules were overexpressed in mucosal lymphocytes coupled with increased proportions of CD19+ B cells, and CD3+ T cells bearing CD8+CD11b– and CD4+CD62L– surface phenotypes in H. pylori‐positive gastric mucosa. The frequencies of apoptotic epithelium and infiltrating lymphocytes in H. pylori‐associated gastritis were significantly greater than those of H. pylori‐negative normal mucosa (P < 0.01).

Conclusion: The present findings show that flow cytometric analysis is useful for detection of membrane‐bound TRAIL and its receptors in gastric epithelium and infiltrating mucosal lymphocytes.

© 2003 Blackwell Publishing Asia Pty Ltd
Effect of different doses of furazolidone with amoxicillin and omeprazole on eradication of Helicobacter pylori
Authors: ROGHANI HASSAN SALMAN , MASSARRAT SEDEGH , SHIREKHODA MOHAMMAD , BUTORAB ZIA
Published: June 2003

Background: Resistance to metronidazole is one of the most common reasons for Helicobacter pylori treatment failure with classic triple therapy. In contrast, the clarithromycin‐based regimen is not cost‐effective for developing countries. Furazolidone is a very good substitute for metronidazole and clarithromycin, but its many side‐effects limit widespread use. The aim of the present study was to assess the efficacy of two different doses of furazolidone in combination with amoxycillin and omeprazole.

Methods: A total of 123 patients with duodenal ulcer were randomized and received the following medications for two weeks. Group A: furazolidone 2 × 200 mg + amoxycillin 2 × 1 g + omeprazole 2 × 20 mg/day. Group B: furazolidone 2 × 50 mg + amoxycillin 2 × 1 g + omeprazole 2 × 20 mg/day. Control endoscopy was performed after 6 weeks and two biopsy specimens from the antrum and two from the corpus were taken for a urease test and histology. Eradication was concluded if all tests were negative for H. pylori.

Results: In total, 110 patients completed the study. Four patients in group A did not tolerate the regimen on day 8 of therapy and were excluded from the study. Serious complications such as fever, and fatigue and dizziness, which occurred in the beginning of the second week of treatment (days 8–10), were more common in group A than in group B (19%, 15.9% and 14.3%, respectively, in group A vs 0% in group B). The eradication rate by per protocol analysis was significantly higher in group A than in group B (88.9%vs 67.9%, respectively, P = 0.008). However, this difference was low and not statistically significant by intention‐to‐treat analysis (76.2% in group A and 62.3% in group B, P = 0.09).

Conclusion: The regimen with a non‐reduced dose of furazolidone in combination with amoxycillin and omeprazole was effective when the patients tolerated the drugs and completed the study.

© 2003 Blackwell Publishing Asia Pty Ltd
Pulse‐wave velocity and cardiovascular risk factors in subjects with Helicobacter pylori infection
Authors: ADACHI KYOICHI , ARIMA NORIYUKI , TAKASHIMA TOSHIHARU , MIYAOKA YOUICHI , YUKI MIKA , ONO MASAHIRO , KOMAZAWA YOSHINORI , KAWAMURA AKIRA , FUJISHIRO HIROFUMI , ISHIHARA SHUNJI , KINOSHITA YOSHIKAZU
Published: June 2003

Background: Helicobacter pylori infection has been reported to correlate with the onset of cardiovascular diseases. However, the relationship between H. pylori infection and the development of arteriosclerosis has not been fully investigated. We performed a cross‐sectional study to clarify the possible role of H. pylori infection in the development of arteriosclerosis.

Methods: The subjects were 996 cases who attended their annual medical check‐up between April and August 2001. H. pylori infection status was determined by assaying serum anti‐H. pylori immunoglobulin G antibodies. Total cholesterol, high‐density lipoprotein cholesterol (HDLC), triglyceride, fasting blood glucose, hemoglobin A1c and leukocyte levels were determined. Arteriosclerotic parameters (systolic blood pressure (SBP), ankle brachial index (ABI) and pulse‐wave velocity (PWV)) were measured non‐invasively using an automatic device. The data for H. pylori‐seropositive and ‐seronegative individuals were compared.

