bluuebunny/crossref_metadata_2025_split huggingface dataset:
Some factors associated with mortality in perforated peptic ulcer: A case‐control study
Authors: McINTOSH JEAN H. , BERMAN KAREN , HOLLIDAY FIONA M. , BYTH KAREN , CHAPMAN RENATA , PIPER DOUGLAS W. 
Published: March 2008

AbstractThis study examined the associations of individual coexisting illnesses, septicaemia, intra‐abdominal abscess, marital status, smoking and alcohol use, with mortality following perforation of peptic ulcer without pre‐operative evidence of haemorrhage. Patients who died in hospital following ulcer perforation (cases; n= 300) were compared with patients who survived following ulcer perforation (controls; n= 276) The controls were frequency‐matched to the cases on age, sex and perforation site. Data were analysed by logistic regression. Cardiac, respiratory, cerebrovascular, renal, liver and malignant diseases, and septicaemia and intra‐abdominal abscess were associated with mortality and the coexisting illnesses were significantly increased in cases compared to controls both on admission and at the end of hospital stay. During hospitalization, the odds of pneumonia decreased in cases, otherwise there was little change in strengths of associations over this period. Being widowed or never married was positively associated with mortality, and moderate alcohol use was negatively associated. In conclusion, this study identifies several coexisting illnesses, septicaemia and intra‐abdominal abscess as risk factors for mortality following ulcer perforation. The results suggest that, with little exception, the same level of mortality risk is associated with coexisting illnesses whether the beginning or end of hospital stay is used as the index time point.
Doppler ultrasound evaluation of acute effects of cigarette smoking on portal blood flow in man
Authors: RAPACCINI GIAN LUDOVICO , POMPILI MAURIZIO , MARZANO MARIA‐ADELAIDE , GRATTAGLIANO ANNA , CEDRONE AUGUSTO , ALIOTTA ANTONIO , PIGNATARO FRANCESCO , CATURELLI EUGENIO , CELLERINO CATERINA , GASBARRINI GIOVANNI 
Published: March 2008

ABSTRACTThe acute systemic haemodynamic effects of cigarette smoking are well known, but there are no studies dealing with the possible smoke‐related acute changes of splanchnic circulation in man. In the present study we evaluated the acute effects of cigarette smoking on portal blood flow (PBF) in normal subjects by the use of Doppler ultrasound. Twenty‐three normal volunteers were asked to smoke two cigarettes with a known total nicotine content (1.1 mg each) in a supine position. Each cigarette was smoked during a 5 min period and a 5 min interval between the two cigarettes was allowed. Both mean PBF velocity and volume were evaluated at time 0 (basal values) and 8, 15, 30, 45 and 60 min after the first inhalation of the first cigarette. The basal mean PBF velocity (22 cm/s; 95% CI 20.9–24.2) was significantly decreased at 8 min (19 cm/s; 95% CI 17.9–20.8; P< 0.0007) and 15 min (20 cm/s; 95% CI 17.8–21.3; P< 0.005). Similarly, the PBF volumes at 8 min (710 mL/min; 95% CI 660–876; P< 0.002) and 15 min (750 mL/min; 95% CI 650–862; P< 0.005) were significantly lower than those measured at time 0 (850 mL/min; 95% CI 766–987). Both mean PBF velocity and volume measured at successive times did not differ significantly from basal values. The present study shows that cigarette smoking causes acute and transient reduction of PBF velocity and volume in normal subjects.
Case Report: Agranulocytosis induced by interferon‐α therapy for chronic hepatitis C
Authors: HIGASHI YOICHIRO , SAKAI KENJI , TADA SHUJI , MIYASE SHUICHI , NAKAMURA TAIZOU , KAMIO TAKIHIRO , HARAGUCHI OSAMU 
Published: March 2008

ABSTRACTA 60‐year‐old woman presented with chronic active hepatitis C whose HCV‐RNA genotype was II according to Okamoto's classification and serum HCV‐RNA concentration was 104 copies/mL. Agranulocytosis was induced 13 days from the commencement of interferon (IFN)‐α 2b (6 MU/day) therapy, so the IFN therapy was immediately discontinued. The agranulocytosis improved rapidly with the administration of a granulocyte colony stimulating factor (G‐CSF). The possibility that IFN was associated with maturational arrest of myeloid progenitor cells was considered. During the course of 3 years of follow‐up, her liver function has remained normal and serum HCV‐RNA remains negative.
Morgagni: His book, vision and views on hepatic coma
Authors: CHEN THOMAS SN , CHEN PETER SY 
Published: March 2008

