bluuebunny/crossref_metadata_2025_split huggingface dataset:
Imaging of liver disease: Comparison between quadruple‐phase multidetector computed tomography and magnetic resonance imaging
Authors: Balci N Cem , Befeler Alex S , Leiva Paula , Pilgram Thomas K , Havlioglu Necat 
Published: August 2008

AbstractBackground and Aim:  To compare quadruple‐phase multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) for the assessment of focal and diffuse liver disease.Methods:  Quadruple‐phase contrast‐enhanced MDCT and MRI of 37 consecutive patients were retrospectively reviewed by two readers (R1 and R2). In patients with focal liver lesions, the gold standard was histopathology (n = 17) and/or long‐term (>6 months) follow‐up imaging (n = 27) or transarterial chemoembolization (n = 1). Diffuse liver disease was confirmed by histopathology in all patients, when present.Results:  Both readers identified 60 focal liver lesions on MDCT and 56 focal liver lesions on MRI. Gold standard diagnoses revealed 48 focal liver lesions in 25 patients. Diagnosis of malignant liver lesions revealed a sensitivity of 88% (R1) and 91% (R2) for MRI; 63% (R1) and 66% (R2) for MDCT; and a specificity of 75% (R1) and 79% (R2) for MRI; 50% (R1) and 64% (R2) for MDCT. MRI was superior to MDCT for the diagnosis of malignant focal liver lesions, when the mean areas under the alternative free‐response receiver operating characteristic curves (AZ) were compared (MRI = 0.93 vs CT = 0.69), (P < 0.00001). Thirty‐three patients had histopathologically confirmed diffuse liver disease. Overall diagnosis of diffuse liver disease revealed a sensitivity of 88% (R1) and 92% (R2) for MRI; 75% (R1) and 74% (R2) for MDCT; and a specificity of 100% for both modalities by both readers.Conclusions:  MRI is superior for the assessment of malignant focal liver lesions and diffuse liver disease compared to quadruple‐phase MDCT, and can be considered as primary diagnostic imaging modality for liver imaging.
Diabetes mellitus worsens the recurrence rate after potentially curative therapy in patients with hepatocellular carcinoma associated with nonviral hepatitis
Authors: Kawamura Yusuke , Ikeda Kenji , Arase Yasuji , Yatsuji Hiromi , Sezaki Hitomi , Hosaka Tetsuya , Akuta Norio , Kobayashi Masahiro , Saitoh Satoshi , Suzuki Fumitaka , Suzuki Yoshiyuki , Kumada Hiromitsu 
Published: August 2008

AbstractBackground and Aim:  The aim of this retrospective study was to examine the relationship between diabetes mellitus and recurrence of hepatocellular carcinoma after potentially curative therapy for hepatocellular carcinoma with nonviral hepatitis.Methods:  We studied 40 consecutive hepatocellular carcinoma patients who were diagnosed between 1980 and 2006 with hepatocellular carcinoma associated with non‐B, non‐C hepatitis, and later underwent surgical resection or radiofrequency ablation.Results:  Twenty‐two out of the 40 patients developed hepatocellular carcinoma recurrence within a median of 3.7 years. In the 18 patients with diabetes mellitus, the cumulative rates of hepatocellular carcinoma recurrence were 22.2% at the first year, 55.6% at the second year, 61.1% at the third year, 61.1% at the fourth year, and 80.6% at the fifth year. The cumulative rates of hepatocellular carcinoma recurrence in 22 nondiabetic patients were 24.6% at the first year, 24.6% at the second year, 31.5% at the third year, 31.5% at the fourth year, and 31.5% at the fifth year. The hepatocellular carcinoma recurrence rate was significantly higher in diabetic patients than in nondiabetics (P = 0.026). The multivariate Cox proportional model identified old age and diabetes as the only significant predictors for recurrence. The hazard ratio of hepatocellular carcinoma recurrence in diabetic patients was 4.61 (P = 0.007). There was no significant difference in overall survival rate between diabetic and nondiabetic patients (P = 0.392).Conclusion:  Diabetes is a significant predictor of tumor recurrence after potentially curative therapy for hepatocellular carcinoma in patients with nonviral hepatitis.
Endoscopic fibrin sealing of gastrocutaneous fistulas after sleeve gastrectomy and biliopancreatic diversion with duodenal switch
Authors: Papavramidis Theodossis S , Kotzampassi Katerina , Kotidis Efstathios , Eleftheriadis Efthymios E , Papavramidis Spiros T 
Published: August 2008

