bluuebunny/crossref_metadata_2025_split huggingface dataset:
Non‐transferrin‐bound iron and hepatic dysfunction in African dietary iron overload
Authors: Mcnamara Lynne , Macphail A , Mandishona Eberhard , Bloom Peter , Paterson Alan , Rouault Tracey , Gordeuk Victor 
Published: March 2003

Background: Circulating iron is normally bound to transferrin. Non‐transferrin‐bound iron (NTBI) has been described in most forms of iron overload, but has not been studied in African dietary iron overload. This abnormal iron fraction is probably toxic, but this has not been demonstrated. Methods: High‐pressure liquid chromatography was used to assay serum NTBI in 25 black African subjects with iron overload documented by liver biopsy and in 170 relatives and neighbours. Levels of NTBI were correlated with indirect measures of iron status and conventional liver function tests. Results: Non‐transferrin‐bound iron (> 2 μmol/L) was present in 43 people, 22 of patients of whom underwent liver biopsy and 21 relatives and neighbours. All but four of these had evidence of iron overload on the basis of either liver biopsy or elevated transferrin and serum ferritin concentrations. Among all 195 subjects, the presence of NTBI in serum was independently related to elevations in alanine and aspartate aminotransferase activity and bilirubin concentration. This relationship between serum NTBI and hepatic dysfunction was confirmed in the subgroup of 25 subjects with iron overload documented by liver biopsy. Non‐transferrin‐bound iron correlated significantly with elevations in alanine and aspartate aminotransferase activities after adjustment for hepatic iron grades, inflammation and diet. Conclusions: Non‐transferrin‐bound iron was found to be commonly present in African patients with dietary iron overload and to correlate with transferrin saturation and serum ferritin concentration. The independent relationship between NTBI and elevated liver function tests suggests that it may be part of a pathway leading to hepatic injury.
Effect of ursodeoxycholic acid on autoimmune‐associated chronic hepatitis C
Authors: Nakamura Kimihide , Yoneda Masashi , Takamoto Shujiro , Nakade Yukiomi , Yokohama Shiro , Tamori Keisuke , Aso Kazunobu , Matui Tomoko , Sato Yoichi , Aoshima Masaru , Makino Isao 
Published: March 2003

Background: Hypergammaglobulinaemia and various auto‐antibodies which are commonly seen in autoimmune hepatitis are also found in patients with chronic hepatitis C. We recently reported that ursodeoxycholic acid (UDCA) improved liver function tests and immunoserological markers in patients with type I autoimmune hepatitis. The aim of this study was to prospectively evaluate the efficacy of UDCA on autoimmune‐associated chronic hepatitis C. Methods: Immunoglobulin G (IgG), anti‐nuclear antibodies (ANA) and anti‐smooth muscle antibodies (ASMA) were determined in 95 patients with chronic hepatitis C. All patients were positive for hepatitis C virus RNA. Autoimmune‐associated chronic hepatitis C (C‐AIH) was defined by elevated serum IgG level (≥ 2.0 g/dL) and high titres of ANA and/or ASMA (≥ 1 : 160). Nine (9%) of 95 patients were diagnosed as C‐AIH. All the C‐AIH patients and 30 of the remaining 86 chronic hepatitis C patients without autoimmune features (CHC) were treated with UDCA (600 mg/day) for 1 year. Results: Autoimmune‐associated chronic hepatitis C patients included one man and eight women and their AIH scores, as defined by the International Autoimmune Hepatitis Group, were significantly higher than the CHC patients. Before UDCA therapy, there were no significant differences in aspartate aminotransferase (AST), alanine aminotransferase (ALT) and γ‐glutamyl transpeptidase (γ‐GTP) levels between C‐AIH and CHC patients. However, after 1 year UDCA therapy, AST, ALT and γ‐GTP were significantly lower in C‐AIH patients (P < 0.05) than in CHC patients. In C‐AIH, ANA titres in seven of nine patients and ASMA titres in five of seven patients were reduced after 1 year UDCA treatment. Conclusions: These results suggest that UDCA is a useful therapeutic agent for autoimmune‐associated chronic hepatitis C.
Colonic tuberculosis: Clinical features, endoscopic appearance and management
Authors: Misra Sri Prakash , Misra Vatsala , Dwivedi Manisha , Gupta Suresh 
Published: March 2003