ABSTRACTThe study of pathological anatomy reached a culmination in the magnum opus of Morgagni, The Seats and Causes of Diseases. It represented an innovative way of looking at the patient and his illness, a change that Foucault described as occurring in the 18th century. Physicians saw symptoms penetrating the body and converging upon an organ. We suggest that Morgagni and his fellow workers derived their vision from the practice of visual perspective discovered by Italian Renaissance artists. Perceiving in three dimensional terms, Morgagni added spatial depth to our understanding of disease. His acute vision was brilliantly displayed in his views of hepatic coma. He was among the first to provide the clinical‐pathological associations of acute liver failure. The limitations of gross morphology precluded a complete elucidation of the disorder.
Gastric metaplasia of regenerating duodenal mucosa and deformity of duodenal bulb: A correlative study
Authors: PAN SHIANN , LIEN GI‐SHIH , LIAO CHENG‐HSIUNG , CHEN SHENG‐HSUAN 
Published: March 2008

AbstractThe correlation between the presence and degree of gastric metaplasia of regenerating duodenal mucosa and the deformity of duodenal bulb was studied. Based on the endoscopically morphological patterns of bulb, the duodenal ulcers were divided into three types: type I, with a normal‐shaped bulb; type II, with a mildly deformed bulb; and type III, with a markedly deformed bulb. A total of 159 patients with active duodenal ulcers were scheduled to be treated with H2‐receptor antagonists. Of these patients, 124 proved to have a healed duodenal ulcer 4 weeks after initial treatment upon follow‐up endoscopic examinations. Two biopsies were taken from the centre of the ulcer scar when the ulcer was found to be healed for light microscopic study. Histologically, the degree of gastric metaplasia was divided into three grades: grades 0, 1 and 2. The results show that a healed duodenal ulcer with a normal‐shaped bulb is not frequently accompanied by gastric metaplasia. However, a healed ulcer with a markedly deformed bulb has a high incidence and degree of gastric metaplasia, which may be easily colonized by Helicobacter pylori and thus develop an environment of easy recurrence. Therefore, a cycle of healing and recurrence may exist in patients with a duodenal ulcer and a markedly deformed bulb. Eradication of H. pylori may be the best way to break this cycle.
Endemicity and clinical picture of liver disease due to obstruction of the hepatic portion of the inferior vena cava in Nepal
Authors: SHRESTHA SANTOSH M. , OKUDA KUNIO , UCHIDA TOSHIKAZU , MAHARJAN KRISHNA GOPAL , SHRESTHA SHOBHANA , JOSHI BISHNU L. , LARSSON STIG , VAIDYA YOGESH 
Published: March 2008

AbstractObstructive lesion of the hepatic portion of the inferior vena cava is common in Nepal. The clinical data on 150 patients who were seen at the Liver Unit, Bir Hospital, Kathmandu, in three years from 1990 to 1992 were analysed. Although the majority of patients were over 20 years of age, 25 patients were below 10 years of age; there were more males than females in this study. This disease accounted for 17% of 866 patients with chronic liver disease and for nearly one quarter of 267 biopsies performed on this patient group during the same period. Obstructive lesions of the inferior vena cava seem to be more common among poor people with malnutrition. Clinically, our patient group could be divided into acute (n= 27), subacute (n= 43) and chronic (n= 80) cases. The important clinical features are hepatomegaly and/or ascites and, in chronic cases, prominent dilated superficial veins over the body trunk with cephalad flow. Ultrasound is the most helpful diagnostic procedure, especially in subacute and chronic cases, as it frequently demonstrates caval obstruction, thrombosis, dilated hepatic veins and intrahepatic collaterals. Diagnosis is confirmed by cavography, which shows a caval obstruction of varying lengths at the cavo‐atrial junction or a marked narrowing of the hepatic portion of the vena cava. In subacute and chronic cases cavography also demonstrates collateral veins, such as the ascending lumbar, hemiazygos and azygos that drain into the superior vena cava. Chronic cases had periods of exacerbation often associated with bacterial infection. The aetiology of inferior vena cava obstruction at its hepatic portion is not known, but there seems to be a frequent association of bacterial infection with the disease.
Hepatic angiomyelolipoma and tuberous sclerosis
Authors: YEO W. , LEONG ASY , WARD SC , HUI PK , JOHNSON PJ 
Published: March 2008

