bluuebunny/crossref_metadata_2025_split huggingface dataset:
Azathioprine and prednisone combination therapy in refractory coeliac disease
Authors: Goerres M. S. , Meijer J. W. R. , Wahab P. J. , Kerckhaert J. A. M. , Groenen P. J. T. A. , Van Krieken J. H. J. M. , Mulder C. J. J. 
Published: September 2003

SummaryIntroduction:  Refractory coeliac disease (RCD) is a rare syndrome with a poor prognosis, defined by malabsorption due to gluten‐related enteropathy after initial or subsequent failure of a strict gluten‐free diet and after exclusion of any disorder mimicking coeliac disease.Patients and methods : Nineteen patients were included and treated. Based on intraepithelial T‐lymphocyte(IEL) phenotyping, patients were recorded as having RCD type I with normal IELs, or RCD type II with phenotypically immature IELs defined by a lack of characteristic T‐cell markers. Treatment consisted of azathioprine combined with prednisone for 1 year, which was tapered and, if possible, stopped.Results : Clinical improvement was seen in nearly all patients in both groups. Eight of 10 RCD type I patients responded histologically, and complete normalization of villi was seen in four patients. In RCD type II, 6/8 patients developed enteropathy‐associated T‐cell lymphoma (EATL) and 7/8 patients died.Conclusions : For the first time we report a promising therapeutic treatment option for RCD type I. In RCD type II, azathioprine and prednisone therapy (APT) is not effective, therefore we suggest that other (chemo)therapeutic agents are considered. Not all RCD type II patients presented with a monoclonal TCRγ‐gene rearrangement and immunohistological changes as is currently reported in the literature. Therefore, immunophenotyping seems mandatory in the work‐up of RCD.
Systematic review: hepatotoxic events associated with herbal medicinal products
Authors: Pittler M. H. , Ernst E. 
Published: September 2003

SummaryBackground : Large proportions of patients use herbal medicinal products, and encouraging data in terms of effectiveness exist for some of these. One aspect, however, which is still largely under‐investigated is the question of potential harm.Aim : To review the recent evidence on hepatotoxic events associated with the use of herbal medicinal products.Methods : Systematic literature searches were performed on Medline, Embase, The Cochrane Library, Amed and Ciscom. To identify additional data, searches were conducted by hand in relevant medical journals and in our own files. The screening and selection of articles and the extraction of data were performed independently by the two authors. There were no restrictions regarding the language of publication. In order to be included articles were required to report data on hepatotoxic events associated with the therapeutic use of herbal medicinal products.Results : Single medicinal herbs and combination preparations are associated with hepatotoxic events. Clinically, the spectrum ranges from transient elevations of liver enzyme levels to fulminant liver failure and death. In most instances hepatotoxic herbal constituents are believed to be the cause, while others may be due to herb–drug interactions, contamination and/or adulteration.Conclusions : A number of herbal medicinal products are associated with serious hepatotoxic events. Incidence figures are largely unknown, and in most cases a causal attribution is not established. The challenge for the future is to systematically research this area, educate all parties involved, and minimize patient risk.
Gastroduodenal tolerability of lumiracoxib vs. placebo and naproxen: a pilot endoscopic study in healthy male subjects
Authors: Rordorf C. , Kellett N. , Mair S. , Ford M. , Milosavljev S. , Branson J. , Scott G. 
Published: September 2003

SummaryBackground : Lumiracoxib (Prexige®) is a cyclooxygenase‐2 (COX‐2) selective inhibitor.Aim : To compare the gastroduodenal tolerability of lumiracoxib with placebo and naproxen in a randomized, parallel‐group, double‐blind study.Methods : Sixty‐five healthy male subjects were randomized to receive 8 days' dosing with lumiracoxib 200 mg twice daily (b.d.) (n = 21), placebo (n = 22) or naproxen 500 mg b.d. (n = 22). Endoscopic evaluations of gastric and duodenal mucosae were conducted at baseline and after 8 days' dosing. Serum was assayed for ex‐vivo concentrations of thromboxane B2 (TxB2) to determine cyclooxygenase‐1 (COX‐1) inhibitory activity.Results : Sixty subjects (20 per group) completed the study. No gastroduodenal erosions were observed in subjects receiving lumiracoxib. Thirteen subjects receiving naproxen developed duodenal erosions. At the gastric site, one subject in each of the naproxen and placebo groups had erosions; one subject receiving naproxen also developed a small asymptomatic gastric ulcer. Gastrointestinal adverse events accounted for 42.3% of all adverse events, occurring in 3/21, 4/22 and 6/22 of the lumiracoxib, placebo and naproxen groups, respectively. TxB2 levels were similar for patients receiving placebo or lumiracoxib, but were reduced by > 95% in patients receiving naproxen, compared with placebo.Conclusions : Multiple doses of lumiracoxib resulted in gastroduodenal tolerability similar to placebo and superior to naproxen.
Review article: a medicine based on cell transplantation – is there a future for treating liver diseases?
Authors: Di Campli C. , Gasbarrini G. , Gasbarrini A. 
Published: September 2003

