bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endoscopic management of acute calculous cholangitis
Authors: SHARMA BC , AGARWAL DK , BAIJAL SS , SARASWAT VA , CHOUDHURI G , NAIK SR 
Published: March 2008

ABSTRACTAcute cholangitis is associated with significant morbidity and mortality. Endoscopic drainage procedures have been shown to be a safe and effective mode of treatment in acute cholangitis. As there is paucity of large series on endoscopic management of acute cholangitis, a study was performed to evaluate safety and efficiency of endoscopic biliary decompression in acute cholangitis. The study included 89 consecutive patients (mean age 55 ± 15 years; range 35–70 years; 50 males) with acute cholangitis requiring biliary drainage. Main presenting features were upper abdominal pain (84%), fever with chills (90%) and jaundice (74%). Altered sensorium, hypotension, features of peritonitis and acute renal failure were present in 15, 11, 18 and 5%, respectively. Endoscopic procedures performed were endoscopic sphincterotomy (ES) with stone extraction (n= 40); ES with endoscopic nasobiliary drainage (ENBD; n= 30); ENBD without ES (n= 8); and ES with stent placement (n= 11). Of the 89 patients, 85 (95%) responded within 48–72 h. Endoscopic common duct clearance could be achieved in 58 of 78 (74%) patients, whereas in 11 patients undergoing stent placement, stone extraction was not attempted. Complications included post‐sphincterotomy bleed (n= 2), retroduodenal perforation (n= 1) and acute pancreatitis (n= 1) with an overall complication rate of 4.4%. All the complications were seen in patients undergoing ES with stone extraction. Mortality was 3.3%. In conclusion, endoscopic biliary drainage is a safe and effective mode of treatment for acute cholangitis. Endoscopic nasobiliary drainage or stent placement is safer than ES in acute cholangitis as an initial step.
Risk factors and the effect of interferon therapy in the development of hepatocellular carcinoma: A multivariate analysis in 343 patients
Authors: KUWANA KENJI , ICHIDA TAKAFUMI , KAMIMURA TOMOTERU , OHKOSHI SHOWGO , OGATA NORIO , HARADA TAKESHI , ENDOH KAZUO , ASAKURA HITOSHI 
Published: March 2008

ABSTRACTThe aims of the present study were to clarify the risk factors for the development of hepatocellular carcinoma (HCC) in chronic hepatitis C virus (HCV) infection and to investigate the effectiveness of interferon (IFN) therapy. We retrospectively studied 343 patients who had been admitted to our hospital; 161 with chronic hepatitis, 49 with liver cirrhosis, 42 with chronic hepatitis bearing HCC and 91 with liver cirrhosis bearing HCC. The mean (±SD) observation period was 41.6 ± 31.1 months. The mean age of HCC and non‐HCC patients was 63.5 ± 7.6 and 56.9 ±12.5 years, respectively (P< 0.001). The HCV genotype II (1b) was the most prevalent genotype (92.5%) in HCC patients and the mean age was highest among patients with this genotype (63.6 ± 7.7 years). Multivariate analysis identified age (P< 0.001), the male gender (P<0.01), HCV genotype II (1b) (P<0.05) and excessive alcohol intake (P<0.05) as independent factors associated with the development of HCC. There was no relationship between the development of HCC and serum HCV levels as quantified by branched DNA assay or competitive reverse transcription polymerase chain reaction. The incidence of HCC in patients who had not received IFN therapy was 10.4/100 person‐year, while that of patients who had received IFN therapy was 1.2/100 person‐year (P<0.01) by the person‐year method. The low incidence of HCC in patients treated with IFN suggests that IFN may prevent the development of HCC.
CASE REPORT: Haemothorax due to hepatocellular carcinoma rupture successfully controlled by transcatheter arterial embolization
Authors: MASUMOTO AKIHIDE , MOTOMURA KENTA , UCHIMURA KOUTARO , MOROTOMI IKUO , MORITA KAZUNORI 
Published: March 2008

ABSTRACTA 64‐year‐old man was admitted to our hospital with multiple hepatocellular carcinoma (HCC) lesions in the liver and lung. On the seventh hospital day, a chest radiograph showed a marked increase in right pleural effusion. A thoracentesis revealed a haemothorax. Despite repeated pleural taps and blood transfusions, the patient's clinical status worsened and he developed severe dyspnoea. An inferior phrenic arteriography on the 19th hospital day showed a tumour growing over the diaphragm into the right thoracic cavity, suggesting a tumour rupture. A transcatheter arterial embolization (TAE) of the inferior phrenic artery successfully controlled the bleeding and improved the haemothorax. There was no rebleeding; however, the patient died of advanced HCC 3 months later. To our knowledge, this is the first case of a haemothorax secondary to a ruptured HCC that was treated successfully with TAE.
Relationship between hepatic blood flow, liver tests, haemodynamic values and clinical characteristics in patients with chronic liver disease*
Authors: GADANO ADRIÁN , HADENGUE ANTOINE , VACHIERY FLORENCE , MOREAU RICHARD , SOGNI PHILIPPE , SOUPISON THIERRY , YANG SONG , CAILMAIL STÉPHANE , LEBREC DIDIER 
Published: March 2008

