bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of clinical impact of endoscopic ultrasound on esophageal cancer
Authors: HAREWOOD GAVIN C , KUMAR K SHIVA 
Published: March 2004

AbstractBackground and Aim: Endoscopic ultrasound (EUS) with fine needle aspiration (FNA) is the most accurate imaging modality for locoregional staging of esophageal cancer. It remains unclear whether this technology impacts on the outcome of patients with this malignancy. The aim of the present study was to assess the impact of EUS FNA by comparing the clinical outcomes of patients with esophageal cancer before and after the introduction of this staging modality in our institution.Methods: Outcomes of patients with de novo non‐metastatic esophageal cancer seen in 1998 without EUS FNA evaluation (non‐EUS control group) were compared to patients evaluated in 2000 with EUS FNA (EUS group).Results: Outcomes of 60 (non‐EUS control group) and 107 (EUS group) patients with non‐metastatic esophageal cancer were compared. Preoperative neoadjuvant therapy was administered to 35 patients in the EUS group, all of whom had advanced disease. Cox proportional hazards demonstrated EUS FNA to be associated with reduced recurrence risk (hazard ratio [HR]: 0.63; 95% confidence interval [CI]: 0.43–0.87),P = 0.004, and reduced mortality (HR: 0.66; 95% CI: 0.47–0.90),P = 0.008.Conclusions: The EUS staging of esophageal cancer leads to appropriate use of preoperative neoadjuvant therapy in patients with advanced disease. Use of EUS is associated with a recurrence‐free survival advantage and overall survival advantage in patients, thus supporting its routine use in esophageal cancer staging.
p16INK4A Gene alterations are not a prognostic indicator for survival in patients with hepatocellular carcinoma undergoing curative hepatectomy
Authors: ANZOLA MONICA , CUEVAS NEREA , LOPEZ‐MARTINEZ MONICA , DE PANCORBO MARIAN MARTINEZ , BURGOS JUAN JOSE 
Published: March 2004

AbstractBackground and Aim:  Hepatocellular carcinoma (HCC) is a common malignancy worldwide that is highly associated with chronic hepatitis B or C infection and cirrhosis. The tumor suppressor gene p16INK4A is an important component of the cell cycle and inactivation of the gene has been found in a variety of human cancers. The present study was performed to determine genetic and epigenetic alterations in the p16INK4A tumor suppressor gene and the effect of these on HCC progression.Methods:  The status of p16INK4A was evaluated in 117 HCC tumoral nodules and 110 corresponding peritumoral tissues by loss of heterozigosity (LOH) at the 9p21–22 region, homozygous deletions, single‐strand conformation polymorphism–polymerase chain reaction (PCR) mutational analysis and methylation specific PCR.Results:  The most frequent inactivation mechanism was hypermethylation of the promoter region, which was found in 63.2% of the tumor samples and in 28.2% of the peritumoral samples. Loss of heterozygosity at the 9p21 region was detected in 27.3% and 10% of tumor and peritumoral tissues, respectively. Homozygous deletions and mutations were less common events in hepatocarcinogenesis. The authors found 5.9% of the tumor cases with exon 2 homozygous deletions and 8.6% with mutations. Two polymorphisms were detected, one at codon 148 (GCG → ACG, Ala → Thr) in three cases and the other in exon 3 at 540 bp (34.2% of the samples). No association was found between inactivation of p16INK4A and clinicopathological characteristics or prognosis.Conclusion:  p16

INK4A
is altered frequently and early in HCC, being the predominant mechanism of inactivation promoter hypermethylation. The present results suggest that the p16INK4A gene plays an important role in the pathogenesis of HCC.
Responses of human clasp and sling fibers to neuromimetics
Authors: TIAN ZI‐QIANG , LIU JUN‐FENG , WANG GUI‐YING , LI BAO‐QING , WANG FU‐SHUN , WANG QI‐ZHANG , CAO FU‐MIN , ZHANG YUE‐FENG 
Published: March 2004

