bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endoscopic retrograde cholangiopancreatography in hepatic alveolar echinococcosis
Authors: Ozturk Gurkan , Polat Kamil Yalcin , Yildirgan Mehmet Ilhan , Aydinli Bulent , Atamanalp Sabri Selcuk , Aydin Unal 
Published: August 2009

AbstractBackground and Aim:  Hepatic alveolar echinococcosis (HAE) involves both the vascular and biliary structures of the liver. Endoscopic retrograde cholangiopancreatography (ERCP) is said to be an alternative for the diagnosis and treatment of biliary complications of HAE. We present here our experience with ERCP in HAE.Methods:  We followed 13 patients who underwent ERCP for the treatment of biliary complications of HAE in the endoscopy unit of our clinic at Ataturk University School of Medicine, Erzurum between January 2002 and June 2008.Results:  Eight men and five women were followed up. Mean age was 43.2 (24–64 years). All patients had non‐resectable HAE. Indications for ERCP were biliary fistula in seven patients, obstructive jaundice in five patients and cholangitis in one patient. Endoscopic sphincterotomy (ES) was carried out in 12 patients, and in one patient with biliary leakage, a stent was inserted into the right hepatic branch. ERCP findings were dilated common bile duct, irregular narrowing and distortion of the common bile duct and common hepatic duct, communication with the cystic cavity or biliocutaneous fistula and complete disappearance of the biliary tree above the level of the common hepatic duct or hepatic bifurcation. In patients with biliary leakage, biliary drainage decreased only in two patients after ERCP and in patients with obstructive jaundice, the high bilirubin levels decreased in only one patient.Conclusion:  ERCP showed structural changes of the external biliary tract and ES has a limited effect on these changes and stents can be used in selected cases.
Assessment of gastric motor function by cine magnetic resonance imaging
Authors: Baba Shigeaki , Sasaki Akira , Nakajima Jun , Obuchi Toru , Koeda Keisuke , Wakabayashi Go 
Published: August 2009

AbstractBackground and Aim:  The aim of the present study was to evaluate gastric motor function by magnetic resonance imaging (MRI) and investigate whether this examination is a useful tool for therapeutic efficacy or postoperative gastric motor function.Methods:  Twenty‐five healthy volunteers and 10 gastric cancer patients with pylorus‐preserving gastrectomy (PPG) underwent cine‐MRI. Gastric volume was determined by 3D‐volumetry. Gastric motility was quantified by calculating the gastric motility index (GMI).Results:  The image acquisition and analysis were successfully carried out for all subjects. In healthy volunteers, mean frequency, amplitude, velocity of gastric peristaltic waves and GMI 30 min after the intake of jelly were 3/min, 8.8 mm, 2.2 mm/s and 19.6 mm2/s, respectively. Mean amplitude (8.8 vs 10.4 mm, P = 0.027), velocity (2.2 vs 2.6 mm/s, P < 0.001) of peristaltic waves, and GMI (19.6 vs 26.7 mm2/s, P < 0.001) significantly increased at 30 min after giving mosapride citrate (MS). Mean gastric volume after MS administration was significantly decreased; 0 min (317.3 vs 272.9 mL, P = 0.021), 45 min (263.4 vs 206.4 mL, P = 0.004) and 60 min (228.7 vs 165 mL, P = 0.001). PPG patients with postprandial symptoms were observed having antiperistalsis‐like contraction waves and reflux of gastric contents from the pyloric region into the upper part of the stomach. Mean gastric volume in PPG patients with postprandial symptoms at 30 min after intake of jelly tended to be greater than in those without such symptoms.Conclusions:  The present study demonstrates that cine‐MRI is a sensitive and non‐invasive imaging technique for simultaneously measuring gastric motility and emptying.
Treatment strategy for laterally spreading tumors in Japan: Before and after the introduction of endoscopic submucosal dissection
Authors: Kobayashi Nozomu , Saito Yutaka , Uraoka Toshio , Matsuda Takahisa , Suzuki Haruhisa , Fujii Takahiro 
Published: August 2009

