bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endoscopic manometry of the sphincter of Oddi
Authors: TOOULI J. , ROBERTS‐THOMSON I. C. 
Published: March 2008

AbstractEndoscopic manometry of the sphincter of Oddi is a new and invasive test which is currently being evaluated in patients with biliary‐type pain, particularly after cholecystectomy, and idiopathic recurrent pancreatitis. Technical aspects of the test appear to have been clarified, but data are incomplete on the potential effect on manometric records of variables such as patient anxiety, prolonged endoscopy and the injection of radiological contrast material prior to the procedure. Despite these considerations, abnormal manometric records are frequent in patients with post‐cholecystectomy pain and idiopathic recurrent pancreatitis, and minor abnormalities have been associated with choledocholithiasis. The term structural stenosis is currently being applied to those in whom the sphincter basal pressure is high while biliary dyskinesia describes a variety of manometric changes including rapid phasic contractions, an excess of waves oriented in a retrograde direction and an abnormal response to the intravenous infusion of cholecystokinin octapeptide. Reasons for the motility disorders remain unclear but may include histopathological changes in sphincter tissue, enteric nerve dysfunction, autonomic dysfunction, hormonal/metabolic changes and psychiatric disorders. Heterogeneity within the patient population needs to be carefully addressed in any prospective study of potential benefit from drugs or other procedures such as endoscopic sphincterotomy and operative sphincteroplasty.
Neurotensin and the exocrine pancreas
Authors: EAVES E. R. , LAMBERT J. R. , KORMAN M. G. , MERCURI J. , HANSKY J. 
Published: March 2008

AbstractIt has been postulated that neurotensin (NT) has a physiological role in the regulation of the exocrine pancreas, but this is controversial. Using the Thomas cannula canine model, the effect of intravenous NT, in physiological and pharmacological doses on exocrine pancreatic secretion, and on plasma pancreatic polypeptide, secretin and cholecystokinin (CCK) levels is reported. The infusion of physiological doses of NT alone (0.2 pmol/kg per min) did not stimulate pancreatic secretion; however, in conjunction with secretin, NT stimulated protein and bicarbonate output, the latter synergistically. Higher doses of NT (20 and 100 pmol/kg per min) resulted in a dose‐dependent stimulation of pancreatic volume, bicarbonate and protein secretion. Cholinergic blockade with atropine reduced pancreatic secretion stimulated by low doses of NT (2–20 pmol/kg per min), but at higher doses (100 pmol/kg per min) protein secretion was reduced whilst bicarbonate secretion was enhanced. The infusion of graded doses of NT had no effect on plasma secretin or CCK levels. In contrast, NT did release pancreatic polypeptide in a dose‐dependent manner, but only at pharmacological infusion levels. NT, acting synergistically with other hormones, may thus play a role in exocrine pancreatic stimulation.
Prophylaxis against ERCP sepsis with cefoperazone
Authors: PATTINSON NEIL R. , CHAPMAN BRUCE A. 
Published: March 2008

AbstractFifty patients were given cefoperazone (1 g) intravenously over 2–3 min immediately prior to endoscopic retrograde cholangiopancreatography (ERCP). In 16 of these subjects an aliquot of common duct bile was obtained via the ERCP cannula at the commencement of the procedure. Therapeutic biliary levels of cefoperazone were found in 10 subjects. Cholestasis and sampling distal to calculi may account for those in whom undetectable levels were found. Multiple samples from one patient showed that the biliary concentration increased with time. Therapeutic serum levels were detected in all patients and no side effects were observed.
The effect of iron, iron‐binding proteins and iron‐overload on human natural killer cell activity
Authors: CHAPMAN D. E. , GOOD M. F. , POWELL L. W. 
Published: March 2008

AbstractThe in vitro natural killer (NK) activity of peripheral blood lymphocytes (PBL) was assessed in 13 patients with genetic haemochromatosis (HC) and 27 normal subjects, using a 51Cr‐release cytotoxicity assay against the target K‐562 leukaemic cell line. Mean NK function did not differ between these two groups. This conclusion differs from the reported deficit in NK activity in other diseases in which increased iron stores may occur, including alcoholic cirrhosis and β‐thalassaemia major.The effect of ferric citrate (0.1–1.0 mmol/1), normal human liver ferritin (100–10 000 μg/1) and transferrin (2 g/1) on NK activity was also assessed for both groups. In neither group was NK activity affected by any of these additives.These results suggest that peripheral blood NK function is not compromised in haemochromatosis, and that the diminished NK activity which has previously been reported in some patients with thalassaemia or alcoholic cirrhosis is due to factors other than to a direct effect of increased iron stores.
Hepatitis B in renal transplant recipients: An assessment of the relationship of viral replication to liver pathology
Authors: LAWSON M. J. , FOCK K. M. , GOWANS E. J. , MATHEW T. H. , BURRELL C. J. 
Published: March 2008

