bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical significance of liver biopsy in chronic hepatitis B patients with persistently normal transaminase
Authors: YANG Liu Ming , XU Ke Cheng , ZHAO Yan Long , WU Zhi Rong , CHEN Tu Fang , QIN Zhuo Ying , ZUO Jian Sheng , WEI Bei Hai 
Published: March 2003

OBJECTIVE:  The aim of this study was to study the clinical significance of liver biopsy for individuals who had chronic hepatitis B virus infection and persistently normal serum transaminases for more than 6 months.METHODS:  A total of 452 patients with positive hepatitis B surface antigen for over 6 months underwent percutaneous liver biopsy. All liver biopsy specimens were assessed by experienced liver pathologists blinded to the liver biochemistry, and were scored according to the modified criteria of grade and stage of chronic hepatitis. Patients were divided into four groups: group A and group C patients had normal transaminases, and were hepatitis B e antigen (HBeAg) positive and HBeAg negative, respectively; group B and group D patients had elevated transaminases, and were HBeAg positive and HBeAg negative, respectively.RESULTS:  All patients had necrosis and inflammation in the liver. Patients with increased serum transaminases had a significantly higher grade (G) of hepatic necrosis and inflammation and more severe (S) fibrosis compared with patients with normal transaminases (P < 0.05). However, in the latter patients, G3 was seen in 10 (5.5%) and 13 cases (9.1%), S3 in seven (3.8%) and 16 cases (11.1%), and S4 in three (1.6%) and seven cases (4.9%) in Group A and Group C, respectively. Moreover, in patients with normal transaminases, the HBeAg‐negative group had more severe fibrosis than the HBeAg‐positive group (P < 0.05).CONCLUSION:  Although more severe pathological changes were more frequent in patients with elevated transaminases, significant hepatic pathology could still be found in cases with persistently normal transaminases. Liver biopsy in cases of chronic hepatitis B virus infection is helpful to accurately assess both the activity of the disease and the degree of fibrosis, and to estimate if antiviral therapy is justifiable. Patients with normal transaminases and serious hepatic necrosis, inflammation and fibrosis need proper management.
Multicenter randomized controlled trial of heat‐killed Lactobacillus acidophilus LB in patients with chronic diarrhea
Authors: XIAO Shu Dong , ZHANG De Zhong , LU Hong , JIANG Shi Hu , LIU Hou Yu , WANG Geng Sheng , XU Guo Ming , ZHANG Zhong Bing , LIN Geng Jin , WANG Guo Liang 
Published: March 2003

OBJECTIVE:  Chronic diarrhea is a common bowel disorder, and disturbance of intestinal microorganisms may play a role in its pathogenesis. The aim of this study was to assess the clinical efficacy of lyophilized heat‐killed Lactobacillus acidophilus LB compared with living lactobacilli in the treatment of chronic diarrhea.METHODS:  One hundred and thirty‐seven patients with chronic diarrhea were randomly allocated to receive either a 4‐week course of two capsules of Lacteol Fort twice a day as the Lacteol group (69 patients completed the course) or a 4‐week course of five chewable tablets of Lacidophilin three times a day as the Lacidophilin group (64 patients completed the course). The frequency of stools was recorded quantitatively and the semiquantitative parameters such as stool consistency, abdominal pain, distension and feeling of incomplete evacuation were evaluated.RESULTS:  At the second and fourth week of the treatment, the mean bowel frequency was significantly lower in the Lacteol group than in the Lacidophilin group (1.88 ± 1.24 vs 2.64 ± 1.12, 1.39 ± 0.92 vs 2.19 ± 1.05, respectively; P < 0.05). At the end of the treatment, the clinical symptoms were markedly improved in the Lacteol group.CONCLUSIONS:  Lactobacillus acidophilus LB is more effective than living lactobacilli in the treatment of chronic diarrhea.
Study on functional constipation and constipation‐predominant irritable bowel syndrome by using the colonic transit test and anorectal manometry
Authors: ZHAN Li Xing , ZHOU Duo Wu , XU Guo Ming , LI Zhao Shen , YIN Nin , ZHANG Mei Qin 
Published: March 2003

