bluuebunny/crossref_metadata_2025_split huggingface dataset:
Detection of hepatitis A viral RNA in sera of patients with acute hepatitis A
Authors: Kwon Oh Sang , Byun Kwan Soo , Yeon Jong Eun , Park Sang Hoon , Kim Jae Seon , Kim Ju Hyun , Bak Young Tae , Kim Jin Ho , Lee Chang Hong 
Published: March 2003

Abstract
Background and Aims
: The Detection of hepatitis A virus (HAV) is important for diagnosis and epidemiological studies of hepatitis A. The polymerase chain reaction (PCR) technique is a sensitive test to detect HAV‐RNA in specimens. The aims of the present study were to clarify the detection rate of serum HAV‐RNA by PCR and the natural history of HAV viraemia, and to determine the correlation between viraemia and the clinical characteristics in patients with acute hepatitis A.
Methods
: Hepatitis A virus RNA was tested in 74 serum samples which were serially collected from 27 patients with acute hepatitis A. A nested reverse transcription (RT)‐PCR for HAV‐RNA was performed with primer sets located at the VP1 region of the HAV genome and the PCR products were eletrophoresed on a 1.5% agarose gel.
Results
: Hepatitis A virus RNA was found in 18 of 27 (67%) patients with hepatitis A. There were no significant differences between groups positive and negative for HAV‐RNA in clinical and laboratory data, except the time interval between clinical onset and initial serum sampling for RT‐PCR (10 ± 6 vs 19 ± 14 days) and the alanine aminotransferase (ALT) level at initial serum sampling for RT‐PCR (1436 ± 1416 vs 518 ± 432 IU/L). The mean duration of HAV viraemia was 30 ± 19 days (range, 5–59 days). The duration of HAV viraemia and duration of abnormal ALT levels from clinical onset were positively correlated (r = 0.685, P = 0.007).
Conclusion
: In conclusion, HAV‐RNA RT‐PCR is a useful tool to detect HAV viraemia and to study the molecular epidemiology of HAV infection.
Comparison of intraductal ultrasonography with percutaneous transhepatic cholangioscopy for the identification of residual bile duct stones during lithotripsy
Authors: Tamada Kiichi , Ohashi Akira , Tomiyama Takeshi , Wada Shinichi , Satoh Yukihiro , Higashizawa Toshihiko , Ido Kenichi , Sugano Kentaro 
Published: March 2003

AbstractBackground: An imaging modality that can be used to identity small stones after a biliary lithotripsy is required. Intraductal ultrasonography was evaluated by using percutaneous transhepatic cholangioscopy as the gold standard.Methods: Lithotripsy, under percutaneous transhepatic cholangioscopy guidance, was performed in 20 patients. A thin‐caliber ultrasonic probe (2.0 mm in diameter and 20 MHz frequency) was inserted into the bile duct through the percutaneous tract after lithotripsy, and residual stones were identified. This was followed by percutaneous transhepatic cholangioscopy.Results: In the extrahepatic bile ducts, intraductal ultrasonography provided images of all the stones demonstrated on cholangioscopy (n = 11). The sensitivity was superior to that of cholangiography (P < 0.005). However, in the intrahepatic bile ducts, intraductal ultrasonography only visualized the stones located in the cannulated lobe. Extrahepatic stones smaller than 5.0 mm in diameter or in a common hepatic duct larger than 15.0 mm in diameter were missed by cholangiography, but were visualized by the use of intraductal ultrasonography (P < 0.05).Conclusions: Intraductal ultrasonography is equivalent to cholangioscopy in the extrahepatic bile ducts. Cholangiography and intraductal ultrasonography should be used in combination to image intrahepatic and extrahepatic stones.
Shift of the gastric T‐cell response in gastric carcinoma
Authors: Ren Zhigang , Pang Gerald , Clancy Robert , Li Liang Chen , Lee Cheok Soon , Batey Robert , Borody Tom , Dunkley Margaret 
Published: March 2003

