bluuebunny/crossref_metadata_2025_split huggingface dataset:
Percutaneous radiofrequency ablation as first‐line treatment for small hepatocellular carcinoma: Results and prognostic factors on long‐term follow up
Authors: Waki Koji , Aikata Hiroshi , Katamura Yoshio , Kawaoka Tomokazu , Takaki Shintaro , Hiramatsu Akira , Takahashi Shoichi , Toyota Naoyuki , Ito Katsuhide , Chayama Kazuaki 
Published: January 2010

AbstractBackground and Aims:  We evaluated the prognosis and associated factors in patients with small hepatocellular carcinoma (HCC; up to 3 nodules, each up to 3cm in diameter) treated with percutaneous radiofrequency ablation (RFA) as first‐line treatment.Methods:  Eighty‐eight consecutive patients who underwent percutaneous RFA as first‐line treatment were enrolled, among whom 70 who had hypervascular HCC nodules which were treated by a combination of transcatheter arterial chemoembolization and RFA. RFA was repeated until an ablative margin was obtained.Results:  The rate of local tumor progression at 1 and 3 years was 4.8% and 4.8%, respectively. The rate of overall survival at 3 and 5 years was 83.0% and 70.0%, and the rate of disease‐free survival at 3 and 5 years was 34.0% and 24.0%, respectively. On multivariate analysis, age (< 70 years; hazard ratio [HR] = 2.341, 95% confidence interval [CI] = 1.101–4.977, P = 0.027) and indocyanine green retention rate at 15 min (< 15%; HR = 3.621, 95% CI = 1.086–12.079, P = 0.036) were statistically significant determinants of overall survival, while tumor number (solitary, HR = 2.465, 95% CI = 1.170–5.191, P = 0.018) was identified for disease‐free survival. Overall survival of patients with early recurrence after RFA was significantly worse than that of patients with late recurrence. Tumor size was the only independent risk factor of early recurrence after RFA of HCC (tumor size > 2 cm; risk ratio [RR] = 4.629, 95% CI = 1.241–17.241, P = 0.023).Conclusion:  Percutaneous RFA under the protocol reported here has the potential to provide local tumor control for small HCC. In addition to host factors, time interval from RFA to recurrence was an important determinant of prognosis.
Treatment of type I gastric neuroendocrine tumors with somatostatin analogs
Authors: Khuroo Mehnaaz Sultan , Khuroo Mohammad Sultan , Khuroo Naira Sultan 
Published: January 2010

AbstractBackground and Aim:  There are limited data on response and long‐term follow‐up of octreotide therapy in type‐I gastric neuroendocrine tumors. The objective of the present study was to assess the response of type‐I gastric neuroendocrine tumors to octreotide‐long acting, repeatable (LAR) therapy and evaluate long‐term follow up of such patients after therapy.Methods:  Three patients with documented type‐I gastric neuroendocrine tumors from a tertiary gastroenterology centre were studied. Octreotide‐LAR therapy 20 mg intramuscularly every 28 days was administered for one year. Serum gastrin and chromogranin levels, gastroscopies and biopsies from tumor nodules at 6 months and one year on therapy and every 6 months after completion of drug therapy were taken. Follow‐up after completion of therapy extended for 3 years in two and 2.5 years in one patient.Results:  During octreotide therapy there was normalization of serum gastrin levels and serum chromogranin levels. Tumors in all three patients had regressed at 6 months of treatment. Following cessation of therapy, there was progressive rise of serum gastrin to pre‐treatment levels. Serum chromogranin levels remained within normal limits. Gastroscopic and histologic examination of gastric biopsies did not reveal recurrence of tumors in any patients. All patients tolerated therapy well and became asymptomatic soon after drug therapy.Conclusions:  Octreotide‐LAR therapy causes regression of type‐I gastric neuroendocrine tumors. After completion of drug therapy there was no recurrence of tumors even with continued hypergastrinemia. Octreotide therapy should be considered as one of the treatment options in such patients.
Terlipressin therapy for reversal of type 1 hepatorenal syndrome: A meta‐analysis of randomized controlled trials
Authors: Sagi Sashidhar V , Mittal Sahil , Kasturi Krishna S , Sood Gagan K 
Published: January 2010

