bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of a gastric mucosal protecting agent in rats with liver cirrhosis
Authors: KURIHARA TAKESHI , AKIMOTO MASUMI , KUROKAWA KAORI , ISHIGURO HISATAKA , NIIMI AKIKO , MAEDA ATUSHI , SHIGEMOTO MUTSUO , YAMASHITA KATSUKO , YOKOYAMA IZUMI
Published: March 2008

Male Sprague–Dawley rats were fed a 0.1% ethionine‐added choline‐deficient diet for 8 weeks to induce liver cirrhosis. At the same time 100 mg/kg/day teprenone was administered orally in order to evaluate its effects on the liver and gastric mucosal blood flow. Blood flow increased not only in gastric mucosa but also in liver tissues in the teprenone group. Serum transaminase levels and histopathologic findings of the liver also improved. These findings suggest that teprenone alleviates hepatocellular injuries. This effect may be partly attributable to cytoprotective effects of the catenoid isoprenoid moiety of teprenone on liver cells.
Relationship between fatty liver, alanine aminotransferase, HBsAg and hepatitis C virus
Authors: CHANG W‐Y. , CHEN C‐J. , LU S‐N. , YOU S‐L. , CHUANG W‐L. , CHEN S‐C. , SU W‐P. , WANG L‐Y. , HSIEH M‐Y. , WU M‐M. , TAI T‐Y.
Published: March 2008

A community health survey of 923 residents aged 30 years or more was performed in Putai Township of Taiwan. To elucidate the relationships between hepatitis C virus (HCV) and surrogate tests for non‐A, non‐B hepatitis in hyperendemic areas of hepatitis B virus (HBV) serum levels of alanine aminotransferase (ALT), triglycerides, cholesterol, hepatitis B surface antigen (HBsAg) and antibody to HCV (anti‐HCV) were examined. Glucose tolerance tests and the history of diabetes treatment were used to define the diabetes status. Fatty liver was diagnosed by sonography. The prevalence of anti‐HCV was 2.6% (95% confidence interval, 1.6–3.6%). Elevated ALT and fatty liver were significantly associated with anti‐HCV in univariate analysis. Anti‐HCV was not an associated factor for fatty liver after adjusting for serum triglycerides and cholesterol, sex, body mass index and diabetes status through multiple logistic regression. However elevated ALT was still associated with anti‐HCV after adjusting for serum triglycerides, sex, body mass index, HBsAg and age through multiple linear regression. The anti‐HCV prevalence was similar between HBsAg‐positive and negative subjects. Aggregation of HCV infection was found among spouses. It was concluded that elevated ALT and intimate contact with HCV carriers might be associated factors for HCV infection, and that HBV infection and fatty liver were not related to HCV infection in Taiwan.
Role of endogenous platelet‐activating factor (PAF) in endotoxin‐induced portal hypertension in rats
Authors: KITAGAWA S. , KUBOTA Y. , YAMAGUCHI T. , FUJIMURA K. , BINNAKA T. , TANI K. , OGURA M. , MIZUNO T. , INOUE K.
Published: March 2008

To determine the role of platelet‐activating factor (PAF) in endotoxin‐induced portal hypertension, we performed continuous recording of both blood pressure (BP) and portal venous pressure (PVP) in rats following the administration of intravenous PAF (25 ng/kg), intraportal PAF (25 ng/kg), intraportal endotoxin (2 mg/kg), and intraportal endotoxin (2 mg/kg) for 1 min subsequent to pretreatment with a specific PAF‐antagonist (CV‐6209, 1 mg/kg, i.v.). Basal resting values of both BP (102.3 ± 9.3 mmHg) and PVP (7.7 ± 1.2 mmHg) fell rapidly after intravenous infusion of PAF (BP: 36.7 ± 5.8 mmHg; PVP: 5.7 ± 0.8 mmHg) and followed by gradual return. Intraportal PAF infusion elicited a rapid but less severe depression of BP (57.2 ± 9.4 mmHg) as compared with intravenous PAF infusion, whereas PVP was increased transiently around 4 min after treatment (11.0 ± 5.3 mmHg). A similar degree of PVP elevation (10.7 ± 2.0 mmHg) was observed between 8 and 20 min after intraportal administration of endotoxin. Depression of BP was initiated 12 min after endotoxin administration but was not severe (76.6 ± 12.8 mmHg). CV‐6209 significantly alleviated the endotoxin‐induced elevation of PVP and completely inhibited the hypotension. These observations suggest that: (i) PAF‐induced elevation of PVP is a direct response of the liver to PAF; and (ii) endogenous PAF plays an important role in the endotoxin‐induced portal hypertension.
Primary hypertrophic pyloric stenosis in the adult
Authors: IKENAGA T. , HONMYO U. , TAKANO S. , MURAKAMI A. , HARADA K. , MIZUMOTO S. , YOSHINAKA I. , HIRATA T. , MAEDA M. , KIYOHARA H. , MISUMI A.
Published: March 2008

A case is reported of a 55 year old male patient with primary hypertrophic pyloric stenosis who was subjected to distal gastrectomy. Adult hypertrophic pyloric stenosis is an uncommon condition which is usually misdiagnosed as carcinoma of the antrum. It is a benign disease resulting from hypertrophy of the circular fibres of the pyloric canal and is recognizable radiologically by narrowing and elongation of the pyloric canal and endoscopically by appearances resembling those of the cervix. This condition is probably congenital although aetiology has not been established. In the absence of symptoms, no clinical treatment is required. However, surgical intervention is advocated, when stenosis gives rise to symptoms, there is a suspicion of malignancy, or the ulceration due to the disease. Distal gastrectomy with gastroduodenostomy is the treatment of choice.
Treatment of peptic ulcer disease with furazolidone
Authors: ZHENG Z‐T. , WANG Y‐B.
Published: March 2008

