bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of apoptosis in Helicobacter pylori‐associated gastric mucosal injury
Authors: Suzuki Hidekazu , Ishii Hiromasa 
Published: March 2003

AbstractApoptosis, a programmed cell death, was ignored, just like Helicobacter pylori, only to reappear recently. However, the number of current publications dealing with apoptosis or H. pylori has increased exponentially. Although gastric epithelial apoptosis is a programmed physiological event in the superficial aspect of the mucosa and is important for healthy cell turnover, H. pylori infection reportedly promotes such a cell death sequence. Because apoptosis regulates the cycle of cell turnover in balance with proliferation, dysregulation of apoptosis or proliferation evoked by H. pylori colonization would be linked to the gastric carcinogenesis. In other words, a reduced level of apoptosis could contribute to the generation of gastric cancer. Herein, we review apoptosis as well as its associated pathological events, such as hyperproliferation, in H. pylori‐colonized gastric mucosa.
Role of serum C‐reactive protein as a marker of hepatocellular carcinoma in patients with cirrhosis
Authors: Lin Zu‐Yau , Wang Liang‐Yen , Yu Ming‐Lung , Chen Shinn‐Cherng , Chuang Wan‐Long , Hsieh Ming‐Yuh , Tsai Jung‐Fa , Chang Wen‐Yu 
Published: March 2003

Abstract
Background
: The usefulness of C‐reactive protein (CRP) as a tumour marker in patients with hepatocellular carcinoma (HCC) is controversial. The purpose of this study was to determine whether CRP estimation could be used to identify patients with HCC among those with cirrhosis.
Methods
: Serum levels of CRP and α‐fetoprotein (AFP) were investigated in 122 previously untreated patients with cirrhosis and HCC. Another 76 patients with cirrhosis alone were also investigated as controls.
Results
: Of the subjects tested, 47.5% of patients with HCC and 39.5% of controls had elevated CRP values (> 6 μg/mL). Although using elevated CRP and/or AFP (> 20 ng/mL) as a criterion showed a significant difference between controls and patients with multiple nodular, massive, or diffuse type HCC (all P < 0.005), the clinical application of this criterion was limited because of low specificity (58%) and accuracy (all < 73%). By using receiver‐operating characteristic curves no valuable threshold value of CRP was found to discriminate various types of HCC, except for distinguishing the diffuse type from controls. The CRP value of 12 μg/mL could be used as the cut‐off value to differentiate diffuse‐type HCC from controls (sensitivity 82.4%, specificity 82%, accuracy 82.1%, P < 0.005).
Conclusions
: Serum CRP is not a good marker for HCC. However, very high values of CRP in patients with cirrhosis may suggest the presence of a diffuse‐type HCC.
Budd–Chiari syndrome: Our experience of 71 patients
Authors: Singh V , Sinha Sk , Nain Ck , Bambery P , Kaur U , Verma S , Chawla Yk , Singh K 
Published: March 2003

Abstract
Background
: Hepatic venous outflow obstruction (Budd–Chiari syndrome) is frequently encountered as a cause of portal hypertension at our centre.
Methods and Results
: We studied the clinical presentation, therapeutic modalities and outcome of 71 patients with hepatic venous outflow obstruction between 1992 and 1997. Twenty‐seven patients presented with acute disease, while 44 had chronic presentation. Abdominal pain, distension, jaundice and upper gastrointestinal bleeding were the commonest presenting symptoms. The majority of patients had distended veins, hepatomegaly, splenomegaly, ascites and ankle oedema. The diagnosis was made on the basis of inferior vena cavography/functional hepatography and pulsed Doppler ultrasonography and/or liver biopsy in 39 patients and pulsed Doppler ultrasonography and/or liver biopsy in 32 patients. Pulsed Doppler ultrasonography accurately detected the site of the block in 31 of 39 patients (79.4%). The obstruction was in the hepatic vein in 20 patients, in the inferior vena cava in 10, and in both in 41 patients. Aetiologically, four had pregnancy‐related disease, four tumour‐related, three hypercoagulable states, 18 inferior vena cava membranes and 42 were idiopathic. Of 30 patients in whom liver biopsy was carried out, eight had centrizonal congestion and necrosis, 13 had mixed features and nine had established cirrhosis. Seven patients underwent a shunt operation and surgical membranotomy was carried out in one. Three patients (4.2%) died in the hospital.
Conclusions
: Hepatic venous outflow obstruction is a common problem; patients present with abdominal pain, distension, jaundice, distended veins, ascites and ankle oedema. Chronic presentation is more frequent. Pulsed Doppler ultrasound, venography and liver biopsy are very helpful in diagnosis.
Oesophageal pH monitoring in infants: Elimination of gastric buffering does not modify reflux index
Authors: Hegar Badriul , Vandemaele Kris , Arana Albaro , Vandenplas Yvan 
Published: March 2003

