bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reactive Nitrogen Species Mediate DNA Damage in Helicobacter pylori‐Infected Gastric Mucosa
Authors: Katsurahara Masaki , Kobayashi Yoshinao , Iwasa Motoh , Ma Ning , Inoue Hiroyuki , Fujita Naoki , Tanaka Kyosuke , Horiki Noriyuki , Gabazza Esteban C. , Takei Yoshiyuki 
Published: November 2009

AbstractBackground:  Reactive oxygen species (ROS) and reactive nitrogen species (RNS) can play an important role in cellular injury and carcinogenesis of gastric epithelial cells infected with Helicobacter pylori. 8‐OH‐deoxy guanosine (8‐OHdG) and 8‐nitroguanine (8‐NG) are markers for ROS‐ and RNS‐mediated DNA oxidation, respectively. In this study, RNS‐mediated DNA damage in gastric mucosa was observed directly using a newly developed antibody to 8‐NG to clarify how H. pylori infection causes nitrative DNA damage to gastric epithelial cells.Methods:  Immunohistochemistry with anti‐8‐OHdG and anti‐8‐NG antibodies was performed on gastric tissue samples from 45 patients (25 men and 20 women) with H. pylori‐positive gastritis and 19 patients (11 men and 8 women) exhibiting successful H. pylori eradication. Histologic factors for gastric mucosal inflammation were graded according to the guidelines of the Updated Sydney system.Results:  In corpus mucosa, 8‐OHdG and 8‐NG production were significantly associated with the degree of glandular atrophy, infiltration of chronic inflammatory cells and intestinal metaplasia in the glandular epithelial cells. Successful H. pylori eradication resulted in a significant reduction of chronic inflammatory cell infiltration and neutrophilic activity. Mean 8‐OHdG production was lower after H. pylori eradication in both corpus and antral mucosa (p = .022 and .049, respectively). However, the reduction in 8‐NG exhibited was more pronounced than the reduction of 8‐OhdG (p = .004 and .007, respectively).Conclusions:  Helicobacter pylori infection can induce inflammatory cells infiltration, which evokes DNA damage of gastric epithelial cells through ROS and RNS production. 8‐NG might be a more sensitive biomarker than 8‐OHdG for H. pylori‐induced DNA damage in gastric mucosa.
The Modified Sequential Treatment Regimen Containing Levofloxacin for Helicobacter pylori Eradication in Turkey
Authors: Aydin Ahmet , Oruc Nevin , Turan Ilker , Ozutemiz Omer , Tuncyurek Muge , Musoglu Ahmet 
Published: November 2009

AbstractBackground:  Eradication rates of Helicobacter pylori have declined to unacceptable levels in recent years. New and effective treatment options are warranted both as a first and second line treatment.Aim:  To test an effectiveness of modified sequential therapy with levofloxacin for H. pylori eradication in Turkey.Material and Methods:  Helicobacter pylori infected dyspeptic patients were included to the study. Subjects were treated with modified sequential therapy consisting of rabeprazole 20 mg b.i.d. and amoxicillin 1 g b.i.d., for 7 days followed by rabeprazole 20 mg b.i.d, levofloxacin 500 mg q.d. and metronidazole 500 mg b.i.d for the remaining 7 days.Results:  Sixty‐three treatment naive patients and 37 previous treatment failures were enrolled to the study (59 F, 41 M, age: 21–80 years). There was five drop out. Helicobacter pylori eradication was achieved in 80 patients, intention‐to‐treat (ITT): 80% (95% CI: 71–87%) and per‐protocol (PP): 84.2% (95% CI: 75–91%), totally. In treatment naive patients ITT and PP eradication rates were 82.5% (95% CI: 71–91%), and 86.7% (95% CI: 75–94%), respectively. As a second line treatment eradication was successful in ITT 75.7%.(95% CI: 59–88%), and PP 80% (95% CI: 63–92%).Mild side effects were reported by 8 patients (8.4%).Conclusions:  Sequential therapy using “rabeprazole and amoxicillin 7 days followed by rabeprazole, metronidazole and levofloxacin for 7 days” is a new regimen with acceptable eradication rates in naïve patients in Turkey. Further modifications in the dose or duration of this new sequential therapy might increase its effectiveness as both first and second line treatment.
Clarithromycin–Amoxycillin‐Containing Triple Therapy: A Valid Empirical First‐Line Treatment for Helicobacter pylori Eradication in Hong Kong?
Authors: Hung Ivan F.N. , Chan Pierre , Leung Sally , Chan Fion S.Y. , Hsu Axel , But David , Seto Wai Kay , Wong Siu Yin , Chan Chi Kuen , Gu Qing , Tong Teresa S.M. , Cheung Ting Kin , Chu Kent Man , Wong Benjamin C.Y. 
Published: November 2009