SummaryCell‐based therapies, comprising isolated hepatocyte transplantation, ex vivo gene therapy and bioartificial liver devices, may actually design a new scenario in the treatment of patients with liver failure. Recent advances in the liver repopulation field and the considerable excitement surrounding the use of haematopoietic stem cells for a ’regenerative medicine’, allow us to see under a new light the alternative cell sources actually under investigation. In particular, the major drawbacks and the most important advantages of xenogenic primary cells, tumour‐derived cell lines, immortalised hepatocytes and stem cells in the wide range of experimental and clinical applications are presented. Even if up to now none of them represent a ’gold standard’ in the clinical practice, the intersecting advances in the development of mechanical components of artificial devices and in the liver biology and bioengineering will open tantalising possibilities to treat patients with liver failure, by tailoring the therapeutic choice on the basis of the aetiology and the stage of liver disease.
Evaluation of Helicobacter species in inflammatory bowel disease
Authors: Bell S. J. , Chisholm S. A. , Owen R. J. , Borriello S. P. , Kamm M. A. 
Published: September 2003

SummaryBackground : Bacteria have been implicated in the pathogenesis of inflammatory bowel disease. Helicobacter species have been shown to cause colitis in animal models and have been identified in human diarrhoeal illness and Crohn's disease.Aim: : To determine whether Helicobacter species are present in human inflammatory bowel disease tissue.Methods: : Thirty patients undergoing colonoscopy for clinical reasons were studied. Nine had Crohn's disease, 11 had ulcerative colitis and 10 had histologically normal colons. Tissue was snap‐frozen at −70 °C. DNA was extracted and examined by five different polymerase chain reaction (PCR) assays that were either genus or species specific for Helicobacter.Results : Analyses of colonic biopsies by two Helicobacter genus‐specific PCR assays, two H. pylori‐specific assays and a PCR assay designed to amplify fragments of ‘H. heilmannii’‐like organisms demonstrated that product was not generated by any test. Internal control PCR demonstrated that PCR results for the five assays were not negative due to the presence of residual substances inhibitory to PCR.Conclusions : Helicobacter species were not identified in this study, using multiple PCRs to eliminate the problems of non‐specific cross‐reaction. This suggests that Helicobacter species do not play a role in the pathogenesis of inflammatory bowel disease.
The effect of Lactobacillus plantarum 299v on the bacterial composition and metabolic activity in faeces of healthy volunteers: a placebo‐controlled study on the onset and duration of effects
Authors: Goossens D. , Jonkers D. , Russel M. , Stobberingh E. , Van Den Bogaard A. , StockbrÜgger R. 
Published: September 2003

SummaryAim : To study the onset and duration of a possible effect of a fermented oatmeal drink containing Lactobacillus plantarum 299v on the composition of the faecal flora of healthy volunteers in a placebo‐controlled, double‐blind study.Methods : Twenty‐two participants consumed a fermented oatmeal drink with or without L. plantarum 299v for 4 weeks. Faecal samples were collected weekly: two samples before, four during and four after the consumption of the drink. Several bacterial species were counted and enzyme activities, short‐chain fatty acid concentrations, endotoxin concentration and pH were determined. L. plantarum 299v was identified using randomly amplified polymorphic DNA.Results : In contrast with the placebo group, median lactobacilli counts increased significantly from 4.2 (3.4–6.3) to 8.2 (7.3–8.5) log colony‐forming units/gram faeces (P = 0.005) after 1 week of consumption of L. plantarum 299v, thereafter remaining stable during the treatment period. One week after cessation, a significant decrease in lactobacilli [to 4.4 (2.2–6.5) log colony‐forming units/gram faeces] was observed (P = 0.003). These lactobacilli were identified as L. plantarum 299v. All other bacterial counts, enzyme activities, short‐chain fatty acid concentrations, endotoxin concentration and pH remained unchanged.Conclusions : L. plantarum 299v significantly increased the number of lactobacilli in the faecal flora within 1 week, and this effect disappeared within 1 week after cessation of intake. No other changes in bacterial counts and metabolic products were observed.
Dilated intercellular spaces as a marker of oesophageal damage: comparative results in gastro‐oesophageal reflux disease with or without bile reflux
Authors: Calabrese C. , Fabbri A. , Bortolotti M. , Cenacchi G. , Areni A. , Scialpi C. , Miglioli M. , Di Febo G. 
Published: September 2003

