bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of colchicine on the maximum biliary excretion of cholephilic compounds in rats
Authors: TACHIZAWA HIDETAKA , SANO NAOYO , TAKIKAWA HAJIME 
Published: August 2004

AbstractBackground and Aim:  Colchicine, an inhibitor of intracellular vesicular transport, has been reported to inhibit the biliary excretion of bile acids and organic anions, but the previous findings are controversial. In order to systematically evaluate the effect of colchicine on the biliary excretion of cholephilic compounds, we studied the effect of colchicine on the biliary excretion of substrates of various canalicular transporters, which were administered at or above the excretory maximum in rats.Methods:  Substrates of various canalicular adenosine triphosphate‐binding‐cassette transporters were infused at or above the rate of maximum excretion into rats, and the effect of colchicine (0.2 mg/100 g), which was intraperitoneally injected 3 h before, on the biliary excretion was studied. Furthermore, the effect of tauroursodeoxycholate (TUDC) co‐infusion on the biliary excretion of taurocholate (TC) after colchicine treatment was also studied.Results:  The biliary excretion of TC and cholate administered at the rate of 1 µmol/min/100 g was markedly inhibited by colchicine, whereas that of TUDC was not inhibited even with the infusion rate of 2 µmol/min/100 g. TUDC co‐infusion at the rate of 1 µmol/min/100 g increased the biliary excretion of TC (1 µmol/min/100 g), which was decreased by the colchicine pretreatment. The biliary excretory maximum of taurolithocholate‐sulfate and sulfobromophthalein, substrates of the multidrug resistance protein 2, of erythromycin, a substrate of the P‐glycoprotein, and of indocyanine green were not affected by colchicine.Conclusions:  The different excretory maximums of TC and TUDC and the different effect of colchicine on the excretion of these bile acids are considered to be a result of different regulatory mechanisms of vesicular targeting of the bile salt export pump to the canalicular membrane by these bile acid conjugates. The vesicular targeting of the multidrug resistance protein 2 and the P‐glycoprotein to the canalicular membrane is considered to be colchicine insensitive in the absence of bile acid coadministration.
Gastric epithelial cell CXC chemokine secretion following Helicobacter pylori infection in vitro
Authors: SIEVEKING DANIEL , MITCHELL HAZEL M , DAY ANDREW S 
Published: August 2004

AbstractBackground and Aims:  Helicobacter pylori infection of the stomach is commonly associated with infiltration of neutrophils. Gastric epithelial cells are recognized as central mediators of tissue responses to this organism. The aim of the present study was to ascertain patterns of production of three neutrophil chemoattractant chemokines following infection of gastric epithelial cells with H. pylori in vitro.Methods:  Two gastric cancer‐derived epithelial cell lines were infected with H. pylori organisms of previously defined cagE and cagA status for periods of up to 24 h. The production of three chemokines (interleukin [IL]‐8, epithelial neutrophil activating protein [ENA]‐78 and growth‐related oncogene [GRO]‐α) over this time was measured in culture supernatants using immunoassays.Results:  Both IL‐8 and GRO‐α were produced by both AGS and KATO‐III cells in response to H. pylori infection, and in a cag PAI‐dependent manner. ENA‐78, however, was not increased following H. pylori infection.Conclusions:  GRO‐α is expressed by epithelial cells following H. pylori infection along with IL‐8. Both may contribute to neutrophilic infiltration present in gastric mucosa associated with H. pylori infection. In contrast, H. pylori infection does not lead to an increased synthesis of ENA‐78, suggesting that this may not be as important in vivo.
Endoscopic biliary drainage for severe acute cholangitis in biliary obstruction as a result of malignant and benign diseases
Authors: KUMAR RAKESH , SHARMA BARJESH C , SINGH JAGDEEP , SARIN SHIV K 
Published: August 2004

