bluuebunny/crossref_metadata_2025_split huggingface dataset:
Glucose‐6‐phosphate dehydrogenase deficiency is associated with increased initial clinical severity of acute viral hepatitis A
Authors: Gotsman Israel , Muszkat Mordechai 
Published: March 2003

AbstractBackground and Aim:In glucose‐6‐phosphate dehydrogenase (G6PD) deficiency, the enzyme is deficient in liver cells as well as in erythrocytes. It has been suggested that this may be associated with a more severe clinical presentation of acute viral hepatitis A. The aim of this study is to determine the severity of liver disease in patients with viral hepatitis and G6PD deficiency.Methods:Eighteen patients with diagnosed G6PD deficiency and acute hepatitis A were compared with 18 matched control patients with hepatitis A in a university hospital for liver disease severity and clinical outcome.Results:Two of 18 patients with G6PD deficiency had neurological deterioration. Patients with G6PD deficiency had a mean peak prothrombin time (PT) that was significantly prolonged as compared with the control group (15.5 ± 3.7 vs 12.9 ± 2.0 s, respectively, P < 0.02), and a significantly higher proportion had an abnormal PT (PT > 13.3 s): 61 versus 11% (P < 0.0001). Hemolysis occurred in 44% of the G6PD deficiency patients. Total and direct bilirubin were significantly higher in all patients with G6PD deficiency, including patients without hemolysis. There was no significant difference in liver enzyme levels between the two groups. Patients with G6PD deficiency had a longer average hospital stay (9.5 ± 4.8 vs 3.4 ± 0.8 days, respectively, P < 0.001). There was no difference in the final clinical outcome between the two groups, and recovery of liver function was seen in all patients.Conclusions:Glucose‐6‐phosphate dehydrogenase deficiency in patients with hepatitis A causes a more severe initial clinical presentation, but does not alter the final clinical outcome.
Effect of alcohol withdrawal on liver transaminase levels and markers of liver fibrosis
Authors: Campbell Stewart , Timms Peter M , Maxwell Paul R , Doherty Elizabeth M , Rahman Mohammad Z , Lean Michael EJ , Danesh Booth J 
Published: March 2003

AbstractBackground and Aim:Acute alcohol withdrawal causes changes in hepatic blood flow and metabolism that may result in liver damage. This study aims to assess liver function tests and markers of hepatic fibrogenesis following alcohol withdrawal in alcoholics with clinically compensated liver disease.Methods:Serial liver function tests and clinical assessments were performed on 22 male alcoholics during alcohol withdrawal. Plasma tissue inhibitor of metalloproteinase 1 (TIMP1), an inhibitor of collagen degradation, and plasma amino‐terminal procollagen III peptide (PIIINP), a collagen precursor molecule, were measured in these alcoholics and in 11 control subjects.Results:Transaminase levels did not change significantly over 7 days when all subjects were analyzed together. However, 32% of subjects showed a marked transaminase rise. These subjects did not differ from the others in baseline characteristics or short‐term outcome, but had a greater benzodiazepine requirement. Only one subject consumed paracetamol (acetaminophen; 1–2 g/day). He had the largest transaminase rise. By comparing PIIINP assays, intact PIIINP concentration appears to increase following alcohol withdrawal. The TIMP1 levels were elevated in alcoholic subjects, but did not change following withdrawal.Conclusions:Increasing PIIINP suggests that hepatic fibrogenesis increases, or hepatic clearance falls, during acute alcohol withdrawal. The TIMP1 elevation in these alcoholics suggests that the inhibition of collagen degradation occurs while liver disease is still compensated. The period following alcohol withdrawal may be a time of marked increased susceptibility to paracetamol. The biochemical changes we observed were not associated with adverse short‐term outcome, but the cumulative effect after repeated episodes of abrupt withdrawal may be of concern.
Vitamin C inhibits corpus gastritis in Helicobacter pylori‐infected patients during acid‐suppressive therapy
Authors: Yoshinaga Masahiro , Ohtani Akira , Harada Naohiko , Fukuda Yuriko , Nawata Hajime 
Published: March 2003