AbstractBackground and Aim:  Hepatorenal syndrome (HRS) is a serious complication of advanced liver disease and carries a poor prognosis. Recent trials have indicated that terlipressin may be effective in reversing HRS. Our aim was to evaluate the efficacy of terlipressin therapy in reversing type 1 HRS defined as a serum creatinine <1.5 mg/dL during treatment.Methods:  Randomized controlled trials in which patients with type 1 HRS received at least 3 days of terlipressin therapy and albumin in the intervention arm were included after a systematic search of the published English reports. Studies with other vasoconstrictor therapies in the control group were excluded.Results:  A total of 223 patients with HRS type 1 in four different trials, were included in the final analysis. Alcohol‐related cirrhosis was the most common underlying etiology. The risk ratio for reversal in type 1 HRS with terlipressin therapy was 3.66 (95% confidence interval 2.15–6.23). Recurrence of HRS was low (8%). Serious side‐effects requiring discontinuation of therapy were seen only in 6.8% of patients on terlipressin therapy. There was a trend towards improved transplant‐free survival at 90 days in the terlipressin group (relative risk 1.86 95% confidence interval 1.0–3.4, P = 0.05).Conclusions:  Terlipressin is effective in reversing HRS type 1. Recurrence of HRS is rare with at least 14 days of therapy. Serious side‐effects requiring discontinuation of therapy are less common. There appears to be a survival benefit in patients with HRS treated with terlipressin.
Population‐based cases control study of inflammatory bowel disease risk factors
Authors: Gearry Richard B , Richardson Ann K , Frampton Christopher M , Dodgshun Andrew J , Barclay Murray L 
Published: January 2010

AbstractBackground and Aim:  The rapid increase in inflammatory bowel disease (IBD) incidence confirms the importance of environment in its etiology. We aimed to assess the role of childhood and other environmental risk factors in IBD.Methods:  A population‐based case‐control study was carried out in Canterbury, New Zealand. Participants comprised 638 prevalent Crohn's disease (CD) cases, 653 prevalent ulcerative colitis (UC) cases and 600 randomly‐selected sex and age matched controls. Exposure rates to environmental risk factors were compared. Unadjusted and adjusted odds ratios (OR) with 95% confidence intervals (CI) are presented.Results:  A family history of IBD (CD OR 3.06 [2.18–4.30], UC OR 2.52 [1.90–3.54]), cigarette smoking at diagnosis (CD OR 1.99 [1.48–2.68], UC OR 0.67 [0.48–0.94]), high social class at birth (CD and UC trend, P < 0.001) and Caucasian ethnicity (CD OR 2.04 [1.05–4.38], UC OR 1.47 [1.01–2.14]) were significantly associated with IBD. City living was associated with CD (P < 0.01). Being a migrant was associated with UC (UC OR 1.40 [1.14–2.01]). Having a childhood vegetable garden was protective against IBD (CD OR 0.52 [0.36–0.76], UC OR 0.65 [0.45–0.94]) as was having been breast‐fed (CD OR 0.55 [0.41–0.74], UC OR 0.71 [0.52–0.96]) with a duration‐response effect. Appendicectomy, tonsillectomy, infectious monomucleosis and asthma were more common in CD patients than controls (P < 0.01).Conclusions:  The importance of childhood factors in the development of IBD is confirmed. The duration‐response protective association between breast‐feeding and subsequent development of IBD requires further evaluation, as does the protective effect associated with a childhood vegetable garden.
Inhibitory effect of human interferon‐beta‐1a on activated rat and human hepatic stellate cells
Authors: Rao Hui‐Ying , Wei Lai , Wang Jiang‐Hua , Fei Ran , Jiang Dong , Zhang Quan , Chen Hong‐Song , Cong Xu 
Published: January 2010