AbstractBackground and Aims:  Endoscopic biliary drainage is an established mode of biliary decompression in patients with acute cholangitis as a result of biliary obstruction secondary to stones and benign strictures. However, there are no reports on endoscopic management of severe acute cholangitis caused by malignant conditions. We prospectively compared the efficacy of the endoscopic drainage for severe acute cholangitis in biliary obstruction as a result of malignant and benign diseases.Methods:  Forty‐three patients with severe acute cholangitis requiring urgent biliary drainage were included. Sixteen patients (mean age 58.2 ± 9.3 years; seven men, nine women) had biliary obstruction as a result of malignant diseases and 27 had benign biliary diseases (mean age 41.6 ± 14.3 years; nine men, 18 women). Indications for urgent drainage included any one of the following: temperature >38°C (n = 21), septic shock with systolic blood pressure <100 mmHg (n = 9), localized peritonism (n = 21), impaired consciousness (n = 6) and failure to improve within 72 h of conservative management (n = 13). After successful bile duct cannul°ation, patients received either a nasobiliary catheter (n = 38) or an in‐dwelling stent (n = 5) with or without sphincterotomy for biliary drainage. Outcome measures included complications and clinical response.Results:  Endoscopic drainage was established successfully in all the patients in both the groups. Clinical improvement after biliary drainage occurred in 94% patients (15/16) in the malignant group compared with 96% patients (26/27) in the benign group (P = not significant [NS]). Fever subsided at a median of 2.2 days in the malignant group and at 1 day in the benign group (P = NS). Normalization of leukocyte count was seen at a median of 6 days (range 1–17) and 2 days (range 1–5) days in the malignant group and the the benign group, respectively (P = NS). There were no endoscopic retrograde cholangiopancreatography‐related complications. The mortality rate as a result of cholangitis was 4.6%, that is two of 43 patients (6.2% of the malignant group vs 3.7% of the benign group; P = NS).Conclusions:  Endoscopic biliary drainage is equally effective in patients with severe acute cholangitis caused by either malignant or benign biliary diseases.
Survey on chronic pancreatitis in the Asia–Pacific region
Authors: GARG PRAMOD KUMAR , TANDON RAKESH KUMAR 
Published: August 2004

AbstractBackground and Aims:  A survey was conducted of chronic pancreatitis (CP) in different countries in the Asia–Pacific region. The main objective of the survey was to generate a database containing information regarding the prevalence, etiology, clinical presentation, diagnostic work‐up, and management of CP in the Asia–Pacific region.Methods:  Data were collected from seven countries using a structured questionnaire. Expert participants were asked to respond to the questionnaire based on the data of patients with CP studied in their centers.Results:  The prevalence of CP was found to be very high in southern India (114–200/100 000 population), in contrast to the low reported rate of 4.2/100 000 population in Japan. Alcohol was the most common etiological factor in Australia (95%) and Japan (54%) while idiopathic pancreatitis was the most common type in India (tropical pancreatitis) and China, accounting for approximately 70% of all cases of CP. Pain was the most common clinical feature. Diabetes and steatorrhea were uncommon. With regard to the diagnosis of CP, all the experts believed that a patient could be diagnosed as having CP in the presence of any one or more of the following: ductal changes on endoscopic retrograde cholangiopancreatography, a positive secretin test, pancreatic calcification, and endosonographic abnormalities suggestive of CP. Most experts suggested pancreatic enzymes and analgesics as initial medical therapy for pain relief in CP. Endotherapy was suggested as the therapy of choice if medical therapy failed. Surgery was offered only after the failure of endotherapy. Most experts agreed that research should focus on genetic abnormalities in CP and the role of endotherapy for pain relief.Conclusion:  The survey brought out the prevalent types and presentation of CP, common management practices, and also the shortcomings in the existing knowledge of CP in the Asia–Pacific region. These findings might help focus attention on the research priorities for CP in this region.
Pancreatic enzyme supplement improves dysmotility in chronic pancreatitis patients
Authors: MIZUSHIMA TAKAAKI , OCHI KOJI , ICHIMURA MITSUKO , KIURA KATSUYUKI , HARADA HIDEO , KOIDE NORIO 
Published: August 2004

