bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship between albumin excretion rate and aortic stiffness in untreated essential hypertensive patients
Authors: Mulè G. , Cottone S. , Vadalà A. , Volpe V. , Mezzatesta G. , Mongiovì R. , Piazza G. , Nardi E. , Andronico G. , Cerasola G. 
Published: June 2004

Abstract.Objectives.  To evaluate, in a group of nondiabetic essential hypertensive patients with normal renal function, the relationship between albumin excretion rate (AER) and carotid‐femoral pulse wave velocity (PWV), as an index of aortic stiffness.Design.  Cross‐sectional study.Setting.  Outpatient hypertension clinic.Subjects.  Seventy patients with mild‐to‐moderate essential hypertension, aged 42 ± 8 years, never pharmacologically treated. All subjects underwent routine laboratory tests, 24‐h ambulatory blood pressure (BP) monitoring, measurement of carotid‐femoral PWV, by means of a computerized method, and AER.Results.  Microalbuminuric patients (AER ≥ 20 μg min−1; n = 19), when compared with normoalbuminuric subjects, showed more elevated 24‐h BP (136/88 ± 10/10 vs. 128/83 ± 7/6 mmHg; P < 0.001 and P = 0.013, for systolic and diastolic BP respectively) and higher values of carotid‐femoral PWV (10.4 ± 2 m s−1 vs. 9.2 ± 1.3; P = 0.006). This latter difference remained statistically significant, even after correction by ancova for 24‐h systolic and diastolic BP, and body mass index (BMI, P = 0.016). Univariate regression analysis disclosed a tight correlation between AER and carotid‐femoral PWV (r = 0.42; P = 0.0003). This association was confirmed in a multiple regression model (β = 0.35; P = 0.009) in which, as independent variables, besides PWV, 24‐h BP, age, serum glucose values, smoking status, gender and BMI, were added.Conclusions.  Our results seem to confirm that microalbuminuria may represent the early renal manifestation of a widespread vascular dysfunction, and therefore it is an integrated marker of cardiovascular risk.
Tyrosine phosphatase 1B and leptin receptor genes and their interaction in type 2 diabetes
Authors: Santaniemi M. , Ukkola O. , A. Kesäniemi Y. 
Published: June 2004

Abstract.Objectives.  The association between three tyrosine phosphatase 1B (PTP1B) gene polymorphisms and type 2 diabetes was examined by comparing the prevalence rates of these polymorphisms in type 2 diabetic patients and healthy control subjects. Furthermore, the association of the polymorphisms and PTP1B and leptin receptor (LepR) gene–gene interactions with complications of type 2 diabetes were examined in type 2 diabetic patients.Subjects and methods.  A total of 257 Finnish patients with type 2 diabetes and 285 nondiabetic subjects were screened. Single nucleotide polymorphisms were determined using polymerase chain reaction and restriction enzymes. The diagnosis of coronary heart disease was based on clinical and ECG criteria. The prevalences of cerebrovascular and peripheral vascular diseases were assessed on the basis of clinical criteria. Laboratory analyses were carried out in the hospital laboratory.Results.  We did not find any differences in the genotype distributions or allele frequencies of IVS6 + G82A and Pro387Leu polymorphisms between the type 2 diabetics and controls. There were differences in the genotype frequencies of the Pro303Pro (C981T) – polymorphism between the two studied groups (P = 0,018); there were eight T981T subjects in the control population but none amongst the type 2 diabetics. However, there were no differences in the allele frequencies. In addition, significant associations between the IVS6 + G82A polymorphism and body mass index (BMI), albuminuria, glycohaemoglobin A1 (GHBA1) and hypertension in type 2 diabetic patients (P = 0,026–0,031) were observed. Pro387Leu and Pro303Pro did not associate with risk factors or diabetic complications. We also found a gene–gene interaction effect between PTP1B and the LepR gene with the genotype combination IVS6 + A82A and Arg223Arg having the highest BMI compared with the other genotype combinations (P = 0.0043 for trend). The interaction between these two polymorphisms explained 3% of the variation in BMI in diabetic patients when the other covariates were taken into account.Conclusions.  We conclude that the PTP1B IVS6 + G82A polymorphism was associated with BMI, albuminuria, GHBA1 and hypertension in type 2 diabetic patients. The 981T/T‐genotype of the Pro303Pro‐ polymorphism might have some protective role against the development of type 2 diabetes. The interaction effects between the PTP1B IVS6 + A82A and LepR Arg223Arg genotypes influenced BMI, explaining 3% of its variation. A synergistic effect of PTP1B and LepR variants on the leptin signalling may be involved.
An open, randomized, controlled study of transdermal hormone replacement therapy on the rate of bone loss in primary biliary cirrhosis
Authors: Ormarsdóttir S. , Mallmin H. , Naessén T. , Petrén‐Mallmin M. , Broomé U. , Hultcrantz R. , Lööf L. 
Published: June 2004