AbstractBackground and Aims:  Hepatic stellate cells (HSC) are the primary cell type mediating hepatic fibrosis. Although known for its antiviral effects, the inhibitory effects of interferon‐beta (IFN‐β) on HSC treatment have not yet been established.Methods:  Both human and rat activated HSC cell lines were incubated with increasing concentrations of recombinant human IFN‐β1a (rhIFN‐β1a) for 24, 48 or 72 h. The effects of rhIFN‐β1a on α‐smooth muscle actin (α‐SMA), collagen types I and III, transforming growth factor‐β1 (TGF‐β1), platelet‐derived growth factor‐BB (PDGF‐BB), and mothers against decapentaplegic homolog (Smad4, Smad7) expression in HSC were examined using Western blotting and immunocytochemistry. Proliferation of HSC was evaluated via bromodeoxyuridine assay.Results:  rhIFN‐β1a treatment had a dose‐dependent, inhibitory effect on α‐SMA and collagen type I protein expression. In addition, rhIFN‐β1a decreased the expression of collagen type III, TGF‐β1, PDGF‐BB and Smad4 protein expression in HSC compared with untreated cells. We also observed increased Smad7 protein expression and decreased proliferation in rhIFN‐β1a‐treated HSC.Conclusions:  Our data suggest that rhIFN‐β1a treatment decreased α‐SMA and collagen expression and inhibited the activation of HSC through the inhibition of the TGF‐β and PDGF pathways.
Endoscopic band ligation plus argon plasma coagulation versus scleroligation for eradication of esophageal varices
Authors: Harras Fouad , Sheta El Shazly , Shehata Mona , Saadany Sherif El , Selim Mahmoud , Mansour Loai 
Published: January 2010

AbstractBackground and Aim:  The aim of this study was to evaluate endoscopic band ligation plus argon plasma coagulation versus scleroligation.Methods:  Patients were randomized to: Group I, 50 patients subjected to endoscopic injection sclerotherapy; Group II, 50 patients subjected to variceal band ligation; Group III, 50 patients subjected to combined endoscopic sclerotherapy and band ligation; and Group IV, 50 patients subjected to endoscopic band ligation plus argon plasma coagulation.Results:  A comparison of the number of therapeutic sessions showed that group III underwent significantly fewer sessions. As regards post‐treatment complications, Group I showed a high incidence of transient pyrexia, transient dysphagia and/or retrosternal pain and ulceration, while in group II a higher incidence of rebleeding was demonstrated, as well as a higher incidence of esophageal varix recurrence after eradication during the follow‐up period. A higher mortality incidence was detected in groups I and II. The follow‐up incidence did not significantly differ between the different study groups.Conclusion:  Scleroligation allows very rapid eradication of varices, has a low recurrence rate, avoids the disadvantage of high recurrence of band ligation alone, and does not require special skills over sclerotherapy or band ligation. Also, band ligation plus argon plasma coagulation allows for very rapid eradication of varices, and a low recurrence rate, with no obvious recorded complications, but it has the disadvantage of being the most expensive technique and requires special equipment that is only available in a few endoscopic centers.
Locoregional therapies for hepatocellular carcinoma: Which patients are most likely to gain a survival advantage?
Authors: Mahady Suzanne E , Charlton Barbara , Fitzgerald Patrick , Koorey David J , Perry John F , Waugh Richard C , McCaughan Geoffrey W , Strasser Simone I 
Published: January 2010

