bluuebunny/crossref_metadata_2025_split huggingface dataset:
Helicobacter pylori and extra‐digestive diseases
Authors: Tsang Kenneth W , Lam Shiu‐Kum 
Published: March 2003

Abstract Helicobacter pylori is a recently rediscovered Gram‐negative bacteria that causes peptic ulcer disease, gastric lymphoma and gastric carcinoma. Helicobacter pylori achieves its pathogenetic role by triggering an intense leucocyte infiltration of the gastric submucosa which is mediated by proinflammatory cytokines. This pathogenetic mechanism is common to many other diseases and, therefore, Helicobacter pylori seroprevalence has also been investigated in other diseases. It is now known that H. pylori seropositivity is associated with an increasing number of cardiovascular, respiratory, extra‐gastroduodenal digestive, neurological, skin, autoimmune, growth and miscellaneous disorders. Although the precise role for H. pylori is unknown in these diseases, it is of tremendous interest to most clinicians and scientists as H. pylori is amenable to eradication therapy using simple and reliable drug regimens. The conditions associated with H. pylori seropositivity are highlighted in this concise article.
Peripheral cholangiocarcinoma (cholangiocellular carcinoma): Clinical features, diagnosis and treatment
Authors: Chen Miin‐Fu 
Published: March 2003

AbstractPeripheral cholangiocarcinoma is a relatively rare cancer. However, it is known to have an unfavourable prognosis compared with that of hepatocellular carcinoma. Little is known about its aetiology, clinical or pathological features. Recently, with the development of imaging modalities, early staged cholangiocarcinoma has been diagnosed with relative ease. Surgery is the optimal therapy. Total hepatectomy does not provide survival benefit. Conventional surgery remains the only effective treatment, even for patients with advanced‐stage tumours. Factors influencing survival after hepatectomy were tumour‐free margin, lymphnodes metastasis and histopathology of tumour. Palliative intrahepatic tubing or percutaneous transhepatic biliary drainage and brachytherapy can alleviate jaundice and cholangitis, thereby prolonging survival in some cases.© 1999 Blackwell Science Asia Pty Ltd
Medium‐chain triglycerides modulate ileitis induced by trinitrobenzene sulfonic acid
Authors: Tsujikawa Tomoyuki , Ohta Noriyasu , Nakamura Tsuyoshi , Satoh Jin , Uda Katsuhiro , Ihara Takashi , Okamoto Toshihiko , Araki Yoshio , Andoh Akira , Sasaki Masaya , Fujiyama Yoshihide , Bamba Tadao 
Published: March 2003

Abstract
Background
: It is important to develop an appropriate animal model for further investigation into inflammatory bowel disease (IBD). We therefore investigated a trinitrobenzene sulfonic acid (TNBS) ileitis model. Dietary fat in Crohn’s disease is still a controversial risk factor for IBD. We therefore also studied the effects of medium‐chain triglycerides (MCT) and long‐chain triglycerides (LCT) on TNBS ileitis.
Methods and Results
: An intraileal injection of TNBS induced ulceration and inflammation with thickening of the intestinal wall, which were characterized histologically by infiltration of polymorphic nuclear leucocytes and by granuloma formation. The mucosal damage score and serum sialic acid levels reached their highest 7 days after the TNBS injection and then gradually decreased. The mucosal damage series in the MCT group was significantly lower than in the LCT group, and levels of tumour necrosis factor‐α (TNF‐α) and leukotriene B4 (LTB4) tended to be lower in the MCT group.
Conclusions
: These results suggested that TNBS enteritis might be useful as an IBD animal model and that MCT modulates intestinal inflammation and is less damaging than LCT.© 1999 Blackwell Science Asia Pty Ltd
Helicobacter pylori infection occurs via close contact with infected individuals in early childhood
Authors: Miyaji Hideki , Azuma Takeshi , Ito Shigeji , Abe Yoshimichi , Gejyo Fumitake , Hashimoto Norikazu , Sugimoto Hidehiro , Suto Hiroyuki , Ito Yoshiyuki , Yamazaki Yukinao , Kohli Yoshihiro , Kuriyama Masaru 
Published: March 2003

