bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of obstructive jaundice on neutrophil chemotactic activity: An in vivo assessment in zymosan‐induced peritonitis model in rats
Authors: YAMAMOTO SHIN , KUBOTA YOSHITSUGU , TSUJI KAZUYUKI , YANAGITANI KAORI , TAKAOKA MAKOTO , KIN HIDEYUKI , OGURA MAMI , INOUE KYOICHI
Published: March 2008

The effect of obstructive jaundice on local neutrophil accumulation in response to inflammatory stimulus was investigated in rats. Obstructive jaundice was produced by bile duct ligation for 7 days. Zymosan (200 mg) was injected intraperitoneally and 4h later myeloperoxidase activity in the peritoneal fluid was measured to quantify neutrophil recruitment. Zymosan‐induced neutrophil recruitment was significantly greater (more than two‐fold) in bile duct‐ligated rats than in sham‐ligated or normal animals. Depletion of peritoneal cells significantly suppressed neutrophil recruitment after zymosan injection in all three groups, with no significant differences between the groups. In normal rats, replacement of their peritoneal cells by those from bile duct‐ligated rats did not enhance zymosan‐induced neutrophil recruitment. In contrast, bile duct‐ligated rats treated with peritoneal cell replacement from normals showed significantly increased neutrophil recruitment after zymosan injection. In vitro neutrophil chemotaxis in response to formyl‐Met‐Leu‐Phe was significantly enhanced in bile duct‐ligated rats, compared with that in sham‐ligated animals. The results suggest that local neutrophil recruitment in response to inflammation may be enhanced in obstructive jaundice and that increased neutrophil chemotactic activity, not macrophage activity, may play a prime role in the mechanism.
Effects of colchicine and phenothiazine on biliary excretion of organic anions in rats
Authors: TAKIKAWA HAJIME , SANO NAOYO , AKIMOTO KAZUKO , OGASAWARA TAKASHI , YAMANAKA MASAMI
Published: March 2008

Vesicular transport inhibitors have been reported to inhibit biliary excretion of some organic anions, suggesting that vesicular transport has a role in intracellular transport of these compounds. However, these inhibitors are substrates for P‐glycoprotein. To examine whether P‐glycoprotein has a role in canalicular transport of organic anions in addition to the canalicular multispecific organic anion transporter, we studied the effect of colchicine, a vesicular transport inhibitor, and phenothiazine to increase P‐glycoprotein expression on biliary excretion of various organic anions in rats. Colchicine treatment slightly but significantly inhibited biliary excretion of indocyanine green, dinitrophenylglutathione and pravastatin, and had no effect on biliary excretion of sulphobromophthalein and dibromosulphophthalein. Phenothiazine treatment did not affect biliary excretion of indocyanine green and pravastatin, but it increased biliary sulphobromophthalein‐glutathione excretion. In conclusion, the present findings suggest that P‐glycoprotein plays an additive role on biliary excretion of some organic anions in addition to the canalicular multispecific organic anion transporter.
The liver in traditional Chinese medicine
Authors: CHEN THOMAS SN , CHEN PETER SY
Published: March 2008

Medical thinkers in China visualized the liver in microcosmal and macrocosmal terms. An anatomical tradition did not exist, hence the liver was described grossly in broad outline. It was recognized as being functionally important in the movement of qi (vital energy) and storage of xue (‘blood’). The liver corresponded to various phenomena in both the natural and social orders, according to the scheme of yin‐yang and five phases. These interrelationships provided the basis for the diagnosis and treatment of liver dysfunctions. The disorders fell into three general groups: (1) hepatic qi stasis; (ii) hepatic yang excess with yin deficiency; and (iii) hepatic yin insufficiency. The signs and symptoms represented the logical outcomes of the disturbed physiology. Acupuncture, moxibustion and herbal drugs were used to redress the imbalance of hepatic qi and yin‐yang. The impact of Western medicine led traditional authors to recognize the hepatobiliary role in bile secretion and in jaundice. The exchange between the Western and Chinese medical traditions revealed that active agents were included in the Chinese formulary, such as glycyrrhizin, which has recently been shown to be beneficial in chronic viral hepatitis.
Current risks of viral hepatitis from blood transfusions
Authors: GRESENS CHRISTOPHER J , HOLLAND PAUL V
Published: March 2008

The incidence of transfusion‐associated hepatitis in the United States has fallen dramatically since the late 1960s. Where once the risks were so great that as many as one in three transfused patients contracted hepatitis, now they are infinitesimal. Many factors share responsibility for this accomplishment; however, two stand above the rest: (i) improved donor selection and screening criteria, especially elimination of paid blood donations; and (ii) major advances in testing for viral hepatitis carriers. Currently, four tests are used for the prevention of transfusion‐associated hepatitis: (i) hepatitis B surface antigen; (ii) hepatitis C virus antibody; (iii) hepatitis B core antibody; and (iv) alanine aminotransferase. The first two tests are largely responsible for the current low risks of transfusion‐associated hepatitis due to hepatitis B virus and hepatitis C virus of 1 in 63000 and 1 in 125000, per unit, respectively. To further reduce the risks of transfusion‐associated hepatitis will require the enhanced sensitivity provided by nucleic acid amplification techniques (e.g. polymerase chain reaction). Currently, however, no such tests are licensed and practical, automated, or inexpensive enough for individual blood donor screening. We have made such great strides in the prevention of transfusion‐transmitted hepatitis that background rates of viral hepatitis now greatly exceed the risk of transmission via transfusion. For this reason, while it may still be reasonable to consider a transfusion as a possible cause for hepatitis, it is imperative that many other possibilities (e.g., iatrogenic and other risk factors) be ruled out.
CASE REPORT: A long‐term survivor of jejunal leiomyosarcoma with liver metastasis: Effective transcathetel arterial embolization for hepatic metastatic foci
Authors: HARA TOSHIYA , WADA IKUKO , KAJIHARA SUSUMU , MIZUTA TOSHIHIKO , YAMAMOTO KYOSUKE , SAKAI TAKAHIRO
Published: March 2008