Furazolidone (FZ) has been used in China as a treatment of peptic ulcer disease for about 20 years. Clinical and experimental studies suggest that it has good short‐term and long‐term effects on both human and animal ulcers. The ulcer healing rate is related to the dosage and course of treatment. The healing rate of a high dose, 2 week course is about 70–75% and the relapse rate after 3 years is 9.5%. The adverse reactions to FZ are not severe, and are well tolerated in most patients. However the mutagenic studies of several biological systems indicate that it has a mutagenic effect, but the mutagenic and carcinogenic effects on humans and animals remain questionable, because FZ has been biotransformed into other metabolites. The mechanisms of FZ in the treatment of peptic ulcer disease are not fully understood, perhaps partly due to the monoamine oxidase (MAO) inhibitory reaction and partly to the antibacterial activity to Helicobacter pylori (HP). The long‐term effects of FZ are still not clear.
BOOK REVIEW
Authors: Chapuis Pierre , McDonald Charles
Published: March 2008

Lasers in Gastroenterology. Edited by Neville Krasner. London: Chapman and Hall
A meta‐analysis comparing the efficacy of omeprazole with H2‐receptor antagonists for acute treatment of duodenal ulcer in Asian patients
Authors: BAMBERG P. , CASWELL C. M. , FRAME M. H. , LAM S. K. , WONG E. C. K.
Published: March 2008

A meta‐analysis was performed on pooled data from five large double‐blind studies (a total of 1057 patients), which were conducted in Asia to compare the effects of omeprazole with H2‐receptor antagonists (H2‐RA) in duodenal ulcer. As each study followed the same protocol and data evaluation procedures, a detailed analysis of ulcer healing, symptom relief and influence of prognostic factors across the data was possible. Patients received omeprazole 20 mg om or standard doses of H2‐RA for a minimum of 2 and a maximum of 4 weeks, depending on healing (as verified by endoscopy). All efficacy analyses were based on per protocol data. The mean healing rates at 2 weeks were 72% for omeprazole and 42% for H2‐RA (difference 30%; 95% CI: 24–36%; P< 0.0001) and at 4 weeks were 96% for omeprazole and 83% for H2‐RA (difference 13%; 95% CI: 10–17%; P< 0.0001). In addition to treatment, ulcer size had a significant influence on healing, with large ulcers (diameter>10 mm) taking longer to heal than small ulcers. There was no significant influence of smoking and alcohol drinking on ulcer healing. Patients on omeprazole experienced significantly less epigastric pain after 2 weeks than those on H2‐RA, 79% of them being completely symptom‐free on omeprazole compared with 65% on H2‐RA. The incidence of adverse events was approximately 5% on each treatment and profiles were similar for each drug. It is concluded that omeprazole, even in the presence of adverse prognostic influences, results in significantly better healing of duodenal ulcer and relief from symptoms than H2‐RA.
Clinical significance of the serum levels of the 7S domain of type IV collagen in patients with primary biliary cirrhosis
Authors: FUKUTOMI T. , SAKAMOTO S. , ISOBE H. , SAKAI H. , MASUMOTO A. , NAWATA H.
Published: March 2008

The serum levels of the 7S domain of type IV collagen were measured with a radio‐immunoassay in 42 patients with primary biliary cirrhosis (asymptomatic: n= 28; symptomatic: n= 14), 10 patients with chronic active hepatitis, 10 patients with liver cirrhosis and 10 healthy female controls. Serum levels of the 7S domain of type IV collagen were: 4.28 ng/mL (3.88–4.72 ng/mL; mean and range of mean ± s.d.) in healthy controls; 5.97 ng/mL (5.07–7.02 ng/mL) in patients with chronic active hepatitis; 8.23 ng/mL (6.40–10.58 ng/mL) in patients with liver cirrhosis; and 6.79 ng/mL (4.76–9.67 ng/mL) in patients with primary biliary cirrhosis. Patients with liver cirrhosis and primary biliary cirrhosis had higher levels of serum 7S domain of type IV collagen than healthy controls (P < 0.001, respectively). Serum levels of the 7S domain of type IV collagen in patients with asymptomatic primary biliary cirrhosis, 5.83 ng/mL (4.55–7.48 ng/mL) were significantly lower than those in symptomatic primary biliary cirrhosis, 9.18 ng/mL (6.53–12.91 ng/mL; P<0.001). Serum levels of the 7S domain of type IV collagen increased significantly along with advancement of the histological stages of primary biliary cirrhosis. Serum levels of the 7S domain of type IV collagen in the paired sera of eight patients with asymptomatic primary biliary cirrhosis (mean interval 30 months, range 12–48 months) showed significant rises during the intervals (P < 0.05), while serum levels of albumin and total bilirubin did not change significantly during these intervals. It is concluded that serum levels of the 7S domain of type IV collagen were good markers of fibrosis and may be useful for evaluation of the clinical status in the patients with primary biliary cirrhosis.
16, 16‐dimethyl prostaglandin E2 modulates aflatoxin B1‐induced injury of rat hepatocytes in primary culture: Possible role of cAMP
Authors: BERGASA N. V. , VERGALLA J. , COLE K. E. , WAHL L. M. , JONES E. A.
Published: March 2008