SummaryBackground : The dilation of oesophageal intercellular spaces, clearly apparent in transmission electron microscopy images, is a marker of cellular damage induced by acid.Aim : To analyse the presence of dilated intercellular spaces and to quantify the scores in controls and in patients with gastro‐oesophageal reflux disease or duodenal gastro‐oesophageal reflux accompanied by erosive or non‐erosive reflux disease.Methods : Thirty‐eight symptomatic patients with gastro‐oesophageal reflux disease or duodenal gastro‐oesophageal reflux and 12 asymptomatic controls, classified on the basis of pH‐metry and bilimetry, underwent endoscopy. Six tissue biopsies were taken from the normal mucosa for light microscopy and transmission electron microscopy evaluation. Dilated intercellular spaces were measured on photomicrographs of the specimens (at least 100 transects were measured for each patient).Results : Twenty‐two patients with gastro‐oesophageal reflux disease had normal macroscopic mucosa but, at histology, five patients with erosive gastro‐oesophageal reflux disease had mild oesophagitis and one had moderate oesophagitis. Seven patients with duodenal gastro‐oesophageal reflux had normal mucosa, whilst three with erosive duodenal gastro‐oesophageal reflux had mild oesophagitis at histology. At transmission electron microscopy, all controls had dilated intercellular spaces of less than 1.69 µm. Each symptomatic patient had a mean dilated intercellular space value and a mean value of the maximum dilated intercellular space at least three or more times greater than that in controls (P < 0.001). No statistical differences were observed between erosive and non‐erosive oesophagitis.Conclusions : The dilated intercellular space is an extremely sensitive marker of damage in gastro‐oesophageal reflux disease, duodenal gastro‐oesophageal reflux and non‐erosive reflux disease, and serves as the most appropriate marker of damage evaluation in non‐erosive reflux disease reported to date. A mean dilated intercellular space of 0.74 µm provides a cut‐off score for damage. No quantitative or qualitative differences in dilated intercellular space scores were found between pure and mixed acid reflux.
Proffered Papers  10.30–11.15 Monday 15 September 2003 5 Colposcopic excisional biopsies with normal histology. Is this a cytology problem?
Authors: Giles J. , Knowles S. , Cox S. 
Published: September 2003

Introduction  Colposcopy Quality Standards state that more than 85% of excisional biopsies should show CIN 1 or worse. Data from the National KC65 reports show a large difference between units (50% to 100%). This study investigates the reasons for failure to meet the standard.Methods  A review of 1158 consecutive new and 1043 follow‐up colposcopy examinations from a colposcopy database in East Somerset. Patients were treated at the time of initial examination if there was a clinically significant lesion, or at follow‐up depending on the results of investigations.Results  Only 59% of excisional biopsies showed CIN 1 or worse. The possible reasons for failure to meet the standard were explored. Possible explanations explored are erroneous colposcopy, false negative histology, and false positive cytology. The cytology–histology correlation was compared between excisional and directed biopsies, and between the two local cytology screening departments.Conclusions  The collection of meaningful national data has more to do with careful definition than clinical practice or data collection.
Proffered Papers  16.00–16.30 Monday 15 September 2003 7 Papillomavirus testing using Hybrid capture II in a community‐based primary screening setting: preliminary results and potential clinical applications
Authors: Chana P. , Ktori E. , Nowicki M. , Best J. , Herbert A. , Kubba A. A. 
Published: September 2003