AbstractTo determine the natural history of hepatitis B virus (HBV) infection in renal transplant recipients, 16 recipients who remained chronic HBsAg carriers were followed for 2–15 years by assaying hepatitis Be antigen (HBeAg) and hepatitis B viral DNA (HBV DNA). The results were compared with sequential liver biochemistry and histology. Similarly, nine HBsAg‐negative renal transplant patients were studied for up to 10 years. It was found that different patterns of HBV replication were described in a majority of long‐term HBsAg‐positive renal transplant patients with intermittent virus replication being particularly common. A minority of patients with viral replication showed co‐existing elevated transaminases. Development of liver disease was more common among HBsAg‐positive patients, but when the various patterns of infection were correlated with long‐term outcome, no one pattern was clearly more predictive of an adverse outcome.
Treatment of severe peptic ulcer haemorrhage with the heat probe
Authors: LIN HWAI‐JENG , TSAI YANG‐TE , LEE SHOU‐DONG , LAI KWOK‐HUNG , NG WAI‐WAH , TAM TSENG‐NIP , CHANG FULL‐YOUNG , LEE CHEN‐HSEN 
Published: March 2008

AbstractFrom September to December 1986, 30 cases of persistent upper gastrointestinal bleeding were collected and treated, via the endoscope, with a heat probe. All cases had either gastric or duodenal ulcers. Ten cases were in shock. After treatment, all bleeding episodes initially stopped, but six cases (20%) re‐bled. Five cases received repeat heat probe therapy and did not re‐bleed thereafter. Thus the ultimate success rate was 96.7% (29/30). Twenty of 21 ulcers (94.3%) were found to be healed with scars 2 months after therapy. During therapy and the follow‐up period, only one complication occurred and this was a mild aspiration pneumonia. The heat probe is an ideal haemostatic device for severe non‐variceal upper gastrointestinal bleeding.
Intra‐operative secretin test for the rapid evaluation of curative operation in a case of Zollinger‐Ellison syndrome
Authors: AZUMA TAKESHI , IMAMURA MASAYUKI , SHIMADA YUTAKA , INOKUCHI HIDETO , KAWA KEIICHI 
Published: March 2008

AbstractThe intra‐operative measurements of serum gastrin levels and an intra‐operative secretin test were carried out as the rapid evaluation of curative operation in a case of Zollinger‐Ellison syndrome (ZES). In this case, pre‐operative investigations suggested that the tumours were located in the head of the pancreas and the duodenal wall. The surgeon planned a pan‐creato‐duodenectomy. Serum gastrin levels were reduced after the resection of the head of the pancreas and duodenum, and the secretin test after resection was negative. The surgeon ensured that gastrinomas were resected completely during the operation. The secretin test carried out 1 month post operatively was also negative. The patient has experienced no further complications, to date. This case suggests that intra‐operative secretin test is useful for the rapid evaluation of curative operation in case of ZES.
The function in vitro of macrophages from the intestinal mucosa of patients with Crohn's disease: An association between chemotactic migration and granulomata
Authors: HERMANOWICZ A. , GIBSON P.R. , PALLONE F. , MASON C.H. , JEWELL D.P. 
Published: March 2008