AbstractA patient with angiomyelolipoma of the liver, together with radiological evidence of pancreatic, renal and bony lesions characteristic of tuberous sclerosis, is described. Although the patient had no other clinical features of tuberous sclerosis, her daughter was found to suffer from the classical triad of this syndrome and also has had hepatic lipomatous lesions and bony involvement. This is the first histologically proven case of hepatic angiomyelolipoma associated with tuberous sclerosis.
Sequential changes in serum levels of individual bile acids in patients with chronic cholestatic liver disease
Authors: AZER SAMY A. , COVERDALE SHIRLEY A. , BYTH KAREN , FARRELL GEOFFREY C. , STACEY NEILL H. 
Published: March 2008

ABSTRACTIn order to determine the value of serum bile acids in predicting the course of chronic cholestatic liver diseases, we measured individual serum bile acids serially, using high‐performance liquid chromatography, over a 4 year observation period in 12 patients with primary biliary cirrhosis and six patients with primary sclerosing cholangitis. The changes in individual serum bile acids and the ratios thereof, conventional liver tests and Child‐Turcotte and Mayo scores were compared between survivors (n= 10) and patients who underwent liver transplantation for (n= 3) or died of the liver disease (n= 5). Patients with a serum total chenodeoxycholic acid concentration at study entry that exceded 15 μmol/L were 10 times more likely to die or need a liver transplant in the following 4 years than those with chenodeoxycholic acid levels < 15 μmol/L (P< 0.05). None of the other biochemical parameters or clinicopathological scores could similarly discriminate between the two groups at entry. Time‐dependent analyses for the cholic acid/chenodeoxycholic acid ratio, serum total bilirubin and albumin concentrations and Child‐Turcotte and Mayo scores were able to differentiate between primary sclerosing cholangitis patients who died or were transplanted and those who were not, whereas age of the patients and other parameters did not. The taurocholic acid /taurochenodeoxycholic acid ratio fell during progression of primary biliary cirrhosis but rose in temporal relationship with primary sclerosing cholangitis. This differential pattern of change was unique compared with other clinical and laboratory indices. In conclusion, serum chenodeoxycholic acid levels and the cholic acid /chenodeoxycholic acid ratio in both diseases were independent indices that allowed for the prediction of survival or the need for liver transplantation. These indices are worthy of further examination in a larger group of patients as prognostic criteria for chronic cholestatic liver disease and in the assessment of the efficacy of therapeutic interventions, including liver transplantation.
Clinical and histological features of gastric antral vascular ectasia: Successful treatment with endoscopic laser therapy
Authors: NG IOL , LAI KC , NG M. 
Published: March 2008

ABSTRACTGastric antral vascular ectasia is a rare but important cause of chronic gastrointestinal bleeding. We report five patients in whom endoscopic laser therapy successfully controlled repeated blood loss. The patients were elderly (age range: 61–84 years; mean age: 75 years) and three of them were female. Endoscopically, all patients presented with a characteristic antral appearance of either ectatic vascular ‘stripes’ radiating out from the pylorus, or multiple cherry‐red spots. In all patients, the gastric mucosal biopsy specimens showed dilatation of the capillaries with focal fibrin thrombi and fibromuscular hyperplasia. Marked improvement of both endoscopic and histological features was achieved with endoscopic laser treatment using Nd‐YAG laser photocoagulation. Its importance lies in its recognition and successful treatment with endoscopic laser therapy, which offers an effective and relatively safe alternative to surgery, particularly in elderly patients.
Polymerase chain reaction diagnosis of Helicobacter pylori in gastroduodenal diseases: Comparison with culture and histopathological examinations
Authors: LIN SHYR‐YI , JENG YEONG‐SHAN , WANG CHUNG‐KWE , KO FU‐TSONG , LIN KUANG‐YANE , WANG CHAUR‐SHINE , LIU JEAN‐DEAN , CHEN PAO‐HUEI , CHANG JAN‐GOWTH 
Published: March 2008