AbstractBackground:Previous studies have shown that gastric acid suppression worsens corpus gastritis in Helicobacter pylori (H. pylori)‐positive patients. We evaluated the effect of acid‐suppressive therapy and vitamin C on H. pylori‐associated gastritis.Methods:Forty patients with reflux esophagitis were divided into three groups by the status of H. pylori and therapy: group A (n = 15), H. pylori (+) and omeprazole 20 mg; group B (n = 15), H. pylori (+) and omeprazole 20 mg + vitamin C 1200 mg; and group C (n = 10), H. pylori (−) and omeprazole 20 mg. In all three groups, the mucosal interleukin (IL)‐8 contents, H. pylori colonization density, neutrophil infiltration in the corpus, and serum gastrin were evaluated at entry and 2 weeks after starting therapy; in group B, serum vitamin C levels were also measured.Results:In group A, the IL‐8 contents and the degree of neutrophil infiltration during therapy exceeded those at entry, whereas in groups B and C, these values did not change significantly with treatment. Helicobacter pylori colonization density during therapy was similar to that at entry in all three groups. The serum gastrin (in all groups) and vitamin C levels (in group B) during therapy exceeded those at entry.Conclusions:Potent acid suppression worsens H. pylori‐associated corpus gastritis, although such worsening gastritis may be inhibited by vitamin C.
Early studies on the safety and efficacy of thalidomide for symptomatic inflammatory bowel disease
Authors: BARIOL CAROLYN , MEAGHER ALAN P , VICKERS CHRISTOPHER R , BYRNES DAVID J , EDWARDS PAUL D , HING MICHAEL , WETTSTEIN ANTONY R , FIELD ANDREW 
Published: March 2003

AbstractBackground and Aim Thalidomide is clinically effective in the treatment of graft versus host disease in bone marrow transplantation and aphthous ulceration in HIV infection. It appears to exert a selective effect on tumor necrosis factor‐α (TNF‐α) production. Tumor necrosis factor‐α is implicated in the pathogenesis of inflammatory bowel disease (IBD). The aim of this study was to assess the efficacy and safety of thalidomide in symptomatic IBD.Methods Eleven patients (nine males, mean age 33 years, range 20–77 years) with chronic inflammatory bowel disease (six Crohn’s disease (CD), four ulcerative colitis (UC), one indeterminate colitis (IC)) who were symptomatic despite standard medical therapy were administered a daily dose of thalidomide for 12 weeks in an open‐labeled protocol. Their response was assessed by using clinical, colonoscopic, histological, and immunological methods.Results Two patients withdrew at 3 weeks because of mood disturbances. Of the remaining nine patients, eight (five CD, two UC and one IC) had a marked clinical response, while one patient with CD had no response. The mean stool frequency decreased from 4.3 to 2.3 per day (P = 0.0012), and the stool consistency increased from 2.1 to 1.2 (P = 0.02). The mean Crohn’s Disease Activity Index decreased from 117 to 48 (P = 0.0008). Endoscopic inflammatory and histological grade, C‐reactive protein and erythrocyte sedimentation rate (ESR) all decreased significantly (P = 0.011, P = 0.03, P = 0.023 and P = 0.044, respectively). However, the serum TNF‐α levels did not change. Side‐effects included mild sedation, xerostomia and skin dryness in all, constipation in three, and minor abnormalities in nerve conduction in one patient.Conclusion These data strongly suggest that thalidomide is an effective short‐term treatment for symptomatic IBD.
Non‐cirrhotic portal fibrosis (idiopathic portal hypertension): Experience with 151 patients and a review of the literature
Authors: DHIMAN RADHA KRISHAN , CHAWLA YOGESH , VASISHTA RAKESH KUMAR , KAKKAR NANDITA , DILAWARI JANG BAHADUR , TREHAN MANJIT SINGH , PURI PANKAJ , MITRA SOMEN KUMAR , SURI SUDHA 
Published: March 2003

