bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health‐related quality of life of chronic liver disease patients with and without hepatocellular carcinoma
Authors: Kondo Yuji , Yoshida Haruhiko , Tateishi Ryosuke , Shiina Shuichiro , Mine Norio , Yamashiki Noriyo , Sato Shinpei , Kato Naoya , Kanai Fumihiko , Yanase Mikio , Yoshida Hideo , Akamatsu Masatoshi , Teratani Takuma , Kawabe Takao , Omata Masao 
Published: June 2006

AbstractBackground and Aim:  Impaired health‐related quality of life has been reported in patients with cirrhosis and chronic hepatitis. However, only limited data are available concerning the influence of hepatocellular carcinoma.Methods:  Health‐related quality of life was assessed in 97 patients with hepatocellular carcinoma who had been treated successfully with percutaneous ablation therapy, and 97 patients with chronic liver disease without hepatocellular carcinoma matched for age and sex, using the Japanese version of Short‐Form 36. Raw scores were transformed using norm‐based scoring. The relations with objective variables including status of hepatocellular carcinoma and laboratory data were analyzed.Results:  Health‐related quality of life was lower in both groups than in the general population. Patients with hepatocellular carcinoma and patients in the control group showed similar scores. By multivariate analysis, liver function, especially serum albumin, strongly predicted health‐related quality of life, but status of hepatocellular carcinoma did not.Conclusions:  Impaired health‐related quality of life was not associated with the presence of hepatocellular carcinoma but dependent on the level of liver function, indicating the importance of preserving liver function in following up patients. Serum albumin level was a useful objective variable to assess health‐related quality of life of patients with chronic liver disease.
Non‐mitogenic acidic fibroblast growth factor reduces intestinal dysfunction induced by ischemia and reperfusion injury in rats
Authors: Li Hai‐Hong , Fu Xiao‐Bing , Sun Tong‐Zhu , Cai Cun‐Liang , Zhou Gang , Chen Wei , Sheng Zhi‐Yong 
Published: June 2006

AbstractBackground:  Acidic fibroblast growth factor (aFGF) has potentially therapeutic uses in some diseases, but the mitogenic activity of aFGF has been found to contribute to several human pathologies, so the extensive applications of wild‐type aFGF have been limited. The purpose of the present study was to explore the effects and mechanisms of wild‐type (aFGF) and non‐mitogenic aFGF on gut ischemia–reperfusion injury in rats.Methods:  Rat intestinal ischemia–reperfusion injury (I/R) was produced by clamping the superior mesenteric artery (SMA) for 45 min followed by reperfusion. One hundred and fourteen rats were randomly divided into four groups: sham operation (group C, n = 6), intestinal I/R + 0.1 mL saline (group S, n = 36), intestinal I/R + 4 µg/0.1 mL wild‐type aFGF (group W, n = 36) and intestinal I/R + 4 µg/0.1 mL modified aFGF (i.e. non‐mitogenic aFGF; group M, n = 36). According to different periods after reperfusion, groups S, W and M were further divided into 0.5‐, 1‐, 2‐, 6‐, 12‐ and 24‐h subgroups. The contents of d‐lactate and nitrite/nitrate were determined, the changes of intestinal histology were analyzed, the protein expressions of caspase‐3, extracellular signal‐regulated kinase (ERK)1/2, and p38 were detected by western blot, and apoptotic cells were examined by the terminal deoxynucleotidyl transferase (TdT)‐mediated dUDP‐biotin nick end labeling (TUNEL) assay at 0.5, 1, 2, 6, 12 and 24 h after I/R, respectively.Results:  Compared with rats in group S, intestinal histological damage, apoptotic index, d‐lactate content and nitrite/nitrate level all decreased significantly in group W and group M rats. However, there was no difference between rats treated with wild‐type aFGF and those with non‐mitogenic aFGF. The protein expression of caspase‐3, ERK1/2, and p38 in saline‐treated rats was higher than those in aFGF‐treated rats.Conclusions:  Both types of aFGF had protective effects on gut I/R and there was no significant difference between the two aFGF. The protective effects of aFGF may come from the non‐mitogenic activity rather than the mitogenic activity of aFGF in tissue repair, indicating a potentially clinical use for the non‐mitogenic effects of aFGF in preventing visceral organ injury triggered by I/R injury in the future.
Expression of the caudal‐type homeodomain transcription factor CDX2 is related to clinical outcome in biliary tract carcinoma
Authors: Chang Yu‐Ting , Hsu Chiun , Jeng Yung‐Ming , Chang Ming‐Chu , Wei Shu‐Chen , Wong Jau‐Min 
Published: June 2006

