bluuebunny/crossref_metadata_2025 huggingface dataset:
A migration model of magmatism explaining a ridge subduction, and its details on a statistical analysis of the granite ages in Cretaceous Southwest Japan
Authors: Kinoshita Osamu
Published: March 2003

A migration model of magmatism based on the granite ages in Southwest Japan is proposed to explain the ridge subduction beneath the Eurasia continent as the cause of the along‐arc and across‐arc youngings of the granite ages and the very high activity of the magmatism in the Cretaceous. For the construction of the magmatic model, the localities of the granite age samples are denoted by the cartesian coordinates X and Y, which are measured along and normal to the Median Tectonic Line (MTL), respectively, and their ages are set corresponding to the coordinate Z vertical to the X–Y plane. The age trend is then formulated by a regression plane of Z on X and Y, which inclines in both directions along and normal to the MTL, and approximates the ages with the very high multiple correlation coefficient 0.91. Evaluating the magmatic trend by such a method, various characteristics of the activities can be taken easily; for example, the isochronous line of the magmatism, which is an intersection of the regression plane and an arbitrary horizontal plane, is found to extend landward obliquely across the continental margin. The migrating rate of the isochronous line along the MTL is also taken to be 2.8 cm/year as a reciprocal of the inclination of the along‐arc younging. The isochronous line is speculated to be the out‐cropped manifestation of the subcrustal linear heat source. Such a migrating linear heat source is probably due to the subduction of an active ridge, the Kula (or Izanagi)–Pacific ridge in the Cretaceous. The migration model of magmatism harmonizes very well with the plates and the ridge motions in the East Asia area during the late Mesozoic. The ridge subduction is one of the important phenomena that explain the unusually active arc magmatism and the migrating slab window; it is important to grasp dynamically the geological messages issued from the system.
Sea‐floor positioning with global positioning system–acoustic link system
Authors: Obana K. , Katao H. , Ando M.
Published: March 2003

The present study describes a new system designed and developed for observing crustal deformation on the sea floor. The system consists of two parts, the kinematic positioning by global positioning system (GPS) and acoustic ranging techniques. Since the location of a site at the ocean bottom relative to a reference site on land cannot be determined directly, the procedure was divided into two steps. First, the position of a vessel was determined using differential and kinematic GPS techniques, and then the position of a reference point at the ocean bottom was located relative to the vessel using the acoustic ranging technique. Thus, the location of the ocean‐bottom station is determined relative to the reference sites on land in the global reference system. The accuracy was tested in several ways. In one experiment, a buoy was used as the surface station which linked the positions of a GPS receiver to the acoustic transponder. Assuming a simple sound velocity profile of the seawater, the position of an ocean‐bottom reference point was estimated with an accuracy of several meters. Thus, with the present system, it is difficult to observe ocean‐bottom crustal deformations generated by typical plate motions. Methods are being investigated to improve the observation system for more accurate sea floor positioning.
Geochemical contrast between the Sanbagawa psammitic schists (Oboke unit) and the Cretaceous Shimanto sandstones in Shikoku, Southwest Japan and its geologic significance
Authors: Kiminami Kazuo , Hamasaki Asami , Matsuura Takuji
Published: March 2003

Abstract A systematic geochemical study of sandstones from the Cretaceous Shimanto Supergroup and psammitic schists from the Oboke unit in Shikoku has been carried out in order to clarify the depositional age of the protoliths of the Oboke psammitic schists. The geochemical data, together with chronological and geologic data, led to the following conclusions. (i) It is inferred that Oboke psammitic schists are metamorphically equivalent to sandstones in the Hiwasa Formation of the Shimanto accretionary complex, deposited in a trench area during the Campanian, in eastern Shikoku. (ii) The protolith attained to maximum metamorphic conditions within 20 million years after the deposition. (iii) The accumulation of a large amount of coarse‐grained clastic sediments in the trench area induced offscraping and underplating of the sediments in the subduction zone, forming the Hiwasa Formation and Oboke unit, respectively.
An unconformity in the early Miocene syn‐rifting succession, northern Noto Peninsula, Japan: Evidence for short‐term uplifting precedent to the rapid opening of the Japan Sea
Authors: Kano Kazuhiko , Yoshikawa Toshiyuki , Yanagisawa Yukio , Ogasawara Kenshiro , Danhara Tohru
Published: March 2003

Abstract  The present paper describes the newly discovered early Miocene unconformity in the northern Noto Peninsula, on the Japan Sea side, central Japan. The unconformity marks the boundary between an early Miocene non‐marine to marine succession and a more extensive, late early to early middle Miocene marine succession, and contains a time gap of an order of 1 million years or less from 18 Ma or earlier to 17 Ma. The early Miocene succession likely represents an early phase of marine transgression and initial slow rifting. The overlying early to early middle Miocene succession records the climax of the opening of the Japan Sea at ca 16 Ma with widespread, rapid subsidence of the Japan Arc. The unconformity between the two transgressive successions may represent a global sealevel fall or, more likely, crustal uplifting because no upward‐shallowing or regressive facies remains between the two successions. Early Miocene unconformities that are thought to be correlative with this unconformity in the northern Noto Peninsula occur in places along the Japan Sea coast of Sakhalin and Japan. They are likely to have been produced during rifting in response to upwelling of asthenospheric mantle, although more accurate age constraints are necessary to evaluate this idea.
Clinical relevance of viral dynamics and genotypes in hepatitis B virus
Authors: LOCARNINI STEPHEN A
Published: March 2003

Abstract  Advances in molecular diagnostic technology make it possible to accurately measure viral loads and this has allowed the detailed study of viral dynamics of HIV, hepatitis C virus (HCV) and hepatitis B virus (HBV). Following antiviral therapy, there are at least two phases of viral load decay: one corresponding to clearance of free virions and a second, slower phase corresponding to eradication of infected cells. Application of mathematical models allows for the assessment of antiviral efficacy and improved design of therapeutic regimens. The clinical application of these tools should help optimize patient outcome. Another advantage of molecular diagnostics is characterization of the heterogeneity of viruses in particular patient populations under selective pressure situations. The HBV can be classified into seven major genotypes (A–G) that have mainly a geographic distribution. Recent genotypic studies have revealed the clinical and therapeutic relevance of viral genotyping in HBV infections.

