bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of the lightcycler PCR assay for diagnosis of invasive aspergillosis in paediatric patients with onco‐haematological diseases
Authors: Cesaro S. , Stenghele C. , Calore E. , Franchin E. , Cerbaro I. , Cusinato R. , Tridello G. , Manganelli R. , Carli M. , Palù G. 
Published: March 2008

SummaryA reliable diagnosis of invasive aspergillosis (IA) is hampered by the difficulty in obtaining suitable tissue samples. To evaluate the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the LightCycler PCR for the diagnosis of IA, 536 blood samples were collected over a 22‐month period from 62 paediatric patients (median age 10 years, range 1–18) considered at risk of IA. The galactomannan antigen (GM) and fungal DNA were assessed on serial blood samples. IA was diagnosed in eight of 62 patients (13%): proven, five, probable, three. Sensitivity, specificity, PPV and NPV of LightCycler PCR varied according to the number of positive samples used to define positivity: 88%; 37%; 17% and 95% for single sample positivity; and 63%, 81%, 33% and 94% for serial sample positivity respectively. The concordance between positivity of LightCycler PCR assay and the diagnosis of IA was 79%. The single positivity of LightCycler PCR assay showed a good sensitivity for the diagnosis of IA in paediatric patients. The high NPV makes LightCycler PCR a promising tool in addition to GM testing to design a strategy of pre‐emptive antifungal therapy, although further validation studies are needed.
Duodenal mucosal histology and histochemistry in active, treated and healed duodenal ulcer: Correlation with duodenal prostaglandin E2 production
Authors: PUGH S. , JAYARAJ AP , BARDHAN KD 
Published: March 2008

AbstractWe investigated whether impaired duodenal mucosal prostaglandin E2 (PGE2) production previously observed in duodenal ulcer (DU) was a primary pathophysiological abnormality or secondary to mucosal architectural changes that accompany ulceration. One hundred patients were studied: at endoscopy, paired duodenal biopsies were taken in patients with normal endoscopies and from the ulcer edge or scar and background mucosa in active or healed DU. One of the pair of biopsies was used to estimate PGE2 synthesis ability, the other was processed for histology and histochemistry. The following features graded: goblet cell numbers and staining with Periodic acid‐Schiff reagent (PAS), epithelial staining with PAS, villous atrophy, columnar cell height, inflammatory cell infiltrate and micro‐erosions and gastric metaplasia taken as a whole. Patients were found to have normal endoscopy (n= 31), active untreated DU (n= 20), active DU on treatment with either cimetidine or ranitidine (n= 13), healed DU on maintenance treatment (n= 27) and healed DU off treatment (n= 9). Active duodenal ulceration was found to be associated with decreased numbers of goblet cells, loss and blunting of villi, increased columnar cell height, increased epithelial cell PAS staining and with gastric metaplasia. After healing, only villous blunting remained. These changes were present, but less marked, at sites removed from the ulcer and were not apparent in the patient groups with healed ulcers. A strong correlation between overall gastric metaplasia and epithelial cell PAS staining and the reduced ability to synthesize PGE2 (P < 0.001) was only apparent when biopsies from all patients were grouped together, but not within individual patient subgroups. There was no consistent correlation between PGE2 generation and individual parameters of pathological change in the duodenum.We conclude that, although inflammatory and mucosal changes may contribute, the evidence suggests that the impaired PGE2 generation in DU disease is, to a large extent, independent of histological and histochemical features.
Does Crohn's disease need differentiation from tuberculosis?
Authors: JAYANTHI V. , ROBINSON RJ , MALATHI S. , RANI B. , BALAMBAL R. , CHARI SURESH , TAGHURAM K. , MADANAGOPALAN N. , MAYBERRY JF 
Published: March 2008

