bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of gastric fundal varices by balloon‐occluded retrograde transvenous obliteration
Authors: KANAGAWA HIROSHI , MIMA SATOAKI , KOUYAMA HARUKAZU , GOTOH KENICHIROH , UCHIDA TOSHIKAZU , OKUDA KUNIO 
Published: March 2008

AbstractAlthough less common than oesophageal varices in portal hypertension, gastric fundal varices carry a higher mortality rate when they rupture. They are less amenable to sclerotherapy. We have developed a minimally invasive balloon‐occluded retrograde transverse obliteration (B‐RTO) procedure to treat gastric fundal varices. B‐RTO involves inserting a balloon catheter into an outflow shunt (gastric‐renal or gastric‐vena caval inferior) via the femoral or internal jugular vein. Blood flow is then blocked by inflating the balloon, and 5% ethanolamine oleate iopamidol is injected in a retrograde manner. The embolized gastric varix subsequentlyl disappears. B‐RTO was performed in 32 patients with gastric varices. Follow‐up endoscopies were performed at intervals of 2–4 months for an average observation period of 14 months. Eradication of the varices has been confirmed in 31 of 32 patients. No recurrence occurred in any patients in the follow‐up period. There were no significant changes in liver function after the procedure. We conclude that B‐RTO is a safe and effective procedure for the treatment of gastric fundal varices.
Prevalence of gastric ulcer in cirrhotic patients and its relation to portal hypertension
Authors: CHEN LING‐SHENG , LIN HAN‐CHIEH , HWANG SHINN‐JANG , LEE FA‐YAUH , HOU MING‐CHIH , LEE SHOU‐DONG 
Published: March 2008

AbstractThe prevalence of gastric ulcer and its relationship to the severity of cirrhosis and degree of portal hypertension was evaluated in 245 cirrhotic patients, and compared with 245 age‐ and sex‐matched healthy subjects. Portal and systemic haemodynamic studies were performed in cirrhotic patients. The prevalence of gastric ulcer in cirrhotic patients was 20.8%, which was significantly higher than the 4.0% found in healthy controls. Using a multivariate logistic regression model, the hepatic venous pressure gradient was found to be the only predictor of the prevalence of gastric ulcer in cirrhotic patients to present with gastric ulcer. The hepatic venous pressure gradient was significantly higher in cirrhotic patients with gastric ulcer than in those without (17.3 ± 4.4 vs 15.5 ± 5.0 mmHg, P= 0.01). Other variables, including sex, smoking, cardiac output and severity or aetiology of cirrhosis did not show significant differences between the two patient groups. The prevalence of gastric ulcer in cirrhotic patients whose hepatic venous pressure gradient was below 12 mmHg (4.5%) was similar to that observed in the healthy controls (4.0%). However, when the hepatic venous pressure gradient was > 12 mmHg, the prevalence of gastric ulcer (24.4%) was significantly higher than that in control subjects. However, the incidence of gastric ulcer was not related to the degree of portal hypertension. In conclusion, the prevalence of gastric ulcer in cirrhotic patients was found to be significantly higher than in the age‐ and sex‐matched healthy subjects. Portal hypertension with a hepatic venous pressure gradient > 12 mmHg may be an important factor contributing to the increased prevalence of gastric ulcer observed in patients with liver cirrhosis.
A comparative study of the influence of differing barley brans on DMH‐induced intestinal tumours in male Sprague‐Dawley rats
Authors: MCINTOSH GRAEME H. , LE LEU RICHARD K. , ROYLE PETER J. , YOUNG GRAEME P. 
Published: March 2008