ABSTRACTAlthough hepatic blood flow (HBF) has been measured in patients with liver disease for many years, the results of these studies have not provided clear information concerning the usefulness of this measurement. Hepatic blood flow was measured in 392 patients with either cirrhosis (n= 356) or hepatic fibrosis (n= 36). The control group included 59 subjects with normal liver architecture. Hepatic clearance of indocyanine green (ICG) was markedly reduced in patients with cirrhosis and hepatic fibrosis compared with controls (182±5, 276±22 and 421±25 mL/min, respectively). In patients with cirrhosis, ICG clearance and extraction were significantly correlated, but were not correlated to HBF. Although HBF did not differ between patients with cirrhosis and controls (1.26±0.04 vs 1.35±0.07 L/min, respectively), patients with hepatic fibrosis had lower HBF (1.04±0.07 L/min; P< 0.05). In patients with cirrhosis, no correlation was observed between HBF and cardiac output, mean arterial pressure, azygos blood flow, the hepatic venous pressure gradient or Pugh's score. However, a significant difference in HBF was observed in patients with and without hepatic encephalopathy (1.00±0.09 vs 1.28±0.03 L/min, respectively; P<0.05). In conclusion, the present study shows that, in patients with cirrhosis, HBF is normal and is not related to other haemodynamic values or liver tests. These results discourage the measurement of HBF in the evaluation of patients with cirrhosis.
Review: Barrett's Oesophagus in Taiwan
Authors: CHEN PAO‐HUEI 
Published: March 2008

ABSTRACTBarrett's oesophagus is the eponym applied to the columnar epithelium‐lined lower oesophagus which is acquired as a complication of chronic gastro‐oesophageal reflux (GER). Various complications seen in the Barrett's oesophagus, such as peptic ulcer, stricture, adenocarcinoma are named as Barrett's ulcer, Barrett's stricture and Barrett's carcinoma, respectively. It is now generally accepted that Barrett's oesophagus is an acquired condition resulting from chronic repetitive GER. The frequency of Barrett's oesophagus seems to be higher in Caucasian than in Oriental or Negro populations. There is a tendency towards increasing prevalence rates all over the world, including Taiwan, due to the Westernization of diet, rapid growth in the elderly population, obesity etc. Almost 6% of the patients who manifest heartburn in GI clinics in Taiwan now suffer from GER, which is almost similar to the 7% reported by Nabel, (USA) in 1976. During the last 30 years, the incidence of esophageal adenocarcinoma has increased rapidly. Patients with Barrett's oesophagus have an increased risk of developing oesophageal adenocarcinoma and should be kept under surveillance. Regular follow‐up, at least twice a year or preferably, every 2–3 months, for those patients with SCE using endoscopic surveillance and biopsy for those with severe dysphasia (oesophageal columnar intraepithelial neoplasia) in the surrounding area to detect Barrett's oesophagus cancer, is very important.
Peptic ulcer disease in the 1990s: An Asian perspective
Authors: FOCK KWONG MING 
Published: March 2008

ABSTRACTPeptic ulcer disease is still a common disease in many parts of Asia, although it is less common today than it was 2–3 decades ago. Contrary to this general trend, peptic ulcers are on the rise in the elderly, particularly elderly females. Two important factors that could explain the observed changes in the trends of peptic ulcer disease are: Helicobacter pylori and NSAID. The seroprevalence of H. pylori, determined in three previous studies, would appear to have decreased over the last few decades, while NSAID and aspirin are used increasingly for arthritis, cerebrovascular disease and coronary artery disease. The major complication of peptic ulcer disease is gastrointestinal haemorrhage and in the 1990s endoscopic haemostatic therapy has replaced surgery as the treatment of choice. Treatment of peptic ulcer disease caused by H. pylori is directed at eradication of H. pylori itself; four classes of drug regimens are currently available for this. Antibiotic resistance, particularly metronidazole resistance, is an important factor that determines the outcome of therapy. Metronidazole resistance is reported to be present in 50% of all strains of H. pylori in Hong Kong and Singapore, and is present in 80–90% of all strains in India. Eradication rates in Asia, may for this reason, differ from those in the West, if the regimen contains metronidazole. Treatment of NSAID‐associated ulcer consists of discontinuation of NSAID, if possible, and administration of anti‐secretory drugs such as H2 blockers, proton pump inhibitors or mucosal protective agents. Co‐prescription with misoprostol has been shown to reduce the risk of NSAID‐induced ulcer. New NSAID or NO NSAID are being developed with few gastrointestinal side effects.
Prevalence of and risk factors for Helicobacter pylori infection in a multi‐racial dyspeptic Malaysian population undergoing endoscopy
Authors: GOH KL 
Published: March 2008

