bluuebunny/crossref_metadata_2025_split huggingface dataset:
Secondary oesophageal peristalsis in gastro‐oesophageal reflux disease
Authors: Pai C Ganesh 
Published: March 2003

Abstract
Background and Aims
: To evaluate the status of secondary oesophageal peristalsis in gastro‐oesophageal reflux disease (GORD) and the effect of healing of oesophagitis on these abnormalities.
Methods
: Twenty‐one patients diagnosed with GORD and 10 control subjects in the same age group were studied. Primary peristalsis was elicited by 10 5 mL water boluses and secondary peristalsis by 10 20 mL boluses of air injected 15 cm above the lower oesophageal sphincter.
Results
: The pattern of primary peristalsis was normal in a significantly lower number of patients compared with control subjects, six patients (28.6%) versus seven controls (70%), (P < 0.05). Similarly, the number of subjects with a normal pattern of secondary peristalsis was also lower in the patient group (zero vs three; P < 0.05). A normal primary peristaltic response occurred with 71 (33.8%) of the 210 water boluses in the patients and 73 (73%) of the 100 water boluses in the control subjects, respectively (P < 0.001). A normal secondary peristaltic response was seen with 15 (7.1%) of 210 air boluses in patients and 32 (32%) of 100 air boluses in the control subjects (P < 0.001). The amplitude of secondary peristaltic waves and the duration of contraction (mean ± SEM) were significantly lower in patients compared with the control subjects (43.5 ± 4.7 vs 89.0 ± 13.1 and 3.4 ± 0.8 vs 3.9 ± 0.3, respectively; P = < 0.05). In the 13 patients in whom repeat evaluation was performed after healing of oesophagitis, there was no significant change in the number of patients with normal peristaltic response, number of normal responses to air and water boluses, or amplitude, duration and velocity of peristalsis.
Conclusion
: Significant abnormalities of secondary oesophageal peristalsis occur in patients with GORD and these are not reversed by healing of oesophagitis.
Heartburn: Community perceptions
Authors: Bolin Terry D , Korman Melvyn G , Hansky Jack , Stanton Rosemary 
Published: March 2003

Abstract
Background and Aims
: To determine the prevalence of heartburn in the Australian community, and document factors precipitating it and medications used in treatment.
Methods
: Telephone interviews with 1200 individuals aged 18 years or more were conducted one weekend in 1996. Each respondent was asked four questions about heartburn, its severity, factors causing it and current therapy.
Results
: Fifty‐six per cent of respondents reported that they had suffered from heartburn at some time in the past and 37% had symptoms at least once every 4–6 months. The frequency of heartburn increased with age and was more common in men (40.7%) than women (32.6%). There was no difference in frequency between city and rural dwellers, or between white‐ and blue‐collar workers. Almost half the individuals experienced mild pain or discomfort, one‐third had moderate discomfort and 15% reported severe pain or discomfort. Women were more likely to report greater problems than men. Aggravating factors included spicy foods, greasy/rich foods, stress, alcohol, overeating, pregnancy, smoking, food allergy and coffee. More than half the respondents relied on antacids to control symptoms, 20% used prescription medications and a similar number did not use any medication.
Conclusion
: Heartburn is common in the Australian community and sufferers attribute symptoms to various lifestyle events, including diet and stress. Antacid usage is the commonest mode of therapy.
Effect of intragastric pH on control of peptic ulcer bleeding
Authors: Li Yuyuan , Sha Weihong , Nie Yuqiang , Wu Huisheng , She Qingzhu , Dai Shoujun , Jia Lin , Yu Weixiong 
Published: March 2003

AbstractBackground: We have performed series studies to investigate the effect of intragastric pH on control of peptic ulcer bleeding. In laboratory and animal studies, both platelet aggregation and gastric mucosal bleeding time were shown to be extremely sensitive to different pH levels. Platelet aggregation decreased significantly at pH ≥ 6.8 and gastric mucosal bleeding time fell significantly at pH ≥ 6.4. In a prospective clinical trial, primed infusions of different dosages of omeprazole (8 or 4 mg/h) after a bolus (40 mg) produced consistently high intragastric pH values in patients with bleeding duodenal ulcer. These results were not significantly different from that obtained from omeprazole 40 mg bolus treatment every 12 h (P> 0.05). However, primed injection with cimetidine (800 mg/12 h) was less effective (P< 0.05).Methods: In a retrospective analysis, 303 patients with bleeding peptic ulcer who were treated with cimetidine and 326 patients who were treated with omeprazole were compared.Results: The emergency surgery (4.91%) and mortality rates (1.84%) in the omeprazole group were not significantly different (P> 0.05) from those (7.28 and 1.99%) in the cimetidine group. However, the standardized emergency surgery rate of the omeprazole group (3.28%) was significantly lower than that (9.28%) of the cimetidine group (P< 0.05).Conclusion: We conclude that increased intragastric pH to at least 6.4 with omeprazole is helpful in controlling peptic ulcer bleeding. Chinese patients require a lower dose of omeprazole than their Western counterparts to control ulcer bleeding.
Cytokine profile of liver‐infiltrating CD4+ T cells separated from murine primary biliary cirrhosis‐like hepatic lesions induced by graft‐versus‐host reaction
Authors: Itoh Shinichi , Matsuzaki Yasushi , Kimura Takeshi , Ikegami Tadashi , Shoda Junichi , Fujiwara Michio , Tanaka Naomi 
Published: March 2003