AbstractBackground and Aim:  The caudal‐type homeodomain transcriptional factor CDX2, a member of the caudal‐related homeobox gene family, plays a crucial role in the regulation of cell proliferation and differentiation in the gut. Recent studies have reported that expression of CDX2 was an independent marker of outcome in patients with resected adenocarcinoma of ampulla of Vater, gastric cancer, and colon cancer. The clinicopathological significance of CDX2 expression has hitherto remained unclear in biliary tract carcinoma (BTC). The aim of this study was to determine whether CDX2 expression in BTC indicates clinical outcome.Methods:  The expression of CDX2 was investigated immunohistochemically in surgically resected specimens from 164 patients with BTC, including 74 intrahepatic cholangiocarcinomas, 49 extrahepatic cholangiocarcinomas, and 41 gallbladder carcinomas. The correlation between expression of CDX2 and clinicopathological factors, including overall survival, tumor location, tumor stage, and degree of tumor differentiation, was examined in patients with BTC.Results:  In total, 27 of the 164 (16.46%) patients with BTC expressed CDX2. The frequency of CDX2 expression was much higher in the extrahepatic cholangiocarcinomas (22.45%) and gallbladder carcinomas (29.27%) than in the intrahepatic cholangiocarcinomas (5.41%), the difference being statistically significant (P = 0.002). Factors influencing survival on univariate analysis were tumor stage (P < 0.00001), degree of tumor differentiation (P = 0.0002), and CDX2 expression (P = 0.01). On multivariate analysis using the Cox proportional hazard model, CDX2 expression and tumor stage were independent prognostic factors in patients with BTC.Conclusion:  Expression of CDX2 was an independent indicator of outcome in patients with BTC in addition to tumor stage and tumor differentiation. The mechanism by which CDX2 expression influences behavior of biliary tract carcinoma needs further investigation.
Survival predictors in patients with node‐negative gastric carcinoma
Authors: Lee Chin‐Chun , Wu Chew‐Wun , Lo Su‐ Shun , Chen Jen‐Hao , Li Anna F‐Y , Hsieh Mao‐Chin , Shen King‐Han , Lui Wing‐Yiu 
Published: June 2006

AbstractBackground: Presence or absence of nodal metastasis influences outcome of gastric cancer patients. This study gives insight into survival predictors and clinicopathological features of node‐negative gastric adenocarcinoma.Methods: Between 1988 and 1999, 689 gastric cancer patients without other cancer or gastrectomy for benign disease who underwent curative resection were enrolled in this study. Clinicopathological data in patients with node metastasis were compared with those without.Results: The survival rate at 5 and 10 years for node‐negative cases was 91.7% and 89.7%, respectively. On univariate analysis, node‐negative patients were characterized by frequent location in the lower two‐thirds of the stomach (84.9%), tumor size less than 4 cm (63.5%), grossly superficial type (71.6%), more medullary stromal reaction (50.5%) and intestinal type (67.7%), tumor invasion confined to serosa (78.4%), less poorly differentiated cell type (43.2%), and less lymphovascular invasion (33.4%). Multivariate analysis demonstrated that lymphovascular invasion (relative risk: 5.036) and depth of cancer invasion (relative risk: 4.404) were independent poor prognostic factors. However, lymphovascular invasion and serosal invasion were also correlated (P < 0.001).Conclusion: Patients with node‐negative gastric adenocarcinoma had less disease progression and a favorable survival. Lymphovascular invasion and depth of cancer invasion were two independent but correlated survival predictors.
Excess mortality of hepatocellular carcinoma and morbidity of liver cirrhosis and hepatitis in HCV‐endemic areas in an HBV‐endemic country: Geographic variations among 502 villages in southern Taiwan
Authors: Tsai Meng‐Chin , Kee Kwong‐Ming , Chen Yao‐Der , Lin Li‐Chu , Tsai Lin‐San , Chen Hsiu‐Hsi , Lu Sheng‐Nan 
Published: June 2006