OBJECTIVE:  To investigate the visceral perception, anorectal pressure and colonic transit time (CTT) in patients with functional constipation and constipation‐predominant irritable bowel syndrome (C‐IBS), and to study the manometric abnormalities of these two conditions.METHODS:  The CTT in patients with functional constipation and C‐IBS was studied by using radiopaque markers. Rectal visceral perception thresholds, rectal compliance and anorectal pressure were examined by electric barostat.RESULTS:  The CTT in both groups of constipated patients was abnormal. A lot of radiopaque markers remained in the right colon in C‐IBS patients, whereas in patients with functional constipation, the radiopaque markers remained in each segment of the colon. The anorectal resting pressure, squeezing pressure and relaxation pressure were normal in both groups. Rectal compliance and defecation thresholds were much higher compared with controls, and the rectal visceral perception of functional constipation was also abnormal.CONCLUSIONS:  The motility abnormalities of functional constipation and C‐IBS occurred in different colonic segments. Results suggest that CTT measure­ment and anorectal manometry could be helpful in the differential diagnosis of these two conditions.
Determinants of further survival in centenarians
Authors: Shimizu Kenichiro , Hirose Nobuyoshi , Arai Yasumichi , Gondo Yasuyuki , Wakida Yasushi 
Published: March 2003

Background:The purpose of the present paper was to study the impact of selected clinical and demographic variables on further survival in subjects over 100 years old.Methods:In 1992 the authors assessed activities of daily living, cognitive function, and nutritional status in 38 centenarians (seven men and 12 women living in the Tokyo metropolitan area as well as three men and 16 women living in Aichi prefecture; mean age: 100.9 ± 1.6 years). Survival data were recorded until 1996. Cox proportional hazard regression analysis was used to identify variables influencing likelihood of further survival in centenarians.Results:In 1996 21 subjects had died and 17 were still living. Of the 38 subjects, nine had illnesses at initial evaluation such as hypertension or other cardiovascular disease. Centenarians with a high cognitive level tended to have a high (independent) activities of daily living (ADL) score and/or a good nutritional condition. Cognitive levels were higher in men than in women. Cox proportional hazard regression analysis indicated that a high ADL score, a high level of cognitive function, or nutritional status tended to be advantageous for further survival in centenarians. Of the three parameters, after adjustment for clinical variables, only a high serum albumin concentration was a significant factor favoring survival in centenarians (hazard ratio: 0.44 for a 1‐SD increment in serum albumin concentration; 95% confidence interval: 0.23–0.85). The presence of illness, the age in 1992, or gender was not related to mortality risk in centenarians.Conclusion:Undernourishment jeopardizes survival even in late life.
Assessment of brain atrophy in elderly subjects with diabetes mellitus by computed tomography
Authors: Ushida Chika , Umegaki Hiroyuki , Hattori Ayako , Mogi Nanaka , Aoki Shigetaka , Iguchi Akihisa 
Published: March 2003

Background:Several studies have shown cognitive functional impairment in elderly subjects with diabetic mellitus (DM). However, there have been few studies on the image of the brain in DM subjects.Methods:To assess brain atrophy in elderly DM subjects their brain images were evaluated using computed tomography (CT). Thirty‐eight DM subjects and 17 non‐DM subjects (60–80 years of age) were included. The mean age for DM subjects and control subjects were 71.2 ± 5.5 years and 71.6 ± 5.7 years, respectively. For assessment of brain CT images, five indices (Evan’s ratio, inverse cella media index, width of the third ventricle, the width of the temporal horns on both sides, and the maximal width of the Sylvian fissure at insula on both sides) were used.Results:Evan’s ratio and the temporal horns on both sides in DM subjects were significantly larger than those in control subjects. Further analysis within DM subjects, who were divided into three groups according to their therapy (insulin, medication, and diet therapy), showed that insulin‐treated subjects had the widest temporal horns.Conclusions:The current study suggested that elderly DM subjects had brain atrophy compared with age‐matched non‐DM subjects. The insulin‐treated group had the highest amount of brain atrophy of the DM subjects.
Sleep problems as a risk factor for fall in community‐dwelling older persons
Authors: Kawamoto Ryuichi , Doi Takaaki 
Published: March 2003