AbstractBackground and Aims: The etiology and pathophysiology of stomach carcinoma is complex, and the mechanism whereby H. pylori directly or indirectly induces carcinoma remains unclear. In this study, interleukin (IL)‐8, IL‐4 and interferon (IFN)‐γ were measured in the tissue culture supernatant of gastric organ cultures from subjects with chronic gastritis with or without H. pylori infection, and with or without gastric cancer and gastric dysplasia.Results: Interleukin‐8 levels were higher in cancer‐ and H. pylori‐infected gastritis subjects than in H. pylori‐negative subjects (12.95 ± 3.16, 10.48 ± 1.55 and 4.49 ± 1.28 ng/mL, respectively). Elevated levels of IFN‐γ were detected in both H. pylori‐infected and non‐infected subjects with uncomplicated gastritis (72.23 ± 19.0 and 34.61 ± 5.30 pg/mL) and in non‐infected dysplasia subjects (88 ± 20.5 pg/mL). Background levels of IL‐4 (≤ 9.4 pg/mL) in uncomplicated gastritis subjects and relatively high levels of IL‐4 in dysplasia subjects (25.8 ± 7.3 pg/mL) were detected. In contrast, trace amounts of IFN‐γ (16.01 ± 0.35 pg/mL) and high levels of IL‐4 (42.81 ± 8.49 pg/mL) in gastric biopsy culture supernatants were found in cancer subjects. Mucosal IL‐4 levels (but not IL‐8 levels) correlated with infection and mucosal anti‐H. pylori immunoglobulin G antibody.Conclusions: The significant differences between gastritis with and without cancer and dysplasia indicated a shift from a Th1 to a Th2 helper cell pattern of cytokine secretion. This study has identified a local mucosal defect in gastric cancer. The near absence of IFN‐γ production from the mucosa at the margins of the tumor may be a critical factor in promoting growth of neoplastic cells.
Vascularity of advanced gastric carcinoma: Evaluation by using power Doppler imaging
Authors: Kawasaki Toshihiko , Ueo Taro , Itani Toshinao , Shibatohge Mitsushige , Mimura Jun , Komori Hideshi , Todo Akio , Kudo Masatoshi 
Published: March 2003

AbstractBackground: We investigated the vascularity of advanced gastric adenocarcinomas by using percutaneous power Doppler imaging.Methods: Seventeen patients with gastric cancer and 10 without a gastric tumor, but with a slightly thick gastric wall in the B‐mode ultrasound, were investigated with the use of power Doppler imaging. The color signals of the gastric lesion were graded as follows: 1, no color signals or the same as the surroundings; 2, color signals were slightly increasing; and 3, color signals were obviously increasing.Results: The color signals of three patients were graded 1, those of eight patients were graded 2 and those of six patients were graded 3 in the gastric cancer group. The color signals of all 10 patients without a gastric tumor were grade 1. This difference was statistically significant (P = 0.0002).Conclusions: Power Doppler imaging showed vascularity of gastric cancer increasing in the majority of patients (14 of 17: 82%). Thus, power Doppler imaging might be a good screening examination method for gastric cancer.
Clinical significance of TT virus in chronic hepatitis C
Authors: Meng Xiang Wei , Komatsu Masafumi , Goto Takashi , Nakane Kunio , Ohshima Shigetoshi , Yoneyama Kazuo , Lin Jiun Guey , Watanabe Sumio 
Published: March 2003