AbstractBackground and Aims:  It has previously been demonstrated that clasp and sling fibers at the human gastroesophageal junction respond differently to acetylcholine (Ach). The present study was undertaken to investigate the differences between the physiological and pharmacological properties of the two types of muscle fiber.Methods:  Recordings were made of the isometric tension of human sling and clasp fibers in response to Ach, dopamine (DA), phenylephrine (Phe), and isoprenaline (Iso). These specimens were obtained from 18 patients who were operated on for esophageal cancer.Results:  Both Ach and Phe increased the tension of the two types of muscle; the values in the Ach group being 3–4‐fold greater than those in the Phe group, while Iso decreased the tension of both types of muscle strip. The tension of the sling fibers was reduced by DA at lower concentration, and then increased gradually as the concentration was increased. In contrast, the tension of the clasp fibers did not obviously change when the concentration of DA was lower, but a slow elevation of tension was seen with the increase in DA concentration.Conclusions:  The sensitivities and maximum responses to each agent differed between the clasp fibers and sling fibers. This suggests that the two kinds of fiber have different roles in establishing tension in the lower esophageal sphincter, with implications for the medical and surgical treatment of disorders in this region.
Role of transfusion‐transmitted virus in acute viral hepatitis and fulminant hepatic failure of unknown etiology
Authors: DAS KUNAL , KAR P , GUPTA RK , DAS BC 
Published: March 2004

AbstractBackground and Aim:  The role of the newly described transfusion‐transmitted virus (TTV), a circular single‐stranded DNA virus, has been investigated in acute liver disease, comprising 36 patients with acute viral hepatitis (AVH) and 25 with fulminant hepatic failure (FHF), including 50 volunteer blood donors as controls.Methods:  Detection of  TTV DNA sequences was carried out by polymerase chain reaction (PCR) using primers derived from the UTR(A) region of the TTV genome. The clinical course and biochemical profile when infected with TTV alone or coinfected with other classical hepatotropic viruses were analyzed. All patients were first evaluated for liver function profile and for the presence of various hepatotropic viruses using serological tests and PCR in serologically negative patients.Results:  Transfusion‐transmitted virus DNA was detected in 80.6% (29/36) of the AVH cases and in 76% (19/25) of the FHF cases, which were significantly higher levels (P < 0.05) than the 52% (26/50) observed in volunteer blood donors. No significant difference in symptoms, clinical course, liver function and risk factor profile between TTV‐positive and TTV‐negative patients could be observed in both AVH and FHF patients. TTV was found to coexist with both parenterally and non‐parenterally transmitted hepatotropic viruses in similar frequency in both AVH and FHF patients. Further, there was no significant difference in the mortality rates between TTV‐positive and TTV‐negative FHF patients. Also, there was no difference between patients coinfected by TTV and other hepatotropic viruses and those with TTV infection alone.Conclusion:  Thus, it appears that TTV, although it exists in a very high frequency in the Indian population, appears to have no significant etiological role in AVH and FHF.
Evaluation of the 13C‐triolein breath test for fat malabsorption in adult patients with cystic fibrosis
Authors: RITZ MARC A , FRASER ROBERT J , DI MATTEO ADDOLORATA C , GREVILLE HUGH , BUTLER ROSS , CMIELEWSKI PATRICIA , DAVIDSON GEOFF 
Published: March 2004