AbstractThe influence of barley brans on the incidence and burden of intestinal tumours in rats induced by 1,2‐dimethylhydrazine (DMH) was studied in a 7 month feeding experiment. The basic diet was American Institute of Nutrition (AIN) 76 modified by adjustment to 20% fat and 40% starch; brans were added so as to supply 5% dietary fibre. The barley brans studied were commercial barley bran (BB1; 13.0% dietary fibre) from the aleurone/subaleurone layer, outerlayer barley bran (BB2) including the germ (25.5% dietary fibre) and spent barley grain bran (SBG; a by‐product of the brewery and including the hull; 47.7% dietary fibre). They were compared with wheat bran (WB; 44% dietary fibre) and cellulose (or control; 98% dietary fibre). Commercial barley bran and wheat bran were most effective in reducing tumour incidence and burden. The incidence of tumours fell significantly from 70% (BB2) and 50% (SBG) to 10% (BB1) and 20% (WB) and tumour burden and tumour mass index (TMI) were also reduced by similar orders of magnitude. There were significantly higher short chain fatty acid (SCFA) concentrations in WB‐ and BBl‐fed rat faecal pellets relative to cellulose‐ and BB2‐fed rat faeces; butyrate, in particular, was affected. Regression analysis of butyrate against tumour incidence showed a trend (r=‐0.898; P=0.055), but the concentration of butyrate alone could not account for the reduction in tumour incidence observed. In a second experiment, when two brans (BB1 and SBG) were introduced after DMH dosing, there were higher incidences and burdens of tumours, indicating that protection by such brans was not as effective under these circumstances. Commercially available barley bran and wheat bran appear to significantly reduce tumour incidence and burden in this model relative to other brans, influencing both the initiatory as well as promotional stages of chemically induced carcinogenesis.
Endoscopic management of postoperative bile leak
Authors: SARASWAT VA , CHOUDHURI G. , SHARMA BC , AGARWAL DK , GUPTA R. , BAIJAL SS , SIKORA SS , SAXENA R. , KAPOOR VK 
Published: March 2008

AbstractSignificant bile leak is an uncommon but serious complication of biliary tract surgery. Of twenty‐five patients presenting with postoperative bile leak, 11 had complete tie‐off of common bile duct and required surgery, while the remaining 14 had injury without complete obstruction and could be managed by endoscopic methods. Of these 14 cases, bile leak occurred from the cystic duct in 11 patients and from the common hepatic duct, right hepatic duct and left hepatic duct in one patient each. Endoscopic procedures performed included sphincterotomy alone (four patients), sphincterotomy and stent placement (seven patients) and sphincterotomy followed by nasobiliary catheter drainage (three patients). There was no technical failure and bile leak was stopped in all patients. One patient died of haemobilia 5 days after stent placement. When technically feasible, postoperative bile leak can be managed safely and effectively by endoscopic methods, obviating the need for surgical reexploration.
Relationship between hepatocellular carcinoma and subtypes of hepatitis C virus: A nationwide analysis
Authors: TAKADA AKIRA , TSUTSUMI MIKIHIRO , ZHANG SHUN‐CAI , OKANOUE TAKESHI , MATSUSHIMA TAKASHI , FUJIYAMA SHIGETOSHI , KOMATSU MASAFUMI 
Published: March 2008

AbstractAlthough hepatitis C virus (HCV) has now been classified into several subtypes, the clinical significance of HCV subtypes is not well known. Typing of HCV is now routinely performed in Japan. In the present study, HCV subtypes in hepatocellular carcinoma (HCC) patients were analysed from nationwide data collected in Japan using a standard questionnaire. Answers to the questionnaire concerning HCV subtypes in patients with chronic hepatitis (CH), liver cirrhosis (LC) and HCC were obtained from 14 hospitals. The prevalence of the 1b‐related subtype, which includes the mixed subtype of 1b and 2a or 2b, in patients with LC and HCC in each hospital was higher than in patients with CH, with few exceptions. However, the differences were not statistically significant because of the small number of patients in each hospital. In summarized data from all 14 hospitals, the 1b‐related subtype was found in 1370 of 1922 patients with CH (71.2%). In 356 LC and 426 HCC patients, the prevalence of the 1b‐related subtype was 79.8 and 80.5%, respectively. The prevalence of the 1b‐related subtype in patients with LC and HCC was significantly higher than in patients with CH. There was no significant difference between the prevalence of the 1b‐related subtype in patients with HCC and LC. These results indicate that the oncogenic activity of subtype 1b, although not yet clearly characterized, may be stronger than subtypes 2a and 2b.
Acute pancreatitis induced by hypercalcaemia associated with adult T‐cell leukaemia: A case report
Authors: ONO YASUHIRO , KIMURA TOSHINARI , NAKANO ITSURO , FURUKAWA MASAYUKI , ITO TETSUHIDE , SAKAMOTO SHIGERU , KONOMI KOHKI , NAWATA HAJIME 
Published: March 2008

