bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and side effects of intermittent recombinant interferon‐α2a in chronic aggressive hepatitis C: With or without initial daily administration
Authors: ITOH HIDEKAZU , NAKATA HIDENORI , YOKOYA YUKIHIRO , NAKASHIMA SHOICHI , YAMANISHI TETSUJI , HARA TAKESHI , KAWAI JUN , MIYAMOTO HISAO , HIGASHI KATSUHIKO , NISHIOKA SHINGO 
Published: March 2008

ABSTRACTTo investigate the therapeutic effect and incidence of side effects of recombinant interferon‐α2a (IFN‐α) in chronic aggressive hepatitis C under stratification by administration mode, a study was conducted by assigning patients to either group A (daily consecutive administration of 9 million units (MU) IFN‐α for 2 weeks and, thereafter, 3 MU intermittently 3 times weekly for 22 weeks) or group B (exclusively intermittent administration; 9 MU IFN‐α twice weekly or 6 MU IFN‐α thrice weekly for 24 weeks). The 28 patients in group A received IFN‐α for 24 weeks up to a total dose of 324 MU and the 53 patients in group B received the same for 24 weeks up to a total dose of 432 MU. When recovery was defined as the absence of hepatitis C virus (HCV)‐RNA 6 months after the completion of treatment, the rate of recovery for group A was 32.1% and that for group B was 37.7%, the latter being higher but without significance. Side effects in groups A and B consisted of leucopenia occupying 14.3 and 7.5%, respectively, and thrombocytopenia occupying 42.9 and 11.3%, respectively; group B exhibited lower values for both side effects. No difference was detected between these groups in other side effects, including pyrexia, generalized malaise, arthralgia or psilosis. Intermittent administration from the outset permitted shortened duration of hospitalization and earlier rehabilitation. Intermittent administration of INF‐α is required when treating patients with chronic hepatitis C showing lower leucocyte or platelet counts.
Case Report: Primary splenic non‐Hodgkin's B cell lymphoma in a patient with chronic hepatitis C
Authors: FUKUTOMI TAKAYOSHI , FUKUSHIMA MARIE , TANABE YUICHI , HIROSHIGE KAICHIRO , ITASAKA HIDETOSHI , MATSUMATA TAKASHI , KASAI NORIKO , YOSHIDA KISAKU , SUZUMIYA JUNJI , KIKUCHI MASAHIRO , YUFU YUJI , SAKAI HIRONORI , NISHIMURA JUNJI , NAWATA HAJIME 
Published: March 2008

ABSTRACTA case of primary splenic lymphoma in a patient with chronic hepatitis C is reported. A 69‐year‐old man with chronic hepatitis C was admitted to Fukuoka City Hospital for evaluation of an enlarging splenic tumour. In the spleen, ultrasonographic examination revealed a hypoechoic tumour and computed tomography demonstrated a non‐enhancing low density area measuring 7 cm in diameter; coeliac angiography revealed a hypovascular tumour. Gallium scintigraphy showed uptake of the radioisotope in the splenic tumour. A splenectomy was performed and the morphological and immunohistochemical findings of this tumour were compatible with those of non‐Hodgin's B cell lymphoma. Recently, cases of malignant B cell lymphoma associated with hepatitis C virus infection have been reported. Lymphotropism of hepatitis C virus may play a pathological role in the development of non‐Hodgkin's lymphoma. We emphasize the importance of considering lymphoma in the differential diagnosis of extrahepatic disorders during the course of chronic hepatitis C virus infections.
Case Report: Delayed resolution of severe pulmonary hypertension after isolated liver transplantation in a patient with cirrhosis
Authors: LEVY MT , TORZILLO P , BOOKALLIL M , SHEIL AGR , McCAUGHAN GW 
Published: March 2008