AbstractBackground and Aims: A simple non‐invasive test not requiring the use of radioactive isotopes is required to assess fat malabsorption in adult cystic fibrosis (CF) patients. Breath tests using substrates labeled with 13C meet these conditions. The 14C‐triolein breath test is sensitive and specific for measuring fat malabsorption, but involves radiation exposure. The aim of this study was to examine the utility of a test using a 13C label and to determine whether pancreatic replacement therapy would return the test to the values of a normal control group.Methods: 13CO2 recovery was assessed after an overnight fast in six adult patients with CF, both with and without pancreatic enzyme replacement therapy (PERT) in the usual dose for a light snack, in a randomized order, on different days. Studies were also performed in eight healthy volunteers after oral ingestion. Subjects drank 50 mL of a liquid meal mixed with 200 µL 13C‐triolein and breath samples were collected by blowing through a straw into collection tubes every 30 min for 6 h. The effect of gastric emptying was assessed by comparison of oral ingestion with intraduodenal infusion. Intra‐individual variability was assessed in nine volunteers by repeating the breath test after drinking the test meal on a separate day.Results: Compared with healthy subjects there was virtually no recovery of 13CO2 in CF patients without PERT. The median (interquartile range) cumulative percentage dose recovery (cPDR) at 6 h was 3% (0–8) in CF patients compared with 28% (22–41) in healthy controls (P < 0.01). Fat absorption was normalized (37%) (36–43) after ingestion of PERT. Gastric emptying delayed the peak in 13CO2 recovery, but there was no difference in the cPDR at 6 h. There was no difference in recovery between days 1 and 2.Conclusions: The 13C‐triolein breath test is a simple and reproducible method to measure fat malabsorption. The test provides a screening technique for fat malabsorption in adult CF patients and may be useful for monitoring the lowest effective dose of PERT.
Biliary excretion of azelnidipine, a calcium antagonist, in rats
Authors: HANAWA NAOKO , SANO NAOYO , TAKIKAWA HAJIME 
Published: March 2004

AbstractBackground and Aims:  Azelnidipine (CS‐905) is a novel dihydropyridine calcium antagonist that is known to be excreted in feces. To examine the mechanism of biliary excretion of azelnidipine, the authors studied its biliary excretion in Eisai hyperbilirubinuria rats (EHBR), multidrug resistance protein (Mrp)2‐deficient rats, and the effect of cholephilic compounds on the biliary excretion of azelnidipine in rats.Methods:  Radiolabeled azelnidipine was intravenously administered to EHBR and control rats, and the biliary excretion of radiolabeled metabolites was studied. Furthermore, the effect of sulfobromophthalein, taurocholate and vinblastine on the biliary excretion of azelnidipine metabolites was also studied in control rats.Results:  The biliary excretion of azelnidipine metabolites was delayed in EHBR. The biliary excretion of azelnidipine metabolites was inhibited by sulfobromophthalein and vinblastine, but was not inhibited by taurocholate or phenothiazine pretreatment.Conclusion:  These findings suggest that the metabolites of azelnidipine are excreted into the bile partly by Mrp2 and P‐glycoprotein.
Comparison of image quality between electronic and mechanical radial scanning echoendoscopes in pancreatic diseases
Authors: NIWA KATSUSHI , HIROOKA YOSHIKI , NIWA YASUMASA , ITOH AKIHIRO , OHMIYA NAOKI , HASHIMOTO SENJU , ISHIKAWA HIDEKI , OKADA NAOTO , ITOH TERUTOMO , GOTO HIDEMI 
Published: March 2004