ABSTRACTThe aim of the present study was to determine the risk factors for Helicobacter pylori in a dyspeptic Malaysian population. A cross‐sectional survey of 1060 consecutive patients presenting with dyspepsia at the Endoscopic Unit, University Hospital, Kuala Lumpur, Malaysia from January 1994 to July 1995 was undertaken. All patients answered a detailed questionnaire and underwent endoscopy, with two antral biopsies taken for diagnosis of H. pylori using a rapid urease test. An overall H. pylori prevalence of 49.0% was recorded. Helicobacter pylori prevalence in relation to the major endoscopic diagnoses were as follows: non‐ulcer dyspepsia (NUD) 31.2%; duodenal ulcer (DU) 91.4%; and gastric ulcer (GU) 74.1%. The prevalence among the races were as follows: Malay 16.4%; Chinese 48.5%; and Indians 61.8%. Multiple logistic regression analysis identified the following as independent risk factors: > 45 years old 1.5 (1.1,2.0); male gender 1.6 (1.2,2.1); ethnic group: Chinese 2.5 (1.7,3.7); Indians 4.9 (3.2,7.5); level of education: low 2.3 (1.5,3.5); middle 1.7 (1.1,2.6); and smoking 1.6 (1.2,2.3). Analysis was also performed on DU, GU and non‐UD patients separately; in both DU and GU patients, H. pylori prevalence was high regardless of age, sex, race or level of education. However, in DU patients, Indian race had an independent risk factor (Odds ratio = 7.8 (1.2,48.4)). The findings in the NUD group reflected the findings in the ‘all patients’ group; > 45 years old, male gender, Indian and Chinese race, and low level of education were also significant, independent risk factors. The overall differences in H. pylori prevalence between the different subgroups were mainly due to differences in the NUD group. The increased risk of H. pylori infection in Chinese and Indians points to either an inherent ethnic genetic predisposition or to socio‐cultural practices peculiar to the particular race which may be responsible for transmission of the infection.
How to apply modern scientific and technological advances to the practice of clinical gastroenterology in Vietnam
Authors: VAN HA MAO 
Published: March 2008

ABSTRACTThere are some differences between the spectrum of gastroenterological diseases in Vietnam compared with those of more developed countries. These may be due to different living standards, quality of nutrition, and different infection rates of intestinal parasites and hepatotropic viruses. Gastric carcinoma and hepatocellular carcinoma (HCC) are leading malignancies, while colorectal cancer is less frequent. Bile duct stones often have Ascaris eggs in the centre, and they prevail in incidence over gallbladder stones. The majority of digestive cancers are detected at a very late stage. The Vietnamese Association of Gastroenterology aims to contribute to the development of modern gastroenterology (GE) in Vietnam, to study and apply recent advances in imaging technology, such as fibre‐optic diagnostic and therapeutical endoscopy, ultrasonography, laparoscopic surgery etc. and to do further work in molecular biology. For this purpose, besides our self‐reliance, we need, and ask for, support and assistance from the Japanese Society of GE (JSGE), the Asian Pacific Association of GE (APAGE) and the Organisation Mondiale de GE (OMEGE). At the same time, we suggest a choice be made among the different technologies, bearing in mind their cost‐effectiveness, and to give preference to measures for the primary prevention and early detection of the diseases. Japanese experience in the early detection of gastric cancer and HCC, and in the Percutaneous Ethanol Injection Therapy (PEIT) for treatment of HCC, are highly appreciated. We recommend also a judicious and scientific combination of traditional medicine and modern technology in the research and the struggle against digestive diseases.
REVIEW: The controversy over the pathophysiology of ascites formation in cirrhosis
Authors: WONG FLORENCE , GIRGRAH NIGEL , BLENDIS LAURENCE 
Published: March 2008

