bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anti‐inflammatory response in patients with obstructive jaundice caused by biliary malignancy
Authors: Kimura Fumio , Miyazaki Masaru , Suwa Toshikazu , Sugiura Toshiyuki , Shinoda Tokuzou , Itoh Hiroshi , Nagakawa Koji , Ambiru Satoshi , Shimizu Hiroaki , Yoshitome Hiroyuki 
Published: March 2003

AbstractBackground: Obstructive jaundice potentially modulates the host defense mechanism resulting in perioperative infection. It has been reported that a systemic inflammatory response occurs in patients with obstructive jaundice. An anti‐inflammatory response was studied in 29 jaundiced patients undergoing biliary drainage.Results: Plasma concentrations of interleukin (IL)‐10, soluble tumor necrosis factor receptor (STNFR) p55, STNFR p75, IL‐1 receptor antagonist (IL‐1ra), IL‐6 and soluble CD14 (sCD14) were measured by using immunoassay. Plasma concentrations of IL‐10, STNFR p55, STNFR p75, IL‐1ra, IL‐6 and sCD14 were significantly higher in jaundiced patients than in the controls (P < 0.01). After biliary drainage, the concentrations of IL‐10, the three cytokine antagonists, and IL‐6 decreased significantly (P < 0.05). The sCD14 concentration did not decrease. At the time of drainage, the concentrations of STNFR p55 and STNFR p75 were significantly higher in 10 patients with positive bile cultures than in 19 patients with negative bile cultures (P < 0.05). Bile cultures became positive 14 days after drainage in 10 patients, and remained negative in nine. The concentration of STNFR p55 before drainage was significantly higher in the former group (P = 0.05). The plasma concentrations of IL‐10 and STNFRs were significantly correlated with the IL‐6 concentration, body temperature and the white blood cell count (P < 0.05). Serum total bilirubin levels did not affect plasma levels of anti‐inflammatory mediators, and sCD14.Conclusion: Jaundiced patients exhibited an anti‐inflammatory immune response that potentially modulates the host defense mechanism and results in anergy and increased susceptibility to infection. Biliary infection may be one of the major stimuli of the immune response.
Influence of climatic factors in the incidence of upper gastrointestinal bleeding
Authors: Nomura Tetsuya , Ohkusa Toshifumi , Araki Akihiro , Chuganji Yoshimichi , Momoi Masaru , Takashimizu Ichizen , Watanabe Mamoru 
Published: March 2003

AbstractBackground and Aim:Previous reports have indicated seasonal fluctuations in the incidence of peptic ulcer activity, but the reasons for the seasonal pattern are not clear. We assessed the seasonal incidence of hematemesis caused by peptic ulcers or gastroesophageal varices, and the correlations between those and climatic factors.Methods:We examined the number of cases of upper gastrointestinal (GI) bleeding caused by gastric ulcer (GU), duodenal ulcer (DU), or gastroesophageal varices (varix) diagnosed by urgent endoscopies between 1 January 1996 and 31 December 1999 in our hospital (Tokyo Metropolitan Bokutou Hospital). We evaluated the monthly and seasonal incidence of them and investigated correlations among the incidence and climatic factors.Results:Four hundred and forty‐one patients participated in this study, including 275 patients with GU (62.4%), 51 (11.6%) with DU, and 115 (26.0%) with varix. The number of cases of hematemesis caused by GU showed significant monthly and seasonal fluctuations (P = 0.0002, P = 0.0018): it decreased in summer and increased in autumn–winter. Moreover, there were inverse relations between the monthly number of cases of hematemesis caused by GU and the mean temperature (P = 0.0016) and vapor pressure (P = 0.0013), and a parallel relation to the mean atmospheric pressure (P = 0.0057). In contrast, the number of cases of hematemesis caused by DU and varices did not show any monthly or seasonal fluctuations.Conclusions:We found that the incidence of hematemesis because of GU had an inverse relationship to temperature and vapor pressure, and had a parallel relation to atmospheric pressure. Therefore, climatic factors may play an important role in hemorrhage from GU.
Influence of gender difference and gastritis on gastric ulcer formation in rats
Authors: Liu Edgar SL , Wong Benjamin CY , Cho Chi‐Hin 
Published: March 2003