ABSTRACT Helicobacter pylori has been associated with a variety of upper gastrointestinal diseases. Histopathological examination and culture are considered to be the more specific tests in the diagnosis of H. pylori infection. In the present study, we evaluated the efficiency of a polymerase chain reaction (PCR) assay of the H. pylori urease A gene as a procedure in the diagnosis of gastric H. pylori infection in various gastroduodenal diseases. Biopsy specimens were obtained from the antral mucosa of 83 patients during endoscopic examination and were submitted to three tests for the detection of H. pylori infection. The detection rates of H. pylori using PCR, histopathological examination and culture were 84, 77 and 63%, respectively. When the infection was defined, by the agreement of culture and histopathological examination or by positive culture, the PCR assay had a sensitivity of 98.1% and a specificity of 84.6%. When the infection was defined by a positive result of either two of the three tests or by positive culture, the PCR assay had a sensitivity of 98.6% and a specificity of 85.7%. We conclude that the PCR assay is a valuable test for the diagnosis of H. pylori infection in gastroduodenal diseases.
The transjugular intrahepatic portosystemic stent‐shunt: A review of the literature and own experiences
Authors: RÖSSLE M. , HAAG K. , BLUM HE 
Published: March 2008

ABSTRACTThe transjugular intrahepatic portosystemic stent‐shunt (TIPS) technique consists of a transhepatic puncture of the portal vein and stenting of the parenchymal tract between the hepatic and portal veins. Complications of both puncture and stenting are observed in approximately 5% of procedures. Most of the complications are without clinical consequences and the procedural mortality is very low in experienced hands (1%). During a 1 year follow up, 35% of patients were seen to develop stenosis and 15% developed occlusion of the stent‐shunt. However, in spite of the considerable incidence of stenosis/occlusion, the rate of variceal rebleeding is rare when patients are followed up carefully by duplex sonography, which allows accurate and early detection of shunt insufficiency. One of the major long‐term clinical problems of TIPS is the induction or worsening of hepatic encephalopathy. Although most patients respond to medical treatment, some develop debilitating encephalopathy or progressive liver failure. In these patients, reduction of shunt flow by the implantation of a reducing stent, or its occlusion with a balloon catheter, may be indicated. In conclusion, in spite of many complications, TIPS is relatively safe and efficient and hepatic encephalopathy is manageable in most cases.
Pedunculated extraluminal leiomyoma of the sigmoid colon
Authors: DAVID SURESH S. , SAMUEL JOSEPH J. 
Published: March 2008

ABSTRACTLeiomyoma of the colon is an extremely rare entity. Reports are those of sessile intraluminal lesions that are accessible to colonoscopy. This is a case report of a pedunculated extraluminal leiomyoma of the sigmoid colon which has not been previously reported.
Bile acids produce a generalized reduction of the catalytic activity of cytochromes P450 and other hepatic microsomal enzymes in vitro: Relevance to drug metabolism in experimental cholestasis
Authors: CHEN JIEZHONG , FARRELL GEOFFREY C. 
Published: March 2008

AbstractIn bile duct‐ligated male rats, there is a reduction of total hepatic microsomal cytochrome P450 (P450) levels and of NADPH‐cytochrome P450 reductase (P450‐reductase) activity, but the changes in activity of individual microsomal enzymes are nonuniform. We have proposed that the initial effect of cholestasis on microsomal proteins is a non‐specific reduction caused by bile acid‐mediated destruction, whereas the disproportionate lowering of male‐specific P450 enzymes results from secondary down‐regulation of some cytochrome P450 (CYP) genes. We report herein the results of experiments to test the first part of this hypothesis, at least as indicated by enzyme inhibition. Hepatic microsomal fractions from normal male rats were incubated at 37°C with increasing concentrations of a range of bile acids selected for their varying physicochemical properties. The endpoints were catalytic activity of three individual CYP proteins, CYP 2A1 (measured as testosterone 7α‐hydroxylase activity), 2C11 (testosterone 2α‐hydroxylase and 16α‐hydroxylase) and 3A2 (testosterone 6β‐hydroxylase), and the non‐CYP enzymes, steroid 17β‐dehydrogenase and P450‐reductase. With 0.25 mmol/L cholic acid, a concentration exceeded in serum following bile duct ligation, there was a significant reduction in the activity of all enzymes at 4 h. Cholic acid‐mediated inhibition was dose‐dependent and there was no difference in inhibitory activity towards the male sex‐dependent CYP 2C11 and 3A2 and the non‐sex‐dependent CYP 2A1 and other microsomal enzymes. Taurocholic acid was twice as potent an inhibitor as unconjugated cholic acid, the respective apparent I50 values being ∼0.6 mmol/L compared with ∼1.2 mmol/L. The dihydroxy bile acids, chenodeoxycholic acid and deoxycholic acid, were also more potent inhibitors than cholic acid, exhibiting I50 values in the range of 0.3–0.5 mmol/L, but the monohydroxy bile acid, lithocholic acid, was the most potent inhibitor (I50∼0.2 mmol/L). Thus, the inhibitory potential of bile acids towards microsomal enzymes was inversely related to their extent of hydroxylation, while taurine conjugation enhanced the inhibitory potential of cholic acid. These data confirm the potential of bile acids to inhibit the activity of microsomal enzymes in livers of bile duct‐ligated rats and indicate that such changes can occur with concentrations of bile acids that are physiologically relevant. Further, the results are consistent with the proposal that the disproportionately greater reduction of the male sex‐dependent CYP, 2C11 and 3A2, is not explained by a destructive mechanism.
Treatment with a novel lipid A analogue, FS‐112, and partial hepatectomy causes submassive liver necrosis and impaired liver regeneration in mice
Authors: MAEDA T , OHNISHI H , HAYASHI T , ISHIKI Y , MORIWAKI H , MUTO Y 
Published: March 2008