AbstractCrohn's disease (CD) and tuberculosis (TB) of the gastrointestinal tract pose major diagnostic problems for clinicians where these conditions coexist. Clinically and radiologically, the diseases are similar. In the West, TB is considered in the differential diagnosis of all suspected cases of CD, particularly among Asian migrants. Earlier age of presentation, perianal disease and enteric fistulae favour a diagnosis of CD. Aphthoid ulceration, pseudopolyps and filliform mucosa at endoscopy are suggestive of CD and a negative tuberculin test is useful. The final diagnosis depends largely on histopathology and the presence or absence of acid fast bacilli. Tuberculosis is more common in developing countries and intestinal TB frequently coexists with pulmonary tuberculosis. TB is known to affect all age groups and fistulous communication, although uncommon, does occur. In addition to radiology and endoscopy, laparotomy may be required to establish the diagnosis. In developing countries, CD is uncommon and remains largely a diagnosis of exclusion. A trial of anti‐tuberculosis therapy may often be prescribed before definitely diagnosing CD. The development of molecular biology techniques has led to a revival of interest in mycobacteria as a possible aetiological agent in CD. DNA from Mycobacterium paratuberculosis and Mycobacterium kansaii have both been identified in CD cases but the significance of this finding has not been established. However, in the near future polymerase chain reaction will become increasingly useful in differentiating CD from intestinal TB because it allows the amplification and identification of very small quantities of mycobacterium DNA.
Chronic liver disease: Do alcohol and hepatitis C virus interact?
Authors: COOKSLEY WGE 
Published: March 2008

AbstractIn chronic liver disease, alcoholism and hepatitis C virus (HCV) frequently coexist, and it is widely believed that they interact to result in more severe disease. However, the issue is far more complex and that view may be incorrect. Newer HCV assays cast doubt on the earlier results. Data acquired in one country are often at variance with those from other countries, suggesting that other factors may be involved in the variability of the disease. Further comparison of histologically different groups of individuals with excess alcohol intake is unlikely to shed further light on the issue unless information on the duration and quantity of alcohol consumption and the duration of HCV infection is available. The net evidence is that HCV and alcohol produce different histological appearances in the precirrhosis stage, with the end result cirrhosis often being indistinguishable, regardless of aetiology. Nevertheless, even with both aetiologies, progression is slow and only a minority of people develop cirrhosis despite the combination of HCV and heavy alcoholism. As yet there is no definite evidence that cirrhosis develops more frequently or sooner if both HCV and alcohol are present. Although the majority of the evidence suggests that these insults are probably additive, there is a possibility that alcohol and HCV do interact in the pathogenesis of chronic liver disease. Further studies will be necessary, however, to clarify their relationship.
Correlation between transmucosal potential difference and morphological damage during aspirin injury of gastric mucosa in rats
Authors: COOK GREGORY A. , ELLIOTT SUSAN L. , SKELJO MARYANNE V. , GIRAUD ANDREW S. , YEOMANS NEVILLE D. 
Published: March 2008

ABSTRACTThe potential difference (PD) that is maintained across healthy gastric mucosa is thought to be due to asymmetric ion pumping combined with resistance to back‐diffusion of the separated charge. However, the structures that are responsible for this have not been clearly defined. This study examined the temporal changes in PD in rat stomach after injury by a single dose of aspirin. Multiple linear regression was used to compare this with the time course of several parameters of histological damage: (i) the per cent mucosal length showing superficial (confined to surface and gastric pits), deep (involving the isthmus or deeper in oxyntic glands) and total damage; (ii) the number of discrete erosions; and (iii) the total area of erosions per cm sectioned. Mucosal PD fell during the first 30–60 min after aspirin. Superficial damage appeared early and was already recovering by this time. The time course of deep damage more closely matched the alterations in PD and stepwise regression analysis showed that this could be predicted by the amount of deep damage alone (P < 0.001). Changes in transmucosal PD after acute aspirin injury probably reflect damage to structures in the oxyntic glands and not just the breaking of the surface and pit cell ‘barrier’.
Pre‐ and postoperative nutritional care in liver transplantation in children
Authors: SHEPHERD ROSS W 
Published: March 2008

ABSTRACTOrthotopic liver transplantation (OLT) is now a definitive treatment option for most cases of endstage liver disease (ESLD) in children. Efforts now focus on active supportive treatment to maintain, if not improve, the patient's clinical status before OLT and to ensure normal patterns of growth and development after OLT. Malnutrition adversely affects the outcome of OLT and is probably the single area in pre‐operative management where the largest potential improvement can be made. Our studies indicate significant abnormalities of protein energy metabolism and body composition in children referred for OLT. We have shown that the use of enteral formulae, enriched with branched‐chain amino acids, have significant advantages. Other adjunctive therapy, such as growth hormone, is the subject of current investigation. Following transplantation, catch‐up weight and growth does occur with the advent of normal liver functioning, but patients at continuing risk for undernutrition, such as those with rejection and/or chronic infection, need to be targeted for specific nutritional therapy.
Case report: Paucity of interlobular bile ducts in Chinese children
Authors: CHIU HSIU‐HUI , CHANG MEI‐HWEI , CHEN CHI‐LONG , HSU HONG‐YUAN , NI YEN‐HSUAN 
Published: March 2008