Abstract
Background
: The manner in which Helicobacter pylori is transmitted is of fundamental importance when considering strategies for its control, yet, to date, the exact mode of transmission remains uncertain.
Methods
: The seroprevalence of H. pylori in a relatively isolated rural town in Japan (A‐town) was examined to analyse the H. pylori infection route. The immunoglobulin G antibodies against H. pylori in 1684 subjects who had received public health examinations in A‐town were determined with an enzyme‐linked immunosorbent assay. The seroprevalence was compared in five areas according to the water source. The possibility and frequency of intrafamilial infection was analysed by comparing the seroprevalence among family members residing in the same home.
Results
: The seroprevalence of H. pylori did not differ significantly between the five areas examined. Seropositivity was significantly more common in the children whose mothers were seropositive (45.0%, 27/60) than in the children whose mothers were seronegative (10.0%, 2/20; odds ratio (OR) = 7.36, P = 0.0036, 95% confidence interval (CI) = 1.57–34.59). Seropositivity was significantly more common in the children whose older siblings were seropositive (55.0%, 22/40) than in the children whose older siblings were seronegative (23.5%, 20/85; OR = 3.97, P = 0.00051, 95% CI = 1.79–8.84). There was no significant relationship in seroprevalence between children and fathers, grandchildren and grandfathers, grandchildren and grandmothers, or within couples. Seropositivity was significantly more common in the adolescents who had attended a nursery school (44.4%, 20/45) than in the adolescents who had not attended a nursery school (25.6%, 109/426) (OR = 2.33, P = 0.0070, 95% CI = 1.24–4.36).
Conclusions
: The acquisition of H. pylori infection occurs by close contact with infected individuals in early childhood, especially via contact with infected mothers and other infected children.© 2000 Blackwell Science Asia Pty Ltd
Prevalence of enteric pathogens among community based asymptomatic individuals
Authors: Hellard Margaret E , Sinclair Martha I , Hogg Geoffrey G , Fairley Christopher K 
Published: March 2003

Abstract
Background and Aims
: The objective of this study was to describe the prevalence of pathogenic microorganisms in asymptomatic individuals in a community study in Melbourne, Australia.
Methods
: The study population was a subset of 2803 individuals participating in the Water Quality Study; a community based randomized trial. Faecal specimens (1091) were collected over a 3‐month period from asymptomatic individuals. Specimens were tested for a range of bacteria including Salmonella, Shigella and Campylobacter species. Rotavirus and adenovirus were detected using a Rota‐Adeno latex kit, and protozoa were detected using a permanent stain (modified iron‐haemotoxylin).
Results
: Twenty‐eight known pathogens were identified from the 1091 faecal specimens, a total carriage rate of 2.6%. Giardia species were present in 18 specimens (1.6%), Salmonella in four (0.4%), Campylobacter in one (0.1%), Cryptosporidium in four (0.4%) and adenovirus in one (0.1%). Blastocystis hominis was found in 65 specimens. The median age of those without a pathogen was 12.5 years compared with 6.6 years for those with a pathogen (P = 0.02).
Conclusions
: Except for Giardia, pathogens were rarely found in asymptomatic individuals in the community. The prevalence of pathogens was higher in children than adults.© 2000 Blackwell Science Asia Pty Ltd
Public health challenges in hepatitis C virus infection
Authors: Kaldor John M , Dore Gregory J , Correll Patricia Kl 
Published: March 2003

AbstractThe discovery a decade ago of the hepatitis C virus (HCV) led to control of post‐transfusion hepatitis in many countries, but raised a number of further questions about the transmission and epidemiological distribution of the newly discovered virus. In some countries, the diagnosis of HCV infection has been designated as a notifiable condition, with doctors (or laboratories, or both) required to send case reports to public health authorities. Such case reports of HCV diagnosis are inevitably biased towards people with symptomatic presentations or a known history of exposure, or those who undergo screening for other purposes, such as blood transfusion. Another approach has been the use of serological prevalence surveys either making use of blood that had been taken or tested for other purposes or recruiting specific population groups for the explicit purpose of measuring HCV prevalence. A limited number of surveys have either attempted to obtain true random samples of geographically defined populations, or recruited subjects, such as pregnant women, who may be considered to be broadly representative of the wider population. Injecting drug use is clearly the main mode of HCV transmission in countries that have established comprehensive blood screening, and it remains a major public health challenge. Although mother‐to‐child transmission is known to occur with a frequency of about 7% there is no proven means of prevention and very little is known about the long‐term consequences of maternally transmitted infection. The conclusion from a number of somewhat conflicting studies is probably that HCV infection should not be viewed as a sexually transmissible infection from the perspective of population health strategies. However, people with HCV infection and their sexual partners should minimize the extent of blood contact that may occur through sexual activity.
Sustained response to combination therapy in a patient with chronic hepatitis C and thrombocytopenia secondary to α‐interferon
Authors: Jiménez‐Sáenz Manuel , Rojas María , Piñar Angel , Salas Ernesto , Rebollo Jaime , Carmona Isabel , Herrerías‐Esteban Juan Manuel , Herrerías‐Gutiérrez Juan Manuel 
Published: March 2003

