bluuebunny/crossref_metadata_2025 huggingface dataset:
Long‐term follow up of chronic hepatitis C patients after α‐interferon treatment: A functional study
Authors: Giannini Edoardo , Fasoli Alberto , Botta Federica , Testa Emanuela , Romagnoli Paola , Ceppa Paola , Testa Roberto
Published: March 2003

Aim: To evaluate the long‐term functional outcome of chronic hepatitis C (CHC) patients treated with interferon (IFN) therapy.

Methods: Thirty‐six patients with CHC were followed up for a mean of 36 months (± 19, SD) after a course of IFN therapy. Biochemical, virological (qualitative hepatitis C virus (HCV)‐RNA and HCV genotype), and functional (monoethylglycinexylidide (MEGX) test) evaluations were carried out at the time of liver biopsy. Patients were divided into long‐term responders (LTR), relapsers (RR), or non‐responders (NR) according to IFN therapy outcome. At the end of follow up, patients were non‐invasively re‐evaluated by means of biochemistry, qualitative HCV‐RNA, MEGX test, and liver ultrasonography.

Results: A significant decrease in MEGX values was observed in all patients. However, when patients were examined according to treatment outcome, only NR and RR showed a significant decrease in liver function as compared to pretreatment levels (MEGX30, 80.5 ± 26.8–62.9 ± 24.2 ng/mL, P < 0.01; MEGX60, 72.9 ± 18.1–60.5 ± 19.7 ng/mL, P < 0.05; MEGXAUC, 3816 ± 1243–3095 ± 1205 ng/mL per h, P < 0.05). On the contrary, LTR patients showed no significant modifications in MEGX values at each sampling time (MEGX15, 72.9 ± 31.4–70.3 ± 29.7 ng/mL; MEGX30, 84.0 ± 27.6–71.5 ± 21.8 ng/ mL; MEGX60, 69.5 ± 26.8–63.2 ± 14.4 ng/mL; MEGXAUC 4028 ± 1378–3620 ± 1041 ng/mL per h). At the end of follow up, LTR patients showed normal liver biochemistry and negativity of serum HCV‐RNA, while NR and RR patients showed a significant decrease in platelets.

Conclusions: In CHC patients long‐term response to IFN therapy, besides favoring positive clinical and virologic long‐term outcome, results in maintaining preserved liver function. Furthermore, IFN therapy seems to determine a decrease in the rate of functional disease progression, even in NR and RR. The MEGX test may be considered as a useful tool for performing serial follow up of CHC patients.
Epidemiology of gallstone disease in Chandigarh: A community‐based study
Authors: Singh Virendra , Trikha Bandana , Nain Chanderkanwal , Singh Kartar , Bose Shashankamohan
Published: March 2003

Background: Cholelithiasis is frequent in our country (India), and is a common cause for abdominal surgery. We studied the prevalence of gallstone disease and its association with various risk factors in the city of Chandigarh.

Methods: A house‐to‐house survey of residents aged 15 years or above in a subsector of Chandigarh was conducted as a part of a pilot survey. All individuals with a history of gallstone disease, and equal or more number of asymptomatic individuals were asked to attend the outpatient department of the Postgraduate Medical Institute. On the basis of the pilot survey, the sample size to be studied was 2648 and we screened 2649 persons.

Results: Two hundred and fifty‐four individuals attended the outpatient services of the Institute, and 248 underwent an ultrasound. There were 37 symptomatic and 211 asymptomatic individuals (male : female, 93:155). Gallstone disease was seen in 24 out of 37 (64.9%) in the symptomatic, and seven out of 211 (3.3%) in the asymptomatic group. Out of these, 27 females and four males had gallstone disease (mean age: 48.30 ± 16.03 years). Approximately 67% of patients were between 20 and 60 years of age. Gallstone disease was more frequently seen in those from high socioeconomic status as compared to middle socioeconomic status (χ2 = 8.9, d.f. = 1, P < 0.01), and in multiparous as compared to nulliparous females (χ2 = 4.8, d.f. = 1, P < 0.05). Body mass index, smoking, alcohol consumption, and a vegetarian/non‐vegetarian diet did not influence the prevalence of gallstone disease.

Conclusions: Gallstone disease is frequent in northern India. Gallstones were frequent in those belonging to high socioeconomic status and multiparous females. However, body mass index, smoking, alcohol or other dietary habits did not make a difference.
Influence of hepatitis C virus on the profiles of patients with chronic hepatitis B virus infection
Authors: Dai Chia‐Yen , Yu Ming‐Lung , Chuang Wan‐Long , Lin Zu‐Yau , Chen Shinn‐Cherng , Hsieh Ming‐Yuh , Wang Liang‐Yen , Tsai Jung‐Fa , Chang Wen‐Yu
Published: March 2003

Background:

Hepatitis B virus (HBV) and hepatitis C virus (HCV) are the most common causes of chronic liver disease, cirrhosis and hepatocellular carcinoma. The influence of HCV infection on the clinicopathological and virological profiles of chronic HBV infection was investigated.

Methods:

A total of 100 chronic HBV carriers with histopathological diagnoses by liver biopsy were studied. Hepatitis B e antigen (HBeAg) and anti‐HCV antibody were tested. Serum HCV‐RNA was detected by using a nested reverse transcription–PCR assay. A branched DNA (bDNA) assay was used to detect HBV‐DNA and quantitate the serum levels.