Abstract
Background
: Oesophageal pH monitoring is considered to be the gold standard investigation in the diagnosis of gastro‐oesophageal reflux disease. Results of pH monitoring in regurgitating infants, however, may be within normal ranges. Therefore it was hypothesized that prolonged buffering of gastric acidity caused by milk‐feeding may falsely normalize the pH data. Therefore, it may be relevant to omit the periods of gastric acid buffering in the analysis of the oesophageal pH monitoring data.
Methods
: Combined gastric and oesophageal pH monitoring (Digitrapper Mark III, two‐channel antimony electrode, Synectics) was performed in 90 consecutive infants, 0.5–10 months old, who were referred to the unit by outdoor paediatricians for pH measurement. The data were analysed in three different ways. The reflux index (RI), or the percentage time that the pH in the oesophagus was < 4.0, was calculated in three different ways: (i) the total duration of the investigation; (ii) excluding 90‐min postprandial periods, starting from the beginning of a feeding; and (iii) excluding all periods with a gastric pH > 4.0, which are the periods of gastric buffering with a theoretical impossibility of recording an oesophageal pH < 4.0.
Results
: The mean duration of the pHmetries was 19.20 ± 2.01 h (A; mean ± 1 SD), with a RI of 5.38 ± 5.39% (B; median 3.45%). If the 90‐min postprandial periods were not considered, the mean duration decreased to 12.21 ± 2.41 h (C; P(A vs C) < 0.001), with an oesophageal RI of 6.82 ± 6.57% (D; median: 4.65; P(B vs D) = NS; r (B vs D) = 0.97). If all periods with a gastric pH > 4.0 were elminated, the duration available for analysis of the data with a gastric pH < 4.0 was 12.53 ± 4.00 h (E; P(A vs E) < 0.001; P(C vs E) = NS), with an oesophageal RI of 7.06 ± 7.52% (F; median: 4.50; P(B vs D vs F) = NS; r(B vs F), (D vs F) = 0.96).
Conclusion
: Overall the data do not support a benefit from including periods of gastric buffering in the routine analysis of oesophageal pH monitoring data. Therefore standard oesophageal pH monitoring should be with a single electrode and should not include periods of gastric buffering.
Overexpression of c‐H‐ras p21 is correlated with vascular endothelial growth factor expression and neovascularization in advanced gastric carcinoma 1
Authors: Kim Young‐Bae , Han Jee Young , Kim Tae Sook , Kim Pum Soo , Chu Young Chae 
Published: March 2003

AbstractBackground and Aims ras Gene and its product (p21) have been reported to be associated with vascular endothelial growth factor (VEGF), which is one of the most important angiogenic factors, and tumor‐associated angiogenesis. We tried to evaluate the correlation between the expression of c‐H‐ras gene product p21 and angiogenesis in advanced gastric carcinoma.MethodsImmunohistochemical expression of c‐H‐ras p21 and VEGF was examined in 49 advanced gastric adenocarcinomas. In addition, double immunohistochemical staining was performed using anti‐CD34 and anti‐Ki‐67 antibodies, and the intratumoral microvessel densities and their endothelial proliferative labeling indices were then counted to evaluate the degree of angiogenesis.ResultsThe expression of c‐H‐ras p21 was demonstrated in 43 out of 49 gastric adenocarcinomas (87.8%). It did not correlate with histologic type, depth of invasion or metastasis. However, the degree of c‐H‐ras p21 expression was correlated with VEGF. In addition, the degree of c‐H‐ras p21 expression was correlated with increased intratumoral microvascular density and endothelial proliferative activity.ConclusionsWe suggest that c‐H‐ras oncogene product p21 contributes to the upregulation of tumor‐associated angiogenesis by the increased production of VEGF in advanced gastric carcinomas. Therefore, treatment involving the targeting of ras oncogene could inhibit solid tumor growth by suppressing tumor‐associated angiogenesis.
Non‐steroidal anti‐inflammatory drugs with different cyclooxygenase inhibitory profiles that prevent aberrant crypt foci formation but vary in acute gastrotoxicity in a rat model 1
Authors: Brown Wendy A , Skinner Stewart A , Malcontenti‐Wilson Caterina , Misajon Aileen , Dejong Tanya , Vogiagis Daphne , O’Brien Paul E 
Published: March 2003