Abstract
Background and Methods
: We have previously reported that CD4+ T cells induced primary biliary cirrhosis (PBC)‐like hepatic lesions in mice with graft‐versus‐host reaction due to major histocompatibility complex class II disparity. To clarify the relationship between the cytokine profile produced by CD4+ T cells and the formation of hepatic lesions, we sorted CD4+ T cells from the liver by using flow cytometry and examined their cytokine mRNA expression at various times after GVHR induction. We also examined the associated changes in the serum levels of antimitochondrial antibodies (AMA).
Results
: Histologically, the infiltration of CD4+ T cells around the bile ducts was observed from day 5, and the lesions deteriorated gradually until day 14. On day 14, CD8+, B220+ and Mac‐1+ cells, as well as CD4+ T cells were seen around the bile ducts. In the liver‐infiltrating CD4+ T cells, the expression level of interferon‐γ (IFN‐γ) mRNA was observed to increase at an early phase (day 3), whereas that of interleukin (IL)‐10 mRNA was elevated at a later phase (day 14). The elevation of IFN‐γ mRNA expression at an early phase before the appearance of non‐suppurative destructive cholangitis suggests that IFN‐γ may be related to the pathogenesis of PBC in this model. Serum levels of AMA on day 14 were significantly higher than those on day 5. Interleukin‐10 was considered to stimulate antibody production, to show an inhibitory effect upon the function of T helper 1 cells, and to inhibit fibrosis.
Conclusion
s: Interferon‐γ may play an important role in the pathogenesis of this model. Moreover, delayed expression of IL‐10 mRNA may control PBC‐like hepatic lesions.
Complete disappearance of recurrent hepatocellular carcinoma with peritoneal dissemination and splenic metastasis: A unique clinical course after surgery
Authors: Terasaki Takamitsu , Hanazaki Kazuhiro , Shiohara Eiichi , Matsunaga Yuji , Koide Naohiko , Amano Jun 
Published: March 2003

AbstractSpontaneous regression of hepatocellular carcinoma (HCC) is a rare phenomenon. We report a case of complete disappearance of intrahepatic, peritoneal and splenic metastases in HCC after hepatectomy using treatment with tegafur and uracil (UFT). The effect of UFT alone was not likely to have caused the disappearance of this tumour because HCC recurrence advance markedly within 5 months of surgery despite oral administration of UFT. This case demonstrates a unique postoperative clinical course that suggests spontaneous regression of HCC. This is the first case of complete disappearance of unresectable HCC with peritoneal seeding and splenic metastasis.© 2000 Blackwell Science Asia Pty Ltd
Natural history of chronic hepatitis B virus infection
Authors: Yuen Man‐Fung , Lai Ching‐Lung 
Published: March 2003

AbstractIn chronic hepatitis B virus (HBV) infection acquired during adulthood, which is the type mostly seen in the Caucasian population, there is biochemical and histologic regression after HBeAg seroconversion, and the risk of death from hepatitis B‐related causes is low. In chronic HBV infection acquired during birth or early childhood, which is the type most commonly seen in the Asian population, there is a prolonged phase of immunotolerance. The immune clearance phase is characterized by multiple acute exacerbations preceeded by elevations in serum HBV DNA levels, HBeAg concentration and HBeAg/anti‐HBe immune complexes. Of these patients, 2.4% may develop hepatic decompensation during the stage of HBeAg seroconversion. The development of cirrhosis occurs more frequently in patients with episodes of decompensation and with repeated severe acute exacerbations. However progression to cirrhosis can be relatively silent and can occur even in children. After HBeAg seroconversion, precore and core promotor mutations occur frequently in the Asian population. However, there is little correlation between the occurrence of these mutations and alanine aminotransferase elevation in patients who are positive for anti‐HBe. Although cirrhosis develops during the process of HBeAg seroconversion, 68% of the complications of cirrhosis and of hepatocellular carcinoma occur after HBeAg seroconversion. These complications may still occur even after HBsAg seroclearance.
Aspartate aminotransferase : alanine aminotransferase ratio in chronic hepatitis C infection: Is it a useful predictor of cirrhosis?
Authors: Park Gordon J‐H , Lin Betty Pc , Ngu Meng C , Jones D Brian , Katelaris Peter H 
Published: March 2003