© 2002 Blackwell Publishing Asia Pty Ltd
Herbal medicines for liver diseases in India
Authors: THYAGARAJAN SP , JAYARAM S , GOPALAKRISHNAN V , HARI R , JEYAKUMAR P , SRIPATHI MS
Published: March 2003

Abstract  The use of natural remedies for the treatment of liver diseases has a long history, starting with the Ayurvedhic treatment, and extending to the Chinese, European and other systems of traditional medicines. The 21st century has seen a paradigm shift towards therapeutic evaluation of herbal products in liver diseases by carefully synergizing the strengths of the traditional systems of medicine with that of the modern concept of evidence‐based medicinal evaluation, standardization of herbal products and randomized placebo controlled clinical trials to support clinical efficacy. The present review provides the status report on the scientific approaches made to herbal preparations used in Indian systems of medicine for the treatment of liver diseases. In spite of the availability of more than 300 preparations for the treatment of jaundice and chronic liver diseases in Indian systems of medicine using more than 87 Indian medicinal plants, only four terrestrial plants have been scientifically elucidated while adhering to the internationally acceptable scientific protocols. In‐depth studies have proved Sylibum marianum to be anti‐oxidative, antilipidperoxidative, antifibrotic, anti‐inflammatory, immunomodulating and liver regenerative. Glycyrrhiza glabra has been shown to be hepatoprotective and capable of inducing an indigenous interferon. Picrorhiza kurroa is proved to be anti‐inflammatory, hepatoprotective and immunomodulatory. Extensive studies on Phyllanthus amarus have confirmed this plant preparation as being anti‐viral against hepatitis B and C viruses, hepatoprotective and immunomodulating, as well as possessing anti‐inflammatory properties. For the first time in the Indian systems of medicine, a chemo‐biological fingerprinting methodology for standardization of P. amarus preparation has been patented.

© 2002 Blackwell Publishing Asia Pty Ltd
Hepatitis C virus: Clades and properties
Authors: HOWARD COLIN R
Published: March 2003

Abstract  Hepatitis C virus (HCV) is a member of the virus family Flaviviridae. At present HCV is classified into a discrete hepacivirus genus and is represented by six clades according to genome sequencing. Each clade is further divisible into subtypes, which may prove important for the study of clinical differences and epidemiological studies. Limited homology also exists with hepatitis G/GB viruses, despite the fact that the hepatotropic nature of the latter agents remains contentious. The variability amongst the six HCV clades is less than that observed between the four serotypes of dengue, suggesting that each clade may represent a distinct virus were tests such as plaque neutralization to become available for delineating HCV isolates. The distribution worldwide varies, with Clades 1 and 2 predominating in most regions—an important consideration for the development of any vaccine. In addition, the clade distribution among cohorts may vary according to age. Point source outbreaks of HCV, for example in large numbers of women inadvertently infected with HCV‐contaminated anti‐D globulin, offers an opportunity to study the evolution of HCV genotypes over several decades. Parallel studies in chimpanzees have shown that the hypervariable region of E2 may play a role in HCV immunity, with quasispecies rapidly replacing the predominant subtype as immunity develops to the initiating virus strain. There is some evidence that an IFN‐sensitive motif exists in the NS5 gene which may have some predictive value in determining the likely outcome of IFN treatment. A database is available for all HCV sequences, together with information about their properties and guidance for the evaluation of new isolates (http://s2as02.genes.nig.ac.jp).

© 2002 Blackwell Publishing Asia Pty Ltd
Intraportal perfusion of prostaglandin E1 attenuates hepatic postischaemic microcirculatory impairments in rats
Authors: Iwata Kenji , Shimazu Motohide , Wakabayashi Go , Ohshima Atsushi , Yoshida Masashi , Kitajima Masaki
Published: March 2003

Background: The efficacy of intraportal perfusion with prostaglandin E1 (PGE1) in decreasing postischaemic hepatic microcirculatory damage was studied in rats.

Methods: An extrahepatic portosystemic shunt was created by attaching the spleen to a subcutaneous site on the left lateral wall of the abdomen in male Wistar rats weighing between 200 and 350 g. Four weeks later, when the shunt was mature, the portal vein and hepatic artery were occluded for 60 min. The animals were divided into the following three groups according to the type of intraportal perfusion during the ischaemic phase: group 1 consisted of untreated animals; group 2, animals perfused with lactated Ringer’s solution; and group 3, animals perfused with PGE1 (0.1 μg/kg per min). The hepatic microcirculation was observed under an inverted intravital microscope after the injection of fluorescent dyes to label leucocytes and damaged cells 30 and 60 min after reperfusion. The liver was removed 60 min after reperfusion and stained immunohistochemically using 1A29, an anti‐rat intercellular adhesion molecule‐1 (ICAM‐1) antibody.

Results: The leucocyte velocity during reperfusion was lowest in group 1 and highest in group 3. Of the three groups, group 3 showed the least leucocyte adhesion to the sinusoidal walls and terminal venules, the lowest damaged cell count and the lowest ICAM‐1 expression on the sinusoidal walls.