AbstractRecent data suggest that hepatitis C viral (HCV) infection may induce a significant autoimmune reaction to platelets, but the mechanism is unknown. Many patients with chronic hepatitis C, in fact, have high levels of platelet‐associated immunoglobulin G (PAIgG) and HCV‐RNA is present in the platelets of 100% of those patients with thrombocytopenia and high PAIgG levels. Hepatitis C virus infection has been associated with the development of thrombocytopenic purpura, sometimes triggered during interferon (IFN) therapy. In such cases, the treatment of the underlying disease is a difficult problem to solve. We report the case of a patient with chronic hepatitis C, who developed life‐threatening thrombocytopenic purpura after a prolonged course of IFN‐α2b over a 4‐year period. Treatment with anti‐immunoglobulin gammaglobulin (Polyglobin®; Química Farmaceutica Bayer, Barcelona, Spain) had a transient effect on the platelet count, but prolonged therapy with prednisone was necessary for definitive relief of the haematological complication. Two years later, the patient was treated with combined therapy, including ribavirin (1200 mg/day) and IFN‐α2b (5 mU, t.i.w.) for 12 months. This therapy induced a sustained response, both biochemical and virological, without haematological complications. This observation suggests that ribavirin may be of benefit in the treatment of immune‐mediated thrombocytopenia in patients with chronic hepatitis C, preventing the harmful effect of IFN‐α but also allowing both drugs to be combined so as to increase the probability of sustained remission of the liver disease.
Surgery for gastric carcinoma in patients more than 85 years of age
Authors: Otani Yoshihide , Kubota Tetsuro , Kumai Koichiro , Ohgami Masahiro , Hayashi Noritaka , Ishikawa Yoichiro , Wada Norihito , Kitajima Masaki 
Published: March 2003

Abstract
Background
: The incidence of gastric carcinoma is increasing in elderly patients. It has not been determined whether surgery improves the quality of life or prolongs survival in patients older than 85 years. This study was designed to evaluate surgery as a treatment option in patients more than 85 years of age.
Methods
: The records of 18 patients aged 85 to 91 years (mean 87.3 years), who underwent surgery for gastric carcinoma between 1983 and 1997 were analysed.
Results
: Three patients had multiple lesions. A total of 21 lesions were examined. Operative procedures included distal gastrectomy (n = 12), total gastrectomy (n = 4), proximal gastrectomy (n = 1), and laparoscopic wedge resection (n = 1). Perigastric lymphadenectomy was performed in 15 patients. No lymph node dissection was performed in three patients. Postoperative complications, including delirium, respiratory dysfunction, cardiac dysfunction, anastomotic leakage, bleeding, and ileus, occurred in 11 patients. There were two hospital deaths in patients who underwent emergency surgery. Survival was neither shortened nor prolonged by surgery as determined by life table analysis.
Conclusions
: Surgical treatment should not be avoided based solely on the age of the patient, and quality of life in this population may be improved by surgery. Careful patient selection should include an assessment of the will to live.
Risk of gastric cancer is not increased after partial gastrectomy
Authors: Bassily R , Smallwood Ra , Crotty B 
Published: March 2003

Abstract
Background
: It has been suggested that there is an increased risk of gastric cancer following partial gastrectomy. This question has not been studied in an Australian population.
Methods
: The records of a total of 569 patients who had a partial gastrectomy for peptic ulcer disease at Repatriation General Hospital, Heidelberg, between 1957 and 1976 were reviewed. All were followed to date of death or 31 December 1996. The expected rate of gastric cancer for this population was estimated from published Australian age‐and sex‐specific gastric cancer mortality rates over this period, and a standardized incidence ratio was calculated.
Results
: The mean age at surgery was 53.5 years (range 27–83 years). There were 547 male (96.4%) and 22 female (3.6%) patients. Five hundred and seven (83.5%) had a Billroth II procedure. Thirty‐eight patients (6.3%) were lost to follow up and were not included in the analysis. From the records of the Department of Veterans’ Affairs, it was established that 125 (20.6%) were alive in December 1996, a mean survival after surgery of 18.8 years. The mean documented duration of follow up was 17.3 years (range 1–41 years). Nine patients developed cancer in the gastric remnant. The expected number of cancers in this population was 6.5. Assuming all survivors were free of gastric cancer, the standardized incidence ratio was 1.39 (95% confidence intervals 0.64–2.65, P = 0.313).
Conclusion
: The risk of gastric cancer was not increased after partial gastrectomy in this Australian population.
Racial differences in the prevalence of ulcerative colitis and Crohn’s disease in Singapore
Authors: Lee Ym , Fock Km , See Sj , Ng Tm , Khor C , Teo Ek 
Published: March 2003