ABSTRACTSixteen Chinese children with cholestasis since early infancy were diagnosed to have paucity of interlobular bile ducts (PILBD) or its equivalent. Twelve children belonged to the syndromic group of PILBD and four children belonged to the non‐syndromic group. A definite histological diagnosis of bile duct paucity was established in only two children (aged 4 and 9 months) during the first percutaneous needle biopsy. In the remaining 14 children a varying degree of bile duct destruction was evident in the follow up percutaneous or wedge liver biopsies. The evolving changes were characterized by inflammatory infiltration near or at the ductal wall, the presence of dysmorphic ductules, the degeneration of ductal epithelia and a progressive decrease of interlobular bile ducts. Of 10 children who underwent laparotomy for definite diagnosis, kasai operation was performed in two of them. In the syndromic PILBD group, all children, including two paired siblings, had at least three of five major clinical features. Hypoplasia of the extrahepatic biliary tree was found in five children and atresia of the extrahepatic bile duct was found in one. Three of six children studied were shown, by polymerase chain reaction, to have cytomegalovirus infection in the liver. This study demonstrates that bile duct paucity is a result of progressive bile duct destruction. A definitive diagnosis is difficult to make in early infancy. Thus, the careful evaluation of extrahepatic features in cholestatic children and follow‐up liver biopsies are indicated. Although the pathogenetic mechanism of PILBD is unknown, bile duct destruction is the common pathway leading to paucity of bile ducts irrespective of syndromic or non‐syndromic types.
Case report: Liver function abnormalities in a severe case of hyperreactio luteinalis
Authors: SENTURK HAKAN , ERDINÇCL SEVAL , TASYUREKLI MUSTAFA , MERT ALI , ARVAS MACIT , SEN CIHAT 
Published: March 2008

ABSTRACTRare causes of liver dysfunction in pregnancy may pose a challenge to the consulting gastroenterologist or hepatologist from both the diagnostic and therapeutic standpoints. We describe here liver function abnormalities in a case of hyperreactio luteinalis with light and electron microscopic findings.
Effects of leminoprazole, omeprazole and sucralfate on indomethacininduced delayed healing of kissing gastric ulcers in rats
Authors: TSUKIMI Y. , NOZUE C. , OKABE S. 
Published: March 2008

AbstractWe have examined whether or not repeated treatment with indomethacin delays the healing of kissing gastric ulcers induced in rats. The effects of leminoprazole, omeprazole and sucralfate on any delay in ulcer healing caused by indomethacin were also determined in relation to myeloperoxidase activity. Kissing gastric ulcers were induced by luminal application of an acetic acid solution. Indomethacin significantly delayed ulcer healing in a dose‐dependent manner. Leminoprazole and omeprazole decreased the size and depth of ulcers, the healing of which was delayed by indomethacin, while sucralfate only decreased the ulcer depth. Histological studies showed that indomethacin inhibited tissue contraction and regeneration of the ulcerated mucosa. Leminoprazole and omeprazole prevented the inhibition of these parameters. The myeloperoxidase (MPO) activity of the ulcer portion in animals treated with indomethacin was markedly higher than in the control group. Both leminoprazole and omeprazole, but not sucralfate, significantly reduced MPO activity in contrast to the control value (in the presence of indomethacin). There was a significant relationship between the ulcerated area and myeloperoxidase activity. These results suggested that: (i) leminoprazole and omeprazole prevent the indomethacin‐induced delay in ulcer healing by promoting tissue contraction and regeneration of the ulcerated mucosa; (ii) sucralfate prevents the indomethacin‐induced delay in ulcer healing via the promotion of the formation of granulation tissue; and (iii) MPO activity will be useful to biochemically ensure the healing state of ulcers.
Cold activation of complement in sera from patients with persistent hepatitis C virus infection on interferon therapy
Authors: AIKAWA TATSUYA , KIMURA IZUMI , KOJIMA MAKI , UENO CHISATO , MIYAMOTO KUNIKO , TANGO TOSHIRO , TANAKA NAOMI 
Published: March 2008