AbstractBackground:  Recent studies have suggested the eradication rate for Helicobacter pylori infection with standard amoxycillin–clarithromycin‐containing triple therapy as first‐line treatment have fallen below 80%. Levofloxacin‐containing triple therapy was proposed as an alternative. The aim of this study is to compare the efficacy and tolerability of the standard 7‐day clarithromycin‐containing triple therapy against the 7‐day levofloxacin‐containing triple therapy, and to assess whether the classical triple therapy is still valid as empirical first‐line treatment for H. pylori infection in Hong Kong.Methods:  Three hundred consecutive H. pylori‐positive patients were randomized to receive either 1 week of EAL (esomeprazole 20 mg b.d., amoxycillin 1 g b.d., and levofloxacin 500 mg daily) or EAC (esomeprazole 20 mg b.d., amoxycillin 1 g b.d., and clarithromycin 500 mg b.d.). H. pylori status was rechecked by 13C‐urea breath test 6 weeks after treatment. Patients who failed either of the first‐line eradication therapy were invited to undergo H. pylori susceptibility testing.Results:  H. pylori eradication was achieved in 128 of 150 (85.3%) patients in EAL and 139 of 150 (92.7%) patients in EAC groups, respectively (p = .043), for both intention‐to‐treat and per‐protocol analysis. More patients in the clarithromycin‐ than the levofloxacin‐containing therapy group developed side effects from the medication (21.3% vs 13.3%, p = .060). Nine patients (six from the EAL group and three from the EAC group) who failed their corresponding eradication therapy returned for susceptibility testing. All nine isolates were highly resistant to levofloxacin (minimum inhibitory concentration or MIC > 32 μg/mL), whereas only two of the six isolates from the EAL group were resistant to clarithromycin (MIC > 0.5 μg/mL).Conclusions:  The standard 7‐day clarithromycin‐containing triple therapy is still valid as the most effective empirical first‐line eradication therapy for H. pylori infection in Hong Kong, as prevalence of primary resistance of H. pylori to amoxycillin and clarithromycin remains low. Patients who failed their empirical first‐line eradication therapy should undergo H. pylori susceptibility testing to guide further treatment.
Helicobacter pylori Multiplex Serology
Authors: Michel Angelika , Waterboer Tim , Kist Manfred , Pawlita Michael 
Published: November 2009

