bluuebunny/crossref_metadata_2025_split huggingface dataset:
Review article: can post‐operative recurrence in Crohn's disease be prevented?
Authors: LÉMANN M. 
Published: August 2006

SummaryThe decision regarding prophylactic treatment after surgery in Crohn's disease (CD) requires a good estimation of the risk of recurrence. It is also important to consider the consequences of recurrence for the patient, and the risks and benefits of treatment, bearing in mind that it will be given over a long period.Several drugs have been tried to decrease the risk of recurrence. Corticosteroids and budesonide have proved to be ineffective. Mesalazine has significant efficacy in some, but not all trials, and a meta‐analysis has established that it decreases the absolute risk by 10–15% after 1–2 years. Mercaptopurine seemed to be effective in a recent study. Metronidazole and ornidazole have significant efficacy, but cannot be tolerated for long periods. Probiotics represent a new approach, but evidence for their efficacy in CD is still lacking.In the past, the strategy was to give no treatment until clinical recurrence. Another approach is to give no treatment, and then to treat the patient according to severity of endoscopic recurrence. Alternative strategies include treating all patients with mesalazine until either severe endoscopic or clinical recurrence occurs, and then to use azathioprine/mercaptopurine, or to give azathioprine/mercaptopurine immediately, especially in high‐risk patients.
Review article: recurrence of Crohn's disease after surgery – the need for treatment of new lesions
Authors: RUTGEERTS P. 
Published: August 2006

SummaryCrohn's recurrence is the appearance of objective signs – defined radiologically, endoscopically or pathologically – of Crohn's disease in the bowel of a patient who has previously had a resection of all macroscopically diseased tissue.New lesions can be visualized endoscopically within weeks to months after ileal resection and ileocolonic anastomosis in the neoterminal ileum. The evolution of these lesions mimics the natural history of ileal Crohn's disease at the onset. If we are able to prevent recurrence of early lesions, we will probably interrupt the natural course of the disease.The drugs tested to date include different 5‐aminosalicylate formulations, nitro‐imidazole antibiotics, steroids and azathioprine. None of these therapies has convincingly been shown to prevent recurrent lesions. Metronidazole and ornidazole are effective, but cannot be used in the long‐term because of side effects.Since there is a lag time of months to years between the development of recurrent lesions in the bowel and the recurrence of symptoms, we recommend performing imaging of the bowel 6 months after the operation to assess the severity of recurrence, and basing the further treatment strategy on this assessment.
Review article: should we treat symptoms or lesions in Crohn's disease? The case for treating symptoms
Authors: SCHÖLMERICH J. 
Published: August 2006

SummaryApart from treating symptoms, mucosal healing is a reasonable aim of therapy in Crohn's disease. In most patients, however, the disease takes a mild course and treating symptoms seems sufficient. Eliminating lesions may change the course of the disease long‐term but this has not yet been proven. Thus far we need to treat symptoms efficiently and may attempt to restore bacterial epithelial interaction.
Review article: aminosalicylates for distal colitis
Authors: GIONCHETTI P. , RIZZELLO F. , MORSELLI C. , TAMBASCO R. , CAMPIERI M. 
Published: August 2006

SummaryAbout two‐thirds of patients with ulcerative colitis have an inflammatory involvement distal to the splenic flexure and therefore may be effectively treated with topical treatment. This allows the delivery of the active drug directly to the site of inflammation, limiting the systemic absorption and the potential side effects.Topical aminosalicylate therapy is the most effective approach, provided that the formulation reaches the upper extent of the disease. Suppositories should be considered the treatment of choice for proctitis and distal sigmoiditis. A 1 g Pentasa‐suppository once daily induces a quicker clinical and endoscopic remission and was better tolerated than a 500‐mg suppository twice daily. Enemas, foams and gel, thanks to their proximal spread, should be the treatment of choice for proctosigmoiditis and left‐sided colitis.Oral aminosalicylates are less effective than topical therapies for patients with active disease; however, a combination of oral and topical aminosalicylates can be successfully tried in refractory patients.Topical aminosalicylates also play an important role in the maintenance of remission, and the combination of oral plus rectal 5‐aminosalicylate is superior to the single agent. Patients who prefer not to continue on long‐term rectal therapy can be treated with oral aminosalicylates.
Review article: how to control and improve adherence to therapy in inflammatory bowel disease
Authors: LÓPEZ‐SANROMÁN A. , BERMEJO F. 
Published: August 2006