AbstractAims:  The aim of this study was to investigate excess mortality for hepatocellular carcinoma (HCC) and prevalence of hepatitis and liver cirrhosis (LC) in hepatitis C virus (HCV)‐endemic areas in Taiwan, which is a hepatitis B virus (HBV)‐endemic country.Methods:  Tainan County, located in southern Taiwan, consists of 533 villages in 31 townships. A total of 56 702 subjects ≥ 40 years old (mean age, 60.9 ± 11.8 years) were enrolled from 502 of the 533 villages between April and November 2004 (n ≥ 20/village). Serum blood HBV surface antigen (HBsAg), antibody to HCV (anti‐HCV) and alanine transaminase (ALT) levels and platelet counts were measured. Township‐specific mortality for liver cancer (ICD = 155) for both sexes between 1992 and 2001 were obtained from official publications.Results:  The prevalence of anti‐HCV in Tainan County was 10.2% (township range, 2.6–30.9%; village range, 0–90.5%). The prevalence of HBsAg was 10.9% (township range, 5.5–17.2%; village range, 0–30.8%). The prevalence of hypertransaminemia (serum ALT > 40 IU/L) was 12.8%. At township levels, prevalence of anti‐HCV (r2 = 0.92, P < 0.001), HBsAg and anti‐HCV (multiple r2 = 0.94) were correlated with hypertransaminemia prevalence by single and multiple linear analysis, respectively. At village levels, prevalence of anti‐HCV (r2 = 0.52, P < 0.001), HBsAg and anti‐HCV (multiple r2 = 0.53) were each correlated with prevalence of hypertransaminemia, respectively. The prevalence of thrombocytopenia (<150 000 platelets/µL) was 5.5%, and adopted as a surrogate prevalence for LC. At township levels, prevalence of anti‐HCV (r2 = 0.58) was the only factor correlated by multivariate analysis with prevalence of thrombocytopenia. At village levels, prevalence of anti‐HCV and female‐to‐male ratio (multiple r2 = 0.43) were each independently associated with prevalence of thrombocytopenia. At township levels, HBsAg prevalence (r2 = 0.42) was more correlated with HCC mortality than anti‐HCV prevalence (r2 = 0.28) for male subjects, while anti‐HCV prevalence (r2 = 0.45) was more correlated with HCC mortality than HBsAg prevalence (r2 = 0.14) for female subjects. Prevalence of HBV and HCV infection were associated by multivariate analysis with both male (multiple r2 = 0.62) and female (multiple r2 = 0.53) HCC mortality.Conclusions:  Prevalence of anti‐HCV showed significant correlations with prevalence of hypertransaminemia, thrombocytopenia and liver cancer mortality. The findings indicate excessive mortality due to HCC, and LC and hepatitis prevalence in HCV‐endemic areas in Taiwan, an HBV‐endemic country.
Helicobacter pylori eradication prevents recurrence after simple closure of perforated duodenal ulcer
Authors: Bose Ashitha C , Kate Vikram , Ananthakrishnan Nilakantan , Parija Subhash Chandra 
Published: June 2006

AbstractBackground and Aim:  Evidence remains inconclusive as to whether eradication of Helicobacter pylori prevents ulcer relapse after simple closure of a perforated duodenal ulcer. This study was conducted to determine the effect of H. pylori eradication using a quadruple drug regimen along with a probiotic on ulcer recurrence after perforation closure.Methods:  A total of 93 patients who had presented with perforated duodenal ulcer and had a simple closure of a duodenal perforation comprised the study group. Three months postoperatively, patients who were found to be positive for H. pylori infection (n = 60) were administered quadruple therapy consisting of omeprazole, clarithromycin, amoxicillin and colloidal bismuth subcitrate for 10 days along with the probiotic Lactobacillus sporogenes for 14 days. Diagnosis of H. pylori was carried out by urease test and histology. Patients were followed for 18 months. Recurrence of ulcer was analyzed for correlation with H. pylori status.Results:  Of 60 patients who received H. pylori eradication therapy, 53 were available for subsequent follow up. H. pylori eradication was achieved in 43/53 (81.1%) patients. The ulcer recurrence in the eradicated group was 18.6% (8/43) compared to 70% (7/10) in the noneradicated group (P = 0.003).Conclusion:  Eradication of H. pylori significantly reduces the relapse of duodenal ulcer after simple closure of perforation. Anti H. pylori therapy must be recommended for all H. pylori positive patients after simple closure of a perforated duodenal ulcer.
Meta‐analysis of the effects of prokinetic agents in patients with functional dyspepsia
Authors: Hiyama Toru , Yoshihara Masaharu , Matsuo Keitaro , Kusunoki Hiroaki , Kamada Tomoari , Ito Masanori , Tanaka Shinji , Nishi Nobuo , Chayama Kazuaki , Haruma Ken 
Published: June 2006