AbstractBackground:  Helicobacter pylori infection is associated with severe gastrointestinal disease including cancer. It induces complex antibody responses that might vary depending on disease state but currently cannot be assessed adequately. The objective of this work was the development of a sensitive and specific H. pylori multiplex serology assay with high‐throughput capability that allows simultaneous detection of antibodies to a protein array.Methods:  Seventeen proteins of up to three H. pylori strains (26695, G27, 151), including CagA, VacA, UreA, Catalase, Omp, and GroEL, were recombinantly expressed as glutathione‐S‐transferase fusion proteins, affinity‐purified, and used as antigens in a fluorescent bead‐based antibody‐binding assay. Reference sera (n = 317) characterized by commercial assays (screening ELISA with Western blot confirmation) were used for validation.Results:  H. pylori seropositivity by multiplex serology defined as reactivity with at least four proteins showed good agreement (kappa: 0.70) with commercial serologic assay classification, and a sensitivity of 89% and specificity of 82%. For individual antigens, agreement with Western blot was good for CagA (kappa: 0.77), moderate for UreA (kappa: 0.53), and weak for VacA (kappa: 0.12). Of the 13 proteins expressed from two strains, only VacA showed serologic strain differences. High antibody reactivity to CagA (Type I infection) was negatively associated with antibodies to GroEL, Cad, CagM, catalase, HcpC, NapA, and UreA, suggesting type‐specific differences in protein expression patterns and/or immune response.Conclusion:  With its high‐throughput and simultaneous detection abilities, H. pylori multiplex serology appears suited as tool for large seroepidemiologic studies assessing H. pylori prevalence, antibody patterns, and associations with specific diseases.
Bioaccumulation of Amylose‐Like Glycans by Helicobacter pylori
Authors: Ferreira José A. , Pires Cristiana , Paulo Marina , Azevedo Nuno F. , Domingues M. Rosário , Vieira Maria João , Monteiro Mario A. , Coimbra Manuel A. 
Published: November 2009

AbstractBackground:  Helicobacter pylori cell surface is composed of lipopolysaccharides (LPSs) yielding structures homologous to mammalian Lewis O‐chains blood group antigens. These structures are key mediators in the definition of host‐microbial interactions and known to change their expression pattern in response to environmental pressure.Aims:  The present work is focused on the identification of new H. pylori cell‐surface glycosides. Special attention is further devoted to provide insights on the impact of in vitro subcultivation on H. pylori cell‐surface phenotypes.Methods:  Cell‐surface glycans from H. pylori NCTC 11637 and two clinical isolates were recovered from the aqueous phase resulting from phenol:water extraction of intact bacteria. They were evaluated in relation to their sugars and glycosidic‐linkages composition by CG‐MS, size‐exclusion chromatography, NMR, and Mass Spectrometry. H. pylori glycan profile was also monitored during subcultivation in vitro in agar and F12 liquid medium.Results:  All three studied strains produce LPS expressing Lewis epitopes and express bioaccumulate amylose‐like glycans. Bioaccumulation of amylose was found to be enhanced with the subcultivation of the bacterium on agar medium and accompanied by a decrease in the expression of LPS O‐chains. In contrast, during exponential growth in F12 liquid medium, an opposite behavior is observed, that is, there is an increase in the overall amount of LPS and decrease in amylose content.Conclusions:  This work shows that under specific environmental conditions, H. pylori expresses a phase‐variable cell‐surface α‐(1→4)‐glucose moiety.
Serum Levels of Leptin As Marker For Patients At High Risk of Gastric Cancer
Authors: Capelle Lisette G. , De Vries Annemarie C. , Haringsma Jelle , Steyerberg Ewout W. , Looman Caspar W. N. , Nagtzaam Nicole M. A. , Van Dekken Herman , Ter Borg Frank , De Vries Richard A. , Kuipers Ernst J. 
Published: November 2009