AbstractBackground and Aim:  Gastrocutaneous fistulas (GCF) are uncommon complications accounting for 0.5–3.9% of gastric operations. When their management is not effective, the mortality rate is high. This study reports the conservative treatment of GCF in morbidly obese patients who underwent biliopancreatic diversion with duodenal switch.Methods:  Ninety‐six morbidly obese patients were treated in our department with biliopancreatic diversion with duodenal switch (Marceau technique) and, in six of them, a high‐output GCF developed. A general protocol was applied to all patients presenting a GCF. Everyone was treated by total parenteral nutrition (TPN) and somatostatin for at least 7 days after the appearance of the leak. If the leak continued, then fibrin glue was used as a tissue adhesive. Endoscopic application of the sealant was accomplished under direct vision via a double‐lumen catheter passed through a forward‐viewing gastroscope.Results:  All patients were treated successfully with conservative treatment (either solely with TPN and somatostatin, or with endoscopic fibrin sealing sessions). No evidence of fistula was observed at gastroscopy 3 and 24 months after therapy.Conclusion:  The conservative treatment of GCF following biliopancreatic diversion with duodenal switch is highly effective. All patients should enter a protocol that includes TPN and somatostatin. When the GCF persist, endoscopic sealing glue should be considered before operation because it is simple, safe, effective and, in some cases, life‐saving. Therefore, conservative treatment should be employed as a therapeutic option in GCF developing after bariatric surgery.
Role of intestinal metaplasia subtyping in the risk of gastric cancer in Korea
Authors: Kang Kyung P , Lee Hye S , Kim Nayoung , Kang Hyung M , Park Young S , Lee Dong H , Choe Gheeyoung , Kim Joo S , Jung Hyun C , Song In S 
Published: August 2008

AbstractBackground and Aim:  Gastric cancer is believed to develop by a multistage process. Intestinal metaplasia (IM) is regarded as a premalignant condition; it is classified into subtypes I, II and III. The aim of this study was to evaluate whether the subtypes of IM were associated with progression to gastric cancer.Methods:  The study cohort consisted of 861 subjects, categorized as controls, gastric ulcers, dysplasia and cancer. The IM was scored histologically using the Sydney classification for the antrum and the body of the stomach. The biopsies were stained with high iron diamine and alcian blue (pH 2.5) (HID‐AB2.5), and the IM was subtyped as I, II or III.Results:  The proportion of IM subtypes I, II and III were 14.5%, 47.2% and 38.3% in the antrum, and 28.1%, 57.8% and 14.1% in the body of the stomach, respectively. These distributions did not show significant differences depending on disease or Helicobacter pylori positivity. In cases that were H. pylori‐positive, the prevalence of IM subtype II in the cancer and dysplasia groups was higher than in the control group in the body of the stomach (P < 0.05). The proportion of IM subtype III in the antrum increased in proportion with age (P = 0.036).Conclusions:  IM subtyping was not found to play a major role in the prediction of gastric cancer development in Korea. IM subtype III was associated with aging, and IM subtype II appeared to be related to gastric carcinogenesis in the presence of H. pylori infection.
Can computed tomography with coronal reconstruction improve the diagnosis of choledocholithiasis?
Authors: Tseng Chih‐Wei , Chen Chun‐Chia , Chen Tseng‐Shing , Chang Full‐Young , Lin Han‐Chieh , Lee Shou‐Dong 
Published: August 2008