AbtsractA 44 year old Japanese woman with adult T‐cell leukaemia (ATL) was admitted to Kyushu University hospital to receive a course of α‐interferon treatment. She experienced a sudden onset of hypercalcaemia and epigastric pain associated with an increase in the level of pancreatic enzymes. Her serum parathyroid hormone related protein level was above normal although her high sensitive PTH level was within the normal range. Ultrasonography and computed tomography (CT) of the abdomen showed enlargement of the pancreas with indistinct margins and massive accumulation of extrapancreatic fluid. Cullen's sign was observed. A few days after the onset of acute pancreatitis, the serum amylase level increased to 3400 IU/L, and the serum calcium level fell to 4.2 mg/dL from 13.3 mg/dL. Her fasting blood glucose level increased to 242 mg/dL. Although the first episode of pancreatitis appeared to respond to treatment, she experienced a second episode of pancreatitis accompanied by an elevation of the serum calcium level. These findings suggest that acute pancreatitis was caused by hypercalcaemia associated with ATL.
Distribution of the different subtypes of hepatitis C virus in Japan and the effects of interferon: A nationwide survey
Authors: TAKADA AKIRA , TSUTSUMI MIKIHIRO , OKANOUE TAKESHI , MATSUSHIMA TAKASHI , KOMATSU MASAFUMI , FUJIYAMA SHIGETOSHI 
Published: March 2008

AbstractInterferon (IFN) is now commonly used for the treatment of type C hepatitis; however, its effects differ depending upon the subtype of hepatitis C virus (HCV) being treated. It has been recently confirmed in many studies in Japan that the effectiveness of IFN treatment is poor in patients having type 1b and better in patients having type 2a HCV. However, the effects of IFN treatment on other subtypes of HCV were not clear because of the small number of patients in each hospital. In the present study, the effects of IFN treatment in patients with other HCV subtypes were analysed from nationwide data collected in Japan using a standard questionnaire. From this questionnaire, local differences in the distribution of HCV subtypes in Japan were also analysed. A standard questionnaire, consisting of questions about the number of patients with chronic type C hepatitis with different HCV subtypes and the number of patients showing different responses to IFN treatment, was sent to over 40 study groups in Japan, Answers to the questionnaire concerning HCV subtyes and the effects of IFN treatment were obtained from 26 and 22 hospitals, respectively, throughout Japan. The incidence of HCV type 1b was highest in the Kinki area (south‐central Japan). The incidence of type 1b HCV decreased in parallel with distance from this area. The mortality rates of hepatic cancer in different areas were significantly corrclated with the incidence of HCV type 1b. The efficacy of IFN treatment was significantiy better for both types 2a and 2b HCV than for type 1b HCV; the efficacy of IFN treatment was poor in the mixed type of 1b and 2a and tended to be better in type 1a. The efficacy of IFN treatment for other types of HCV was also better. These results indicate that there are local differences in the distribution of HCV subtypes in Japan and that these differences may be closely associated with the clinical features of HCV‐related liver disease. The efficacy of IFN treatment was significantly poorer in patients with the 1b‐related type HCV than in patients with other types of HCV.
Hepatic HCV‐RNA as a predictor of outcome after interferon therapy in patients with chronic hepatitis C
Authors: KONDO MASAAKI , TANAKA KATSUAKI , IKEDA MASANORI , ARATA SHINJU , SAITO SATORU , SAKAGUCHI TAKASHI , MORIMOTO MANABU , FUJII TAKANDO , MITSUI KONOMI , OKAZAKI HIROSHI , HOSHINO MASATO , SEKIHARA HISAHIKO 
Published: March 2008