Background: Although rare in the West, colonic tuberculosis is not an uncommon disease in developing countries. However, the clinical manifestations and radiological appearance of the disease are non‐specific. In recent years, colonoscopy has been found to be very useful in diagnosing patients with colonic tuberculosis. Methods: Clinical features, colonoscopic findings, histology and response to treatment were recorded in 50 patients with colonic tuberculosis. Results: Abdominal pain, fever, anorexia, weight loss and diarrhoea were the common symptoms. The colonoscopic features consisted of ulcers (92%), nodules (88%), deformed caecum and ileocecal valve (42%), strictures (25%), multiple fibrous bands (8%) and polypoid lesions (6%). Segmental tuberculosis and lesions simulating carcinoma were seen in 22 and 16% of patients, respectively. Histological examination of the colonic biopsy specimens showed well‐formed, non‐caseating granulomas in 18%, collection of loosely arranged epithelioid cells in 40% and chronic non‐specific inflammatory changes in 42% of the patients. Six patients needed surgical intervention. The other 44 patients responded well to anti‐tuberculous therapy and became asymptomatic. Conclusions: It is concluded that colonoscopy is a useful method for diagnosing colonic tuberculosis. It is suggested that if the clinical picture and colonoscopic appearance are suggestive of tuberculosis and target biopsies reveal non‐caseating granulomas, a collection of loosely arranged epithelioid cells, or even non‐specific changes, then a therapeutic trial of anti‐tuberculous drugs should be given and continued if there is clinical improvement.
Anti‐neutrophil cytoplasmic antibodies in patients with chronic liver diseases: Prevalence, antigen specificity and predictive value for diagnosis of autoimmune liver disease
Authors: Lindgren Stefan , Nilsson Stefan , Nässberger Lennart , Verbaan Hans , Wieslander Jörgen ,   MEMBERS OF THE SWEDISH INTERNAL MEDICINE LIVER CLUB (SILK)
Published: March 2003

Abstract
Background
: Anti‐neutrophil cytoplasmic antibodies (ANCA) against proteinase 3 are diagnostic of Wegener’s granulomatosis, but ANCA occur also in patients with other inflammatory disorders, such as ulcerative colitis, primary sclerosing cholangitis (PSC) and autoimmune hepatitis. As their predictive value for autoimmune liver disease remains unknown, we analysed the prevalence and antigen specificity of ANCA in patients with various chronic liver diseases (CLD).
Methods
: We studied sera from 100 patients with primary biliary cirrhosis (PBC), from 76 with PSC and from 279 with various CLD, consecutively drawn during a 5‐year period at the time of liver biopsy. The ANCA were detected by indirect immunofluorescence (IIF) while the antigen specificity was characterized by ELISA by using lactoferrin, neutrophil elastase, cathepsin G and BPI (bactericidal/permeability increasing protein) as antigens.
Results
: In PBC, ANCA were detected by IIF in 39 patients (39%). The antigen reactivity by ELISA was lactoferrin in seven, elastase in 15, BPI in 20 and cathepsin G in four patients. Four patients had reactivity against more than one antigen. In PSC, IIF demonstrated ANCA in 49 patients (65%). The antigen reactivity was lactoferrin in 17, elastase in 14, BPI in 20 and cathepsin G in four patients. Twelve patients showed reactivity against more than one antigen. In CLD, ANCA were observed in sera from 55 patients (20%). Nineteen of 45 patients (42%) with autoimmune liver disease were ANCA positive versus 36/234 (15%) with non‐autoimmune liver disease (P = 0.0002). Among IIF‐positive patients, antibody reactivity against lactoferrin was noted in 14, elastase in 28, BPI in 25 and cathepsin G in five patients. Twenty‐one patients had reactivity against more than one antigen. Elastase and BPI antibodies occurred more frequently in patients with autoimmune compared to non‐autoimmune liver disease (P < 0.01).
Conclusions
: Anti‐neutrophil cytoplasmic antibodies are prevalent in patients with chronic liver diseases, but although they occur more frequently in patients with autoimmune liver disease their specificity and sensitivity for autoimmune liver disease is low. The predominant antigens are lactoferrin, elastase and BPI, but the correlation between IIF findings and ELISA reactivity against these antigens is weak.
Role of mucosal blood flow: A conceptional review in gastric mucosal injury and protection
Authors: Kawano Sunao , Tsuji Shingo 
Published: March 2003