ABSTRACTPulmonary hypertension is now recognized to be a rare association of liver disease and portal hypertension. This report describes the slow resolution of symptomatic pulmonary hypertension in a 33‐year‐old woman with cirrhosis who underwent isolated liver transplantation. The patient survived the surgery and perioperative period without significant haemodynamic compromise. After liver transplantation, the patient was monitored with regular Doppler echocardiography. By 27 months the pulmonary hypertension had almost completely resolved. This observation is important, as it suggests that patients with severe pulmonary hypertension who survive the perioperative period may have an excellent outcome, although resolution may be slow.
Comparison of haptoglobin and apolipoprotein A‐I on biliary lipid particles involved in cholesterol crystallization
Authors: YAMASHITA GUNJI , SECKNUS ROGER , CHERNOSKY ANN , KRIVACIC KIMBERLY A , HOLZBACH R THOMAS 
Published: March 2008

ABSTRACTSeveral proteins are known to modulate cholesterol crystallization. We recently demonstrated that haptoglobin has cholesterol crystallization promoting activity. However, this effect is still not well understood mechanistically. The current study examined the distribution of haptoglobin compared to apolipoprotein A‐I (apo A‐I) to micelles, vesicles and crystals as an initial step in providing a focus for further studies of the mechanism of cholesterol crystallization activity. Specific protein purification was accomplished by immunoaffinity chromatography. The crystallization‐promoting activity of biliary haptoglobin, albumin and commercial apo A‐I was measured by a photometric crystal growth assay. The distribution of micelles, vesicles and proteins in model bile was determined by Sepharose CL‐6B column chromatography. Detection of the presence of test proteins in cholesterol crystals was determined using specific 125I‐radiolabelled proteins. Haptoglobin (20 μg/mL) showed a significant crystallization promoting‐activity, whereas apo A‐I (30 μg/mL) only tended to show a slight inhibitory activity. The cholesterol crystal‐bound protein in each case was found to be less than 1% of the total concentration of that protein that had been added to the model bile system. The elution profile of commercial apo A‐I from a Sepharose CL‐6B column was strikingly altered when it was added to model bile prior to elution. In contrast, the column elution profiles for both haptoglobin and albumin were unchanged when model bile was similarly added to the sample. Haptoglobin increased the amount of cholesterol found in the vesicular fraction when compared to apo A‐I. Haptoglobin does not bind tightly to either biliary lipid particles or to cholesterol crystals but does increase the amount of cholesterol in vesicles by inducing a shift from micellar cholesterol (P=0.046). This shift appears to explain in part its promoting effect on cholesterol crystallization.
A Clinicopathological study on combined hepatocellular and cholangiocarcinoma
Authors: TAGUCHI JUN , NAKASHIMA OSAMU , TANAKA MASAYA , HISAKA TOHRU , TAKAZAWA TSUTOMU , KOJIRO MASAMICHI 
Published: March 2008

ABSTRACTWe clinicopathologically studied 23 surgically resected cases of combined hepatocellular and cholangiocarcinoma (HCC‐CC). The frequency of this cancer in our subjects, who had primary liver cancer and who underwent hepatectomy, was 6.3%. The mean age of patients was 64.0 years old and the male: female ratio was 1.9:1. Serum α‐fetoprotein was positive in 70% of cases and its levels were relatively low (≤ 1000 ng/mL) in most cases. The positive rate of serum carcinoembryonic antigen was 18% and its levels were also low. In regard to hepatitis virus markers, 17% of the 20 combined HCC‐CC cases were positive to HBs antigen and 70% were positive to the HCV antibody. Of the 23 combined HCC‐CC cases, 9 cases (39%) were associated with liver cirrhosis. Tumours were classified macroscopically into a separated type (HCC and CC are clearly separated 17%), a HCC‐predominant type (resembles HCC 49%), and a CC‐predominant type (resembles CC 34%). The separated and HCC‐predominant types were associated with liver cirrhosis in 50 and 55% of cases, respectively. These cases with liver cirrhosis presented the features of HCC more apparently, while those without liver cirrhosis presented the features of CC. Histologically, all cases were classified into either Type I (HCC and CC were clearly distinguished; 17%), Type II (HCC and CC were contiguous and shared transitional features; 66%), and Type III (cancer cells were able to be evaluated as either HCC or CC and were considered to be an intermediate type; 17%). Immunohistological stains for cytokeratin were useful to distinguish HCC and CC. Specifically, CC was positive to cytokeratin 7 and 19. The tumour, in which HCC and CC were almost indistinguishable, such as Type III), indicates the presence of intermediate tumour cells that can differentiate either to HCC or CC.
Case Report: Mucin‐producing cystic neoplasm of the pancreas with onset in childhood
Authors: KOYANAGI SHUJIRO , MIYAHARA TOSHIHIKO , MIGITA YOSIKATSU , GOTO MASAYOSHI , ITO TETSUHIDE , YAMAGUCHI HIROYA , NAKANO ITSURO , TAKANO SOICHIRO , HARA YASUHIRO , FUKUYAMA TOKIHIKO , KONOMI KOHKI , HARATAKE JYOJI , NAWATA HAJIME 
Published: March 2008