Introduction  The aims of this study were (i) to assess the use of Hybrid‐capture II (HCII) alongside conventional cytology for triage of mildly abnormal smears and (ii) to establish the local prevalence of high‐risk human papillomavirus (HRHPV).Study design  In an on‐going study, 669 women aged 20–50 were recruited into (i) a study group, with current abnormal cytology or a history of previous abnormal cytology and (ii) an anonymous control group with current negative cytology and no history of abnormal smears. HCII positive was used as a surrogate for mild dyskaryosis in women with negative smears in the study group.Results  There was strong correlation between positive HCII tests with degree of cytological abnormality. HCII was positive in 13 of 13 (100%) of women with at least moderate dyskaryosis, 27 of 34 (79%) with mild dyskaryosis, 18 of 36 (50%) with borderline abnormalities, 36 of 250 (14%) of negative smears. In the control group, 50 of 308 (16%) of negative smears were positive. HCII was positive in four of 28 (14%) women with inadequate smears in both groups. HCII was positive at low levels (<10 RLU) in 3% of samples from both groups. No indication of clinical outcome is yet available and also further work is in progress to assess the significance of low‐level positive results. Overall, 148 of 669 (22%) of women were HCII positive.Conclusion  HCII can be carried out alongside conventional cytology for the triage of women with mildly abnormal smears. The results suggest a role for HPV testing in re‐assuring women with a past history of abnormal cytology.
Proffered papers  14.00–15.00 Tuesday 16 September 2003 8 Ampullary, pancreatic and biliary duct exfoliative brush cytology prepared by the thinprep method: performance and morphology
Authors: Duggan Máire A. , Brasher Penny , Medlicott Shaun 
Published: September 2003

Background  ERCP‐directed brush cytology is used to sample lesions of the pancreatic and biliary ducts and the ampulla of Vater. With conventional preparations, the sensitivity and specificity range from 44% to 63% and 80% to 98%, respectively, and increased N : C ratio, nuclear molding and loss of honeycombing are reliable features of malignancy. The performance and morphology of specimens prepared by ThinPrep, a liquid‐based cytology technique is mostly unknown.Methods  The laboratory information system was searched for all cases prepared by ThinPrep. Patient disease classification of benign or malignant was determined by linkage with the provincial cancer registry and was the gold standard against which sensitivity, specificity, positive (PPV) and negative predictive values (NPV) were calculated. True positives and negatives were reviewed to identify predictive cytomorphologic features.Results  Between 1996 and 2001, there were 149 ThinPrep specimens; 55 (37%) were reported as positive for malignancy and 94 (63%) as negative. Disease was classified as malignant in 86 (58%) patients and benign in 63 (42%). There were 42 false negative, 11 false positive, 52 true negative, and 44 true positive cytology results. Sensitivity was 51.2% (CI; 40.2 : 62.0), specificity 82.5% (CI; 70.5 : 90.6), and PPV and NPV 80.0% (CI; 66.6 : 89) and 55.3% (CI; 44.7 : 65.5), respectively. Cell groups with crowded, enlarged, irregular nuclei and nuclear features of vesicular chromatin and large, multiple irregular nucleoli correlated with malignant disease, while monolayered sheets of uniform columnar cells, regular nuclei and a finely granular chromatin correlated with benign disease.Conclusions  The performance of ThinPrep brushings from this anatomic site equals conventional preparations. Cytomorphologic features of malignancy are more frequent and pronounced with ThinPrep.
Proffered papers  14.00–15.00 Tuesday 16 September 2003 10 Multilingual image gallery and web‐based training for cytopathology
Authors: Schenck Ulrich , Seidl Stefan , Weirich Gregor , Schenck Ulrike 
Published: September 2003

Aims  A multilingual image gallery on the web (http://zytologie.schenck.de) with user administration (free registration) has been offered since several years and reaches more than 2500 registrants. The aim of this study was to implement web‐based training (WBT) into the technical context of the image gallery with the purpose to offer structured information and monitor student activities and success.Methods  The WBT platform was programmed externally in php‐script language in a linux software surrounding and is running on remote web servers. It has been implemented in a way that user administration of image gallery and WBT are closely linked. User, trainer and administrative access is via web browsers and optimized for use with Microsoft Internet Explorer 5.5+.Results  Users, trainers and administrators have access (http://zytotraining.schenck.de) by their username and password which is identical with that for the image gallery. A symbol oriented navigation surface allows training in different languages according to the availability of teachers. Documents are integrated in various formats including html, ppt, pdf, word, jpg, excel. Links and tests with a variety of question types are implemented into training programs. Documents and tests may be shared by different courses. Administration takes care of user access and regulates trainer's rights. Trainers can rearrange the presentation or implement new information for free or supervised training. Model applications were the implementation of the proceedings of the 16. Munich postgraduate course of clinical cytology, medical student training at the Technical University of Munich and a course of lung cytology for the School of Cytotechnology in Munich.Conclusions  The software has the essential components to offer continuing education. More trainings related to different fields of cytopathology will be integrated.
Proffered papers  14.00–15.00 Tuesday 16 September 2003 11 Galectin‐3 in thyroid nodules: a cytohistological correlation
Authors: Davies R. , Dina R. 
Published: September 2003