AbstractBackground:  Functional dyspepsia (FD) is often treated with prokinetic agents; however, the efficacy of prokinetic agents in patients with FD has been questioned recently. The aim of this study was to perform a meta‐analysis of the effects of prokinetic agents in patients with FD.Methods:  Prokinetic agents, including metoclopramide, domperidone, trimebutine, cisapride, itopride and mosapride, used for treatment of FD between 1951 and 2005 were identified. Twenty‐seven studies were selected. Difference in the probability of response between the interventional drug and placebo was used as a summary statistic for the treatment effect. Meta‐regression analysis was used to detect sources of heterogeneity.Results:  In total, 1844 subjects were assigned to an experimental arm, and 1591 subjects were assigned to a placebo arm. Publication bias was ruled out by funnel plot and statistical testing (P = 0.975). In the overall analysis, the summary statistic was 0.295 (95% confidence interval: 0.208–0.382, P < 0.001), indicating that the interventional drug has 30% excess probability of producing a response compared with placebo. The most significant source of heterogeneity was the year of publication (P < 0.001).Conclusion:  The data clearly indicate that prokinetic agents are significantly more effective than placebo in the treatment of FD. Although FD is a chronic condition, efficacy was assessed over short periods. Long‐term randomized controlled trials are needed to confirm the effect.
Hospice patients’ views on research in palliative care
Authors: Terry W. , Olson L. G. , Ravenscroft P. , Wilss L. , Boulton‐Lewis G. 
Published: June 2006

AbstractBackground: This project was conducted to investigate whether the concerns that researchers have about including terminally ill patients in research were shared by a sample of terminally ill patients.Methods: Twenty‐two patients admitted to a hospice participated in semistructured interviews; 18 patients had advanced malignant disease and 13 were women; their ages ranged from 28 to 93 years. The interview transcripts were analysed for common themes and particular attention was paid to the reasons patients gave for their views.Results: All the patients wanted to participate in research. Patients advanced one or more of several reasons for participation, the commonest being altruism, enhancement of a sense of personal value, the assertion of persisting autonomy and the value they placed on a commitment by doctors to optimising care by research. They rejected the view that their consent might be non‐autonomous and put forward consistent views about what they considered relevant to consent.Conclusions: Our patients did not share the concerns of ethicists about the difficulties and hazards of research with the terminally ill. These patients’ views are not reflected in the professional consensus.
Symptomatic and asymptomatic carotid stenosis: just when we thought we had all the answers
Authors: Gates P. C. , Chambers B. , Yan B. , Chong W. , Denton M. 
Published: June 2006

AbstractThe management of symptomatic and asymptomatic carotid stenosis has been a hotly debated topic for decades. The publication of four randomized controlled trials of carotid endarterectomy has clarified many of the issues. Patients with symptomatic carotid stenosis >70% benefit most with an absolute risk reduction of 17% over 2 years with numbers needed to treat of 3–6, whereas in patients with asymptomatic carotid stenosis >60%, the absolute risk reduction is 1% per annum (numbers needed to treat = 14–17). There is doubt about the benefit in women >70 years of age with asymptomatic stenosis. Carotid angioplasty and stenting is in its infancy and may one day supplant carotid endarterectomy as the treatment of choice; however, currently indications for this procedure include participation in randomized controlled trials, surgically inaccessible stenosis, in patients with combined symptomatic carotid and symptomatic coronary artery disease or in patients with severe co‐morbidities that preclude formal carotid endarterectomy.
Apical sparing in tako‐tsubo cardiomyopathy
Authors: Abdulla I. , Kay S. , Mussap C. , Nelson G. I. C. , Rasmussen H. H. , Hansen P. S. , Ward M. R. 
Published: June 2006

AbstractBackground: Tako‐tsubo cardiomyopathy (TTC) is an acute reversible cause of segmental myocardial dysfunction that is poorly understood. We have noted a variant of this condition where a tiny segment at the apex retains some contractile function. This paper delineates the frequency of this variant relative to the classical form and the clinical differences between patients suffering from the two forms.Methods: All cases of TTC (n = 35) were identified from our infarct angiography database and separated on the basis of apical sparing (n = 14) or no apical sparing (n = 21).Results: Compared with the classical form, those with apical sparing were significantly younger (63 ± 12 vs 72 ± 13 years) and were more likely premenopausal (5/14 vs 0/21) and had higher ejection fractions (35 ± 6% vs 32 ± 4%). There was a trend towards higher recurrence (4/21 vs 0/14). There were no differences in time or season of presentation, precipitant stressor, premorbid drug therapy, haemodynamics at catheterization or acute outcomes.Conclusion: The apical sparing variant of TTC is common, accounting for 40% of cases. While the patients are younger and more likely premenopausal, there are no other distinguishing features between the classical and the variant form.
Newer options in the management of acromegaly
Authors: Burt M. G. , Ho K. K. Y. 
Published: June 2006