Conclusion: The results of this study suggest that hepatic perfusion with PGE1 markedly alleviates microcirculatory damage associated with ischaemia and reperfusion through the inhibition of leucocyte–endothelium interactions.
Alpha‐interferon therapy in chronic hepatitis due to active dual infection with hepatitis B and C viruses
Authors: Guptan Rc , Thakur V , Raina V , Sarin Sk
Published: March 2003

Background
: Nearly 14% of non‐alcoholic chronic liver disease in India is related to hepatitis B virus (HBV) and hepatitis C virus (HCV) dual infection. There are no clear data available from the literature on the therapeutic management of these patients who often suffer an unfavourable course.

Methods
: Fourteen consecutive cases of biopsy‐proven chronic liver disease fulfilling the following criteria were included: Child’s A or B liver disease, hepatitis B surface antigen positive, HBV‐DNA positive, antibody to HCV positive and HCV‐RNA positive. Seven patients had chronic liver disease (group I), while the remaining seven patients (group II) had additional disorders (non‐Hodgkin’s lymphoma (two), acute leukaemia (two), thalassaemia (two), chronic renal failure (one). Interferon alpha‐2b (IFN) was given in a dose of 6 MIU thrice weekly for 6 months. Complete response was defined as loss of HBV‐DNA and HCV‐RNA at 6 months and sustained response (SR) as the sustained loss of HBV‐DNA and HCV‐RNA for more than 6 months during the follow‐up period.

Results
: At the end of 6 months, alanine aminotransferase (ALT) levels remained unchanged (120 ± 40 vs 136 ± 64 IU/L), but six of the seven (86%) patients in group I lost HBV‐DNA. All three hepatitis Be antigen (HBeAg)‐positive patients lost HBeAg with an early flare of ALT (at 45 ± 12 therapy days). Two of these patients (29%) lost HCV‐RNA. Thus, SR was seen in 29%, while HBV‐DNA loss was found in 100% during the follow‐up period. In group II patients, there was a significant decrease in ALT (308 ± 14 vs 65 ± 25 IU/L, P < 0.001), but only three (43%) patients lost HBV‐DNA and two (29%) lost HCV‐RNA. One patient with acute leukaemia and another with renal failure had a complete response to IFN, but none of the lymphoma patients showed any antiviral response.

Conclusions
: In chronic hepatitis due to dual infection with HBV and HCV, interferon therapy is: (i) safe; (ii) effective (more so in clearing HBV); (iii) often associated with early ALT flare; and (iv) may be less effective if non‐Hodgkin’s lymphoma is present.
Transfusion‐transmitted virus infection in China: Prevalence in blood donors and in patients with liver diseases
Authors: He Chuan , Nomura Fumio , Yukimasa Nobuyasu , Itoga Sakae , Yamada‐Osaki Maki , Sumazaki Ryo , Nakai Toshiaki
Published: March 2003

Background
: Prevalence of transfusion‐transmitted virus (TTV) infection among blood donors and in patients with liver diseases in China was studied.

Methods
: DNA was extracted from serum and amplified by seminested polymerase chain reaction with reported primer sets from a conserved region of the TTV genome.

Results
: TT Virus DNA was detected in 55 of 196 blood donors (28%); 31% (40 of 127) in the north and 22% (15 of 69) in the south. TT Virus DNA was also detected in 14 of 31 patients (45%) with non‐A–non‐G fulminant hepatitis and in eight of 25 patients (32%) with non‐A–non‐G chronic hepatitis. The rate of TTV viraemia in these patients with liver disease was comparable to that in blood donors. TT Virus DNA sequencing of 12 isolates showed that the prevalence of genotype 2 was significantly higher than that reported in Japan (66.7 vs 2.6%, P < 0.001). Furthermore, genotyping assays based on restriction fragment length polymorphism were carried out on all 88 TTV DNA‐positive samples. It was found that 42 isolates (47.7%) belonged to genotype 1 and 40 (45.5%) to genotype 2. It was of particular interest that the prevalence of genotype 1 in patients with non‐A–non‐G fulminant hepatitis was significantly higher than that in blood donors (10/14 vs 22/55, P < 0.05).

Conclusions
: The data indicate that TTV infection is common in China and that the pathogenic potential of TTV toward the liver (if any) may differ between genotypes.
Is Helicobacter pylori the primary cause of duodenal ulceration?
Authors: Tovey Frank I , Hobsley Michael
Published: March 2003

Helicobacter pylori infection may not be the primary cause of duodenal ulceration in cases not associated with non‐steroidal anti‐inflammatory drugs, but may be a secondary complication. In developing countries with a uniformly high prevalence of H. pylori infection there are marked regional differences in the prevalence of duodenal ulcer (DU). In some countries, especially those with a low prevalence of H. pylori, 30–40% or more patients with DU may be H. pylori negative. The absence of H. pylori infection in early cases of DU is also reported. In DU patients with antral H. pylori infection, duodenal colonization by H. pylori may often be absent. After complete H. pylori eradication, recurrence of DU within 6 months in some reports is as high as 20%. The evidence suggests that high acidity and reduced duodenal mucosal resistance remain the primary causes of DU and that H. pylori infection, when present, results in chronicity. Reduced mucosal resistance results in duodenal gastric metaplasia which permits colonization of the duodenum with H. pylori from the antrum. Therefore, whatever causes reduced mucosal resistance may be the primary factor and evidence suggests that this cause may be diet related. This would explain the enigma of regional variations in DU prevalence unrelated to H. pylori prevalence.