Results: Five hundred and seventy‐three subjects (57.5%) were H. pylori‐seropositive. After adjustment for sex, age, body mass index, and smoking and drinking habits, the HDLC levels of the seropositive and seronegative groups differed markedly (55.0 vs 58.0 mg/dL, P < 0.0001). Although there were no differences between the overall adjusted SBP and ABI values, the PWV was higher in H. pylori‐seropositive than ‐seronegative young (<39 years old) individuals (heart–carotid PWV: 632.2 vs 589.7 cm/s, P = 0.027). These differences tended to disappear with aging.

Conclusions: The degree of arterial stiffness in H. pylori‐positive young subjects is higher than that in H. pylori‐negative young subjects. However, no difference between the arterial stiffness values of H. pylori‐seropositive and ‐seronegative elderly individuals was observed.

© 2003 Blackwell Publishing Asia Pty Ltd
Simple method of preparation of rat colonocyte apical membranes using polyethylene glycol precipitation
Authors: PRABHU RAMAMOORTHY , BALASUBRAMANIAN KUNISSERRY A
Published: June 2003

Background: Although a number of methods are available for the preparation of brush border membranes (BBM) from the small intestine, very few studies have been performed on the isolation of colonic apical membranes (CAM). Cation precipitation is one of the methods used for the isolation of these membranes, which can result in altered lipid composition as a result of activation of phospholipase. We have earlier established a method for BBM isolation using polyethylene glycol (PEG) precipitation. In the present study, CAM from isolated colonocytes were prepared using PEG and the isolated membranes were characterized.

Methods: The CAM were prepared from isolated rat colonocytes using PEG precipitation and differential centrifugation. Purity was assessed by enrichment of the marker enzymes and contamination by other subcellular particles. Lipid composition and sugar components were analyzed in the isolated membranes.

Results: The CAM showed 11–12‐fold enrichment in alkaline phosphatase and 9–10‐fold enrichment in γ‐glutamyl transpeptidase as compared with the cell homogenate. The final membrane preparation also showed good vesicle formation as seen by electron microscopy. There was very little contamination of basolateral membranes, microsomes or lysosomes in the final membrane preparation. Analysis of sugars indicated high content of fucose and sialic acid as compared with hexoses. Lipid analysis indicated the presence of various neutral and phospholipids and a cholesterol/phospholipid ratio of 0.65 was seen.

Conclusion: This study has shown a simple method of CAM preparation using PEG precipitation, which is less time‐consuming than other methods and comparatively pure.

© 2003 Blackwell Publishing Asia Pty Ltd
Pretransplant hepatitis C virus infection and its effect on the post‐transplant course of living renal allograft recipients
Authors: EINOLLAHI BEHZAD , HAJARIZADEH BEHZAD , BAKHTIARI SIAMAK , LESANPEZESHKI MAHBOUB , KHATAMI MOHAMAD REZA , NOURBALA MOHAMAD HOSSEIN , POURFARZIANI VAHID , ALAVIAN SEYED MOAYED
Published: June 2003

Background: Hepatitis C virus infection (HCV) is a main health problem in end‐stage renal disease (ESRD) patients. The effect of pretransplant HCV infection on survival among ESRD patients who have undergone renal transplantation is controversial. We report the results of a large monocenter study that evaluated the effect of hepatitis C on the patient, and on graft survival in renal‐transplanted patients who received living donated allograft.

Methods: A historical cohort study, we investigated all 1006 patients who received a living kidney transplant at Baghiatollah Medical Center in Tehran, Iran, between March 1995 and October 2001 (up to 85 months follow up). Patients’ sera had been routinely assayed for anti‐HCV antibodies and hepatitis B surface antigen (HBsAg) at the time of transplantation. The HBsAg‐positive patients were excluded from the survival analysis. Survivals were examined using Kaplan–Meier analysis and compared using the log–rank test. Multivariate analysis was performed using Cox's model.

Results: Forty‐five patients (4.5%) were anti‐HCV‐antibody positive. Anti‐HCV‐antibody‐positive patients spent a longer time on dialysis and had a higher rate of retransplantation. There were no differences in recipients’ sex and age and donors’ age between the two groups. The 7‐year patient survival rate was 89.9% in the anti‐HCV‐antibody‐positive group and 95.5% in the HCV‐negative group (P = 0.74). Seven‐year graft survival was 82.0% and 75.0% in the anti‐HCV‐antibody‐positive and HCV‐negative groups, respectively (P = 0.39). In the multivariate analysis, age was the only significant parameter correlated with patient survival (P = 0.02).