AbstractBackground and Aim: It is common knowledge that endoscopic ultrasonography (EUS) can accurately diagnose pancreatic diseases. Echoendoscopes for EUS are roughly classified into two categories, the mechanical radial scanning echoendoscope (MR‐ES) and the electronic linear array echoendoscope, both of which have their merits and demerits. In 2000, a newly designed echoendoscope, the electronic radial scanning echoendoscope (ER‐ES), appeared. The aim of the present study was to compare B‐mode image quality between the ER‐ES and the MR‐ES in pancreatic diseases.Methods: Patients with pancreatic diseases (30 cystic diseases and 22 solid diseases) underwent EUS with both ER‐ES and MR‐ES. The B‐mode images obtained using both echoendoscopes were graded using a scoring system and statistically analyzed. The assessed point for cystic lesions was the existence of mechanical‐noise‐like ring‐like artifacts derived using multiple reflections (‘ring‐down’), grating robe and so on, and that for solid lesions was the scale of penetration. The authors compared maneuverability, endurance and endoscopic images between the two types of echoendoscopes.Results: The ER‐ES had a significantly higher score than the MR‐ES (P < 0.05) in the analysis of both cystic and solid diseases. There was no apparent difference as to maneuverability, endurance and endoscopic images.Conclusion: Ultrasound images acquired by ER‐ES appear better compared with those acquired by MR‐ES.
Characteristics of antepartum and intrapartum eclampsia in the National Maternal and Child Health Center in Cambodia
Authors: Koum Kanal , Hy Soryaphea , Tiv Say , Sieng Tharith , Obara Hiromi , Matsui Mitsuaki , Fujita Noriko 
Published: March 2004

AbstractAim:  To measure maternal and perinatal outcome and analyze risk factors for antepartum and intrapartum eclampsia, which is one of main causes of high maternal mortality at the top referral hospital in the Kingdom of Cambodia.Methods:  A hospital‐based retrospective study of 164 antepartum and intrapartum eclampsia cases out of 20 449 deliveries.Results:  Overall case–fatality rate was 12%. Rate of stillbirth and low birth weight were 20% and 44%, respectively. Eighty percent of the cases presented signs of severe pre‐eclampsia and 27% of the patients who gave birth received cesarean section. Living outside the capital city, teenage pregnancy and twin pregnancy are more frequently associated with eclampsia.Conclusion:  Antepartum and intrapartum eclampsia is associated with severe pre‐eclampsia and with poor maternal and perinatal outcome. Recommendations to reduce the burden of eclampsia are promoting and improving quality of antenatal care and health education especially in the third trimester; increasing access to high‐quality essential obstetric care; improving the service delivery in rural areas; and monitoring the progress by hospital data.
Significance of endometrial polyps detected hysteroscopically in eumenorrheic infertile women
Authors: Shokeir Tarek A. , Shalan Hesham M. , El‐Shafei Mohamed M. 
Published: March 2004

AbstractAim:  To determine if the incidence of small endometrial polyps detected hysteroscopically in an infertile eumenorrheic population differed from that in an apparently fertile eumenorrheic population. Evidence was sought to determine whether removal of such lesions would enhance reproductive performance.Methods:  In a prospective study, 266 consecutive infertile women had undergone complete fertility evaluation. None of the women had experienced any change in their menstrual cycle. They were divided into two groups; 235 infertile patients (group 1) and 31 requesting a reversal of a previous tubal sterilization (group 2). All patients were examined by simultaneous combined laparoscopy and hysteroscopy as part of their routine infertility evaluation. When endometrial polyps were noted they were removed by hysteroscopy and histopathologically examined. Patients in whom the only apparent finding was endometrial polyps were followed up to determine their reproductive outcomes subsequent to removal of the polyps.Results:  Of the 224 uterine cavities successfully visualized in the infertile group, 134 were judged to be normal (60%) and 90 were abnormal (40%). Endometrial polyps were noted in 35 patients of group 1 and in one patient of group 2 (P < 0.01). Most polyps were located in the region of the utero‐tubal junction and proved to be functional. A 50% pregnancy rate was achieved by hysteroscopic polypectomy. Fertility‐related factors in women whose only apparent finding was endometrial polyps before and after hysteroscopy were comparable.Conclusion:  Diagnostic hysteroscopy should be used routinely in the work‐up of infertile woman, even in the presence of eumenorrhea. Persistent functional endometrial polyps, even if small, are likely to impair fertility in this select patient group. Removal of such lesions may improve subsequent reproductive performance.
Pelvic pain caused by intraperitoneal Enterobius vermicularis (threadworm) ova with an associated systemic autoimmune reaction
Authors: Thomson John C. 
Published: March 2004