AbstractParadigms for managing acromegaly have undergone major changes in the past two decades. This has been brought about by combining surgical, pharmacological and radiotherapeutic approaches that provide tight biochemical control to reduce mortality to that of the general population. The biochemical targets for treatment are a growth hormone of <2.5 ng/mL (∼7.5 mU/L) and a normal, age‐adjusted insulin‐like growth factor‐1. Until 20 years ago, dopamine agonists were the only class of pharmaceutical agents available to control acromegaly. They have a limited adjunctive role, even with the development of second‐generation selective agonists such as cabergoline. Surgery and radiotherapy were the mainstay of acromegaly management before the advent of the effective pharmacological therapies of the modern era: somatostatin analogues and pegvisomant, a growth hormone receptor antagonist. Somatostatin analogues achieve biochemical control in approximately 60% of patients. Pegvisomant, which is available in the USA and Europe and has just been registered in Australia, normalizes insulin‐like growth factor‐1 in nearly all patients but has no effect on tumour mass. Surgery is an appropriate first‐line therapy for microadenomas as the chance of success is high. For large and/or invasive tumours where the prospect of surgical cure is remote, first‐line therapy is somatostatin analogue treatment with debulking surgery having an adjunctive role to achieve tight control or to alleviate compression of the optic chiasm. Although acromegaly remains a challenging disease to manage, the expanding range of therapeutic options is likely to result in a better outcome for patients and offers the potential to tailor therapy based on a patient’s individual requirements.
Heparin‐induced thrombocytopenia: recent experience in a large teaching hospital
Authors: Sturtevant J. M. , Pillans P. I. , Mackenzie F. , Gibbs H. H. 
Published: June 2006

AbstractBackground: Heparin‐induced thrombocytopenia (HIT) is a potentially serious adverse reaction caused by platelet‐activating antibodies.Aim: To describe experience with HIT.Methods: Twenty‐two patients identified by laboratory records of heparin‐associated antibodies with a 50% or greater decrease in platelet count were reviewed in our 600‐bed metropolitan teaching hospital from 1999 to April 2005.Results: There was an increase in the frequency of HIT diagnosed during the review period, which was associated with a rise in the number of requests for HIT antibodies. Thrombotic complications were identified in 14 of 22 patients with HIT. Mean age was 65 years, and 11 patients were men. Seven patients died and HIT was considered contributory in four. One patient required mid‐forearm amputation. Unfractionated heparin was used in all cases and five patients also received enoxaparin. Mean time to HIT screen, reflecting when the diagnosis was first suspected, was 14 days. Platelet nadir ranged from 6 × 109/L to 88 × 109/L, with a percentage drop in platelet count of 67–96%. Alternative anticoagulation (danaparoid) was not used in three patients, two of whom died.Conclusions: HIT is a potentially life‐threatening complication of heparin therapy, associated with a fall in platelet count and a high incidence of thromboembolic complications. It is most frequently seen using unfractionated heparin therapy. The increase in frequency of HIT diagnosed in our hospital appears to be associated with a greater awareness of the entity, although detection is often delayed. Platelet count should be monitored in patients on heparin and the presence of antiplatelet antibodies determined if HIT is suspected. Treatment involves both discontinuation of heparin and the use of an alternative anticoagulant such as danaparoid because of the persisting risk of thrombosis.
Evidence‐based clinical policy: case report of a reproducible process to encourage understanding and evaluation of evidence
Authors: Rikard‐Bell G. , Waters E. , Ward J. 
Published: June 2006

AbstractWe report within a case study a reproducible process to facilitate the explicit incorporation of evidence by a multidisciplinary group into clinical policy development. To support the decision‐making of a multidisciplinary Intersectoral Advisory Group (IAG) convened by the Royal Australasian College of Physicians Health Policy Unit, a systematic review of randomized controlled trials about environmental tobacco smoke and smoking cessation interventions in paediatric settings was first undertaken. As reported in detail here, IAG members were then formally engaged in a transparent and replicable process to understand and interpret the synthesized evidence and to proffer their independent reactions regarding policy, practice and research. Our intention was to ensure that all IAG members were democratically engaged and made aware of the available evidence. As clinical policy must engage stakeholder representatives from diverse backgrounds, a process to equalize understanding of the evidence and ‘democratize’ judgment about its implications is needed. Future research must then examine the benefits of such explicit steps when guidelines, in turn, are implemented. We hypothesize that changes to future practice will be more likely if processes undertaken to develop guidelines are transparent to clinicians and other target groups.