bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of mosapride on gastrointestinal transit time and diagnostic yield of capsule endoscopy
Authors: Wei Wei , Ge Zhi‐Zheng , Lu Hong , Gao Yun‐Jie , Hu Yun‐Biao , Xiao Shu‐Dong 
Published: August 2007

AbstractBackground and Aim: Since its introduction, capsule endoscopy (CE) has made it possible to visualize the small intestine mucosa directly. However, owing to the limited battery life, only 60–80% of the capsules could reach the cecum and would possibly affect the diagnostic yield. The aim of this study was to determine the effect of oral mosapride on gastrointestinal transit time and the diagnostic yield of CE.Method: Sixty patients were involved in this randomized, prospective and controlled study. The patients were randomly allocated to groups receiving either mosapride citrate or nothing. Patients in the mosapride group (n = 30) received 10 mg mosapride citrate 1 h before CE examination, while patients in the control group (n = 30) received no preparation. The gastrointestinal transit time, the number of CE reaching the cecum, and the diagnostic yield of each group were assessed in a single‐blinded fashion.Result: Gastric emptying time was significantly shorter in the mosapride group than in the control group (13.5 minvs34 minP = 0.035). Compared with the control group, the complete transit rate was significantly higher in the mosapride group (93.3%vs66.7%P = 0.021). There was no significant difference between the two groups on the small bowel transit time and diagnostic yield.Conclusion: Mosapride citrate accelerates the gastric emptying and completion rate of small bowel examination in patients undergoing CE.
Zonation of multidrug resistance‐associated protein 2 in rat liver after induction with dexamethasone
Authors: Micuda Stanislav , Fuksa Leos , Brcakova Eva , Osterreicher Jan , Cermanova Jolana , Cibicek Norbert , Mokry Jaroslav , Staud Frantisek , Martinkova Jirina 
Published: August 2007

AbstractBackground and Aim:  The present study was aimed to evaluate the hepatic zonation of multidrug resistance‐associated protein 2 (mrp2), an important drug transporter, and its potential changes during the induction of its expression by known inducer, dexamethasone (DEX).Methods:  The hepatic expression of mrp2 was studied by immunohistochemistry with consequent quantification by measurement of integral optical densities of mrp2 staining in the periportal and perivenous areas of the liver acinus in control and DEX‐pretreated rats (1 mg/kg daily per os for 4 days). Overall changes in mrp2 expression and function produced by DEX were monitored using Western blotting and an in vivo clearance study of endogenous‐conjugated bilirubin, a mrp2 substrate.Results:  In the control animals, a quantitative image analysis revealed the primary periportal localization of mrp2 within the liver acinus with the expression of mrp2 being 16.7‐fold of that in the perivenous area. After DEX pretreatment, the expression of mrp2 increased, especially in the perivenous hepatocytes. The overall expression of mrp2 increased 3.2‐fold in comparison with the control group. This observation was confirmed by Western blotting, which showed a 1.3‐fold increase in the mrp2 protein after DEX pretreatment. The functional consequences of the induced mrp2 protein in the livers of the DEX‐pretreated rats were demonstrated by the increased biliary excretion of conjugated bilirubin.Conclusion:  In conclusion, these results indicate the zonation of mrp2 protein expression primarily to periportal hepatocytes. The induction by DEX produced spatially disproportional changes with an increase in the mrp2 protein being most prominent in the perivenous hepatocytes.
Comparison of three current staging systems for hepatocellular carcinoma: Japan integrated staging score, new Barcelona Clinic Liver Cancer staging classification, and Tokyo score
Authors: Chung Hobyung , Kudo Masatoshi , Takahashi Shunsuke , Hagiwara Satoru , Sakaguchi Yasuhiro , Inoue Tatsuo , Minami Yasunori , Ueshima Kazuomi , Fukunaga Toyokazu , Matsunaga Takashi 
Published: August 2007