AbstractBackground and Aim:  Locoregional therapies for hepatocellular carcinoma (HCC) are considered to confer a survival advantage, however, the patient group that should be targeted is not clearly defined. This study aimed to determine the impact on survival of locoregional therapies compared with supportive care, within prognostic categories as stratified by the Cancer of the Liver Italian Program (CLIP) scoring system.Methods:  A prospective database was used to identify those patients who were treated with either locoregional therapy (n = 128) or supportive care (n = 92). Survival analysis was performed for groups matched by CLIP score at presentation. Comparison of important prognostic factors was undertaken and univariate and multivariate analysis was performed to assess determinants of survival.Results:  Use of locoregional therapies was only associated with a survival benefit in patients with a CLIP score of 1 or 2. In this group, the median survival in patients who received locoregional therapies was 25.0 months (95% confidence interval 22.7–27.4) compared with 8.9 months (95% confidence interval 7.3–10.5) for supportive care (P = 0.001). For patients with CLIP scores of 3 or greater, no survival benefit of locoregional therapies was observed. Multivariate analysis revealed locoregional intervention, CLIP score, tumor symptoms, α‐fetoprotein level, bilirubin and alkaline phosphatase level as independent prognostic indicators.Conclusion:  Locoregional therapies should be targeted specifically to patients with non‐advanced hepatocellular carcinoma as assessed by validated scoring systems. Use of these therapies in patients with advanced disease does not appear to be associated with a survival benefit and may expose patients to unnecessary harm.
Asymptomatic chronic hepatitis B virus infection does not increase the risk of diabetes mellitus: A ten‐year observation
Authors: Huang Zei‐Shung , Huang Tien‐Shang , Wu Tzy‐Haw , Chen Ming‐Fong , Hsu Ching‐Sheng , Kao Jia‐Horng 
Published: January 2010

AbstractBackground and Aim:  Chronic hepatitis C virus infection has been known to increase the risk of diabetes. Whether this association holds true for chronic hepatitis B virus (HBV) infection remains unclear. We thus conducted this study to investigate the influence of asymptomatic chronic HBV infection on the incidence of diabetes in a longitudinal cohort.Methods:  A total of 1233 adults who received health examinations in 1997–1998 and in 2000–2001 were enrolled. Among them, 483 subjects who received a third health examination in 2006–2008 were further sampled. The prevalence and incidence of diabetes between asymptomatic HBV carriers and non‐HBV controls were compared using the χ2‐test and logistic regression.Results:  In 1997–1998, the prevalence rates of diabetes (9.49 and 12.0%) and glucose intolerance (28.5 and 25.4%) in HBV carriers and non‐HBV controls were comparable (P > 0.05). There was no significant correlation between asymptomatic HBV infection and the presence of diabetes in subjects examined in 1997–1998, 2000–2001, or 2006–2008 when adjusted for age, gender, and body mass index (P > 0.05). In 296 non‐diabetic subjects during 1997–1998, the ten‐year incidence of diabetes/glucose intolerance was similar between HBV carriers and non‐HBV controls (40.0 and 38.7%, P > 0.05). Moreover, no significant correlation was found between asymptomatic HBV infection and the incidence of diabetes/glucose intolerance in 2006–2008 (P = 0.775).Conclusions:  Compared to non‐HBV controls, subjects with asymptomatic chronic HBV infection do not have an increased risk of diabetes, and thus HBV itself is not pro‐diabetic.
Myocardial ischemia during endoscopic retrograde cholangiopancreatography: An overlooked issue with significant clinical impact
Authors: Lee Ching‐Tai , Lee Thung‐Lip , Liao Wei‐Chih , Chang Chi‐Yang , Tai Chi‐Ming , Chiang Tsung‐Hsien , Tu Chia‐Hung , Tseng Wei‐Kung , Lin Jaw‐Town 
Published: January 2010