AbstractBackground and Aims:  Laterally spreading tumors (LST) in the colorectum are considered good candidates for endoscopic resection (ER). Because LST‐non‐granular (NG) tumors show multifocal invasion into the submucosal layer, en bloc resection is necessary for adequate histopathological evaluation. Therefore, surgical resection has been recommended when a lesion is suspected to be an invasive cancer and too large to resect en bloc. The aim of the present study was to evaluate whether the introduction of colorectal ESD, which was developed for en bloc resection of early gastric cancers, could improve the en bloc resection rate of large LST‐NG‐type tumors and reduce the surgical resection rate.Methods:  Between January 1999 and December 2005, a total of 166 LST‐NG‐type tumors measuring ≥ 20 mm in 161 patients were included in this study. The en bloc resection rate and the surgical resection rate were historically compared between two periods, before and after the introduction of ESD.Results:  The en bloc resection rate for ER lesions was significantly higher in the latter period (35.0% [14/40]vs 76.5% [75/98]; P < 0.001), and the rate of surgery for adenomas and intramucosal or sm minute cancers was significantly lower in the latter period (20.0% [10/50]vs 1.1% [1/89]; P < 0.001).Conclusions:  The introduction of colonic ESD was able to change our treatment strategy for LST, improving the en bloc resection rate and reducing the surgical resection rate.
Extracorporeal shock wave lithotripsy of large difficult common bile duct stones: Efficacy and analysis of factors that favor stone fragmentation
Authors: Tandan Manu , Reddy D Nageshwar , Santosh Darisetty , Reddy Venkat , Koppuju Vinod , Lakhtakia Sandeep , Gupta Rajesh , Ramchandani Mohan , Rao Guduru Venkat 
Published: August 2009

AbstractBackground and Aim:  Difficult common bile duct stones (CBD) are those not amenable to extraction by the standard technique of sphincterotomy followed by use of a Dormia basket or balloon. The role of extracorporeal shock wave lithotripsy (ESWL) in stone fragmentation and clearance of difficult CBD stones and the factors which favor fragmentation were prospectively evaluated in the present study.Methods:  A total of 283 patients with large CBD stones were subjected to ESWL. A maximum of 5000 shocks was delivered per session until CBD stones were fragmented to less than 5 mm diameter. CBD was cleared by biliary endotherapy using a basket or balloon. Outcome was assessed by CBD clearance.Results:  Total CBD clearance was achieved in 239 patients (84.4%) and partial CBD clearance in 35 patients (12.3%). Three or fewer sessions of ESWL were required in 74.6% of patients. Minor complications were seen in 45 patients (15.9%). There was no procedure‐related mortality. Epidural anesthesia, shock frequency of 90/min, radiolucent calculi and presence of fluid around the calculus helped in better fragmentation.Conclusion:  A high success rate, negligible complications and non‐invasive nature of the procedure make ESWL a useful tool for removing large CBD stones.
Improving visualization techniques by narrow band imaging and magnification endoscopy
Authors: Muto Manabu , Horimatsu Takahiro , Ezoe Yasumasa , Morita Shuko , Miyamoto Shinichi 
Published: August 2009

AbstractEndoscopy plays an important role in the early detection of gastrointestinal tract neoplasms. Using conventional white light or dye‐based image enhanced endoscopy, it has been difficult to assess pre‐malignant and early neoplastic lesions precisely. However, narrow band imaging (NBI) dramatically improves the detection of these lesions, particularly in combination with magnifying endoscopy. This allows the endoscopist to accomplish accurate diagnosis. Such enhanced detection of pre‐malignant and early neoplastic lesions in the gastrointestinal tract should allow better targeting of biopsy, improved and more appropriate treatment, and thereby contribute to optimal quality of life and patient survival.
Chinese herbal medicine modified xiaoyao san for functional dyspepsia: Meta‐analysis of randomized controlled trials
Authors: Qin Feng , Huang Xi , Ren Ping 
Published: August 2009

AbstractBackground:  To critically assess the evidence of modified xiaoyao san (MXS) for treating functional dyspepsia (FD).Methods:  Systematic literature searches were carried out on the Medline database, CNKI database, Wanfang Data, VIP Information and the Cochrane Library. Reference lists located were checked for further relevant publications. Experts in the field and manufacturers of identified products were contacted for unpublished material. Studies were selected according to predefined inclusion and exclusion criteria. All randomized clinical trials of MXS for treating FD were included. Study selection, data extraction and validation were carried out by at least two reviewers with disagreements being settled by discussion. Weighted means and 95% confidence intervals were calculated and sensitivity analyses were carried out.Results:  Thirty‐three potentially relevant articles were retrieved for further evaluation. Fourteen were suitable for inclusion in the meta‐analysis. There was evidence that MXS compared with prokinetic drugs reduced symptoms (odds ratio 3.26, 95% CI 2.24 to 4. 47). There was evidence that MXS + prokinetic drugs compared with prokinetic drugs reduced symptoms (odds ratio 4.32, 95% CI 2.64 to 7.08).Conclusion:  MXS appears to be more effective compared to prokinetic drugs in the treatment of FD and no serious side‐effects were identified. However, the evidence remains weak due to publication bias and methodological flaws, which may amplify the therapeutic benefit of MXS.
Overexpression of metastasis‐associated protein 2 is associated with hepatocellular carcinoma size and differentiation
Authors: Lee Hyunseung , Ryu Soo Hyung , Hong Soon Sun , Seo Dong Dae , Min Hyun Joo , Jang Myoung Kuk , Kwon Ho Jeong , Yu Ensil , Chung Young‐Hwa , Kim Kyu‐Won 
Published: August 2009