AbstractBackground: Male patients with gastritis are found to have a high risk of developing peptic ulcer diseases. However, how gastritis or gender difference affects gastric ulcer formation is unclear. The present study aimed to investigate the relationship between ethanol‐induced acute gastritis and gastric ulcer formation in rats.Methods: Acute gastritis or gastric ulcer was induced in the rat stomach by 80% ethanol or 60% acetic acid, respectively. Rats were killed either with gastritis alone or thereafter at day 1, 3 or 6 after ulcer induction. The number of proliferating and apoptotic cells, the mucosal mucus and prostaglandin E2 (PGE2) level were also determined.Results: Male rats with acute gastritis potentiated gastric ulcer formation, while gastritis in female rats prevented ulceration. Female rats with gastritis had a significantly faster ulcer‐healing rate. More apoptotic cells were found in the gastritis groups, but only the female gastritis group produced more proliferating cells and had a decrease in the apoptosis‐over‐proliferation ratio. The mucus level was higher in female rats after ulcer induction. Mucosal PGE2 level was higher in female rats with acute gastritis. Both mucus and PGE2 were increased during ulcer healing in both genders.Conclusions: This study shows that gender difference plays a role in the pathogenesis of ulcer formation. The number of cells with apoptosis or proliferation determines, in part, the gender difference on gastric ulcer formation in rats. Gastric PGE2 not only contributes to this process, but also together with gastric mucus participates in the ulcer‐healing process in the stomach.
Intraductal ultrasonography for hepatocellular carcinoma with tumor thrombi in the bile duct: Comparison with polypoid cholangiocarcinoma
Authors: Tamada Kiichi , Isoda Norio , Wada Shinichi , Tomiyama Takeshi , Ohashi Akira , Satoh Yukihiro , Ido Kenichi , Sugano Kentaro 
Published: March 2003

AbstractBackground and Aim: Tumor thrombi in the bile duct caused by hepatocellular carcinoma (HCC), and cholangiocarcinoma show polypoid lesions on cholangiographic findings. This study prospectively compared the images of intraductal ultrasonography between HCC and polypoid cholangiocarcinoma.Methods: In five patients with tumor thrombi in the bile duct caused by HCC, a 2.0 mm diameter ultrasonic probe with a frequency of 20 MHz was inserted into the bile duct via the transpapillary route (n = 4) or the transhepatic route (n = 1). The images were compared to that of 65 patients with cholangiocarcinoma.Results: In all patients with HCC, intraductal ultrasonography showed a ‘polypoid tumor with a narrow base’. In 16 of 65 patients with cholangiocarcinoma, it showed a ‘polypoid tumor with a narrow base’. When intraductal ultrasonography showed a ‘polypoid tumor with a narrow base’, the findings of a positive ‘nodule within a nodule’ (40 vs 0%; P < 0.05), and the absence of a ‘papillary‐surface pattern’ (80 vs 13%; P < 0.05) were more highly associated with tumor thrombi caused by HCC than to polypoid‐type cholangiocarcinoma.Conclusions: Intraductal ultrasonography was useful to distinguish between tumor thrombi caused by HCC and polypoid‐type cholangiocarcinoma.
Observer variation of diagnoses based on simple biopsy criteria differentiating among Crohn's disease, ulcerative colitis, and other forms of colitis
Authors: Tanaka Masanori , Masuda Takayuki , Yao Takashi , Saito Hiroshi , Kusumi Tomomi , Nagura Hiroshi , Kudo Hajime 
Published: March 2003

Abstract Background and Aim: Simple mucosal biopsy criteria proposed by authors reliably differentiate idiopathic inflammatory bowel disease (IBD) from other forms of colitis (non‐IBD) and Crohn's disease involving the colon (CD) from ulcerative colitis (UC). The aim of this study is to investigate the reproducibility of these criteria.Methods: Three established pathologists and two medical students blindly examined 20 sets of multiple biopsy slides from patients with CD, 20 from those with UC, and 20 from those with non‐IBD. The students had been given instructions on histological definitions using another 15 sets previously. Each observer evaluated 10 histological items required in the criteria and determined categorical diagnoses such as definite IBD and probable UC. Interobserver agreement for the individual histological items was measured by using kappa analysis and Pearson's correlation, while it was measured for categorical diagnoses with the use of Spearman's rank correlation.Results: All of the individual histological items expressed excellent or fair‐to‐good agreement among the five observers, although two items associated with the criteria for CD and UC had poor agreements among the students. With regard to categorical diagnoses based on the criteria for IBD and non‐IBD, and those for CDand UC, coefficients for Spearman's rank correlation exceeded 0.92 and 0.86 among the pathologists, and 0.76 and 0.74 among the students, respectively; all of the coefficients were statistically significant (P < 0.05).Conclusions: The simple criteria were sufficiently reproducible and would help most pathologists to make an automated and objective diagnosis.
Profile, spectrum and significance of HBV genotypes in chronic liver disease patients in the Indian subcontinent
Authors: THAKUR VARSHA , GUPTAN RAJKUMAR CHANDRA , KAZIM SYED NAQUI , MALHOTRA VEENA , SARIN SHIV KUMAR 
Published: March 2003