Conclusions: HCV infection does not seem to influence patient and graft survival within a medium‐time follow up in living allograft recipients, and anti‐HCV‐antibody positive status (alone) is not a contraindication for renal transplantation. However, further studies are needed to better define the role of HCV infection in long‐term prognosis.

© 2003 Blackwell Publishing Asia Pty Ltd
Clinical usefulness of edaravone for acute liver injury
Authors: TADA SHINICHIRO , NAKAMOTO NOBUHIRO , KAMEYAMA KAORI , TSUNEMATSU SATOSHI , KUMAGAI NAOKI , SAITO HIDETSUGU , ISHII HIROMASA
Published: June 2003

Background: Edaravone, a newly synthesized radical scavenger, has shown an excellent effect on treating stroke patients. The effect of edaravone on carbon tetrachloride (CCl4)‐induced acute liver injury was examined.

Methods: Six rats were injected with CCl4 alone and six rats were intravenously injected with edaravone immediately after and 3 h after injection of CCl4. Another six rats were injected with olive oil alone. The animals were killed at 24 h after the CCl4 injection.

Results: Injection of CCl4 was followed by a marked increase in serum alanine aminotranferase (ALT) level (CCl4, 1630.6 ± 606.8 IU/L; olive oil, 21.0 ± 2.6 IU/L; P < 0.001), lactate dehydrogenase (LDH) level (CCl4, 5068.0 ± 2956.4 IU/L; olive oil, 203.6 ± 30.5 IU/L; P < 0.005), and total bilirubin (TB) level (CCl4, 0.88 ± 0.48 mg/dL; olive oil, 0.37 ± 0.05 mg/dL; P < 0.01), whereas in the edaravone‐treated rats, the ALT (119.4 ± 113.5 IU/L, P < 0.001), LDH (369.7 ± 288.2 IU/L, P < 0.005), and TB values (0.29 ± 0.16 mg/dL, P < 0.01) were significantly decreased. Histological examination of the liver by hematoxylin and eosin and oil red O staining showed a marked reduction of steatosis in the CCl4 and edaravone‐treated rats compared with the CCl4‐injected rats. Significant inhibition of hepatocytic apoptosis was demonstrated by the terminal deoxynucleotidyl transferase‐mediated UTP nick‐end labeling (TUNEL) method in the edaravone‐treated rats.

Conclusions: These results suggest that edaravone has a marked preventive effect on oxidative stress‐induced acute liver injury.

© 2003 Blackwell Publishing Asia Pty Ltd
Ethanol administration generates oxidative stress in the pancreas and liver, but fails to induce heat‐shock proteins in rats
Authors: RAKONCZAY ZOLTÁN , BOROS IMRE , JÁRMAY KATALIN , HEGYI PÉTER , LONOVICS JÁNOS , TAKÁCS TAMÁS
Published: June 2003

Background: Heat‐shock proteins (HSP) play an essential role in the sequestration and reparation of denatured cellular proteins. Because ethanol treatment can result in oxidative stress‐induced protein damage, it is possible that expression of HSP is altered after ethanol consumption. Dose–response and time‐course studies were performed to investigate whether acute and chronic intragastric ethanol administration can induce tissue damage, oxidative stress and expression of the heat‐shock proteins HSP60 and HSP72 in the pancreas and liver of male Wistar rats.

Methods: Laboratory and morphological analysis of pancreatic and liver damage were investigated. The degree of oxidative stress was assessed by measurement of the reduced glutathione content, lipid peroxidation and protein oxidation. The levels of HSP were examined by western blot analysis.

Results: Ethanol administration dose‐ and time‐dependently elevated the serum ethanol concentration and hepatic enzyme activities. Chronic ethanol treatment also resulted in morphological damage of the liver. We observed that acute and chronic ethanol consumption had markedly different effects on the oxidative parameters in the pancreas and liver. Acute ethanol administration caused oxidative stress in the liver, whereas there was no such effect in the pancreas. In contrast, chronic ethanol feeding resulted in oxidative stress in both the pancreas and the liver. Furthermore, neither acute nor chronic ethanol intake induced the synthesis of HSP, a major defense system against cellular damage in the examined organs.

Conclusion: Ethanol administration generates oxidative stress in the pancreas and liver, but fails to induce HSP in rats.