AbstractBackground and Aim:  Metastasis is a multistep event in which neoplastic cells detach from the tumor, migrate, disseminate, extravasate, and eventually proliferate at the secondary distant sites. Hepatocellular carcinoma (HCC) is characterized by hypervascularity and frequent metastasis. Recently, metastasis‐associated proteins were identified and named metastatic tumor antigens (MTA) 1, 2, and 3. They have been found to be contained in the nucleosome remodeling and histone deacetylase complex. MTA2 has been reported to interact with p53 and inhibit p53‐mediated cell growth arrest and apoptosis by deacetylation. Although it has been reported that the expression of MTA1 is related to tumor progression and metastasis, it is still unclear how MTA2 is involved in HCC. In this study, we found that the overexpression of MTA2 is associated with HCC size and differentiation after hepatectomy.Methods:  The expression of MTA2 was examined in 506 human HCC samples that underwent hepatic resection using tissue microarray. The expression of MTA2 was classified into 0, 1, 2, and 3, based on immunoreactivity.Results:  The expression of MTA2 was predominantly localized to the nucleus. MTA2 was detected in 487 (96.2%) of the 506 human HCC samples. Notably, the MTA2 expression level strongly increased depending on the size and differentiation of HCC.Conclusions:  These findings indicate a tight correlation between the MTA2 expression level and HCC size and differentiation. Therefore, MTA2 might be a predictor of aggressive phenotypes and a possible target molecule for anticancer drug design in human HCC.
Prevention of hepatocellular carcinoma in hepatitis B virus infection
Authors: Lim Seng Gee , Mohammed Rosmawati , Yuen Man‐Fung , Kao Jia‐Horng 
Published: August 2009

AbstractChronic hepatitis B is the main risk factor for hepatocellular carcinoma (HCC) in Asia. The most important preventive strategy's adoption of the universal hepatitis B vaccination program is now in its third decade. There is a clear reduction in both chronic hepatitis B virus (HBV) infection (hepatitis B surface antigen “carriage”) but also in childhood HCC in Taiwan. An outstanding concern is variability in vaccine coverage between countries. For patients with chronic hepatitis B, serum HBV DNA levels have emerged as the key risk factor for development of HCC. The initial treatment for chronic hepatitis B was interferon. One randomized control trial, and several case–control or cohort studies have shown benefits for preventing HCC, particularly in cirrhotic patients who responded to therapy. With nucleos(t)ide analogs, the most important study has been the Asian Cirrhosis Lamivudine multicenter randomized controlled trial. This showed that lamivudine can reduce disease progression in HBV‐related cirrhosis, including an approximately 50% decrease in HCC incidence. Such efficacy was achieved despite emergence of drug resistance in approximately 50% of cases. Case–control studies have suggested that hepatitis B cases without cirrhosis may also benefit. In conclusion, it is now possible to prevent HBV‐related HCC. The most effective method is hepatitis B vaccination, which prevents chronic HBV infection and chronic liver disease resulting therefrom. Interferon therapy appears to confer benefit but the evidence is weaker. First‐generation oral antiviral (lamivudine) reduces HCC risk, particularly in cirrhotics. Long‐term outcome data with newer, more potent HBV antivirals that have a higher genetic barrier to drug resistance are eagerly awaited.
Risk factors for adult‐onset asthma: A 14‐year longitudinal study
Authors: JAMROZIK Euzebiusz , KNUIMAN Matthew W. , JAMES Alan , DIVITINI Mark , MUSK AW (Bill) 
Published: August 2009