SummaryAny chronic disease is a risk situation for non‐adherence to treatment. This results in suboptimal medication, and poor disease control. Adherence and compliance are directly related to therapeutic success, which is further complicated in inflammatory bowel disease patients.There is a wide array of circumstances that increase the likelihood of non‐compliance in a given patient: difficult‐to‐follow treatment schedules (multiple doses and multiple drugs), insufficient patient information, longer evolution of the disease and inactive disease. Depression, male gender, active employment and living alone are also associated with poorer adherence to therapy.Monitoring drug intake is possible in many circumstances, directly or indirectly (urinary salicylate levels; erythrocyte metabolites and increased mean corpuscular volume and bilirubin in patients under azathioprine; blood levels of ciclosporin or tacrolimus). However, such measures are probably better utilized for dose adjustment and not for the identification of non‐compliant patients. High‐risk patients are a target group in which pre‐emptive intervention could ensure better compliance.If the question of non‐adherence arises, for instance, as a possible cause of therapy failure, the patient should be carefully approached. This should take into consideration factors that may be corrected and, most importantly, should aim at building a better patient–doctor relationship.
Review article: what are the important endoscopic lesions for detection of dysplasia in inflammatory bowel disease?
Authors: GEBOES K. 
Published: August 2006

SummaryIt is recognized that inflammatory bowel diseases predispose to colorectal adenocarcinoma. Early detection of precursor lesions and subsequent treatment may prevent cancer development and this is possible with colonoscopy and biopsy.Inflammatory bowel disease‐associated precursor lesions (dysplasia = intraepithelial neoplasia) must be distinguished from sporadic adenomas, occurring in non‐colitic mucosa.Macroscopic lesions suspected of harbouring precursor lesions include irregular ‘polypoid or elevated’ lesions, which are usually broad‐based and ‘flat’ lesions. Flat lesions are more common than elevated lesions and they are usually smaller.Chromoendoscopy increases the detection rate substantially as it allows targeted biopsies from suspicious lesions that increase the diagnostic yield of dysplasia.Ultimately, the combination of chromoendoscopy, or more advanced endoscopic techniques, and targeted biopsies may become the standard approach, rather than random biopsy sampling.
Review article: saving the colon in severe colitis – the case for medical therapy
Authors: TRAVIS S. 
Published: August 2006

SummaryThe choice between ciclosporin (CsA), infliximab (IFX) and surgery for severe colitis not responding to intensive intravenous treatment, is challenging. With the advent of vislizumab and alternatives such as tacrolimus or leucocytapheresis, decisions will get harder.This article reviews the evidence for each intervention, draws attention to disparities in the definition of severe colitis between different trials and gives practical guidance.Early medical decision making is critical. Standard intensive treatment with intravenous steroids is still the first‐line approach. Progress should be monitored objectively using a simple predictive index. Rescue therapy with CsA (oral 5 mg/kg or 2 mg/kg iv) or IFX (5 mg/kg) should be started on the third day of intensive treatment if predictive factors are poor (e.g. C‐reactive protein > 45 mg/L).Physicians should discuss with their patients that there is just one attempt at rescue therapy, because only one patient death, as a consequence of delayed colectomy, changes the balance of benefit between medicine and surgery.
Review article: colon‐saving medical therapy vs. colectomy in ulcerative colitis – the case for colectomy
Authors: ÖRESLAND T. 
Published: August 2006

SummaryIn the era of expanding medical therapy for ulcerative colitis, surgery is still a very valid option in those patients, where medicine is not able to control symptoms, both in the acute and chronic stages, and also for those at risk of developing a cancer.The ileal pouch–anal anastomosis (IPAA) will, for the vast majority of patients, give a very acceptable functional outcome. There is a risk of surgical complications and pouchitis; however, mortality is very low and compares well with medical therapy. Reduced female fertility is a concern but compared with the preoperative state, overall sexual function is largely improved.The ileorectal anastomosis is undergoing a revival and can be used especially in the case of female fertility concerns.Either the continent ileostomy or a conventional ileostomy is an option for those 10–15% of patients who will eventually experience pouch failure, usually either because of septic complications or an unacceptable bowel function.Quality of life following both these options, and IPAA, is excellent and does not differ from that of the matched background population.
Review article: biological drugs in Crohn's disease
Authors: KAMM M. A. 
Published: August 2006