AbstractBackgroundStandard non‐steroidal anti‐inflammatory drugs (NSAIDs) reduce the risk of colorectal cancer; however, their use as preventive agents is limited by their inherent toxicity. Drugs that selectively inhibit cyclooxygenase‐2 (COX‐2) may be useful in this setting as they are supposedly less toxic. No study has directly compared the ability of standard NSAIDs and selective COX‐2 inhibitors to inhibit colorectal cancer at clinically relevant doses.MethodsAberrant crypt foci (ACF) were induced in Sprague–Dawley rats by using 1,2‐dimethylhydrazine (DMH). Test agents or vehicle were then administered for 3 weeks, twice daily through orogastric gavage. At the end of this period, the number and multiplicity of ACF were determined. The agents tested at equivalent anti‐inflammatory doses were: sulindac and indomethacin (standard NSAIDs), meloxicam (selective COX‐2 inhibitor), celecoxib (specific COX‐2 inhibitor) and sulindac sulfone (no known COX activity). Acute gastrotoxicity of NSAID in rats was compared by using quantitative histology.ResultsAll test agents reduced the number of ACF. There was a 42% reduction with indomethacin, 46% with sulindac, 46% with meloxicam, 22% with celecoxib and 36% with sulindac sulfone. Only the COX‐2 inhibitors caused no significant gastrotoxicity in rats.ConclusionsCyclooxygenase‐2 inhibitors are potentially ideal chemopreventive agents as they inhibit ACF and are not gastrotoxic.
Risk of alanine aminotransferase flare‐up among asymptomatic hepatitis C virus RNA carriers: A 10‐year follow‐up study
Authors: Tsuji Kenichirou , Yamasaki Kazumi , Yamanishi Mikio , Kawakami Masuhiro , Shirahama Satoshi 
Published: March 2003

AbstractAims: The aim of this study was to determine the cumulative rate of flare‐up of serum alanine aminotransferase (ALT) level during a 10‐year follow‐up period, and characterize the clinical, virologic features in 120 hepatitis C virus (HCV) RNA‐positive asymptomatic carriers with persistently normal ALT levels for 6 months.Results: All flare‐up cases occurred during the first 5 years of the present study, 27.4% of carriers showed ALT flare‐up during this period, but none in the second half of the study. Multivariate analysis showed that C100–3 antibody (Ab) and anti‐human T cell leukemia virus (HTLV)‐I Ab were two independent and significant predictors of ALT flare‐up in hepatitis C virus (HCV) RNA asymptomatic carriers (P = 0.04, P = 0.03, respectively). Liver biopsy was performed in 44 patients (11 with flare‐up of ALT level, whereas 33 had normal ALT levels). Histological features of chronic hepatitis with lymphoid infiltration in the portal tracts were commonly observed in all specimens, and no differences were noted between the flare‐up ALT group and the persistently normal ALT group.Conclusions: Our results indicated that flare‐up of ALT levels in asymptomatic HCV‐RNA carriers with normal ALT levels occurs during the first 5 years of diagnosis, and that the presence of C100–3 and anti‐HTLV‐I antibodies are good predictors of a transient rise in ALT.
Autoimmune liver disease in children
Authors: Yachha Surender K , Srivastava Anshu , Chetri Kamal , Saraswat Vivek A , Krishnani Narendra 
Published: March 2003

AbstractBackground and Aim:Autoimmune liver disease (AILD) in children progresses to cirrhosis and liver failure if not diagnosed and managed in time. We prospectively analyzed our patients with liver disease for autoimmune etiology and their outcome with treatment.Methods:All patients with liver disease were evaluated with liver function tests, abdominal ultrasonography, endoscopy, liver biopsy, viral markers and investigations for Wilson’s disease. Immunoglobin (Ig)M hepatitis A virus, hepatitis E virus (HEV) and IgM hepatitis B core antibody were tested if acute viral hepatitis was suspected. Antinuclear antibody (ANA), antismooth muscle antibody (SMA), and liver kidney microsomal antibody (anti‐LKM‐1) were done in all cases. Autoimmune liver disease was diagnosed when one or more autoantibodies tested positive (> 1:40), and no other etiology of liver disease was identified. We also applied criteria proposed by the International Autoimmune Hepatitis Group. Cases diagnosed to have AILD were treated with immunosuppressive drugs.Results:Autoimmune liver disease constituted 3.9% (6/153; median age and duration of illness 8.5 years and 3 months, respectively) of chronic liver disease cases. Four patients had acute hepatitis‐like presentation. Of the six cases, two each were ANA and SMA + ; one was anti‐LKM‐1 +, and the other was positive for both SMA and anti‐LKM‐1. Three of the patients achieved remission with combination therapy of oral prednisolone (OP) and azathioprine (AZT), and one with only OP. The other two patients were not treated. Two of the patients in remission have been weaned off from immunosuppressive therapy, and one is in a withdrawal phase. Another patient, while in biochemical remission developed superimposed anicteric acute HEV infection.Conclusion:Although AILD is uncommon in children, its search is rewarding, as remission is achieved with immunosuppressive therapy. Superimposed acute viral hepatitis can occur in endemic areas.
Diagnostic value of serum type IV collagen test in comparison with platelet count for predicting the fibrotic stage in patients with chronic hepatitis C
Authors: Murawaki Yoshikazu , Koda Masahiko , Okamoto Kinnya , Mimura Kenichi , Kawasaki Hironaka 
Published: March 2003