Abstract
Background
: The clinical usefulness of the ratio of serum aspartate aminotransferase (AST) to alanine aminotransferase (ALT) has been explored in several liver disorders. It has been suggested that in patients with chronic hepatitis C virus (HCV) infection an AST : ALT ≥ 1 has 100% specificity and positive predictive value in distinguishing cirrhotic from non‐cirrhotic patients. Such statistical certainty attached to a simple biochemical test merits further evaluation. The present study, therefore, assessed the AST : ALT in patients with chronic HCV infection to determine the validity of the ratio in predicting cirrhosis and to correlate the ratio with the histological grade of necroinflammatory activity and fibrosis.
Methods
: A retrospective analysis of 153 patients with chronic HCV infection was conducted. Serum biochemistry had been obtained within a mean of 4 weeks of liver biopsy. The histology was scored in terms of activity and fibrosis as described by Scheuer and correlated with AST : ALT.
Results
: In 30 patients with cirrhosis, the mean AST : ALT (0.99 ± 0.06) was higher than in 123 patients without cirrhosis (0.60 ± 0.02; P < 0.001). A ratio ≥ 1 had 95.9% specificity and 73.7% positive predictive value in distinguishing cirrhotic from non‐cirrhotic patients, with a 46.7% sensitivity and 88.1% negative predictive value. The ratio also parallelled the Scheuer score with respect to fibrosis but not with respect to inflammation.
Conclusion
: Although relatively insensitive, an AST : ALT ≥ 1 is highly specific but not diagnostic for the presence of cirrhosis in patients with chronic HCV infection. The ratio reflects the grade of fibrosis in these patients.
Life‐threatening haemorrhage from a sternal metastatic hepatocellular carcinoma
Authors: Chen Chih‐Yen , Chau Gar‐Yang , Yen Sang‐Hue , Hsieh Yu‐Hsi , Chao Yee , Chi Kwan‐Hwa , Li Chung‐Pin , Chang Full‐Young , Lee Shou‐Dong 
Published: March 2003

AbstractRupture of the tumour is a catastrophic complication of hepatocellular carcinoma. The prognosis in patients with a ruptured hepatocellular carcinoma is usually unfavourable. We describe a 46‐year‐old man who suffered from visible massive tumour haemorrhage due to a hepatitis B‐related hepatocellular carcinoma that metastasized to the sternal bone. The prominent tumour mass was bulging over the anterior chest wall on the sternum of the patient, and bled spontaneously. This episode of life‐threatening haemorrhage was stopped by surgical ligation of the bleeding site. Palliative radiotherapy shrank the tumour mass size and prevented further possible bleeding. This is likely to be the first reported case with a visible spontaneous tumour bleeding from a sternal metastatic hepatocellular carcinoma.
Serotyping and genotyping of hepatitis C virus in Taiwanese patients with type C chronic liver disease and uraemic patients on maintenance haemodialysis
Authors: Yu Ming‐Lung , Wang Liang‐Yen , Chuang Wan‐Long , Dai Chia‐Yen , Sung Ming‐Hsing , Chen Shinn‐Cherng , Lin Zu‐Yau , Hsieh Ming‐Yuh , Tsai Jung‐Fa , Chang Wen‐Yu 
Published: March 2003