© 1999 Blackwell Science Asia Pty Ltd
CASE REPORT: Hepatic involvement in antiphospholipid syndrome
Authors: Barak Nir , Orion Yael , Schneider Mordechai , Bernheim Joel
Published: March 2003

Three cases of hepatic involvement in antiphospholipid syndrome are described. One patient had catastrophic antiphospholipid syndrome with haemorrhages and necrosis in the liver parenchyma. The second patient had blood clots in the small hepatic vessels. The third patient had autoimmune hepatitis type I associated with antiphospholipid syndrome. Other possible hepatic manifestations of antiphospholipid syndrome are also discussed.

© 1999 Blackwell Science Asia Pty Ltd
THE PREVALANCE OF HELICOBACTER PYLORI IN PATIENTS WITH DYSPEPSIA: REPORT FROM PERTAMINA CENTRAL HOSPITAL JAKARTA ‐ INDONESIA
Authors: Simanjuntak Weldemar , Prasetyo Haris Tri
Published: March 2003

Introduction

Helicobacter pylori is now recognized as major cause of upper gastrointestinal diseases and has a world wide distribution in the normal population. The prevalence of Helicobacter pylori in Asia Pacific countries, varies from 20 to 90 %. This study was performed to document the prevalence of Helicobacter pylori infection in patients with dyspepsia in our hospital.

Patients and Method

From June 1997 to June 1999, 428 dyspeptic patients female 222 and male 206, age 15 to 80 years were included in this study. The presence of Helicobacter pylori was detected by histopathology of biopsy specimens from antrum and gastric body, which colored by hematoksilin Eosin, Giemsa and Toluidin Blue.

Result

56 (13,08%) of 428 patients were Helicobacter pylori positive, 31 patients (55,4%) female and 25 patients (44,6%) were male. The prevalence of Helicobacter pylori in patients under 39 years was 33,9% (19 patients) and over 40 years was 66,1% (37 patients). According to Ethnic origin, 14 (25,0%)of 56 patients (25,0%) were Javanese, 18 patients (32,1%) Batak, 6 patients (10,7%) Sundanese and 5 patients (8,9%) were Betawi. Helicobacter pylori was not found amongst the Minangkabau patients. The histopathological finding of 56 patients showed chronic active antral gastritis in different severity, 2 patients with gastric carcinoma and 2 patients with gastric ulcer.

Result

Our experience showed a low prevalence of Helicobacter pylori infection in our hospital. We observed an increased prevalence of Helicobacter pylori in dyspeptic patients with increasing age. The prevalence was higher in female patients than in male. According to ethnic origin, Batak had higher prevalence followed by Javanese, Sundanese and Betawi.
EFFECT OF THE HELICOBACTER PYLORI INFECTION ‐ AT GASTROPATHY
Authors: J Sembiring , A Nababan , Hakim Zain Lukman , S Pardede , G Tambunan
Published: March 2003

Background

There is an opinion that Helicobacter Pylori may contribute to the progression of gastropathy. The presence of Helicobacter Pylori infection can accelerate the damage of gastric and duodenal mucosa. Gastropathy is mucosal disturbances that usually accompany with gastritis gastric ulcer, duodenal ulcer and gastric cancer. Endoscopically, the mucosal appearances consisted of mosaic pattern, adema, hyperemia, superficial ulceration and red spot.

Objective

To assess the influence of Helicobacter Pylori on gastropathy.

Methods

The study enrolled a total 50 patients with gastroscopic lesions (gastritis, gastric ulcer, duodenal ulcer, gastric cancer) and positive CLO test, to undergo evaluation on gastropathic appearences.

Result

Reported in the third western pacific Helicobacter congress June 22‐24 Bali Indonesia
ANTIMICROBIC SUSCEPTIBILITY TEST OF HELICOBACTER PYLORI AGAINST FIRST LINE ANTIMICROBIAL AGENTS IN VITRO
Authors: Waskito Eddy Bagus , Adi Pangestu , Mudihardi Eddy
Published: March 2003

This preliminary study was done to investigate the susceptibility of 6 isolates of Helicobacter pylori against first line antimicrobial agents in vitro in relation with therapy for the patient. The bacteria were isolated on skirrow medium from 2 gastric mucosal biopsy specimens each of 54 dispeptic patients who seeked medical treatment in Dr Soetomo General Hospital and Private Hospital in Surabaya. Identification on Helicobacter pylori were made on the basis of Gram stain reaction and morphology and on urease, catalase and oxidase reactions. The susceptibility test were done by diffusion methods against Amoxycilline, Chloramphenicol, Erythromycin, Metronidazole and Tetracycline.

The result showed that susceptibility against these antimicrobial agents were 33.3%, 83.3%, 16.7%, 16.7% and 33.3% respectively.

It could be said that Chloramphenicol still represent the most active antimicrobial agent against Helicobacter pylori then the other ones used.
GASTRODUODENITIS, ULCER AND HELICOBACTER PYLORI IN SURAKARTA
Authors: M Tantoro Harmono
Published: March 2003

Objective

Most of the patients with dyspeptic complains are always have organic abnormality in their stomach and duodenum. It is realized that this statement are rather in the contrary with many Western publication that state not always patients who complaint dyspeptic has organic abnormality in their stomach or duodenum. To proof it, I do endoscopy and biopsy for histopathological examination and Helicobacter pylori culture.

Material & Methods

Dyspeptic patients in four years (1996‐1999) in Brayat Minulya Hospital was the cases to study. All the patients was endoscopied, some was biopsied for histopathological exam and Helicobacter culture.

Result

All the 465 (100%) clinically dyspeptic patients confirm have gastroduodenal abnormality in endoscopy. The 434 (81%) patient with gastroduodenitis and the other 31 (19%) patients have gastroduodenal ulcer. Only 41 patients being biopsied, all of them had chronic gastrodudenitis and just 7 (17%) patients with Helicobacter pylori growth in the culture.