AbstractBackground and Aim: The serum type IV collagen test is now used as a diagnostic aid for the detection of liver fibrosis and cirrhosis. Recently, a platelet count has been reported to be a useful marker for assessing the fibrotic stage in chronic hepatitis C. The aim of this study was to compare the usefulness of the serum type IV collagen test and platelet count for diagnosing the fibrotic stage in chronic hepatitis C patients.Methods: The diagnostic values were assessed by the use of receiver operating characteristic (ROC) analysis in 165 patients with chronic hepatitis C, with the exception of those patients with cirrhosis.Results: The serum type IV collagen level increased, and the platelet count decreased significantly with the progression of fibrosis staging. As judged from ROC curves, the serum type IV collagen test was more useful than the platelet count for differentiating moderate or severe fibrosis from no or mild fibrosis. At a cut‐off value of 110 ng/mL, the serum type IV collagen test had an overall diagnostic accuracy of 75%, while at a cut‐off value of 16 × 104/mm3, the platelet count had a diagnostic accuracy of 70%. The serum type IV collagen test and platelet count were similar in differentiating severe fibrosis from no, mild or moderate fibrosis. Both serum type IV collagen (at a cut‐off value of 130 ng/mL) and platelet count (at a cut‐off value of 14 × 104/mm3) had a diagnostic accuracy of 73%.Conclusion: The serum type IV collagen test was slightly superior to the platelet count for assessing the fibrotic stage in patients with chronic hepatitis C.
Disease recurrence after liver transplantation in Western Australia
Authors: YUSOFF IAN F , HOUSE ANTHONY K , FERGUSON JOHN , GARAS GEORGE , HEATH DUGAL , MITCHELL ANDREW , JEFFREY GARY P 
Published: March 2003

AbstractBackground and Aim Orthotopic liver transplantation (OLT) is now the accepted therapy for end‐stage chronic liver disease. Long‐term survival is now expected in the majority of patients and, consequently, disease recurrence has emerged as a major concern. Our aim was to document the rate of disease recurrence after liver transplantation for conditions other than hepatitis C, in patients followed up by the Western Australian Liver Transplant Service (WALTS).Methods The case notes of all post‐OLT patients followed up by WALTS were reviewed. Patients were excluded if survival was less than 3 months post‐OLT; OLT was performed for hepatitis C alone or follow up was unavailable. Detection and definition of disease recurrence depended on pretransplant diagnosis, and were based on patient interview, biochemical, immunological and serological tests. Radiological and histological confirmation were obtained where clinically indicated.Results Eighty‐seven patients were identified (89 OLTs performed). The overall rate of recurrence was 10%. Recurrence rates by disease were: primary sclerosing cholangitis (17%), primary biliary cirrhosis (12%), autoimmune hepatitis (17%), hepatitis B (40%) and alcoholic liver disease (4%). Alcohol use relapse after transplantation occurred in 25%. The overall survival post‐OLT was 87%, with a mean follow up of 53 months. Survival in patients with recurrent disease was 89%.Conclusions Disease recurrence after OLT does occur, but overall, it is relatively uncommon. Recurrence rates vary significantly and depend, in part, on indication for OLT. With medium‐term follow up, recurrent disease does not have an effect on mortality.
Biliary guidewire facilitates bile duct biopsy and endoscopic drainage
Authors: HIGASHIZAWA TOSHIHIKO , TAMADA KIICHI , TOMIYAMA TAKESHI , WADA SHINICHI , OHASHI AKIRA , SATOH YUKIHIRO , GOTOH YASUHIKO , MIYATA TAKAMITSU , IDO KENICHI , SUGANO KENTARO 
Published: March 2003