AbstractBackground and Aim:  Although various staging systems for hepatocellular carcinoma (HCC) have been developed in recent years, there is no worldwide consensus which staging system is best. The aim of the present study was to compare the performance of the currently developed three staging systems: the Japan integrated staging (JIS) score, new Barcelona Clinic Liver Cancer (BCLC) staging classification, and the Tokyo score.Methods:  A total of 290 consecutive patients with HCC before initial treatment at Kinki University between January 1999 and December 2001 were included. The patients were stratified according to the three staging systems, and the performance of the staging systems was compared using survival time as the only outcome measure.Results:  There were significant differences between all stages in the JIS score, while no significant difference was found between stages C and D in the BCLC staging classification and between all the scores, except between scores 0 and 1 and 2 and 3 in the Tokyo score. For all patients (n = 290), the radical treatment group (n = 208) and the non‐radical treatment group (n = 82), the likelihood ratio χ2‐test showed the highest value, and the Akaike information criterion value was lowest in the JIS score.Conclusion:  The JIS score provided the best prognostic stratification in a Japanese cohort of HCC patients who were mainly diagnosed at early stages and treated with radical therapies.
Major complications of ultrasound‐guided percutaneous radiofrequency ablations for liver malignancies: Single center experience
Authors: Chen Tsung‐Ming , Huang Pi‐Teh , Lin Lien‐Fu , Tung Jai‐Nien 
Published: August 2007

AbstractBackground and Aim:  Despite radiofrequency ablation (RFA) for malignant liver nodular lesions having promising therapeutic effects, the trade‐off between the risks and benefits must be acceptable. This study analyzed the major complications of ultrasound (US)‐guided percutaneous RFA procedures encountered at a single center, by a single physician.Methods:  A total of 104 patients (total 183 tumors) underwent 172 US‐guided percutaneous RFA sessions between May 2003 and March 2006. The definition of major complications was according to the standardized Society of Interventional Radiology grading system (classification C‐E).Results:  Eighty‐six patients had hepatocellular carcinoma (HCC) and 18 patients had hepatic metastatic tumors. Nine major complications occurred from 172 RFA sessions (9/172, incidence of 5.2% per session); namely, two cases of transient liver function impairment, two cases of infection (liver abscess and septicemia), two cases of tumor seeding along the ablated track, one case of colon perforation, one case of acalculous cholecystitis and, lastly, a case of hemocholecyst. We further analyzed the possible risk factors precipitating these complications, and found that only tumor size (Pearson's correlation coefficient, 0.324; P < 0.05) and baseline liver function reserve (compensated 0%, 0/148 vs decompensated 8.3%, 2/24; P = 0.019) were significant factors for the complication of transient liver function impairment.Conclusion:  Radiofrequency ablation for liver malignancy is a safe procedure with acceptable incidence of complications. Decompensated baseline liver function reserve and large tumor size are precipitating factors for transient liver function impairment after RFA and warrant a close follow up.
Expression of inducible nitric oxide synthase in the liver is under the control of nuclear factor kappa B in concanavalin A‐induced hepatitis
Authors: Ma Xue‐Lian , Li Yue‐Hua , Gao Jian‐Xin , Li Jing , Guo Lin , Wu Cui‐Zhen 
Published: August 2007

AbstractBackground and Aim:  Both nuclear factor kappa B (NF‐κB) activation and inducible nitric oxide synthase (iNOS) expression increase in the liver injury, and there are NF‐κB binding sites in the iNOS promoter. The aim of this study was to investigate the correlation between iNOS expression and NF‐κB activation in hepatitis induced by concanavalin A (con A).Methods:  Eighty‐eight male BALB/c mice were randomly divided into three groups: vehicle control group, con A group and pyrrolidine dithiocarbamate (PDTC) plus con A group. In the vehicle control group, the mice were treated with saline (0.3 mL, i.v.). In the con A group, the mice were treated with con A (20 mg/kg, i.v.). In the PDTC + con A group, the mice were pretreated with PDTC (120 mg/kg, i.p.) 30 min before administration of con A (20 mg/kg, i.v.). Blood samples were taken from the retro‐orbital venous plexus at 0.5, 1, 4, 8 and 16 h after con A injection and the mice were killed immediately. The plasma alanine aminotransferase (ALT) levels were measured by the standard photometric method. Nitric oxide (NO) levels in the liver homogenate were assayed by spectroscopy. Liver tissues were sectioned and stained with hematoxylin–eosin for histological examination. Activation of NF‐κB, degradation of inhibitor of kappa B alpha (IκBα), and expression of iNOS were measured by western blot.Results:  In the con A group, the plasma ALT activity and NO levels in the liver increased significantly at 1 h (P < 0.05, n = 8) and reached a peak at 4 h after con A injection. The liver injury in this group was characterized by liver necrosis, cell swelling and fatty degeneration. Cytosolic IκBα decreased slightly at 30 min after con A challenge, was undetectable at 1 h and reappeared at 4 h. Correspondingly, the NF‐κB level in the nucleus was highest at 1 h. The iNOS expression increased at 30 min after con A injection and reached a maximum at 4 h. Pretreatment with PDTC prevented these changes and attenuated the liver injury.Conclusion:  Con A‐induced iNOS expression in the liver is dependent on the activation of NF‐κB.
Predictive factors for platelet increase after partial splenic embolization in liver cirrhosis patients
Authors: Hayashi Hiromitsu , Beppu Toru , Masuda Toshiro , Mizumoto Takao , Takahashi Masashi , Ishiko Takatoshi , Takamori Hiroshi , Kanemitsu Keiichiro , Hirota Masahiko , Baba Hideo 
Published: August 2007