ABSTRACTMeasurement of serum HCV‐RNA is a useful index for evaluating the antiviral effect of interferon therapy in chronic hepatitis C. In the present study, we investigated whether the detection of hepatic HCV‐RNA after interferon treatment, using a polymerase chain reaction assay, predicted long‐term response to therapy in patients with chronic hepatitis C. Thirty‐three patients underwent liver biopsies before and after interferon therapy. Histology and clinical courses were compared after treatment. Before therapy, serum and hepatic HCV‐RNA was detected in specimens from 32 (97%) and 33 (100%) patients, respectively. Serum HCV‐RNA became undetectable in samples from 22 (67%) patients; however, in 10 of these patients (45%), serum HCV‐RNA levels relapsed after therapy. Hepatic HCV‐RNA became undetectable in 14 patients after therapy and the serum aminotransferase concentration remained within normal limits during and following (24–92 weeks) therapy in 12 of these patients (86%). All 11 patients with detectable hepatic HCV‐RNA also had serum HCV‐RNA and elevated aminotransferase concentrations refractory to therapy. The absence of hepatic HCV‐RNA at the end of interferon treatment thus predicted a long‐term complete response to therapy with a sensitivity of 100%, a specificity of 90% and an accuracy of 94%. We conclude that hepatic rather than serum HCV‐RNA is a more useful index for the prediction of the long‐term efficacy of interferon therapy.
Hyperglucagonaemia in cirrhotic patients and its relationship to the severity of cirrhosis and haemodynamic values
Authors: LIN HAN‐CHIEH , YANG MAY C‐M , HOU MING‐CHIH , LEE FA‐YAUH , HUANG YI‐TSAU , LIN LI‐FEN , LI SHU‐MIN , HWANG SHINN‐JANG , WANG SUN‐SANG , TSAI YANG‐TE , LEE SHOU‐DONG 
Published: March 2008

ABSTRACTPlasma glucagon concentrations were measured in 160 cirrhotic patients (Pugh's grade A in 52 patients, Pugh's grade B in 64 patients and Pugh's grade C in 44 patients). These values were compared with plasma glucagon concentrations in 57 age and sex‐matched healthy subjects. Systemic and portal haemodynamic measurements, effective renal plasma flow and creatinine clearance were recorded for each patient. Plasma glucagon levels were significantly increased in cirrhotic patients compared with healthy subjects. In addition, plasma glucagon levels were higher in cirrhotic patients with ascites than in those without ascites and were increased in relation to the severity of cirrhosis as assessed by Pugh's score. Multiple linear regression found that only Child‐Pugh's score was estimated to be an independent predictor of hyperglucagonaemia in cirrhotic patients. However, in patients with different degrees of oesophageal varices and in patients without oesophageal varices, plasma glucagon concentrations were no different among the different groups of patients, but were still higher than plasma glucagon concentrations in healthy subjects. In contrast, plasma glucagon levels were negatively correlated with mean arterial pressure and systemic vascular resistance. The results of the present study suggest that impairment of liver function plays, in part, a role in increased plasma glucagon levels observed in patients with cirrhosis. In addition, these data support the hypothesis that hyperglucagonaemia may contribute, at least in part, to the pathogenesis of peripheral arterial vasodilatation in cirrhosis with portal hypertension.
Case report: A patient with primary biliary cirrhosis and autoimmune haemolytic anaemia
Authors: YOSHIDA ERIC M , NANTEL STEPHEN H , OWEN DAVID A , GALBRAITH PAUL F , DALAL BAKUL I , BALLON HENRY S , KWAN SUSAN YL , WADE JOHN P , ERB SIEGFRIED R 
Published: March 2008