SummaryBiological drugs have opened new therapeutic horizons for treating Crohn's disease (CD), but have also brought with them issues related to immunogenicity, long‐term efficacy, safety and cost.At present, inhibitors tumour necrosis factor and adhesion molecules are the most advanced in use and development.When treating luminal disease with infliximab, two‐thirds of patients respond initially. The ACCENT 1 study demonstrated that 28% of initial responders are in remission for 1 year. Infliximab has also had a major impact on the management of Crohn's anorectal fistulas. The ACCENT 2 study demonstrated initial response in two‐thirds of patients. One‐fifth of all treated patients were healed at 1 year. Infliximab diminished the need for further surgery.Magnetic resonance imaging scanning allows the extent of deep healing to be assessed and may influence the duration of treatment. The Mayo Clinic experience in 500 patients demonstrated 6% serious adverse events related to infliximab. The TREAT registry will provide long‐term safety data on a larger group of patients. Concurrent immunosuppressive drugs and pre‐infusion steroids can decrease antibody formation to infliximab. Screening for tuberculosis (TB) diminishes the rate of TB activation.Biological drugs can offer great therapeutic benefit, but their use must be considered in context.
Oral V2 receptor antagonist (RWJ‐351647) in patients with cirrhosis and ascites: a randomized, double‐blind, placebo‐controlled, single ascending dose study
Authors: THULUVATH P. J. , MAHESHWARI A. , WONG F. , YOO H. W. , SCHRIER R. W. , PARIKH C. , STEARE S. , KORULA J. 
Published: August 2006

SummaryBackgroundRWJ‐351647 is a selective V2 receptor antagonist that inhibits vasopressin‐induced water reabsorption in the kidney.AimTo investigate the safety and tolerability of RWJ‐351647 compared with placebo after single oral dose administration to patients with cirrhosis and ascites, on a stable treatment with furosemide and spironolactone.MethodsSingle oral doses of 1, 2 and 5 mg of RWJ‐351647 were administered to 24 patients with ascites on stable concomitant diuretic treatment.ResultsRWJ‐351647 had a tmax of 1 to 1.1 h and mean half‐life of 10.4–17.4 h. There was no affect on the pharmacokinetics of concomitant diuretics. Increases in cumulative urine volume and free water excretion, and a decrease in urine osmolality were noted in a dose‐dependent manner reaching the statistical significance at the 5‐mg dose. Four patients exhibited a decrease of >2 kg in weight in the 24 h after dosing. RWJ‐351647 was well tolerated, with no evidence of a dose‐related increase in adverse events when compared with placebo. No changes in either serum chemistry or plasma AVP (arginine vasopressin) and renin levels were observed despite the observed aquaresis.ConclusionRWJ‐351647 is an effective aquaretic causing dose‐dependent increases in urine output and free water clearance, when co‐administered with conventional diuretics in patients with cirrhosis and ascites.
Alterations in peripheral blood lymphocyte cytokine expression in obesity
Authors: O'Rourke R W , Kay T , Lyle E A , Traxler S A , Deveney C W , Jobe B A , Roberts C T , Marks D , Rosenbaum J T 
Published: August 2006

Summary
Obesity is characterized by alterations in immune and inflammatory function. In order to evaluate the potential role of cytokine expression by peripheral blood mononuclear cells (PBMC) in obesity-associated inflammation, we studied serum protein levels and mRNA levels in PBMC of interleukin (IL)-6, IL-1β, tumour necrosis factor (TNF)-α and IL-1Ra in nine lean and 10 obese subjects. Serum IL-1β was undetectable, IL-1Ra serum levels were elevated, serum levels of TNF-α were decreased and serum levels of IL-6 were similar in obese subjects compared to lean subjects, while transcript levels of IL-6, IL-1β and TNF-α, but not IL-1Ra, were decreased in PBMC from obese subjects. PBMC from obese subjects did, however, up-regulate cytokine expression in response to leptin. Thus, obesity-associated changes in IL-1Ra serum levels and IL-6 mRNA levels were not correlated with changes in cognate mRNA and serum levels, respectively, while TNF-α serum levels and PBMC mRNA levels were both decreased in obese patients. While immune alterations in obesity are manifest in peripheral blood lymphocytes, the general lack of correlation between altered serum levels and altered PBMC gene expression suggests that PBMC may not be the source of aberrant serum cytokine levels in obesity.
Coincidence of different structures of mucosa-associated lymphoid tissue (MALT) in the respiratory tract of children: no indications for enhanced mucosal immunostimulation in sudden infant death syndrome (SIDS)
Authors: Debertin A S , Tschernig T , Schürmann A , Bajanowski T , Brinkmann B , Pabst R 
Published: August 2006