Results:

Eighteen (18%) of 100 patients were positive for anti‐HCV and HCV‐RNA. Patients with concurrent HCV and HBV infection were significantly older than those without HCV infection (P < 0.05). The positive rates of HBeAg and HBV‐DNA as well as the serum levels of HBV‐DNA in patients with concurrent HCV and HBV infection were significantly lower than those without concurrent HCV and HBV infection (P < 0.01, P < 0.05, and P < 0.001, respectively). By using multivariate analysis, the factors of seroconversion of HBeAg and decreasing level of HBV‐DNA were significantly correlated to concurrent HCV and HBV infection in chronic HBV carriers. The factors of increasing age and concurrent HCV and HBV infection were significantly correlated to seroconversion of HBeAg.

Conclusions:

The concurrent HCV and HBV infection in chronic HBV carriers might result in a suppression of HBV replication that presented with a lower level of serum HBV‐DNA and HBeAg seroconversion. Nevertheless, neither more obvious increase in biochemical parameters nor histopathological progression to more advanced liver diseases was observed.
Maintenance of connexin 32 and 26 expression in primary cultured rat hepatocytes treated with 3‐acetylpyridine
Authors: Higaki Nagato , Mitaka Toshihiro , Sato Fumihiko , Hirata Koichi , Mochizuki Yohichi
Published: March 2003

Background and Aim: We recently reported that primary rat hepatocytes treated with 3‐acetylpyridine (3‐AP), an analog of nicotinic acid, could maintain hepatic differentiated functions such as albumin, tryptophan 2,3‐dioxygenase, and connexin 32 (Cx32) mRNA expressions for more than a week. In the present experiment, we investigated the expression of not only Cx32, but also Cx26 in cells treated with 10 mmol/L 3‐AP in detail.

Methods: We examined the expression of Cx32 and Cx26 in primary rat hepatocytes by using the methods of immunocytochemistry, immunoelectron microscopy, northern blotting, and dye‐transfer.

Results: The hepatocytes treated with 3‐AP were polygonal with a large cytoplasm from day 3, and were maintained for approximately 2 weeks, whereas the cells without 3‐AP began to die from day 4. Immunocytochemically in the cells with 3‐AP, many Cx32‐ and Cx26‐positive spots were observed between most adjacent cells, and the intensity of positive spots increased with time in culture, whereas in the cells without 3‐AP, Cx32‐ and Cx26‐positive spots disappeared at day 4. Furthermore, most Cx26‐positive spots were colocalized with Cx32‐positive ones. The amounts of Cx32 and Cx26 mRNA transcripts in the cells with 3‐AP at day 14 were more than 80% and approximately 30% of those of Cx32 and Cx26 mRNA transcripts in the cells at day 1, respectively. Gap junctional intercellular communication was maintained in the cells treated with 3‐AP at day 8, although it was lost in the cells without 3‐AP.

Conclusion: Thus, the addition of 10 mmol/L 3‐AP to the medium enhanced the maintenance of Cx32 and Cx26 expression, which is one of the hepatic differentiated functions, in primary rat hepatocytes for a long time.
Measurement of serum hyaluronic acid level during the perioperative period of liver resection for evaluation of functional liver reserve
Authors: Nanashima Atsushi , Yamaguchi Hiroyuki , Shibasaki Shinichi , Sawai Terumitsu , Yamaguchi Eiichiro , Yasutake Toru , Tsuji Takashi , Jibiki Masaaki , Nakagoe Tohru , Ayabe Hiroyoshi
Published: March 2003

Background and Aim: The serum hyaluronic acid (HA) concentrations reflect the degree of hepatic fibrosis and sinusoidal endothelial cell damage. The HA concentrations were examined to evaluate liver damage during the perioperative period of hepatectomy.

Methods: The HA level of serum samples from 79 patients who underwent a hepatectomy was measured, and the results were compared to conventional liver function tests, the degree of fibrosis, liver regeneration and complications.

Results: Hyaluronic acid concentrations correlated with the severe fibrosis or histological activity index, and also correlated with liver function tests including transaminase level, platelet counts, prothrombin time activity, indocyanine green retention rate at 15 min (ICG R15), liver activity at 15 min by technetium‐99m galactosyl human serum albumin scintigraphy (LHL 15), and portal pressure. The HA level postoperatively correlated with liver function, especially with total bilirubin. Hyaluronic acid levels at day 28 postoperatively correlated with ICG R15 and LHL 15. The hyaluronic acid level before surgery and at day 28 postoperatively correlated with the regeneration of remnant liver in major hepatectomy. The HA levels were significantly higher in patients with hepatic failure or prolonged ascites.

Conclusion: Our results indicate that the measurement of the HA level is useful for monitoring liver damage or predicting complications associated with liver surgery.
Inverse relationship between circulating levels of leptin and bone mineral density in chronic liver disease
Authors: Ormarsdóttir Sif , Ljunggren Östen , Mallmin Hans , Olofsson Helena , Blum Werner F , Lööf Lars
Published: March 2003

Background and Aim: The pathophysiology of osteoporosis complicating chronic liver disease is unknown. Recent animal studies have found leptin to be a potent inhibitor of bone formation. The aim of this study was to investigate the relationship between serum leptin levels and bone mineral density in patients with chronic liver disease.

Methods: Fifty‐eight patients, 39 females and 19 males, and age‐ and gender‐matched controls were included. Bone mineral density was measured by using dual energy X‐ray absorptiometry. Serum leptin was measured by using a radioimmunoassay.

Results: The mean serum leptin concentration was 10.4 ± 11.3 and 15.2 ± 17.9 ng/mL; P = 0.11, in the patients and controls, respectively. Leptin correlated positively with body mass index in patients (r = 0.40; P = 0.003) and in controls (r = 0.55; P < 0.0001). In patients classified as Child–Pugh grade B and C, serum leptin correlated negatively with bone mineral density in females at both the lumbar spine and the femoral neck (r = –0.78; P = 0.04 and r = –0.86; P = 0.03, respectively). In male patients, the correlation was only significant at the lumbar spine (r = –0.99; P = 0.002 and r = –0.86; P = 0.06, at the lumbar spine and femoral neck, respectively). No correlation was found between serum leptin and bone mineral density in the controls.