AbstractThe present article overviews the role of gastric mucosal blood flow (MBF) in gastric mucosal injury and protection. The MBF maintains the structure and function of the stomach and, thereby, is closely associated with the pathogenesis and the healing of gastrointestinal lesions. Gastric blood flow was regulated and modified by systemic and also local metabolic factors, such as prostaglandin, leukotrienes and other endogenous chemical mediators, in the mucosa. In the present article, we review the role of endothelin (ET) and nitric oxide (NO) in the development of gastric mucosal injury and protection via mucosal microcirculation. Endothelin‐1 was increased under various stressful conditions and caused microcirculatory disturbances resulting in mucosal injury. Inhibitors of NO aggravated mucosal injury induced by ethanol, which produced mucosal congestion. Thus, regionally disturbed gastric circulation is closely associated with the pathogenesis of ethanol‐ and non‐steroidal anti‐inflammatory drug‐induced gastric lesions. The endothelium‐derived vasoactive substances ET and NO regulate gastric mucosal microcirculation and an imbalance of endothelium‐derived factors may play an important pathophysiological role in the development of gastric lesions.
Clinical significance of urokinase‐type plasminogen activator activity in hepatocellular carcinoma
Authors: Itoh Takashi , Hayashi Yoshitake , Kanamaru Taichi , Morita Yasushi , Suzuki Satoshi , Wang Weiping , Zhou Li , Rui Jing‐An , Yamamoto Masahiro , Kuroda Yoshikazu , Itoh Hiroshi 
Published: March 2003

Abstract
Background and Methods
: The plasminogen activation system plays a crucial role in the process of cancer invasion and metastasis. To evaluate the most effective factor in the invasion, metastasis and prognosis of hepatocellular carcinoma (HCC), we examined urokinase‐type plasminogen activator (uPA), plasminogen activator inhibitor (PAI)‐1, PAI‐2 and uPA activity by enzyme‐linked immunosorbent assays (ELISA) in HCC tissues obtained from 46 patients. The results were compared with the patients’ clinicopathological features and prognoses.
Results
: Of the clinicopathological features, only histological portal involvement or intrahepatic metastasis, or both (INV), was significantly correlated to the disease‐free survival rates (DFS; P < 0.05). The levels of uPA, PAI‐1 and PAI‐2 antigens were significantly associated with INV and histological grade. The DFS was not different, however, between cases with uPA, PAI‐1 and PAI‐2 values above and below the median. The high levels of uPA activity were closely related to INV (P < 0.001), and the activity gradually raised histological grades (P < 0.0001). The DFS was significantly different between patients with uPA activity below and above the median (0.70 ng/mL; P = 0.0092); it was also significantly different between such patients without INV (P < 0.05).
Conclusions
: Urokinase‐type plasminogen activator activity may be the most sensitive factor affecting HCC invasion in the plasminogen activation system and a strong predictor for the recurrence of HCC. We suggest that cases with uPA activity of more than 0.70 ng/mL should be carefully followed up for possible HCC recurrence.
Late biliary tract complications after orthotopic liver transplantation: Diagnostic and therapeutic role of endoscopic retrograde cholangiopancreatography
Authors: Mosca Sandro , Militerno Giuseppe , Guardascione Maria Anna , Amitrano Lucio , Picciotto Francesco P , Cuomo Oreste 
Published: March 2003

Abstract
Background
: Biliary tract complications are frequent after orthotopic liver transplantation. Late biliary tract complications occurring after T‐tube removal mostly include stones and strictures which may be associated with sepsis and worsening of the liver function. Endoscopic retrograde cholangiopancreatography (ERCP) has a role in the diagnosis and therapy of these complications. The aim of our study was to report our experience of endoscopic diagnosis and treatment of late biliary tract complications in liver‐transplanted patients.
Methods and Results
: One hundred and thirty‐six adult liver‐transplanted patients have been followed since 1988. Seventeen patients (12.5%) needed a total of 30 ERCP because of evidence of clinical and/or biochemical cholestases: eight with biliary stricture; six with biliary stones; one with both stricture and stones; and two with normal ERCP findings. Interventional endoscopic procedures included 14 sphincterotomies, six stone removals, seven biliary balloon dilatations, seven biliary stent placements, 11 biliary stent replacements, seven nasobiliary catheter placements and one mechanical lithotripsy. No complications were seen. In all cases, ERCP was able to identify the location, entity and dimension of the late biliary tract complication, thus allowing a therapeutic strategy to be used. Two patients had medical cholestasis. Forty‐seven per cent of patients with late biliary tract complications could definitely be cured by ERCP alone. The ERCP improved the patients’ condition to allow subsequent surgery in five patients (33%).
Conclusions
: These results confirms that ERCP is a valuable diagnostic tool and should be considered as the first step in the non‐surgical management of late biliary tract complications after orthotopic liver transplantation.
Sequence‐motif analysis of 5′‐untranslated region of GB virus‐C in Japanese patients
Authors: Kanda Tatsuo , Yokosuka Osamu , Kawal Shigenobu , Imazeki Fumio , Saisho Hiromitsu 
Published: March 2003