Conclusion

Indeed, when all the clinically dyspeptic patients were endoscopied, they was confirm had abnormality in their gastro duodenal mucosa (majority of the cases was gastroduodenitis & in smal number gastroduodenal ulcer). Most of the patients which were biopsied are chronic gastroduodenitis and only in a smaller portion the culture positive for the Helicobacter Pylori.
Clinical presentation of Helicobacter pylori‐positive and ‐negative functional dyspepsia
Authors: Werdmuller Bibi Fm , Putten Toon Bmm Van Der , Balk Ton G , Lamers Cornelius Bhw , Loffeld Ruud Jlf
Published: March 2003

Background
: A questionnaire was used to record the clinical presentation of functional dyspepsia in relation to Helicobacter pylori infection in a consecutive series of patients sent for upper gastrointestinal endoscopy. Only patients without macroscopic abnormalities in their oesophagus, stomach and duodenum were included.

Methods
: The study questionnaire included two questions related to daily life, and the calculation of a symptom score. Biopsy specimens were taken from all patients for histological and microbiological examination, and immunoglobulin G antibodies were also determined.

Results
: Two hundred and twenty‐two patients were H. pylori positive and 182 patients were H. pylori negative. Loss of weight was significantly more common in the H. pylori positive group (P < 0.001). Patients with H. pylori infection had a significantly higher overall symptom score compared with H. pylori‐negative subjects (P < 0.05). In addition, the severity of epigastric and nocturnal pain, heartburn, retrosternal heartburn, and vomiting was significantly higher in H. pylori‐positive functional dyspeptic patients, and the influence on daily life and activities was significantly worse.

Conclusions
: The combination of retrosternal pain, weight loss, food intolerance and the absence of halitosis signified a 64% accuracy in predicting H. pylori infection. It is not possible to differentiate between H. pylori‐positive and H. pylori‐negative functional dyspeptics on the basis of clinical presentation and the number of complaints. However, overall symptom score and severity of several symptoms was significantly higher in the H. pylori‐positive group.
Early colorectal cancer: Flat or depressed type
Authors: Kudo Shin‐Ei , Kashida Hiroshi , Tamura Tomoyuki
Published: March 2003

The present review describes the changes in views about the early forms of colorectal cancers. In 1985, a concept of ‘flat adenoma’ was born in Japan. At around the same time, depressed type early colorectal cancers started to be reported by Japanese colonoscopists. Neither flat adenomas nor depressed lesions have been frequently reported in Western countries, but increasing numbers of such cases are now described. The problem is that flat adenomas and depressed lesions seem to have been confused by many researchers. The biological aggressiveness of these lesions is quite different. The rate of submucosal invasion is very high in depressed lesions, but fairly low in small flat adenomas. Some adenomas may even look depressed at first, but such lesions should not be mistaken for truly depressed lesions. Ignorance or resistance to the concept may inhibit the detection of flat or depressed lesions. Differences of diagnostic criteria between Japanese and Western pathologists may influence the apparent frequency of mucosal cancers, but not that of invasive carcinomas. Many small adenomas do not grow if followed, but depressed lesions grow rapidly and invade the deeper layers and, as a result, may look elevated as a whole. Many cases in previously published papers suggest that small depressed carcinomas of the large intestine may develop without a precursory stage of an adenomatous polyp. At least two carcinogenic pathways, one through adenomatous polyps and one de novo, should be recognized. In addition, the importance of small depressed cancers should be emphasized.
Gene therapy for liver cirrhosis
Authors: Fujimoto Jiro
Published: March 2003

Liver cirrhosis is the irreversible end result of chronic liver disease and is characterized by fibrous scarring and hepatocellular regeneration. It is a major cause of morbidity and mortality world‐wide and is induced by factors such as chronic hepatitis virus infection, drug abuse and alcohol abuse. The ideal strategy for the treatment of liver cirrhosis should include prevention of fibrogenesis, stimulation of hepatocyte mitosis and reorganization of the liver architecture. Hepatocyte growth factor (HGF) gene therapy has been investigated in a rat model of liver cirrhosis. In rats with lethal liver cirrhosis produced by dimethylnitrosamine, repeated transfection of the HGF gene into skeletal muscle induced a high plasma level of HGF and tyrosine phosphorylation of the c‐Met/HGF receptor. Hepatocyte growth factor gene transduction inhibited fibrogenesis and hepatocyte apoptosis and also produced resolution of fibrosis in the cirrhotic liver. Hepatocyte growth factor gene therapy may have the potential to be useful for the treatment of patients with liver cirrhosis.
Decreased function of peripheral blood dendritic cells in patients with hepatocellular carcinoma with hepatitis B and C virus infection
Authors: Kakumu Shinichi , Ito Satomi , Ishikawa Tetsuya , Mita Yukiko , Tagaya Tsuneaki , Fukuzawa Yoshitaka , Yoshioka Kentaro
Published: March 2003

Background
: Tumour immunity does not seem to be induced effectively in tumour‐bearing hosts, including in patients with hepatocellular carcinoma (HCC). One possible reason is that function of dendritic cells (DC) is decreased in such hosts.

Methods
: We evaluated T cell stimulatory activity and interleukin (IL)‐12 production of DC and interferon (IFN)‐γ and IL‐10 production of T cells of peripheral blood from 12 control individuals and 21 patients with chronic hepatitis C virus (HCV) infection (six with chronic hepatitis (CH), eight with liver cirrhosis (LC) and 13 with HCC). Five hepatitis B virus (HBV)‐infected patients with HCC were included as a disease control group. The DC were prepared by the culture of T cell‐depleted populations of peripheral blood mononuclear cells in the presence of granulocyte‐macrophage colony stimulating factor and IL‐4 for a total of 11–12 days. The cytokine levels were assayed by ELISA. To test the stimulatory function of DC in T cell proliferation, mytomycin C‐treated DC were cultured with allogeneic T cells from a control.