ABSTRACTDiseases of an autoimmune nature are well recognized in association with primary biliary cirrhosis. Although autoimmune thyroiditis and many rheumatological conditions are well described in primary biliary cirrhosis, autoimmune haematological diseases have been less well reported. We report on a 66 year old North American Indian man with coincident primary biliary cirrhosis and warm antibody haemolytic anaemia. This case report supports the suggestion of an association between autoimmune haemolytic anaemia and primary biliary cirrhosis.
Serum markers for fibrosis and plasma transforming growth factor‐β1 in patients with hepatocellular carcinoma in comparison with patients with liver cirrhosis
Authors: MURAWAKI YOSHIKAZU , IKUTA YUJIRO , NISHIMURA YUUKO , KODA MASAHIKO , KAWASAKI HIRONAKA 
Published: March 2008

ABSTRACTIn order to elucidate collagen metabolism in hepatocellular carcinoma (HCC) tissue, we compared levels of different potential markers of collagen metabolism and plasma transforming growth factor‐β1 in patients with HCC and in patients with liver cirrhosis. Serum levels of prolyl hydroxylase and the tissue inhibitor of metalloproteinase‐1 in patients with HCC were significantly higher than those in patients with liver cirrhosis and increased with the size of the HCC tumour, whereas the serum levels of procollagen type III propeptide and type IV collagen 7S domain were similar in the two groups. In HCC, the increased plasma transforming growth factor‐β1 levels were closely correlated with serum levels of prolyl hydroxylase and the tissue inhibitor of metalloproteinase‐1. These findings suggest that, in HCC tissue, the intracellular biosynthesis of collagen is enhanced, whereas the secretion of procollagen is disturbed and the degradation of collagen is suppressed by the excess production of the tissue inhibitor of metalloproteinase‐1. The results also suggest that plasma transforming growth factor‐β1 plays an important role in the altered metabolism of collagen in HCC.
Differential effects between tauroursodeoxycholic and taurochenodeoxycholic acids in hepatic fibrosis: An assessment by primary cultured Ito and Kupffer cells from the rat liver*
Authors: SUGATA KOICHI , KAMIMURA SEIICHIRO , SHIJO HIROSHI 
Published: March 2008

ABSTRACTThe pathogenesis of hepatic fibrosis in cholestasis is still unknown, except for endotoxaemia. There is a possibility that the elevation of serum bile acids in cholestasis may play an important role in hepatic fibrogenesis due to a reaction to perisinusoidal cells, such as Ito or Kupffer cells. To assess the effects of bile acids, we investigated the cell proliferation and collagen formation of primary cultured Ito cells that were incubated with a Kupffer cell conditioned medium (KCCM) treated with either taurochenodeoxycholic acid (TCDCA) or tauroursodeoxycholic acid (TUDCA) in short‐term (8 h) or long‐term (48 h) cultures. KCCM treated with TCDCA (100 μmol/L) but not with TUDCA increased cell proliferation of Ito cells in short‐term cultures and also partially elevated collagen formation by Ito cells in long‐term cultures. The release of tumour necrosis factor‐α (TNFα) from Kupffer cells was increased by TCDCA in short‐term cultures, but not in long‐term cultures. The release of transforming growth factor‐β1 (TGFβ1) from Kupffer cells was increased by TCDCA in long‐term cultures, but not in the short‐term cultures. TUDCA showed no significant effect on the release of TNFα and TGFβ1 from Kupffer cells. TUDCA or TCDCA itself showed no direct effect on the cell proliferation and collagen formation of Ito cells. In conclusion, these findings are thus considered to show the potentially important role of TCDCA on the development of hepatic fibrosis in the early phase of cholestasis without endotoxaemia.
Review: Regulation of liver regeneration by pro‐inflammatory cytokines
Authors: DIEHL ANNA MAE , RAI RUDRA 
Published: March 2008