We report a case of jejunal leiomyosarcoma with liver metastases in a 52‐year‐old Japanese male. An echogram demonstrated multiple cystic liver masses in April 1991. The diagnosis of metastatic leiomyosarcoma was made on the basis of characteristic hepatic angiography images and liver biopsy findings. The jejunal leiomyosarcoma was resected and unresectable liver metastatic foci were treated repeatedly with transcathetel arterial embolization. Transcathetel arterial embolization was considered to be effective in this case as the patient survived 4 years and 9 months after the first treatment.
Altered intrahepatic pathway of para‐umbilical vein in portal hypertension
Authors: OHHIRA MOTOYUKI , OHTA HITOYOSHI , OHHIRA MASUMI , MATSUMOTO AKINORI , OHTAKE TAKAAKI , FUJIMOTO YOSHINORI , MURAZUMI KAZUHIKO , ONO MINORU , KOHGO YUTAKA
Published: March 2008

The object of this study was to determine the frequency and characteristics of altered paraumbilical vein in the hepatic parenchyma, developed from portal hypertension, using computed tomography (CT). Two hundred and ninety‐two patients who presented with portal hypertension from 1986 to 1996 were studied retrospectively. The pathway of the dilated para‐umbilical vein was demonstrated by contrast‐enhanced CT. Thirty‐one (11%) patients had a dilated para‐umbilical vein arising from the left portal vein into the falciform ligament. In 24 (77%) of these patients, the para‐umbilical vein followed the expected route, passing through the fissure of ligamentum teres hepatis. The remaining seven patients (23%) displayed the unusual pathway, with the vein arising from the left branch of the portal vein and passing into the hepatic parenchyma. In these seven patients, four had one collateral vein, and three patients had two collateral veins in the liver parenchyma. The dilated para‐umbilical vein frequently passes through the hepatic parenchyma in patients with portal hypertension.
Altered biliary bilirubin profile in patients with persistent hyperbilirubinaemia after hepatic resection: Analysis of bile bilirubin subfractions by high‐performance liquid chromatography
Authors: ISHIYAMA SHUICHI , FUSE AKIRA , KUZU HIROSHI , IGARASHI YUKIO , URAYAMA MASAHIRO , TSUKAMOTO MASARU
Published: March 2008

Subfractions of bilirubin in bile, obtained via biliary drainage tubes from 23 patients who had undergone radical surgery for bile duct cancer, were analysed by high‐performance liquid chromatography for 14 days after surgery. Five principal conjugated bilirubins were resolved: bilirubin diglucuronide (BDG); bilirubin monoglucuronide monoglucoside (BGG); bilirubin monoglucuronide monoxyloside (BGX); and two isomers of bilirubin monoglucuronide. After surgery, depression in concentration of BDG and elevation of BGG and BGX were found. These alterations were of higher magnitude in patients who had undergone hepatectomy, and especially prolonged in patients with hyperbilirubinaemia. These results suggest that the alteration in proportions of bilirubin conjugates might be a cause of hyperbilirubinaemia after hepatectomy.
Case Report: Secondary biliary cirrhosis possibly related to congenital hepatic fibrosis. Evidence for decreased number of portal branch veins and hypertrophic peribiliary vascular plexus
Authors: DE LÉDINGHEN VICTOR , LE BAIL BRIGITTE , TRILLAUD HERVÉ , BERNARD PIERRE‐HENRI , SARIC JEAN , BALABAUD CHARLES , BIOULAC‐SAGE PAULETTE
Published: March 2008

A 30‐year‐old man with presinusoidal portal hypertension was transplanted for cryptogenic cirrhosis. On the explanted liver, few intrahepatic stones, biliary cirrhosis, chronic cholangitis of the large bile ducts and a peculiar proliferation of small dilated bile ducts at the periphery of the portal tracts led to the diagnosis of secondary biliary cirrhosis and cholangitis, possibly linked to ductal plate malformation, including congenital hepatic fibrosis associated with a minor form of Caroli's disease. Ex vivo portogram and histology showed the paucity of portal vein branches and the hypertrophy of the peribiliary vascular plexus. This hypertrophy, which has been reported in livers with presinusoidal hypertension, is another indirect argument to suggest the diagnosis of congenital hepatic fibrosis.
Symptom relief with amitriptyline in the Irritable Bowel syndrome
Authors: RAJAGOPALAN MANI , KURIAN GEORGE , JOHN JACOB
Published: March 2008

Anti‐depressants have been reported to be useful in the management of the Irritable Bowel syndrome. We studied the efficacy of amitriptyline for 12 weeks in a randomized double‐blind placebocontrolled trial. Forty patients who met predefined criteria entered the trial. They received 25 mg amitriptyline for the first week, 50 mg for the second week and 75 mg nightly thereafter until the end of the 12th week. The drug and placebo groups were comparable in all major pretreatment variables. Amitriptyline was found to be significantly more effective than placebo in producing global improvement, increasing feelings of well‐being, reducing abdominal pain and increasing satisfaction with bowel movements. Younger age and increasing extroversion predicted a better response to amitriptyline. Severity of depressive and anxiety symptoms and other personality variables did not influence outcome.
Cerebral changes in hepatic encephalopathy
Authors: WATANABE AKIHARU
Published: March 2008