AbstractBackground and Aim:  Many technical developments of computed tomography (CT) made in recent years have improved imaging quality. However, the diagnostic efficacy of CT with coronal reconstruction for choledocholithiasis remains uncertain. This study aimed to investigate if CT with coronal reconstruction can aid in the diagnosis of choledocholithiasis.Methods:  Two hundred and sixty‐six patients with clinically suspected choledocholithiasis undergoing abdominal CT before endoscopic retrograde cholangiopancreatography were recruited. Among them, 163 patients confirmed with choledocholithiasis were divided into three groups: group 1, 92 patients undergoing CT using 5‐mm thick sections with coronal reconstruction; group 2, 32 patients undergoing CT using 5‐mm thick sections without coronal reconstruction; and group 3, 39 patients undergoing CT using 7‐mm thick sections without coronal reconstruction. The diagnostic rate of CT for choledocholithiasis, the stone size and biochemical data among the three groups were analyzed.Results:  The sensitivity and specificity of CT in diagnosing choledocholithiasis were 77.3% and 72.8%. There was no significant difference of CT diagnostic rate among the three groups (75.0%, 81.2% and 79.5%, respectively). The diameter of common bile duct (CBD), size of CBD stones and white cell count showed significant differences between CT true‐positive and false‐negative cases in group 1 patients. The CT diagnostic rate was significantly lower in patients with choledocholithiasis of less than 5 mm than in patients with choledocholithiasis of 5 mm or more (56.5% vs 81.2%).Conclusion:  The coronal reconstruction of CT imaging did not increase its diagnostic efficacy on choledocholithiasis. The stone size affects the diagnostic rate of abdominal CT for detecting choledocholithiasis.
Expression of adiponectin and its receptors in livers of morbidly obese patients with non‐alcoholic fatty liver disease
Authors: Ma Hong , Gomez Victoria , Lu Liang , Yang Xiangjiu , Wu Xiaoyan , Xiao Shu‐Yuan 
Published: August 2008

AbstractBackground and Aim:  Obesity is one of the risk factors for non‐alcoholic fatty liver disease (NAFLD) and a common disease that comprises simple steatosis and non‐alcoholic steatohepatitis (NASH), and can eventually lead to liver cirrhosis. Adiponectin is an adipocyte‐derived protein that has anti‐obesity, antidiabetic and anti‐inflammatory properties, and is considered to possess a hepatoprotective function. Its role in the development and progression of NAFLD in morbidly obese patients is unknown. In this study, we examined the expression levels of adiponectin and its receptors in liver biopsies of morbidly obese patients and then determined whether there was an association with the disease severity.Methods:  Liver biopsies from 30 morbidly obese patients (18 NASH vs 12 steatosis) were analyzed. The needle core biopsies were subjected to routine histological examination and stained immunohistochemically for adiponectin, adiponectin receptor I (adipoRI) and receptor II (adipoRII).Results:  The two groups were comparable with respect to body mass index, age and gender distribution. The expression of adiponectin decreased in liver biopsies with NASH as compared to those with simple steatosis (1.61 ± 0.70 vs 2.25 ± 0.75, P = 0.028). Spearman's rank correlation coefficient analysis showed that the staining intensity of adiponectin negatively correlated with the grade of inflammation (r = −0.368, P = 0.045) and stage of fibrosis (r = −0.380, P = 0.038). There was no significant difference in expression of adipoRI and adipoRII between the two groups.Conclusion:  These findings indicate that decreased liver adiponectin expression may play a role in the development and progression of NAFLD, from simple steatosis to NASH, in morbidly obese patients.
Long‐term results of balloon‐occluded retrograde transvenous obliteration for gastric variceal bleeding and risky gastric varices: A 10‐year experience
Authors: Akahoshi Tomohiko , Hashizume Makoto , Tomikawa Morimasa , Kawanaka Hirofumi , Yamaguchi Shohei , Konishi Kouzo , Kinjo Nao , Maehara Yoshihiko 
Published: August 2008

AbstractBackground and Aim:  Balloon‐occluded retrograde transvenous obliteration (B‐RTO) is a new alternative treatment for gastric varices (GVx), but the long‐term efficacy is not known. We investigated the long‐term effects of B‐RTO on rebleeding, prevention of first bleeding, mortality and occurrence of risky esophageal varices (EVx).Methods:  B‐RTO was performed in 68 cirrhotic patients with GVx. Twenty patients had recent bleeding, transiently treated by endoscopic Histoacryl injection or balloon tamponade. Forty‐eight patients had varices likely to bleed, but no bleeding. After B‐RTO, the recurrent bleeding, occurrence of EVx and mortality over the long‐term were evaluated.Results:  B‐RTO was successfully performed in 63 of 68 patients (92.6%). Varices eradication was confirmed by endoscopy in 61 of 63 patients (96.6%). During follow up, GVx bleeding occurred in two patients (3.2%). The 8‐year cumulative rebleeding rates of patients with bleeding and risky GVx were 14% and 0%, respectively. Risky EVx occurred in 10 patients (17%) and the cumulative occurrence rate was 22% in 8 years. The cumulative occurrence rate of risky EVx was higher in GVx with EVx (GOV2‐GVx) compared to GVx without EVx (IGV1, P < 0.05). No ectopic variceal bleeding occurred. No patients died from variceal bleeding. Hepatocellular carcinoma was the only significant prognostic factor (P < 0.05).Conclusion:  B‐RTO is beneficial over the long‐term, despite worsening EVx in some patients, because of excellent treatment efficacy and improved mortality. We believe that B‐RTO can become a first‐choice radical treatment following hemostasis for gastric variceal bleeding and prophylactic treatment for risky GVx.
Radiofrequency ablation of hepatic tumors: Lessons learned from 3000 procedures
Authors: Rhim Hyunchul , Lim Hyo K , Kim Young‐sum , Choi Dongil , Lee Won Jae 
Published: August 2008