AbstractBackground: Non‐cirrhotic portal fibrosis (NCPF), the equivalent of idiopathic portal hypertension in Japan and hepatoportal sclerosis in the United States of America, is a common cause of portal hypertension in India. The clinical features, portographic and histological findings, and management of 151 patients with non‐cirrhotic portal fibrosis are presented.Methods: The disease is diagnosed by the presence of unequivocal evidence of portal hypertension in the definite absence of liver cirrhosis and extrahepatic portal vein obstruction (EHPVO). Retrospective analysis of records of 151 patients with NCPF was analyzed for the clinical presentation, physical findings, laboratory tests, radiological and histological findings, and for the outcome of treatment.Results: The disease is characterized by massive splenomegaly with anemia, preserved liver function and benign prognosis in a majority of patients. Splenoportovenography (SPV) showed massive dilatation of the portal and splenic veins, and the presence of collaterals. Twenty‐four (15.9%) patients showed evidence of natural/spontaneous shunts (splenorenal 15, umbilical nine) on SPV; these patients had a lower incidence of variceal bleeding. Liver histology demonstrated maintained lobular architecture, portal fibrosis of variable degree, sclerosis and obliteration of small‐sized portal vein radicles, and subcapsular scarring with the collapse of the underlying parenchyma. Piecemeal or hepatocytic necrosis was absent in all histology specimens. Three patients showed nodular transformation along with abnormal liver functions, and may represent late manifestation of NCPF where features are similar to those seen in patients with incomplete septal cirrhosis. In the initial part of the study, surgery (side‐to‐side lieno‐renal shunt) was the preferred modality of treatment, however, endoscopic sclerotherapy or variceal ligation has now become the preferred first line of management of variceal bleeding.Conclusions: The epidemiological and clinical features of NCPF have more similarity to IPH than has previously been documented. The development of spontaneous shunts tends to protect these patients from variceal bleeding.
Four cases of hepatitis B virus‐related fibrosing cholestatic hepatitis treated with lamivudine
Authors: JUNG SAERA , LEE HAN CHU , HAN JI‐MIN , LEE YUN‐JUNG , CHUNG YOUNG‐HWA , LEE YUNG SANG , KWON YOUNGMEE , YU EUNSIL , SUH DONG JIN 
Published: March 2003

AbstractFibrosing cholestatic hepatitis (FCH) is a rare and extremely severe form of hepatitis B virus (HBV) infection. This condition was originally described in HBV‐infected recipients after a liver transplantation. Recently, FCH has been reported not only in liver transplant recipients, but also in other immunosuppressed patients. It is characterized clinically by cholestatic hepatic dysfunction, and pathologically by severe periportal fibrosis, cholestasis, widespread balloon degeneration of hepatocytes, and only a mild infiltration of inflammatory cells. Without treatment, FCH is universally fatal within a few months of diagnosis. There have been only two isolated case reports of FCH with long‐term patient survival, and one case report with treatment failure after lamivudine therapy. Because of the rarity of this clinical entity, the therapeutic efficacy of lamivudine in patients with FCH cannot be evaluated systematically. Here, we present four patients with HBV‐related FCH treated with lamivudine. One received antineoplastic therapy for acute lymphoblastic leukemia, and the other three were renal graft recipients. Two patients who developed FCH after a renal transplantation survived with an improvement in liver function and were followed up for 20 and 30 months, respectively, and were found to be in good health. However, the other two patients died of sepsis, possibly as a consequence of the immunosuppression with hepatic failure despite lamivudine treatment. Our experience suggests that lamivudine can alter the grave natural history of FCH.© 2001 Blackwell Science Asia Pty Ltd
Wild‐type and ‘a’ epitope variants in chronic hepatitis B virus carriers positive for hepatitis B surface antigen and antibody
Authors: MESENAS STEVEN J , CHOW WAN C , ZHAO YI , LIM GEK K , OON CHONG J , NG HAN S 
Published: March 2003

AbstractAims This study aims to examine the genomic variants of the ‘a’ epitope in chronic hepatitis B virus (HBV) carriers positive for both hepatitis B surface antigen (HBsAg) and antibody to HBsAg (anti‐HBs).Methods Eighteen HBV carriers were studied. Hepatitis B virus (HBV) DNA was extracted and the ‘a’ epitope region was amplified and sequenced.Results Eighteen Chinese asymptomatic HBV carriers were studied. There were 13 patients who were positive for both HBsAg and anti‐HBs. Of these, one patient had only wild‐type HBV, three had a viral mixture, and five had only ‘a’ epitope variant HBV. Of the three patients with a viral mixture, all had variants in the less conserved region (123–137). Of the five patients with pure HBsAg mutants, three had variants in the less conserved region while two had variants in the highly conserved region. In this study with a limited number of patients, the serum alanine aminotransferase (ALT) levels were higher in patients with wild‐type HBV, compared with those with either ‘a’ epitope variants or a viral mixture consisting of wild type and variants.Conclusion Eight of the nine (89%) patients positive for both HBsAg and anti‐HBs harbored an ‘a’ epitope variant. The lower ALT levels seen in patients who had either pure ‘a’ epitope variant or a mixture of wild type and mutants suggest that a closer monitoring of these ‘a’ epitope variants should be required, as patients carrying these infectious viral strains may remain asymptomatic.
Systemic administration of liposome‐encapsulated OK‐432 prolongs the survival of rats with hepatocellular carcinoma through the induction of IFN‐γ‐producing hepatic lymphocytes
Authors: UEHARA KAZUHIRO , ICHIDA TAKAFUMI , SUGAHARA SATOSHI , ISHIKAWA TORU , YAMAGIWA SATOSHI , YOSHIDA YUHEI , NOMOTO MINORU , KATOH MASASHI , SATOH HIROSHI , WATANABE HISAMI , ABO TORU , ASAKURA HITOSHI 
Published: March 2003