Hepatic encephalopathy (HE) accompanied by an impairment of consciousness from orientation disorder (grade II) to coma (grade IV) is considered to be overt HE and is treated as an emergency. However, subclinical hepatic encephalopathy (SHE) can be detected by sensitive and quantitative neuropsychological examinations in cirrhotic patients without overt HE. The introduction of the SHE concept is clinically important for preventing the deterioration of SHE (grades 0 and I) to overt HE (grade II and more severe), prolonging the compensated state of cirrhosis without its deterioration to hepatic failure, and the continuation of patient treatment at home. We developed a new diagnostic method for SHE using a quantitative neuropsychological test, with the computerization of all operations. Evaluations of cerebral function and morphology are useful for the determination of the patho‐physiology of HE, and assist the diagnosis of SHE. The latencies of the P3 wave in the visually evoked potential and the P300 wave in the event‐related potential are prolonged in cirrhotic patients with SHE and are well expressed in three‐dimensional coloured topograms (brain mapping). Automated polysomnographic analysis is useful for continuous‐monitoring electroencephalograms (EEG) and for the detection of the sleep disturbance observed in cirrhotic patients with SHE. Brain atrophy in computed tomography (CT), magnetic resonance imaging (MRI) and high signals in the basal ganglia in the MR‐T1‐weighted images have frequently been observed in patients with SHE. The reduction of regional cerebral blood flow (rCBF) by 99mtechnetium‐1, 1‐ethylcysteinate dimer (99mTc‐ECD)‐single photon emission computed tomography (SPECT) and the choline/N‐acetylaspartic acid ratio by 1proton‐magnetic resonance spectroscopy (1H‐MRS) were observed in the hippocampus in patients with SHE. These approaches (cerebral function tests and imaging diagnoses of the brain) can also be used to evaluate the effectiveness of treatments for HE; for example, branched‐chain amino acid (BCAA) was shown by automated continuous polysomnographic analysis to be a psychotropic drug which acts directly on the central nervous system and the clinical significance of choline administration to HE patients is now being evaluated by 1H‐MRS and neuropsychological tests.
Effects of hepatitis G virus coinfection on severity of hepatitis C: Relationship to risk factors and response to interferon treatment
Authors: LIN RITA , DUTTA USHA , KABA SONGUL , KENCH JAMES , CREWE EVELYN , COVERDALE SHIRLEY , BYTH KAREN , LIDDLE CHRISTOPHER , FARRELL GEOFFREY C
Published: March 2008

The aims of the present study were to identify characteristics that are more often associated with hepatitis G virus (HGV) coinfection in Australian patients infected with the hepatitis C virus (HCV) and to investigate the effects of HGV on the histological and functional severity of chronic hepatitis C. Serum samples from 209 patients with chronic hepatitis C were tested for HGV‐RNA using single‐round reverse transcriptase—polymerase chain reaction to primers directed at the NS5 region of the HGV genome. Hepatitis G virus RNA was detected in 40 cases (19%). Hepatitis G virus‐coinfected patients tended to be younger and parenteral risks could be identified in all but six. Although country of birth did not differ significantly between the coinfected and HCV‐alone groups, HGV‐positive patients appeared to be less likely to have originated from Asia. On logistic regression analysis, HCV genotype 3a was found in a significantly higher proportion of patients with HGV coinfection than other genotypes (P<0.01). Liver histology and response to interferon were similar in the HGV‐coinfected and HCV‐alone groups and liver‐related complications appeared to occur less frequently in patients with both HGV and HCV. On univariate analysis, antipyrine clearance was found to be higher in the coinfected group (P<0.05), implying better preservation of hepatic metabolic function, but this difference was lost when adjusted for HCV genotype. In conclusions coinfection with HGV was more commonly associated with HCV genotype 3a, a genotype associated with injection drug use in younger patients. However, the presence of HGV coinfection did not adversely affect liver disease or the response to interferon treatment in patients with chronic hepatitis C.
A comparative study of nucleolar organizer region, proliferating cell nuclear antigen and epidermal growth factor receptor staining in colon tumours
Authors: SHIMADA NAOKI , SUZUKI JUNICHI , FUJITA JUN , KAWAKAMI YOSHIKAZU , TSUKAKOSHI HIROMOTO , HOSOKAWA MASAO , SATO NORIYUKI
Published: March 2008

Several studies have reported that proliferating cell nuclear antigen (PCNA), nucleolar organizer regions (NOR) and epidermal growth factor receptor (EGF‐R) are cellular proliferation parameters in malignant tumours. However, the correlation of EGF‐R with PCNA and NOR has not been reported in colon tumours. To clarify this, we investigated the correlation of the expression of EGF‐R with PCNA and NOR in colonic epithelial tumours. Using immunohistochemical staining and one‐step silver staining techniques, the expressions of EGF‐R‐, PCNA‐ and NOR‐associated protein were studied in paraffin sections from five normal mucosae, 10 adenomas with mild atypia, 16 adenomas with moderate atypia, 32 adenomas with severe atypia including carcinoma in situ and 47 with invasive colon carcinomas. Significant differences were found among the respective degrees of atypia in Ag‐NOR counts, PCNA labelling index (LI), and the expression of EGF‐R. However, there were no significant differences among the Ag‐NOR counts of the severe atypia and invasive carcinoma. There was a significant positive correlation between Ag‐NOR counts and PCNA LI (P<0.001). The Ag‐NOR counts and PCNA LI in EGF‐R‐positive cases were higher than in EGF‐R‐negative cases (P<0.001). These results indicate that each of the parameters increased significantly with the increase in atypia and the progression of cancer. Epidermal growth factor receptor provokes an exacerbation of protein synthesis and the cell cycle in colonic epithelial tumours.
A quantitative immunohistochemical evaluation of inflammatory cells at the affected and unaffected sites of inflammatory bowel disease
Authors: YAMAGATA KAZUFUMI , TANAKA MASANORI , KUDO HAJIME
Published: March 2008