Conclusion: An inverse relationship between serum leptin and bone mineral density was found in patients with advanced chronic liver disease. The reasons for these findings are uncertain, but a pathophysiological role of circulating leptin in osteoporosis in chronic liver disease is possible.
Buried bumper syndrome: Old problem, new tricks
Authors: Vu Charles KF
Published: March 2003

Buried bumper syndrome is a rare complication of percutaneous endoscopic gastrostomy (PEG). The condition results from excessive tension between the external and internal bumpers. Several attributing factors may predispose the internal bumper to embedding in the gastric or abdominal wall. Surgical treatment was a reasonable approach to remove the internal bumper. The novel endoscopic method of exposing the buried internal bumper and subsequent removal using a needle knife sphincterotome has been reported. A radiological technique of removing the buried internal bumper was also recently described. We report two cases of buried soft‐tip bumpers that were easily removed by external traction without the need for surgical, invasive endoscopic or radiological methods of removal. In the first case, the original tract was incompletely closed, allowing a new PEG tube to be inserted via the same route. In the second case, an adjacent site was used for the re‐insertion as the original tract had completely closed. Both cases illustrate the ease with which the buried bumpers were removed. The advent of externally removable internal bumpers reduces the need for endoscopic or surgical removal of buried internal bumpers.
Cell kinetics of slow renewing cell populations in mice stomach
Authors: MAGAMI YASUSHI , AZUMA TAKESHI , INOKUCHI HIDETO , MORIYASU FUMINORI , KAWAI KEIICHI , HATTORI TAKANORI
Published: March 2003

Backgorund: The renewal rates of parietal and chief cells in the
gastric mucosa and smooth muscle cells of muscularis propria have not been examined
as precisely as superficial epithelial cells. To examine cell renewal of these cells,
continuous labeling with tritiated ([3H])‐thymidine was performed.

Methods: Mice received 112 repeated injections of [3H]‐thymidine at 6‐hour intervals for 28 days after birth and were killed immediately thereafter, or 60, 120, 200 or 300 days after the last injection.

Results: After continuous labeling, most cells in the stomach were labeled. At 60 days, unlabeled parietal cells in the neck area of the gland and unlabeled chief cells in the middle part of the gland appeared. Thereafter, the area of unlabeled cells expanded downwards to the bottom of the gland. Times required for labeling of total cell populations of parietal and chief cells to half were less than 60 days and more than 200 days, respectively. At 300 days, most parietal cells and about half of the chief cells remained labeled in the bottom of the gland. The labeling index of smooth muscle cells was about 100% for 300 days.

Conclusions: The time required for the newly formed parietal and chief cells to reach the lower end of the gland was more than 300 days. As a total cell population, the renewal rate of parietal cells was more rapid than that of chief cells. However, in terms of the downward migrating cell population, the renewal rate of parietal cells was a little slower than that of chief cells. Smooth muscle cells showed almost no renewal.

© 2002 Blackwell Science Asia Pty Ltd
Routine colonic mucosal biopsy and ileoscopy increases diagnostic yield in patients undergoing colonoscopy for diarrhea
Authors: YUSOFF IAN F , ORMONDE DONALD G , HOFFMAN NEVILLE E
Published: March 2003

Background and Aims: In patients undergoing colonoscopy for diarrhea, when the examination is normal, the role of routine mucosal biopsy remains controversial, particularly in the open‐access setting. It is uncertain whether routine ileoscopy adds anything to colonoscopy alone. We aimed to assess the yield of mucosal biopsy and ileoscopy in patients with diarrhea.

Methods: We retrospectively reviewed all colonoscopies performed for diarrhea over a 9‐year period in a tertiary referral center with an open‐access service. We then selected cases where the examination was normal and biopsies were performed. The histopathology reports of these selected cases were then reviewed.

Results There were 1131 cases identified. The mucosal examination was normal in 465 cases (41%); 362 of these had colonic biopsies performed. Histology was normal in 316 cases (87%) and was non‐specific in 28 cases (8%). Significant histopathology was present in 18 cases (5%) with a significantly higher prevalence of microscopic colitis in patients above 60 years old. Ileoscopy was performed in 508 cases and was abnormal in 26 cases (5%). The abnormality on ileoscopy was the sole abnormality in 13 cases (3%).

Conclusions Routine colonic mucosal biopsy and ileoscopy each identify significant additional pathology in 5% of cases when investigating patients with diarrhea, and are recommended as routine practice in this setting. We found ileal biopsy unhelpful when ileoscopy was normal.

© 2002 Blackwell Science Asia Pty Ltd
Detection of serum nitrite and nitrate in primary biliary cirrhosis: Possible role of nitric oxide in bile duct injury
Authors: HOKARI ATSUSHI , ZENIYA MIKIO , ESUMI HIROYASU , KAWABE TOMONOBU , GERSHWIN M ERIC , TODA GOTARO
Published: March 2003

Background: The role of nitric oxide synthase (NOS) in autoimmune disease is gaining increased attention because of the relationships between NOS activity and T‐lymphocyte subpopulations and, in particular, the influence of NO on cytokine production by Th1 versus Th2 cells. In addition, there is evidence that both the liver and infiltrating hepatic T cells have inducible NOS‐2 activity.

Methods: We studied serum levels of nitrite (NO2–) and nitrate
(NO3–) in groups of patients with liver disease secondary to hepatitis B, hepatitis C, autoimmune hepatitis and primary biliary cirrhosis (PBC). Simultaneously, in a nested subpopulation, we studied the liver expression of NOS‐2.