AbstractBackground and Aim:  Partial splenic embolization (PSE) is often performed for improving thrombocytopenia in cirrhotic patients. We investigated the largely unclear predictive factors for platelet increase at both 1 month and 1 year after PSE.Methods:  Aimed at increasing the platelet count, PSE was performed in 42 cirrhotic patients with thrombocytopenia (platelets < 80 × 104/mL) caused by hypersplenism. The clinical data were analyzed to clarify the predictive factors for platelet increase at 1 month (n = 42) and 1 year (n = 38) after PSE.Results:  The mean splenic infarction ratio was 76.7% ± 11.2%. The platelet count increased to 259% ± 112% and 228% ± 75% of the pretreatment values at 1 month and at 1 year after PSE, respectively. Stepwise multiple linear regression analysis showed that the infarcted splenic volume had a positive independent association with the increase in platelet count at both 1 month (P = 0.00004) and 1 year (P = 0.005) after PSE (increase in platelet count (×104/mL): at 1 month = 0.752 + 0.018 × infarcted splenic volume (mL), R2 = 0.344; at 1 year = 2.19 + 0.01 × infarcted splenic volume (mL), R2 = 0.203). Receiver operating characteristic analysis yielded a cut‐off value of 388 mL of infarcted splenic volume for achieving an increase of 5.0–8.0 × 104/mL in platelet count at 1 year.Conclusions:  PSE can reduce the platelet pool and induce an increase in platelet count. This increase is greatly dependent on the infarcted splenic volume.
Combination adefovir–lamivudine prevents emergence of adefovir resistance in lamivudine‐resistant hepatitis B
Authors: Van Der Poorten David , Prakoso Emilia , Khoo Teh‐Liane , Ngu Meng C , McCaughan Geoffrey W , Strasser Simone I , Lee Alice U 
Published: August 2007

AbstractBackground and Aim:  The outcomes of lamivudine‐resistant chronic hepatitis B patients treated with long‐term adefovir dipivoxil have not been well described. This study aims to characterize the virological and biochemical response and to determine factors that may influence the development of resistance to adefovir.Methods:  A retrospective review was conducted on all patients with lamivudine‐resistant chronic hepatitis B treated with adefovir for a minimum of 6 months at two tertiary referral centers.Results:  Data on 161 patients were analyzed. Seventy‐two percent achieved an initial virological response with eventual normalization of alanine aminotransferase in only 67% of patients. Seventeen patients developed adefovir resistance with cumulative resistance rates of 3.2%, 8.8%, and 18% at 12, 24, and 36 months, respectively. Twelve (71%) of these patients had a biochemical breakthrough, with one death from fulminant hepatic failure. The median duration of lamivudine crossover was 1 month in adefovir‐resistant patients, compared with 12 months for the remainder of the cohort (P < 0.01). Longer crossover therapy reduced the adefovir resistance rate, but did not eliminate it. No adefovir resistance is reported in those who were continued on long‐term combination lamivudine–adefovir without a period of adefovir monotherapy.Conclusions:  Combination lamivudine–adefovir therapy protected against the emergence of adefovir resistance.
Usefulness of human leucocyte antigen‐B27 subtypes in predicting ankylosing spondylitis: Taiwan experience
Authors: Hou T.‐Y. , Chen H.‐C. , Chen C.‐H. , Chang D.‐M. , Liu F.‐C. , Lai J.‐H. 
Published: August 2007