Background: Falls cause serious problems for the elderly. Sleep problems impair the control of postural balance and cause falls, and lack of sleep induces sleepiness, which in turn causes inattentiveness. The present study aims to clarify the relation between sleep disorders and falls among the community‐dwelling elderly and to determine whether or not sleep disorder is an independent risk factor for falls.Methods: Of 2274 community‐dwelling persons aged 65 and older who participated in the first study in July 1998, 1771 (77.9%) who responded to the questions concerning sleep disorders were the subjects in the present study.Results: There were 1521 persons (85.9%) who had not experienced any fall during
the past year, 194 (11.0%) who had one or two falls, 27 (1.5%) had
three to four falls and 29 (1.6%) had more than five falls. The relation
between the history of falls and the sleep problems indicates that the odds ratio
for the history of falls was significantly higher if the nocturnal sleep disorder
was more intense (P < 0.001) and the sleep hours during the day were longer
(P < 0.01). In order to determine the independent risk factors for falls,
the general linear model analysis was conducted using the significantly different
background. The nocturnal sleep problems (F = 4.05; P = 0.018), the
daytime sleep (F = 4.17; P = 0.016) and nocturnal sleep problems and
interaction between (*) daytime sleep (F = 2.54; P = 0.038) were significant
independent explanatory variables as the age (F = 14.4; P < 0.001),
difficulty in walking (F = 4.30; P = 0.038), history of stroke (F
= 64.1; P < 0.001) and arthralgia (F = 5.31; P = 0.021).Conclusion: The data emphasize that the sleep disorder is closely related to falls.
Self‐reported functional ability predicts three‐year mobility and mortality in community‐dwelling older persons
Authors: Kawamoto Ryuichi , Doi Takaaki 
Published: March 2003

Background:  A comprehensive evaluation of the functions of community‐dwelling older persons was conducted in 1988. Three years after the 1988 study commenced, the relationship between these background factors and changes during the subsequent 3 years were examined.Methods:  The study was a comprehensive evaluation of the daily functions of community‐dwelling elderly people, and encompassed age, gender, mode of living, marital status, financial status, family relationships, basic activities of daily living, visual and hearing impairment, a history of disease, self‐related feeling, social role, social support, habits and physical exercise and the relationship between independence and survival for 3 years after the basic study. The subjects were 2274 community‐dwelling elderly people who participated in the first survey in July 1998 and who were aged 65 years and over at that time. Unassisted questionnaire sheets were used for the first survey and changes since the first survey.Results:  Thirty men and 60 women died during the 3 year period. Data were also gathered about the daily activity levels of 1709 persons (75.2%) with 1499 (87.7%) ranking J for independence and 210 persons (12.3%) ranking A to C for dependence. Age, gender, basic activities of daily living (BADL), history of falls, self‐related happiness, participation in community events and physical‐exercise habits were found to be explanatory variables for independence after three years; as were age, gender, and BADL for survival.Conclusion:   The explanatory variables relating to independence and prognosis of life of the elderly obtained in this study will be important in future considerations of the issue of care‐taking and measures to enable it.
Ethnic difference in contribution of alleles of the interleukin‐1 receptor antagonist gene to predisposition to osteoporosis
Authors: Sugiyama Hiroaki , Ogawa Sumito , Emi Mitsuru , Shiraki Masataka , Hosoi Takayuki , Orimo Hajime , Ouchi Yasuyoshi , Inoue Satoshi 
Published: March 2003

Background:  The interleukin‐1 receptor antagonist (IL‐1RA) plays an important role in bone metabolism, and molecular defects are implicated in the pathogenesis of osteoporosis. Studies performed in Caucasian populations have demonstrated an association between allelic variants of the IL‐1RA gene and bone mineral density (BMD).Methods: In the study reported here, we examined whether variation of the IL‐1RA gene would correlate with osteoporosis among 287 Japanese postmenopausal women.Results:  The allele frequencies and distribution in this ethnic group were remarkably different from those reported for Caucasians and phenotypes such as Z scores of lumbar spine (L2–4) and total body BMD, as well as various biochemical markers related to bone metabolism, were not significantly different among groups of IL‐1RA genotypes in the present study.Conclusion:  Our results emphasize the importance of considering ethnic background in assessing the etiological significance of candidate genes in osteoporosis.
Arterial pulse wave velocity in elderly patients with dementia
Authors: Komai Norio , Ohishi Mitsuru , Kaibe Masaharu , Jinno Toyohisa , Katsuya Tomohiro , Higaki Jitsuo , Rakugi Hiromi , Inoue Takashi , Ogihara Toshio 
Published: March 2003