Levels of T lymphocytes, histiocytes and mast cells have been reported to be increased in the affected mucosa of Crohn's disease (CD) and ulcerative colitis (UC), but the colorectal distribution of these cells is not fully understood. We hypothesized that differences in cell densities between CD and UC would be characteristic, not only in the affected, but also in the unaffected mucosa. The aims of the present study were to clarify whether there were any differences in cell densities in CD, UC and infectious colitis (IC) in the affected mucosa and between CD and UC in the unaffected mucosa. Using mouse monoclonal antibodies recognizing memory T cells (OPD4), cytotoxic/suppressor T cells (C8/144B), histiocytes (PG‐M1) and mast cells (AA1), we evaluated mucosal cell densities in biopsy specimens from both endoscopically affected and unaffected sites of CD (n= 12) and UC (n= 15) and from affected sites of IC (n= 10). Ten normal controls were also examined. At affected sites, all cells were significantly more abundant in UC than in the other conditions, except that the density of PG‐M1+ in CD was similar to that seen in UC. Although the densities of OPD4+ and C8/144B+ cells at unaffected sites were slightly higher in both CD and UC and in UC, respectively, there was no significant difference in cell densities between CD and UC. The ratio of OPD4+ cell density at affected sites to that at unaffected sites was appreciably higher in UC than in CD. The results suggest that a common feature of UC and CD is an increase in PG‐M1+ cells at the affected mucosa but that the other inflammatory cells studied are more abundant, particularly in UC, and that the difference between UC and CD is conspicuous when comparing the OPD4+ cell density of the affected mucosa with that of the unaffected mucosa.
Geranylgeranylacetone, an anti‐ulcer drug, stimulates hexosamine production in a rat gastric mucosal cell line through binding to a specific cytosolic protein
Authors: HASSAN SAZZAD , KINOSHITA YOSHIKAZU , OKADA AKIHIKO , MAEKAWA TORU , FUKUI HIROKAZU , CHIBA TSUTOMU
Published: March 2008

An anti‐ulcer drug, geranylgeranylacetone (GGA), stimulates hexosamine production in a rat gastric mucosal cell line (RGM‐1). The aim of this study was to elucidate the mechanism of this action. The role of protein kinase A, inositol phospholipid turnover and tyrosine kinase in the stimulatory action of GGA on hexosamine production in RGM‐1 was determined by observing cAMP production, [3H]‐inositol phosphate turnover and western blotting of tyrosine phosphorylation, respectively. Any trophic effect of GGA on RGM‐1 was also checked by [3H]‐thymidine incorporation. Our experiments showed that GGA has no effect on cAMP production, inositol phospholipid turnover, tyrosine phosphorylation or DNA synthesis in RGM‐1. Finally, a [14C]‐GGA competitive receptor binding assay was performed on RGM‐1 and we found that [14C]‐GGA specifically bound to RGM‐1 cytosolic protein. Although retinoic acid (RA), another polyisoprenoid compound significantly stimulated hexosamine production in RGM‐1, we confirmed that the [14C]‐GGA binding site in RGM‐1 is different from the RA binding site. In summary, GGA stimulates hexosamine production in RGM‐1 and this action is probably mediated through its binding to a specific cytosolic protein in RGM‐1.
Assessment of autonomic nervous activity during gastrointestinal endoscopy: Analysis of blood pressure variability by tonometry
Authors: SAIJYO TETSUYA , NOMURA MASAHIRO , NAKAYA YUTAKA , SAITO KEN , KONDO YUKI , YUKINAKA MICHIKO , SHIMIZU ICHIRO , ITO SUSUMU
Published: March 2008

We continuously measured blood pressure by tonometry in 30 patients during endoscopy to determine the influence of upper gastrointestinal endoscopy on cardiac events. Patients were divided into two groups: one group treated with scopolamine butylbromide as premedication (SB group) and another group without premedication (C group). Time‐ and frequency domain analyses of beat‐to‐beat systolic blood pressure variability were performed for 128 consecutive beats. For time‐domain analysis, we calculated the coefficient of variation of systolic blood pressure (CVBP). For the frequency domain analysis, we determined the low‐frequency (LFBP; 0.04–0.15 Hz) and high‐frequency (HFBP; 0.15–0.40 Hz) powers of the variation in systolic blood pressure and the ratio of LFBP to HFBP (LFBP/HFBP) during endoscopy. The CVBP and HFBP, indicators of parasympathetic tone, increased in the early phase of endoscopy but decreased significantly in the middle and late phases compared with the pre‐endoscopy value. The ratio of LFBP/HFBP, an indicator of indirect sympathetic tone, increased throughout the endoscopic procedure. Moreover, premedication with scopolamine butylbromide prevents the excessive parasympathetic nervous reflex when an endoscope passes through the upper digestive tract and also brings both decreased parasympathetic tone and increased sympathetic tone at the late phase of endoscopic procedure. Our results indicate that gastrointestinal endoscopy induced an autonomic nervous abnormality, which may contribute to the occurrence of cardiac events during endoscopic procedures.
Case Report: Three paediatric cases of primary sclerosing cholangitis treated with ursodeoxycholic acid and sulphasalazine
Authors: KOZAIWA KOSUKE , TAJIRI HITOSHI , SAWADA ATSUSI , TADA KANAE , ETANI YURI , MIKI KAZUNORI , OKADA SHINTARO
Published: March 2008