Abstract
Background
: GB Virus C (GBV‐C) is considered to belong to the Flaviviridae; however, the structures of the N‐terminal end of its putative polyprotein are not well known. The internal ribosomal entry site (IRES) at the 5′‐untranslated region of GBV‐C and an initiating codon at nucleotides (nt) 552–554 have been proposed. We investigated the validity of this proposal.
Methods
: The 5′‐untranslated region of GBV‐C was amplified from serum samples of 17 Japanese patients. Polymerase chain reaction‐amplified products were directly sequenced and the obtained sequences were analysed by comparing them with the IRES structure of other viruses.
Results
: Fifteen of the 17 (88%) GBV‐C strains in our patients were classified as being Asian type. The box‐A‐like sequence (UUUC) and box‐B‐like sequence (AUCAUGG) observed in the IRES of picornaviruses were highly conserved in all the strains. Based on pair‐wise comparisons with the multiple alignment data, overall sequence divergence for the 5′‐terminus was 2.9–12%. When compared with the proposed secondary structure of the IRES model, the sequence divergences of the Asian‐type GBV‐C were higher at the regions of loop structures and lower at the regions of double‐stranded RNA. The AUG codons, except for the one located at nt 552–554, produced truncated polyproteins or were not in‐frame with the putative protein.
Conclusions
: Our examination of the sequence motif of GBV‐C supports the proposal that the GBV‐C has common structural motifs for IRES at its 5′‐untranslated region and the AUG codon at nt 552–554 may be an initiating codon.
Vasoactive intestinal polypeptide appears to be one of the mediators in misoprostol‐enhanced small intestinal transit in rats
Authors: Chang Full‐Young , Doong Ming‐Luen , Chen Tseng‐Shing , Lee Shou‐Dong , Wang Paulus S 
Published: March 2003

Abstract Background and Aims: Prostaglandin analogs have the pharmacologic effect of speeding up small intestinal transit (SIT). It remains unknown whether some gut peptides also mediate this enhancement. We studied the effect of misoprostol on rat SIT and looked at the role of vasoactive intestinal polypeptide (VIP) release during its action.Methods: A group of rats initially received oral misoprostol treatment of 1, 10, 50 and 100 μg/kg, respectively. By using orally fed charcoal as a motility marker, the SIT was assessed at 30 min following oral misoprostol treatment. Another group of rats received misoprostol as an intraperitoneal injection in similar doses to the group above. The small intestinal transit was computed for this group at 30 min following misoprostol injection via an instilled radiochromium motility marker that went through a previously placed intraduodenal catheter. The plasma VIP level was measured by using a radioimmunoassay kit.Results: Neither charcoal evaluated transit nor the plasma VIP level was influenced by the lower doses of oral misoprostol treatment (1 and 10 μg/kg), whereas other doses enhanced SIT and diminished the plasma VIP level (P < 0.01). The similar effects on radiochromium computed SIT (P < 0.01) and plasma VIP levels were obtained in tubed rats following misoprostol intraperitoneal treatment. The SIT results correlated negatively with plasma VIP levels.Conclusions: Enhanced SIT and diminished VIP levels are found in rats following misoprostol treatment. It appears that inhibited VIP release is one of the mechanisms in misoprostol‐enhanced SIT.
Helicobacter pylori infection among Japanese children
Authors: Kurosawa Michiko , Kikuchi Shogo , Inaba Yutaka , Ishibashi Teruo , Kobayashi Fumimune 
Published: March 2003