ABSTRACTBackground and objectives:  Few longitudinal studies have examined the risk factors and natural history of adult‐onset asthma. This study assessed the subject characteristics and lifestyle factors that predicted the new diagnosis of asthma in adulthood and how these factors changed over time in those who developed asthma compared with those who do not.Methods:  The study enrolled 1554 adults from the Busselton Health Study seen in 1981 and again in 1994–1995 who initially reported never having had doctor‐diagnosed asthma. Questionnaire measures were used to assess doctor‐diagnosed asthma, respiratory history and tobacco smoking. Height, weight and spirometric measures of lung function were measured. Atopy was assessed by skin prick tests. Logistic regression analysis was used to identify risk factors for adult‐onset asthma and changes over time.Results:  Reported wheeze, rhinitis, chronic cough, smoking and lower levels of lung function in 1981 each predicted asthma diagnosis by 1994–1995. Neither initial skin‐prick reactivity nor newly positive skin‐prick tests at follow up were associated with adult‐onset asthma. Those diagnosed with asthma were more likely to have new wheeze, new rhinitis, new habitual snoring, weight gain and excess decline in lung function.Conclusions:  Adult‐onset asthma has risk factors that are distinct from those observed in childhood asthma. The presence of upper airway symptoms including rhinitis, as well as lifestyle factors, such as smoking, predicts those at greatest risk. However, neither pre‐existing atopy nor new atopy as measured by skin prick tests was associated with adult‐onset asthma.
The effect of natural adjuvants on tracheal responsiveness and cell count in lung lavage of sensitized guinea pigs
Authors: NEAMATI Ali , BOSKABADY Mohammad H. , AFSHARI Jalil T. , HAZRATI Saleh M. , ROHANI Ali H. 
Published: August 2009

ABSTRACTBackground and objective:  Airway inflammation is a well‐characterized pathological feature of asthma. The effects of two natural adjuvants on lungs of sensitized guinea pigs were examined.Methods:  The responses of guinea pig tracheal chains, WBC, differential WBC in lung lavage and IL‐4 and interferon (IFN)‐γ levels in serum were examined in control guinea pigs and four treatment groups, including sensitized animals (S) and sensitized animals treated with the adjuvants PC (S + PC), G2 (S + G2) or both adjuvants (S + PCG2) (n = 6). Animals were sensitized by injection and inhalation of ovalbumin.Results:  Tracheal responsiveness to methacholine (concentration of methacholine causing 50% of maximum contraction), WBC, eosinophil, neutrophil and basophil numbers were increased and lymphocyte numbers were decreased in lung lavage of sensitized animals compared with the control group (P < 0.01 to P < 0.001). However, G2 adjuvant and the combination of G2 and PC adjuvants caused a significant reduction in tracheal responsiveness (P < 0.01 and P < 0.001, respectively). In addition both adjuvants prevented changes in WBC (P < 0.001 for both). Both adjuvants and the combination prevented changes in eosinophil, neutrophil and basophil numbers in lung lavage of sensitized animals (P < 0.05 to P < 0.001). The adjuvants also prevented changes in IL‐4 but increased IFN‐γ levels in all treatment groups compared with group S (P < 0.001 for all cases).Conclusions:  These results indicate that the two natural adjuvants (especially G2 adjuvant) and their combination have therapeutic effects, with reduction in tracheal responsiveness and WBC in lung lavage of sensitized guinea pigs.
The effects of a swimming intervention for children with asthma
Authors: WANG Jeng‐Shing , HUNG Wen‐Ping 
Published: August 2009

ABSTRACTBackground and objective:  Asthma is a common paediatric airway disease with increasing prevalence. Studies comparing swimming with other sports have found that swimming is unlikely to provoke unstable asthma but possible benefits are not defined. This study investigated the benefits of a 6 week swimming intervention on pulmonary function tests (PFT), PEF and severity of asthma in children.Methods:  Young asthmatics were randomly assigned to the experimental or the control group, with 15 subjects in each group. In addition to regular treatment for asthma, the experimental group received swimming training for 6 weeks. PFT, PEF and severity of asthma were measured.Results:  There was a significant improvement (P < 0.01) in PEF in the experimental group compared with the control group (330 L/min, 95% CI: 309–351 vs. 252 L/min, 95% CI: 235–269) after the swimming intervention. There was also a significant improvement (P < 0.05) in the severity of asthma in the experimental group compared with the control group.Conclusions:  These data suggest that a swimming programme for asthmatic children can improve some disease parameters (PEF and the severity of asthma). Swimming may be an effective non‐pharmacological intervention for the child or adolescent with asthma.
Factors influencing visibility and diagnostic yield of transbronchial biopsy using endobronchial ultrasound in peripheral pulmonary lesions
Authors: HUANG Chun‐Ta , HO Chao‐Chi , TSAI Yi‐Ju , YU Chong‐Jen , YANG Pan‐Chyr 
Published: August 2009