AbstractBackground and Aims:  Impaired gallbladder contraction and rapid gastric emptying in patients with chronic pancreatitis may be the result of depleted pancreatic exocrine function. The authors tested whether oral pancreatic enzymes can improve the dysmotility or not.Methods:  Study subjects consisted of 15 patients with chronic pancreatitis and 18 healthy controls. The gastric emptying time and gallbladder contraction were studied. All patients were initially studied using a test meal without pancreatic enzymes, followed on separate days by a test meal with a single and a triple dose of pancreatic enzymes. Blood samples were taken before and 2 h after the test meal to determine the pancreatic polypeptide levels.Results:  In patients with chronic pancreatitis, gallbladder contraction at 15 min after the meal was impaired. The gastric emptying time was faster and the ratio of pre‐ to postprandial pancreatic polypeptide levels was enhanced. A single dose and a triple dose of oral enzymes further improved the gastric emptying time and the pancreatic polypeptide ration, but did not improve the gallbladder contraction rate at 15 min.Conclusions:  It was demonstrated that the oral pancreatic enzymes improved the gastric dysmotility, confirming the previous findings that suggested the depleted pancreatic enzyme output caused the dysmotility.© 2004 Blackwell Publishing Asia Pty Ltd
Closed lesser sac lavage in the management of pancreatic necrosis
Authors: WIG JAI DEV , METTU SRINIVAS REDDY , JINDAL RAVUL , GUPTA RAJESH , YADAV THAKUR DEEN 
Published: August 2004

AbstractBackground and Aim:  Surgery for pancreatic necrosis complicating acute severe pancreatitis carries a high risk of morbidity and mortality. We evaluated the efficacy of necrosectomy and closed lesser sac lavage as a method of management of pancreatic necrosis.Methods:  Fifty‐eight patients with pancreatic necrosis who underwent pancreatic necrosectomy consecutively in a tertiary care referral center were retrospectively analyzed. The technique of necrosectomy and postoperative lavage is described in detail. Details regarding the patient profile, disease severity, surgical details, postoperative morbidity, repeat interventions and the mortality are presented.Results:  Of the 58 patients, irrigation was able to be started in 48. Lavage was able to be continued until disease resolution or death in all but 10 patients. Post‐operative locoregional complications were residual abscesses in 10, bleeding in eight, enteric fistulae in 12 and pancreatic fistulae in nine. Six patients needed postoperative percutaneous procedures, while 16 patients needed repeat surgery. Seventeen patients died (29%), all of whom had multiple organ failure involving more than two organs, while 11 developed sepsis.Conclusion:  Pancreatic necrosectomy and postoperative closed lesser sac lavage is an effective method of managing these patients, with acceptable morbidity, re‐operation rates and mortality.
Effects of home‐based combined resistance training and walking on metabolic profiles in elderly Japanese
Authors: Tokudome Mizuho , Nagasaki Masaru , Shimaoka Kiyoshi , Sato Yuzo 
Published: August 2004

Background:  To evaluate the effects of home‐based combined resistance training and walking on metabolic profiles in elderly Japanese subjects.Methods:  Two hundred and forty‐four elderly Japanese participants were divided into two groups (184 training group and 60 controls). Each exercise training session consisted of one set of 10 repetitions of 11 different resistance exercises, and the training lasted 12 weeks. Fasting blood samples were obtained for measurements of serum levels of total cholesterol, high‐density lipoprotein cholesterol (HDL‐C), triglycerides, hemoglobin A1c, insulin and plasma glucose, before and after the training period. We estimated insulin resistance using the homeostasis model assessment. Five subjects further underwent a two‐step hyperinsulinemic‐euglycemic clamp to evaluate insulin action directly before and after the training.Results:  Training resulted in a significant increase in HDL‐C (60 ± 1–62 ± 1 mg/dL, mean ± SE, P < 0.01) and a significant decrease in triglycerides (115 ± 5–106 ± 4 mg/dL, P < 0.05), while no significant changes were observed for total cholesterol, plasma glucose, insulin, homeostasis model assessment or hemoglobin A1c. Glucose infusion rates during the hyperinsulinemic‐euglycemic clamp increased by 30% (P < 0.05) at the 40 mU/m2 per min infusion rate, from 5.4 ± 0.9 to 7.0 ± 1.1 mg/kg per min and by 15% (P < 0.01) at the 400 mU/m2 per min infusion rate, from 9.4 ± 1.0 to 10.8 ± 1.2 mg/kg per min. In the control group, no significant changes were noted except for a significant decrease in HDL‐C.Conclusions:  Our home‐based exercise program for elderly is safe and effective for improving metabolic profiles.
Long‐term prognosis and satisfaction after percutaneous endoscopic gastrostomy in a general hospital*
Authors: Onishi Joji , Masuda Yuichiro , Kuzuya Masafumi , Ichikawa Masaaki , Hashizume Makoto , Iguchi Akihisa 
Published: August 2004