Summary
Mucosa-associated lymphoid tissue (MALT) is the principal inductive site for mucosal immune responses that are capable of T and B cell responses and antigen-specific responses. In previous independent studies different structures of MALT, e.g. bronchus-, larynx- and nose-associated lymphoid tissue (BALT, LALT, NALT) have been described separately in various frequencies in the human respiratory tract over life spans. Because upper respiratory tract infections are common in infants, dysregulations of mucosal immune responses might be seriously involved in the aetiology of sudden infant death syndrome (SIDS). In the present study the coincidental occurrence of the three different MALT structures in the respiratory tract within the same patients were studied, and cases of SIDS and children who had died from different traumatic and natural causes of death (non-SIDS) were compared. First, the frequency of BALT and LALT in 46 children (35 SIDS, 11 non-SIDS) with or without NALT were examined. A tendency was found of a coincidence of respiratory MALT structures. In 50 additional cases of infant death (30 SIDS, 20 non-SIDS) from the multi-centric German Study on Sudden Infant Death Syndrome (GeSID) where death had occurred in the first year of life, the coincidence was evaluated. A coincidental occurrence of BALT, LALT and NALT or BALT and LALT (each about 30%) was found in both groups, whereby the coincidence in SIDS and the control patients did not differ. Interestingly, the children with coincidental MALT were strikingly older, supporting the hypothesis of respiratory MALT formation via environmental stimulation over time.
Role of Th1-stimulating cytokines in bacillus Calmette–Guérin (BCG)-induced macrophage cytotoxicity against mouse bladder cancer MBT-2 cells
Authors: Luo Y , Yamada H , Evanoff D P , Chen X 
Published: August 2006

SummaryPreviously, we have demonstrated that macrophages exhibited cytotoxicity toward mouse bladder cancer MBT-2 cells upon bacille Calmette–Guérin (BCG) stimulation. In this study, we have investigated the role of Th1-stimulating cytokines in BCG-induced macrophage cytotoxicity. Thioglycollate-elicited peritoneal exudate cells (PECs) were used as a conventional source for macrophages and the induction of PEC effector functions (cytolytic activity and cytokine production) by BCG was evaluated in vitro. The BCG-activated PECs showed potent cytotoxicity and killed MBT-2 cells in a dose-dependent manner. Depletion of T cells, natural killer (NK) cells, or both, in PEC preparations exhibited a marginal or small reduction of MBT-2 cell killing, suggesting that macrophages played a primary role in PEC cytotoxicity. Transwell assays indicated that the maximal PEC cytotoxicity required both direct cell–cell contact and soluble factors such as interferon (IFN)-γ and tumour necrosis factor (TNF)-α. Neutralizing endogenous cytokines interleukin (IL)-12, IL-18, IFN-γ or TNF-α reduced PEC cytotoxicity by 38%, 22%, 15% and 94%, respectively. Supplementation of BCG with recombinant (r)IL-2, rIL-12 or rIL-18 increased PEC cytotoxicity by approximately twofold. Compared with control BCG for PEC stimulation, rBCGs expressing IL-2 or IL-18 showed enhanced MBT-2 cell killing by PECs. Increased cytokine production (IFN-γ, TNF-α and IL-6) was also observed in rBCG-stimulated PEC cultures. Taken together, these results suggest that Th1-stimulating cytokines play an important role in BCG-induced macrophage cytotoxicity and that combination of BCG with selected Th1-stimulating cytokines, either supplemented or expressed by BCG, may enhance the effect of BCG in the treatment of bladder cancer patients.
Post-translational modifications of the major linear epitope 169–190aa of Ro60 kDa autoantigen alter the autoantibody binding
Authors: Terzoglou A G , Routsias J G , Moutsopoulos H M , Tzioufas A G 
Published: August 2006