AbstractBackgroundIn Japan, there are few reports describing Helicobacter pylori infection among young children. The aim of the present study was to identify risk factors associated with H. pylori in school‐aged children.MethodsSubjects were first–grade students of three elementary schools (n = 310) and second–grade students of a junior high school (n = 300). Personal information, such as student’s medical history, parent’s history, family size, sibshipsize and household pets, was collected from guardians using a questionnaire. Saliva samples and personal information were collected twice (1995 and 1996). By using the saliva samples, H. pylori IgG antibody was measured using a commercial kit. To analyze the risk factors for H. pylori infection, sex‐ and age‐adjusted odds ratios (OR) were calculated using a multiple logistic model.ResultsAmong the children, factors related to Helicobacter antibody in saliva included spending a longer period of time in a nursery school or kindergarten (OR = 4.0) and a maternal history of stomach disease (OR = 2.8). Birth order (OR = 2.2), sleeping situation (OR = 2.3) and sibshipsize (OR = 1.6) were not factors that were significantly related to Helicobacter antibody in the saliva. Chewing food for the infant, family size, rooms in the household, sharing a bedroom during childhood, pets, a past history and a paternal history were not related to positivity.ConclusionsThe results indicate that transmission is person‐to‐person, mainly through close contact with other children and intrafamilial infection. Helicobacter pylori infection seems to occur frequently early in life, probably before 6 years of age.
Duodenal tuberculosis with a choledocho‐duodenal fistula
Authors: Miyamoto Shin‐Ichi , Furuse Junji , Maru Yasushi , Tajiri Hisao , Muto Manabu , Yoshino Masahiro 
Published: March 2003

Abstract A 22‐year‐old man visited our hospital (National Cancer Center Hospital East) complaining of fatigue and anorexia. A laboratory investigation demonstrated a biochemical ‘picture’ of obstructive jaundice. An abdominal CT showed a low density mass in the retropancreatic area with multiple enlarged periportal lymph nodes. Upper gastrointestinal endoscopy revealed active ulceration on the dorsal wall of the descending part of the duodenum, and histopathology of the biopsy specimen revealed an ulcer with reactive inflammatory cell infiltration; no tumor cells were detected. The possibility of neoplasm had been ruled out by the use of CT and angiography. The jaundice recovered spontaneously and the abdominal mass gradually decreased in size. Endoscopic retrograde pancreatography showed no evidence of pancreatic disease; however, endoscopic retrograde cholangiography showed a choledocho‐duodenal fistula. This patient showed hypersensitivity against the tuberculin skin test and Mycobacterium tuberculosis was successfully detected in gastric juice by using a polymerase chain reaction method and culture. Biopsy samples obtained from the duodenal ulcer at the second upper gastrointestinal endoscopy showed chronic inflammation with an epithelioid granuloma, suggesting tuberculosis. We thus diagnosed this case as a duodenal tuberculosis with a choledocho‐duodenal fistula. To the best of our knowledge, there has been no report available of duodenal tuberculosis being the cause of a choledocho‐duodenal fistula.© 2001 Blackwell Science Asia Pty Ltd
Importance of achieving complete necrosis during the first treatment for hepatocellular carcinoma to prevent bone metastasis: A prospective study
Authors: Iwata Mitsuhiro , Kaneko Shuichi , Terasaki Shuichi , Matsushita Eiki , Urabe Takeshi , Kobayashi Kenichi , Matsui Osamu 
Published: March 2003

AbstractBackground and Aims: Recent advances in the treatment of hepatocellular carcinoma (HCC) have changed the importance of bone metastasis during the follow up of such patients. In the present study, we investigated risk factors for bone metastasis after treatment for HCC.Methods: Two hundred and two patients with HCC were diagnosed as free of bone metastasis by technecium 99m‐methylene diphosphonate bone scintigraphy and were followed prospectively after treatment of the primary lesions (follow‐up period 2–146 months; median 20 months). We statistically analyzed the risk factors for bone metastasis using the clinical characteristics at the time of first treatment.Results: Multiple tumors (P < 0.005), main tumor size > 5 cm in diameter (P < 0.005), the presence of distant metastasis (P < 0.005), elevation of serum α‐fetoprotein (> 100 ng/mL; P < 0.05), chemotherapy (P < 0.05) and insufficient therapeutic response (P < 0.0005) were identified as risk factors for bone metastasis by univariate analyses. Insufficient therapeutic response and main tumor size > 5 cm in diameter (both P < 0.05) were identified as independent predisposing factors for bone metastasis.Conclusions: Complete necrosis of primary HCC during the first treatment is important to prevent subsequent bone metastasis.