Results: Interestingly, there was a significant elevation both of nitrite and of nitrate in patients with PBC but not other liver diseases. Despite such increments, there was no correlation of the levels of nitrite and nitrate with sera levels of tumor necrosis factor‐α, interferon‐γ, alanine aminotransferase, total bilirubin, alkaline phosphatase, gamma‐glutamyl transpeptidase, platelet count, IgG, IgM, antimitochondrial antibodies or prothrombin time. These data were extended by demonstrating the expression of NOS‐2 by immunohistochemistry in 13/14 patients with PBC, including in 9/14 patient hepatocyte populations and 4/14 bile duct cells. In contrast, NOS‐2 expression was noted in hepatitis B and hepatitis C, but only found within mononuclear cells.

Conclusion: Our data suggest that NO produced through NOS‐2 may play a role in the pathogenesis of bile duct injury in some PBC patients.

© 2002 Blackwell Science Asia Pty Ltd
Development of small hepatocellular carcinoma in a patient with chronic hepatitis C after 77 months of a sustained and complete response to interferon therapy
Authors: Yamaura Takahiro , Matsumoto Akihiro , Rokuhara Akinori , Ichijo Tetuya , Tanaka Ehji , Hanazaki Kazuhiro , Kajikawa Shoji , Kiyosawa Kendo
Published: March 2003

Abstract  We report a case of hepatocellular carcinoma (HCC) that developed 77 months following sustained and complete response to interferon (IFN) therapy for chronic hepatitis C. A 67‐year‐old Japanese woman presented with a small mass in the liver that was diagnosed as HCC, 77 months after having completed IFN therapy and having shown a complete response to the therapy with sustained normalization of serum aminotransferases and eradication of serum hepatitis C virus (HCV). Hepatitis C virus RNA was also not detected in the resected tumorous and non‐tumorous liver tissues by polymerase chain reaction. This suggests that all patients with chronic HCV infection should be followed closely for as long as possible for the potential development of HCC, even after a complete and sustained response to IFN treatment.

© 2002 Blackwell Publishing Asia Pty Ltd
Liver as an ideal target for gene therapy: Expression of CTLA4Ig by retroviral gene transfer
Authors: Cheung Siu Tim , Tsui Tung Yu , Wang Wei Lin , Yang Zhen Fan , Wong San Yu , Ip Ying Chi , Luk John , Fan Sheung Tat
Published: March 2003

Background and Aims: Liver has been a target organ for gene therapy as it plays a central role in metabolism and production of serum proteins. Many metabolic disorders result from a deficiency of liver‐derived protein products. In transplantation settings, modulation of the immune responses caused by CTLA4Ig protein has been shown to be an attractive direction. In this study, we investigated the efficacy of hepatocyte transduction via introduction of the exogenous CTLA4Ig gene to the rat liver graft by retrovirus vector, and examined the presence of target serum protein after gene transfers.

Methods: We constructed a replication defective retroviral vector that contained the CTLA4Ig gene. The liver graft regeneration index was first examined by 5‐bromo‐2‐deoxyuridine, Ki‐67 and proliferating cell nuclear antigen antibodies to determine the optimal time of gene transduction. The liver graft was then perfused with the retroviral vector, and animals were killed at constant time points to examine for the presence of CTLA4 protein in the graft and peripheral blood.

Results: CTLA4 protein was detected on postoperative days 5, 9 and 14, with liver graft tissue transduction indexes of 7.2, 10.9 and 1.8, respectively. Blood protein levels were at 151.6, 26.5 and 21.4 ρg/mL, respectively. A transduction index reaching 22.1 was observed in the graft with the most rapid liver regeneration.

Conclusions: We had established the gene delivery model in rat with auxiliary partial liver transplantation. Expression of the exogenous gene delivered by retrovirus was demonstrated in the liver with secretion of diffusible protein in the bloodstream. The present study provides important information for gene transfer using the liver to produce the target protein in situ and as serum protein. This will also be applicable to the treatment of other metabolic diseases.

© 2002 Blackwell Publishing Asia Pty Ltd
Reflux esophagitis facilitates low Helicobacter pylori infection rate and gastric inflammation
Authors: Jang Tae Jung , Kim Nam Il , Suh Jeong Ill , Yang Chang Heon
Published: March 2003

Abstract Background: Helicobacter pylori
is regarded as an important pathogen in upper gastrointestinal diseases. However, little is known about the relationship between
H. pylori
infection and reflux esophagitis. Therefore, an investigation was undertaken in Korean subjects regarding the incidence of
H. pylori infection, and a histopathological study of reflux esophagitis was also carried out.

Methods: Analysis of gastric biopsy specimens was conducted for 73 patients with reflux esophagitis and 132 control subjects without reflux esophagitis. The H. pylori infection was assessed by using rapid urease test and the immunohistochemical method, and gastric mucosal morphologic change was analyzed according to the updated Sydney system.

Results: The prevalence of H. pylori infection was significantly lower in patients with reflux esophagitis than in the non‐reflux group. Grade of inflammation and glandular atrophy in the antrum and body were higher in patients in the non‐reflux group compared with those in the reflux esophagitis group.

Conclusions: It is suggested that H. pylori infection decreases the risk of reflux esophagitis by inducing atrophic gastritis.

© 2002 Blackwell Publishing Asia Pty Ltd
Combination therapy for children with chronic hepatitis B virus infection
Authors: Dikici Bunyamin , Bosnak Mehmet , Bosnak Vuslat , Dagli Abdullah , Ece Aydin , Yagci Rasit Vural , Haspolat Kenan
Published: March 2003

Background and Aim: To compare the therapeutic efficacy of two different interferon (INF)‐α and lamivudine (LAM) combination therapy regimens in childhood chronic hepatitis B (CHB) infections.