The hepatocellular cytoprotective effects of 16, 16‐dimethyl prostaglandin E2 (dmPGE2), ananalogue of PGE2, were investigated using primary cultures of rat hepatocytes and aflatoxin B1 as the hepatotoxin. Lactic dehydrogenase (LDH) release by hepatocytes was used as an index of hepatotoxicity. When aflatoxin‐treated hepatocytes were co‐cultured with 16, 16‐dmPGE2 (0.01–0.5 μg/mL) LDH release was significantly reduced and ultrastructural changes of hepatocellular injury were markedly diminished. The magnitude of the cytoprotective effect was not dependent on the concentration of the prostaglandin over the range tested. A significant cytoprotective effect was also induced when hepatocellular cyclic AMP (cAMP) levels were increased by the addition of dibutyl‐cAMP. In contrast to 16, 16‐dmPGE2, PGF2α Tromethamine, an analogue of PGF2α, which does not stimulate cAMP, induced insignificant changes in cytoprotection. These findings indicate that only a low concentration of 16, 16‐dmPGE2 (? 0.01 μg/mL) is necessary to induce a maximal hepatocellular cytoprotective effect and suggest that this effect may be dependent on activation of cAMP.
Alpha‐fetoprotein in patients with hepatocellular carcinoma after transcatheter arterial embolization
Authors: HSIEH M‐Y. , LU S‐N. , WANG L‐Y. , LIU T‐Y. , SU W‐P. , LIN Z‐Y. , CHUANG W‐L. , CHEN S‐C. , CHANG W‐Y.
Published: March 2008

To assess the usefulness of α‐fetoprotein (AFP) in monitoring treatment effects of transcatheter arterial embolization (TAE) in hepatocellular carcinoma (HCC) patients, a total of 31 sets of AFP levels after TAE in 21 HCC patients were analysed by linear regression between logarithmic AFP levels and days. Eleven sets of AFP data with poor linear declination were accompanied with poor TAE results except in one patient who had chronic hepatitis with acute exacerbations. Twenty sets of data with good linear declination in the first month after TAE indicated good TAE results. Seven of them showed no evidence of tumour recurrence nor elevated AFP levels within a follow‐up of 6 months. The mean, standard deviation and range of half‐lives of AFP in the non‐recurrent group were 5.0, 1.6 and 2.9–7.2 days, respectively. The others experienced late tumour recurrence that was detected by rebound of AFP levels except one who had another non‐AFP‐secreting HCC. Thus, the results might be used as a reference in monitoring the treatment effects of TAE and the timing selection of repeated TAE.
Ursodeoxycholic acid in the treatment of primary biliary cirrhosis: A short‐term, randomized, double‐blind controlled, cross‐over study with long‐term follow up
Authors: HWANG S‐J. , CHAN C‐Y. , LEE S‐D. , WU J‐C. , TSAY S‐H. , LO K‐J.
Published: March 2008

Abstract In order to evaluate the efficacy of ursodeoxycholic acid (UDCA) in the treatment of Chinese patients with primary biliary cirrhosis, a short‐term, randomized, double‐blind controlled, cross‐over study was done with long‐term follow up. In the first part of the study, 12 patients were randomly chosen to receive either UDCA 600 mg/day for 3 months followed by a placebo for 3 months or a placebo for 3 months followed by UDCA for 3 months. The clinical symptoms of pruritus improved when the patients were receiving UDCA but became worse when receiving a placebo. Mean serum levels of alkaline phosphatase (ALPase), γ‐glutamyl transferase (γ‐GT), total bilirubin, cholesterol, alanine aminotransferase (ALT) and aspartate aminotransferase all decreased below the baseline values when receiving UDCA treatment and all increased above the baseline values when receiving the placebo. The difference was statistically significant. In the second part of the study, 19 patients received long‐term UDCA treatment (mean 20 months). The clinical symptoms of pruritus improved in 90% of the pruritic patients. Serum levels of ALPase, γ‐GT and ALT fell significantly from the pretreatment values 6, 12 and from the mean 20 months after UDCA treatment. Serum levels of total bilirubin fell significantly 6 and 12 months after UDCA treatment but did not reach statistical significance at the last follow up. No patient lost antimitochondrial antibody and elevated immunoglobulin levels did not improve significantly, but the Mayo clinical risk score improved significantly after long‐term UDCA treatment. Treatment failure was noted in three patients: two patients in the histologic stage IV with clinical overt jaundice died of complications 4 and 5 months after UDCA treatment, respectively; another patient underwent a liver transplantation 1 year after the UDCA treatment due to progressive jaundice. No severe adverse reaction was noted during UDCA treatment, only one patient suffered from a mild allergic reaction. In conclusion, UDCA is safe and effective in the treatment of Chinese PBC patients in stages I—III.
The interactive role of mucosal T lymphocytes in intestinal growth, development and enteropathy
Authors: MARSH MICHAEL N. , CUMMINS ADRIAN G.
Published: March 2008

Abstract Over the past 15–20 years, research has progressively focused on the mucosal T cell as the central factor in the initiation of physiological or pathological changes, first in the growth and maturation of the early (postnatal) intestine, and second in adult‐type enteropathies resulting from sensitivity to either food or pathogen‐derived antigens. T cell‐mediated events may be measured, for example, in terms of specific immunopathologic patterns of change and injury, such as type 1 (lymphocyte infiltration), type 2 (crypt hyperplasia) and type 3 (flat‐destructive), which can be recognized and quantitated microscopically; by determination of lymphocyte reactivity through secretion of interleukin‐2 receptors (IL‐2R) into plasma or expression by mucosal lymphocytes; by quantitation of lymphocyte subsets emigrating into inflamed tissues by immunoperoxidase‐labelled monoclonal antibodies; or by the determination of T cell receptor polymorphisms. Alterations in intestinal growth, structure and function at weaning are likely to be T cell‐mediated as they are analogous to the same type 1/2 lesions that reflect modulation of adult mucosal architecture in food and parasite‐induced hypersensitivity reactions. Enteropathies associated with HIV infection and T cell deficiency display a milder degree of villous flattening and impaired crypt hyperplasia than that typical of gluten‐sensitivity, suggesting a reversion to lesser degrees of mucosal pathology (type 1/2). Clearly more information will accrue; meanwhile the remarks in this brief survey should provide a firm basis whereby clinician and scientist can meet, and together recognize and further dissect the modulatory effect of T lymphocytes on mucosal structure and function.
Helicobacter pylori and gastric cancer
Authors: NOMURA A. , STEMMERMANN G. N.
Published: March 2008