AbstractRadiofrequency ablation has been accepted as the most popular local ablative therapy for unresectable malignant hepatic tumors. For 9 years from April 1999, we performed 3000 radiofrequency ablation procedures for hepatic tumors in our institution. Our results on the safety (mortality, 0.15%/patient) and therapeutic efficacy (5‐year survival rate, 58%) are similar to those of previous studies reported, supporting the growing evidence of a clear survival benefit, excellent results for local tumor control and improved quality of life. The most important lesson learned from our 3000 procedures is that the best planning, safe ablation and complete ablation are key factors for patient outcome. Furthermore, multimodality treatment is the best strategy for recurrent hepatocellular carcinoma encountered after any kind of first‐line treatment.
Age and gender affect likely manometric diagnosis: Audit of a tertiary referral hospital clinical esophageal manometry service
Authors: Andrews Jane M , Heddle Richard , Hebbard Geoffrey S , Checklin Helen , Besanko Laura , Fraser Robert J 
Published: August 2008

AbstractBackground and Aim:  Awareness of patient demographics, common diagnoses and associations between these may improve the use and interpretation of manometric investigations. The aim of the present study therefore was to determine whether age and/or gender affect manometric diagnosis in a clinical motility service.Methods:  An audit of all 452 clinical manometry reports issued from December 2003 to July 2005 with respect to age, gender and diagnosis was carried out. Patients were divided by age (17–24 years n = 14, 25–44 years n = 87, 45–64 years n = 216 and ≥65 years n = 135), and gender and data compared using contingency tables.Results:  Women were more commonly referred overall (59%) and in each age bracket except <25 years (64% male). Men were more likely to have ‘hypotensive’ motor problems P = 0.01. With aging, normal motor function became less common (P = 0.013), with non‐specific motor disorder, ineffective/hypotensive peristalsis and ‘achalasia‐like’ conditions each more common (individual P = NS). Increasing age showed a trend for increased spastic motor disorders (P = 0.06). Gender did not, however, influence whether motility was abnormal (P = 0.5), spastic (P = 0.7) or whether a non‐specific motor disorder was present (P = 0.1). In the total cohort, the principal manometric diagnoses were: non‐specific motor disorder 33%, normal motility 29%, low basal lower esophageal sphincter pressure 18%, hypotensive/ineffective peristalsis 10%, achalasia/achalasia‐like 6%, diffuse esophageal spasm 3% and other 1%.Conclusions:  Aging leads to increasing esophageal motor abnormalities. Men and women have similar rates of dysfunction, although ‘low‐pressure problems’ were more common in men.
Tuberculosis epidemiology in the Asia–Pacific region
Authors: MORI Toru 
Published: August 2008

Abstract:  The Asia–Pacific region accounts for about 20% of the global burden of tuberculosis (TB). However, there are a wide variety of TB problems between countries and areas. This variety could be described in three dimensions: (i) historical trends of the TB epidemics, closely related to the advent of industrialization or urbanization; (ii) success in modern TB control in the early days; and (iii) expansion of the directly observed therapy, short course (DOTS) strategy during the past 20 years. Moreover, these dimensions have been subject to the ‘health infrastructure’ based on such social goods as people's education, economic standards, and social security or stability. The Asia–Pacific Region offers very good examples to illustrate the roles of these factors in leading to such a variety of TB problems as seen today. Thus, this region was the first to achieve the global target of DOTS by the end of 2005, that is to detect 70% of patients and to treat them with DOTS, and to successfully cure 85% of those detected.However, we should remember that we are currently challenged by TB combined with HIV infection and AIDS; TB with drug‐resistance, especially multidrug‐resistant (MDR) or extensively drug resistant (XDR) forms; TB in people with special risk factors, for example diabetes and senility; and other medical and socioeconomic problems. At the same time, we have to be careful about the premature loss of people's interest in TB, due to illusion or unfounded optimism, especially among medical professionals and the government.
Detrimental effects of high levels of antioxidant vitamins C and E on placental function: Considerations for the Vitamins in Preeclampsia (VIP) trial
Authors: Aris Aziz , Leblanc Samuel , Ouellet Annie , Moutquin Jean‐Marie 
Published: August 2008