Background:  Percutaneous endoscopic gastrostomy (PEG) has been widely acknowledged as a safer method for enteral feeding; however, its long‐term impact on prognosis and quality of life in elderly patients is not sufficiently understood. There are issues still to be studied regarding the indications for PEG, due to the lack of convincing evidence that it reduces expected complications such as aspiration pneumonia or for improving the prognosis of patients with severe dementia.Method:  In this study we investigated the survival rate after PEG and the families’ satisfaction in 78 inpatients who underwent PEG. We conducted the investigation by sending questionnaires to the families.Results:  The results for the 69 cases (88%) in which the patient recovered showed that the 1‐year survival rate was 64.0%, and the 2‐year survival rate was 55.5%. Fifty‐three per cent of patients’ families indicated overall satisfaction regarding of PEG.Conclusions:  The survival rates were relatively higher than those from previously reported studies. This may be attributed to variations in patients’ clinical, socio‐economic, or cultural backgrounds in therapeutic interventions. We recognized the importance of clarifying factors that would affect the living and functional prognosis and quality of life in elderly patients who underwent PEG. The indications for PEG are based on a comprehensive assessment of the relevant factors in individual cases, and by taking patients’ and families’ wishes into consideration.
Improvement of inappropriate prescribing and adverse drug withdrawal events after admission to long‐term care facilities
Authors: Mita Yumiko , Akishita Masahiro , Tanaka Katsuaki , Yamada Shizuru , Nakai Ryuhei , Tanaka Eigo , Nakamura Tetsuro , Toba Kenji 
Published: August 2004

Background:  The objectives of this study were to determine whether medications, particularly inappropriate prescribing, would be reduced after admission to long‐term care facilities, and whether adverse drug withdrawal events (ADWEs) would occur in relation to discontinuation of medications.Methods:  The study consists of a retrospective survey using medical chart review in five health service facilities for the elderly in Japan. All the patients who were admitted to the facilities between January 2001 and December 2002 (N = 627) were participants in the study. Medications taken on admission, at 1 month and 3 months after admission, and events (significant worsening of the disease status, accidents, new symptoms and signs, and other acute events) during a 3‐month period were recorded. Inappropriate prescribing was determined using Beers’ criteria with some modification. ADWEs were determined using the Naranjo causality algorithm.Results:  On admission, the patients were taking 3.5 ± 2.5 (mean ± SD) drugs. One month later, the number of prescribed drugs was decreased by 17% (P < 0.01 vs on admission), but did not show an additional reduction 3 months later. Inappropriate prescribing was found in 10% of the patients taking drugs on admission, but the number of inappropriately prescribed medications was reduced by 33% after 1 month. Of 105 events recorded, only five (2% of the patients with drug reduction) were considered ADWEs; three cases of confusion, a case of depression, and a case of hyperglycemia, following discontinuation of psychotropic drugs, antidepressants and a sulfonylurea, respectively.Conclusion:  Adverse drug withdrawal events were not frequent despite the significant reduction of medications after admission to long‐term care facilities. This might be because the rate of reduction was relatively high for inappropriately prescribed medications.
Strategy for treating elderly Japanese with hypercholesterolemia*
Authors: Horiuchi Hisanori , Matsuzawa Yuji , Mabuchi Hiroshi , Itakura Hiroshige , Sasaki Jun , Yokoyama Mitsuhiro , Ishikawa Yuichi , Yokoyama Shinji , Mori Seijiro , Ohrui Takashi , Akishita Masahiro , Hayashi Toshio , Yamane Kiminori , Egusa Genshi , Kita Toru 
Published: August 2004