SummaryRo60 kDa is a member of the Ro/LaRNP ribonucleoprotein complex and its major linear B cell epitope, corresponding to the region 169–190aa, has been found to be the initial target of the autoimmune response in patients with systemic lupus erythematosus. This sequence contains one serine and two arginine amino acid residues, which can potentially be modified post-translationally by phosphorylation or citrullination, respectively. The aim of this study was to develop an immunoassay for anti-Ro60 kDa epitope antibody detection and to investigate the changes in the antigenicity of the Ro60 kDa epitope when it is post-translationally modified, by either citrullination or phosphorylation. Peptide analogues corresponding to the unmodified form of the epitope, its phosphorylated form, and a form with both arginine residues citrullinated were synthesized. The peptide coating conditions were investigated and it was found that the use of highly hydrophilic surfaces increase the efficiency of the coating, as well as the sensitivity of the method for anti-peptide antibody detection. All peptides were tested by the optimized enzyme-linked immunosorbent assay (ELISA) against 119 sera from patients with primary Sjögren's syndrome, systemic lupus erythematosus and rheumatoid arthritis with anti-Ro/SSA reactivity, 20 sera from patients with systemic diseases without anti-Ro/SSA immune reactivity, as well as against 65 sera from normal individuals. A large proportion of the tested sera reacted against all three peptide analogues, although with a preference for the unmodified form of the epitope. In conclusion, post-translational modifications of the major Ro60 kDa B cell epitope can alter the autoantibody binding.
The role of the cellular prion protein in the immune system
Authors: Isaacs J D , Jackson G S , Altmann D M 
Published: August 2006

SummaryPrion protein (PrP) plays a key role in the pathogenesis of prion diseases. However, the normal function of the protein remains unclear. The cellular isoform (PrPC) is expressed widely in the immune system, in haematopoietic stem cells and mature lymphoid and myeloid compartments in addition to cells of the central nervous system. It is up-regulated in T cell activation and may be expressed at higher levels by specialized classes of lymphocyte. Furthermore, antibody cross-linking of surface PrP modulates T cell activation and leads to rearrangements of lipid raft constituents and increased phosphorylation of signalling proteins. These findings appear to indicate an important but, as yet, ill-defined role in T cell function. Although PrP–/– mice have been reported to have only minor alterations in immune function, recent work has suggested that PrP is required for self-renewal of haematopoietic stem cells. Here, we consider the evidence for a distinctive role for PrPC in the immune system and what the effects of anti-prion therapeutics may be on immune function.
Methionine‐rich storage protein gene in the rice stem borer, Chilo suppressalis, is expressed during diapause in response to cold acclimation
Authors: Sonoda S. , Fukumoto K. , Izumi Y. , Ashfaq M. , Yoshida H. , Tsumuki H. 
Published: August 2006

AbstractGene expressions of acclimatized and non‐acclimatized diapausing larvae were examined in Chilo suppressalis using a subtraction technique. A gene encoding a methionine‐rich storage protein, CsSP1, was cloned and its complete cDNA sequence was determined. Potentially, CsSP1 encoded a 758‐amino acid protein, with a calculated molecular weight of 88.8 kDa. The expression level of CsSP1 was higher in nondiapausing larvae than in diapausing ones. The CsSP1 expression was up‐regulated in diapausing larvae when the temperature of cold acclimation was shifted to 5 °C. The up‐regulated level was maintained at 40 days after incubation at 5 °C. In nondiapausing larvae, CsSP1 expression was down‐regulated when the temperature was below developmental zero. Involvement of CsSP1 in diapause, cold tolerance acquisition and postdiapause development in C. suppressalis is discussed.
Rehydration properties of dried plant tissues
Authors: Witrowa‐Rajchert Dorota , Lewicki Piotr P. 
Published: August 2006

SummaryApples, carrots and potatoes cut in cubes were dried by convection and then subjected to rehydration in water at room temperature. Mass and volume changes were followed during rehydration. A minimal displacement gauge was used to record changes of height of individual cubes during wetting. Porosity of the dried material was calculated and its changes during rehydration were observed. Comparing volume increase with mass gain during rehydration it was found that the mechanism of water imbibing is strongly influenced by porosity and chemical composition of the dried material. Dried apple was very porous, hence its mass gain was much faster than the volume increase. On the other hand, gelatinised starch in dried potato strongly absorbed water and the volume increase outpaced the mass gain. Recording changes of height of the dried cubes upon rehydration evidenced phase changes and injury incurred to the tissue structure by dehydration. In apple a collapse of structure was observed, while potato cubes swelled from the very beginning of the wetting process. In carrot instantaneous changes of height of the cube were observed, which could be due to relaxation of shrinkage stresses and displacements of injured tissue structures.