ABSTRACTMucin‐producing tumours of the pancreas have been recently reported with increasing frequency and most cases have occurred in middle‐aged and elderly people. In the present report, a case of a 21‐year‐old man with mucinous cystadenoma of the pancreas is reported. He had a long history of recurrent pancreatitis from the age of 8. When he was aged 10, the first branch of the main pancreatic duct was shown to be enlarged on endoscopic retrograde pancreaticography (ERP). A series of ERP studies and computed tomography scans performed over a period of 11 years demonstrated continuing growth of this enlargement of the pancreatic duct. Pancreaticoduodenectomy was performed and the patient has been well without further episodes of acute pancreatitis and has been free of recurrent tumour for 1 year.
Abnormal gastro‐oesophageal reflux in Chinese with atypical chest pain
Authors: LAU GEORGE KK , HUI WAI MO , LAU CHU PAK , HU WAYNE HC , LAI KAM CHUEN , LAM SHIU KUM 
Published: March 2008

ABSTRACTAlthough atypical chest pain has been well described in the Western population, its frequency in Chinese is unknown. Over a period of 42 months, we studied 521 Chinese patients with chest pain and identified 108 patients (20.7%) whose pain was not related to cardiac causes, as determined by exercise ECG or cardiac catheterization. Using 24 h ambulatory pH monitoring and baseline oesophageal manometry, 28.7, 19.4 and 5.6% of these patients were found to have abnormal reflux parameters, abnormal manometric findings or both, respectively. There were significantly more patients complaining of chest pain during the study in the gastro‐oesophageal reflux disease (GERD) group than in the non‐GERD group (16/31 vs 20/77; P< 0.001). The lower oesophageal sphincter pressure was lower in those with abnormal reflex parameters than in those with normal reflux parameters (12.7±5.4 vs 17.8±5.8 mmHg; P< 0.05). There was no significant difference in symptoms, such as heartburn (54.8 vs 42.9%), regurgitation (38.7 vs 35.1%) and dysphagia (19.4 vs 24.7%), among the two groups. Non‐specific changes were the most frequent baseline motility pattern. In conclusion, atypical chest pain and gastro‐oesophageal reflux disease are not uncommon in Chinese and this deserves special emphasis as the continuation of anti‐anginal drugs may aggravate their condition.
Effects of endoscopic variceal sclerotherapy on azygos vein blood flow and systemic haemodynamics*
Authors: YOKOYAMA MASANORI , SHIJO HIROSHI , OTA KAZUHIRO , KUBARA KATSUHIKO , KOKAWA HIROSHI , KIM TETSUHIRO , AKIYOSHI NOBUO , TOKUMITSU HIDEO , OKUMURA MAKOTO 
Published: March 2008