Abstract
Background
: The aim of this study was to determine the prevalence rates of inflammatory bowel disease in the different races in Singapore.
Methods
: The patients studied consisted of 58 people with an established diagnosis of ulcerative colitis (UC) and Crohn’s disease (CD) as determined by a combination of clinical, radiological, endoscopic and histological criteria. The patients were residents of a well‐defined geographical area in the northern part of Singapore and had been referred to the single regional hospital. Epidemiological data including sex, age, ethnicity, family history and disease type and extent were collected from case records and patient interviews.
Results
: There were 37 UC and 21 CD patients. Of the patients with UC, 67.5% were Chinese, 13.5% were Malay and 19% were Indian. The CD group consisted of 81% Chinese, 9.5% Malay and 9.5% Indian patients. The study population from which the patients were drawn was approximately 0.5 million in size.
Conclusions
: The overall prevalence of UC was 6 per 100 000 and of CD was 3.6 per 100 000 in Singapore. There were disproportionately more Indians suffering from UC, with a prevalence of 16.2 per 100 000 in comparison with six per 100 000 for Chinese and seven per 100 000 for Malays. The relative risk of UC in Indians is 2.9‐fold greater than for the Chinese (CI = 1.25–6.7) which was statistically significant. This trend was not seen for CD.
Clinical features and etiology of hepatocellular carcinoma arising in patients with membranous obstruction of the inferior vena cava: In reference to hepatitis viral infection
Authors: Matsui Shigeru , Ichida Takafumi , Watanabe Masashi , Sugitani Soichi , Suda Tsuyoshi , Takahashi Toru , Asakura Hitoshi 
Published: March 2003

Abstract Background and Aims: Budd–Chiari syndrome (BCS) comprises hepatic vein thrombosis and inferior vena cava (IVC) obstruction known as membranous obstruction of the IVC (MOVC). The latter is frequently complicated by hepatocellular carcinoma (HCC). The etiology of MOVC‐associated HCC in relation to hepatitis viral infection is not known. In this study, we investigated the clinical features and etiology of HCC in MOVC.Methods: Membranous obstruction of IVC and HCC were diagnosed and studied by using imaging techniques. Sera from patients with MOVC, complicated by HCC, were examined for hepatitis viral antigens and antibodies (hepatitis B surface antigen (HBsAg), antibody to HBsAg (anti‐HBs), antibody to hepatitis B core antigen (anti‐HBc) and third generation antibody to hepatitis C virus (anti‐HCV)) and for hepatitis viral nucleic acids (hepatitis B virus (HBV)‐DNA, hepatitis C virus (HCV)‐RNA, hepatitis G virus (HGV)‐RNA and TT virus DNA).Results: We studied 12 patients with BCS who were seen between April 1968 and February 1999. All of them had MOVC. Hepatocellular carcinoma developed in three (25%) of them. There were no obvious differences in the clinical features and imaging findings concerning MOVC between patients with and without HCC. Hepatocellular carcinoma in these three patients showed no clear trend in clinical features and imaging findings. Of the hepatitis viral markers examined, HBsAg, anti‐HBc and HBV‐DNA were positive in only one of three patients with HCC and all of the viral markers were negative in the other two patients.Conclusions: Chronic congestion in the liver, caused by an outflow block of hepatic veins and subsequent histopathologic change, must have led to HCC in two patients without any hepatitis viral markers. Patients with MOVC should be followed closely as a high‐risk group for HCC.
Botulinum toxin for achalasia in children
Authors: Ip Kin Sing , Cameron Donald Js , Catto‐Smith Anthony G , Hardikar Winita 
Published: March 2003