AbstractAim:  The aim of this paper, based on a case study was two‐fold; firstly to review the sites and gynecologic complications of ectopic Enterobius vermicularis and secondly study the autoimmune accompaniments of parasitic infestations.Methods:  A case of intraperitoneal ectopic Enterobius vermicularis, with accompanying autoimmune signs and symptoms, is presented and its response to surgical and medical treatment described. A medical literature search was carried out into the subject of ectopic Enterobius vermicularis, particularly from the gynecologic perspective along with a study of autoimmune activation associated with parasitic infestation.Results:  Pelvic pain was found to be caused by chronic inflammation from ectopic Enterobius vermicularis. This was treated both surgically and medically, with the surgical treatment proving to be inadequate but with a good response to immune modification. In the literature ectopic Enterobius vermicularis was found to be treatable surgically.Conclusion:  Ectopic Enterobius vermicularis was found to create symptomatic inflammatory lesions that could be treated surgically and an associated autoimmune response treatable by immune modification.
Premature luteinization defined as progesterone estradiol ratio >1 on hCG administration day seems to adversely affect clinical outcome in long gonadotropin‐releasing hormone agonist cycles
Authors: Özçakir Hasan Tayfun , Levi Rafael , Tavmergen Erol , Göker Ege Nazan Tavmergen 
Published: March 2004

AbstractAim:  To examine the effect of premature luteinization on the outcomes in long gonadotropin‐releasing hormone agonist cycles.Methods:  Two‐hundred and forty‐eight patients who had undergone assisted reproductive technology for infertility treatment between 2001 and 2002 were enrolled into the study. The patients were separated into two groups according to P/E2 ratios on human chorionic gonadotropin administration day. Group A consisted of the patients whose P/E2 ratio was 1 (n = 116) and Group B consisted of the patients with premature luteinization of which P/E2 ratio was > 1 (n = 132). The P/E2 ratio calculation was performed as follows: P (in ng/mL) ×†1,000/E2 (in pg/mL). The primary outcome measures included oocyte quality, fertilization rates and clinical pregnancy rates.Results:  The mean number of mature oocytes retrieved in the groups were 9.5 ± 4.8 and 6.4 ± 3.6, respectively, and the difference was statistically significant (P < 0.05). Although the difference between the fertilization rates in Group A and Group B was not statistically significant (P > 0.05), the clinical pregnancy rates seemed to be affected adversely in the Group B patients with premature luteinization (41.4%versus 28%, respectively; P < 0.05).Conclusion:  Premature luteinization, defined as P/E2 > 1 on human chorionic gonadotropin administration day, in long gonadotropin‐releasing hormone agonist cycles seems to adversely affect clinical outcome.
Non‐puerperal uterine inversion and uterine sarcoma (malignant mixed müllerian tumor): Report of an unusual case
Authors: Hanprasertpong Jitti , Wootipoom Virach , Hanprasertpong Tharangrut 
Published: March 2004

AbstractA 45‐year‐old woman with a history of cervical cancer (stage IIa), who had received complete radiation treatment 16 years previously, presented with a huge mass protruding from her vaginal introitus. She had had the condition for about 1 week. Diagnosis was difficult, and she elected to have a diagnostic laparoscopic procedure plus tumor removal. The pathologic investigation revealed a malignant mixed müllerian tumor of the endometrium. Post‐operative course was uneventful. She underwent postoperative pelvic radiation. No recurrence was found during the 13 months follow up period. This rare case of chronic non‐puerperal uterine inversion due to malignant mixed müllerian tumor (MMMT) is herein reported.
Placental site trophoblastic tumor of the uterine cervix occurring from undetermined antecedent pregnancy
Authors: Soma Hiroaki , Okada Takahiko , Yoshinari Tsutomu , Furuno Atsuo , Yaguchi Seiichi , Tokoro Kazuo , Kato Hidenori 
Published: March 2004