ABSTRACTThe pathogenesis of renal sodium retention and ascites formation in cirrhosis is a subject of much controversy. The generally accepted ‘peripheral arterial vasodilatation hypothesis’ seems to best explain the mechanism of sodium retention and other clinical findings, such as the hyperdynamic circulation of cirrhosis. However, recent data in pre‐ascites and in early ascites do not seem to conform to the peripheral arterial vasodilatation hypothesis. Sodium handling abnormalities can be demonstrated in pre‐ascitic cirrhosis when patients are challenged with a sodium load, in the absence of systemic vasodilatation or arterial underfilling. Therefore, an alternative hypothesis with a direct hepatorenal interaction, acting via sinusoidal portal hypertension and/or hepatic dysfunction as the affector mechanism, is proposed to be the initiating event in renal sodium retention in cirrhosis. The second and later process is the development of systemic arterial vasodilatation, possibly due to the presence of excess systemic vasodilators and/or decreased responsiveness of the vasculature to endogenous vasoconstrictors. This, in turn, will lead to a relatively underfilled circulation with consequent activation of neurohumoral systems, promoting further renal sodium retention as described by the peripheral arterial vasodilatation hypothesis and ultimately leading to ascites. When compensatory natriuretic mechanisms fail, refractory ascites develops and hepatorenal syndrome sets in. Thus, renal sodium retention in cirrhosis is the result of interplay of many factors, with direct hepatorenal interaction predominating in earlier stages of the cirrhotic process, while systemic vasodilatation becomes a more important pathogenetic factor as the disease progresses.
Quantitative analysis of interferon α/β receptor mRNA in the liver of patients with chronic hepatitis C: Correlation with serum hepatitis C virus‐RNA levels and response to treatment with interferon
Authors: YATSUHASHI HIROSHI , YAMASAKI KAZUMI , ARITOMI TOMOYUKI , DEL CARMEN PARQUET MARIA , INOUE OSAMI , KOGA MICHIAKI , YANO MICHITAMI 
Published: March 2008

ABSTRACTWe analysed the expression of interferon (IFN) α/β receptor mRNA in the liver of patients with chronic hepatitis C and examined the relationship between the expression of this receptor gene and the level of hepatitis C virus (HCV)‐RNA as well as the response to 16 weeks of 6 × 106 units IFN. The mean level of IFNα/β receptor mRNA in patients with chronic HCV infection (expressed as δ cycle; 10.8±1.9 (mean±SD); n = 39) was significantly higher than that of control subjects (9.4±0.5; n=6; P<0.01). There was a significant negative correlation between the level of IFNα/β receptor mRNA and serum HCV‐RNA in 39 patients with chronic hepatitis C (R=‐0.546; P<0.01). The mean level of IFNα/β receptor mRNA in six patients who showed a complete response to IFN therapy (12.3±1.6) was higher than that of 15 patients who failed to respond to therapy (10.1±1.5; P< 0.01). Our results are consistent with the suggestion that the anti‐viral activity of IFN depends on the level of the IFNα/β receptor on hepatocytes in patients with chronic hepatitis C.
Sucralfate attenuates gastric mucosal lesions and increased vascular permeability induced by ischaemia and reperfusion in rats
Authors: AL‐SWAYEH OA , AL‐HUMAYYD MS , MUSTAFA AA , AL‐TUWAIJRI AS , AL‐RASHED RS , ALI ATMM 
Published: March 2008

ABSTRACTRecent evidence suggests that oxygen‐derived free radicals are involved in mediating gastric microvascular and parenchymal cell injuries induced by ischaemia and reperfusion. Therefore, the effect of the locally acting anti‐ulcer drug, sucralfate, was studied on ischaemia and reperfusion (e.g. induced gastric lesions, intraluminal bleeding, changes in vascular permeability and non‐protein sulfhydryl levels in the rat stomach). Allopurinol was used as a known standard antioxidant drug. Rats were subjected to 30 min of gastric ischaemia in the presence of 100 mmol/L hydrochloric acid and reperfusion periods of 15, 30 or 60 min duration. The gastric lesions were assessed microscopically under an inverted microscope. The vascular permeability was quantified by measuring the extravasated Evans blue in the stomach. There were significantly greater numbers of gastric lesions, intraluminal bleeding and leakage of Evans blue during all reperfusion periods as compared with those of ischaemia, with maximum effects occurring at 60 min following reperfusion. Pretreatment with sucralfate (31.25–250 mg/kg, p.o.) or allopurinol (12.5–50 mg/kg, i.p.) 30 min before the procedure, dose‐dependently reduced the gastric lesions, intraluminal bleeding, and decreased the vascular permeability induced by ischaemia and reperfusion. Furthermore, sucralfate dose‐dependently reverses the ischaemia and reperfusion‐induced depletion of mucosal non‐protein sulfhydryl levels and inhibited the superoxide radical production in both cell‐free xanthine‐xanthine oxidase and in the stimulated polymorphonuclear cellular systems. These results suggest that the protection produced by sucralfate against gastric injury may be due to its antioxidant effects.
CASE REPORT: Haemorrhagic colitis associated with royal jelly intake
Authors: YONEI YOSHIKAZU , SHIBAGAKI KEIGO , TSUKADA NOBUHIRO , NAGASU NAOKO , INAGAKI YASUTAKA , MIYAMOTO KEI , SUZUKI OSAMU , KIRYU YASUYOSHI 
Published: March 2008