AbstractBackground:  Genetic factors are clearly attributed to the susceptibility of ankylosing spondylitis (AS). The human leucocyte antigen (HLA)‐B27 proved to be the very useful marker for diagnosing AS. The aim of this study was to determine the prevalence of HLA‐B27 subtypes in Taiwan and to investigate whether these subtypes may be of help in predicting the diagnosis of AS.Methods:  A total of 314 patients with AS and a control group of 71 subjects positive for HLA‐B27 detected by flow cytometry analysis were recruited for the study. HLA‐B27 subtypes were confirmed by the polymerase chain reaction‐sequence‐specific primers and sequence‐specific oligonucleotide probing.Results:  Four B27 alleles were identified: B*2704, B*2705, B*2706 and B*2707. HLA‐B*2704 was the predominant allele. There were significant differences in the distribution of HLA‐B27 subtypes between patients with AS and controls. Five of them who were homozygous for the B*2704 allele were solely found in AS group but not in controls. Statistical analysis showed that B*2704 was positively associated with AS, which suggested an increased possibility of having AS. Other HLA‐B27 subtypes showed no strong correlation with AS.Conclusion:  In the Taiwanese population, susceptibility to AS was determined by the presence of HLA‐B*2704. Although B*2706 was reported to have a negative association with AS in Taiwanese, Thai and Chinese Singaporean populations, we report, in our study, two AS patients with B*2706 (0.6%). Disease heterogeneity suggests that other than genetic background, many pathogenic factors could be associated with AS. This may need to be investigated with a larger group of patients with AS and controls.
Adverse effects of a multicentre system for ethics approval on the progress of a prospective multicentre trial of cancer treatment: how many patients die waiting?
Authors: Christie D. R. H. , Gabriel G. S. , Dear K. 
Published: August 2007

AbstractBackground: As cancer survival is improving approximately by 1–2% per year, delays in the clinical trials that lead to that improvement could cost lives.Aims: To review the process of ethics committee approval for a multicentre clinical trial of cancer treatment and to estimate the delay it will cause in obtaining the results and the effects of such delays on survival for all cancers in Australia.Methods: A survey was sent to each of the 15 centres participating in the study to obtain details about submissions they had made to their ethics committees and the replies received from them.Results: The survey response rate was 100%. The average time required to complete an ethics submission was 12 h, and the average length of time for a final reply was 70 days. Wide variation was noted in the replies, 40% were considered constructive. Most centres said the effort in ethics submissions is sufficient to limit participation in other clinical trials that are available.Conclusion: The multicentre system of ethics approval has significantly delayed this multicentre trial and may delay advances in cancer care. Extrapolating this delay to determine an influence on improvements in cancer survival suggests that it may be responsible for 60 cancer deaths per year. A method for measuring the effect on the shape of the accrual curve is defined, and the term DIABOLECAL (Delays in Accrual Brought On Largely by Ethics Committee Activity Lag‐time) is proposed to describe it. Attempts to overcome this problem have been introduced overseas.
Meta‐analysis of B type natriuretic peptide and N‐terminal pro B natriuretic peptide in the diagnosis of clinical heart failure and population screening for left ventricular systolic dysfunction
Authors: Ewald B. , Ewald D. , Thakkinstian A. , Attia J. 
Published: August 2007