AbstractBackground and Aim Certain hepatitis B virus (HBV) genotypes have been alleged to be associated with the development of cirrhosis and hepatocellular carcinoma (HCC), and the response to interferon therapy in Taiwanese patients. We undertook to study the prevalence and significance of HBV genotypes in the Indian subcontinent.Methods One hundred and thirty histopathologically proven chronic HBV‐infected patients, including 52 incidentally detected asymptomatic hepatitis B surface antigen (HBsAg)‐positive subjects (IDAHS) with chronic HBV infection (group I), 48 cirrhotics (group II) and 30 hepatocellular carcinoma (HCC; group III) patients were studied. Hepatitis B virus genotypes were determined by using restriction fragment length polymorphism, and direct sequencing of the s gene including the ‘a’ determinant region.Results Only genotypes A (46%) and D (48%) were found in the chronic HBV‐infected patients. A mixed infection with genotypes A and D was seen in 6% of patients. Genotype A was found in 42, 48 and 50%, and genotype D in 48, 50 and 47% of group I, II and III patients, respectively (P = NS). The patients who had mixed genotypes were significantly younger (P < 0.05). In group I (IDAHS) patients infected with genotype D, none had a histological activity index (HAI) of < four. Genotype D was significantly more common in group I patients with HAI > 4 as compared to genotype A (53 vs 32%, P < 0.05). Similarly, genotype D was associated with more severe liver diseases (61 vs 30%, P < 0.05). Genotype D was more prevalent in HCC patients of < 40 years of age, as compared to IDAHS (63 vs 44%, P = 0.06).Conclusions (i) Hepatitis B virus genotypes A and D are prevalent in chronic liver disease patients of Indian origin; and (ii) HBV genotype D is associated with more severe diseases and may predict the occurrence of HCC in young patients.
Characteristic endoscopic and magnified endoscopic findings in the normal stomach without Helicobacter pylori infection
Authors: YAGI KAZUYOSHI , NAKAMURA ATSUO , SEKINE ATSUO 
Published: March 2003

AbstractBackground and Aims: The aim of this study was to clarify the endoscopic features of the Helicobacter

pylori (H. pylori)‐free stomach by examining the arrangement of minute points

visible on the corpus. Since these points were clarified by magnifying endoscopy

as collecting venules, this finding was termed ‘regular arrangement of collecting

venules (RAC)’. The findings from more endoscopic studies are presented and

the differences between magnified views of the normal and H. pylori‐infected corpus and antrum are described in particular.Methods: The study group consisted of 557 patients who were subjected to endoscopy and checked for H. pylori. The RAC in each patient was assessed. Magnifying endoscopy in 301 patients was used to examine the corpus and in 94 patients to examine the antrum.Results: One hundred and fifty‐eight patients had normal stomachs without H. pylori.

We diagnosed 389 patients with H. pylori gastritis. In 10 patients

H. pylori was not detected, but inflammation was present. Of the 158 patients

with H. pylori‐negative normal stomachs, 151 had RAC. As a determinant of

the normal stomach without H. pylori infection, the presence of RAC had 93.8%

sensitivity and 96.2% specificity. All 30 patients with H. pylori‐negative

normal stomachs had a well‐defined ridge pattern (wDRP) on the antrum as observed

under magnifying endoscopy. As a determinant of the normal stomach without H.

pylori infection, wDRP had a specificity of 100%, but a sensitivity of only 54.5%.Conclusions: The presence of RAC is characteristic of a normal stomach without H. pylori. Magnified views of the normal antrum were different from that of the normal corpus.
Iron‐deficiency anemia complicating AL amyloidosis with recurrent small bowel pseudo‐obstruction and hindgut sparing
Authors: HURLSTONE DP 
Published: March 2003