Methods: Thirty‐two children with CHB infection were prospectively evaluated in two random groups. In the first group, patients received INF‐α 10 MU/m2 and LAM 4 mg/kg (max 100 mg) simultaneously for 6 months, and then LAM alone was continued for 6 months. In the second group, LAM was started alone for the first 2 months, then INF‐α added to LAM for 6 months, after which INF‐α was stopped, and LAM alone was continued for 4 months. The same doses of LAM and INF‐α were used in both groups.

Results: In the first group, the mean values of alanine aminotransferase (ALT) were 125 ± 100 IU/L and 28 ± 8 IU/L at the beginning of the treatment and at the end of the 12 months, respectively (P < 0.05). At the end of 6 months of the follow‐up period, the mean ALT value was 36 ± 37 IU/L. In group 2, mean ALT values were 111 ± 63 IU/L, 35 ± 2 IU/L and 34 ± 2 IU/L initially, at the end of 12 months and at the end of 6 months of follow up, respectively (P < 0.05). At the end of therapy, the ratios of hepatitis B early antigen (HBeAg) clearance and antibody to HBeAg (anti‐HBe) seroconversion were 65% and 47% in group 1 and 60% and 40% in group 2, respectively (P > 0.05). After 6 months from completion of therapy, rates of seroconversion to anti‐HBe were found to be 64% and 47% in group 1, and 53% and 46% in group 2, respectively (P > 0.05). Hepatitis B virus (HBV) DNA was detectable by polymerase chain reaction in only one patient in group 1 at the end of therapy and 6 months after termination of therapy. Clearance of HBV DNA in group 2 was observed in all but one patient at the end of the therapy. However, two patients relapsed within 6 months of cessation of therapy. Complete response occurred in 47% and 40% of patients at the end of the therapy in group 1 and 2, respectively (P > 0.05). These ratios were changed to 47% and 46%, respectively, 6 months after discontinuation of drugs (P > 0.05).

Conclusions: Comparison of our two different combination regimens disclosed similar results in the normalization of ALT, clearance of HBeAg and HBV DNA and seroconversion to anti‐HBe. However, the most beneficial combination of LAM and INF‐α treatment modalities needs to be further investigated.
Effect of antisense human telomerase RNA on malignant phenotypes of gastric carcinoma
Authors: Yang Shi‐Ming , Fang Dian‐Chun , Yang Jin‐Liang , Liang Guang‐Ping , Lu Rong , Luo Yuan‐Hui , Liu Wei‐Wen
Published: March 2003

Aim
: The study was designed to explore the effects of antisense human telomerase RNA (ahTR) on the malignant phenotype of gastric carcinoma cell line SGC‐7901, and its potential role in gene therapy for tumors.

Methods
: An ahTR eukaryotic expression vector, including the sequence of template region of telomere repeats, was constructed by recombinant technology of molecules and then transfected into gastric carcinoma cell line SGC‐7901 by liposome DOTAP. Subsequently, the expression of hTR RNA and ahTR RNA by reverse transcription–polymerase chain reaction, telomerase activity by telomeric repeat amplification protocol‐ELISA (TRAP‐ELISA), telomere length by Southern blotting, cell morphology under light microscope, cellular proliferation capacity by 3‐(4,5‐dimethyl‐2 thiazoyl)‐2,5‐diphenyl‐2H‐tetrazolium bromide assay, cell‐cycle distribution by flow cytometry, efficiency of clone formation in soft agar, and tumorigenecity in nude mice were examined and evaluated in ahTR‐transfected cells, control plasmid pCI‐neo transfected cells and their parental cells.

Results
: An ahTR eukaryotic expression vector was constructed and successfully transfected into SGC‐7901 cells. The telomerase activity in ahTR‐transfected SGC‐7901 cells decreased from 100% to ap‐proximately 25%, and telomere length in the cells shortened to 3.35 from 4.08 Kb at 60 population doublings. Compared with the parental cells and pCI‐neo transfected cells, ahTR‐transfected cells displayed some morphological changes, such as decreased atypia, and recovery of contact inhibition and density inhibition under light microscope. Furthermore, ahTR‐transfected cells displayed decreased invasive capacity in Borden's chamber invasive model, increased G0/G1 phase rate and apoptotic rate. Surprisingly, ahTR‐transfected SGC‐7901 cells lost their capacity for clone formation in soft agar and tumorigencity in nude mice.

Conclusion
: Antisense‐hTR transfection can inhibit the growth of SGC‐7901 cells and partially reverse the malignant phenotypes. This study provides an exciting approach for cancer therapy by inhibiting telomerase activity using an antisense gene.

© 2002 Blackwell Publishing Asia Pty Ltd
Accuracy of a new near patient test for the diagnosis of Helicobacter pylori infection in Chinese
Authors: WONG WAI MAN , LAM SHIU KUM , XIA HARRY HX , TANG VERA SY , LAI KAM CHUEN , HU WAYNE HC , CHAN CHI KUEN , CHEUNG KWAN LOK , WONG BENJAMIN CY
Published: March 2003

Background and Aim:
The performance of existing near patient tests for the diagnosis of Helicobacter pylori remains unsatisfactory. The aim of this study is to evaluate the accuracy of a new near patient test (Signify H. pylori) for the diagnosis of H. pylori and the usefulness of the Signify H. pylori test for a test and treat strategy.

Methods:
Consecutive dyspeptic patients referred for upper endoscopy were recruited. Rapid urease test and histology were used as the gold standard. After endoscopy, blood was collected for the Signify H. pylori test and compared with a gold standard.