ABSTACT

We present here three paediatric patients with primary sclerosing cholangitis. In case 1, the serum γ‐glutamyl transpeptidase was decreased only temporarily by ursodeoxycholic acid (UDCA) treatment and 34 months later, sulphasalazine was added because of microscopic colitis. The enzyme level decreased with dual therapy. Similarly, in case 3, first diagnosed as autoimmune hepatitis, the transpeptidase levels remained elevated for 18 months during treatment with UDCA, prednisolone and mizoribin. The enzyme decreased only after a diagnosis of primary sclerosing cholangitis complicated with ulcerative colitis was established and sulphasalazine was introduced. Case 2 also had Crohn's colitis and was put on UDCA and sulphasalazine from the start. The enzyme level was normalized within 1 month and has remained normal for the following 5 years. Liver biopsies were analysed repeatedly in these three patients. In case 1, periductal fibrosis remained unchanged while being treated by UDCA. There appeared to be no progression in liver cirrhosis in case 3 while being treated by UDCA, prednisolone, and mizoribin. In case 2, who has been treated with both UDCA and sulphasalazine from the start, periductal fibrosis and portal fibrosis were remarkably improved 45 months later. We suggest that sulphasalazine in addition to UDCA might be a viable treatment for children with primary sclerosing cholangitis.
Expression of cellular adhesion regulatory molecule in hepatocellular carcinoma
Authors: SUNAGA MASAHIKO , YOSHIKAWA MASAHARU , EBARA MASAAKI , KONDO FUKUO , KASHIWADA MASAKI , TAKEMORI TOSHITADA , SAISHO HIROMITSU
Published: March 2008

Cellular adhesion regulatory molecule (CMAR) enhances the adhesiveness of cells to collagen and laminin and is considered to be a candidate anti‐oncogene. The purpose of the present study was to investigate the relationship between the expression of CMAR and clinical features of hepatocellular carcinoma (HCC). Small amounts of liver tissue were obtained from HCC and non‐cancerous portions of the liver in 29 patients and from normal liver in seven patients with metastatic liver tumour by biopsy under ultrasound guidance. RNA was extracted with acid guanidinium thiocyanate‐phenol‐chloroform. Expression of CMAR was assessed by quantitative PCR using β‐actin as an internal standard. A 4 b.p. insertion polymorphism at nucleotide 241 of the CMAR coding region was then investigated using extracted RNA to assess the relationship between the expression of variant mRNA of CMAR and HCC carcinogenesis. The relative expression of CMAR was significantly reduced in HCC compared with non‐cancerous and normal livers and had a relationship with certain clinical background factors. The reduced expression of CMAR was thought to be closely associated with the progression of HCC. However, the 4 b.p. insertion polymorphism pattern of CMAR was the same between HCC and non‐cancerous liver in all cases in which it was found. These results suggest that progression of HCC may be predicted based on the relative expression of CMAR.
A case of well‐differentiated minute hepatocellular carcinoma with extrahepatic metastasis
Authors: KIM SOO RYANG , HAYASHI YOSHITAKE , MATSUOKA TOSHIYUKI , PARK SOK YONG , SHINTANI SHIGEYUKI , SASAKI KAZUNORI , ASANO JUN , KIM JUNG HYO , KIM KE IH , IMOTO SUSUMU , ITOH HIROSHI , KUDO MASATOSHI
Published: March 2008

A rare case of well‐differentiated minute hepatocellular carcinoma (HCC) metastasizing to distant sites in a 77‐year‐old man with hepatitis C virus (HCV)‐related cirrhosis is presented. Ultrasonography (US) disclosed a 9 mm hypoechoic lesion in segment seven (S7) of the liver, although computed tomography (CT), magnetic resonance imaging (MRI) and angiography did not reveal any space‐occupying lesion. Ultrasound‐guided biopsy showed the histological features of well‐differentiated HCC. A plain film of the abdomen and CT revealed osteolytic changes in the sacrum and the lumbar vertebra. Ultrasound‐guided biopsy of the sacrum revealed well‐to‐moderately differentiated HCC metastasizing from the liver. Percutaneous ethanol injection therapy (PEIT) effected complete response and completely eliminated the abnormal findings on US. Three months after PEIT, metastasis to the thoracic vertebra was revealed by CT, despite negative α‐fetoprotein‐mRNA in serum. This is the first report describing a well‐differentiated HCC with metastatic potential. Further studies may provide insights into metastasis of well‐differentiated HCC.
Immunological features of patients with primary biliary cirrhosis (PBC) overlapping systemic sclerosis: A comparison with patients with PBC alone
Authors: AKIMOTO SACHIKO , ISHIKAWA OSAMU , TAKAGI HITOSHI , MIYACHI YOSHIKI
Published: March 2008

To characterize the immunological features of patients with primary biliary cirrhosis (PBC) overlapping systemic sclerosis (SSc), 26 patients with PBC were classified according to the presence of scleroderma‐related features (Raynaud's phenomenon, sclerodactyly etc.). The patients were classified into 10 patients with PBC overlapping SSc (PBC‐SSc), four patients with some scleroderma‐related features although not meeting the criteria of SSc (PBC‐SSc spectrum) and 12 patients with PBC alone. Sera from PBC‐SSc showed a significantly higher positivity to anti‐centromere antibody (P < 0.01) and to E1β of pyruvate dehydrogenase complex (P < 0.005) than those from patients with PBC alone. The same tendency was observed in PBC‐SSc spectrum patients. Patients with PBC exhibiting scleroderma‐related features, in both the PBC‐SSc and PBC‐SSc spectrum, may comprise a subset in PBC, not only clinically, but also immunologically.
Hepatitis G virus in multitransfused thalassaemics from India
Authors: PANIGRAHI ASWINI K , SAXENA ALKA , ACHARYA SUBRAT K , PANDA SUBRAT K
Published: March 2008