© 2003 Blackwell Publishing Asia Pty Ltd
Australian women's experiences of living with hepatitis C virus: Results from a cross‐sectional survey
Authors: GIFFORD SANDRA M. , O'BRIEN MARY L. , BAMMER GABRIELE , BANWELL CATHY , STOOVÉ MARK
Published: June 2003

Background:Of the estimated 160 000 Australians currently infected with the hepatitis C virus (HCV), over one‐third are women and very few have received clinical treatment, with most managing their illness in non‐specialist settings. Little is known about the experiences of women living with HCV in the general community. The present study provides the results from the first comprehensive social survey of Australian women's experiences of living with HCV.

Methods:In 2000, a questionnaire was administered to a largely non‐clinical sample of women with HCV (n = 462) living in the state of Victoria and the Australian Capital Territory, Australia. The questionnaire was self‐administered with a return rate of 75%. The mean age was 35 years and 83% were ‘current’ or ‘past’ injecting drug users. The mean time since diagnosis was 4.6 years (SD = 4.0) and the mean time since infection was 10.5 years (SD = 8.2).

Results:Fifty‐eight percent of women reported experiencing symptoms related to their HCV, the most common being tiredness (78%) and nausea (44%). Of the sample, 56% currently saw a doctor for their HCV, and while 52% had ever been referred to a specialist, only 17% of the total sample had ever begun interferon‐based combination or monotherapy. Forty‐eight percent of women reported experiencing less favorable treatment by a health professional because of their HCV. Age‐related self‐assessed health status was significantly lower than Australian norms, as were SF‐12 physical and mental health scores. The SF‐12 physical and mental health scores were highly correlated, indicating a significant physical and mental health burden associated with HCV.

Conclusion:The social, physical and mental health needs of women living with HCV are considerable. Most women had not accessed specialist treatment and the response of the primary health care system to HCV‐related women's health issues requires improvement.

© 2003 Blackwell Publishing Asia Pty Ltd
Utilization of hepatoprotectants within the National Health Insurance in Taiwan
Authors: CHEN TZENG‐JI , CHOU LI‐FANG , HWANG SHINN‐JANG
Published: June 2003

Background: Although the hepatoprotectants of Western medicine have centuries of history, their utilization patterns have been seldom documented. Because the National Health Insurance program in Taiwan reimburses hepatoprotectant use, we could estimate the age‐ and sex‐specific prevalence and utilization patterns of hepatoprotectants in Western medicine within the health insurance system in Taiwan.

Methods: We analyzed the outpatient prescription data of 50 000 randomly sampled insured patients in 2000. Only patients using drugs indicated for liver diseases and diagnostic codes related to liver diseases on the same visit were considered to be receiving hepatoprotectants. Drugs involved in Chinese medicine were not included.

Results: Among the valid cohort of 46 614 people, 783 (1.7%) were identified as patients with liver disease and receiving hepatoprotectants. Highest prevalence of hepatoprotectant use was 4.9% in the 60–69 years age group. Silymarin, multivitamins, methionine, ursodeoxycholic acid, and liver hydrolysate accounted for 88.8% of the 3215 prescribed items of hepatoprotectants. Patients receiving hepatoprotectants had, on average, visited the clinics more frequently than those not using hepatoprotectants (30 vs 14 times in a year, P < 0.001), and used more insurance benefits (US$1352 vs US$456, P < 0.001).

Conclusions: The frequency of use of major hepatoprotectants in Taiwan corresponded to the current modalities of treatment under discussion worldwide.

© 2003 Blackwell Publishing Asia Pty Ltd
Validation of Rome II criteria for functional gastrointestinal disorders by factor analysis of symptoms in Asian patient sample
Authors: KWAN AMBROSE CHI‐PONG , BAO TRAN NGOC , CHAKKAPHAK SURIYA , CHANG FULL‐YOUNG , KE MEI YUN , LAW NGAI MOH , LEELAKUSOLVONG SOMCHAI , LUO JIN YAN , MANAN CHUDAHMAN , PARK HYO JIN , PIYANIRAN WANICH , QURESHI AKHTAR , LONG TA , XU GUO MING , XU LIYING , YUEN HON
Published: June 2003

Background: It has been unclear as to whether the Rome II criteria could be applied to patients in the Asia region with functional gastrointestinal (GI) diseases. The aim of the present study was to determine if symptoms of Asian patients with functional gastrointestinal disorders formed groups which corresponded to the Rome II diagnostic criteria.