ABSTRACTThe present study was designed to determine the systemic haemodynamic effects of obliterating oesophageal varices by endoscopic sclerotherapy. We evaluated systemic and splanchnic haemodynamics before and after the first course of sclerotherapy in cirrhotic patients. The baseline cardiac index was significantly correlated with baseline azygos vein blood flow (r = 0.64; P< 0.01) and the azygos vein blood flow and cardiac index significantly decreased (‐33% and ‐16%, respectively; P< 0.01) following sclerotherapy. The systemic vascular resistance index was also increased significantly (+20%; P<0.01) in these patients. Moreover, the per cent change in azygos vein blood flow was directly correlated with that of the cardiac index (r=0.51; P< 0.03). We conclude from these findings that the obliteration of portosystemic collaterals by sclerotherapy significantly reverses hyperdynamic circulation in such patients via a decrease in cardiac preload. The blood flow of the portosystemic shunt per se is a leading contributor to the hyperdynamic circulation observed in patients with well‐developed portal systemic collateral vessels.
Chronic upper abdominal pain due to duodenal ulcer and other structural and functional causes: Its localization and nocturnal occurrence
Authors: KANG JY , HO KY , YEOH KG , GUAN R. 
Published: March 2008

AbstractThe aim of the present study was to determine the degree of pain localization and frequency of nocturnal pain in duodenal ulcer and other causes of chronic upper abdominal pain. These parameters were prospectively recorded in a consecutive series of 1615 patients with chronic upper abdominal pain presenting to one gastroenterologist. The proportion of patients who were able to localize the site of their pain using a single finger was 13% for duodenal ulcer, 5% for gastric ulcer, 17% for biliary disease, 7% for functional dyspepsia and 8% for irritable bowel syndrome. The numbers of subjects with the above diagnoses who experienced nocturnal pain were 63, 63, 51, 41 and 58%, respectively. The sensitivity, specificity, positive predictive value and negative predictive value for duodenal ulcer were 13, 92, 14 and 91%, respectively, for localized pain; 63, 50, 11 and 93%, respectively, for nocturnal pain occurrence; and 9, 96, 20 and 90%, respectively, if the pain was both localized and nocturnal. If the pain was neither localized nor nocturnal, the corresponding values for the absence of duodenal ulcer disease were 49, 68, 93 and 13%, respectively. The pain of duodenal ulcer was therefore more likely to be nocturnal and well localized compared with pain from other causes. However, while the absence of these features made duodenal ulcer unlikely, their presence was less helpful in the diagnostic process.
Case Report: Multiple Cancers: Hepatocellular carcinoma and adenocarcinomas of the common bile duct and the gall‐bladder in a woman with primary biliary cirrhosis
Authors: IMADA JUNKO , HOSHINO HIROSHI , NISHIMURA DAISAKU , MORITA KIYOSHI , YOSHIDA NORIO , KATADA NAOYUKI , SANO HIROSHI , KATO KATSUMOTO , MORI NAOYOSHI 
Published: March 2008

AbstractWe present a case of primary biliary cirrhosis associated with simultaneous triple cancers: a hepatocellular carcinoma and adenocarcinomas of the common bile duct and gall‐bladder. A 70 year old Japanese woman, who had been diagnosed with primary biliary cirrhosis (stage 2 by Scheuer) 15 years before, was admitted to Koseiren Kamo Hospital in a comatose state. Laboratory data were as follows: the ammonia level was high (164.0 μg/dL), the antimitochondrial antibody showed a 320‐fold increase, a high level of alpha‐fetoprotein was indicated (2677 ng/mL), hepatitis B surface antigen was negative and hepatitis C antibody by enzyme immunoassay was negative, although a test for the RNA of hepatitis C virus by polymerase chain reaction was positive (103.5 copies/50 μL). The patient's condition gradually worsened and the patient died of liver failure. Autopsy showed triple cancers in the liver (hepatocellular carcinoma; trabecular type, moderately differentiated), the common bile duct (well‐differentiated papillary adenocarcinoma) and the gall‐bladder (well‐differentiated papillary adenocarcinoma) with primary biliary cirrhosis (stage 4). Primary biliary cirrhosis has been believed to be a low risk for the development of hepatocellular carcinoma, despite the high risk of extrahepatic malignancy. The simultaneous occurrence of triple cancers with primary biliary cirrhosis, to the best of our knowledge, has never been reported. The present case may provide additional evidence for a predisposition to malignancy in primary biliary cirrhosis.
Longitudinal study of intrahepatic portal flow: A novel approach using Doppler technique
Authors: LIN ZU‐YAU , CHANG WEN‐YU , WANG LIANG‐YEN , WANG JING‐HOUNG , CHEN SHINN‐CHERNG , CHUANG WAN‐LONG , HSIEH MING‐YUH , TSAI JUNG‐FA 
Published: March 2008