AbstractBackground and Aims: Much is still unknown about the clinical significance of TT virus (TTV), which has been reported as a candidate for non A–G hepatitis virus. The aim of this study was to clarify the clinical significance of TTV in patients coinfected with TTV and hepatitis C virus (HCV).Methods: The 95 subjects studied had chronic hepatitis C (CHC), and underwent interferon (IFN) therapy. TT Virus DNA was detected by using polymerase chain reaction. The nucleotide sequences were determined by using a dideoxy chain termination method. A phylogenetic tree was drawn up by using the neighbor‐joining method.Results: TT Virus DNA was detected in 37.9% of patients with the use of an open reading frame 1 (ORF1) primer, and in 88.4% of patients by using a 5′ untranslated region (5′ UTR) primer. Using both sets of primers, no differences were found between TTV‐DNA‐positive and ‐negative subjects with CHC in the clinical findings. Serum TTV DNA was eradicated in 30.6% of patients with the ORF1 primer, and in 19.1% of patients with the 5′ UTR primer at 6 months after the cessation of IFN therapy. The levels of TTV DNA before IFN therapy were significantly lower in the viral eradication group than in non‐eradication group. The changes in alanine aminotransferase (ALT) concentrations were significantly correlated with changes in HCV‐RNA in CHC patients with TTV. Moreover, there was no correlation between the changes in TTV DNA and the course of ALT.Conclusion: Hepatocellular injury in patients with chronic hepatitis who are coinfected with HCV and TTV appears to primarily be caused by HCV and is less attributable to TTV.
Lipid peroxidation in hepatic steatosis in humans is associated with hepatic fibrosis and occurs predominately in acinar zone 3
Authors: Macdonald Graeme A , Bridle Kim R , Ward Patrick J , Walker Neal I , Houglum Karl , George D Keith , Smith Jeffery L , Powell Lawrie W , Crawford Darrell Hg , Ramm Grant A 
Published: March 2003

AbstractBackground and Aims:Hepatic steatosis has been shown to be associated with lipid peroxidation and hepatic fibrosis in a variety of liver diseases including non‐alcoholic fatty liver disease. However, the lobular distribution of lipid peroxidation associated with hepatic steatosis, and the influence of hepatic iron stores on this are unknown. The aim of this study was to assess the distribution of lipid peroxidation in association with these factors, and the relationship of this to the fibrogenic cascade.Methods:Liver biopsies from 39 patients with varying degrees of hepatic steatosis were assessed for evidence of lipid peroxidation (malondialdehyde adducts), hepatic iron, inflammation, fibrosis, hepatic stellate cell activation (α‐smooth muscle actin and TGF‐β expression) and collagen type I synthesis (procollagen α1 (I) mRNA).Results:Lipid peroxidation occurred in and adjacent to fat‐laden hepatocytes and was maximal in acinar zone 3. Fibrosis was associated with steatosis (P < 0.04), lipid peroxidation (P < 0.05) and hepatic iron stores (P < 0.02). Multivariate logistic regression analysis confirmed the association between steatosis and lipid peroxidation within zone 3 hepatocytes (P < 0.05), while for hepatic iron, lipid peroxidation was seen within sinusoidal cells (P < 0.05), particularly in zone 1 (P < 0.02). Steatosis was also associated with acinar inflammation (P < 0.005). α‐Smooth muscle actin expression was present in association with both lipid peroxidation and fibrosis. Although the effects of steatosis and iron on lipid peroxidation and fibrosis were additive, there was no evidence of a specific synergistic interaction between them.Conclusions:These observations support a model where steatosis exerts an effect on fibrosis through lipid peroxidation, particularly in zone 3 hepatocytes.
Glucose‐6‐phosphatase gene mutations in 20 adult Japanese patients with glycogen storage disease type 1a with reference to hepatic tumors
Authors: Nakamura Toshifumi , Ozawa Takachika , Kawasaki Tsunehisa , Nakamura Hirotoshi , Sugimura Haruhiko 
Published: March 2003