Abstract
Background
: To evaluate a recombinant immunoblot hepatitis C virus (HCV) serotyping assay, which determines HCV serotypes 1, 2, and 3 by detecting type‐specific antibodies to core‐and NS‐4‐derived peptides.
Methods
: Immunoreactivity of type‐specific antibodies among 173 chronic hepatitis C patients and 43 haemodialysis patients in Taiwan was examined and the serotyping results were compared with genotyping by Okamoto’s method. Serial specimens from 29 patients undergoing interferon‐α therapy were also evaluated.
Results
: Of the 205 specimens for which genotyping data were available, 51.2% were of serotype 1, 31.7% of serotype 2, 1.0% of serotype 3, 2.4% of either serotype 1 or 3, and the remaining 13.7% were untypable. The serotypable rate was significantly lower in haemodialysis patients than in chronic hepatitis C patients (70.0%vs 94.9%; P < 0.001). Serotyping of genotype 2b specimens was significantly more dependent on core peptide bands than other genotypes. Using genotyping as the reference, the overall sensitivity, specificity and concordance of the recombinant immunoblot HCV serotyping assay were 86.3%, 97.2% and 83.9%, respectively. However, the serotyping assay had significantly lower sensitivity (69.2%), specificity (77.8%) and concordance (53.8%) for genotype 2b specimens. Of nine HCV complete responders, one lost type‐specific antibodies 6 months after the cessation of interferon‐α treatment.
Conclusions
: These results suggest that, except for less than optimal performance with immunocompromised or genotype 2b patients, the HCV serotyping assay is a practical and useful method for HCV typing in the clinical setting in Taiwan.
Hepatitis G virus genotypes in Australia, Papua New Guinea and the Solomon Islands: A possible new Pacific type identified
Authors: Mison Lm , Hyland Ca , Poidinger M , Borthwick Ia , Faoagali J , Aeno U , Gowans Ej 
Published: March 2003

Abstract
Background
: Hepatitis G Virus (HGV)/GB Virus‐C (GBV‐C) is a newly discovered RNA virus. Nucleotide sequence comparison and phylogenetic studies of the 5′ untranslated region (5′UTR) within the viral genome have identified at least three different types which have provisionally been classified as type 1 (West African origin), type 2 (North American origin) and type 3 (Asian origin).
Methods and Results
: The products of RT‐PCR were sequenced by using blood donors and patients infected with HGV/GBV‐C in Australia, Papua New Guinea and the Solomon Islands to investigate the genotype distribution in this area of the world. All the Australian isolates showed strong sequence homology with type 2, while the Papua New Guinea and Solomon Islands sequences were more closely related, but differ from type 3, which has previously been reported from isolates studied within Asia.
Conclusions
: Phylogenetic analysis suggests that these latter sequences are either a new HGV/GBV‐C Pacific type or a subtype of the Asian type RNA virus. Isolates homologous with type 1 were not identified in these population groups.
Are there any sex differences in fatty liver? A study of glucose metabolism and body fat distribution
Authors: Lonardo A , Trande P 
Published: March 2003

Abstract
Background and Aims
: Fatty liver is a common condition found more often in males. Whether sex differences affect its development is presently unknown. The hypothesis that glucose metabolism alterations or central body fat distribution are gender‐related in fatty liver was investigated.
Methods
: Overall 199 consecutive subjects seen in the Division of Internal Medicine and Gastroenterology, Modena City Hospital, were enrolled. In the main arm of the present study, 44 men with sonographic fatty liver and 47 controls without, and 18 women with and 19 without fatty liver had their body mass index (an index of overall adiposity), hepatobiliary serum enzymes, serum cholesterol and triglycerides determined. All underwent oral glucose tolerance tests (estimated through the glucose area under the curve with the trapezoidal method). In the ancillary arm study, 17 other men with and 14 without, and 11 other women with and 29 without fatty liver had anthropometric measurements of body fat distribution (waist/hip, waist/height and skinfold thickness).
Results
: Following statistical evaluation including univariate and multivariate analyses (main study), elevated body mass index was found to be an independent predictor of fatty liver in either sex. Glucose area under the curve and a central‐type body fat distribution (ancillary study) predicted FL only in women.
Conclusions
: Fatty liver could be gender‐related in the present series.
Comparison of clinical, serological and histological findings between non‐ulcer dyspepsia patients with and without Helicobacter pylori infection
Authors: Lo Ching‐Chu , Hsu Ping‐I , Lo Gin‐Ho , Lai Kwok‐Hung , Cheng Jin‐Shiung , Tseng Huei‐Hwa , Lin Chiun‐Ku , Chan Hoi‐Hung , Wang Ya‐Yu , Ku Ming‐Kun , Lin Chi‐Pin , Peng Nan‐Jing , Chien Eileen Jea 
Published: March 2003