AbstractBackground: The introduction of a guidewire through bile duct strictures may facilitate transpapillary bile duct biopsy and subsequent biliary drainage.Methods: Endoscopic bile duct biopsy was attempted in 61 patients with bile duct strictures. After the introduction of a guidewire into the bile duct, biopsy forceps were inserted via the papilla. Both devices were inserted through the working channel (3.2 mm in diameter) of a conventional duodenoscope. After the procedure, an endoscopic naso‐biliary drainage catheter was advanced along the guidewire. The success rate of inserting the biopsy forceps, the sensitivity of the biopsy, and the success rate of endoscopic biliary drainage after the biopsy were analyzed prospectively.Results: The final diagnosis was malignant strictures in 50 patients and benign strictures
in 11. The success rate of inserting biopsy forceps without performing endoscopic
papillary balloon dilation was 85%. The sensitivity of the biopsy for primary
bile duct cancer (83%) was significantly higher (P < 0.05) than that of pancreatic cancer (47%). All patients had successful endoscopic biliary drainage after the procedure.Conclusion: A previously placed guidewire facilitates insertion of biopsy forceps and endoscopic biliary drainage. The histological diagnosis of cancer is more likely with bile duct cancer than with pancreatic cancer.© 2002 Blackwell Science Asia Pty Ltd
Accelerated reversal of carbon tetrachloride‐induced cirrhosis in rats by the endothelin receptor antagonist TAK‐044
Authors: ANSELMI KRISTIN , SUBBOTIN VLADIMIR M , NEMOTO EDWIN , GANDHI CHANDRASHEKHAR R 
Published: March 2003

Abstract
Background
: A multifunctional mediator, endothelin (ET)‐1 is implicated in the pathophysiology of liver cirrhosis. Carbon tetrachloride (CCl4)‐induced cirrhosis in rats resolves upon termination of CCl4 treatment. We determined the hepatic ET‐1 system during such reversal and assessed whether ET‐1 receptor antagonism enhances this process.
Methods
: Cirrhosis was induced in rats by CCl4 treatment for 8 weeks. Treatment with an ETA/ETB antagonist TAK‐044 (10 mg/kg per day) was then started and determinations were made at 1, 2 and 4 weeks.
Results
: After termination of CCl4 treatment, accelerated normalization of liver architecture and portal hypertension occurred in TAK‐044‐treated rats compared with saline‐treated rats. The increased hepatic hydroxyproline concentration and collagen I mRNA expression also declined to greater extents in the TAK‐044‐treated group. Higher collagenase activity in cirrhosis decreased in saline‐treated rats, but did not reach basal values. In TAK‐044‐treated rats, collagenase activity tended to increase at weeks 2 and 4. Increased ET‐1 concentration and ETA receptor density declined to normal values in both groups. In contrast, increased ETB receptor density did not change in saline‐treated rats, but decreased to control values in TAK‐044‐treated rats.
Conclusions
: Our results emphasize the role of ET‐1 in chronic liver disease and strongly indicate the potential for ET‐1 receptor antagonists in its treatment.© 2002 Blackwell Publishing Asia Pty Ltd
Diagnosis of common bile duct calculi with intraductal ultrasonography during endoscopic biliary cannulation
Authors: KUBOTA YOSHITSUGU , TAKAOKA MAKOTO , YAMAMOTO SHIN , SHIBATANI NOBUYUKI , SHIMATANI MASAAKI , TAKAMIDO SHOICHIROH , IMAI YOSHIHITO 
Published: March 2003

AbstractBackground: Choledocholithiasis can be difficult to diagnose, even with direct cholangiography. We examined the role of biliary intraductal ultrasonography in detecting common bile duct stones that had been overlooked during endoscopic retrograde cholangiopancreatography.Methods: Eighty consecutive patients who underwent endoscopic retrograde cholangiography for suspected choledocholithiasis with negative results were evaluated with intraductal ultrasonography (20 MHz) for the presence of biliary concrements. The diagnostic criterion for stones was a strong‐echo structure with acoustic shadowing. Materials of low amplitude echoes without acoustic shadowing were considered sludge.Results: Intrabile duct scanning was successful in all patients. Of the 80 patients, 20 (25%) had ultrasonic evidence of common bile duct stones. The stones measured 5 mm or less on ultrasound and their presence was confirmed macroscopically during endoscopic (17 patients) or laparoscopic (three patients) bile duct clearance. Another 37 patients (46%) had biliary sludge alone and have been followed up uneventfully.Conclusions: Biliary intraductal ultrasonography may become a useful adjunct to establish the diagnosis of occult bile duct concrements and a guide to appropriate therapeutic selection during endoscopic biliary cannulation.