Abstract This review focuses on the similarities between the epidemiology of gastric cancer and the epidemiology of Helicobacter pylori. Their demographic patterns and the results of studies regarding familial and environmental risk factors are described. The association of gastric cancer and H. pylori infection with both gastric ulcer and chronic atrophic gastritis is also characterized and the possibility that a H. pylori infection could lead to gastric cancer is discussed.
Diagnosis of gastric adenoma versus early gastric cancer by Bromodeoxyuridine immunohistochemistry from gastric biopsy specimen
Authors: MIWA HIROTO , WADA RYO , ABE HIROSHI , OHKURA RYUICHI , YANG SUNG WOOK , WATANABE HARUO , OGIHARA TATSUO , HAMADA TSUTOMU , SATO NOBUHIRO
Published: March 2008

Differentiation between gastric adenomas and type IIa early gastric cancer by macroscopic and histologic examinations is often difficult. This study has shown that there are differences in the distribution of S‐phase cells in these two types of tumour, and these differences can be exploited to differentiate between them. The distribution of S‐phase cells was assessed by Bromodeoxyuridine (BrdU) immunohistochemistry using an in vitro BrdU‐labelling method. Biopsy specimens were obtained from 27 lesions (12 adenomas and 15 type IIa early gastric cancers), and the distributions of BrdU‐labelled cells in the tumour thickness as well as in the superficial layer of the tumour were determined. Significant difference was seen in the labelling of the two tumour types with regard to both these parameters. Using the criteria of BrdU immunohistochemisty, the accuracy of differentiation between gastric adenomas and cancers was 88.9%. Therefore, it is concluded in this study that in vitro BrdU labelling is a useful method of diagnosing gastric adenomas and cancers.
Dipeptidyl peptidase IV is down‐regulated in rat hepatoma cells at the mRNA level
Authors: McCAUGHAN G. W. , SIAH C‐L. , ABBOTT C. , WICKSON J. , BALLESTEROS M. , BISHOP G. A.
Published: March 2008

Dipeptidyl peptidase IV (DPP‐IV) is a cell surface ectopeptidase that has been implicated in cell‐extracellular matrix interactions, lymphocyte growth and the regulation of biological peptides. Previous studies have shown that immunostaining for DPP‐IV and DPP‐IV enzyme levels is decreased in hepatoma cells and levels have been correlated with the ability of such cells to adhere in vitro. The aim of this paper was to measure DPP‐IV enzyme levels in rat hepatoma cells and to examine whether changes were associated with alterations at the mRNA level. The results indicate a greater than 90% reduction in DPP‐IV enzyme levels in two rat hepatoma cell lines, HTC and H35, compared with rat hepatocytes. Enzyme levels of the control enzyme leucine aminopeptidase (LAP) were not decreased. mRNA studies indicated that these changes were associated with similar reductions in rat DPP‐IV mRNA. It is concluded that DPP‐IV is markedly reduced at the protein, enzyme and mRNA levels in rat hepatoma cells. The significance of these changes is unclear but may lead to decreased extracellular matrix interactions by such cells.
Selection of patients for liver transplantation
Authors: McCAUGHAN GEOFFREY W.
Published: March 2008

Liver transplantation is now available world‐wide. It plays an important role in the treatment of irreversible acute and chronic liver disease (CLD). Selection of patients for liver transplantation is subject to many factors including economic, cultural, availability of donor organs and degree of illness. This article looks at seven general considerations for receipients of liver transplantation. As well, disease‐specific criteria are investigated and include such areas as cirrhosis due to chronic hepatitis B virus (HBV), hepatitis C virus (HCV) positive cirrhosis, fulminant hepatic failure (FHF), malignancy, alcoholic liver disease (ALD), metabolic conditions and Budd–Chiari syndrome. If hepatic transplantation surivival rates were to approach 95%, the relative risk ratio between transplantation and conservative therapy would increase. At present an 80% 1–5 year survival rate following transplantation should be expected.
Hepatic‐pericardio‐phrenic collateral (natural shunt) in a patient with Budd‐Chiari syndrome
Authors: DILAWARI J. B. , NAGPAL N. , CHAWLA Y. K. , KAUR U. , VERMA J. , BALI H. , DAS K. M. , SURI S.
Published: March 2008

Hepatic venous outflow tract obstruction, Budd‐Chiari syndrome (BCS), leads to portal hypertension and to the development of collaterals that bypass the obstruction. Described here is a BCS patient with an unusually large transdiaphragmatic collateral between the left hepatic and left innominate veins, which decompressed the oesophageal varices. This has not been reported earlier in the literature.
The protective effect of pyrroloquinoline quinone and its derivatives against carbon tetrachloride‐induced liver injury of rats
Authors: TSUCHIDA TOSHIHIRO , YASUYAMA TOSHIFUMI , HIGUCHI KIYOHIRO , WATANABE AKIHARU , URAKAMI TEIJI , AKAIKE TAKAAKI , SATO KEIZO , MAEDA HIROSHI
Published: March 2008

Pyrroloquinoline quinone (PQQ) and its derivative, oxazo pyrroloquinoline (OPQ‐G), protected rats from experimental liver injury induced by carbon tetrachloride (CCl4) in vivo. This effect was observed after an intraperitoneal injection of 5 mg/kg PQQ or OPQ‐G, which was given twice, 10 min and 1 h before CCl4 administration. Pyrroloquinoline quinone protected primary cultured rat hepatocytes from CCl4 toxicity in vitro. This protection was most effective at a concentration of 3 μmol/L PQQ. Pyrroloquinoline quinone derivatives (oxazo pyrroloquinoline, methyl‐thioethyl oxazo pyrroloquinoline and PQQ‐allylester) also protected the hepatocytes from CCl4 toxicity. Pyrroloquinoline quinone and its derivatives inhibited the lucigenin‐enhanced chemiluminescence from isolated hepatocytes initiated by CCl4. These results suggest that eliminating free radicals is one of the protective mechanisms of PQQ and its derivatives against CCl4‐induced liver injury.
Pertussis toxin‐induced redistribution of cortical actomyosin and inhibition of phagocytosis in rat Kupffer cells
Authors: HIROSE MIYOKO , WATANABE SUMIO , UENO TAKASHI , KITAMI NORIYUKI , SATO NOBUHIRO
Published: March 2008