Hepatitis G virus (HGV)/GB virus‐C (GBV‐C) has been identified as a blood‐borne agent with disputed pathogenicity. This virus belongs to the flaviviridae with a distant relationship to hepatitis C virus (HCV). Genetically divergent HGV isolates have been reported from different parts of the world. This study describes the prevalence of HGV in multitransfused thalassaemic children in India and genomic sequence variations in 11 HGV isolates from the same geographical location. Hepatitis G virus RNA was detected in 39.7% multitransfused thalassaemic children. The seroprevalence of hepatitis B virus (HBV) and HCV was 23.8% and 17.1%, respectively, and 11.4% had dual infection. The nucleotide sequence of a 166 bp HGV genomic segment from the putative capsid‐envelope region (nucleotide; nt 578–743) from 11 Indian isolates was compared to the sequences available in the nucleotide databases. The isolates from India were 81.3–94.5% homologous to the isolates from other parts of the world. On phylogenetic analysis, it was observed that HGV isolates from India may belong to two genetically divergent types.
Gastric mucosal blood flow and hepatic perfusion index in patients with portal hypertensive gastropathy
Authors: GUPTA RAJIV , SAWANT PRABHA , PARAMESHWAR RV , LELE VIKRAM R , KULHALLI PRABHAKAR M , MAHAJANI SHRIRAM S
Published: March 2008

Endoscopic laser Doppler velocimetry is a simple non‐invasive method to measure gastric mucosal blood flow. The present study is an attempt to determine a correlation, if any, between gastric mucosal blood flow and the hepatic perfusion index in patients with portal hypertensive gastropathy and their relationship to the severity of liver disease. Thirty patients with portal hypertensive gastropathy due to cirrhosis of the liver (eight class A, 13 class B, nine class C, according to Child‐Pugh Classification) and six normal subjects were recruited into the study. In all subjects, the gastric mucosal blood flow and venous vasomotor reflex response was measured at two sites: the lesser and greater curvature, using endosoopic laser Doppler velocimetry. The hepatic perfusion index was measured using dynamic liver scintigraphy. The hepatic perfusion index (ratio of arterial/portal venous perfusion) in normal subjects and patients with portal hypertensive gastropathy belonging to Child‐Pugh class A, B and C were 0.36 ± 0.02, 0.53 ± 0.08, 0.62 ± 0.14 and 1.04 ± 0.28, respectively. The gastric mucosal blood flow was similar in Child's A, B and C cases, while the venous vasomotor reflex response was reduced according to the Child‐Pugh score (Child's A 37.4 ± 5.4%, normal control 62.3 ± 10.9%, Child's B 38.3 ± 18.2%, Child's C 22.5 ± 15.2%) and was statistically significant. The gastric mucosal blood flow and hepatic perfusion index are inversely correlated. The hepatic perfusion index altered with grading of cirrhotic change. This study confirms that the severity of portal hypertensive gastropathy is correlated with Child‐Pugh score.
Relationship between severity and symptoms of reflux oesophagitis in elderly patients in Japan
Authors: MAEKAWA TORU , KINOSHITA YOSHIKAZU , OKADA AKIHIKO , FUKUI HIROKAZU , WAKI SHINYA , HASSAN SAZZAD , MATSUSHIMA YUMI , KAWANAMI CHIHARU , KISHI KIYOHIKO , CHIBA TSUTOMU
Published: March 2008

Since information concerning reflux oesophagitis in the elderly is limited, particularly in Japan, the severity and symptomatic profiles of reflux oesophagitis in elderly patients were investigated. One hundred and nineteen patients with reflux oesophagitis found among 2278 endoscopy cases between 1993 and 1996 were investigated in this study. The patients were divided into two groups, elderly and non‐elderly. The severity of reflux oesophagitis was estimated by the Los Angeles classification. The presence or absence of typical symptoms (heartburn and regurgitation) was determined by interview. Reflux oesophagitis was not only more frequently found in the elderly group, but was more severe than in the non‐elderly. Although the degree of manifestation of typical symptoms was similar between the elderly and the non‐elderly with high‐grade oesophagitis, the elderly patients with mild reflux oesophagitis were less symptomatic than the non‐elderly. Mild reflux oesophagitis in the elderly may be missed due to its rarity of typical reflux symptoms and a substantial number of elderly persons might have subclinical reflux oesophagitis.
1979: Affiliation with the Paediatric Research Society of Australia and a Change in Format
Authors: COLE W. G.
Published: March 2008

During 1978 the Australian College of Paediatrics and the Paediatric Research Society of Australia agreed that the Australian Paediatric Journal would now represent both associations. The Paediatric Research Society, which was established in 1966, is now a vigorous group of about 150 scientists and doctors actively involved in paediatric research in Australia.

We welcome this increase in the Journal's affiliation and trust that with it will come an increasing number of papers reporting the wide range of research interests of the Society's members.

This first issue of 1979 is printed on a larger page size. The decision to change page size was made on grounds of economy, both to suit our clients who support the Journal with advertisements and to help contain the increasing costs of printing. We hope the change in format will be welcomed by our readers.
Element and Trace Element Content of Baby Foods Including Effect of Ageing
Authors: BLOOM H. , LEWIS I. C. , NOLLER B. N.
Published: March 2008

Bloom, H. Lewis I. C., Noller, B. N. (1979)
Aust. Paediatr. J., 15, 16–19. Element and trace element content of baby foods, including effect of ageing. The element and trace element contents of canned and bottled baby foods have been analysed and no excessive concentrations were discovered. In a small sample of over age cans metal contamination did occur but was not a health hazard except possibly in one sample where the lead content was high.
Respiratory Studies in an Infant with Neonatal Myasthenia Gravis
Authors: HUTCHISON A.A. , RUSSELL G.
Published: March 2008