ABSTRACTA novel experimental model of submassive liver necrosis with impaired regeneration has been established. A novel lipid A analogue, FS‐112, was injected intravenously into male BALB/c mice, followed 2 days later by a 70% partial hepatectomy. Over the next 9 days, mice became severely jaundiced, with a peak total bilirubin (TBil) concentration of (mean±s.d.) 12.9±2.1 mg/dL 7 days postoperatively. In contrast, the TBil concentration in vehicle‐treated mice remained less than 2 mg/dL. Significant elevations of L‐alanine:2‐oxoglutarate aminotransferase (ALT) were also observed 3–7 days after the operation in mice pretreated with FS‐112, compared with mice pretreated with the vehicle. Submassive liver necrosis was observed with extensive mononuclear cell infiltration in mice treated with FS‐112 and subjected to partial hepatectomy. Furthermore, both the BrdU and the proliferating cell nuclear antigen (PCNA) labelling index (LI) 1 day following partial hepatectomy in mice pretreated with FS‐112 (8.6±4.3 and 7.9±4.2%, respectively) were significantly lower than levels in vehicletreated mice (25.8±3.8 and 26.5±10.5%, respectively). The time course of changes in the BrdU LI in liver specimens from mice treated with both FS‐112 and partial hepatectomy did not increase, even 3, 5, and 7 days postoperatively. Excellent liver regeneration with a PCNA LI 10‐fold higher than the resting level was observed in mice treated with D‐galactosamine hydrochloride. These results strongly suggest that this animal model of submassive liver necrosis may be suitable for clarifying the mechanisms of impaired liver cell regeneration often seen in fulminant hepatitis.
Serum procarboxypeptidase B, amylase and lipase in chronic renal failure
Authors: CHEN CHUN‐CHIA , WANG SUN‐SANG , CHEN TZEN‐WEN , JAP TJIN‐SHING , CHEN SHEN‐JYH , JENG FONG‐SHYA , LEE SHOU‐DONG 
Published: March 2008

ABSTRACTProcarboxypeptidase B (human pancreas‐specific protein) has been reported to be a good serum marker for the diagnosis of acute pancreatitis. The current study was conducted in order to evaluate the frequency and degree of elevated serum levels of procarboxypeptidase B in chronic renal failure and their correlations with serum levels of amylase, lipase and renal function tests. Blood samples were taken from 84 asymptomatic patients with chronic renal failure, including 34 patients with periodical haemodialysis and 50 patients without haemodialysis. Serum levels of procarboxypeptidase B, amylase, lipase, creatinine and blood urea nitrogen were measured. Serum levels of procarboxypeptidase B in 84 patients were 63.4±5.5 μg/L significantly greater than the figure of 29.6±1.6 μg/L in healthy adults in our previous report (P< 0.0001). There was a significant difference in serum levels of PCPB between patients with and without haemodialysis (78.0±9.4 vs 53.6±6.3 μg/L; P< 0.01). The frequencies of elevated serum levels of procarboxypeptidase B, amylase and lipase greater than upper normal limits were 27.4, 35.7 and 26.2%, respectively. The frequencies of elevated PCPB in patients with and without haemodialysis were 38.2 and 20%, respectively. Only one patient had a serum procarboxypeptidase B level greater than three‐fold the upper normal limit. A significant correlation was found between procarboxypeptidase B and lipase (r = 0.785; P< 0.0001). No significant correlation was noted between procarboxypeptidase B vs amylase or renal function tests. In conclusion, in patients with chronic renal failure, the elevation of serum procarboxypeptidase B is as common as the elevations of other pancreatic enzymes.