Methods: A modified English version of Talley's bowel disease questionnaire was developed in collaboration with various research teams in accordance with the Rome II criteria. This instrument was translated into the local languages of the following nine Asian regions: China, Hong Kong, Indonesia, Korea, Malaysia, Singapore, Taiwan, Thailand and Vietnam. From September to December 2001, newly enrolled outpatients attending 14 GI or medical clinics in these regions were invited to complete the questionnaire. From these respondents, patients with functional gastrointestinal disorders fulfilling the ‘12 weeks out of 12 months’ criteria were separated for further analysis. Principal component factor analysis with varimax rotation was used to identify symptom clusters or factors. These factors were compared with the existing classification of functional GI diseases derived from the Rome II criteria.

Results: Factor analysis of symptoms from 1012 functional GI patients supported the Rome II classification of the following groups of functional GI disorders: diarrhea‐predominant irritable bowel syndrome, functional constipation, functional dyspepsia, functional abdominal pain syndrome, functional heartburn, and functional vomiting. Functional diarrhea was combined with functional anorectal disorders, and globus merged with functional dysphagia into one factor. Some of the functional dyspepsia, abdominal bloating and belching symptoms were loaded into one factor.

Conclusions: Factor analysis of symptoms from a sample of Asian patients with functional GI disorders partially supported the use of the Rome II classification.

© 2003 Blackwell Publishing Asia Pty Ltd
Prevalence and associations of dry eye syndrome in an older population: the Blue Mountains Eye Study
Authors: Chia Ee‐Munn , Mitchell Paul , Rochtchina Elena , Lee Anne J , Maroun Rita , Wang Jie Jin
Published: June 2003

This report describes the prevalence of self‐reported dry eye syndrome and associations with systemic and ocular factors in an older Australian population. Participants of the Extension Blue Mountains Eye Study, aged 50 or older (mean age 60.8 years, n = 1174) completed a comprehensive eye examination and dry eye questionnaire. At least one dry eye symptom was reported by 57.5% of participants, with 16.6% reporting moderate to severe symptoms, more frequent in women (age‐adjusted odds ratio [OR] 1.5, 95% confidence interval [CI] 1.1−2.2). Three or more symptoms were reported by 15.3% of participants, also more frequent in women (age‐adjusted OR 1.7, CI 1.2−2.4). No age‐related trends or significant ocular associations were observed. After adjusting for age and sex, systemic factors significantly associated with dry eye syndrome included history of arthritis, asthma, gout, use of corticosteroids, antidepressants and hormone replacement therapy. In this older population, dry eye syndrome was common and has associations with female gender and systemic diseases.
Projected prevalence of age‐related cataract and cataract surgery in Australia for the years 2001 and 2021: pooled data from two population‐based surveys
Authors: Rochtchina Elena , Mukesh Bickol N , Wang Jie Jin , McCarty Cathy A , Taylor Hugh R , Mitchell Paul
Published: June 2003

This study aimed to estimate the number of Australians over 50 with cataract in the years 2001 and 2021. Data from two population‐based studies were pooled: the Blue Mountains Eye Study and Melbourne Visual Impairment Project and Australian Bureau of Statistics population projections were used. Similar definitions for the three cataract types were used in the two studies (nuclear ≥ grade 4, posterior sub­capsular ≥ 1 mm, cortical ≥ 10% lens area or ≥ 25% circumference). Combining the three types and prior surgery, it was estimated that in 2001, 1.7 million Australians had clinically significant cataract in either eye and 320 000 had previously undergone cataract surgery. It was estimated that the number of persons with cataract will rise to 2.7 million by 2021 (over 500 000 will have had cataract surgery). The number of Australians with cataract will grow by two‐thirds during the next 20 years, reflecting continued population ageing. Health care delivery systems will need to develop methods to handle this increased workload.
Prevalence of undetected ocular conditions in a pilot sample of school children
Authors: Rose Kathryn , Younan Christine , Morgan Ian , Mitchell Paul
Published: June 2003