Abstract
AL amyloidosis complicating multiple myeloma is rare but well recognized. Endoscopic appearances of amyloid in the gastrointestinal tract can, however, be highly variable. Macroscopic appearances of the duodenum can range from scalloping (often seen in celiac disease) to that of duodenitis; erosive disease, frank ulceration and even protruberant masses. The importance of small bowel biopsies at the time of duodenal intubation and in gastroscopic examinations for iron deficiency anemia, must therefore be stressed.© 2002 Blackwell Publishing Asia Pty Ltd
Treatment of alcoholic hepatitis
Authors: Maher Jacquelyn J 
Published: March 2003

Abstract  Alcoholic hepatitis is a common disease with an overall 1‐year mortality of 20%. Although the classical treatment for alcoholic hepatitis is abstinence, in some individuals abstinence alone is inadequate to promote survival and recovery. This is particularly true of patients with severe alcoholic hepatitis, who are identified by jaundice, coagulopathy and neutrophilia. Within the last two decades, several agents have been examined as treatments for alcoholic hepatitis and cirrhosis. They have targeted several key processes in the pathophysiology of alcoholic liver disease, including hypermetabolism, inflammation, cytokine dysregulation and oxidant stress. The compounds that offer the greatest survival benefit to patients with severe alcoholic hepatitis are corticosteroids. Several groups have reported excellent results with corticosteroids, but positive results are not uniform, and there remains some controversy over their efficacy. Even if corticosteroids are beneficial for alcoholic hepatitis, they are not recommended for all patients at risk. Consequently, other agents are being tested that have broader applicability to individuals with contraindications to steroids. In this regard, pentoxifylline shows some promise, as does enteral feeding with medium chain triglycerides. Independent efforts are also being directed toward treatment of chronic alcoholic liver disease and alcoholic cirrhosis. Anti‐oxidants have received the greatest attention; drugs such as S‐adenosyl‐methionine may be of benefit. This and others are under active study.© 2002 Blackwell Publishing Asia Pty Ltd
Deficiency of KIT‐positive cells in the colon of patients with diabetes mellitus
Authors: NAKAHARA MASANORI , ISOZAKI KOJI , HIROTA SEIICHI , VANDERWINDEN JEAN‐MARIE , TAKAKURA RENA , KINOSHITA KAZUO , MIYAGAWA JUN‐ICHIRO , CHEN HUI , MIYAZAKI YOSHIJI , KIYOHARA TATSUYA , SHINOMURA YASUHISA , MATSUZAWA YUJI 
Published: March 2003

AbstractBackgroundDiabetes mellitus is a well‐known cause of gastrointestinal dysmotility. The pathogenesis of diabetic gastroenteropathy is mainly considered to be a neuropathy, but the cause of dysmotility remains unknown. Interstitial cells of Cajal (ICC), which express c‐kit receptor tyrosine kinase (KIT), are considered to be pacemaker cells for the gastrointestinal movement. Therefore, we investigated a possible involvement of ICC in the pathogenesis of diabetic gastroenteropathy in humans.MethodsThe KIT‐positive cells in the proper muscle layer of the colon were detected by immunohistochemistry in patients with diabetes mellitus and normal control subjects. Mast cells, which are also known to express KIT, were detected by staining with Alcian blue. The numbers of KIT‐positive cells and Alcian blue‐positive cells in the proper muscle layer were counted under the microscope and the number of KIT‐positive cells apart from Alcian blue‐positive cells was calculated.ResultsIn the normal control subjects, KIT‐positive cells were located at the myenteric plexus region and in the circular muscle layer of the colon. Their distribution pattern was similar to that of ICC. The average number of KIT‐positive cells, apart from mast cells (which reflects the number of ICC), in patients with diabetes mellitus was approximately 40% of that found in normal subjects.ConclusionsDeficiency of ICC might be related to the pathogenesis of diabetic gastroenteropathy in humans.
Gallstone disease prevalence in Western Siberia: Cross‐sectional ultrasound study versus autopsy
Authors: RESHETNIKOV OLEG V , RYABIKOV ANDREI N , SHAKHMATOV SERGEI G , MALYUTINA SOFIA K 
Published: March 2003