AbstractThe present study investigates whether the application of the summation of portal blood flow (SPBF), measured from the left umbilical portion and the right anterior branch by Doppler, could be of use in the longitudinal study of intrahepatic portal flow or not. Forty‐five subjects were divided into two groups. Group I subjects included males and post‐menopausal females. Thirty‐seven subjects (19 normal volunteers, 12 subjects with chronic hepatitis, six cirrhotics) were investigated by the more experienced doctor A at 9 day intervals for an intra‐observer study. Among them, seven subjects (four normal volunteers, three with chronic hepatitis) were also investigated consecutively at 10 min apart by doctor B on days 1 and 10 for an interobserver study. Group II subjects included eight normal subjects with a regular menstrual cycle. They were investigated by doctor A during menstruation, mid‐follicular, ovulatory and mid‐luteal phases of the menstrual cycle to evaluate the possible impact of the menstrual cycle on SPBF measurement. The reproducibility of measurements was assessed by the coefficient of variation (CV) and the reproducibility coefficient. Data are expressed as mean ± s.d. The CV of the SPBF for intra‐observer and interobserver study were 4.88 ± 3.36 and 4.19 ± 2.53, respectively. All differences of SPBF were within their corresponding reproducibility limits. The results of SPBF measurements obtained from different phases of the menstrual cycle were variable. Only the comparison between the data obtained from mid‐follicular and mid‐luteal phases could demonstrate acceptable CV values (3.98 ± 3.12%) and all the differences in SPBF measurements were within the repeatability limit. In conclusion, Doppler SPBF measurement may be useful in the longitudinal evaluation of intrahepatic portal flow changes.
Prolonged bleeding time: A new clinical manifestation of hepatocellular carcinoma?
Authors: CHU CHI‐JEN , LEE FA‐YAUH , HWANG SHINN‐JANG , HSU WAN‐CHING , TSAI YANG‐TE , LIN HAN‐CHIEH , LI CHUNG‐PIN , WANG SUN‐SANG , LEE SHOU‐DONG 
Published: March 2008

ABSTRACTThe association between prolonged bleeding time and hepatocellular carcinoma (HCC) has not been well studied. We investigated whether bleeding time is prolonged in cirrhotic patients with HCC and studied the role of clinical characteristics, tumour size, and laboratory data in predicting bleeding time prolongation. After excluding patients that presented with blood dyscrasia and uraemia, 58 cirrhotic patients with HCC, 106 cirrhotic patients without HCC, and 44 age‐ and sex‐matched healthy subjects were included in the study. Bleeding time, imaging studies, clinical characteristics and biochemical data were obtained for every patient. Cirrhotic patients with and without HCC had longer bleeding times (554±68 and 535±32s, respectively) compared with healthy controls (357±13s, P < 0.05). Hepatocellular carcinoma patients with a large tumour burden (> 5 cm in diameter) had a significantly longer bleeding time than those patients without (663±105 vs 376±23s, respectively, P < 0.05). After excluding patients with a platelet count ≤ 80 000/mm3, cirrhotic patients classified as Child‐Pugh's grading A and with a large tumour burden had longer bleeding times (580±87s) than patients with a small tumour burden (≤ 5 cm in diameter) and cirrhotic patients without HCC (371±22 and 416±29s, respectively, P < 0.05). In cirrhotic patients with HCC, higher serum bilirubin levels, a Child‐Pugh's grading C, and a tumour size > 5 cm in diameter were found to be significant predictors for prolonged bleeding time on univariate analysis. On multivariate analysis, both tumour size > 5 cm in diameter and a Child‐Pugh's grading C (odd's ratio, 95% confidence interval and P value were measured as 38.5, 2.8–534.7, < 0.001, and 10.5, 0.9–117.6, 0.02, respectively) were the significant independent predictors. A significant correlation existed between tumour diameter and bleeding time (r= 0.44, P < 0.01). In conclusion, these results suggest that prolonged bleeding time may be categorized as a new clinical manifestation in patients with HCC. In addition to cirrhosis, HCC itself may also participate in the pathogenesis of bleeding time prolongation.
Laparoscopic prediction of hepatocellular carcinoma in cirrhosis patients
Authors: KAMEDA YOSHIO , ASAKAWA HIDEKI , SHIMOMURA SOHJI , SHINJI YOSHITAKE 
Published: March 2008