Parents of 134 children (age 5−18 years; 84% participation) attending a private school gave informed consent for their child's participation in a pilot study to demonstrate the feasibility and estimate sample size for a larger study of myopia prevalence, the Sydney Myopia Study. LogMAR visual acuity and other ocular assessments, including cycloplegic autorefraction (tropicamide 1%) and examination of the media and fundus, were performed. The prevalence of significant ocular conditions was 28.2%. Eleven children (8.4%) wore glasses. Five were referred for a change in their correction. Previously undetected ocular conditions (19.8%) included one child with ocular pathology and four children with strabismus. Uncorrected refractive error (16.8%) was the most common reason for referral and was more predominant in the senior students (25%), corresponding with an age‐related shift in mean spherical equivalent refraction towards myopia (less than 7 years: +0.40 ± 0.60 D; more than 15 years: −1.15 ± 1.18 D). Three senior students were classified as having socially significant correctable vision impairment. These findings suggest that reliance on ad hoc referrals could result in delayed referral and that vision screening in both early and later school years may be desirable.
Müller cells express the neuronal progenitor cell marker nestin in both differentiated and undifferentiated human foetal retina
Authors: Walcott James C , Provis Jan M
Published: June 2003

Tritiated thymidine studies suggest that Müller cells are the last cells born in the retina, although several authors describe Müller cells throughout the retina from very early ages. In this study immunohistochemistry was used to identify progenitor and Müller cells in human foetal retina. Antibodies to nestin (an intermediate filament protein expressed by neural progenitor cells), vimentin, cellular retinaldehyde binding protein (CRALBP) and glutamate and aspartate transporter (GLAST), which are each expressed by Müller cells, were used in combination with anti‐Ki67 to identify proliferating cells. By definition, Ki67‐positive proliferating cells were present in undifferentiated retina, but not in differentiated retina. Nestin‐immunoreactive (IR) cells colocalized with vimentin throughout the retina. CRALBP‐IR was detected in differentiated retina and in some proliferating cells. GLAST‐IR cells were present only within the differentiated region. Nestin, vimentin and CRALBP each colocalized with mitotic Ki67‐IR cells, suggesting that in foetal retina Müller cells and retinal progenitor cells are overlapping populations and that Müller cells are end‐stage progenitor cells.
Is there an auditory−visual flash‐lag effect?
Authors: Hine Trevor J , White Amanda MV , Chappell Mark
Published: June 2003

A flash adjacent to the path of a moving object appears behind the moving object: the ‘flash‐lag effect’. We sought to test the flash‐lag effect with a ‘click’ instead of a flash: a white triangle horizontally traversed the screen at a constant 12°/s passing through a fixation cross in the presence of a quiet click. The subject judged whether the click occurred before or after the triangle passed through the cross. To be perceived as co‐instantaneous events, the click had to be presented 127 ms after the moving triangle reached the cross (a ‘click‐lead’ effect, providing falsification of predictive accounts of the flash‐lag effect), as opposed to a standard flash‐lag effect condition where a flashed triangle replaced the click and had to appear 60 ms before the moving triangle to appear aligned. With the auditory versus visual processing speed advantage considered, the neural time required to calculate a moving object's position is constant, independent of the modality of the flag.
Sensitivity to the acceleration of looming stimuli
Authors: Trewhella James , Edwards Mark , Ibbotson Michael R
Published: June 2003

The aim of this study was to determine if observers could discriminate between looming stimuli simulating targets approaching the observers at either constant or non‐constant speeds. Discrimination between accelerating and constant‐speed approaches improved after 70−90 trials for accelerations >2 m/s2. For lower accelerations the ability to discriminate was poor regardless of the trial number. Following the learning phase, observers were able to identify accelerating targets from constant‐speed approaches fairly consistently at performance levels of 70−75% for accelerations as low as 4 m/s2 and at 80−96% for accelerations of 6−14 m/s2. Observers’ accuracy in identifying decelerating from constant‐speed targets did not increase as a function of increasing deceleration. In fact, observers had a slight bias to select the constant‐speed stimulus as being the decelerating stimulus. In summary, the sensitivity to acceleration for simulated motion in depth is poor, but increases as acceleration increases and sensitivity to acceleration is far greater than for deceleration.
Light rise of the human electroretinogram is normal in retinitis pigmentosa
Authors: Vaegan  , Lowry Brian , Beaumont Paul
Published: June 2003

Aim: To determine if the electroretinogram (ERG) light rise is reduced below normal in patients with retinitis pigmentosa (RP) and whether it is greater in patients with smaller ERG.

Methods: Both eyes of 31 normal subjects and 59 subjects with RP had photopic ERGs on ISCEV standard and brighter backgrounds, before and after dark adaptation. Recordings <2.5 µV were excluded.