ABSTRACTThe liver has tremendous regenerative capacity. This distinguishes it from other vital organs (e.g. the brain, heart and lungs) that cannot replace functional tissue once it has been destroyed. Although hepatocytes rarely proliferate in the healthy adult liver, virtually all surviving hepatocytes replicate at least once after 70% partial hepatectomy. Therefore, partial liver resection has been used to characterize mechanisms that regulate liver regeneration. Residual hepatocytes up‐regulate both proliferative and liver‐specific gene expression in order to preserve tissue specific function. In addition, hepatocyte proliferation is tightly co‐ordinated to complement regenerative responses in hepatic nonparenchymal cells (e.g. endothelia, biliary epithelia, stellate and Kupffer cells), so that the entire organ can be reconstituted within days. Studies with neutralizing antibodies to tumour necrosis factor‐α (TNF) clearly demonstrate that, after partial hepatectomy, TNF promotes liver cell proliferation. The present review focuses on the regulation of the hepatocyte proliferative response by pro‐inflammatory cytokines.
Autoantibodies to M2 mitochondrial autoantigens in normal human sera by immunofluorescence and novel assays
Authors: OMAGARI KATSUHISA , ROWLEY MERRILL J , WHITTINGHAM SENGA , JOIS JENNIFER A , BYRON SARAH L , MACKAY IAN R 
Published: March 2008

ABSTRACTPrimary biliary cirrhosis (PBC) is characterized by the presence of antimitochondrial antibodies (anti‐M2), directed against the E2 subunits of the 2‐oxo‐acid dehydrogenase complexes (2‐OADC), chiefly pyruvate dehydrogenase complex (PDC‐E2). We present here a detailed study, based on a large panel of normal sera, of the specificity of tests for anti‐M2 by immunofluorescence and for anti‐PDC by other assays for the diagnosis of PBC. The assays for anti‐PDC included immunoblotting with bovine heart mitochondria, ELISA using recombinant PDC‐E2 and an enzyme inhibition assay using purified porcine PDC. The positivity rates for normal sera were 0 (0/170), 2 (4/201), 1.5 (3/198) and 0% (0/186) for immunofluorescence, immunoblotting, ELISA and the enzyme inhibition assay, respectively. The seven positive reactions detected either by immunoblotting (n= 4) or ELISA (n= 3) were negative by the other three assays and in no instance did biochemical indices give any indication of chronic liver disease. Thus, as judged by reactivity with normal sera, the specificity of a positive test for the antibody to the major M2 autoantigen (PDC‐E2) is 100% for immunofluorescence and the enzyme inhibition assay, 98% for immunoblotting and 98.5% for ELISA.
Review: Diagnosis of Helicobacter pylori infection
Authors: AZUMA T , KATO T , HIRAI M , ITO S , KOHLI Y 
Published: March 2008

ABSTRACTA number of diagnostic tests have been developed for the detection of H. pylori. Diagnostic techniques can be divided into invasive and noninvasive methods. The invasive methods require upper gastrointestinal endoscopy and involve culture of gastric biopsy specimens, examination of stained biopsies and detection of urease activity in the biopsies themselves. In addition, we have developed endoscopic diagnosis of H. pylori infection in gastric mucosa using phenol red dye‐spraying. The noninvasive methods include urea breath test and serological techniques. Although there has been considerable improvement in the techniques, a combination of at least two different techniques should be used in order to optimize the diagnostic yield. We recommend the use of one rapid test in the combination. The rapid urease test, cytology and the phenol red dye‐spraying endoscopy give results available before the patient leaves the endoscopy suite.