Abstract.Objectives.  The prevalence of osteoporosis amongst patients with primary biliary cirrhosis (PBC) is high and may be a serious clinical problem. Hormone replacement therapy (HRT) is effective in preventing bone loss but has not been evaluated in randomized trials in PBC. The primary aim was to study the effect of transdermal HRT in combination with daily vitamin D and calcium supplementation on bone loss compared with vitamin D and calcium supplementation only in postmenopausal women with PBC. The secondary aim was to study the safety of transdermal HRT.Subjects/interventions.  Eighteen females with PBC were randomized to receive 2 years therapy with either (i) transdermal oestradiol 50 μg 24 h−1 two times per week + medroxyprogesterone 2.5 mg day−1 + alfacalcidol 0.25 μg day−1 and calcium 1 g day−1 or (ii) alfacalcidol 0.25 μg day−1 and calcium 1 g day−1. Dual‐energy X‐ray absorptiometry for measurement of bone mineral density (BMD) and sampling of blood and serum for measurements of biochemical markers of liver function was performed before, during and at the end of treatment.Results.  BMD increased significantly at the lumbar spine (P < 0.05) and the femoral neck (P < 0.05) in the HRT group whereas no significant change was found in the control group. One oestrogen‐treated patient was excluded after 1 year because of deteriorating, but reversible, aminotransferases. Dropout frequency because of nonliver‐related causes was higher in the HRT group. Otherwise, no difference with respect to adverse liver reactions was found between the groups.Conclusion.  Transdermal HRT increases BMD in PBC patients with few severe side effects related to the liver.
Use of a lead shield for laparoscopic detection of the sentinel lymph nodes in gastric cancer
Authors: Yasuda Kazuhiro , Ishikawa Koichi , Sonoda Kazuya , Inomata Masafumi , Shiraishi Norio , Kitano Seigo 
Published: June 2004

Background:  Accurate staging of lymph node metastasis by sentinel node biopsy is easily achieved in conventional open gastric surgery. Staging is not easily achieved in laparoscopic surgery, however, because of the technical difﬁculty in identifying sentinel nodes. We developed a laparoscopic method that involves lead shielding for detection of sentinel nodes in gastric cancer and examined the efﬁcacy of this method.Methods:  Laparoscopic sentinel node biopsy was performed in 18 patients with early gastric cancer. A combined dye‐ and radio‐guided method was used in the ﬁrst 10 patients; our radio‐guided lead shield method was used in the subsequent eight cases. Laparoscopy‐assisted distal gastrectomy was performed in all patients, and dissected nodes were examined by routine hematoxylin and eosin staining. The detection rate was compared between the two groups.Results:  The detection rate for sentinel nodes was higher with the radio‐guided lead shield method (88%) than with the combined dye‐ and radio‐guided method (40%). Regional lymph node metastasis was recognized in one of 18 patients, and the sentinel node was positive in this case.Conclusions:  Use of a lead shield is beneﬁcial for accurate laparoscopic detection of sentinel lymph nodes.
Evaluation of gastroduodenal mucosal lesions in patients with Crohn's disease and ulcerative colitis
Authors: Maeda Kazuhiro , Okada Mitsuo , Seo Mitsuru , Aoyagi Kunihiko , Yamaguchi Masashi , Sakisaka Shotaro 
Published: June 2004