Results
: When the T cell‐stimulatory activity of DC was expressed as stimulation index value of [3H]‐thymidine incorporation of T cells, the values were lower in HCV‐infected HCC (2.6 ± 1.8, P < 0.01) than in controls (5.5 ± 2.0) and CH (5.0 ± 1.3). Staphylococcus aureus Cowan 1‐induced IL‐12 production of DC was decreased in HCV‐infected HCC (P < 0.001, P < 0.01 and P < 0.05, respectively) compared with controls, CH and LC, while similar amounts of IL‐10 were produced in patients and controls. Interleukin‐10 and IFN‐γ production of T cells in response to anti‐CD3 antibody or IL‐12 were equivalent between patient groups and controls, respectively. Similarly decreased DC function and normal T cell response were observed in HBV‐infected HCC patients.

Conclusions
: These findings suggest that the depressed function of DC is associated with pathogenesis of HCC with HBV or HCV infection.
Rapid urease test is less sensitive than histology in diagnosing Helicobacter pylori infection in patients with non‐variceal upper gastrointestinal bleeding
Authors: Archimandritis Athanasios , Tzivras Michael , Sougioultzis Stavros , Papaparaskevas Iosif , Apostolopoulos Periklis , Avlami Athina , Davaris Panagiotis S
Published: March 2003

Background and Aims
: The validity of the rapid urease (CLO) test to diagnose Helicobacter pylori infection in patients with bleeding ulcers has been questioned. The aim of this paper is to evaluate the validity of the CLO test in comparison with histology in diagnosing H. pylori infection in patients with acute upper gastrointestinal bleeding (UGB), irrespective of non‐steroidal anti‐inflammatory drug (NSAID) use.

Methods
: Upper gastrointestinal endoscopy was performed within 24 h of admission for all patients with UGB admitted to the Department of Pathophysiology, Medical School, Athens, for a period of 12 months. Patients with variceal bleeding, previous gastric operation, recent treatment with proton pump inhibitors (< 2 months) and those with a history of H. pylori eradication therapy were excluded from the study. At least four biopsies (two from the antrum and two from the body) were obtained for the CLO test and histology (modified Giemsa).

Results
: Seventy‐two consecutive patients (aged 18–90 years, 51 men, 21 women) were included. Forty‐six patients (64%) used NSAID. Thirty‐two patients (44%) were found to be positive for H. pylori infection by the CLO test, while 44 patients (61%) were found to be positive on histology (P < 0.045, 95% CI, 0.004–0.331). The sensitivity and specificity of the CLO test were 68 and 93% respectively; positive and negative predictive values were 94 and 65%, respectively. The age of the patient and visible blood in the stomach did not inflence results of either the CLO or histology.

Conclusions
: The CLO test, performed within 24 h of hospital admission in patients with UGB, irrespective of NSAID use, is unreliable for the detection of H. pylori infection. The age of the patient and the presence of blood in the stomach do not seem to influence these results.
Sensory neuropathy in the prodromal phase of hepatitis A and review of the literature
Authors: Islam Shamsul , McDonald Jennifer A
Published: March 2003

We report an unrecognized clinical presentation of hepatitis A with unilateral peripheral acute sensory loss in the prodromal phase of the illness. Although rare, focal neurological signs are known to occur in hepatitis A before, during and after the icteric phase; a pure peripheral sensory neuropathy is distinctly uncommon. Possible lesions could include radiculopathy of the lower thoraco–lumbo–sacral dorsal nerve roots or a partial transverse myelitis of Brown‐Séquad like distribution. The signs and symptoms lasted only a few days and the patient had an uneventful recovery.
Oesophageal varices: Assessment of the risk of bleeding and mortality
Authors: Fevery J , Nevens F
Published: March 2003

Abstract Patients with oesophageal varices run a high risk of bleeding and even death, however rates of bleeding and mortality vary greatly. Indeed, a number of patients with varices never bleed. Prophylactic therapy is effective, but can be associated with side‐effects. It remains to be determined which patients are at high risk of bleeding and require treatment. In addition, since non‐response to medical therapy has been reported to occur in 20–40% of patients, the effect of a given prophylactic drug, or combinations of drugs, needs to be tested. A review is given of available methods of assessment. The Hepatic Venous Pressure Gradient, and measurements of the variceal pressure, are two proven methods, and the latter has the advantages of being non‐invasive and having value in presinusoidal portal hypertension.
Modified rapid urease test for Helicobacter pylori detection in relation to an immunohistochemical stain
Authors: Tokunaga Yukihiko , Shirahase Hiroyuki , Yamamoto Etsuko , Inao Ryou , Hamaguchi Sugihiro , Kanaji Kenji , Kitaoka Akihiro , Yagi Toshikazu , Tokuka Atsuo , Ohsumi Kiyoshi
Published: March 2003

Background
: The rapid urease test and touch cytology have been used for the rapid detection of Helicobacter pylori infection. Recently, a modified rapid urease (MRU) test, which provides results in 20 min has been available on a commercial basis. To date, few reports have evaluated the accuracy of this test. This study evaluated the sensitivity, specificity, and accuracy of the MRU test and touch cytology to detect H. pylori in relation to the density of H. pylori infection determined semi‐quantitatively by using immunohistochemical stains.