AbstractBackground and Aims: The role of Helicobacter pylori (H. pylori) infection in non‐ulcer dyspepsia (NUD) remains controversial. This study investigates the clinical, serological and histological differences between patients with H. pylori‐positive and ‐negative NUD.Methods: One hundred and eighty consecutive patients with NUD were enrolled from January to December 1998. The severity of symptoms was evaluated by the Tucci's scoring system. The histological changes of gastric mucosa were assessed according to the Updated Sydney System, and a fasting blood sample was obtained to test the serum gastrin and pepsinogen I levels.Results: The H. pylori‐positive NUD patients were notably older than H. pylori‐negative NUD patients (48.2 ± 15.9 vs 39.8 ± 15.7 years, P = 0.001). There were no differences in other clinical factors between the two NUD groups. The serum pepsinogen I levels were considerably higher in H. pylori‐positive NUD patients than in H. pylori‐negative NUD patients (78.9 ± 42.2 vs 61.5 ± 43.3 ng/mL, P < 0.01). However, no significant differences in serum gastrin levels were discovered between the two groups. The antrum histological scores for chronic inflammation, acute inflammation, gland atrophy and lymphoid follicles were higher in H. pylori‐positive NUD patients than in H. pylori‐negative NUD patients (2.09 vs 1.01, P < 0.001; 1.22 vs 0.36, P < 0.001; 0.76 vs 0.36, P < 0.01; 0.33 vs 0.13, P < 0.01, respectively).Conclusions: The present study discovered marked differences in age, serum pepsinogen I levels, histological grades of acute inflammation, chronic inflammation, gland atrophy and lymphoid tissue formation between H. pylori‐positive and H. pylori‐negative NUD patients. Further investigation of the clinical prognosis of the two groups of patients is necessary.
Differences in the efficacy of ursodeoxycholic acid and bile acid metabolism between viral liver diseases and primary biliary cirrhosis
Authors: Nakashima Toshiaki , Yoh Takaharu , Sumida Yoshio , Kakisaka Yuko , Mitsuyoshi Hironori 
Published: March 2003

AbstractAim and Methods: The effects of ursodeoxycholic acid (UDCA, 600 mg/day) on liver function test values, and serum and urinary bile acids levels in hepatitis C virus‐related chronic hepatitis (CH, n = 39) and liver cirrhosis (LC, n = 25), and in primary biliary cirrhosis (PBC, n = 25) were compared.Results: The percentages of improvement in alanine transaminase (ALT) and gamma‐glutamyl transpeptidase (γ‐GTP) in CH were almost the same in LC. The rates of improvement in ALT in PBC were negatively correlated with histological stages in the liver. Total serum bile acid levels in LC rose to the same extent as in CH, but the increases in PBC were significantly smaller at stages 3–4 than stages 1–2. The urinary levels of hydroxylated metabolites of UDCA only slightly increased in LC, but they increased significantly at PBC stages 3–4.Conclusions: The efficacy of UDCA was preserved in LC, but diminished at PBC stages 3–4. The poor enrichment of UDCA in the bile acid pool and extensive biotransformation of UDCA may cause the limited efficacy of UDCA in the cirrhotic stage of PBC.
Gastrointestinal transit and anorectal manometry in children with colonic substance P deficiency
Authors: Treepongkaruna Suporn , Hutson John M , Hughes Jodie , Cook David , Catto‐Smith Anthony G , Chow Chung Wo , Oliver Mark R 
Published: March 2003

AbstractBackground and Aims:Severe intractable constipation in children may be associated with a reduction of substance P (SP)‐ containing fibers in colonic circular muscle. The aim of this study was to characterize gastrointestinal transit (GIT), anorectal manometry (ARM) and electromyographic (EMG) changes in these children.Methods:Seromuscular laparoscopic biopsies of the colon were obtained from 35 children with severe constipation. Immunofluorescent staining for SP and vasoactive intestinal peptide (VIP) were then performed on these specimens. The cohort of patients studied included a SP‐deficient group (SPD, n = 25) who had reduced numbers of SP‐immunoreactive nerve fibers. The other group consisted of patients with normal staining for both SP and VIP (SPN, n = 10). Gastrointestinal transit studies (gastric emptying, orocecal and colonic transit) suitable for analysis were available for 17 patients (SPD, n = 9 and SPN, n = 8). The colon was divided into segments and radioactivity counts in each segment were expressed as a percentage of the total colonic count at each time point (6, 24, 32 and 48 h). The geometric center (GC), ARM, EMG, clinical and demographic data characteristics of both groups of patients were compared.Results:There were no differences in demographic data, gastric emptying, orocecal transit or geometric center of transit in the colon between the two patient groups. The ARM and EMG studies suggested that the SPN group have a higher mean threshold volume of balloon distension required to initiate a rectoanal inhibitory reflex, and a higher incidence of anismus; however, this did not reach statistical significance.Conclusions:These data suggest a trend that the SPN patients have a greater problem with obstructive defecation and abnormal rectal sensation than those with SPD. We were unable to confirm any defect in colonic transit in the SPD patients compared with the SPN group.