Results:
Two hundred and forty‐four patients were eligible for analysis and 121 (49.5%) were positive for H. pylori. The Signify H. pylori test showed a sensitivity, specificity, and accuracy of 84.3, 89.4%, and 86.9%, respectively, for whole blood and 79.3, 88.6, and 84.0% for serum, respectively. The sensitivity and specificity of the Signify H. pylori whole blood test was 87.5 and 92.6% for patients less than 45‐years‐old and the accuracy was similar between patients referred from primary care physicians or gastroenterologists. The test is easy to operate and results are available within 5 min.

Conclusion:
The Signify H. pylori test is accurate for the near patient diagnosis of H. pylori infection.

© 2002 Blackwell Publishing Asia Pty Ltd
Rabbit model of non‐cirrhotic portal fibrosis with repeated immunosensitization by rabbit splenic extract
Authors: KATHAYAT R , PANDEY GK , MALHOTRA V , OMANWAR S , SHARMA BK , SARIN SK
Published: March 2003

Background
: Non‐cirrhotic portal fibrosis (NCPF) or idiopathic portal hypertension, a disease of unknown etiology, is a common cause of portal hypertension in developing countries. Attempts to understand the etiopathogenesis of NCPF by developing animal models have been made. We describe a novel approach using repeated injections of rabbit splenic extract that were obtained from a previously primed rabbit, to develop a model of NCPF.

Methods
: Twenty‐eight rabbits (1.5–2.0 kg) were divided into the control (group I, n
= 13) and the experimental (group II, n = 15) groups. The supernatant obtained after centrifugation of a 20% splenic homogenate, containing 6 mg protein/mL, was mixed with Freund's complete adjuvant (1:1 ratio) and injected intramuscularly to the recipient rabbits every 2 weeks for 3 months. Portal pressure was measured by inserting a cannula into the gastrosplenic vein.

Results
: The mean portal pressure in group II was significantly (P < 0.05) higher than group I at 1 (19.4 ± 2.9 vs 10.4 ± 2.2 mmHg), 3 (16.7 ± 1.1 vs 7.2 ± 3.6 mmHg), and 6 (20.3 ± 5.4 vs 10.3 ± 4.8 mmHg) months. The mean splenic weight in group II was significantly (P < 0.05) greater than group I at 1, 3 and 6 months. Histopathology of spleen showed medullary congestion, hemosidrin laden macrophages and mild fibrosis. Liver showed normal hepatocytes with mild portal lymphocytic infiltrates and Kupffer cell hyperplasia. No significant anomalies were observed in the tests of liver function at 1 and 6 months.

Conclusions
: This animal model showed significant splenomegaly, with persistent rise in portal pressure without hepatic parenchymal injury, quite akin to NCPF seen in humans. This study also proposes that repeated immunostimulation may have an important role in the pathogenesis of NCPF.

© 2002 Blackwell Publishing Asia Pty Ltd
Contrast media‐enhanced power Doppler sonography for evaluation of hemangiomas and malignant tumors in the liver
Authors: KARABACAKOGLU AYDIN , KARAKOSE SERDAR , CIL AHMET SAID , KAYA AHMET
Published: March 2003

Aim: To evaluate the characterization of liver hemangiomas and malignant tumors using power Doppler sonography before and after intravenous injection of a sonocontrast agent.

Methods: Forty‐five patients with 57 liver tumors (22 hemangiomas, 24 metastases, 10 hepatocellular carcinomas (HCC) and one cholangiocellular carcinoma) were examined prospectively. The distribution (peripheral, central, mosaic) and extent (none, minimal, moderate and strong) of intratumoral flow pattern in each sonographic examination was subjectively classified.

Results: The administration of the sonocontrast agent by bolus injection caused enhancement to gradually increase up to 2 min and lasted for 4–5 min. After injection of contrast agent, flow signals appeared or increased in 34 tumors. No signal enhancement was observed in 18 hemangiomas, four metastases and one HCC. The sensitivity and specificity of intratumoral vascularity for the detection of malignant liver tumors was 37.1 and 90.9% for unenhanced power Doppler sonography, and 85.7 and 81.8% for contrast‐enhanced power Doppler sonography, respectively.

Conclusion: Contrast‐enhanced power Doppler sonography is superior to unenhanced power Doppler sonography in the demonstration of malignant tumor vascularity, and is helpful in differentiating between hemangiomas and malignant liver tumors. A specific flow pattern within the tumor is not established in primary and metastatic malignant tumors with contrast‐enhanced power Doppler sonography.

© 2003 Blackwell Publishing Asia Pty Ltd
Lafutidine increases hepatic blood flow via potentiating the action of central thyrotropin‐releasing hormone in rats
Authors: YONEDA MASASHI , KUROSAWA MIEKO , WATANOBE HAJIME , TERANO AKIRA
Published: March 2003

Background:  Lafutidine, (±)‐2‐(furfurylsulfinyl)‐N‐[4‐[4‐(piperidinomethyl)‐2‐pyridyl]oxy‐(Z)‐2 butenyl]acetamide, is a newly synthesized histamine H2 receptor antagonist and possesses a cytoprotective efficacy, which comprises mucin biosynthesis and stimulation of gastric blood flow mediated through capsaicin‐sensitive sensory neurons and endogenous calcitonin gene‐related peptide (CGRP). In the present study, an effect of lafutidine on hepatic blood flow was investigated in rats that received an intracisternal injection of a subthreshold dose of thyrotropin‐releasing hormone (TRH) analog, RX 77368.