The mechanism of phagocytosis by Kupffer cells has been shown to be related to the Ca2+ ‐calmodulin and the actomyosin systems. However the role of the transmembrane signal transmitter, G‐protein, is still unknown. In this study, a quantitative evaluation of phagocytosis by Kupffer cells of rats in culture and the effects of pertussis toxin, a G‐protein inhibitor, on the phagocytic function and morphology of Kupffer cells were investigated. Pertussis toxin inhibited phagocytosis of Kupffer cells with dysfunction of the actomyosin system. The inhibitory effects of pertussis toxin suggest that G‐protein may be involved in the mechanism of transmembrane signalling in phagocytosis by Kupffer cells.
Does propranolol maintain post‐sclerotherapy variceal obliteration? A prospective randomized study
Authors: LO GIN‐HO , LAI KWOK‐HUNG , LEE SHOU‐DONG , TSAI YANG‐TE , LO KWANG‐JUEI
Published: March 2008

Variceal recurrence and rebleeding are common after initial obliteration by injection sclerotherapy. To investigate whether propranolol can maintain variceal obliteration by sclerotherapy, 59 patients with oesophageal variceal bleeding after sclerotherapy were enrolled. Patients were allocated to propranolol treatment (30 patients) or served as controls (29 patients). After a mean follow up of 2 years and 4 months, 53 patients completed the study. Fifty‐eight per cent of the propranolol group versus 77% of the control group experienced recurrent varices (P= 0.20). Fifteen per cent of the propranolol group versus 11% of the control group developed cardiac varices. Recurrent variceal bleeding was encountered in 27% of the propranolol group and 19% of the control group. Three patients in the propranolol group, compared with two patients in the control group, died of massive variceal bleeding. Eighty per cent of them bled from cardiac varices. Both groups had similar survival rates. We therefore concluded that the use of propranolol after variceal obliteration by sclerotherapy can neither prevent oesophagogastric variceal recurrence nor prevent further rebleeding.
Epidemiology of precancerous gastric lesions
Authors: YOU WEI‐CHENG , CHANG YUN‐SHENG
Published: March 2008

Research over the past several decades has revealed that the major subtype of gastric cancer (intestinal gastric cancer) is an end result of a multistage transformation of the gastric mucosa over many years and that this process is mainly determined by environmental factors. Epidemiologic studies on precancerous gastric lesions, including a large population‐based study of the natural history and aetiology of precancerous gastric lesions conducted in Shandong, China, are reviewed.
Portal vein thrombosis associated with prolonged ingestion of oral contraceptive steroids
Authors: CHU GEOFFREY , FARRELL GEOFFREY C.
Published: March 2008

The case is described of a 38 year old woman who developed severe right upper quadrant abdominal pain that was associated with partial portal vein occlusion, as confirmed by flow Doppler ultrasonography and dynamic contrast computed tomography. The patient was a cigarette smoker and had taken combined oestrogen/progestagen oral contraceptive steroids (OCS) continuously for 24 years. There were no other risk factors for portal vein thrombosis or for thromboembolic disease. Following anticoagulant therapy and discontinuation of OCS complete recovery occurred. The case is reported to draw attention to portal vein thrombosis as an extremely rare complication of OCS.
Risk of liver cirrhosis and hepatocellular carcinoma in subjects with hepatitis B and delta virus infection: A study from Kure, Japan
Authors: TAMURA I. , KURIMURA O. , KODA T. , ICHIMURA H. , KATAYAMA S. , KURIMURA T. , INABA Y.
Published: March 2008

To investigate the effect of hepatitis delta virus (HDV) superinfection on the long‐term outcome of Japanese subjects with chronic hepatitis B virus (HBV) infection, we examined the presence of antibodies to hepatitis delta antigen (anti‐HD) in serial serum samples collected from 1127 subjects with chronic HBV infection. The subjects were followed for at least 36 months (mean: 121.3 months) between 1973 and 1991. Among 69 cases where anti‐HD was detected, eight (12%) developed liver cirrhosis (LC) and six (9%) developed hepatocellular carcinoma (HCC). However, among 1058 cases without anti‐HD, there were 43 patients (4%) who developed LC and 29 (3%) who developed HCC. The prevalence of LC and HCC was significantly higher among the cases with anti‐HD than those without anti‐HD. The proportion of LC and HCC per 1000 person years was 10.46 and 7.84, respectively among cases with anti‐HD, and 4.05 and 2.73 among those without anti‐HD, respectively. The overall relative risk of LC and HCC was 2.58 and 2.87, respectively; 95% confidence interval (CI): LC, 1.14–5.13; HCC, 1.03–6.23. These results indicate that in the Kure district in Japan, where HDV infection of persons infected with HBV is about 6%, such superinfection increases the risk of LC and HCC.
Crohn's disease in children from the western region of Saudi Arabia
Authors: TOONISI TAHIR S.
Published: March 2008

In this paper, we describe 17 children with Crohn's disease seen at King Abdulaziz Unviersity Hospital, Jeddah, Saudi Arabia, who were followed up during a period of 10 years (1980–90). Their ages ranged from 5 to 15 years. The average duration of symptoms prior to presentation was 25 months (ranging from 4 days to 4 years). In this article, we describe the clinical picture, laboratory investigations and results, as well as the treatment of the affected children.
Peritoneoscopic cholecystectomy has opened the door to minimally invasive surgery
Authors: KITANO S. , SUGIMACHI K.
Published: March 2008