AbstractBackground and Aim:  The occurrence of peri‐procedural myocardial ischemia with endoscopic retrograde cholangiopancreatography (ERCP) has been documented, but its significance remains controversial. This study aimed to investigate the incidence and risk factors of myocardial ischemia during ERCP procedures and to analyze the potential association between myocardial ischemia and post‐ERCP complications.Methods:  Ambulatory 24‐h ST‐segment monitoring from 30 min prior to 24 h after ERCP was obtained on 71 patients from September 2006 to August 2007. Changes in vital signs during ERCP, post‐ERCP complications, and their outcomes were recorded and analyzed.Results:  Cardiac ischemia occurred in 13 patients (18.3%) during ERCP and one patient developed myocardial infarction. More patients in the ischemic group (38.5%) than in the non‐ischemic group (5.2%) had ST‐T changes in pre‐ERCP resting electrocardiography (P < 0.01). Hypotension during ERCP was found only in the ischemic group (15.4% vs 0%; P = 0.03). Patients with cardiac ischemia during ERCP had a significantly higher rate of elevated serum amylase and lipase levels (53.8% vs 15.5%; P < 0.01) and post‐ERCP pancreatitis (30.8% vs 6.9%; P = 0.03). Multivariable logistic regression analysis revealed that cardiac ischemia during ERCP (OR: 5.21, P = 0.050) and pancreatic duct cannulation (OR: 5.7, P = 0.036) were independent predictors for post‐ERCP pancreatitis.Conclusions:  ST‐T changes on resting electrocardiography and intra‐procedural hypotension are risk factors of myocardial ischemia during ERCP. Post‐ERCP hyperamylasemia, hyperlipasemia, and pancreatitis were associated with myocardial ischemia during ERCP.
Expression of advanced glycation end products and related molecules in diabetic fibrovascular epiretinal membranes
Authors: Abu El‐Asrar Ahmed M , Missotten Luc , Geboes Karel 
Published: January 2010

AbstractPurpose:  To investigate associations between expressions of advanced glycation end products (AGEs), transforming growth factor‐β (TGF‐β), tumour necrosis factor‐α (TNF‐α) and integrins and correlations between their expression and level of vascularization and proliferative activity in diabetic fibrovascular epiretinal membranes.Methods:  Membranes from eight patients with active proliferative diabetic retinopathy and nine patients with inactive proliferative diabetic retinopathy were studied by immunohistochemistry.Results:  Blood vessels expressed AGEs, TGF‐β, TNF‐α and αvβ3 integrin in 5, 13, 8 and 8 membranes, respectively. Stromal cells expressed AGEs, TNF‐α and αvβ3 integrin in 15, 13 and 3 membranes, respectively. There was no immunoreactivity for αvβ5, α5β1 and α2β1 integrins. There were significant correlations between number of blood vessels expressing CD34 and number of blood vessels expressing AGEs (rs = 0.496; P = 0.043), TGF‐β (rs = 0.777; P < 0.001) and TNF‐α (rs = 0.699; P = 0.002). There were significant correlations between number of blood vessels expressing AGEs and number of blood vessels expressing TGF‐β (rs = 0.532; P = 0.028) and TNF‐α (rs = 0.626; P = 0.007). The correlation between number of blood vessels expressing TNF‐α and αvβ3 integrin was significant (rs = 0.617; P = 0.008). Number of blood vessels expressing CD34 (P = 0.001), TGF‐β (P = 0.006) and TNF‐α (P = 0.002) and stromal cells expressing AGEs (P = 0.001) and TNF‐α (P = 0.004) were significantly higher in active membranes than in inactive membranes.Conclusion:  Interactions of AGEs, TGF‐β, TNF‐α and αvβ3 integrin might be involved in pathogenesis of proliferative diabetic retinopathy fibrovascular proliferation.
Prospective evaluation of changes in anterior segment morphology after laser iridotomy in Chinese eyes by rotating Scheimpflug camera imaging
Authors: Li Shuning , Wang Hongtao , Mu Dapeng , Fu Jing , Wang Xiaozhen , Wang Jian , Wang Ningli 
Published: January 2010