AbstractBackground and Aims:A few cases are reported of liver neoplasms observed in patients with glycogen storage disease type 1a (GSD1a). Genetic analysis was carried out in adult Japanese patients with GSD1a and their family members, and hepatic tumors were also investigated in these patients.Methods:DNA was extracted from the peripheral blood lymphocytes of 20 adult patients with GSD1a and 21 family members, and mutations were detected based on the differences in the polymerase chain reaction (PCR) products of the glucose‐6‐phosphatase (G6Pase) gene shown by single‐strand conformation polymorphism (SSCP) analysis. Actual mutations were confirmed by direct sequencing. The relationship between the occurrence of liver tumors and the clinical characteristics of the patients was also investigated.Results:Nineteen of the 20 patients were homozygous for the G727T mutation and one was a compound heterozygote for G727T plus G327A mutations. All of the 19 homozygotes for G727T had hepatomegaly, three had hepatocellular carcinoma, one had cholangiocellular carcinoma, and seven had hepatic adenoma. There were no differences between the tumor and non‐tumor groups with respect to laboratory biochemical data (P> 0.05). The mean age of G727T homozygotes with hepatocellular carcinoma was 48.3 years, and that of those with hepatic adenoma was approximately 20 years younger.Conclusion:The G727T mutation seems to be common among Japanese patients with GSD1a, and the discovery of one heterozygote with a combination of G727T and G327A mutations (the latter mutation is common among Chinese) by the use of polymerase chain reaction–single strand conformation polymorphism analysis gave further insight into Japanese ancestry. This is the first study of liver tumors in a large group of adult GSD1a patients with the G727T mutation. As most of the patients in our series are free from other chronic liver diseases such as viral hepatitis, other genetic and/or acquired factors may have influence on the sequel to this metabolic disease.
Temporary amelioration of bilirubin conjugation defect in Gunn rats by transplanting conditionally immortalized hepatocytes
Authors: KIM BYUNG‐HO , HAN YO SEB , DONG SEOK HO , KIM HYO JONG , CHANG YOUNG WOON , LEE JOUNG IL , CHANG RIN 
Published: March 2003

Abstract Background: Conditionally immortalized hepatocytes (CIH) have been used in hepatocyte transplantation as an alternative to primary hepatocytes to cope with the shortage of donor organs. However, CIH are known to undergo apoptosis at body temperature and survive in vivo for a short period. In the present study, we investigated whether CIH function or not and how long their function is maintained in vivo.Methods: Various CIH cell lines that were established with temperature‐sensitive Simian virus 40 large T antigen were transplanted into the spleen of Gunn rats, which are defective in bilirubin uridine diphosphate glucuronoside transferase (BUGT). Then, we measured biological changes over 3 months.Results: Serum bilirubin of the syngeneic CIH recipients decreased by 30%, which was maintained for 8 weeks. Thereafter, it began to rise to basal levels. The recipients of allogeneic CIH showed a minor reduction of bilirubin, although this was not statistically significant. However, there was no significant change in the bilirubin level in recipients of BUGT‐defective congeneic CIH throughout the study period. Bilirubin monoglucuronides in the bile were not detected in the recipients of BUGT‐defective CIH. However, they appeared in recipients of non‐defective CIH and made up approximately 41% of total bile pigments.Conclusions: Conditionally immortalized hepatocytes expressed hepatocyte function in vivo as well as in vitro, but the function lasted for a couple of months. According to our previous study, the limited functional duration may be related to the inevitable occurrence of apoptosis of these cells at body temperature. These data suggest that CIH can be used in hepatocyte transplantation only for temporary hepatic support.© 2002 Blackwell Publishing Asia Pty Ltd
Clinical implications of hepatogenous diabetes in liver cirrhosis
Authors: Holstein A , Hinze S , THIEßEn E , Plaschke A , Egberts E‐H 
Published: March 2003