In 1989 a new trend occurred in the surgical treatment of a diseased gall‐bladder, laparoscopic cholecystectomy (LC). Laparoscopic surgery is now accepted world‐wide as the choice of treatment with the advantages of less pain, good cosmesis, short hospital stay and early recovery. It is also a curative procedure for cholelithiasis as well as a cholecystectomy. The rate of conversion to open surgery is about 5% and the rates of bile duct injury are 0.1–0.6%. This new approach revives controversies concerning cholecystectomy; namely indication, use of intra‐operative cholangiography, ductal calculi and pregnancy. There are new issues to consider, including use of a Veress needle for pneumoperitoneum, type of trocars, cardiovascular responses to pneumoperitoneum using carbon dioxide and so on. With increasing use, these difficulties will be overcome. Advances in technology are expected to make even more new types of surgery possible, even perhaps extending into robotic surgery.
Small angiomyolipoma of the liver diagnosed by fine‐needle aspiration biopsy under ultrasound guidance
Authors: YAMADA NOBUO , SHINZAWA HARUHIDE , MAKINO NAOHIKO , MATSUHASHI TAKAAKI , ITASAKA SATOSHI , TAKAHASHI TSUNEO , FUYAMA SHIGEMI
Published: March 2008

The first reported case of small hepatic angiomyolipoma to be diagnosed by fine‐needle aspiration biopsy (FNAB) is described. A 53 year old man presented with a tumour in segment VI of the liver measuring 0.9 × 0.8 cm. The tumour was hyperechoic on ultrasound examination, showed relatively low density (+ 33 Hounsfield units) on computed tomography (CT), and was hypervascular on angiography. Computed tomography during arterial portography demonstrated a perfusion defect. Magnetic resonance imaging (MRI) revealed high intensity by both T1‐ and T2‐weighted imaging. Diagnosis could not be obtained by these imaging modalities, but it was established successfully by FNAB under ultrasound guidance. Histologically, the tumour was an angiomyolipoma made up of three components: blood vessels, smooth muscle and fatty tissue. Surgery is unnecessary for this benign condition, and the patient has been followed up. Ten months later, the patient is currently doing well without growth of the hepatic angiomyolipoma.
Serum α1‐antitrypsin and duodenal ulcer
Authors: SHAHID ANJUM , SIDDIQUI ANWAR A. , ZUBERI SARWAR J. , WAQAR MOHAMMED A.
Published: March 2008

Evaluation of serum α1‐antitrypsin levels in the South Asian population and its possible involvement in disease conditions such as duodenal ulcer has not been given due consideration. This is mainly because reports from European and North American countries indicate that the genetic deficiency of this protease inhibitor is rare among Asians of the subcontinent.

Using isoelectric focusing (IEF) and radial immunodiffusion (RID) techniques, we analysed serum samples from 100 normal, healthy adults and 50 patients with endoscopically proven duodenal ulcers to determine if there is a possible relationship between α1‐antitrypsin phenotype and this disease. Five duodenal ulcer patients had low α1‐antitrypsin levels as well as SZ and S phenotype. None of the controls showed presence of S or SZ phenotypes. The normal or most common genetic form, MM, is the predominant phenotype in both controls and patients.
Detection of the preneoplastic lesions of small hepatocellular carcinoma in cirrhotic livers
Authors: SEKI S. , SAKAGUCHI H. , KAWAKITA N. , YANAI A. , TAMORI A. , YABUSAKO T. , NISHIGUCHI S. , KUROKI T. , KOBAYASHI K. , MONNA T.
Published: March 2008

To identify the preneoplastic lesions of hepatocellular carcinoma and the fine structure of preneoplastic hepatocytes, we studied proliferative conditions in cirrhosis of the liver. In all, 46 foci of cellular alteration (FCA), three regions of adenomatous hyperplasia (ADH), and 21 small hepatocellular carcinomas (sHCC) were studied by published criteria for sHCC and by the proliferative activity of the lesions as examined with monoclonal antibodies against DNA polymerase alpha and proliferating cell nuclear antigen. The four patients with FCA composed of basophilic hepatocytes were classified by the criteria as having sHCC; cells had features similar to those of sHCC. Two of these four patients with FCA were found to have HCC several years later. The number of hepatocytes stained for proliferating cell nuclear antigen was 72 and 81 per 1000 hepatocyte nuclei in the two patients who developed HCC. In one of the three patients with ADH, a sHCC was found 1 year later, and dysplastic hepatocytes from the region of ADH in this patient had features similar to those of HCC cells by light and electron microscopy. In this patient, the number of hepatocytes stained for DNA polymerase alpha was 452 per 1000 nuclei. Therefore, FCA and ADH might be preneoplastic lesions of sHCC in cirrhosis of the liver. Preneoplastic hepatocytes seem to be small cells with basophilic cytoplasm, with a large nucleus to cytoplasm ratio, finely indented nuclei with a smaller amount of condensed chromatin than normal, and poorly to moderately developed organelles.
Assay of HCV‐related antibodies and their consequent changes following interferon treatment
Authors: MIZUNO M. , MIZOKAMI M. , ORITO E. , OHBA K. , FUJII K. , SUZUKI K. , TOKUDA H. , NARITA M. , OHNO T. , YAMAUCHI M. , HIRASHIMA Y. , NAKANO T. , OGINO M. , YAMAMOTO M.
Published: March 2008