AbstractThe chemotactic migration in vitro of intestinal macrophages and peripheral blood monocytes has been assessed in patients with Crohn's disease, ulcerative colitis, and miscellaneous intestinal diseases. In all groups, the chemotaxis of peripheral blood monocytes was similar to that of healthy subjects. Intestinal macrophages migrated similarly to autologous monocytes in patients with ulcerative colitis and in the miscellaneous group. In contrast, intestinal macrophages from patients with Crohn's disease exhibited a wide range of chemotaxis from markedly suppressed to normal. This variation was independent of drug treatment and the degree of inflammation present. However, patients in whom granulomata were not present exhibited a significant depression of chemotaxis compared with those with granulomata, with disease controls (ulcerative colitis patients), and with the miscellaneous group. Such a difference was not reflected in monocytes from autologous peripheral blood. These findings indicate the presence of local mucosal suppressive factors in some patients with Crohn's disease and could suggest that the diminished ability of macrophages to accumulate in a focus of inflammation may be an underlying mechanism for the failure to form granulomata in these patients.
Evidence of ongoing virus multiplication in type B fulminant hepatitis
Authors: GANDHI B.M. , IRSHAD M. , ACHARYA S.K. , JOSHI Y.K. , TANDON B.N. 
Published: March 2008

AbstractThe presence of HBeAg‐ and HBV‐specific DNA‐polymerase (DNA‐P) activity—regarded as markers of HBV multiplication—were studied in 40 patients with fulminant hepatitis B within 1‐5 days of the onset of hepatic encephalopathy. HBeAg and DNA‐P were detected in three (7 %) and 21 (51%) of the patients respectively. Only three (7%) were positive for anti‐HBs. DNA‐P activity was present in 38.1 % even 10 days after the appearance of icterus. Present findings confirm an ongoing HBV multiplication in about half of the patients of fulminant hepatitis B.
Vasoactive intestinal peptide immunoreactive nerve fibres are deficient in intestinal and nasal mucosa affected by cystic fibrosis
Authors: WATTCHOW DAVID A. , FURNESS JOHN B. , GIBBINS IAN L. , LITTLE KEN E. , CARTER RODNEY F. 
Published: March 2008

ABSTRACTCystic fibrosis (CF) is the most common lethal or debilitating inherited disease amongst Caucasians, with estimates of its frequency of occurrence in this population ranging from 1: 2000 to 1: 15 000 live births. It is characterized by disorders of exocrine secretions, primarily of the skin, respiratory tract and digestive system. The secretory processes of these tissues are influenced by autonomic nerve fibres, many of which contain regulatory peptides. The innervation of the intestinal and respiratory mucosa of CF patients has been investigated in order to determine if there is any derangement of the peptide‐containing nerve fibres that supply these tissues. The present work demonstrates that, in CF, there is a deficiency of vasoactive intestinal peptide immunoreactivity (VIP‐IR) in nerve fibres in the nasal and intestinal mucosa. There is not a generalized loss of fibres that are immunoreactive for this peptide, however, since VIP‐IR fibres innervating the intestinal muscle are largely unaffected. Moreover, other types of nerve fibres innervating the nasal mucosa and the mucosa of the intestinal villi appear to be unaffected in CF patients. Physiological evidence indicates that vasoactive intestinal peptide is contained in secretomotor neurons and is a powerful stimulant of secretion; loss of function restricted to these neurons is consistent with the clinical manifestations of CF.
Influence of intraduodenal chenodeoxycholic acid on secretory and pressure activity of the stomach and duodenum
Authors: EYRE‐BROOK I. A. , READ N. W. , BROWNSON A. , JOHNSON A. G. 
Published: March 2008

ABSTRACTThe influence of duodenal infusion of bile acid at a concentration similar to that in the common bile‐duct (50 mmol/1) on antroduodenal motility, duodenogastric reflux, gastric and duodenal secretion was studied in 10 healthy volunteers. Intraluminal pressures were recorded in the antrum and the first and second parts of the duodenum. Gastric and distal duodenal contents were collected by continuous low pressure sump aspiration during infusion of either saline or chenodeoxycholic acid (CDC) into the second part of the duodenum. Values for duodenogastric reflux and gastric and duodenal secretion were calculated with reference to the recovery of two non‐absorbable markers infused into the stomach and second part of the duodenum. Each volunteer received at least 3 h of saline infusion and 2 h of CDC infusion.During saline infusion, duodenogastric reflux varied with the migrating motor complex (MMC), being statistically greater at the end of duodenal phase III activity than at other times (P<0.05). Infusion of CDC abolished the MMC and inhibited antral contractions but the amount of reflux was not increased compared with the saline period. Infusion of CDC also produced marked increases in measured bicarbonate (P<0.001), trypsin (P<0.001), phospholipase A2 (P<0.05) and endogenous total bile acid (P<0.05) in the duodenum, although gastric acid secretion was unaffected. These findings suggest that bile acid may regulate gastroduodenal motor activity and pancreaticobiliary secretion.
Nodular regenerative hyperplasia of the liver diagnosed by needle biopsy of the liver: Report of a case and review of the literature
Authors: TERANO AKIRA , HONDA ICHIRO , SHIGA JUNJI , KOHMOTO OSAMI , MATSUMOTO KAZUNORI , HIRAISHI HIDEYUKI , OTA ICHI , SUGIMOTO TSUNEAKI 
Published: March 2008