Methods:  Change in hepatic blood flow was determined by laser Doppler flowmetry. Male Wistar rats were anesthetized with urethane (1.5 g/kg, i.p.), and positioned on a stereotaxic apparatus. An abdominal incision was made, and a probe of laser Doppler flowmeter was placed on the surface of the liver. After a 60‐min stabilization, basal hepatic blood flow was measured for 30 min, and lafutidine (0.5, 1, 3, 5 or 10 mg/kg) or vehicle was injected into the portal vein and a subthreshold dose (1.5 ng) of RX 77368 was injected intracisternally. Hepatic blood flow was monitored for 120 min postinjection. To investigate a role of capsaicin‐sensitive sensory neurons and endogenous CGRP, systemic capsaicin treatment (125 mg/kg, s.c., 10–14 days before) and intravenous infusion of a CGRP receptor antagonist, human CGRP‐(8‐37) (15 µg/kg as a bolus, followed by infusion at 3 µg/kg/h) were performed, respectively.

Results:  Intracisternal injection of RX 77368 (1.5 ng) or intraportal lafutidine (10 mg/kg) by itself did not affect hepatic blood flow, but co‐injection of intracisternal RX 77368 (1.5 ng) and intraportal lafutidine (5 mg/kg) increased it with peak response at 30 min postinjection. The effect of lafutidine on hepatic blood flow in rats given RX 77368 was dose‐related over the range 1–5 mg/kg. By contrast, intracisternal injection of RX 77368 (1.5 ng) did not change hepatic blood flow in rats injected with another histamine H2 receptor antagonist, famotidine (5 mg/kg), intraportally. The stimulatory effect of co‐injection of TRH analog and lafutidine was abolished by systemic capsaicin‐treatment and CGRP antagonist.

Conclusion:  These data suggest that lafutidine increases hepatic blood flow by sensitizing the liver to the action of central TRH via both capsaicin‐sensitive sensory neurons and endogenous CGRP in urethane‐anesthetized rats.
Relative bioavailability and plasma paracetamol profiles of Panadol® suppositories in children
Authors: COULTHARD KP , NIELSON HW , SCHRODER M. , COVINO A , MATTHEWS NT , MURRAY RS , VAN DER WALT JH
Published: March 2003

Objective:

To determine the relative bioavailability and plasma paracetamol concentration profiles following administration of a proprietary formulation of paracetamol suppositories to postoperative children.

Methodology and Results:

Study A—eight children undergoing minor surgery had blood samples collected following the rectal administration of either a 250 mg or 500 mg paracetamol suppository on one day and an equivalent oral dose on the following day. A mean dose of 13 mg/kg gave a mean Cmax (Tmax) of 7.7 mg/L (1.6 h) and 4.9 mg/L (2.0 h) following oral and rectal administration, respectively. The mean relative rectal bioavailability was 78% (95% confidence interval of 55–101%). Study B—20 children undergoing tonsillectomy and/or adenoidectomy were randomly assigned to receive a postoperative dose of 500 mg of paracetamol either as 2×250 mg liquid filled or 1×500 mg hard wax Panadol® suppository. A mean dose of 25 mg/kg produced mean maximum plasma paracetamol concentrations of 13.2 mg/L and 14.5 mg/L at 2.1 and 1.9 h for the hard and liquid filled suppository, respectively. The absorption rate constants and areas under the curves suggested no difference in the rate or extent of absorption between the two formulations.

Conclusion:

Absorption of paracetamol following rectal administration of Panadol® suppositories to postoperative children is slower and reduced as compared to oral therapy. The hard wax and liquid filled products have similar absorption characteristics. The usually quoted antipyretic therapeutic range for paracetamol is 10–20 mg/L, although 5 mg/L may be effective. A single rectal dose of 25 mg/kg will obtain this lower concentration within 1 h of administration and maintain it for up to 6 h. When given in an appropriate dose for analgesia, maximum plasma paracetamol concentrations would be available in the immediate postoperative period if the rectal dose was given 2 h before the planned end of the procedure.
Mortality and neurodevelopmental outcome for infants receiving adrenaline in neonatal resuscitation
Authors: O’DONNELL AI , GRAY PH , ROGERS YM
Published: March 2003

Objective:

To document the outcome, in terms of mortality and morbidity, for all infants requiring adrenaline as part of initial neonatal resuscitation, and to identify the differences between term and preterm infants.

Methods:

All infants in a five‐year period who received adrenaline during delivery room resuscitation were retrospectively identified. Data from the perinatal period were ascertained by chart review. Details of survivors at 1 year or later were reviewed.

Results:

Seventy‐eight infants were identified representing 0.2% of all deliveries. Over half of all infants survived, with the proportion increasing with advancing gestational age from 30% below 29 weeks to 67% at term. Seventy‐three per cent of survivors were normal at follow‐up to at least 1 year, with more preterm infants being normal than term infants (79% vs 64%). Over half of survivors below 29 weeks’ gestation were normal, but overall 78% of this group either died or showed evidence of neurodevelopmental disability. Asystolic infants did not differ from the bradycardic infants in terms of survival or rates of disability. Adrenaline may be contraindicated in asystolic very preterm infants.

Conclusions:

Adrenaline retains a role in term and mature preterm infants where there is an acute cause for depression at delivery. In very preterm infants its use is associated with a high rate of death and disability. Failure to stabilise with adequate ventilatory support should be seen as a poor prognostic sign in this group.
Randomised trial of histoacryl blue tissue adhesive glue versus suturing in the repair of paediatric lacerations
Authors: BARNETT P , JARMAN FC , GOODGE J , SILK G , AICKIN R
Published: March 2003

Objective:

To compare histoacryl blue tissue adhesive glue with suturing in the repair of simple paediatric lacerations.