The hepatitis C virus (HCV) core antibody and NS‐4 antibody were measured in 25 cases of type C chronic hepatitis after interferon (IFN) treatment. The antibody titres were quantitated and the changes in the antibody titres and the therapeutic effects were compared. The titres of the passive haemagglutination assay (HCV‐PHA) before and after IFN administration were also measured and compared with the therapeutic effects. No significant correlation was seen between the core, NS‐4 and HCV‐PHA titres before IFN administration and the resultant therapeutic effects, but many cases showing excellent effects were seen among those with core antibody titres under 100 U/L and those with HCV‐PHA titres less than 2.16 In a study of the changes in the core and NS‐4 antibody titres, these titres tended to decrease during IFN administration. In cases showing excellent effects, these decreases continued for a long period after completion of IFN administration and then became negative in some cases. However, in the remaining cases, titres showed increases up to 3 months after completion of IFN administration. HCV‐PHA showed reduced titres in many cases of excellent effects before and after IFN administration; and there were also cases showing decreases with two power differences.
Increased sister chromatid exchange frequency in peripheral lymphocytes of hepatocellular carcinoma patients
Authors: WANG L‐Y. , HUANG S‐J. , LIAW Y‐F. , CHEN C‐J.
Published: March 2008

Hepatocellular carcinoma (HCC) has been documented to be associated with a multifactorial aetiology including hepatitis B virus (HBV), hepatitis C virus, exposure to aflatoxin, tobacco and alcohol. With the specific aim to examine the relationship between HCC and frequency of sister chromatid exchange (SCE) in peripheral lymphocytes as an indicator of integral carcinogen exposure, a total of 14 newly diagnosed untreated HCC patients and 13 healthy controls were studied. Study subjects were matched on age, sex, cigarette smoking and alcohol intake. Peripheral blood samples were collected using heparinized vacuum syringes. Lymphocytes were cultured in RPMI 1640 medium containing fetal calf serum and phytohaemagglutin. After lymphocytes were cultured for 24 h, 5‐bromo‐2‐deoxy uridine was added to the medium and colcemid was added after 70 h. Cells were harvested and fixed in methanol‐acetic acid (3 : 1) solution after 72 h. Cells were first stained with 33258 Hoechst and restained with Giemsa. Photographs were taken from at least 32 lymphocytes at the second metaphase of each study subject. The frequency of SCE was scored by two readers blindly. There was a significantly increased SCE frequency in peripheral lymphocytes of HCC patients than healthy controls, with a mean ± standard deviation of 15.1 ± 4.4 and 8.9 ± 2.7 SCE per metaphase II, respectively. The increased SCE frequency in lymphocytes of HCC patients may be due to the chronic HBV infection, exposure to chemical hepatocarcinogens or both.
Hepatitis B virus infection and hepatocellular carcinoma in Senegal: Prevalence and prevention
Authors: COURSAGET P. , LEBOULLEUX D. , YVONNET B. , SOUMARE M. , CANN P. LE , DIOP M. T. , BAO O. , CHIRON J. P. , COLL‐SECK A‐M. , DIOP‐MAR I.
Published: March 2008

Hepatitis B virus (HBV) infection and related diseases represent some of the major public health problems in Senegal. The prevalence of hepatitis B surface antigen (HBsAg) in infants increased steadily during their first years of life. HBsAg prevalence was 6% at 6 months of age and 13% at 2 years. HBV infection was detected in 30% at 2 years of age and in more than 90% of the population after the age of 10. Hepatitis B e antigen was detected in only 13–19% of HBsAg‐positive adults.

As a consequence of this high frequency of HBV infection occurring early in life, a high frequency of hepatocellular carcinoma is observed in Senegal, with only two‐thirds of them being HBsAg carriers. However, the HBV genome was detected in 58% of HBsAg‐negative patients suffering from liver cirrhosis or primary liver cancer confirming the aetiological link between HBV and primary hepatic carcinoma in HBsAg‐negative patients. On the other hand, confirmed HCV infection has been detected in only 7% of the HBsAg‐negative liver cancer cases.

More than 95% of the vaccinated infants had protective antibodies to HBsAg after a primary set of vaccine doses; this proportion decreased to 80% 6 years later and to 73% 10–12 years later. HBsAg was detected in 25% of infants from the control group and in 2.1% of immunized infants corresponding to an efficacy of more than 90%. No difference was observed between infants who received a booster dose at school age and those who did not. On the other hand, the results show that hepatitis B vaccine may be introduced into the existing recommended Expanded Programme on Immunization schedules without reducing the immune response to any of the currently recommended antigens nor increasing the frequency of untoward reactions.
Expression of multidrug resistance (P‐glycoprotein) gene in liver cancers
Authors: KUO M. TIEN , TEETER L. D. , CURLEY S. , HSU H‐C.
Published: March 2008

Hepatocellular carcinomas have been known to exhibit a poor response to chemotherapeutic agents. However, the mechanism for drug resistance is unknown. Recent studies have demonstrated that expression of a group of membrane proteins known as P‐glycoproteins (P‐gp) or multidrug transporters encoded by multidrug‐resistance (MDR) or P‐glycoprotein gene family is correlated with a poor clinical prognosis for particular non‐responsive neoplasms. The possible involvement ofMDRgene expression with the intrinsic poor response to chemotherapeutic agents is discussed.
Hepatitis B vaccination in Hong Kong
Authors: LOK A. S. F.
Published: March 2008

The Government‐sponsored hepatitis B vaccination programme in Hong Kong was initiated in 1982. The programme initially provided hepatitis B vaccine and hepatitis B immunoglobulin (HBIG) to newborns of carrier mothers only. During the past 8 years, the programme has expanded to include medical and health personnel, medical and dental students and dialysis patients. Universal vaccination of all newborns was implemented in 1988, with a 98% acceptance rate. In the near future the programme will extend to cover children born before 1988 and other polytransfused subjects. In addition, the medical community has been active in public education and in the encouragement of vaccination of other high risk groups. It is hoped that by the beginning of the twenty‐first century, most of the susceptible subjects in Hong Kong will have been vaccinated.
Multiple risk factors of hepatocellular carcinoma: A cohort study of 13 737 male adults in Taiwan
Authors: CHEN C‐J. , YU M‐W. , WANG C‐J. , HUANG H‐Y. , LIN W‐C.
Published: March 2008