Methods
: Biopsy specimens obtained from a total of 60 patients who underwent endoscopy for evaluation of gastroduodenal diseases were studied by using the MRU test, Giemsa stain for touch smear tissue and histological methods. An immunohistochemical stain was used as a standard, and the density of H. pylori infection was graded according to the number of individual bacteria seen as follows: grade 0 = 0; grade 1+ = 1–9; grade 2+ = 10–29; grade 3+ = 30–99; grade 4+ ≥ 100. The severity of gastritis was evaluated histologically in each specimen and compared with the density of H. pylori infection.

Results
: The MRU test had an overall sensitivity of 73%, specificity of 100% and accuracy of 85%. The Giemsa stain had a sensitivity of 91%, specificity of 100% and accuracy of 95%. The sensitivities of the MRU test and Giemsa stain decreased in mild H. pylori infection. In the MRU test, the sensitivity was 47% when the density of H. pylori infection was 1+, while 80–100% sensitivities were obtained when the densities of infection were ≥ 2+. With the Giemsa stain, the sensitivity was 80% when the density was 1+, while the sensitivity increased to 100% when the densities were ≥ 2+. The severity of gastritis determined by the Rauws scores showed a positive correlation with the density of H. pylori infection as evaluated by immunohistochemical staining.

Conclusions
: The MRU test had high sensitivity and specificity for moderate to severe H. pylori infection, but it may result in false‐negative results in tests for mild infection. As the MRU test has the advantages of shorter incubation times and low cost, a combination of the MRU test and the Giemsa stain for touch cytology may be the most time‐ and cost‐efficient tests in a clinical setting for the diagnosis of H. pylori infection.
Enhanced tumorigenicity of insulinoma by X‐irradiation of the gastric regions in Sprague–Dawley male rats
Authors: Kido Soichiro , Haruma Ken , Kitadai Yasuhiko , Yoshihara Masaharu , Sumii Koji , Kajiyama Goro , Watanabe Hiromitsu
Published: March 2003

Background and Aims
: There has been no suitable animal model for human insulinoma because incidence of pancreatic tumours induced by whole‐body irradiation or chemicals has been very low. The purpose of this study was to establish an experimental model with a high incidence of insulinoma. The induction of islet cell tumour by X‐irradiation was investigated.

Methods
: Forty Sprague–Dawley male rats were used in this study. Twenty‐eight rats were irradiated with two 10‐Gy doses to the gastric region at a 3‐day interval, and 12 rats not subjected to X‐irradiation served as a control group. The rats were killed 16 months after the first irradiation. Expression of insulin mRNA and protein was examined by northern blot analysis and immunohistochemistry, respectively. Rat serum insulin and glucose levels were measured using enzyme‐linked immunosorbent assay.

Results
: Tumour incidence was 89.3% (25/28) in X‐ray group and 8.3% (1/12) in the control group (P < 0.05). Pancreatic tumours, which appeared in all 25 rats with tumours, showed the highest incidence of all neoplasms detected. Tumour cells showed strong immunoreactivity for insulin in 20 of 25 pancreatic tumours (80%). Expression of insulin mRNA was confirmed by northern blot analysis. Furthermore, rats with pancreatic tumours had lower serum glucose levels and higher insulin levels than the control rats.

Conclusion
: X‐irradiated SD rats may be considered a suitable model for insulinoma because of their high tumorigenicity.
Effect of argatroban on trinitrobenzene sulfonic acid‐induced colitis
Authors: Onomura Masahisa , Tsukada Hideaki , Fukuda Kazuhito , Kodama Masanobu , Nakamura Hiroshi , Hosokawa Masaya , Ohya Michihiro , Seino Yutaka
Published: March 2003

Background
: Recent studies have suggested that heparin is effective for treatment of inflammatory bowel disease (IBD) and its various effects (in addition to the anticoagulant effect). We evaluated the effects of argatroban as an antithrombin drug on trinitrobenzene sulfonic acid (TNB)‐induced colitis, an established model of IBD.

Methods
: Rats were randomly assigned to four groups in which mini‐osmotic pumps containing saline (TNB‐S), argatroban (TNB‐A), or 100 U/kg heparin (TNB‐H) were intraperitoneally implanted. Three days after the pumps were implanted, TNB was infused via the anus, and colitis was induced. After 5 days, prothrombin time (PT), activated partial prothrombin time (APTT), antithrombin III (AT‐III), platelet, fibrinogen, colonic wet weight, macroscopic damage score, histological score, mucosal myeloperoxidase activity and mucosal leukotrien B4 (LTB4) levels were compared among the four groups.

Results
: The APTT was prolonged in the heparin treatment group but only slightly prolonged in the argatroban treatment group. The platelet count and the fibrinogen level were higher in the TNB‐S group than in the healthy control group and the AT‐III level was slightly lower in the TNB‐S group than in the healthy control group and lower still in the TNB‐H group.