Background:  Cardiovascular events influence the quality of life and mortality of elderly patients. Arterial stiffness measured by aortic pulse wave velocity is a useful means of predicting the presence of cardiovascular diseases, even in subjects over 70 years old. This procedure is non‐invasive, but the usefulness and easiness of aortic pulse wave velocity for patients with dementia are still unclear. Therefore, to determine how useful and easy it is to measure aortic pulse wave velocity, we evaluated arterial stiffness in patients with or without dementia who required care and support for their daily life.Methods:  Fifty‐nine subjects over 70‐years‐old who suffered from dementia were enrolled in this study. After we excluded arteriosclerosis obliterans (ankle‐brachial pressure index < 0.80; n = 10) by arterial pulse wave velocity, we classified these subjects into two groups: subjects with Alzheimer's disease (n = 25) and subjects with vascular dementia (n = 24) who were diagnosed by magnetic resource imaging and mini‐mental state examination.Results:  The authors of the present paper could easily and precisely evaluate arterial stiffness of all patients. The mean pulse wave velocity of right and left brachial‐tibial arteries in subjects with Alzheimer's disease (1740 ± 385 cm/s) was significantly lower than those subjects with vascular dementia (2436 ± 586; P < 0.001).Conclusion:  The data included in the present study indicate that subjects with Alzheimer's disease had decreased arterial stiffness and would show a lower risk of cardiovascular diseases compared to subjects with other diseases including vascular dementia.
Asymptomatic cerebral infarction on brain MR images and cognitive function in elderly diabetic patients
Authors: Araki Atsushi , Ito Hideki 
Published: March 2003

Background:  The assessment of cognitive function is of great importance in the management of elderly patients with diabetes mellitus. The purpose of the present study was to examine the effects of glucose control and asymptomatic cerebral infarction on impaired cognitive function in elderly patients with diabetes mellitus.Methods:  Two hundred and thirteen elderly diabetic patients (59 men, 154 women) with a mean age of 75 years; and 40 non‐diabetic subjects participated in this study and underwent both brain magnetic resonance imaging (MRI) and several domains of cognitive function tests. Based on the brain MRI findings and neurological deficits, the subjects were divided into four groups: (i) the symptomatic cerebral infarction (CI) group; (ii) the asymptomatic CI group; (iii) the diabetic control group without any CI; and (iv) the non‐diabetic control group. Cognitive function was assessed using the mini‐mental state examination (MMSE), and the subtests of Wechsler Adult Intelligence Scale – Revised (WAIS‐R) (the digit symbol test, the backward digit span test, the similarities test, and the picture arrangement test). Attention/complex psychomotor skill and visual memory were assessed with the digit symbol substitution test, the Stroop test, and the Benton visual retention test.Results:  Attention/complex psychomotor skill and visual memory were more impaired in the diabetic control group without any CI than in the non‐diabetic control group. The asymptomatic and symptomatic CI groups were significantly inferior to the non‐diabetic and diabetic controls in the digit symbol substitution test and Stroop test. The degree of cognitive impairment significantly correlated to the presence and number of small‐sized cerebral infarction, but to a less degree, large‐sized infarction. Multivariate analysis revealed that age, HbA1c, and cerebral infarction on MR images were independently associated with the impairment of complex psychomotor skill in patients with diabetes mellitus.Conclusions:  The presence of asymptomatic cerebral infarction on brain MR images as well as hyperglycemia could explain the impairment of attention/complex psychomotor skill and visual memory in elderly patients with diabetes mellitus.
Frequency and predictors of axillary lymph node metastases in invasive breast cancer
Authors: Chua Boon , Ung Owen , Taylor Richard , Boyages John 
Published: March 2003