AbstractThe loss of haemolytic activity in sera during storage at low temperature (the cold activation of complement) was observed in 136 of 184 (74%) patients with chronic liver disease associated with hepatitis C virus (HCV) infection. This was more frequent than observed in the three of 40 (8%) patients with chronic hepatitis B (P < 0.001) or none in 43 normal controls (P < 0.001). Of 103 patients with chronic hepatitis C who had completed a full course of recombinant interferon‐α2a therapy (total dose: 516×106U), 40 responded completely and 21 responded partially, as judged by the normalization or decrease of alanine aminotransferase levels 6 months after the completion of therapy; 42 patients did not respond at all. The cold activation of complement persisted in five (13%) complete responders, less often than in 33 (79%) non‐responders (P < 0.001). At the completion of interferon therapy, the cold activation of complement persisted in 12 of 54 patients despite the normalization of alanine aminotransferase. Spontaneous exacerbation of hepatitis occurred in seven of 12 (58%) patients with cold activation, which was more frequent than in the four of 42 patients (10%) without it (P < 0.01). The cold activation of complement disappeared along with the loss of HCV‐RNA in five of six responders during the 6 month period after the completion of interferon therapy, while both cold activation and HCV‐RNA persisted in all eight non‐responders. These results indicate that the cold activation of complement may be useful as a marker of HCV viraemia for monitoring the response to interferon in patients with HCV infection.
Microheterogeneity of serum transferrin in the diagnosis of hepatocellular carcinoma
Authors: SUZUKI YASUFUMI , AOYAGI YUTAKA , MORI SHIGEKI , SUDA TAKESHI , NAITOH AKIRA , ISOKAWA OSAMU , YANAGI MASAHIKO , IGARASHI HIROTAKA , ASAKURA HITOSHI 
Published: March 2008

AbstractHeterogeneous reactivity of human serum transferrin (Tf) with lectins was analysed using patient sera to determine whether it can be used to distinguish patients with hepatocellular carcinoma (HCC) from those with liver cirrhosis (LC). Microheterogeneity of Tf was analysed by crossed immunoaffinity electrophoresis (CIAE) with concanavalin A (Con A) and Lens culinaris agglutinin (LCA). Sample sera from 58 patients with HCC, 43 patients with LC and 10 normal controls were used in this study and the results were evaluated statistically. The increments of Con A‐non‐reactive (C1) and ‐weakly reactive (C2) species of Tf were observed in HCC compared with those of LC and Norm. Significant increase in the combined percentage of Con A‐ C1 + C2 species was also revealed in HCC (35.5 ± 8.5%, mean ± s.d.) compared with those of LC (29.1 ± 6.8%; P < 0.001) and normal controls (17.1 ± 2.3%; P < 0.001). The elevation of LCA‐reactive (L2) species of Tf was recognized in HCC (8.2 ± 3.8%) in comparison with those of LC (4.8 ± 3.1%; P<0.001) and normal controls (1.3 ± 1.7%; P < 0.001). The increment of C1+C2 species and/or L2 species of Tf was observed in 78% (sensitivity) of patients with HCC. The specificity, the positive predictive value and the overall accuracy were 81, 88 and 72%, respectively. Positive ratio of C1+C2 and/or L2 species was 77 and 70% in alpha‐fetoprotein low and ‐high producing HCC patients, respectively. These results indicate that the microheterogeneity analysis of human serum Tf is useful for distinguishing patients with HCC from those with LC and normal controls.
An analysis of the relationship between bile duct stones and periampullary duodenal diverticula
Authors: CHANDY GEORGE , HART WENDY J , ROBERTS‐THOMSON IAN C 
Published: March 2008

ABSTRACTPrevious studies have suggested a relationship between bile duct stones and periampullary duodenal diverticula. The aim of the present study was to examine this association in more detail, including step‐wise logistic regression to identify independent predictors for the presence of diverticula. Clinical, endoscopic and radiological data were analysed from 794 consecutive subjects with bile duct stones; 44 with primary duct stones (without gall‐bladder stones) and 750 with bile duct stones associated with current or previous gall‐bladder stones. Frequencies of diverticula in subjects with bile duct stones were compared with those in age‐matched controls who had undergone upper gastrointestinal endoscopy using a side‐viewing endoscope (n = 100) or who had undergone endoscopic retrograde cholangiopancreatography (ERCP) for pancreatic cancer (n = 100). The frequencies of diverticula in subjects with primary duct stones (70%) and bile duct stones with current or previous gall‐bladder stones (25%) were significantly higher than in both control groups (7 and 8%, respectively). When subjects with bile duct stones were analysed by step‐wise logistic regression, age and bile duct diameter were independent predictors of the presence of diverticula, but diverticula were unrelated to gender, mode of presentation, number of bile duct stones and outcome after endoscopic sphincterotomy. A significant association exists between duodenal diverticula and bile duct stones, perhaps because diverticula predispose to stone formation through the combined effects of bile stasis and bacterial contamination of bile.
CASE REPORT: Radiological and endoscopic management of bile leak following laparoscopic cholecystectomy
Authors: SAMMAK BASSAM M , YOUSEF BUSHRA A , GALI MOHAMED H , KARAWI MOHAMED A AL , MOHAMED ABDULRAHMAN E 
Published: March 2008