ABSTRACTThe authors report the case of a 45 year old woman in whom the diagnosis of nodular regenerative hyperplasia of the liver was made by needle biopsy of the liver, laparoscopy and hepatic venography. The patient did not have any underlying disorders and had not ingested any of the many drugs and chemicals which may produce the lesion. Clinical manifestations were hepatosplenomegaly, portal hypertension and iron deficiency anaemia, and her condition remains unchanged 5 years after diagnosis.
Anti‐HBs responses after combined injection of recombinant yeast and plasma‐derived hepatitis B vaccines
Authors: YOSHIDA KEN , FUJIYAMA SHIGETOSHI , SATO TATSUO , MIZUNO KYOSUKE 
Published: March 2008

Anti‐HBs responses to a combined injection of recombinant yeast and plasma‐derived hepatitis B vaccines were evaluated in 119 healthy members of medical staff. They were divided into three age‐ and sex‐matched groups. Group I (YHB‐YHB‐YHB) were given recombinant yeast vaccine at 0, 1 and 6 months, group II (PHB‐YHB‐YHB) were given plasma‐derived vaccine at 0 month, and then recombinant yeast vaccine at 1 and 6 months, and group III (YHB‐YHB‐PHB) were given recombinant yeast vaccine at 0 and 1 month and then plasma‐derived vaccine at 6 months.The seroconversion rate in each group at 7 months were similar (group I: 91.2%, group II: 88.5%, and group III: 94.1%). Acquired antibody titre (S/N ratio) was higher, however, in group II than in group I (group I: 37.6 ± 29.1 versus group II: 57.4 ± 44.9).The present study indicated that in this combined injection method, cross antigenicity was observed between plasma‐derived vaccine and recombinant yeast vaccine and that high antibody titres could be obtained by a combined injection of a recombinant yeast vaccine and a plasma‐derived vaccine when compared with the recombinant vaccine alone. Accordingly, this combined vaccination method is recommended because of its easy availability.
Halothane hepatitis: Damage to peripheral blood mononuclear cells produced by electrophilic drug metabolites is Ca2+‐dependent
Authors: FROST LINDA , PRENDERGAST DEBRA , FARRELL GEOFFREY 
Published: March 2008

AbstratPeripheral blood mononuclear (PBM) cells from patients with halothane hepatitis are unusually susceptible to damage from phenytoin metabolites generated by an in vitro drug metabolising system. In order to provide more information about the nature of this susceptibility factor, the effect of removing calcium ions (Ca2+) from the incubation medium of the test system was examined. Phenytoin metabolites were generated by incubating phenytoin with β‐naphthoflavone‐induced rat liver microsomes in the presence of 1,1,1‐trichloropropene oxide (TCPO), an epoxide hydrase inhibitor. When PBM cells from patients who had recovered from halothane hepatitis were incubated in this system and then maintained in Ca2+‐containing tissue culture medium (without α‐tocopherol) for 16 h, cell death, as measured by trypan blue exclusion, was greatly increased (53% and 78% at 0.06 mmol/1 and 0.12 mmol/1 phenytoin, respectively) compared with control incubations (TCPO omitted). Removal of Ca2+ from the tissue culture medium effectively abolished reactive metabolite‐induced cell death. Resting cytosolic free Ca2+ concentration in PBM cells was also measured using the quin‐2 fluorescence method and total Ca2+ content was measured by atomic absorption spectrometry. Although variability appeared greater among patients, mean values for these parameters among 12 patients with halothane hepatitis did not differ from controls. It is concluded that enhanced permeability of PBM cells to extracellular Ca2+ may be an important factor in the pathogenesis of drug metabolite‐induced cell death in patients susceptible to halothane hepatitis. Such permeability to Ca2+ is not evident in resting cells and presumably results from an interaction between electrophilic metabolites and the pumps which regulate cell calcium homeostasis.
Corrosive oesophageal strictures following acid ingestion: Clinical profile and results of endoscopic dilatation
Authors: BROOR S. L. , CHARI A. KUMAR. S. T. , SINGAL A. , MISRA S. P. , KUMAR N. , SARIN S. K. , VIJ J. C. 
Published: March 2008