Background:  The objectives of the present study were to evaluate the incidence and predictors of axillary lymph node metastases (ALNM) in patients with breast cancer, and to identify if axillary surgery could be safely omitted in selected patients.Methods:  Between January 1996 and May 2000, 492 patients underwent 501 axillary lymph node dissections (ALND). The incidence of ALNM was correlated with clinical and pathological characteristics by univariate and multivariate analyses.Results:  Axillary lymph node metastases were found in 41% (207/501) of cases. Univariate analysis showed that palpability of primary and axillary lymph node (ALN), pathological tumour size, grade, lymphovascular invasion (LVI) and multifocality or multicentricity were significant predictors of ALNM. By multivariate analysis, palpability of ALN, pathological tumour size, LVI and multifocality or multicentricity remained as independent predictors. Among the 431 cases without palpable ALN, no ALNM were found if the tumour was ≤ 5 mm, non‐multifocal or multicentric, and without LVI, or the tumour was a tubular or mucinous car­cinoma ≤ 15 mm (n = 21). The frequency of ALNM in the absence of the other risk factors was 11% (7/64) if the tumour size was > 5–10 mm, and 17% (19/113) if the tumour was > 10–20 mm. However, the incidence of ALNM was 72% for the 32 clinically node‐negative cases with multifocal or multicentric tumour ≥ 10 mm and LVI. Those patients with palpable ALN (n = 66) had a greater than 50% risk of ALNM.Conclusions: Routine ALND could be omitted in clinically node‐negative patients with either a ≤ 5‐mm, LVI‐negative tumour, or a ≤ 15‐mm tubular or mucinous carcinoma. Axillary lymph node dissection is still useful for determining pathological nodal status in all other cases, and in most cases with palpable ALN, as a therapeutic manoeuvre.
Surface landmarks of the facial nerve trunk: a prospective measurement study
Authors: Wong David S. Y. 
Published: March 2003

Background:   Facial nerve identification and preservation is the key to safe parotidectomy in most clinical situations. Traditional approaches to the main trunk have depended solely on internal landmarks but localization may further be enhanced if data are avail­able on its position with reference to neighbouring external features.Methods:   Prospective measurements were taken on a series of parotidectomy patients intraoperatively. Using that spot on the main trunk 10 mm proximal to its bifurcation as the reference point, the depth from the skin and its cranio‐caudal distance from the summit of the tragus were measured.Results:   Thirty‐three patients were included, whose body mass index showed that they had average body build. The reference point nerve was 23.6 mm (SD = 5.1 mm) from the skin surface, and 18.8 mm (SD = 6.0 mm) caudal to the tragus.Conclusion:   Measurements relating to the siting of the facial nerve trunk were obtained live at operation. This information should be helpful in the initial mobilization of the parotid gland from its posterior relations and in facilitating the classical internal landmarks in the 3‐D localization of the main trunk, thereby allowing quicker and safer parotidectomy.
Investigating chronic, bright red, rectal bleeding
Authors: Mehanna Daniel , Platell Cameron 
Published: March 2003

Background: Chronic, bright red, rectal bleeding is a common symptom in our community and the aetiology is frequently benign anal disease. The aim of the present study was to determine the efficacy of performing a flexible sigmoidoscopy on patients with chronic, bright red, rectal bleeding who are at low risk for colorectal neoplasia and who, on rigid sigmoidoscopy, are found to have an identifiable anal cause (e.g. haemorrhoids, fissure) for their bleeding.Methods: A prospective study was conducted on patients presenting with chronic, bright red, rectal bleeding. Patients were considered at low risk for colorectal neoplasia if they fulfilled the following criteria: (i) less than 55 years of age; (ii) no past or family history of colorectal neoplasia or inflammatory bowel disease; (iii) no symptoms of altered bowel habit or abdominal pain; and (iv) a source of bleeding identified (e.g. haemorrhoids, fissure) on rigid sigmoidoscopy. All patients underwent a flexible sigmoidoscopy.Results: Eighty‐two patients were entered into the trial, mean age 39 ± 9 years (range: 22–55 years), and the ratio of men:women was 1.8:1. The anal cause of bleeding was haemorrhoids in 96%, and anal fissure in 4%. At flexible sigmoidoscopy, five patients were found to have adenomatous polyps. Rigid sigmoidoscopy missed diminutive neoplastic lesions in 6% of patients.Conclusions: Flexible sigmoidoscopy results in a low yield of colorectal neoplasia in patients presenting with chronic, bright red, rectal bleeding who are at low risk for colorectal neoplasia and who have an identifiable anal cause for their bleeding.