Methodology:

Prospective, randomised controlled trial in tertiary paediatric emergency department. Children 4 years old or older with non‐ragged lacerations <5 cm in length,<12‐h‐old and not involving eyelid or mucous membrane. A total of 163 patients were randomly allocated to either glue (83 cases) or sutures (80 controls) to repair their laceration. Primary outcome measures were cosmetic outcome at 3 and 12 months with secondary outcomes—length of time to perform procedure, and pain assessment of procedure by doctor, nurse, parent and child.

Results:

Cases and controls were similar in age, wound length and width and body part involved, but more females received glue (P=0.013). Time taken to repair the wound was faster in the glue group (median 0–2 mins vs. 6–10 min suture, P<0.001). Doctors (P=0.02), nurses (P<0.01) and parents (P=0.02) but not the children themselves (P=0.24) rated glue repair as less distressing. Complications at 1 week (wound dehiscence, redness and discharge) were the same for both groups (P>0.2). Cosmetic outcome was the same for both groups at 3 (n=65) and 12 (n=65) months (P>0.7).

Conclusion:

Tissue adhesive glue is faster and probably less painful than suturing. Tissue adhesive glue has the same cosmetic result as suturing when used for the repair of simple lacerations in children.
Prevalence of emotional and physical health concerns amongst young people in Victoria
Authors: Waters E , Wake M , Toumbourou J , Wright M , Salmon L
Published: March 2003

Objective: To describe the emotional and physical health concerns of young people, and identify the concerns for which young people are more likely to seek help.

Methods: We surveyed a representative cross‐sectional sample of students from 11 to 18 years of age from 24 Victorian secondary schools in late 1997 within the Health of Young Victorians Study. Included in this survey were items describing worries or concerns of physical and emotional health. Prevalence rates, Chi‐square, and logistic regression analyses were used to describe relationships.

Results: 2361 questionnaires were completed (53% male, response rate 70%). Overall, most frequent reports concerned feelings of depression (40%), worries about weight (37%), worries about self confidence (34%), and trouble falling or staying asleep (30%). Females tended to report a greater range of health concerns. The most frequent reports, by gender, were worries about their weight (52% females), and feelings of depression (30% males). Feelings of being bullied (20%), and concerns about sex, drugs and alcohol (7–11%) were reported equally frequently by males and females. In contrast to the high levels of health concerns reported, few students also reported seeing someone about them other than parents or friends. This finding appeared consistent across ages and for both sexes; with higher rates of seeking help for their physical rather than emotional health concerns.

Discussion: These results show that adolescents across Victoria are reporting high levels of concerns or worries about their health which differ across age and gender. They are more likely to report concerns about emotional health, but less likely to seek professional help than for physical concerns.
Papilloedema secondary to acute purulent sinusitis
Authors: Kumar R Kishore , Ghali MH , Dragojevic F , Young F
Published: March 2003

Abstract: Upper respiratory tract infections and sinusitis are common, but intracranial complications of sinusitis are rare in children and are often clinically unremarkable. Papilloedema secondary to purulent sinusitis is a complication previously not reported. We report two cases to highlight atypical manifestations of sinusitis in children.
Radiofrequency catheter ablation in a haemodynamically compromised premature neonate with hydrops fetalis
Authors: Osborn DA , Lau KC , Uther JB , Coughtrey H , Rochefort MJ
Published: March 2003

Abstract: A preterm infant was born at 35 weeks gestation after failed antenatal antiarrhythmic therapy. The infant had an incessant supraventricular tachycardia, impaired ventricular function and hypotension and failed to respond to adenosine, cardioversion and intravenous amiodarone. After resuscitation from cardiovascular collapse, a successful radiofrequency catheter ablation (RFA) of a left free wall atrioventricular pathway was performed at 24 h of age without extracorporeal support. The infant is normal on follow up at 12 months of age. Whilst most fetal and neonatal supraventricular tachyarrhythmias respond to antiarrhythmic medications and RFA is not required, this is the earliest RFA to be performed on a premature infant when antiarrhythmics have failed.
Transmission of tuberculosis from a seven‐year‐old child in a Sydney school
Authors: Cardona M , Bek MD , Mills K , Isaacs D , Alperstein G
Published: March 2003

Objectives: To determine whether a 7‐year‐old child with extrapulmonary and pulmonary tuberculosis (TB) and direct smear positive sputum for acid‐fast bacilli was infectious to home and school contacts, and to ascertain potential adult sources of infection for these contacts.

Methods: Contact tracing by Mantoux testing was conducted on 220 children at a primary school and after‐school care facility, and 59 selected adults considered potential sources of infection.

Results: The participation rate for the children was 98% and 92% for the adults. Mantoux positivity (induration ≥ 10 mm, or ≥ 15 mm with previous BCG) among children was 13% at the school (anticipated rate 2–3%), 26% among school staff, and 7% among children at the after‐school care centre where the index case attended. One exposed adult hospital staff member converted from Mantoux negative to positive. No other cases of TB disease were detected among children or adults tested.

Conclusion: Although spread of TB from children to others is rare, the findings of this investigation indicate that transmission of TB from a young child to other children and an adult may have occurred, and that sputum testing and contact tracing for sputum smear positive children should be considered.
Ecthyma gangrenosum as a very early herald of acute lymphoblastic leukaemia
Authors: Pouryousefi A , Foland J , Michie CA , Cummins M
Published: March 2003

Abstract: Ecthyma gangrenosum is a manifestation of cutaneous infection by Pseudomonas aeruginosa. The lesion may be associated with immunocompromise, in particular neutropenia. We present a case of ecthyma gangrenosum in a previously healthy child who 3 months later developed acute lymphoblastic leukaemia; we use this to illustrate the lack of information on the growth rate of malignant and premalignant leukaemic cells in children.