ABSTRACTDue to the ever increasing popularity of laparoscopic cholecystectomy (LC), many radiologists and gastroenterologists have noticed an epidemic of bile duct injuries due to subsequent complications. We report on five cases of post‐LC minor bile duct injuries and document our preliminary experience in their management. Although the majority of minor bile leaks resolve spontaneously, particularly if a surgical drain has been left in situ, percutaneous drainage (PD) can be used alone or in addition to endoscopic management to treat symptomatic bile leaks and biloma formation. Bile leaks without associated abdominal collections should be first identified by endoscopic cholangiography followed by sphincterotomy and/or stenting. Surgery should only be reserved for cases of major bile duct injury if PD and endoscopic management have failed initially.
Effects of octreotide on liver regeneration and tumour growth in the regenerating liver
Authors: DAVIES N , YATES J , KYNASTON H , TAYLOR BA , JENKINS SA 
Published: March 2008

ABSTRACTThe ability of the liver to regenerate following resection is remarkable. However, there is evidence to suggest that tumour growth within the regenerating liver is significantly increased. As octreotide (a synthetic analogue of somatostatin) inhibits the growth and development of hepatic tumour in rats, we have investigated its effects on liver regeneration, liver blood flow, hepatic reticuloendothelial system activity and tumour growth in the rat following partial hepatectomy (PH). Octreotide significantly inhibited liver regeneration in the rat 1 and 2 weeks following PH when compared with controls (regeneration index: 1.0 and 1.14 cf. 1.14 and 1.4, respectively). There was no significant difference in hepatic arterial or portal venous blood flow following PH in control or octreotide‐treated rats. However, portal pressure was significantly reduced in octreotide‐treated rats. Hepatic reticuloendothelial system activity was significantly increased in octreotide‐treated rats compared with control animals 1 and 2 weeks after hepatectomy (uptake of radiolabelled technetium‐99m albumin colloid: 2.2 and 3.9 cf. 1.6 and 1.9). The growth of both HSN (fibrosarcoma) and K12‐Tr (colonic adenocarcinoma) cells in the regenerating liver was significantly decreased by octreotide treatment compared with controls (median percentage hepatic replacement: HSN control 71.3%, Octreotide 8.4%, K12‐Tr Control 38.3%, Octreotide 4.5%). The results of the present study demonstrate that octreotide inhibits both liver regeneration and tumour growth following PH, possibly via a similar mechanism.
Functional ablation of afferent nerves aggravates dextran sulphate sodium‐induced colonic damage in rats
Authors: DOMEK MATTHEW J , BLACKMAN EDWARD I , KAO JOHN , ZHANG XIANG Y , IWATA FUMIHIRO , SENO KYOJI , LEUNG FELIX W 
Published: March 2008

ABSTRACTDextran sulphate sodium (DSS) is an oral agent capable of inducing chronic diarrhoea and colonic inflammation and necrosis in rats. The role of the afferent nerves in this model of colonic mucosal damage is not known. The hypothesis that functional ablation of the capsaicin‐sensitive afferent nerves will aggravate DSS‐induced colonic damage in rats was tested. Capsaicin pretreatment was used to ablate afferent nerve function and DSS was administered in the drinking water. Control rats received vehicle pretreatment and water without DSS. There were significant correlations between diarrhoea score, mucosal neutrophil infiltration, mucosal necrosis, and anaemia. Capsaicin pretreatment increased diarrhoea score and colonic mucosal neutrophil infiltration in the rats with colonic damage after 2 or 14 days of DSS. In addition, it induced anaemia and mortality in rats after 14 days of DSS. The data supports the hypothesis that functional ablation of the capsaicin‐sensitive afferent nerves aggravates the colonic damage induced by DSS.