Background:  Patients with Crohn's disease (CD) are reported to suffer from upper gastroduodenal lesions with varying frequency, although concurrent Helicobacter pylori infection is reported to be low.Methods:  A prospective study was carried out on patients diagnosed with CD or ulcerative colitis (UC) in order to evaluate the degree of upper gastroduodenal tract involvement and the prevalence of Helicobacter pylori infection.Results:  Gastroduodenal lesions were found in 18 (78%) of 23 CD patients, the location being the stomach in 18 (78%), the duodenal bulb in 16 (70%) and the descending duodenum in 16 (70%). Bamboo joint‐like lesions were found in four cases (17%) in gastric body and cardia. In contrast, gastroduodenal lesions were found in 10 (53%) of 19 UC patients, the location being the stomach in nine (47%), the duodenal bulb in six (32%), and the descending duodenum in three (16%). The H. pylori‐positive rate in patients with CD and UC was 0%, and 11%, respectively.Conclusion:  Minute upper gastroduodenal lesions are much more common in CD than in UC patients, especially in the descending duodenum. Accordingly, upper gastrointestinal endoscopy would seem to be a useful means with which to obtain a definitive diagnosis in all suspected IBD cases.
Evaluation of the alternate blood FLow in esophageal variceal patients by endoscopic color Doppler ultrasonography
Authors: Sato Takahiro , Yamazaki Katsu , Toyota Jouji , Karino Yoshiyasu , Ohmura Takumi , Kuwata Yasuaki , Akaike Jun , Suga Toshihiro 
Published: June 2004

Background:  Endoscopic color Doppler ultrasonography (ECDUS) is a useful modality for obtaining color ﬂow images of esophageal varices. The direction of blood ﬂow in passageways is fundamentally hepatofugal ﬂow according to ECDUS. The present study is designed to evaluate the alternate direction of color ﬂow image of passageways via ECDUS in esophageal variceal patients.Methods:  The study involved 125 patients with esophageal varices using ECDUS. The grades of red color (RC) were as follows: RC(+) in 79 cases, RC(+ +) in 35 cases, and RC(+ + +) in 11 cases. We investigated the alternate direction on color ﬂow images of the left gastric vein, the palisade vein, and the perforating veins via ECDUS.Results:  Color ﬂow images of the esophageal varices and the left gastric vein were obtained in all 125 (100%) patients by ECDUS. Color ﬂow images of the perforating veins were obtained in 90 (72.0%) of the 125 patients. Vessel images of the palisade veins were detected in 33 (26.4%) of the 125 patients. The alternate direction on color ﬂow images was detected in seven (5.6%) of the 125 patients with ECDUS: in three patients, left gastric vein; in three patients, perforating veins; and in one patients, left gastric vein and palisade veins. This phenomenon was observed periodically at regular intervals. The endoscopic ﬁndings were RC(+) in all seven patients.Conclusion:  The alternate direction of blood ﬂow in the passageways was observed in a few cases of RC(+) esophageal varices. We can observe the hemodynamics of esophageal varices non‐invasively and in real time with ECDUS, and clarify the frequencies of the alternate direction of blood ﬂow in RC‐positive esophageal variceal patients.
Differences in endoscopic views during biopsy through the right and left lower biopsy channels of the upper gastrointestinal endoscope
Authors: Mantani Naoki , Minami Kouhei , Tanaka Michio , Kogure Toshiaki , Tamura Jun’ichi , Shimada Yutaka , Terasawa Katsutoshi 
Published: June 2004

Background:  It has not been established as to which side the biopsy (instrument) channel should be placed in the tip of a front‐viewing upper gastrointestinal (GI) endoscope to allow an en‐face approach to lesions on various aspects of the stomach wall.Methods:  Using a front‐viewing two‐channel endoscope, we identiﬁed a difference in endoscopic views during biopsy between lower‐right and lower‐left channels. Colored marks were distributed on the lesser curvature (LC), greater curvature (GC), anterior wall (AW), and posterior wall (PW) in the ‘stomach’ of a dummy for mock‐performance of upper GI endoscopy. When biopsy forceps through the different channels touched the marks, an endoscopic photograph was taken. Furthermore, when biopsy specimens were obtained from PW lesions in several patients, endoscopic views were compared between the two biopsy channels.Results:  In the dummy study, no remarkable difference was detected in targeting the marks on AW, LC, or GC of the stomach. The dummy and the patient study showed that the lower‐right approach could target PW lesions with a more adequate endoscopic view than from the lower left. The lower‐left approach targeted PW lesions on the higher body with a nearly blinded endoscopic view. Specimens from PW of the upper body, which could be precisely obtained under direct visual control through the lower‐right channel, were no smaller than those obtained using the channel on the lower left.Conclusion:  The present study suggests that the lower‐right channel may be preferable to the lower‐left channel in the tip of a front‐viewing upper GI endoscope.
Endoscopic closure of mucosal defects with metallic clips after endoscopic mucosal resection in patients with intramural tumors of the stomach: A retrospective study
Authors: Inomata Masaaki , Endo Masaki , Terui Torahiko , Oana Syuhei , Kudara Norihiko , Obara Hirohiko , Hashimoto Yasuto , Chiba Toshimi , Orii Seishi , Suzuki Kazuyuki 
Published: June 2004