AbstractBackground: OK‐432 is known to increase the host antitumor response. We previously reported that systemic administration of OK‐432 (OK‐Lipo) specifically induced hepatic lymphocytes in mice. Here we aimed to investigate the antitumor effect of OK‐Lipo on hepatocellular carcinomas (HCC) in experimental rats.Methods: Diethylnitrosamine was administered for 12 weeks to all rats (n = 36). Rats were divided into three groups of 12 rats each. One group was injected with OK‐Lipo from week 5 (OK‐5w group) and another from week 9 (OK‐9w group). A control group was injected with saline from week 5 (Non‐OK group). At week 13, five rats from each group were used for histological analysis and immunofluorescence assays (surface phenotypic and intracellular cytokine analysis of the mononuclear cells in the liver, spleen and peripheral blood). The remaining rats were observed for the remainder of their survival period.Results: The mean survival times of Non‐OK, OK‐5w, and OK‐9w groups differed significantly (98.0 ± 5.3 days, 116.0 ± 5.8 days, and 106.0 ± 5.4 days, respectively,

P < 0.01). Histological examination revealed many apoptotic tumor cells, infiltration of lymphocytes and macrophages in the OK‐5w group. The two‐color immunofluorescence assay showed that the proportion of natural killer (NK) cells and IFN‐γ‐producing cells in the liver were significantly higher in the OK‐5w group.Conclusions: These findings showed that systemic administration of OK‐Lipo contributed to prolonging the survival of rats with HCC. OK‐Lipo induced NK cells and IFN‐γ‐producing cells specifically in the liver and these cells seemed to reduce hepatocarcinogenesis and tumor growth.
Predictive factors by multivariate analysis for colorectal cancer in Malaysian patients undergoing colonoscopy
Authors: TAN YAN M , ROSMAWATI MOHAMED , RANJEEV PRABHAKERAN , GOH KHEAN L 
Published: March 2003

AbstractBackground: The majority of colorectal cancers are still diagnosed in patients who present with symptoms especially in countries where colorectal screening programs are not practised. The aim of our study was to determine the predictive factors for colorectal cancer in patients referred for colonoscopy.Methods: A prospective study of 485 consecutive patients who underwent colonoscopy during a 22‐month period was performed. All patients answered a detailed questionnaire. Indications for colonoscopy and the findings were recorded.Results: The mean age of the study population was 55.7 ± 14.7 years. There were 221 (45.6%) males and 264 (54.4%) females. Sixty‐five (13.4%) were Malays, 298 (61.4%) were Chinese and 112 (23.1%) were Indians. Multiple backward stepwise regression analysis revealed that independent predictors for colorectal cancer (odds ratio [95% CI]) were the presence of rectal bleeding (4.3 [4.0–8.0]) and iron deficiency anemia (4.0 [3.6–10.2]). In those aged 50 and over, male gender (4.5 [2.2–9.3]) and abdominal pain (3.1 [1.4–6.7]) were also significant positive predictors of cancer.Conclusions: With the ever‐increasing demand for gastrointestinal endoscopy, the appropriate utilization of colonoscopy is essential to afford prompt patient evaluation. Our study supports the need to prioritize the use of colonoscopy in patients with rectal bleeding and iron deficiency anemia. In the older patient where the background prevalence of colorectal cancer is higher, referral for colonoscopy is also justified.© 2002 Blackwell Science Asia Pty Ltd
Does a fatty meal improve hepatic clearance in patients after endoscopic sphincterotomy?
Authors: LAI KWOK‐HUNG , PENG NAN‐JING , LO GIN‐HO , LIN CHIUN‐KU , CHAN HOI‐HUNG , HSU PING‐I , CHENG JIN‐SHIUNG , WANG YA‐YU 
Published: March 2003