Hutchison, A. A. and Russell, G. (1979).
Aust. Paediatr. J, 15, 44–46. Respiratory studies in an infant with neonatal myasthenia gravis. Respiratory mechanics were measured in an infant with neonatal myasthenia gravis at the age of six and fourteen days. At the age of six days, but not at the age of fourteen days, an intravenous injection of edrophonium chloride brought about an increase in ventilation and in all components of respiratory work.
A Portable Hand‐Grip Dynamometer
Authors: PEARN J. , BULLOCK K.
Published: March 2008

Pearn, J. and Bullock, K. (1979).
Aust. Paediatr. J., 15, 107–109. A portable hand‐grip dynamometer. A new portable handgrip dynamometer is described. The instrument employs the strain‐gauge principle and measures isometric contraction. The instrument is sensitive, covers a wide range (0.5 to 1500 Newtons), is temperature compensated, portable (battery operated), is light yet robust and has been used in the field. It is suitable for bedside clinical use, or for research procedures requiring analyses of strength‐fatigue curves. It is simple and quick to operate and has linear load‐response curves over the clinical range of hand‐grip strength. Standard test procedures are described. The instrument has been used in validation trials on 221 healthy children aged 5 to 17 years. In a two pull test for each hand (RLRL) there is no fatigue effect even for young children. A practice effect exists for the right hand only. Handedness in children is not related to the laterality of the strongest hand, either for males or females. The principle of using maximum hand‐grip strength from a four trial test (RLRL), as one index of a child's health is briefly described.
Infant Feeding Practices in Sydney 1976–77
Authors: ALLEN JANE , HEYWOOD P. F.
Published: March 2008

Allen, Jane, and Heywood, P. F. (1979). Aust. Paediatr. J., 15, 113–117. Infant feeding practices in Sydney 1976–77. This study reports the results of a survey of infant feeding practices carried out in the Sydney metropolitan area. The sample, 250 children under 12 months of age was stratified by age and sex of infant and parity of mother. Infants were selected from six obstetric hospitals in different geographical locations. The number of children chosen from each hospital was proportional to its contribution to total births. Whilst approximately 80% of mothers attempted breast feeding, only 20% of infants were breast fed at 3 months of age. A high proportion of mothers introduced bottle feeding in the first month of life. Seventy‐two percent of mothers had introduced fluids, other than feeding milks, in the first month of life. Forty‐six percent had introduced solids, predominantly cereal, by the end of the second month of life. The primary reason for introducing bottle feeding was “unsuccessful breast feed ing” and for cessation of lactation was “low milk supply”.
Intra‐Uterine Infection with Herpes Simplex Virus and Observed Radiological Changes
Authors: WALPOLE I. R. , GRAUAUG A.
Published: March 2008

Walpole, I. R., and Grauaug, A. (1979) Aust. Paediatr. J., 15, 123–125. Intra‐uterine infection with herpes simplex virus and observed radiological changes. This is a case report of a premature female infant in whom striking radiological changes in the epiphyses were noted on the day of birth. Subsequent isolation of herpes simplex virus from the urine, the clinical course and autopsy findings suggest this agent was responsible for the bone changes. This observation demonstrates another facet of this condition and provides further evidence that intra‐uterine infection with herpes simplex virus may occur by placental transmission from mother to infant.
Respiratory Failure in Infants Weighing 1000 g or Less at Birth
Authors: YU V. Y. H. , HOLLINGSWORTH E.
Published: March 2008

Yu, V. Y. H., and Hollingsworth, E. (1979).
Aust. Paediatr. J., 15, 152–159. Respiratory failure in Infants weighing 1000 g or less at birth. The prognosis for infants weighing <1000 g has improved coincident with the improved ventilatory support in their neonatal management. There are many problems leading to respiratory failure which are particularly significant and peculiar to these infants. Of the 55 infants weighing <1000 g admitted in 1977 and 1978, 58% had hyaline membrane disease and 69% had preterm recurrent apnoea. Fifty‐one infants required assisted ventilation, or whom 28 were ventilated from birth. Though these infants could be ventilated successfully with low peak airway and positive end‐expiratory pressures, 52% of the ventilated infants required it for more than seven days, despite the use of intermittent mandatory ventilation and continuous positive airway pressure during weaning. The neonatal survival rate for assisted ventilation in infants weighing <1000 g was 57%. Seventeen of the ventilated infants developed pulmonary interstitial emphysema, a condition which was associated with an increased incidence of pneumothorax (four infants) and bronchopulmonary dysplasia (ten infants). Infants recovering from bronchopulmonary dysplasia required up to 76 days of assisted ventilation and 84 days of oxygen therapy. No major handicaps were detected on follow‐up except for one infant with retrolental fibroplasia. Optimal management of respiratory failure in infants weighing <1000 g can now result in increased survival with morbidity approaching those of larger preterm infants. As our knowledge, skills, techniques and equipment continue to improve, so will survival and morbidity rates.
Is “Transient Tachypnoea of the Newborn” Always a Benign Disease? Report of 6 Babies Requiring Mechanical Ventilation
Authors: TUDEHOPE D. I. , SMYTH MARGARET H.
Published: March 2008

Tudehope, D. I., and Symth, Margaret H. (1979).
Aust. Paediatr. J., 15, 160–165. Is “transient tachypnoea of the newborn” always a benign disease? Report of 6 babies requiring mechanical ventilation. A retrospective study in an intensive care nursery revealed that transient tachypnoea of the newborn (TTN) was the commonest cause of respiratory distress. This condition was frequently associated with marginal prematurity, hypoproteinaemia, birth asphyxia, Caesarean section, breech presentation and male babies. The signs associated with TTN abated by 48 hours in 74% of the babies; the remainder had a prolonged, often complicated course. Six of the nine babies with signs persisting more than 46 hours required mechanical ventilation; three because of hypoxaemia and three with severe respiratory acidosis. Babies with the clinical signs and radiographic features consistent with TTN may develop severe ventilation‐perfusion imbalance, fatigue and pulmonary hypertension with right to left shunting of blood across the ductus arteriosus.
Prevalence of Wheezing in Pre‐School Children in Lower Hutt
Authors: ANYON C. P. , FLETCHER T. G.
Published: March 2008