In order to explore multiple risk factors of hepatocellular carcinoma (HCC), a total of 13 737 male adult residents in 12 townships were studied for an average follow‐up period of 5.2 years. Sociodemographic characteristics, history of cigarette smoking and alcohol drinking, dietary habits, as well as personal and familial history of chronic liver diseases were obtained through standardized interviews based on structured questionnaires at the recruitment. Blood samples were also collected from 9688 (71%) study subjects and examined for the hepatitis B surface antigen (HBsAg). A total of 60 new HCC cases occurred giving an incidence rate of 83.3 per 100 000 person‐years. Cox's proportional hazards models were used to analyse multiple risk factors of HCC. In addition the HBsAg carrier status which showed a multivariate‐adjusted relative risk of 17.0, cumulative cigarette smoking, alcohol drinking quantity, vegetarian habit and low vegetable consumption were associated with the development of HCC. The multivariate‐adjusted relative risk was 1.8 for those who smoked 26 or more pack‐years of cigarettes compared with non‐smokers, 3.1 for those who drank alcohol 50 mL or more per day compared with those who were non‐drinkers or drank less than 50 mL per day, 2.5 for vegetarians compared with non‐vegetarians, as well as 4.6 and 2.6, respectively, for those who had a weekly vegetable consumption frequency of less than two meals and two to five meals compared with those who had a frequency of six or more meals.
Histopathology of portal tracts in livers after transcatheter arterial chemo‐embolization therapy for hepatocellular carcinoma
Authors: KOBAYASHI SATOSHI , NAKANUMA YASUNI , MATSUI OSAMU
Published: March 2008

Abstract To study the influence of transcatheter arterial embolization therapy (TAE) on the portal tracts, 32 cases of hepatocellular carcinoma (HCC) with a history of TAE were examined. Portal tract elements are said to be mainly supplied by hepatic arterial blood, as is HCC. The following changes were found: peribile duct fibrosis; biliary epithelial injuries; bile duct necrosis; fibrous thickening of the intima and adventitia of arteries; thrombosis or stenosis of portal vein branches; and fibrosis of portal tract itself. We failed to correlate these histopathologic changes with the frequency of TAE or the interval between TAE therapy and surgery or autopsy. Semi‐quantitative assessment disclosed that vessels of the peribiliary vascular plexus (PVP) which are known to be derived from hepatic arterial branches, were considerably decreased. There was little correlation between the degree of reduction of PVP and the observed histopathologic changes of portal tracts. It is suggested that TAE causes adverse effects on the elements of portal tracts and a reduction in the PVP in the vicinity of HCC, but the relationship between them is unclear.
Intrahepatic peribiliary glands of humans. I. Anatomy, development and presumed functions
Authors: NAKANUMA YASUNI , KATAYANAGI KAZUYOSHI , TERADA TADASHI , SAITO KATSUHIKO
Published: March 2008

AbstractThe intrahepatic biliary tree is regarded as an excretory duct of two secretory units: hepatocytes and intrahepatic peribiliary glands. This review describes the anatomy, development and presumed functions of the latter. These glands are preferentially located around the intrahepatic large bile ducts, and are histologically divided into intramural and extramural structures. The former consist of simple tubular glands with much mucin, and are sparsely and irregularly distributed within the ductal wall. The latter are characterized by the presence of excretory units that consist of seromucinous acini and a conducting system in the periductal tissue. Pancreatic exocrine acini are occasionally admixed with extramural glands. These peribiliary glands appear in the late fetal period and complete their development about 15 years after birth. Extramural and intramural glands secrete neutral and acid mucin into the ductal lumen. Extramural glands contain several enzymes for digestion of protein and lipids. Neural and vascular supply of these glands may be related to the regulation of their secretion. Specific and non‐specific immune responses within this glandular system may also be essential in the sterility of bile.
Intrahepatic peribiliary glands of humans. II. Pathological spectrum
Authors: NAKANUMA YASUNI , SASAKI MOTOKO , TERADA TADASHI , HARADA KENICHI
Published: March 2008

Abstract The pathological spectrum of intrahepatic peribiliary glands is reviewed here. Several categories of histopathological changes such as necro‐inflammation, cystic dilatation, hyperplasia and neoplasia have been identified in this glandular system. Necro‐inflammation is associated with biliary tract diseases and chronic advanced liver diseases and may also appear in the livers of subjects with extrahepatic diseases such as sepsis. Cystic changes of microscopic sizes are not uncommon in autopsy livers of chronic advanced liver diseases, portal hypertensive diseases and also polycystic liver of adult type. Grossly recognizable cysts are, however, infrequent and occasionally cause compression of the adjoining bile ducts. Hyperplasia of these glands, which occurs consistently in hepatolithiasis and more variably in other conditions (e.g. biliary tract infection and submassive hepatic necrosis), may be associated with hypersecretion of seromucinous substances. Hyperplasia of peribiliary glands may then lead to mucin‐related biliary diseases. In addition, these glands, particularly the hyperplastic ones, could be a precursor of cholangiocarcinoma. The pathological spectrum of the intrahepatic peribiliary glands is being expanded, although a clinical pathological correlation remains uncharted. Furthermore, age‐related variations and non‐specific reactive changes of these glands remain unexplored.
Association of lymphocytic (microscopic) colitis with tropical sprue
Authors: PURI A. S. , KHAN E. M. , KUMAR M. , PANDEY R. , CHOUDHURI G.
Published: March 2008

Abstract Lymphocytic (microscopic) colitis is a disease of unknown aetiology which manifests as long‐standing intermittent diarrhoea. Diagnosis is confirmed on histological examination of the colon. An association of this uncommon disease with tropical sprue is described. Tetracycline therapy resulted in a favourable clinical response.