Results: Ratios of amplitudes before and after dark adaptation varied little. The b‐wave averaged 1.88 (SD 0.41) in normal subjects and 1.66 (SD 0.62) in RP subjects, and a‐waves averaged 1.44 (SD 0.42) and 1.31 (SD 0.73), respectively. None of eight t−tests were significant (<2.4). There was a positive (not negative) correlation between RP subjects’ initial b‐wave amplitude and light rise but not for a‐waves. A‐wave light rises were smaller.

Conclusion: Retinitis pigmentosa does not reduce the light rise of recordable ERG. The light rise of the ERG is larger in those RP subjects with larger initial b‐waves. This confirms previous findings. The difference between a‐ and b‐waves in RP suggests post‐receptoral processes are involved.
Oral and intravenous steroids in giant cell arteritis
Authors: Chan Colin CK , O'Day Justin
Published: June 2003

Giant cell arteritis can result in devastating visual loss. Treatment with steroids does result in visual recovery in some patients but the exact percentage is unknown. Intravenous megadose steroids appear to offer some advantage over oral steroids presumably through non‐genomic effects, which manifest at doses of 500 mg or more. Side‐effects are more likely in the elderly especially those with renal and cardiac co‐morbidities. The authors’ current recommendation is that intravenous steroids should be given to patients with established visual loss or amaurosis fugax.
Supplementation of fexofenadine therapy with nedocromil sodium 2% ophthalmic solution to treat ocular symptoms of seasonal allergic conjunctivitis
Authors: Alexander Michael , Patel Piyush , Allegro Stacey , Hicks Angela
Published: June 2003

Purpose: Ocular symptoms are often under‐treated in patients with allergic rhinoconjunctivitis. The efficacy of fexofenadine hydrochloride 60 mg capsules supplemented with nedocromil sodium 2% ophthalmic solution was evaluated to determine the optimal drug regimen for control of ocular allergic symptoms.

Methods: In this 5‐week, open‐label, randomized, multicentre comparative study, 89 patients with documented ragweed pollen allergy received fexofenadine b.i.d. with nedocromil rescue, fexofenadine q.d. with nedocromil b.i.d., or fexofenadine rescue with nedocromil b.i.d. during the ragweed pollen season.

Results: For all regimens, mean symptom severity scores for itching, burning, tearing, redness, grittiness, discharge, light sensitivity and swelling improved significantly (P < 0.003). Similarly, all groups experienced significant (P < 0.02) improvement in all clinical signs: erythema, oedema, discharge, conjunctival injection and conjunctivitis, as well as quality‐of‐life scores (P < 0.0001). All regimens reduced overall symptom severity scores after 5 min (P < 0.05) with relief persisting over 12 h (P < 0.03). Improvements in mean symptoms, signs and quality‐of‐life scores were similar among the treatment groups as were onset and duration of action even though patients in two of the three study arms were taking one‐half or less of the recommended fexofenadine dosage. Patients and physicians judged the regimens containing lower fexofenadine dosages (with nedocromil b.i.d.) to be more effective overall than the regimen containing the highest fexo­fenadine dosage (with nedocromil as rescue only).

Conclusions: Supplementation of oral fexofenadine therapy with nedocromil sodium 2% ophthalmic solution relieves ocular symptoms of seasonal allergic rhinoconjunctivitis, allowing control of rhinal symptoms with half the recommended dosage of fexofenadine.
Trends in cataract surgery and postoperative endophthalmitis in Western Australia (1980−1998): the Endophthalmitis Population Study of Western Australia
Authors: Semmens James B , Li Jianghong , Morlet Nigel , Ng Jonathon
Published: June 2003

Objectives: Postoperative endophthalmitis results from an intraocular infection and usually occurs following cataract surgery. It has significant morbidity and causes severe visual impairment or blindness of the eye. The aim of this study was to assess the trends in the incidence rates of cataract surgery and postoperative endophthalmitis in Western Australia for the period 1980−1998.

Methods: The Western Australian Record Linkage Project was used to link the morbidity records for all patients treated for cataract surgery in Western Australia in 1980−1998. Patient records were selected using the international classification for diagnosis and procedure codes pertaining to cataract surgery and postoperative endophthalmitis. All cases of postoperative endophthalmitis were validated by case‐note review. The separate databases of the Royal Perth Hospital microbiology and anaesthetic departments as well as the vitreo‐retinal surgeon logbooks were used to cross‐validate the hospital morbidity database. Trends in the incidence rates of cataract surgery and postoperative endophthalmitis were assessed by Poisson regression.