AbstractBackground: Hepatogenous diabetes is a common complication of liver cirrhosis. The aim of the present study was to examine the clinical and therapeutic implications and the prognostic significance of hepatogenous diabetes in patients with liver cirrhosis.Methods: The prospective cohort study was conducted in 52 patients with histologically confirmed liver cirrhosis (44% Child A, 37% Child B, 19% Child C). The examination included a history, determination of basal C‐peptide and glycosylated hemoglobin (HbA1c) and, in some cases, a 3 h oral glucose tolerance test with 100 g glucose. Patients were also examined for signs of diabetic retinopathy and information on the further course of illness was obtained.Results: Seventy‐one percent of patients with liver cirrhosis had manifest diabetes, 25% had impaired glucose tolerance and only 4% had normal glucose tolerance. In most cases, the hepatogenous diabetes was clinically asymptomatic. Sixteen percent of patients with hepatogenous diabetes had a family history of diabetes; only 8% had retinopathic complications. Within 5.6 ± 4.5 years after diagnosis of liver cirrhosis, 52% of the diabetics had died, mainly of complications of the cirrhosis. There were no diabetes‐associated or cardiovascular deaths.Conclusions: Hepatogenous diabetes differs from type 2 diabetes in that there is less often a positive family history and that the cardiovascular and retinopathic risk is low. The prognosis of cirrhotic patients with diabetes is more likely to be negatively affected by the underlying hepatic disease and its complications than by the diabetes. Antihyperglycemic treatment of hepatogenous diabetes should always be carefully weighed up in each individual case.
Non‐cirrhotic portal fibrosis: Current concepts and management
Authors: SARIN SK , KAPOOR D 
Published: March 2003

Abstract
Non‐cirrhotic portal hypertension (NCPH) comprises diseases having an increase in portal pressure (PP) due to intraheptic or prehepatic lesions, in the absence of cirrhosis. The lesions are generally vascular, either in the portal vein, its branches or in the perisinusoidal area. Because the wedged hepatic venous pressure is near normal, measurement of intravariceal or intrasplenic pressure is needed to assess PP. The majority of diseases included in the category of NCPH are well‐characterized disease entities where portal hypertension (PHT) is a late manifestation and, hence, these are not discussed. Two diseases that present only with features of PHT and are common in developing countries are non‐cirrhotic portal fibrosis (NCPF) and extrahepatic portal vein obstruction (EHPVO). Non‐cirrhotic portal fibrosis is a syndrome of obscure etiology, characterized by ‘obliterative portovenopathy’ leading to PHT, massive splenomegaly and well‐tolerated episodes of variceal bleeding in young adults from low socioeconomic backgrounds, having near normal hepatic functions. In some parts of the world, NCPF is called idiopathic portal hypertension (IPH) or ‘hepatoportal sclerosis’. Because 85–95% of patients with NCPF and EHPVO present with variceal bleeding, treatment involves management with endoscopic sclerotherapy (EST) or variceal ligation (EVL). These therapies are effective in approximately 90–95% of patients. Gastric varices are another common cause of upper gastrointestinal bleeding in these patients and these can be managed with cyanoacrylate glue injection or surgery. Other indications for surgery include failure of EST/EVL, and symptomatic hypersplenism. The prognosis of patients with NCPF is good and 5 years survival in patients in whom variceal bleeding can be controlled has been reported to be approximately 95–100%.© 2002 Blackwell Publishing Asia Pty Ltd
β ‐Catenin expression in hepatocellular carcinoma: A possible participation of β ‐catenin in the dedifferentiation process
Authors: Suzuki Tetsuya , Yano Hirohisa , Nakashima Yutaka , Nakashima Osamu , Kojiro Masamichi 
Published: March 2003