AbstratThere are several reports on oesophageal strictures caused by alkali ingestion, but information on oesophageal strictures due to acid ingestion is scarce. Endoscopic dilatation, which has been found to be quite safe and effective in the treatment of benign oesophageal strictures of other aetiology, has also not been evaluated adequately in the treatment of these strictures. Over a period of 2 years, of 47 patients treated at this centre of benign oesophageal strictures, 17 (36.2%) patients had strictures following ingestion of corrosive agents. Thirteen patients had ingested acids and only four gave a history of alkali ingestion. The age range of these 13 patients was 14–50 years (mean = 25.5 years, s.d. = 2.6). The amount of acid ingested varied from 10 to 100 ml (median = 50 ml). The interval between acid ingestion and presentation to hospital ranged from 1 to 60 months (median = 2 months). Ten patients had multiple strictures, and the most common site of involvement was the upper third followed by the lower third of the oesophagus. Only five‐of these 13 patients had evidence of gastric involvement in the form of antral stricture (four) and hour glass deformity (one). Strictures were dilated using Eder‐Puestow metal olives passed over a guide wire. The total number of sittings required to achieve adequate dilation in this group ranged from 1 to 30 (median = 14). Most patients were managed successfully with dilatation (good response 63.6%, satisfactory response 18.2%). On follow‐up, recurrence of dysphagia was seen in a high number of patients (66%), but this could be managed easily with repeat dilatation. It is concluded that, in contrast to reports from the West, acid ingestion is a common cause of oesophageal strictures in India. These strictures are usually tight and multiple. The patients not only require several sittings to achieve adequate dilatation, but they also have a high recurrence rate.
Combined hepatocellular‐cholangiocarcinoma associated with dermatomyositis
Authors: HORIE YUTAKA , YAMADA MINORU , NAKAI KAZUHITO , KAWASAKI HIRONAKA , HIRAYAMA CHISATO , MATSUI KATSUAKI , KAMBE NAOTO , SHIMAO SHUUHEI 
Published: March 2008

AbstratA 56 year old female developed combined hepatocellular cholangiocarcinoma associated with dermatomyositis. Serum tumour markers except for carbohydrate antigen (CA 19‐9; 6400 ng/ml) were within normal range. Despite extensive chemotherapy, no clinical response was obtained and the patient's course deteriorated after 4 months. Macroscopically, the liver was mainly occupied by hepatocellular carcinoma but cholangiocarcinoma was found in the hilum. This is the first case of a rare association of combined hepatocellular‐cholangiocarcinoma and dermatomyositis.
Radiolabelled unprocessed bran: Validation of a practical labelling technique and evaluation of gastrointestinal transit profiles in health
Authors: KERLIN PAUL , BYRNES OWEN , WONG LAWRENCE 
Published: March 2008

ABSTRACTUsing a radiolabelled bran preparation, a large field of view gamma‐camera and a computer, a method has been developed to define and analyse the gastrointestinal transit profile of solids. Unprocessed bran, labelled with technetium (99mTc) sulphur colloid is incorporated into biscuits cooked in a microwave oven. With this preparation, less than 3.4% of the isotope dissociated from the bran in a gastric milieu, and more than 90% of recovered radionuclide activity, were retained with the solid phase during small intestinal transit in subjects with stable ileostomy function. A normal range for gastric emptying (GE), small intestinal transit (IT) and colonic filling (CF) was established in 15 healthy volunteers. Anterior and posterior images were taken until all isotope was present in the colon. Using regions of interest for the stomach and colon, decay corrected geometric mean curves for GE and CF were generated. GE was characterized by a lag phase followed by a linear emptying phase. The GE profile (mean and standard deviation) was described by ‘power exponential’ parameters of half‐emptying time (1.6 ± 0.4 h) and β(1.5 ± 0.2). The IT time was 3.9 ± 1.5 h. The onset of CF was determined visually (4.1 ± 1.5 h), and the time of 50% CF filling was determined from the colonic filling curve (5.5 ± 1.4 h). This technique should provide a useful, practical, clinical and research test to study the pathophysiology and pharmacology of intestinal motor disorders.