Anyon, C. P., and Fletcher, T. G. (1979).
Aust. Paediatr. J., 15, 168–169. Prevalence of wheezing in pre‐school children in Lower Hutt. An epidemiological study of pre‐school children in the Hutt Valley has been made. The prevalence of wheezing has been found to be 26%. Wheezing is a common cause of morbidity in Hutt Valley and, presumably, New Zealand children.
Accidents in the first five years of life: A report from the Dunedin Multidisciplinary Child Development Study
Authors: LANGLEY J. , DODGE J. , SILVA P. A.
Published: March 2008

Langley, J., Dodge, J. and Silva, P. A. (1979).
Aust. Paediatr. J., 15, 255–259. Accidents in the first 5 years of life: a report from the Dunedin Multidisciplinary Child Development Study. As part of a longitudinal study of child development, information was collected on all accidents during the first 5 years of life that required medical attention. Four hundred and eighty six of a sample of 991 children had 729 accidents in the first 5 years of life. Sixteen per cent of the children had two or more accidents. Ten per cent of the accidents resulted in a hospitalisation. The more common accidents, those involving falls, poisons, sharp objects, foreign bodies, being caught between objects, and hot substances or objects are described and discussed. We suggest that many accidents could have been prevented. A necessary prerequisite for improved prevention measures is the collection and study of detailed information on the circumstances surrounding accidents. A case is made for an organisation with primary responsibility to monitor the safety of consumer products.
The Mode of Action and Complications of Infant Gaviscon
Authors: KEIPERT J.A.
Published: March 2008

Because impacted gastric masses have occurred in infants taking feeds mixed with Infant Gaviscon, in vitro experiments were performed. Varying concentrations of Infant Gaviscon were added to several infant feeds. Hydrochloric acid was added, under pH control, with and without pepsin, to simulate in vivo conditions. The main changes were the formation of lumps which increased in size and number with increasing acidity, followed by a sudden marked increase in thickness at a critical pH. It has been generally assumed that Infant Gaviscon acts in infants in a similar way to Gaviscon in adults (by producing a viscous protective and neutralizing raft which floats on the gastric contents) but this is unlikely as the compounds are taken in different ways. These experiments suggest that Infant Gaviscon acts mainly by producing thickening of the feeding, and the changes observed in vitro appear to explain the occasional formation of aggregated masses.
Characteristics of Down syndrome infants and their families
Authors: BERRY P. , GUNN P. , ANDREWS R. , PRICE C.
Published: March 2008

ABSTRACT. In a longitudinal study of 31 Down syndrome infants born in the Greater Brisbane area, characteristics of the babies and their families were collected. Such data as ages of mother and father, family size, parental stress, attitudes to “being told of the handicap”, developmental milestones and hearing assessment results are reported.
Möbius syndrome in a patient with α 1 antitrypsin deficiency
Authors: BEREN ROY , DAVIDSON GEOFFREY P.
Published: March 2008

ABSTRACT. This case report details the coincidence of Möbius syndrome and α antitrypsin deficiency.
Newborn transport in metropolitan Sydney: experience with a newborn intensive care unit based regional transport service
Authors: BARR PETER A. , SUTHERS JENNIFER A. , LESLIE GARTH I.
Published: March 2008

ABSTRACT. The effect of skilled transport on the condition of 100 infants referred for intensive care and the factors affecting their survival were analysed. Infants with respiratory failure who were not moribund showed significant increases in pH (P < 0.01) and arterial/alveolar P02 ratio (P < 0.001) with assisted ventilation. Less severely ill infants were transported without significant change in pH and blood gas status. Hypoxaemia (17%), hyperoxaemia (24%) and hyperglycaemia (14%) were not uncommon on admission to the newborn intensive care unit.

Survival rate did not decrease significantly with decreasing birth weight or gestation. Factors significantly more common in infants who died were one minute Apgar score 0–3 (P < 0.05), and pH < 7.25 (P < 0.05) and PaCO2 > 60 mmHg (P < 0.005) on admission to the NICU. Infants mechanically ventilated before transport did not have a significantly higher mortality rate than those ventilated after admission, though moribund infants and those with untreated early onset bacterial pneumonia had high mortality rates.

Pre‐transfer events were responsible for the death of 8 (38%) of the 21 infants who died and perhaps contributed to the death from intraventricular haemorrhage of a further 5 infants (24%).
Playground equipment and accidents
Authors: OLIVER T. I. , McFARLANE J. P. , HAIGH J. C. , CANT G. M. , BODIE A. M. , LAWSON J. S.
Published: March 2008

ABSTRACT. Playground equipment accidents and the associated injuries are a significant cause of trauma among children. Surveys in Northern Sydney have shown that about 1% of all 2 to 12‐year‐old children are treated at hospitals each year for fractures and lacerations due to these accidents. Most injuries occurred following falls.

Risk taking and play are an essential part of childhood development and therefore the approach is not to try and prevent all the accidents but to prevent or reduce the severity of any associated injuries. Experiences with an experimental playground indicate that this objective can be achieved inexpensively by avoiding exposed concrete foundations, using resilient ground covers such as fixed thick rubber sheets or open weave mats so as to reduce wear and injuries on hard surfaces, all swing seats should be made of resilient but non‐injurious materials, slide chute exits should be extended, and (to avoid injury to children running between playground equipment) swings should not be located in a direct path between other items of equipment.