AbstractBackground: β‐Catenin is known as a multifunctional protein acting as a regulator of the cadherin‐mediated cell–cell adhesion system and in the Wingless/Wnt signal transduction pathway. Recent studies reported mutation of the β‐catenin gene in some tissues of hepatocellular carcinoma (HCC).Methods: ‘Nodule‐in‐nodule’ appearance is a feature of well‐differentiated HCC containing a distinct nodule of less‐differentiated cancer tissue inside, and it is presumed to be a morphological expression of the dedifferentiation process. The present study immunohistochemically investigated the β‐catenin expression according to the dedifferentiation process of HCC, that is, in small well‐differentiated HCC with indistinct margins, HCC with a ‘nodule‐in‐nodule’ appearance, moderately differentiated HCC, which does not have a ‘nodule‐in‐nodule’ appearance, and sarcomatous HCC.Results: The expression of β‐catenin was observed in approximately 70% of small well‐differentiated HCC with indistinct margins. In HCC with a ‘nodule‐in‐nodule’ appearance, membranous expression of β‐catenin was higher in the well‐differentiated cancer tissues than in the less‐differentiated cancer tissues (P < 0.01), cytoplasmic expression was higher in the less‐differentiated cancer tissues (P < 0.01), and nuclear expression was higher in the less‐differentiated cancer tissues (P < 0.001). In moderately differentiated HCC, tumors with membranous expression of β‐catenin had more frequent intrahepatic metastasis than those without having the expression (P < 0.001).Conclusions: Accumulation of β‐catenin was already present in the early stage of HCC, and in less‐differentiated cancer tissue the membranous expression of β‐catenin could be related to intrahepatic metastasis.© 2002 Blackwell Publishing Asia Pty Ltd
Cholangiocarcinoma: Recent progress. Part 2: Molecular pathology and treatment
Authors: Okuda Kunio , Nakanuma Yasuni , Miyazaki Masaru 
Published: March 2003

AbstractPart 2 of this review discusses DNA damage in biliary epithelial cells in the development of cholangiocarcinoma, alterations in cell kinetics of biliary epithelial cells, biliary epithelial mitoinhibition, and apoptosis that includes the role of Bcl‐2, transforming growth factor‐β, telomerase activities and deregulation of Ras and p53, cancer‐associated antigens in cholangiocarcinoma, precancerous lesions, stroma formation and angiogenesis, cancer invasion, cell–cell and cell–matrix interactions, and the mechanism of evasion from immune surveillance. These discussions are followed briefly by treatments such as photodynamic therapy, and surgical approaches comparing resection and liver transplantation.
Changes in autonomic nervous activity during endoscopic retrograde cholangiopancreatography: A possible factor in cardiac complications
Authors: Ochi Yoshie , Nomura Masahiro , Okamura Seisuke , Yano Mitsuyasu , Saito Ken , Nakaya Yutaka , Ito Susumu 
Published: March 2003

AbstractBackground and Aims: The changes of autonomic nervous activity during endoscopic retrograde cholangiopancreatography (ERCP) are closely related to the development of cardiovascular complications, such as arrhythmias and acute coronary syndrome. In the present study, the correlation between changes in hemodynamics and autonomic nervous activity during ERCP procedures was evaluated by analyzing heart rate variability and blood catecholamine levels.Methods: Twenty‐three patients who underwent ERCP (ERCP group) and 15 control subjects who were only premedicated (C group) were studied. Ambulant ECG, blood pressure, arterial oxygen saturation, and blood level of catecholamine were measured. Autonomic nervous function was assessed by analyzing the spectral analysis and 1/f fluctuation. The low frequency power (LF power; 0.04–0.15 Hz), high frequency power (HF power; 0.15–0.40 Hz, indicator of parasymapathetic tone), the ratio of LF power to HF power (LF/HF ratio, indicator of sympathetic tone), and 1/f fluctuation (indicator of pleasant mood) were calculated.Results: Blood pressure and heart rate were increased and arterial oxygen saturation was decreased in the ERCP group during the endoscopic procedure. Changes in the parameters of autonomic nervous function (LF power, HF power, LF/HF ratio, and 1/f fluctuation) were significantly greater in the ERCP group than in the C group, especially during cholangiography. Moreover, blood levels of catecholamines were significantly increased during the ERCP procedure. In the C group, however, blood levels of catecholamines did not significantly change except directly after premedication.Conclusions: Autonomic nervous activity varied greatly during cholangiography, demonstrating that ERCP has more than a little influence on the cardiovascular system. The results of the present study indicated that attention should be focused on changes in hemodynamics in patients with cardiovascular complications by monitoring the aforementioned hemodynamic parameters during ERCP.© 2002 Blackwell Publishing Asia Pty Ltd