AbstractBackground:  Serological screening for gastric cancer (GC) may reduce mortality. However, optimal serum markers for advanced gastric precursor lesions are lacking.Aim:  To evaluate in a case–control study whether serum leptin levels correlate with intestinal metaplasia (IM) and can serve as a tool to identify patients at high risk for GC.Materials and Methods:  Cases were patients with a previous diagnosis of IM or dysplasia, controls were patients without such a diagnosis. All patients underwent endoscopy. Fasting serum was collected for the measurement of leptin, pepsinogens I/II, gastrin, and Helicobacter pylori. Receiver operating characteristic (ROC) curves and their area under the curve (AUC) were provided to compare serum leptin levels with other serological markers.Results:  One hundred nineteen cases and 98 controls were included. In cases, the median leptin levels were 116.6 pg/mL versus 81.9 pg/mL in controls (p = .01). After adjustment for age, sex and BMI, leptin levels remained higher in cases than in controls (p < .005). In multivariate analysis, male sex (p = .002), age (<0.001), low pepsinogen levels (p = .004) and high leptin levels (p = .04) were independent markers for the presence of IM. In addition, a ROC curve including age, sex and pepsinogen I levels had an AUC of 0.79 (95% CI (0.73–0.85)). Adding serum leptin levels increased the AUC to 0.81 (95% CI (0.75–0.86)).Conclusions:  High leptin levels are associated with an increased risk of IM. Moreover, serum leptin levels are a significant independent marker for the presence of IM. However, in combination with the serological test for pepsinogen I the additional value of serum leptin levels is rather limited.
A Gentle Introduction to Risk Aversion and Utility Theory
Authors: Cather David A. 
Published: November 2009

AbstractWhile the topics of risk aversion and utility theory have been discussed extensively in the academic literature on risk and insurance, this literature does not include a pedagogical discussion that is widely accessible for classroom use. This article provides a practical introduction to risk aversion that is designed for readers with little prerequisite course work in economics or statistics. We describe a simple model of insurance demand that can be applied to the property, liability, life, and health insurance markets. We also demonstrate how risk aversion affects a variety of real‐life insurance decisions made under conditions of uncertainty, including how much the market will bear to pay for insurance administrative expenses and how demand varies for different types of auto insurance coverage. Exercises and practice problems are provided so that readers can test their mastery of the concepts presented in the article. An instructional note on using this article to teach risk aversion in the classroom is also provided.
The limits of solidarity: Labor and transnational organizing against Coca‐Cola
Authors: GILL LESLEY 
Published: November 2009

ABSTRACTIn this article, I explore the concept of “solidarity” through an examination of the alliances and disjunctures that shaped a transnational campaign against the Coca‐Cola Company. I consider how the balance of power within cross‐class coalitions influenced the framing of issues and the development of tactics, and I examine the tensions that arose among diverse groups who chose to struggle together but shared different goals and perspectives. I argue that the labor philanthropy of northern activists on behalf of Colombian workers could not substitute for the labor solidarity that Colombian workers asked of their northern allies. My study suggests that transnational activists from the North focus on tactics that push states, as well as corporations, to protect labor rights and that they pay closer attention to the analyses and objectives of the working people with whom they claim solidarity.
Detection of the Siphon Internal Carotid Artery Stenosis: Transcranial Doppler versus Digital Subtraction Angiography
Authors: You Yong , Hao Qing , Leung Thomas , Mok Vincent , Chen Xiangyan , Lau Alex , Leung Howan , Wong Ka Sing 
Published: November 2009