AbstractAim:  Supplementation with antioxidant vitamins has been proposed to reduce the risk of preeclampsia and perinatal complications. In a recent study, it has been shown that this supplementation to above physiological doses does not reduce the risk of preeclampsia, but increases the rate of low birthweight babies, suggesting a detrimental effect on placental function, given the lower birthweight. The aim of the present study was to investigate the effects of high levels of antioxidants vitamins C and E on placental cells in vitro.Methods:  Isolated fresh human cytotrophoblasts were exposed to high concentrations of vitamins C and E for 48 h. Then the secretion of human chorionic gonadotropin (hCG) and the production of tumor necrosis factor‐alpha (TNF‐α) were assessed.Results:  High levels of vitamins C and E, separately or combined, decrease the secretion of hCG by cytotrophoblasts and increase their production of TNF‐α.Conclusion:  Exposure of cytotrophoblasts to high levels of antioxidant vitamins C and E may affect placental function, as reflected by decreased secretion of hCG; and placental immunity, as reflected by increased production of TNF‐α. Such alterations are known to lead to endothelial dysfunction and adverse pregnancy outcomes, such as fetal growth restriction (FGR).
Gynecological cancer incidence in a hospital population in Saudi Arabia: The effect of foreign immigration over two decades
Authors: Makoha Frederick W. , Raheem Muhamed A. 
Published: August 2008

AbstractAim:  To determine if the incidence of female genital malignancies changed with foreign immigration.Methods  Retrospective analysis of histopathology records of women with primary genital tract cancers attending a referral gynecological hospital over two decades from 1985 to 2004. Incidence rates for the combined population of foreign migrants and Saudi nationals were compared to rates among Saudi nationals alone. Outcome measures were incidence rates and incidence rate ratios.Results:  The incidence of cervical cancer for the combined migrant and local Saudi population was 48.4%, while for Saudi nationals alone it was 33.5% (incident rate ratio [IRR]= 1.44, 95% CI 1.17–1.88, P < 0.001). For vulvar cancer, the incidence was 1.2% versus 0.5% (IRR = 2.4, 95% CI 2.03–2.79, P < 0.001). Endometrial cancer rate was lower in the combined population than in Saudi nationals alone (11.7% vs 18.0%, IRR = 0.65, 95% CI 0.27–1.02, P < 0.04). There were no differences in incidence for gestational trophoblastic neoplasia, uterine corpus sarcoma, ovarian, and vaginal cancer. Incidence rate ratios differed between decades for cervical cancer (1.1/1.9, 0.58, 95% CI 0.21–0.89, P < 0.001), vulvar cancer (4.2/1.8, 2.33, 95% CI 1.68–3.07, P < 0.001), gestational trophoblastic neoplasia (1.4/1.0, 1.4, 95% CI 1.09–2.13, P < 0.04), and uterine sarcoma (0.3/1.0, 0.03, 95% CI 0.012–0.041, P < 0.02).Conclusion:  The incidence of cervical and vulvar cancer increased among women presenting with gynecological malignancies. For cervical and vulvar cancer, uterine corpus sarcoma, and gestational trophoblastic neoplasia, incidence varied over time.
Why is the choice of future climate scenarios for species distribution modelling important?
Authors: Beaumont Linda J. , Hughes Lesley , Pitman A. J. 
Published: August 2008

AbstractSpecies distribution models (SDMs) are common tools for assessing the potential impact of climate change on species ranges. Uncertainty in SDM output occurs due to differences among alternate models, species characteristics and scenarios of future climate. While considerable effort is being devoted to identifying and quantifying the first two sources of variation, a greater understanding of climate scenarios and how they affect SDM output is also needed. Climate models are complex tools: variability occurs among alternate simulations, and no single ‘best’ model exists. The selection of climate scenarios for impacts assessments should not be undertaken arbitrarily ‐ strengths and weakness of different climate models should be considered. In this paper, we provide bioclimatic modellers with an overview of emissions scenarios and climate models, discuss uncertainty surrounding projections of future climate and suggest steps that can be taken to reduce and communicate climate scenario‐related uncertainty in assessments of future species responses to climate change.