AbstractBackgroundThe aims of this study were: (i) to evaluate the prevalence of gallstones in a Western Siberian urban population; and (ii) to compare the results of ultrasonographic screening of the living population with hospital autopsy data.MethodsA representative sample of 842 men and 870 women (aged 25–64 years) living in Novosibirsk, Western Siberia, was screened for the presence of gallstones by gallbladder ultrasonography. Participants were considered to have gallstone disease if they had already had cholecystectomy or if gallstones were revealed during the survey. Hospital autopsy data (n = 1124) were reviewed retrospectively for the 8‐year period in the same region.ResultsThe prevalence of gallstone disease was significantly higher in women than in men and increased with age. Age‐adjusted prevalence rates of gallstone disease for the 25–64‐year age group were 1.9% in men and 9.5% in women in a cross‐sectional ultrasonographic study. Corresponding values in the autopsy series were 2.2% in men and 11.2% in women.ConclusionsThe present report shows that the prevalence of gallstone disease in the female population is in the range of that reported from Western countries, whereas that in the male population is lower than that in other countries. The results of the ultrasonographic survey of the living population and of hospital autopsy data were comparable, with slightly higher gallstone detection rates in the autopsy study.
Hepatitis C advances in antiviral therapy: What is accepted treatment now?
Authors: Mchutchison John G 
Published: March 2003

Abstract  The vast number of patients with hepatitis C represent a huge medical and economic burden. While 20–30% of these patients progress and develop advanced liver disease, the majority do not. Thus, it is crucial to identify patients suitable for treatment and those who may benefit most from therapy. Anti‐viral therapy is recommended for those patients with chronic hepatitis C who also have elevated liver tests, detectable hepatitis C virus ribonucleic acid and significant inflammation and/or fibrosis on liver biopsy. Currently, the most effective initial therapy is the combination of interferon plus ribavirin. The sustained viral response rate (SVR) is 36–41% following a 24‐ or 48‐week course of therapy. In general, patients with the genotype 1 infection should receive 48 weeks of therapy, and those with genotypes 2 or 3 infection only 24 weeks. Viral load estimations are problematic because of normal fluctuations (up to 0.5–10 log), assay variability and lack of a universally accepted standard; thus, viral load testing is not recommended routinely at present. The sustained viral response rate produces improvements in quality of life and liver histology (including reversal of bridging fibrosis and cirrhosis is some), and durable responses lasting 5–11 years in 95–97% of cases. While the optimal dose of ribavirin is currently unknown, available data suggest that higher doses increase efficacy (albeit with a greater degree of anemia). The dose of 800 mg/day may be the most appropriate lower dose for those patients who require dosage modification for anemia or other side‐effects. Patients who have relapsed after interferon monotherapy can be successfully retreated with higher doses of interferon for 1 year or the combination of interferon and ribavarin for 24–48 weeks. Preliminary data suggest that patients with an unfavorable profile, including those with genotype 1 infection, should probably be retreated with interferon and ribavirin for 48 rather than 24 weeks.With our current best therapies, the majority of patients still do not achieve the benefits of a sustained response. Re‐treatment with interferon and ribavirin may achieve a sustained response in approximately 10–25% of these patients. In the immediate future, once‐weekly pegylated interferons will replace standard interferons. Initial data suggest that SVR achieved with these drugs in combination with ribavirin is increased to 54–61%, but dose modifications and side‐effects are more frequent. They will thus provide an incremental benefit in terms of efficacy, particularly for genotype 1‐infected patients.© 2002 Blackwell Publishing Asia Pty Ltd
Granulomatous phlebitis of small hepatic vein
Authors: SAITO TAKAHITO , HARADA KENICHI , NAKANUMA YASUNI 
Published: March 2003

Abstract

Several cases of granulomatous phlebitis of small hepatic veins are reported in the literature, though the etiology remains unclear. We experienced a similar case of granulomatous phlebitis involving terminal hepatic venules and this case will be reported in comparison with two previous cases presenting in our laboratory. A 39‐year‐old‐female had a long course of medical treatment for epilepsy. She suffered from acute liver injury after prolonged fever for more than 1 week. Leukocytosis (11 100/µL) without eosinophilia, and inflammatory reactions such as C‐reactive protein (21.0 mg/dL) were pointed out. She suffered from transient disseminated intravascular coagulation, but these abnormalities recovered with antibiotic and steroid therapy. Liver biopsy revealed granulomatous lesions mainly involving terminal hepatic venules. The possibility of tuberculosis was excluded by a negative Thiel–Nielsen stain and a negative molecular study for bacterial deoxyribonucleic acid of Mycobacteria species. Extrahepatic involvements were not clear clinically. This case and the previous two cases shared granulomatous phlebitis of the intrahepatic small hepatic veins, as well as clinical features suggestive of bacterial infection. Clinicians should be aware of such a rare clinicopathological entity.© 2002 Blackwell Publishing Asia Pty Ltd