Abstract Background: Injection of botulinum toxin (BTx) into the lower esophageal sphincter (LES) of adult patients with achalasia results in the effective relief of symptoms. The aim of the present study was to examine the effectiveness of BTx in pediatric patients suffering from achalasia.Methods: Seven patients suffering from achalasia with or without prior treatment were treated with intrasphincteric injection of BTx. The median duration of follow up was 15 months.Results: All seven patients improved. The median interval before recurrence of symptoms was 4 months (range 1–14 months). There was an inverse relationship between the pretreatment LES pressure and the duration of response (r = –0.6). The mean pretreatment LES pressure in the subgroup with a response greater than 6 months was 38 ± 10 mmHg compared with 61 ± 12 mmHg in the other four patients (P = 0.05). All seven patients required retreatment.Conclusion: Botulinum toxin is effective in relieving symptoms in pediatric patients suffering from achalasia, producing a sustained response beyond 6 months in 43% of patients.
Monochloramine impairs mucosal blood flow response and healing of gastric lesions in rats: Relation to capsaicin‐sensitive sensory neurons
Authors: Takeuchi Koji , Suzuki Keizo , Mizoguchi Hiroyuki , Araki Hideo , Nishiwaki Hidekazu 
Published: March 2003

AbstractAims: We examined the effects of monochloramine (NH2Cl) on the gastric mucosal blood flow (GMBF) response and the healing of ethanol‐induced gastric lesions in rats.Methods: Rats fasted for 18 h were given the 99% ethanol p.o. for induction of gastric lesions, and were fed normally from 1 h later onwards. Monochloramine, at non‐ulcerogenic doses (5~20 mmol/L), was given p.o. twice daily for 7 days, starting 2 h after ethanol treatment.Results: Gastric lesions caused by ethanol healed almost completely within 7 days with re‐epithelialization. The repeated administration of NH2Cl significantly delayed the healing of ethanol‐induced gastric lesions in a dose‐dependent manner. The damaged mucosa showed a marked rise in H+ permeability, resulting in luminal acid loss, but this process was accompanied by an increase of mucosal blood flow. Monochloramine did not affect the increased mucosal H+ permeability observed in the stomach after damage by ethanol, but significantly inhibited the mucosal hyperemic response associated with luminal acid loss. Prior exposure of the mucosa to NH2Cl (20 mmol/L) did not affect the gastric hyperemic response caused by mucosal application of misoprostol (a prostaglandin E1 derivative) or NOR‐3 (a nitric oxide donor), but totally attenuated the increase of GMBF in response to intragastric capsaicin. Impaired healing and GMBF responses were also observed in rats following chemical ablation of capsaicin‐sensitive sensory neurons.Conclusions: These results suggest that NH2Cl impaired the healing of acute gastric mucosal lesions at low concentrations, and this action may be attributable, at least partly, to the impairment of gastric hyperemic response caused by the dysfunction of capsaicin‐sensitive sensory neurons.
Economic evaluation of the societal costs of hepatitis B in South Korea
Authors: Yang Bong Min , Paik Seung Woon , Hahn Oh Serk , Yi Deok Hee , Choi Moon Suk , Payne Sarah 
Published: March 2003

AbstractBackground and Aims: Hepatitis B (HBV) infection remains a major public health problem in South Korea, and accounts for considerable morbidity and mortality. At present, very little is known about the cost of HBV to the South Korean health‐care system and society. The present study was therefore conducted to estimate the total annual cost of HBV infection in South Korea for a given year (1997).Methods: The study was conducted from the South Korean societal perspective, taking into account the direct and indirect costs of HBV vaccination programs (prevention costs), and those related to the treatment of acute and chronic hepatitis, cirrhosis and liver cancer (disease costs). Several assumptions were made in arriving to actual cost estimates.Results: The total societal cost of HBV in 1997 was 1078.3 billion Won ($US 959.7 million), 142.3 billion Won or 13.2% being attributable to prevention costs and 225.4 billion Won or 20.9% being attributable to indirect costs of HBV‐related diseases. The total cost (direct plus indirect) associated with HBV‐related diseases to the South Korean society was 936.1 billion Won ($US 833.1 million), of which 45.3% was attributable to cirrhosis‐related costs. In terms of disease‐related direct costs alone (710.5 billion Won or $US 632.3 million), the estimated annual spending per patient was 1.37 million Won ($US 1219). The direct costs of the HBV disease (prevention and disease treatment, amounting to 782.2 billion Won or $US 696.2 million) is equivalent to 3.2% of the national health‐care expenditure for 1997.Conclusions: This study confirms that HBV is a significant cost burden to the South Korean society, and in the absence of an effective cure reinforces the importance of continued disease prevention via vaccination.