ABSTRACTPreviously, laparoscopic studies have not been successful in predicting the occurrence of small hepatocellular carcinoma because cirrhotic patients had not been separated into groups of those who developed small hepatocellular carcinoma under 3 cm in diameter, and those who did not. Retrospective examination with better separation of the two groups gave improved results. Of the 26 laparoscopic findings, only the presence of large complex regenerative nodules was closely associated with the occurrence of subclinical small hepatocellular carcinoma. The study of other cirrhotic patients with and without large complex regenerative nodules gave a cumulative hepatocellular carcinoma occurrence rate of 73% for patients who had these nodules by the third year after laparoscopy. In contrast, the rate for patients without such nodules was 6%, showing a significant difference (P < 0.05) between the two groups. We concluded that the laparoscopic finding of large complex regenerative nodules of liver cirrhosis can be used to predict the occurrence, or a complication, of subclinical small hepatocellular carcinoma.
Effect of shunt surgery on spleen size, portal pressure and oesophageal varices in patients with non‐cirrhotic portal hypertension
Authors: SHARMA BC , SINGH RP , CHAWLA YK , NARASIMHAN KL , RAO KLN , MITRA SK , DILAWARI JB 
Published: March 2008

ABSTRACTShunt surgery is considered to be the treatment of choice in patients with non‐cirrhotic portal hypertension. There is little data on the effect of side‐to‐side lieno‐renal (SSLR) shunt on oesophageal variceal size, splenic size and splenic pulp pressure (SPP) in patients with non‐cirrhotic portal hypertension. We evaluated pre‐ and postoperatively endoscopic grading of varices, splenic size and SPP for predicting shunt patency in 86 patients with non‐cirrhotic portal hypertension: 56 with extrahepatic portal venous obstruction (EHPVO) and 30 with non‐cirrhotic portal fibrosis (NCPF). The EHPVO patients with patent shunts (n= 47) showed significant reduction in SPP (pre‐operative 43.56±7.9 vs postoperative 29.96±7.7 cm of saline), splenic size (6.5±2.8 vs 4.00±2.6 cm below costal margin) and varices grades (2.96±0.5 vs 0.92±0.8). Patients with blocked shunt (n= 9) did not show significant reduction in SPP and varices grades. However, there was reduction in spleen size (8.6±3.0 vs 6.3±4.3). In the NCPF group, 28 had patent shunts and showed significant reduction in SPP (46.3±13.5 vs 33.8±7.6 cm of saline), splenic size (9.1±3.3 vs 6.8±4.6 cm below costal margin) and varices grades (2.8±0.7 vs 1.05±0.96). As only two patients with NCPF had blocked shunts, no statistical comparison between patients with patent and patients with blocked shunts could be done. In conclusion, following SSLR, there is a significant reduction in SPP and varices grades in patients with patent shunts. Endoscopic grading of varices can be used to predict shunt patency. However, spleen size is not a good criteria for predicting shunt patency.