AbstractA cervical polyp complicated by severe hemorrhage was removed from a 43‐year‐old Japanese woman (gravida 0), who had undergone tubectomy on the right side 10 years previously. The polyp was diagnosed by immunohistochemical studies as placental site trophoblastic tumor of the cervix, but no metastatic foci were found in any other uterine site. The tumor was further demonstrated by PCR polymorphisms to possess two genomic DNA of the patient and her husband. Serum β‐hCG and urinary hCG titers were both low, which rapidly fell to 0.8 mIU/mL after a total hysterectomy and remained 0.2mIU/mL after dismission.She has been uneventful for 3 years.
Analysis of HLA‐DRB1*0901‐binding HPV‐16 E7 helper T cell epitope†
Authors: Okubo Mitsuo , Saito Maki , Inoku Hiroki , Hirata Ranko , Yanagisawa Masami , Takeda Satoru , Kinoshita Katsuyuki , Maeda Hiroo 
Published: March 2004

AbstractAim:  This study sought to determine the human papillomavirus (HPV)‐16 E7 epitopes that would be presented by HLA‐DR molecules to CD4‐positive T cells in patients with cervical carcinoma.Methods:  HLA‐DR binding assays were performed using HPV‐16 E7‐derived synthetic peptides and, after incubation with these DR‐binding peptides, helper T cell frequencies were analyzed in patients whose HLA and HPV genotypes were confirmed.Results:  We determined that the E7d peptide, 61CDSTLRLCVQSTHVDIRTL80E, was bound by HLA‐DRB1*0901. An increased frequency (0.3–2.4%) of type 2 helper T cell responses was found in HLA‐DRB1*0901‐positive patients with cervical dysplasia and carcinoma. We found that when IL‐12 was combined with E7d‐peptide stimulation in vitro, the frequency of type 1 helper T cell responses also increased in patients with carcinoma.Conclusion:  Thus HPV‐16 E7d peptide as an HLA‐DRB1*0901‐restricted helper T cell epitope might usefully be incorporated into an understanding of the immunological mechanism and immunotherapy for this disease.
Lipopolysaccharide administration enhances hypoxic‐ischemic brain damage in newborn rats
Authors: Yang Li , Sameshima Hiroshi , Ikeda Tomoaki , Ikenoue Tsuyomu 
Published: March 2004

AbstractAim:  To determine whether inflammation and hypoxic‐ischemic insult (HI) act additively to cause brain damage in perinatal animals by examining the dose–response effect of lipopolysaccharide (LPS) administration on HI insult in neonatal rat pups.Methods:  Seven‐day‐old Wistar rats (n = 119) were divided into three groups: (i) a group that received a pre‐injection of LPS and HI (LPS/HI, 1 mg/kg, n = 31; 0.5 mg/kg, n = 20; 0.1 mg/kg, n = 17); (ii) a group that received a pre‐injection of saline and HI (saline/HI, n = 35); and (iii) those that received LPS alone (1 mg/kg, n = 16). At 4 h after the injection, rat pups from groups (i) and (11) were exposed to unilateral carotid artery ligation, followed by 1 h of hypoxia (8% oxygen in 92% nitrogen) at 33°C. Seven days after the insult, they were sacrificed and their brains removed for histological study. Neuronal damage was categorized as mild, ≤25%; moderate, 25–50%; and severe, ≥50% of surface area on a single section.Results:  Mortality rate during the experiment was significantly increased in the 1 mg/kg of LPS/HI group (12 of 31, 39%) compared with the saline/HI group (0%). No neuronal damage was observed in the LPS only group. However, when LPS was added to HI, neuronal loss in the cerebral cortex and hippocampus was significantly increased in a dose–response manner.Conclusion:  LPS potentiates hypoxic‐ischemic insult in a dose‐dependent fashion to cause brain damage in neonatal rats.