Aim  To assess sensitivity and specificity of galectin‐3 to identify malignant lesions of thyroid in cytological specimens.Methods  Fifteen FNA biopsies with a histological correlation out of 392 have been considered suitable for immunostaining with galectin‐3. Galectin‐3 (mouse monoclonal antibody supplied by Novocastra Laboratories Ltd, Newcastle‐upon‐Tyne) primary antibody solution was used at a concentration of 1 : 400. Immunostaining was assessed using a score from 0 to 3 considering 0–1, negative and 2–3, positive.Results  Four cases were cytologically reported as malignant (27%), five as suspicious (33%), six as benign (40%). Histologically, six were follicular adenomas, two hyperplastic nodules, three papillary carcinomas, two follicular carcinomas and one was a medullary carcinoma.Only in one case galectin‐3 immunostaining was positive in cytology, which resulted in histology to be a benign hyperplastic nodule. In histology, the galectin‐3 immunostaining was positive both in benign (three of nine) and malignant (three of six) nodules and negative in half of the carcinomas (three of six). Only in one case, galectin‐3 immunostaining was consistently positive both in cytology and histology (hyperplastic colloid nodule).Conclusion  In our experience, galectin‐3 staining is poorly reproducible in cytological and histological samples and is of little help in the differential between malignant and benign lesions of the thyroid.

Galectin score on cytology
Cytological diagnosis
Galectin score on histology
Histological diagnosis

0
Follicular lesion
2
Benign hyperplasia nodule

0
Follicular neoplasm
1
Follicular adenoma

1
Papillary carcinoma
2
Papillary carcinoma

0
Follicular lesion
0
Follicular adenoma

0
Follicular lesion
0
Hyperplastic colloid nodule

0
Follicular lesion
2
Follicular adenoma

3
Atypical cells
2
Nodular hyperplasia

0
Follicular lesion
1
Follicular adenoma

0
No malignant cells
0
Follicular adenoma

3
Suspicious for malignancy
1
Follicular carcinoma

0
Follicular lesion
1
Follicular adenoma with papillary hyperplasia

0
Malignant cells? Papill. or med. carc.
0
Medullary carcinoma

0
Follicular lesion
3
Low grade minimal invasive follicular carcinoma

1
Papillary carcinoma
3
Papillary carcinoma

0
Suspicious for malignancy
0
Papillary carcinoma with Hurtle change
Posters. P1 A 2‐year audit of thyroid fine needle aspiration cytology
Authors: Cameron I. , Venkatraman L. , Anderson N. 
Published: September 2003

Introduction  Fine needle aspiration (FNA) cytology of the thyroid is a well‐established test in the clinical work‐up of patients with solitary nodules of the thyroid. Thyroid FNA does however have limitations and audit of diagnostic performance is important.Methods  The histopathology archives of the Royal Victoria Hospital were searched for all thyroid resections and the histopathological diagnosis was correlated with the pre‐operative cytological diagnosis, where available. Special emphasis was placed on the accuracy of tumour diagnosis.Results  A total of 173 cases were identified during the 2‐year period, of these 93 had available pre‐operative FNA. A total of 57 tumours were identified. A small number (six of 57) of significant discrepancies were identified. These included a malignant lymphoma diagnosed as Hashimoto's thyroiditis, a metastasis which the FNA had suggested was a medullary carcinoma and an insular carcinoma diagnosed as medullary carcinoma on FNA. False positives included a colloid cyst diagnosed as suspicious of malignancy and a cytological diagnosis of papillary carcinoma not confirmed on histology.Discussion  At present, the majority of thyroid FNAs in our clinics are performed by surgeons and material is not routinely available for immunocytochemistry. In spite of these limitations, there were few major discrepancies. These might be reduced if pathologist aspirators were able to perform FNAs and collect material for further studies, where necessary. This would allow identification of medullary carcinomas and malignant lymphomas.Conclusion  FNA of thyroid lesions is a useful investigation in our clinical setting, however, some areas of potential for improvement have been identified.