ABSTRACTBackground and objective:  Endobronchial ultrasound (EBUS) has increased the diagnostic yield of bronchoscopic biopsy of peripheral pulmonary lesions (PPL). However, certain lesions cannot be localized by EBUS, and the factors associated with the visibility of PPL by EBUS have not been investigated. This study evaluated the factors predicting the visualization of EBUS in PPL and the diagnostic yield of EBUS‐guided transbronchial biopsy (TBB).Methods:  n 2007, 83 patients with PPL underwent EBUS‐guided TBB, and their medical records were reviewed and analysed retrospectively.Results:  Of the 83 patients examined, EBUS images could not be obtained in 23 patients (28%). Lesion size was a determining factor for the visibility of PPL, with the visualization yield of EBUS in lesions <20 mm being significantly lower than that in lesions ≥20 mm (P < 0.001). A definitive diagnosis of PPL localized by EBUS was established using EBUS‐guided TBB in 73% of patients. There were no significant differences in diagnostic yield related to underlying disease, lobar distribution, CT scan appearance or presence of complications. Multivariate analysis revealed that the location of PPL on CT scans and position of the probe were independent predictors of the diagnostic yield by EBUS‐guided TBB (P < 0.001 and P = 0.001, respectively).Conclusions:  Lesion size is a significant factor predicting visualization of EBUS for PPL. The location of PPL on CT scans and position of the probe are significantly related to a higher diagnostic yield with EBUS‐guided TBB.
Low doses of silver nitrate induce pleurodesis with a limited systemic response
Authors: MARCHI Evaldo , VARGAS Francisco S. , ACENCIO Milena M.P. , ANTONANGELO Leila , TEIXEIRA Lisete R. , LIGHT Richard W. 
Published: August 2009

ABSTRACTBackground and objective:  Both talc and 0.5% silver nitrate have been shown to induce effective pleurodesis. However, acute adverse systemic inflammatory effects have been described with both agents. The aim of this study was to assess in rabbits the systemic effects associated with a new technique of pleurodesis using repeated low doses of 0.1% silver nitrate.Methods:  Rabbits were injected intrapleurally through a chest tube with 0.1% silver nitrate at 0, 24 and 48 h. Other groups received a single injection of 0.5% silver nitrate or 400 mg/kg of talc. Blood samples were collected at 24, 48 and 72 h, and at 7 days, and cytological and biochemical measurements were performed. After 28 days, the presence of macroscopic pleural adhesions and microscopic pleural fibrosis in the pleural cavity were evaluated.Results:  Both talc and 0.5% silver nitrate caused significant increases in blood neutrophils, serum LDH, IL‐8, transforming growth factor‐β and CRP in comparison with control at almost all time points, whereas sequential doses of 0.1% silver nitrate only increased LDH and CRP in the first 24 h and transforming growth factor‐β at all time points. All groups showed efficient pleurodesis, with no differences in pleural adhesions or fibrosis.Conclusions:  Sequential doses of 0.1% silver nitrate produced efficient pleurodesis in rabbits, with a low systemic inflammatory response in comparison with 400 mg/kg of talc or 0.5% silver nitrate.
Rehabilitation and palliative care in lung fibrosis
Authors: SPRUIT Martijn A. , JANSSEN Daisy J.A. , FRANSSEN Frits M.E. , WOUTERS Emiel F.M. 
Published: August 2009

ABSTRACTThe idiopathic interstitial pneumonias are a heterogeneous group of diffuse parenchymal lung diseases with varying degrees of inflammation and fibrosis, like interstitial pulmonary fibrosis. Functional exercise tolerance and quality of life have been shown to be significantly affected in patients with lung fibrosis. Moreover, interstitial pulmonary fibrosis is a progressive disease with poor prognosis and limited response to conventional pharmacological treatment like immunosuppressive agents. So, in patients with lung fibrosis there seems a clear indication to refer them for comprehensive pulmonary rehabilitation programmes and to initiate palliative care in an early phase of the disease. In the current review we will present a rationale for pulmonary rehabilitation in patients with lung fibrosis and the effects of this type of non‐pharmacological intervention on exercise capacity and quality of life. In addition, we will discuss possibilities for palliative care in these patients.