Results: There were 94 653 cataract procedures performed for 63 007 patients in Western Australia during the 19‐year period. The majority (88%) of cataract procedures performed were in patients aged 60 years or older. Postoperative endophthalmitis developed in 188 patients, with serious visual impairment occurring in 70.6% of patients for whom visual acuity data was available at presentation. The incidence rate of cataract surgery increased more than three‐fold from 1981 (102 per 100 000 person years) to 1998 (345 per 100 000 person years), mainly due to the increase in extracapsular cataract extraction during the 1980s and phacoemulsification extraction from 1990 onwards. In contrast, the average annual incidence rate of postoperative endophthalmitis remained relatively unchanged at around 2 per 1000 cataract procedures over the same period.

Conclusion: Cataract surgery is becoming more prevalent in the elderly as the life expectancy of the population increases. There has been a dramatic shift in surgical practice during the last 30 years with small‐incision phacoemulsification being the predominant method of intervention used since 1990. Despite changes in surgical practice the incidence rate of postoperative endophthalmitis has remained the same.
Phylogenetic relationships of North American nymphophiline gastropods based on mitochondrial DNA sequences
Authors: Hershler Robert , Liu Hsiu‐Ping , Thompson Fred G.
Published: June 2003

Phylogenetic relationships of 36 nymphophiline species representing 10 genera were inferred from mtCOI sequence data and compared to recent morphology‐based classifications of this group. Parsimony and maximum likelihood analyses of the molecular data set suggested monophyly of the North American nymphophilines and a sister or otherwise close relationship between this fauna and a European species assigned to the subfamily. Results also supported a previously hypothesized close relationship between the predominantly freshwater nymphophilines and the brackish‐water genus Hydrobia. Our analyses resolved a North American nymphophiline subclade composed of Floridobia, Nymphophilus, and Pyrgulopsis, and depicted the remaining North American genera (Cincinnatia, Marstonia, Notogillia, Rhapinema, Spilochlamys, Stiobia) as either a monophyletic or paraphyletic group. Two of the large North American genera (Floridobia, Marstonia) were supported as monophyletic groups while monophyly of Pyrgulopsis, a western North American group containing > 100 species, was equivocal. North American nymphophiline phylogeny implies that vicariance of eastern and western North American groups was followed by a secondary invasion of eastern coastal areas from the west. We attribute this to dispersal of salt‐tolerant progenitors along the Gulf of Mexico coast
Phylogeny of Vestimentifera (Siboglinidae, Annelida) inferred from morphology
Authors: Schulze Anja
Published: June 2003

Vestimentifera, formerly considered a phylum, are here included in the annelid clade Siboglinidae which also encompasses Frenulata and Sclerolinum. All Siboglinidae inhabit reducing habitats, mostly in the deep sea. Vestimentifera are known from hydrothermal vents and cold seeps. Cladistic analyses of vestimentiferan relationships are performed on three levels: (1) among the vestimentiferan species, (2) among the reconstructed ancestral vestimentiferan and other siboglinids and (3) on the level of the families included in the annelidan clade Sabellida. The monophyly of vestimentiferans is confirmed in all analyses. A group of exclusively vent‐inhabiting species forms a derived monophyletic clade. The sister group to the vent clade is the Escarpia complex. Lamellibrachia appears to be paraphyletic. Except for the paraphyly of Lamellibrachia, the reconstructed pattern agrees with the molecular phylogeny based on cytochrome c oxidase subunit I. Ancient ridge systems can be invoked to explain modern day geographical distributions. The Pacific Kula Ridge that spanned the Pacific in an east–west direction during the Early Tertiary, may have been a pathway for the ancestor of the vent clade to reach the eastern Pacific. The biogeography is consistent with the recent divergence of Vestimentifera as inferred from molecular data. The reconstructed phylogeny of the Siboglinidae supports the monophyly of the Frenulata and within those, the Thecanephria and Athecanephria. In contrast to molecular and other morphological analyses, Sclerolinum appears as the sister group to the Frenulata. The family level analysis supports the sister group relationship of the Siboglinidae to a clade formed by Sabellariidae, Sabellidae and Serpulidae. Hypothesized homologies of the vestimentiferan obturaculum and vestimentum to structures in related taxa need further investigation.