Background:  Representative complications of endoscopic mucosal resection to treat intramural gastric tumors include bleeding and perforation. The purpose of the present study was to clarify whether endoscopic closure of mucosal defects using metallic clips decreases the incidence of delayed bleeding following endoscopic mucosal resection.Patients and Methods:  The records of 187 intramural tumors of the stomach in the 181 patients that were treated by endoscopic mucosal resection between 1992 and 2001 were reviewed retrospectively. The patients were classiﬁed into two groups. The ﬁrst group included patients who received endoscopic mucosal resection but were not treated by endoscopic mucosal closure. The second group included patients who were treated with endoscopic mucosal closure using metallic clips after endoscopic mucosal resection. The incidences of delayed bleeding following endoscopic mucosal resection in these two groups were evaluated.Results:  Delayed bleeding following endoscopic mucosal resection was observed in 13 of 96 (13.5%) of the lesions of the ﬁrst group. Delayed bleeding was encountered in only two of 91 (2.2%) lesions of the second group.Conclusions:  Endoscopic closure of mucosal defects with metallic clips after endoscopic mucosal resection in gastric lesions was useful in decreasing the incidence of delayed bleeding following endoscopic mucosal resection.
Modes of spread in early ampullary cancer in terms of establishing proper indications for endoscopic papillectomy
Authors: Ito Kei , Fujita Naotaka , Noda Yutaka , Kobayashi Go , Kimura Katsumi , Horaguchi Jun , Sugawara Toshiki , Takasawa Osamu 
Published: June 2004

Background:  Endoscopic papillectomy for adenomas of the ampulla of Vater has been reported and is gaining acceptance as an alternative to surgery in the treatment of early ampullary cancer. However, whether endoscopic treatment is justified as a treatment of choice for early ampullary cancer remains controversial. The aim of the present study was to elucidate the possibility of endoscopic papillectomy as a treatment of early ampullary cancer from the review of pathology of cases treated by surgical resection.Patients and methods:  Twenty‐three cases of early ampullary cancer (m—tumor limited to the mucosa of the ampulla 14; od—tumor that invades Oddi's sphincter, 9) treated by surgical resection from January 1984 to March 2003 were investigated as to the following: (i) macroscopic type, maximum size, and histological type of tumor; (ii) main location and extension of tumor; (iii) prevalence of extension into the lower bile duct or pancreatic duct, and relationship between ductal infiltration and macroscopic type, maximum size, main location, or depth of invasion of tumor; (iv) lymphatic permeation, vascular invasion, and lymph node metastasis; and (v) prognosis.Results:  All cases were classified macroscopically as exposed‐tumor type or non‐exposed‐tumor type without ulceration. Extension into the lower bile duct or the pancreatic duct was observed in 43% of the cases. There was no correlation between ductal infiltration and macroscopic type, maximum tumor size, main tumor location, or tumor depth. No lymphatic permeation, vascular invasion, or lymph node metastasis were proven in cases with ampullary cancer confined to the mucosa. In the nine cases with involvement of Oddi's sphincter, lymphatic permeation and lymph node metastasis were observed in two cases and one case, respectively.Conclusion:  Endoscopic treatment for early ampullary cancer confined to the mucosa without spread to the bile duct or pancreatic duct is justified as a treatment of choice if detailed histological examination of the resected specimen indicated no invasion beyond its margin.
Evaluation by biliary scintigraphy of recurrence of choledocholithiasis after endoscopic sphincterotomy
Authors: Shimura Junichi , Igarashi Yoshinori , Sakai Yoshihiro 
Published: June 2004