ABSTRACTThe case report of a 53‐year‐old woman with abdominal pain and bloody diarrhoea is described. Prior to the onset of symptoms the patient had taken royal jelly for 25 days. Colonoscopy revealed that the mucosa was haemorrhagic and oedematous throughout the 20 cm long sigmoid colon. Histopathologically, mucosal haemorrhage, oedema, and infiltration of inflammatory cells were observed. Transmission electron microscopic examination revealed platelet aggregation in 30% of capillaries in the mucosal lesions. The drug‐induced lymphocyte stimulation test was slightly positive for royal jelly (847 c.p.m., SI= 147%) compared with the control (576 c.p.m.). The patient's signs and symptoms disappeared within a few days after the initiation of conservative therapy, and the colonic lesions disappeared after 2 weeks of this therapy. This is the first reported case of haemorrhagic colitis associated with royal jelly intake.
Quantitative measurement of HCV RNA in the serum: A comparison of three assays based on different principles
Authors: ICHIJO TETSUYA , MATSUMOTO AKIHIRO , KOBAYASHI MASAKAZU , FURIHATA KENICHI , TANAKA EIJI 
Published: March 2008

ABSTRACTQuantitative measurement of hepatitis C virus (HCV) RNA is useful in patients with chronic hepatitis C, especially with interferon treatment. We examined the clinical usefulness of the AMPLICOR monitor assay, a newly developed assay for quantitative measurement, by comparing it with two other assays with different principles. A total of 48 patients with chronic hepatitis C who were treated with interferon‐α (IFN‐α) were studied: 19 were complete responders and 29 were non‐responders. Hepatitis C virus RNA was measured quantitatively by AMPLICOR, branched DNA (bDNA) probe, and competitive polymerase chain reaction (C‐PCR) assays. An internal quantification standard was used in the AMPLICOR assay. A cDNA competitor with a deletion of 15 base pairs in the middle portion was used in the C‐PCR method. The concentration of HCV RNA was significantly correlated between the three assays adopted in this study. Sensitivity of assays was 100% by C‐PCR, 90% by AMPLICOR and 69% by bDNA assays. The active quantitative range was best with the C‐PCR assay and worst with the bDNA assay. The bDNA assay had a tendency to exhibit lower values for patients with serotype 2 than did the other two assays. The predictive rate of the long‐term response to IFN‐α therapy, before its initiation, was over 75% in all three assays. The predictive rate just after completing IFN‐α therapy was as high as 80% by C‐PCR and the AMPLICOR assays, but was low (58%) with the bDNA assay. The handling of the bDNA and AMPLICOR assays was much easier than the C‐PCR assay, which required time and skill. These results indicate that the AMPLICOR assay is a simple and reliable method for measuring the serum concentrations of HCV RNA, and thus is suitable for clinical application.
Effect of taurolithocholate‐3‐sulphate on biliary excretion of sulphobromophthalein and dibromosulphophthalein in the Eisai hyperbilirubinaemic rat
Authors: TAKIKAWA HAJIME , SANO NAOYO , SATO AKIHIRO , YAMANAKA MASAMI 
Published: March 2008

ABSTRACTWe previously reported that biliary lithocholate‐3‐sulphate excretion was inhibited by dibromosulphophthalein, not by sulphobromophthalein in Eisai hyperbilirubinaemic rats (EHBR); instead its excretion was inhibited by both organic anions in control rats. In the present study, the effect of taurolithocholate‐3‐sulphate on the excretion of sulphobromophthalein and dibromosulphophthalein was studied in EHBR and control Sprague‐Dawley rats. Taurolithocholate‐3‐sulphate infusion inhibited biliary excretion of sulphobromophthalein and dibromosulphophthalein in both EHBR and control rats. These findings indicate that in control rats biliary excretion of taurolithocholate‐3‐sulphate is mediated by a carrier common for both organic anions, and that in EHBR, in which the canalicular multispecific organic anion transporter is impaired, the excretory pathway for taurolithocholate‐3‐sulphate is also partly identical to that for both organic anions.