AbstractBackground:  To investigate the 3‐D morphology changes of anterior segment in primary angle‐closure suspect and primary angle‐closure after laser peripheral iridotomy (LPI) using rotating Scheimpflug camera.Methods:  A total of 37 eyes of 25 patients were enrolled in the study. Just before and after LPI, rotating Scheimpflug camera was performed on each selected eye by one skilled ophthalmologist. Comparison of anterior segment parameters before and after LPI such as central corneal thickness, central anterior chamber depth, peripheral anterior chamber depth, anterior chamber volume, pupil diameter and anterior chamber angle of cross‐section photographs from 0° to 180° (ACA) were analysed.Results:  Before and after LPI, central corneal thickness increased from 537.92 ± 27.92 µm to 541.49 ± 27.85 µm (P = 0.074); no statistic changes of central anterior chamber depth were found before LPI (1.72 ± 0.27 mm) and after LPI (1.70 ± 0.24 mm) (P = 0.337); peripheral anterior chamber depth deepen from 0.89 ± 0.26 to 1.14 ± 0.26 mm (P = 0.000); anterior chamber volume increased from 55.54 ± 14.25 to 82.65 ± 17.63 mm3 (P = 0.000); average pupil diameter of all patients are 1.72 ± 0.42 and 1.63 ± 0.46 mm, respectively, showed no statistic difference (P = 0.228). ACA widen from 25.51 ± 5.66° to 28.11 ± 5.67° in 9 o'clock direction(P = 0.005), and from 25.77 ± 5.15° to 27.91 ± 4.87° in 3 o'clock direction after LPI (P = 0.020).Conclusion:  LPI induce dramatic changes of 3‐D anterior segment morphology in primary angle‐closure suspect and primary angle‐closure.
Quantification of stress redistribution due to mismatch in creep properties in welded branch pipes
Authors: LEE K.‐H. , KIM Y.‐J. , YOON K.‐B. , NIKBIN K. , DEAN D. 
Published: January 2010

ABSTRACTThis paper reports steady‐state stress distributions within the weld metal in a welded branch component, via detailed three‐dimensional elastic‐creep finite element analyses. The creep exponent and constants for the base and weld metal are systematically varied to simulate under‐matching, even‐matching and over‐matching conditions in creep. Various loading conditions are also considered to see the effect of the loading mode. It is found that the mismatch effect in creep on steady‐state stresses within the weld metal can be uniquely quantified by the mismatch factor, defined as a function of creep exponent and constant. Ratios of section‐averaged (effective and maximum principal) stresses for the mismatched case to those for the even‐matched case are linearly dependent on the mismatch factor.
Cannabinoid modulation of limbic forebrain noradrenergic circuitry
Authors: Carvalho Ana F. , Mackie Kenneth , Van Bockstaele Elisabeth J. 
Published: January 2010

AbstractBoth the endocannabinoid and noradrenergic systems have been implicated in neuropsychiatric disorders. Importantly, low levels of norepinephrine are seen in patients with depression, and antagonism of the cannabinoid receptor type 1 (CB1R) is able to induce depressive symptoms in rodents and humans. Whether the interaction between the two systems is important for the regulation of these behaviors is not known. In the present study, adult male Sprague–Dawley rats were acutely or chronically administered the CB1R synthetic agonist WIN 55,212‐2, and α2A and β1 adrenergic receptors (AR) were quantified by Western blot. These AR have been shown to be altered in a number of psychiatric disorders and following antidepressant treatment. CB1R agonist treatment induced a differential decrease in α2A‐ and β1‐ARs in the nucleus accumbens (Acb). Moreover, to assess long‐lasting changes induced by CB1R activation, some of the chronically treated rats were killed 7 days following the last injection. This revealed a persistent effect on α2A‐AR levels. Furthermore, the localization of CB1R with respect to noradrenergic profiles was assessed in the Acb and in the nucleus of the solitary tract (NTS). Our results show a significant topographic distribution of CB1R and dopamine beta hydroxylase immunoreactivities (ir) in the Acb, with higher co‐localization observed in the NTS. In the Acb, CB1R‐ir was found in terminals forming either symmetric or asymmetric synapses. These results suggest that cannabinoids may modulate noradrenergic signaling in the Acb, directly by acting on noradrenergic neurons in the NTS or indirectly by modulating inhibitory and excitatory input in the Acb.