ABSTRACTBACKGROUND Transcranial Doppler (TCD) is widely applied to evaluate the intracranial large artery stenosis. We aimed to evaluate the accuracy of TCD in detecting siphon internal carotid artery (SICA) stenosis against digital subtraction angiography (DSA). METHODS A total of 145 patients with TCD and DSA performed were recruited. The SICA and other intracranial arteries were evaluated through transorbital and transtemporal acoustic window by TCD. We defined the best cutoff value for significant SICA stenosis by receiver‐operating characteristic (ROC) curve analyses and calculated the sensitivity, specificity, and positive and negative predictive values (PPV and NPV). RESULTS Mean age of the patients was 65.7 years (range 28‐88 years) and 75.1% (109/145) were men. The peak systolic velocity (PSV) = 120 cm/second had the largest area under the ROC curve (area under the ROC curve = .868) compared with the MFV = 70 cm/second and MFV = 80 cm/second (area under the ROC curve = .822 and .845). So the criteria for SICA stenoses were defined as PSV = 120 cm/second plus additional parameters (abnormal spectrum, circumscribed velocity changes, or side‐to‐side difference). Twenty‐nine patients were diagnosed with SICA stenosis or occlusion on TCD. Fourteen patients had abnormal TCD findings that were not confirmed by DSA. One patient with normal TCD but DSA showed mild (40%) stenoses. Accuracy parameters for TCD were as follows: sensitivity = 96.7% (95% confidence interval [CI]= 80.9‐99.8), specificity = 93.9% (95% CI = 89.9‐96.4), PPV = 65.9% (95% CI = 50.0‐79.1), NPV = 99.6% (95% CI = 97.2‐1.0). Most false‐positive patients (11 of 15 patients) had other significant intracranial large arteries lesions. CONCLUSIONS The criteria have limited but acceptable sensitivity and specificity in detecting SICA stenoses. Abnormal findings of siphon carotid on TCD require further clarification.
Myocardial Stress Perfusion with a Novel Dual‐Source CT Scanner – Technical Update and Initial Clinical Experience
Authors: Bamberg F. , Nikolaou K. , Becker A. , Klotz E. , Schmidt B. , Flohr T. 
Published: November 2009

SummaryTraditionally, myocardial perfusion imaging by CT has been hampered by limited detector size and stability of Hounsfield Units in moving cardiac acquisition modes. In the present article, we describe the technical principles of a novel, dynamic heart shuttle scan acquisition using a second generation dual source CT system (SOMATOM Definition Flash, Siemens Healthcare, Forchheim, Germany). With simultaneous injection of iodinated contrast agent, this protocol allows for sequential assessment of myocardial enhancement with reasonable radiation exposure of less than 10 mSv. We also present the case of a 69‐year‐old male patient who underwent dynamic CT‐based myocardial perfusion imaging to determine the hemodynamic relevance of a stenosis in the left anterior descending coronary artery.
A clinical review of 105 patients with PFAPA (a periodic fever syndrome)
Authors: Feder HM , Salazar JC 
Published: November 2009

AbstractAims: We describe the presentations and clinical outcomes of pediatric patients diagnosed with PFAPA (Periodic Fever, Aphthous lesions, Pharyngitis, and cervical Adenitis).Materials and methods: The medical records of children with recurrent fever and referred between 1998 and 2007 to a tertiary pediatric care hospital were reviewed. Children who met clinical criteria for PFAPA were then asked to participate in a follow‐up study.Results: One hundred and five children met study criteria for PFAPA which included at least six episodes of periodic fever. Most (62%) were males, the mean age at onset of PFAPA was 39.6 months (80% were <5 years at onset), the mean duration of individual fever episodes was 4.1 days, and the mean interval between episodes was 29.8 days. Accompanying signs and symptoms included aphthous stomatitis (38%), pharyngitis (85%), cervical adenitis (62%), headache (44%), vomiting with fever spikes (27%) and mild abdominal pain (41%). A prodrome (usually fatigue) preceded the fever in 62% of patients. Parents noted that when their child with PFAPA had fever, other family members remained well. Laboratory tests in patients with PFAPA were nonspecific. Individual episodes of fever usually resolved with a single oral dose (∼1 mg/kg) of prednisilone. The interval between fever episodes shortened in 50% of patients who used prednisilone. PFAPA resolved spontaneously (mean length 33.2 months) in 211105 (20%) patients. PFAF’A episodes continued (mean length 23 months) at the end of this study in 661105 (63%) patients. Cimetidine therapy was associated with the resolution of the fevers in 7/26 (27%) patients; tonsillectomy was associated with the resolution of the fevers in 11/11 (100%) patients.Conclusion: PFAPA can usually be defined by its clinical characteristics. Individual febrile episodes usually resolve dramatically with oral prednisilone. The cause of PFAPA is unknown and research is needed to define its etiology. The overall prognosis for children with PFAPA is excellent.
The prognostic value of amplitude integrated EEG in neonatal sepsis and/or meningitis
Authors: Ter Horst HJ , Van Olffen M , Remmelts HJ , De Vries H , Bos AF 
Published: November 2009