AbstractBackground:  We set out to review the validity of tests for B type natriuretic peptide (BNP) and N‐terminal pro BNP (NTproBNP) in the diagnosis of clinical heart failure (HF) in primary care and hospital settings and to examine the effect of age. We also examined the accuracy of the test in population screening for left ventricular systolic dysfunction.Methods:  Medline and Embase were searched systematically till June 2005. Forty‐seven studies were identified for systematic review and 27 were included in meta‐analyses. Test performance was summarized as the diagnostic odds ratio (DOR). As a secondary data analysis, this paper does not require ethical approval.Results:  In groups of symptomatic patients with average age less than 80 years, the summary DOR of 27 for BNP equates to a sensitivity of 85% and specificity of 84% in the detection of clinical HF. Summary of head‐to‐head studies shows BNP is a better indicator than NTproBNP. The performance of both tests decreased with the age of patients, the DOR declining by a factor of 2.0 for BNP and 2.5 for NTproBNP for each decade of increasing age. BNP correlated better to clinical status than to echocardiographic parameters, and test performance was similar in acute inpatient and general practice settings.Conclusion:  Tests for BNP are helpful in the diagnosis of clinical HF or in screening for left ventricular systolic dysfunction and are superior to NTproBNP. In the clinical setting, test performance declined with increasing patient age.
Empiric antibiotic prescribing for patients with community‐acquired pneumonia: where can we improve?
Authors: Buising K. L , Thursky K. A. , Black J. F. , MacGregor L. , Street A. C. , Kennedy M. P. , Brown G. V. 
Published: August 2007

AbstractBackground:  Community acquired pneumonia is one of the most common infections for which antibiotics are prescribed in Australia.Methods:  We audited empiric antibiotic prescribing for 392 adults with community‐acquired pneumonia.Results:  Only 61.9% of patients received empiric antibiotic coverage for both typical and atypical pathogens. Of those who required intensive care unit management, 34.6% did not receive antibiotic cover for atypical pneumonia pathogens within the first 24 h. Approximately 21.9% of patients reporting antibiotic allergies were given antibiotics to which they had a documented allergy.Conclusion:  Efforts to improve prescribing practices could be focused towards identifying patients with severe illness early and improving recognition of documented allergies.
Improving quality and safety of hospital care: a reappraisal and an agenda for clinically relevant reform
Authors: Scott I. A. , Poole P. J. , Jayathissa S. 
Published: August 2007

AbstractImproving quality and safety of hospital care is now firmly on the health‐care agenda. Various agencies within different levels of government are pursuing initiatives targeting hospitals and health professionals that aim to identify, quantify and lessen medical error and suboptimal care. Although not denying the value of such ‘top–down’ initiatives, more attention may be needed towards ‘bottom–up’ reform led by practising physicians. This article discusses factors integral to delivery of safe, high‐quality care grouped under six themes: clinical workforce, teamwork, patient participation in care decisions, indications for health‐care interventions, clinical governance and information systems. Following this discussion, a 20‐point action plan is proposed as an agenda for future reform capable of being led by physicians, together with some cautionary notes about relying too heavily on information technology, use of non‐clinical quality personnel and quantitative evaluative approaches as primary strategies in improving quality.
When nitrous oxide is no laughing matter: nitrous oxide and pediatric anesthesia
Authors: BAUM VICTOR C. 
Published: August 2007

SummaryAlthough often felt to be relatively innocuous, nitrous oxide can have significant metabolic effects in settings of abnormal vitamin B12 and B12‐related metabolism in children. These conditions can be genetic or environmental. Symptoms may not appear until days to weeks after exposure to nitrous oxide. Although overt genetic diseases are relatively uncommon, the implications of nitrous oxide interactions with much more frequent but less symptomatically obvious single nucleotide polymorphisms are potentially more concerning. In addition, nitrous oxide can have direct and differing neurotoxic effects on both immature and aged brain, the clinical impact of which remains undetermined.
Interactions between soil and tree roots accelerate long‐term soil carbon decomposition
Authors: Dijkstra Feike A. , Cheng Weixin 
Published: August 2007

AbstractDecomposition of soil organic carbon (SOC) is the main process governing the release of CO2 into the atmosphere from terrestrial systems. Although the importance of soil–root interactions for SOC decomposition has increasingly been recognized, their long‐term effect on SOC decomposition remains poorly understood. Here we provide experimental evidence for a rhizosphere priming effect, in which interactions between soil and tree roots substantially accelerate SOC decomposition. In a 395‐day greenhouse study with Ponderosa pine and Fremont cottonwood trees grown in three different soils, SOC decomposition in the planted treatments was significantly greater (up to 225%) than in soil incubations alone. This rhizosphere priming effect persisted throughout the experiment, until well after initial soil disturbance, and increased with a greater amount of root‐derived SOC formed during the experiment. Loss of old SOC was greater than the formation of new C, suggesting that increased C inputs from roots could result in net soil C loss.