Background:  It has been widely accepted that control of serum cholesterol levels is effective for prevention of cardiovascular events. Recent data have suggested that this is also the case in the elderly.Methods:  A research group (chaired by T. Kita) was organized as part of the Comprehensive Research on Aging and Health conducted by the Japanese Ministry for Health, Labour, and Welfare in 1999–2002 to determine the best strategy for control of cholesterol levels in elderly Japanese with hypercholesterolemia. In order to do this a review of the literature was conducted.Conclusion:  The research group concluded: (i) Japanese patients aged 65–74 years with hypercholesterolemia should be treated by following the Guideline for Diagnosis and Treatment of Atherosclerotic Cardiovascular Diseases by the Japan Atherosclerosis Society (2002), as cholesterol‐lowering therapy would bring a similar, or even larger, preventive effect to the elderly, whose absolute risk of cardiovascular events is higher than that in the younger population; (ii) target cholesterol levels in elderly Japanese aged ≥ 75 years with hypercholesterolemia should be determined individually according to their physical activities. It is noted that the elderly are more susceptible to drug‐related adverse effects than the younger since renal and liver functions, required for metabolizing drugs, in the elderly are relatively weaker.
Assessment of effects of traditional herbal medicines on elderly patients with weakness using a self‐controlled trial
Authors: Kogure Toshiaki , Sato Nobuhiko , Tahara Eiichi , Sakai Shinya , Shimada Yutaka , Ochiai Hiroshi , Origasa Hideki , Terasawa Katsutoshi 
Published: August 2004

Background:  The objectives of this study were to evaluate the effects of traditional herbal medicine on elderly patients with weakness, and to devise a suitable study design for assessing the clinical effectiveness of traditional herbal medicines.Methods:  Twenty‐one elderly patients with weakness (mean age, 78.2 ± 7.5; male : female, 8 : 13) were studied using a self‐controlled design with a run‐in period. The observation term was 3 months, and quality of life (short form‐36 and profile of mood status) were adopted as evaluation endpoints. In addition, natural killing activity and surface antigens (CD19, CD3, CD4, CD16, CD56, CD158a, CD158b) on lymphocytes obtained from peripheral blood were analyzed to evaluate patients’ immune status.Results:  EK‐41 (Hochu‐ekki‐to), EK‐48 (Juzen‐taiho‐to) and EK‐98 (Ogi‐kenchu‐to) were administered to 10, 10 and one patients, respectively. There were no dropouts due to side‐effects. Results of the short form‐36 were significantly improved after 3 months, with the patients in the EK‐48 group showing greater improvement than those in the EK‐41 group. Each component of the profile of mood status was improved by the treatment, and the improvement of V, D and F was especially significant. D and A‐H were considerably improved in the patients of the EK‐48 group. In contrast, the improvement of D and T‐A was most marked in the EK‐41 group. Some augmentation of NK activity was observed after 3 months, but the effect was not significant. Although neither the CD4/8 ratio nor the percentages of CD3+, CD19+ or CD16+ CD158a + cells was changed significantly, the percentage of CD56+, CD56+ CD16+ and CD16+ CD158b + cells were significantly increased.Conclusion:  A preliminary clinical trial for elderly patients with weakness was carried out to assess the efficacy of traditional medicines, resulting in evidence of their clinical and immunomodulating effects, although this evidence had some limitations. In addition, we obtained some insights into the elements of designing studies suitable for assessing the clinical efficacy of traditional herbal medicines.
Unemployment Invariance
Authors: Karanassou Marika , Snower Dennis J. 
Published: August 2004

Abstract
This paper provides a critique of the ‘unemployment invariance hypothesis’, according to which the behavior of the labor market, by itself, ensures that the long-run unemployment rate is independent of the size of the capital stock, productivity and the labor force. In the context of an endogenous growth model, we show that the labor market alone need not contain all the equilibrating mechanisms to ensure unemployment invariance; in particular, other markets may perform part of the equilibrating process as well. By implication, policies that raise the growth path of capital or increase the effective working-age population may influence the long-run unemployment rate.
Testing for Seasonal Fractional Roots in German Real Output
Authors: Caporale Guglielmo M. , Gil-Alana Luis A. 
Published: August 2004

AbstractThis paper examines the seasonal structure of German real GNP per capita by using a version of Robinson’s (1994) tests which is suitable in the context of seasonality. This method has several advantages over alternative approaches when testing for seasonal unit roots. First, unlike standard tests, which are nested in AR alternatives, it is embedded in fractional alternatives. Second, it allows testing at the zero frequency and at each of the seasonal frequencies separately. Third, it makes it possible to test for different orders of integration at each of the frequencies simultaneously. The empirical analysis suggests that the real output series may have a unit root at the zero frequency, and fractional rather than unit roots at the seasonal ones. This is in contrast to the findings reported by Lutkepohl et al. (1999) in their study on German money demand, and shows the importance of modelling the seasonal features of the data in alternative ways.