Background:   It is difﬁcult to predict recurrence of choledocholithiasis after endoscopic sphincterotomy (EST). Because cholestasis is considered to cause recurrence of choledocholithiasis, it may be possible to predict recurrence by objective evaluation of cholestasis. The aim of the present study was to examine the relationship between cholestasis and recurrence of choledocholithiasis by biliary scintigraphy in post‐EST cases.Methods:  Seventy‐ﬁve patients who had undergone EST were tested by biliary scintigraphy. Cases with positive and negative detection of hot spots in the duodenum within 60 min after isotope infusion were categorized as ‘maintained bile excretion’ (Group M) and ‘delayed bile excretion’ (Group D), respectively. Age, gender, biliary tract enzyme levels, diameter of the common bile duct, presence of the gallbladder, presence of juxtapapillary duodenal diverticula, and the recurrence rates of choledocholithiasis were compared between the two groups.Results:  Seventy‐ﬁve cases were distributed into 66 cases (88%) in Group M and nine cases (12%) in Group D. There was no statistical differences in age, gender, biliary tract enzyme levels, diameter of the common bile duct, and presence of juxtapapillary diverticula. In Group D, all the cases had retained the gallbladder. Of 41 cases who had been followed up for more than 1 year, 35 cases (85%) were assigned to Group M and six (15%) to Group D. Recurrence of choledocholithiasis was observed in ﬁve cases, with two in Group M and three in Group D. The recurrence rate was signiﬁcantly higher in Group D than in Group M.Conclusions:  Biliary scintigraphy was considered useful for objectively predicting recurrence of choledocholithiasis.
Five‐year follow‐up study on histological and endoscopic alterations in the gastric mucosa after Helicobacter pylori eradication
Authors: Oda Yoshio , Miwa Jun , Kaise Mitsuru , Matsubara Yasuo , Hatahara Trumasa , Ohta Yasuhiko 
Published: June 2004

Background:  To investigate long‐term changes in the gastric mucosa after Helicobacter pylori eradication, we examined histological and endoscopic ﬁndings of the gastric mucosa before and 5 years after eradication.Methods:  The subjects comprised 59 H. pylori‐positive patients with peptic ulcer who had been periodically followed for 5 years after H. pylori eradication. Acid‐suppressive drugs were not given after eradication, and endoscopic examination and tests for H. pylori infection (urea breath test (UBT), culture and histology) were performed before and 1 to 2 months, 1 year, and 5 years after eradication. Biopsy samples were taken from the greater curvature of the gastric antrum and upper corpus, and were scored histologically according to the Updated Sydney System. The atrophic border was evaluated endoscopically based on Kimura and Takemoto's classiﬁcation. Antral erosion and spotty redness in the corpus were also scored.Results:  (1) Neutrophil inﬁltration was signiﬁcantly reduced 1 to 2 months after eradication and remained around the reduced level over the next 5 years. Mononuclear cell inﬁltration began to decrease 1 to 2 months after eradication and continued to subside 1 year and 5 years later. (2) Histological atrophy of the gastric glands was signiﬁcantly improved 1 year and 5 years after eradication. However, endoscopy revealed no consistent alteration in the atrophic border. (3) There was no signiﬁcant change in the degree of intestinal metaplasia for 5 years. (4) In some cases, antral erosion became more conspicuous after 5 years. Spotty redness in the corpus was observed in 15% of cases (9/59) before and 10% (6/59) 1 year after eradication, but had disappeared in all cases 5 years later.Conclusions:  Neutrophil inﬁltration improved rapidly after H. pylori eradication in contrast with mononuclear cell inﬁltration, which decreased gradually over 5 years. Glandular atrophy improved in the long term, whereas intestinal metaplasia had not altered 5 years after eradication. Spotty redness in the gastric corpus disappeared in all cases after eradication, suggesting that it is an endoscopic ﬁnding related to H. pylori infection.
Is Natural Law a Border Concept Between Judaism and Christianity?
Authors: Novak David 
Published: June 2004

ABSTRACTWith the passing of disputations between Jewish and Christian thinkers as to whose tradition has a more universal ethics, the task of Jewish and Christian ethicists is to constitute a universal horizon for their respective bodies of ethics, both of which are essentially particularistic being rooted in special revelation. This parallel project must avoid relativism that is essentially anti‐ethical, and triumphalism that proposes an imperialist ethos. A retrieval of the idea of natural law in each respective tradition enables the constitution of some intelligent common ground for ethical cooperation in both theory and practice between the traditions. This essay also suggests how the constitution of this common ground could include Muslims as well. The constitution of this common ground enables religious ethicists to present more cogent ethical arguments in secular space, but only of course, when those who now control secular space are open to arguments from members of any religious tradition.
Introduction: Parts, Wholes, and Opposites: John Milbank as Geisteshistoriker
Authors: Bowlin John 
Published: June 2004

ABSTRACTThis special focus of the Journal of Religious Ethics begins with the mixture of admiration and apprehension that John Milbank's use of historical materials so often inspires and moves to specific reflection on specific figures and texts that appear in his grand story of secular modernity. Throughout, the focus is not on his moral theology per se, but rather on the way he treats certain figures, how he constructs his historical tale, and how his critical enterprise and his normative proposals depend upon his historical efforts. This introduction considers the difficulties of constructing and assessing a Geistesgeschichte, the genre of historical writing that Milbank prefers.