AbstractAim:  To investigate the longitudinal course and prognostic value of amplitude integrated EEG (aEEG) in infants with neonatal sepsis or meningitis.Methods:  Amplitude integrated EEG recordings of 22 infants with sepsis/meningitis were retrospectively evaluated. Mean gestational age was 38 weeks (range: 34–42 weeks). Thirteen infants had meningitis. Survivors were seen for neurological follow‐up. Four infants died, two were severely abnormal at 24 months. Amplitude integrated EEG background pattern, sleep wake cycling (SWC) and electrographic seizure activity (EA) were appraised.Results:  All infants with continuous low voltage or flat trace on aEEG (n = 4) had an adverse outcome. Low voltage aEEGs (n = 9) had a positive LR (LR+) for an adverse outcome of 5.3 (95% CI: 1.9–14.8) at 6 h and 8.3 (95% CI: 1.3–55) at 24 h after admission. EA was more frequent in infants with adverse outcome (p < 0.01) and had a LR+ for adverse outcome of 10.6 (95% CI: 1.5–76). SWC appeared more frequent in infants with good outcome (p < 0.05).Conclusion:  Low voltage background pattern, SWC and EA on aEEG are helpful to predict neurological outcome in infants with neonatal sepsis or meningitis.
Arterial Occlusion Sites on Magnetic Resonance Angiography Influence the Efficacy of Intravenous Low-Dose (0·6 mg/kg) Alteplase Therapy for Ischaemic Stroke
Authors: Nakashima T. , Toyoda K. , Koga M. , Matsuoka H. , Nagatsuka K. , Takada T. , Naritomi H. , Minematsu K. 
Published: November 2009

Aims To determine the predictors of efficacy, including magnetic resonance imaging information, for low-dose intravenous alteplase therapy for stroke patients. Methods Seventy-eight patients were prospectively enrolled in a single Stroke Unit (SU) receiving alteplase at a dose of 0·6 mg/kg during the initial 27 months after its approval in Japan. Ischaemic changes and vascular lesions were identified using computed tomography, diffusion-weighted magnetic resonance imaging, and magnetic resonance angiography. Early ischaemic signs were assessed using the Alberta Stroke Program Early CT Score. Results The median baseline National Institutes of Health Stroke Scale score of 78 patients was 12. In 19 patients (24%), the National Institutes of Health Stroke Scale score improved by ≥8 points at 24 h. After multivariate adjustment, occlusion at the internal carotid artery (odds ratio 11·82, 95% confidence interval 1·73–142·74), Alberta Stroke Program Early CT Score on diffusion-weighted imaging ≤6 (15·23, 1·88–351·50), and a lower National Institutes of Health Stroke Scale score (1·24, 1·08–1·47, per 1-point decrease) were inversely correlated with early improvement. Four patients (5%) had symptomatic intracranial haemorrhage. At 3 months, 76 patients (98%) survived, and 36 of 78 patients (46%) overall, but only two of 19 patients (11%) with internal carotid artery occlusion, had a favourable functional outcome, corresponding to a modified Rankin scale score 1. After multivariate adjustment, internal carotid artery occlusion (odds ratio 15·84, 95% confidence interval 3·12–128·69) and Alberta Stroke Program Early CT Score on diffusion-weighted imaging ≤6(15·62, 1·78–410·12) were independent predictors of poor outcome. Conclusions Intravenous alteplase therapy at a dose of 0·6 mg/kg resulted in a relatively good overall outcome when compared with outcomes reported by western studies using an alteplase dose of 0·9 mg/kg. However, patients with occlusion at the internal carotid artery did not respond to this low-dose alteplase therapy.