AbstractBackground: Delayed biliary emptying is a cause of recurrent bile duct stones in patients after endoscopic sphincterotomy (ES) for choledocholithiasis. This study aimed to evaluate the effect of fatty meal on hepatic clearance in patients after ES.Methods: Sixty patients who had received ES and complete clearance of bile duct stones were enrolled. Delayed hepatic clearance (45 min clearance of radioisotope [E45′] < 57%) from quantitative cholescintigraphy (QC) and absence of sphincteric function confirmed by sphincter of Oddi manometry were found in each patient after normalization of liver function. Patients then received another QC 30 min after a fatty meal (two fried eggs and 250 mL full milk, fat 28 g) within 2 months.Results: Improvement of hepatic clearance in QC after fatty meal was found in 20 of 24 (83%)
cholecystectomized patients and 27 of 36 (75%) patients with intact gallbladder.
The E45′ after fatty meal was significantly higher than that without fatty
meal (56 ± 12%vs 40 ± 9% in cholecystectomized
patients, P < 0.001; 52 ± 16%vs 35 ± 11%
in patients with intact gallbladder, P < 0.001). All patients tolerated the fatty meal well during fatty meal QC.Conclusions: Fatty meal can improve hepatic clearance in both patients with intact gallbladder and after cholecystectomy, so routine restriction of fat after ES may be inappropriate. However, further studies are needed to evaluate the role of diet in the prevention of recurrent biliary complications.© 2002 Blackwell Science Asia Pty Ltd
Newly developing hiatus hernia: A survey in patients undergoing upper gastrointestinal endoscopy
Authors: LOFFELD RJLF , VAN DER PUTTEN ABMM 
Published: March 2003

Abstract
Background:
Data on the incidence of hiatus hernia are lacking. A cross‐sectional study was performed in a large population of consecutive patients undergoing endoscopy in order to assess the yearly incidence of hiatus hernia in this population.
Methods:
Consecutive patients undergoing upper gastrointestinal endoscopy in whom no macroscopic abnormalities were seen and who, in addition, underwent a second endoscopy were included in the study. The presence of newly developed hiatus hernia was noted, as well as the time elapsed between both endoscopies.
Results:
Over a period of 8 years, 12 122 endoscopies were performed in 9580 patients. Ninety patients developed a hiatus hernia; this was not the case in a control group of 353 patients. Patients who developed a hiatus hernia were significantly older than those who did not (P < 0.001). The number of women who developed hiatus hernia was higher than the number of men who developed hiatus hernia (P < 0.0001). The total time between both endoscopies in 443 patients was 897 patient years. Ninety patients (20.3%) developed a hiatus hernia. If these data are extrapolated to a yearly occurrence, then 35 of 176 patients will develop a hiatus hernia. It takes an average of 1.9 years for a hiatus hernia to develop.
Conclusions:
In the present study, it was calculated that 19.9% of the studied population would develop a hiatus hernia per year. Patients who developed a hiatus hernia were significantly older than patients who did not. The present study also shows that a hiatus hernia actually develops later in life.© 2002 Blackwell Publishing Asia Pty Ltd
Management of refractory ascites and hepatorenal syndrome
Authors: Chutaputti Anuchit 
Published: March 2003

Abstract  Refractory ascites and hepatorenal syndrome (HRS) are the late complications of the terminal stages of cirrhosis. The definitions of refractory ascites and HRS proposed by the International Ascites Club in 1996 are now widely accepted, and are useful in diagnosis, treatment and research in this field. In both conditions, the only treatment of proven value for improved survival is liver transplantation. However, because of better understanding about the pathophysiology of HRS, including the roles of portal hypertension, ascites formation and hemodynamic derangements, treatments such as transjugular intrahepatic portasystemic shunt (TIPS) and new pharmacological agents may be considered to alleviate the problem prior to transplantation. Symptomatic treatment of refractory ascites includes TIPS and repeated large volume paracentesis. Transjugular intrahepatic portasystemic shunt can improve survival while waiting for liver transplantation. Practical management guidelines for TIPS and large volume paracentesis, including the prevention and management of further complications, are considered in this review.© 2002 Blackwell Publishing Asia Pty Ltd