Conclusions
: The colonic wet weight was similar among the four groups while the macroscopic damage score, histological score, mucosal myeloperoxidase activity and the mucosal LTB4 level were significantly decreased in the TNB‐A and TNB‐H groups. Argatroban, as well as heparin may be effective for treatment of TNB‐induced colitis.
Adult intussuscepted Meckel's diverticulum presenting mainly lower gastrointestinal bleeding
Authors: Lu Ching‐Liang , Chen Chih‐Yen , Chiu Sou‐Tyau , Chang Full‐Young , Lee Shou‐Dong
Published: March 2003

Abstract Herein, we report on an adult with intussusception of an invaginated Meckel's diverticulum presenting mainly with acute intermittent lower gastrointestinal bleeding, whereas the common symptom of abdominal pain, indicating intussusception, was absent. Colonoscopy revealed a reducible polypoid lesion in the ileocecal area. Computed tomography led to suspicion of an intussusception. Surgical resection revealed a Meckel's diverticulum containing an aberrant pancreas. The unique clinical symptoms and the methods of diagnosis are discussed.
Aortic hyporeactivity to norepinephrine induced by lipopolysaccharide in cirrhotic rats: Beneficial effects of a non‐steroidal anti‐inflammatory drug coupled with a nitric oxide donor
Authors: Lefilliatre Pascale , Sogni Philippe , Bertrand Viviane , Soldato Piero Del , Pateron Dominique , Moreau Richard , Lebrec Didier
Published: March 2003

Background and Aims: Cirrhosis is associated with a hyperdynamic syndrome and arterial vasodilation that is related to nitric oxide (NO) synthase 3 overactivity. Septic shock is frequently associated with cirrhosis and with a vascular induction of NO synthase 2. The aims of this study were to compare the effects of lipopolysaccharide (LPS) in normal and cirrhotic rats, and to test the effects of a‐non‐steroidal anti‐inflammatory drug (NSAID) coupled with a (NO) donor.

Methods: Cirrhotic rats received NO‐flurbiprofen, flurbiprofen or vehicle followed by LPS or placebo 15 min later. The heart rate and mean arterial pressure of rats were monitered for 5 h. Thoracic aortic rings were removed and contracted with the use of norepinephrine. Nitric oxide synthase activity was measured in the aorta and stomach of cirrhotic rats.

Results: Arterial pressure decreased in cirrhotic rats in the vehicle/LPS and flurbiprofen/LPS groups. After LPS administration, the heart rate of rats increased in all groups. In the aortic rings, LPS induced hyporeactivity to norepinephrine in all groups except the NO‐flurbiprofen group. This hyporeactivity was abolished after preincubation with Nw‐nitro‐L‐arginine (L‐NNA). Nw‐nitro‐L‐arginine had no effect on norepinephrine‐induced vasoconstriction in the NO‐flurbiprofen/LPS group. Nitric oxide synthase 2 activity in the stomach and aorta of cirrhotic rats was increased in each group except in the NO‐flurbiprofen group after LPS administration. Pretreatment with NO–NSAID prevented aortic hyporeactivity to norepinephrine in cirrhotic rats treated with LPS as it probably inhibited the NO synthase 2 induction.

Conclusions: These findings suggest that NO‐flurbiprofen has a beneficial hemodynamic effect in cirrhotic rats and may help to prevent LPS aortic hyporeactivity.
Polymorphic expression of decay‐accelerating factor in human colorectal cancer
Authors: Nakagawa Masahiro , Mizuno Motowo , Kawada Mikihiro , Uesu Tokurou , Nasu Junichirou , Takeuchi Kazuaki , Okada Hiroyuki , Endo Yuichi , Fujita Teizo , Tsuji Takao
Published: March 2003

Background: We have previously shown that expression of decay‐accelerating factor (DAF), a complement regulatory protein, is enhanced immunohistochemically on the luminal surface of cancer glands in human colorectal cancer and is detected in stool specimens of patients with colorectal cancer. The amount of DAF present in the stools might be influenced by the stability of DAF on the cell surface which is regulated by biochemical properties such as glycosylation of the protein. In the present study, to help elucidate the mechanism for the release of DAF from human colorectal cancers, we biochemically analyzed DAF expression by western and northern blotting by using surgically resected specimens of colorectal cancers.

Methods: Surgically resected colorectal cancer tissues were obtained from 10 patients. Expression of DAF was determined by western and northern blotting, and glycosylation of DAF protein was analyzed with glycosidase digestion.

Results: Northern blot analysis demonstrated that the expression of DAF mRNA in colorectal cancer was enhanced two‐ to threefold compared with normal tissues. In western blotting, expression of DAF protein in the cancer tissue was increased, and heterogeneity in the apparent molecular weight of DAF was observed among patients. When o‐linked sugars were removed, this heterogeneity of DAF size diminished.

Conclusions: The polymorphic expression of DAF in colorectal cancer is likely to reflect variability in the o‐glycosylation of the protein. We speculate that this variability could affect the stability of DAF on the surfaces of cancer cells and, in turn, the amount of DAF shed into the stools of colorectal cancer patients.
Macrocystic type of serous cystadenoma with a communication between the cyst and pancreatic duct
Authors: Hashimoto Masaji , Watanabe Goro , Miura Yasuhiko , Matsuda Masamichi , Takeuchi Kazuo , Mori Masaya
Published: March 2003

Abstract A 42‐year‐old woman with a cystic lesion in the head of the pancreas was evaluated by using abdominal ultrasonography, a computed tomographic scan, magnetic resonance imaging and endoscopic retrograde pancreatography. Multiple cystic lesions, 5 cm in diameter, which had papillary protrusion inside the cyst in the head of the pancreas and had the communication between the cysts and pancreatic duct, were determined. Pylorus‐preserving pancreaticoduodenectomy was performed under the diagnosis of mucinous cystic neoplasm of the pancreas. Although the cut surface of the tumor showed a macrocystic tumor of 3 cm in diameter, part of the cyst wall was cavernous. A histopathological examination showed single‐layered cuboidal cells, which lead to the diagnosis as being serous cystadenoma of the pancreas. Serous cystadenoma is a rare, almost benign pancreatic tumor. The macrocystic subtype of serous cystadenoma is even more rare. We describe a patient who had this macrocystic subtype of serous cystadenoma with a communication between the cyst and pancreatic duct. This case illustrates the difficulty in the diagnosis of cystic lesions in the pancreas, and might support the single category of cystic lesions of the pancreas.